DOC seeks money, staff to improve Racine prison health care as inmates wait for dental services

By Gretchen Schuldt

​More than 400 Racine Correctional Institution inmates were waiting to see a dentist ​as of July, and 23 of those had waited more than 40 weeks, according to a state budget request.

Fifty-seven inmates on the list were waiting for "essential services" and 41 were waiting for dentures.

Dental care at the prison is "inadequate," the request said.

The Department of Corrections detailed the need for improved dental services at RCI in the  2019-21 budget request it submitted to Gov. Scott Walker, who has not visited a state prison during his years in office.

The department is seeking 27 new positions to staff the new $8 million health services unit at RCI scheduled to open in April 2020. The department also is seeking $1 million in fiscal 2020 and $2.8 million in fiscal 2021  to pay for the new positions.

The share of new staff that would go to dental services is fairly minimal - a 60 percent full-time equivalent dentist, a 60 percent full-time equivalent dental assistant, and a 20 percent full-time equivalent dental hygienist.

Those position should, however, help the institution "rectify the inadequate dental care that inmates receive as a result of long delays" in getting treatment, the request said.

Wisconsin is not alone in struggling to meet inmate dental needs. Standards vary from state to state and agency to agency, according to a report by The Marshall Project.

"Even before their incarceration, prisoners are likely to have unmet dental needs, research shows," The Marshall Project reported. "While in prison, they have a constitutional right to dental care, but the courts have offered little guidance on the services that institutions must provide. If a tooth or gum problem is causing more than minimal pain, facilities are required to treat it, said David Fathi, director of the ACLU National Prison Project. 'Even a few days of untreated dental pain is not allowed.' ”

Also included in the budget request for the new facility is funding for guards, nurses, and medical assistants.

The new unit, triple the size of the existing one, will allow DOC to better meet health care needs, the request said. 

As of May, it said, "41.6 percent of RCI’s inmates had a mental health condition and 7.7 percent of inmates had a severe mental illness. ... Additionally, the DOC believes that the inmate population will continue to age going forward, which will further increase the need for expanded health services to inmates. "

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Source: DOC 2019-21 budget request

With the smaller facility and smaller staff used now, staff members "currently struggle to consistently monitor chronic conditions," the request said.

There are  seven to 10 offsite medical visits every day, and about one of those is a trip to the local emergency room.

"These offsite treatments not only have greater medical costs but also require at least one security staff member to accompany inmates on trips out of the institution," the request said. 

Adding the requested staff would allow for improved preventative care for inmates, it said.

"Inmates’ chronic conditions, such as HIV, diabetes, and hypertension, would be less likely to worsen while they are incarcerated and less likely to result in expensive hospital visits," the request said. 

Improved on-site health care also means fewer off-site trips for corrections staff, it said. 

If the prison does not get the additional staff, it will have to rely on contracted help and limited-term employees, who are employees who sign on for short stints and do not plan to stay. Contracted and limited-term employees are harder to recruit and have higher turnover than full-time employees, the request said.

Relying on contracted and limited-term employees also would reduce the benefits of the new building as they "provide less continuity of care to patients due to their higher turnover and they are often less experienced than FTE staff," the request said.