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10.24.19
Behind bars but free from copays BY MARGHERITA BEALE
“She died in prison, and many other women die Crystal Hall was convicted in 2013 for attempted in prison because of lack of health care,” Ralston murder. Since being in jail, Hall says she has said. “They should be here today. They should be developed several medical conditions, including alive.” diabetes and cervical cancer. Hall says that through In Sacramento, this bill is especially relevant. her time in the California Institution for Women in Just a month ago, a settlement was reached Corona, no word has rolled off the tongue of prison in the 2018 federal class-action lawsuit filed health-care providers as often as “copay.” against Sacramento County, which alleged the “It’s like a vicious cycle, a cycle that goes “unconstitutional and illegal treatment” of inmates on all around paperwork and copays,” Hall said. inside county jails. “Everything is about a copay.” Aaron Fischer, counsel with Disability Rights But for inmates like Hall, things are changing. California, which filed the suit, believes the On Oct. 9, Gov. Gavin Newsom signed historic settlement will lead to significant improvements. legislation that permanently bars county jails and One of its more innovative aspects is recognizing state prisons from charging copays for medical and the importance of reducing the jail population, dental services, as well as equipment. particularly for people with mental health needs and Incarcerated people typically earn between 14 disabilities, Fischer said. and 62 cents an hour, if employed at all. A 2017 The lawsuit also addresses study by the Prison Policy Initiative found Sacramento County’s longstanding that California’s standard $5 medical rule under which inmates were copay in prisons is equivalent to an “People are only allowed to raise one medialmost $700 copay for someone cal condition per visit. Not working a minimum wage job dying in prisons only does this practice have on the outside. By eliminating and jails all over this financial implications due to copays, California is the first country all the time copays, but Fischer said it state to take what advocates has health ones. are calling “an important first because of lack of care.” “The example I always step.” Romarilyn Ralston give is someone comes “The governor’s decipolicy director, California Coalition in and says, ‘I want to be sion to permanently remove for Women Prisoners seen because I’ve lost a lot of copays from California jails weight.’ And then they get there and prisons brings us one step and also say, ‘My eyesight has closer to fair and just access to gotten worse,’” Fischer said. “Those are health care for everyone, including two different issues, but both are symptoms of those who are incarcerated,” said Eric diabetes. So the idea that you can only raise one Henderson, policy director of Initiate Justice. condition at a time is deeply problematic.” Though Assembly Bill 45 won’t officially In 2017, Sacramento County collected $20,280 go into effect until January, state prisons started in copays. Divided by the $3 copay required in jails, eliminating copays earlier this year, citing public this means medical care was sought approximately health concerns. AB 45 codifies their decision into 6,670 times. law, and extends the requirement to California jails. Courtney Hanson, an organizer with Romarilyn Ralston, policy director for the Decarcerate Sacramento and Californians United California Coalition for Women Prisoners, said for a Responsible Budget, has been held inside the decision has already helped some members Sacramento County jail twice for brief stints, on the inside. which she cites as the inspiration for her current “The incarceration sometimes murders people because you don’t have the right quality work. “You’re sort of seen as being less than of care and access,” Ralston said. “I know human,” Hanson said. “You’re seen as a maniputhat’s a strong word to use. But people are lator, a complainer. Anyone who’s been on the dying in prisons and jails all over this country inside jokes about how aspirin is the solution to all the time because of lack of care.” Charisse Shumate, founder of CCWP, didn’t everything. We’re talking severe medical conditions and people being written off as not being receive the treatment she needed for sickle cell trustworthy.” Ω anemia while in prison, Ralston said.