The beleaguered S.C. Department of Corrections doesn’t just need correctional officers. It’s in dire need of doctors, psychiatrists, dentists, nurses and hundreds of other medical professionals to improve the health care of its 18,500 inmates and to eventually bring down costs.
On Tuesday, the agency’s head of health services, Terre Marshall, told lawmakers that they, on behalf of taxpayers, cannot afford to be indifferent to inmate health care. And she’s right. The situation is analogous to ignoring a health issue until it becomes a crisis.
Adequate physical and mental health care is mandated by law, and the long-term neglect of inmates dating to recession-triggered budget cuts is a big part of what’s continuing to drive up costs today.
Obviously, the SCDC needs to break out of what is a self-perpetuating cycle. And doing that will require more spending.
But the SCDC health care budget has remained virtually flat in recent years while costs have risen for several reasons. Perhaps first among them is perennial underfunding.
To cover annual cost overruns in the $20 million range, SCDC has been using money meant for hiring medical professionals, who already are hard to recruit in rural areas where many prisons are located and because salaries are among the lowest in the nation among prisons. And when medical services are unavailable at prisons — only a few of the state’s 21 institutions have around-the-clock care — inmates are taken to hospitals where costs are higher for treatment. There’s also the added costs of taking inmates to and from hospitals, requiring correctional officer escorts.
Meanwhile, the percentage of prisoners needing mental health treatment has ballooned from 14% in 2014 to about 25% today.
Despite some successes in hiring physicians, psychiatrists and psychologists, the shortage of nurses is most profound, with vacancy rates ranging from 14% to 36%, SCDC officials testified before a House oversight committee. Across the board, SCDC medical professionals are consistently paid less than in the private sector, 18% to 43% less for nurses.
So until lawmakers can see the wisdom and prudence of preventing the type of problems that have rolled up on SCDC, not unlike some other state agencies, costs will continue to climb.
Rep. Gary Clary, R-Clemson, compared SCDC’s plight to that of the Department of Transportation, which for years was denied funding for maintaining roads.
“People need to understand,” the former circuit judge said, addressing prisons Director Bryan Stirling, “that you were in a deep hole you had to dig yourselves out of.”
Indeed. The SCDC is also being asked to improve officer training, do a better job of tackling gang violence and to offer inmates more chances to reduce their sentences, among other things, all of which will require more funding.
But, sadly, the SCDC hasn’t been adequately funded for years. Addressing inmate health care should rank high on the Legislature’s priority list this coming session because some preventive medicine should ease pressure on the rest of the system. Failure to do so will only mean mounting costs in the future.