COVID-19 Again Hits Illinois Prisons, Exacerbating Long-Standing Failures in Medical and Mental Health Care
COVID-19 is once again sweeping through Illinois’ prisons, sickening thousands of Illinois prisoners and hundreds of staff members. And while hospitalizations have been rare during the latest wave, state prison officials are struggling to keep a lid on the infection rate.
The prison system is better prepared for the omicron surge than it had been in previous waves of the disease, in part because the prison population has plummeted by more than 25% in the past two years.
But this latest COVID-19 surge follows years of systemic lapses by the Illinois Department of Corrections, experts say, at providing medical and mental health care to an ever-aging population deeply affected by psychiatric issues — failures that have been exacerbated by the pandemic.
“When COVID hit (Illinois prisons), it was like you had a cracked rock and took a sledgehammer to it,” said Jobi Cates, the executive director and founder of Restore Justice, a nonprofit advocating for less punitive sentencing, particularly for youths.
IDOC appeared to have the pandemic largely under control, with fewer than 160 incarcerated people and staffers infected with COVID-19 throughout Illinois as recently as early December. But the number of infections has shot up since then with the emergence of the omicron variant.
In mid-January, 3,300 incarcerated people and nearly 1,100 staff members at Illinois prisons were infected with the disease. While hospitalizations have been rare during the latest wave, according to the state, one person in custody and two staff members have died.
With the pandemic fast approaching its third year, state prison officials are facing difficulties containing the virus once again because of the lagging vaccine rate of prison staff, the main conduit of COVID-19 into the prisons.
In August, Gov. J.B. Pritzker ordered all guards to be vaccinated, but their union protested the mandate and took it to arbitration. The governor prevailed in late December. Now, all prison workers must have their first shot by the end of January.
By the end of December, 65% of prison staff had been vaccinated, according to department officials who nevertheless remain confident that nearly all staff will meet the January deadline, citing markedly improving vaccination rates since the end of October, when only 49% were vaccinated.
But the slow rollout means very few of them — only 12% — have had booster shots, which are administered six months after the first round of vaccines but are crucial to warding off the omicron variant. By comparison, 44% of Illinois prisoners had received boosters by the end of 2021.
Over almost the last two years, there have been nearly 19,000 cases of COVID-19 among people in prison — 90 of whom died, mostly in 2020, according to figures from the state corrections department and the UCLA Law COVID Behind Bars Data Project.
“COVID has taught us a lot,” Rob Jeffreys, the department’s director, said in a December interview with the Better Government Association as omicron cases were starting to climb.
Cruel and unusual punishment
The surge of COVID-19 cases in Illinois prisons comes after federal courts in recent years have held that the mental health and medical care provided to people incarcerated in Illinois violates constitutional protections against cruel and unusual punishment. Judges have ordered systemic improvements and appointed independent monitors to gauge what, if any, progress has been made.
Despite those judicial orders, the corrections department has not found enough doctors, nurses or dentists to care for the prison population — a task made even more difficult by COVID-19 as medical personnel across the country face unprecedented strains.
Court-appointed monitors have repeatedly reported limited progress in reaching court-ordered goals for treating the nearly 12,000 people in prisons — about 43% of the prison population — who have been diagnosed with mental illness, as well as the medical care for the entire population, 23% of whom are age 50 or older.
The monitors have expressed frustration with the department’s opaque processes, its inadequate staffing in key positions and tardy adoption of standard health industry practices.
When COVID-19 hit, those lapses became even more apparent.
According to one recent monitor’s report, staff at the Lawrence Correctional Center in southern Illinois ignored or did not respond to signs of one infected prisoner’s worsening condition for four days before he was hospitalized with a 103 degree fever, a rapid heartbeat and oxygen saturation of only 86%. He died the following month.
Dr. John Raba, the court-appointed monitor tracking IDOC’s efforts to improve medical operations, cast doubt in the report about the department’s ability to resume even the substandard care it provided before the pandemic, noting only a handful of his 235 recommendations had been addressed by September.
IDOC, Raba wrote, “does not yet have a comprehensive plan to address this consent decree; instead, it seems to primarily respond to crises and threats of legal action.”
A critical factor in IDOC’s continuing health care woes, Raba said, has been a sharp drop in the number of medical professionals working for the Illinois prison system since 2019. “Yet nothing has been done to improve the hiring process,” he wrote.
Across Illinois prisons, the vacancy rate for registered nurse positions more than tripled to 29% in 2020, up from 9% in 2019. More than half of the state’s prisons have at least one in four registered nurse positions unfilled, while vacancies at eight prisons exceed 50%, according to Raba’s report.
Raba said he also had “significant concerns about insufficient numbers” of physicians, nurse practitioners, physician assistants, dental hygienists, optometrists and physical therapists.
Jennifer Soble, the founder and executive director of the Illinois Prison Project, an organization that seeks less punitive sentences, said some of its clients with cancer have missed months of chemotherapy treatments since COVID-19 further overwhelmed the prison system’s medical care.
Relatively few people in prison — often very sick or elderly — take up a disproportionate share of the limited medical resources, Soble said. She blamed that in part on truth-in-sentencing laws that require people in prison to fully serve their determinate sentences. Nearly half of the people in prison in Illinois were sentenced under those laws.
“It makes me want to ask the question: Why aren’t these people at home?” Soble said.
Department officials said they have used many different tools to reduce the sentences of people in prison during the pandemic, such as good-time credits, medical furloughs and electronic detention. “We awarded hundreds of thousands of days off individual sentences,” said Alyssa Williams, the chief of programs and support services for the corrections department.
Jeffreys, the department director, said finding a place for people who need high levels of medical care to go once they leave prison has also been a challenge. Often, nursing homes won’t take them, and loved ones can’t afford to pay for their care at home. “What we found in COVID is there are not a lot of places for these people to go,” Jeffreys said.
The lack of staffing at Illinois prisons comes at a time very different from the era when many were built in the 1980s and 1990s, amid promises of new jobs for often financially distressed areas of the state.
To eliminate its sizable overtime costs, the corrections department estimates it would have to hire 2,000 more correctional officers on top of the 6,000 currently on staff statewide. The department says it also is short of sergeants, lieutenants and higher-ranking supervisors. In addition, the department estimates it has to almost double its treatment officers who assist incarcerated people with mental health issues to 390 from 214.
The chronic understaffing has been a problem for nearly two decades and has taken a toll on correctional officers who repeatedly work overtime to fill in the gaps, according to union leaders.
“It’s a lose-lose-lose proposition,” said Eddie Caumiant, the American Federation of State, County and Municipal Employees’ liaison to the corrections department. “It’s more costly, it burns out the workforce … and it affects operations.”
The heavy reliance on overtime comes even though the department’s contract with AFSCME, the biggest union representing prison workers, protects workers from mandatory overtime and includes commitments by the state to hire a set number of additional workers each year.
Caumiant said those goals have never been met.
For the fiscal year that ended in June, overtime expenses in the state prison system shot up to $95.6 million, a 17% jump from the previous year.
Prison officials said in an interview with the BGA that absences caused by COVID-19 increased overtime during the pandemic.
Jennifer Vollen-Katz, the executive director of the John Howard Association, an independent prison monitoring group, said big gaps in staffing limit the exercise time, educational classes and other programs for people in prison.
A review by the organization last April found 250 vacancies among guards and other staffers at Stateville Correctional Center, the maximum-security prison near Joliet that employs about 1,300 people.
But even if the corrections department had the budget to hire more staff, filling all those jobs remains difficult, especially at a time when private employers across the nation are struggling to find workers.
What’s more, state prison officials said COVID-19 forced it to shut down its cadet classes for incoming corrections officers in 2020. The classes resumed last June, but continuing health restrictions limited the training to 75 cadets at a time, half as many as before.
“So we are short security staff,” said John Eilers, the department’s chief of operations, during the recent interview. “And we struggled — just like the (larger) community is struggling and other employers are struggling — with recruiting efforts.”
In a bid to boost hiring amid the pandemic, Illinois prison officials have crafted pitches on social media for corrections officers and nurses, two of its greatest needs. It also has brought human relations specialists to job fairs to conduct interviews on the spot. In addition, it’s allowing job seekers to take qualifying exams at the prisons where they would work, as well as offering those exams on weekends.
Adding to the headaches caused by COVID-19 has been a shortage of supplies at prison commissaries, such as soap, toothpaste and deodorant.
In an interview, Nelson Morris, who served 29 years in prison for a murder conviction before his release in 2020, said the unavailability of those kinds of staples is among the chief complaints of incarcerated people.
While it was often common for certain limited shortages from time to time — “that’s just prison life” — Morris said the “one thing that stayed consistent was you could always buy coffee, you could always buy soap, you could always buy deodorant, you could (always) buy toothpaste.”
“You can’t right now,” said Morris, who as a staff member for Restore Justice keeps in touch with people in prison.
COVID-19 has forced some state prisons to provide breakfast as early as 2:30 or 3 a.m. because of the need — for a time — to feed people in prison in their cells and not in the chow halls. That practice has resumed in facilities recently hit with significant outbreaks, according to a department spokeswoman.
Raba, the court-appointed monitor over the department’s medical services, said the early-hour breakfasts discouraged elderly and disabled people in prison from eating and steered them toward less-healthy food options at the commissaries.
The disruptions to the commissaries make coping with COVID-19 tougher for people in prison who use the shops to buy soap and hygiene items to protect them from getting sick.
Prison leaders said the troubles began last spring, when the department tried to follow state procurement rules requiring that those supplies be bid out competitively. A legal challenge quickly followed, forcing the department to scramble to fill the gaps with five temporary suppliers, a process made more difficult because of nationwide supply chain disruptions.
“This is the point that so often gets missed: We were bound by the law,” Jared Brunk, the department’s chief of administration, said during the recent interview.
With commissaries so important to prison life, empty shelves can lead to outsized problems.
At Stateville Correctional Center, bottled water wasn’t available in the commissary in spite of safety concerns about the discolored and foul-smelling tap water, prompting a jump in complaints from those in the prison, according to Vollen-Katz of the John Howard Association.
“The commissary can mask a lot of problems,” she said.
The uproar among incarcerated people and their loved ones across the state over the missing commissary goods prompted the department director to issue a video message to people in prison in the fall.
For Thanksgiving, the department distributed bags of hygiene items and food products — including soap, toothpaste, Snickers candy bars, coffee, Doritos chips and Goldfish crackers — to all those in custody.
But Vollen-Katz said the situation is still “problematic,” even though the department is trying to address it with the limited options it has under state law.
“At a certain point, it doesn’t matter what the reason is,” she said. “People in prison are suffering, and we need to alleviate it.”