Researchers have found that higher copays for health care obstruct access to receiving care behind bars, even as prison populations in Mississippi and nationwide face increasing rates of physical and mental health conditions.

One in 10 people with at least one chronic condition in state and federal prisons had not been seen by a clinician since they were incarcerated.

Wanda Bertram, communication strategist for the Prison Policy Initiative, said the copays are often less than $7 but they represent massive barriers to health care.

"If you want to be seen, you have to pay, typically anywhere from $2 to $5, or in the case of Mississippi prisons, $6,," Bertram outlined. "and if you can't pay that, either you can't see the doctor or that becomes a debt that you have to the prison."

The research found medical copays in prisons significantly impede health care access for more than 500,000 people with chronic conditions, from heart or kidney disease, to asthma and hepatitis C.

People in Mississippi prisons are not compensated for the jobs they may have while they are incarcerated, so Bertram pointed out it is up to their families to cover any medical costs. She added some states have dropped their copays for people behind bars. Her group thinks Mississippi should do the same.

"We have been advocating for years for states to abolish these copays," Bertram explained. "And some states are doing this, Nevada, I believe, abolished prison copays, either this year or last year. California has also abolished copays. To force people to pay to see a doctor, you know, causes people to not see doctors when they actually need help."

Bertram added the research revealed alarming gaps in mental health care access for incarcerated individuals. More than one-third of those with diagnosed chronic mental illnesses have not seen any mental health clinicians since entering prison.


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The U.S. Department of Justice has released a report on the state of Georgia's prisons, citing horrific conditions and extreme violence.

The investigation found the state has failed to protect incarcerated individuals, leaving them vulnerable to abuse, neglect and gang violence.

Kristen Clarke, assistant Attorney General for civil rights, said urgent action is needed to help keep people behind bars safe.

"We uncovered long-standing systemic violations stemming from complete indifference and disregard to the safety and security of people Georgia holds in its prisons," Clarke reported.

The Justice Department's report uncovered an unconstitutional risk of sexual violence against LGBTQ+ people. From 2018 to 2023, there were also 142 reported homicides, with a nearly 96% spike in 2021 and 2023.

Ryan Buchanan, U.S. Attorney for the Northern District of Georgia, highlighted the report's findings of widespread mismanagement in Georgia's prisons. He said a lack of supervision has allowed gangs to take control of key prison functions.

"Gang members have co-opted certain administrative functions like bed assignments from the Department of Corrections," Buchanan pointed out. "They have extorted money from the family members of incarcerated people."

The Justice Department is recommending urgent reforms, including increased supervision, better staffing and improvements in how those incarcerated are classified and housed. Officials expressed their commitment to working with state authorities to quickly implement changes.


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Recent problems in South Dakota prisons have concerned lawmakers, corrections commission members and family members of those incarcerated, who formed a new support group.

South Dakotans Impacted by Incarceration was formed this year, after the state's Department of Corrections in March suspended calls and messaging on tablets used by people in prison due to what it called an "investigation." The services were eventually reinstated.

Nieema Thasing, co-founder of the advocacy group, said the department's lack of communication on the issue was one of many reasons she started the group, which hosted its first public meeting last month, attended by some lawmakers, sheriffs and other officials.

"They were all taken aback because they had no idea that these things were happening because they had been getting it from other people trying to soothe everything away."

The South Dakota Corrections Commission also met last month for its first meeting since October 2023 and members expressed concerns about the Commission's role. Member David McGirr said the commission "is not serving its intended purpose," according to meeting minutes, and requested a legislative review of the commission.

Erin Vicars, another of the group's co-founders, said she could "go on and on" about major problems at the state's prisons. Her list includes health care access, lack of in-prison jobs, lockdowns, changes in commissary items, food quality and a lack of transparency from prison leadership.

"People often forget that prison itself is a punishment, not the conditions," Vicars pointed out.

The group is planning another meeting this month. Meanwhile, the state has allocated more than $650 million combined toward a planned men's prison in Lincoln County and a women's correctional facility in Rapid City.


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Today, advocates in North Carolina are kicking off a 136-mile "Walk for Commutation" to raise awareness about those on death row who could soon face execution.

Organized by the North Carolina Coalition for Alternatives to the Death Penalty, the walk is part of a larger push that calls on Gov. Roy Cooper to commute the death sentences before he leaves office.

Noel Nickle, executive director of the North Carolina Coalition for Alternatives to the Death Penalty, stresses the urgency as the state prepares for a change in leadership.

"There's really no denying the racism of the death penalty," Nickle explained. "There's also no denying that death sentences have dramatically decreased. Most people on death row were sentenced more than 20 years ago. People are aging. They are no longer, if they ever were, a threat to our communities. We know that the death penalty doesn't keep us safe."

North Carolina has not executed anyone since 2006, but concerns are growing that the state may follow South Carolina's recent decision to restart executions after a 13-year pause.

Nickle called attention to the racial and geographic disparities in death penalty cases. She explained that 60% of the people on death row are Black despite them making up a smaller share of the state population, and added that being put on death row can sometimes depend on where you live.

"For example, we'll be walking through Chapel Hill and Durham as well where there's no one on death row and where the district attorneys have said -- in fact, they were elected on a platform of not seeking the death penalty," she said.

Nickle added the coalition's goal is to spark a statewide conversation about the death penalty's flaws and the urgent need for reform. The walk will begin outside of the Forsyth County Courthouse and conclude on Oct. 10, which is World Day Against the Death Penalty.


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