Medical contractor says managing prisoners’ health a challenge during Covid

The Courier’s recent article “Pike jail neglects inmates’ urgent medical needs, relative says,” received some pushback.

Amanda Lee, who said she works at the Pike County Correctional Facility, reached out to the Courier to say assertions made in the article by the relative of an inmate were false, particularly with regard to Covid safety and care. Lee suggested that we follow up with health services administrator Nicole Rattiner. But Rattiner said her role wasn’t clinical. She said she would read the article and get back to the paper, but has not done so.

However, Tom Weber, the CEO of PrimeCare Medical, the contractor that serves the Pike jail, shared some of the huge challenges facing jails in the time of Covid. PrimeCare serves 78 facilities in Pennsylvania, West Virginia, Maryland, New York, and New Hampshire. “That’s 25,000 lives a day,” Weber said.

He said it’s been very difficult to get people to work in prisons during the pandemic. “Spacing and housing” is a concern, he said, and prisons, in general, have reduced their populations to make social distancing possible. But although PrimeCare Medical makes recommendations to local officials about reducing their prison populations, it has no control over how many inmates are released or how many come in. Pike County, however, “has taken Covid very seriously and has embraced our suggestions,” he said.

Weber said PrimeCare follows all Covid safety guidelines. Its employees are fully vetted and subject to disciplinary action if they do not practice proper protocols, like wearing masks and social distancing, he said. He said lot of Covid enters jails from visitors.

Intake procedures include an initial 14-day quarantine with tests for tuberculosis and Covid, said Weber. Quarantine continues for positive cases and includes a “seven-day stepdown period.” A medical doctor is available to every facility 24/7, he said, “although we do rely on nurse practitioners.”

Weber said anyone who wants a test can get a test, with results available within 24 hours. All inmates and staff are screened daily, including temperature taking and inquiring about symptoms. (For PrimeCare’s full list of policies and procedures, visit primecaremedical.com and click on the Covid-19 tab.)

Workers at the jail who are not employed by PrimeCare Medical might not be truthful about symptoms out of fear they won’t get paid during quarantine or that they’ll lose their jobs. For that reason, Weber recommends paying all workers through their quarantines.

Building trust

For serious problems such as organ failure, patients are transported out of jail and to a hospital, Weber said. End-of-life care, such as for stage 4 cancer, may result in compassionate release. He said prisons are inundated with problem patients who commit serious crimes. He said he knows of 80-year-olds in lifelong loving marriages, “who never had a cross word with their spouses,” developing dementia and killing their spouses. “What do you do with cases like that?” he said. “Hospice doesn’t even want them. It’s very sad.”

Weber said the rate of Covid in the prisons PrimeCare oversees is not as high as it was in the spring. “We have completed 625 COVID-19 tests as of Dec 13,” he said. “There have been 79 positive cases. I am in the process of obtaining the breakdown between patients/security/PCM staff. We have tested 8 of our staff (medical) with 4 positive and 8 correctional officers with zero positive. There were 2 deaths in April and fortunately none since.”

Inmates may be getting different medication regimens than they did before they went to jail, Weber said. He said PrimeCare does a lot of “diagnostic work” on the front end, including for diabetes, and checks diabetics’ blood sugar daily. Many inmates discover they have diabetes or prediabetes during intake, he said.

Inmates who come to jail with a doctor’s prescription for OxyContin or Wellbutrin may not get those same doses as they are weaned off these drugs.

Weber suggested that inmates may be giving their relatives an account of their health and treatment situation that is not accurate. He offered to help our anonymous source get care and medical records for her relative. But the relative said they can’t trust anyone and believes her inmate is not safe.

The Pennsylvania Prison Society says inmates and correctional staff should be prioritized for the Covid vaccine. “To date a total of 55 people confined in state and county jails, as well as 5 people who worked in them, have died in Pennsylvania,” the society posted in a Dec. 17 communication. “Giving the Covid vaccine to people who live and work in prisons can prevent countless more deaths....When outbreaks strike, prisons become incubators that fuel broader spread in the community.”

John Hargreaves, the Pennsylvania Prison Society’s social services director, had high praise for the Pike County jail, telling the Courier it is “among the cleanest county jails in Pennsylvania. The cleanliness shows they respect inmates. They also have volunteers who work with inmates, while a lot of county facilities don’t.”

Two people reached out to the Courier to say their loved one’s experience has been the same as the inmate referred to in our recent article, except in the Schuylkill County Jail, which is also served by PrimeCare Medical. “It’s happening in Schuylkill County too,” Susan Belsak wrote. “Diabetics not being tested. Insulin given without blood sugars. It’s dangerous.” Jill Stramara, Belsak’s daughter, enumerated the dire circumstances of her fiance, Robert Brode, a Schuylkill inmate. See her letter, “Covid raging in our prisons is a humanitarian crisis that needs to be addressed.”

Also see this week’s letter “Corrections officers are exhausted with prisons on the verge of being overcome by Covid” by John Eckenrode, vice president of the Pennsylvania State Corrections Officers Association.

The Pennsylvania Prison Society said the Pennsylvania Department of Corrections has identified all medically vulnerable people eligible for release under the governor’s reprieve. Anyone seeking help with the release of an incarcerated loved one can contact the Pike County public defender, located at 105 West High St. in Milford, at 570-296-5266.

Editor’s note: Pamela Chergotis contributed to the reporting of this article.