It is no surprise that prisons are difficult environments in which to live. Crowding, noise, contagion of disease and illnesses and poor food selection are just a few of the challenges prisoners face each day. While most would suggest that prison should be difficult, it need not be inhumane, especially in a country known for its preference to put people in prison. One would think the United States would be better at it by now.
The Office of Inspector General (OIG) published a report about a surprise inspection it made at FCI Tallahassee, a women’s federal prison in Florida. The inspection is part of the OIG’s initiative to conduct unexpected visits to Federal Bureau of Prisons (BOP) facilities across the country.
OIG reported alarming conditions of FCI Tallahassee’s food service and storage operations. The inspectors noted that they observed inmates being served moldy bread and vegetables rotting in a refrigerator in a food preparation area at the female prison. They also found evidence of rodent droppings and rodents having chewed through boxes of food, as well as bags of cereal with insects in them and warped food containers. The Food Service Administrator position, which is responsible for food safety within the Food Service Department, had been vacant for two years. In fact, FCI Tallahassee’s current Food Service Administrator’s first day of duty in that position was the first day of OIG’s inspection.
The building itself also had infrastructure issues as do many of the BOP’s facilities throughout the country, which needs billions to be modernized. The lack of funding and a clear plan on how to implement the upgrades have plagued the BOP for years. This was evident at the Tallahassee facility, originally built in 1938, where OIG noted that “… serious infrastructure problems that created unsanitary and potentially unsafe conditions.” It noted that a shower at the facility where discolored water had pooled, a shower that flooded when used, and an inoperable toilet. Many female inmates live in housing units in which water frequently leaks from ceilings and windows on or near their living spaces. In some cases the inmates took matters into their own hands and used feminine hygiene products to absorb water from leaking windows and inspectors noted black substance (let’s call it mold) on walls and ceilings.
Of note was the continued shortage of correctional officers and healthcare treatment. At the time of its inspection in May 2023, FCI Tallahassee had a total of 307 positions composed of 292 BOP positions authorized specifically for FCI Tallahassee, as well as 15 positions supported through the U.S. Public Health Service and through supplemental staffing allocations from the Department of Justice. Eighty-five percent (260 of 307) of FCI Tallahassee’s total positions were filled. OIG stated that it found “ … staff shortages have negatively affected healthcare treatment and caused staff to modify the time of day it distributes insulin and drugs to female inmates, which may limit the therapeutic benefit of these drugs for certain inmates. Separately, we observed a healthcare provider failing to ask required questions during inmate intake screenings and omitting guidance on how to access healthcare services.” The result of these shortages meant more overtime on those who were at the facility.
The BOP has difficulty hiring healthcare professionals across its institutions. As of May 2023, FCI Tallahassee’s Health Services Department was 62 percent staffed (13 out of 21 positions filled) with longstanding vacancies in registered nurse and mid-level provider positions (which include Nurse Practitioners and Physician Assistants). To supplement this shortcoming, overtime is used to care for ailing inmates along with other changes in protocol to make sure they can care for as many people as possible. However, that too comes at a price. During the inspection the facility was temporarily modifying the time in the afternoon that it distributes insulin and single-dose controlled substance medications to inmates (i.e., pill line) to 2:00 p.m. instead of its regularly scheduled 4:30 p.m. Medical experts who accompanied OIG were concerned that providing insulin well before dinnertime at the institution may make it more difficult for diabetic inmates to control their glycemic levels. Further, the experts and an institution psychologist expressed concern that the pill line time change might cause inmates who are prescribed certain psychiatric medications that facilitate sleep to receive these medications too early in the day for them to be effective.
This inspection on Tallahassee follows another inspection at a women’s prison, FCI Waseca in Minnesota, in early 2023, which found similar issues related to staffing. In addition to a shortage of staff, at the time Waseca housed 806 female inmates, which was approximately 13 percent over its rated capacity of 712 inmates (Note: as of November 8, 2023 Waseca’s population was down to 683 inmates, below capacity).
OIG found that staffing challenges at FCI Waseca were not limited to Correctional Services positions. For example, consistent with the overall vacancy rate for the institution, both the Health Services and Psychology Services Departments were staffed at 75 percent or less, including vacancies for medical provider position. At the time of OIG’s inspection, the Health Services Department had five vacancies, four of which had been open for over a year, including a Midlevel Practitioner position, whose role is to assess, diagnose, and treat medical conditions under the license of the physician.
Short staffing affected implementation of FCI Waseca’s Medication Assisted Treatment (MAT) Program which, according to the BOP, combines medication and psychosocial services as treatment for opioid use disorder (OUD). Specifically, the Psychologist position dedicated to facilitating the psychosocial component of the MAT Program had remained unfilled after 14 consecutive job announcements, as of January 2023.
Mental health treatment was also an issue and one that affects staff as much as inmates. Seventy-two percent of inmates who were prescribed a psychiatric medication skipped at least one dose, and nearly 10 percent skipped doses daily. FCI Waseca’s Chief Pharmacist estimated that rates of missed psychiatric medication could be even higher, closer to 30– 35 percent.
OIG noted that the issues identified during both the Waseca and Tallahassee inspections are issues faced at many BOP facilities. In recent years, the OIG has cited many of the issues identified at the two institutions as BOP-wide challenges, including its aging infrastructure, staffing issues, insufficient security camera coverage, and difficulties preventing the introduction of contraband. Further, OIG has reported on how staff shortages, especially among healthcare professionals, can negatively affect the provision of healthcare at BOP institutions.
These challenges are difficult to overcome but they can be and they must be. It is not just a matter of money to do the job, but the will to make the conditions better, and something BOP Director Peters has repeatedly stated as a priority.