The steep cost of medical co-pays in prison puts health at risk

When we consider the relative cost of medical co-pays to incarcerated people who typically earn 14 to 62 cents per hour, it's clear they can be cost-prohibitive. Co-pays that take a large portion of your paycheck make seeking medical attention a costly choice.

by Wendy Sawyer, April 19, 2017

If your doctor charged a $500 co-pay for every visit, how bad would your health have to get before you made an appointment? You would be right to think such a high cost exploitative, and your neighbors would be right to fear that it would discourage you from getting the care you need for preventable problems. That’s not just a hypothetical story; it’s the hidden reality of prison life, adjusted for the wage differential between incarcerated people and people on the outside.

In most states, people incarcerated in prisons and jails pay medical co-pays for physician visits, medications, dental treatment, and other health services. These fees are meant to partially reimburse the states and counties for the high cost of medical care for the populations they serve, which are among the most at-risk for both chronic and infectious diseases. Fees are also meant to deter people from unnecessary doctor’s visits. Unfortunately, high fees may be doing more harm than good: deterring sick people from getting the care they really do need.

A $2-5 medical co-pay in prison or jail may not seem expensive on its face. But when we consider the relative cost of these co-pays to incarcerated people who typically earn 14 to 63 cents per hour, it’s clear how they can be cost-prohibitive. To compare the cost of medical co-pays in prisons and jails to what people pay on the outside (relative to the wages available to each population), I first calculated how many hours of work it would take a low-paid incarcerated person in each state to pay for one co-pay. Then, I translated this hourly cost into the wages earned by a minimum wage, “free world” worker in the same state.

See the table below for co-pay fees and minimum wages in each state. Policy details and sourcing information can be found in the Appendix. For another perspective, I also graphed what percent of the lowest-paid incarcerated person’s monthly earnings is taken by a single co-pay in each state.

In West Virginia, a single visit to the doctor would cost almost an entire month’s pay for an incarcerated person who makes $6 per month. For someone earning the state minimum wage, an equivalent co-pay that takes the same 125 hours to earn would cost an unconscionable $1,093. In Michigan, it would take over a week to earn enough for a single $5 co-pay, making it the free world equivalent of over $300. I found that fourteen states¹ charge a medical co-pay that is equivalent to charging minimum wage workers more than $200.

The excessive burden of medical fees and co-pays is most obvious in states where many or all incarcerated people are paid nothing for their work: Alabama, Arkansas, Florida, Georgia, Mississippi, South Carolina, and Texas. Texas² is the most extreme example, with a flat $100 yearly health services fee, which some officials are actually trying to double to $200. People incarcerated in these states must rely on deposits into their personal accounts – typically from family – to pay medical fees. In most places, funds are automatically withdrawn from these accounts until the balance is paid, creating a debt that can follow them even after release.

Co-pays in the hundreds of dollars would be unthinkable for non-incarcerated minimum wage earners. So why do states think it’s acceptable to charge people making pennies per hour such a large portion of their earnings? Some might argue that incarcerated people have nothing better to spend wages on than medical care. But wages allow incarcerated people to buy things they need that the prison does not provide: toiletries, over-the-counter medicine, additional clothes and shoes, as well as phone cards, stamps, and paper to help them maintain contact with loved ones. Co-pays that take a large portion of prison wages make seeking medical attention a costly choice.

Part of the justification for charging incarcerated people medical co-pays is to force them to make difficult choices. Administrators want to deter “frivolous” medical visits. The National Commission on Correctional Health Care (NCCHC), however, argues that abuses of sick call can be managed with “a good triage system,” without imposing fees that also deter necessary medical services. And although providers must treat people regardless of their ability to pay, incarcerated people with “low health literacy” may not understand this right. The NCCHC warns that co-pays may actually jeopardize the health of incarcerated populations, staff, and the public.

Out-of-reach co-pays in prisons and jails have two unintended but inevitable consequences which make them counterproductive and even dangerous. First, when sick people avoid the doctor, disease is more likely to spread to others in the facility – and into the community, when people are released before being treated. Second, illnesses are likely to worsen as long as people avoid the doctor, which means more aggressive (and expensive) treatment when they can no longer go without it. Correctional agencies may be willing to take that risk and hope that by the time people seek care, their treatment will be someone else’s problem. But medical co-pays encourage a dangerous waiting game for incarcerated people, correctional agencies, and the public – which none of us can afford.

For details and sourcing information on co-pays (and what happens when incarcerated patients can’t afford them), see the Appendix.

March 2020 update: Please see our post about legislative changes in California, Illinois, and Texas to see what state policies have changed since we first published this briefing, and our page tracking correctional responses to the COVID-19 pandemic, which includes temporary suspensions of copays in some states.

How much do incarcerated people earn in each state?

Prison wages come up again and again in the context of prison conditions and policies. So, we found the most up-to-date information for each state.

by Wendy Sawyer, April 10, 2017

How much do incarcerated people earn? For this update, we combed through the policies of state correctional agencies and any other available sources, and found information for every state. Despite the inaccessibility of data for some state prison jobs, this is the most comprehensive list of wages paid to incarcerated people available today:

One major surprise: prisons appear to be paying incarcerated people less today than they were in 2001. The average of the minimum daily wages paid to incarcerated workers for non-industry prison jobs is now 86 cents, down from 93 cents reported in 2001. The average maximum daily wage for the same prison jobs has declined more significantly, from $4.73 in 2001 to $3.45 today. What changed? At least seven states appear to have lowered their maximum wages, and South Carolina no longer pays wages for most regular prison jobs – assignments that paid up to $4.80 per day in 2001. With a few rare exceptions, regular prison jobs are still unpaid in Alabama, Arkansas, Florida, Georgia, and Texas.

Incarcerated people assigned to work for state-owned businesses earn between 33 cents and $1.41 per hour on average – roughly twice as much as people assigned to regular prison jobs. Only about 6 percent of people incarcerated in state prisons earn these “higher” wages, however. An even tinier portion of incarcerated workers are eligible for “prevailing local wages” working for private businesses that contract with states through the PIE program. The vast majority spend their days working in custodial, maintenance, grounds keeping, or food service jobs for the institutions that confine them.

The wages listed above do not include any deductions, which in reality often leave incarcerated workers with less than half of their gross pay. In Massachusetts, for example, at least half of each paycheck goes into a savings account to pay for expenses after release. “Any and all funds” can be used to pay court-assessed fines, court costs, victim witness assessments, etc. New Mexico deducts 15-50% of each paycheck for a Crime Victims Reparations Fund, discharge money, and family support. These policies arguably serve legitimate purposes, but such deductions also mean that $1 per day earned to make day-to-day life behind bars more bearable is really 50 cents (or even less).

The question of wages paid for prison labor is an important one, especially when we consider the relative costs of fees charged and things sold to incarcerated people. The value of a dollar is different when you earn pennies per hour. (And in six states, the wage is almost always zero pennies per hour.) In Colorado, for example, it costs an incarcerated woman two weeks’ wages to buy a box of tampons; maybe more if there’s a shortage. Saving up for a $10 phone card would take almost two weeks for an incarcerated person working in a Pennsylvania prison.

Making it hard for incarcerated people to earn real money hurts their chances of success when they are released, too. With little to no savings, how can they possibly afford the immediate costs of food, housing, healthcare, transportation, child support, and supervison fees? People with felony convictions are often ineligible for government benefit programs like welfare and food stamps, and face barriers to finding stable housing and employment. And they may leave prison with just a bus ticket and $50 of “gate money,” if they have no other savings. So the meager earnings from prison work assignments can be essential to a person’s success – and even survival – when they return to their community.

Most prison jobs teach incarcerated people very few skills relevant to the labor market they will rejoin upon release, so the wages they earn may be the only payoff they see. These perpetually low wages are especially frustrating when we consider the increasing expenses incarcerated people face, both inside and after release. Of course, raising wages is a tough sell politically, but policymakers and the public must acknowledge that almost everyone in prison will eventually be released. Their success and independence depends largely on financial stability, which is undermined by low wages, nickel-and-diming through “user fees,” mandatory deductions, and work that does little to prepare them for work outside of prisons. Forward-thinking policymakers must consider the importance of earnings and relevant job training for people they hope will be independent one day.

For details about each state’s wage policies, see the Appendix.

Updated April 28, 2017 with information from a new source on Oklahoma’s regular prison jobs (non-industry). Originally, I included information based on a DOC website statement that these jobs pay up to $20 per month. According to DOC policy, however, most pay between $7.23 and $14.45 per month, and the highest possible wage for “special project pay” is 54 cents per hour. The averages have been updated to reflect these changes as well.

Food for thought: Prison food is a public health problem

Research confirms that prison food is not just gross; it is often nutritionally inadequate. A recent report from Washington provides new evidence and our policy analyst examines the public health costs.

by Wendy Sawyer, March 3, 2017

This past fall, a new report from Prison Voice Washington detailed the decline in food quality served in the state’s correctional facilities. While incarcerated people often voice complaints about (very real) quality-of-life issues related to food service, there is a broader public health concern here: the long-term health consequences of forcing incarcerated people to consume unhealthy food.

The Prison Voice Washington report

The report from Prison Voice Washington reveals how changes in food service at the Washington Department of Corrections violate the state’s own Healthy Nutrition Guidelines. Since turning over food service to the Department’s business arm, Correctional Industries, the quality of food has deteriorated and culinary job opportunities that require actual cooking skills have dried up. People incarcerated in Washington are now being forced to eat unhealthy, processed food from its central food factory.

The downturn in prison food quality can be blamed on larger trends toward industrialization and privatization. Industrialization, as exemplified by Washington state prisons, replaces cooking from scratch with processed foods that may only require reheating before serving. “When the Department of Corrections turned over responsibility for food services to Correctional Industries…, it substituted 95% industrialized, plastic-wrapped, sugar-filled ‘food products’ for locally prepared healthy food.”

Highly processed and hastily prepared food is typical of privatized food service as well. Nationally, much of prison food is outsourced to two large private corporations, Aramark Correctional Services and Trinity Services Group, the targets of increasing numbers of inmate grievances and embarrassing lawsuits. While under contract with Aramark, for example, kitchens in Michigan and Ohio prisons reportedly “served food tainted by maggots… rotten meat… food pulled from the garbage…[and] food on which rats nibbled.”

What’s especially disheartening about the state of food in Washington’s prisons is that not long ago, incarcerated people in each facility were preparing food fresh from scratch, using ingredients grown at the prisons or bought from local farmers. According to Prison Voice Washington, “Prisons grew their own food, maintained dairies and bakeries, and the food… was cooked locally.” Today, there is just one massive farm, which Correctional Industries touts as part of its “closed-loop grain-to-baker-to-prison food chain.” The most recent harvest it reports online is 200 acres’ worth of dry peas. There are still gardening programs at some facilities, but according to Prison Voice Washington, “a few small gardens… [present] a rosy veneer of sustainability and fresh produce to circumvent any real scrutiny of the bleak food reality.”

Their point? The Department is capable of doing a better job, and had done so as recently as 2009. Short-sighted administrators looking to save a few cents per meal have made a bad deal with Correctional Industries, trading a fresh, healthy food service program for highly processed foods that make incarcerated people sick.

To make their case, the authors of the Prison Voice Washington report include an incredible amount of evidence including invoices, nutrition labels, and four appendices of order forms and menus. They show that:

• Incarcerated people in Washington do not receive minimum requirements for fruits, vegetables, whole grains, lean protein, or milk.
• Incarcerated people are fed more than the recommended amounts of refined starches, added sugars and sodium.
• The DOC is fully aware of the nutritional shortcomings of its menu, so it supplements meals with fortified drink powders. These are often left untouched, so even those supplements do little to make up for the lack of nutrients in the actual food served.
• Besides the prison menu, the only other choices incarcerated people have are the products available through the commissary, where more than 90% of available products “are very unhealthy, and are categorized as ‘Avoid’ in the [State’s] Healthy Nutrition Guidelines for Vending Machines.” Even the instant oatmeal is the highly sweetened, low fiber variety on the “not recommended” list.

Again, this is all at odds with Washington’s ostensible commitment to improving nutrition. In most states, correctional agencies follow federal guidelines (or attempt to), without so much as lip-service to providing anything above a minimum standard. Washington, however, has the most comprehensive food standards of any state, although many other cities and states have adopted their own standards for food served or sold at other public agencies. The only other state with nutritional standards that apply to correctional facilities is Massachusetts; New York City and Philadelphia have sweeping city-wide nutritional standards that apply to correctional facilities as well. The Prison Voice Washington report should serve as a model to hold other agencies accountable and ensure healthy foods are available to people in correctional facilities.

Other studies of prison food show that Washington’s failings are not unique

Washington’s DOC is certainly not unique; prisons and jails are notorious for serving terrible food. Prison meals are a favorite subject for colorful photo projects and personal experiments — even Buzzfeed has made one of their trademark videos about it. And research confirms that prison food is not just gross; it is often nutritionally inadequate:

• A menu analysis from a large county jail in Georgia found incarcerated people there were served a diet too high in cholesterol, saturated fat, and sodium, and too low in fiber and several micronutrients — all factors linked to an increased risk of heart disease.
• An analysis in South Carolina found similar deficiencies, and like the Washington study, found the menu too stingy in fruits, vegetables, and milk, and too reliant on starches.
• In a Michigan report, correctional officers reported frequent deviations from the menu, especially watering down recipes and serving small portions, making it impossible for people to get the nutrients agreed upon by contract.
• The Centers for Disease Control and Prevention reports that sodium is off the charts in U.S. prisons: in 1989 (the most recent year of available data) federal prisons were serving a diet with 10,000 mg of sodium per day; by 1995, their goal was to reduce it to 6,520 mg per day — still almost three times the recommended upper limit.

So yes, prison food tastes bad. But more importantly, it’s really bad for you.

The links between chronic disease and nutrition mean that prison nutrition matters

Incarcerated people are at increased risk of chronic diseases, but rather than using Food Services to help control both health problems and the costs of medical treatment, prisons exacerbate illnesses by serving and selling unhealthy foods. Half of all incarcerated people in state and federal prisons report having had a chronic illness and are “potentially at risk for future medical problems.” Nearly as many — 40% — report a current chronic condition. Considering 1) the prevalence of chronic illness in prisons, 2) the documented impact of diet on these diseases, and 3) the much lower cost of food compared to medical treatment, it is irresponsible and shortsighted of correctional agencies to prioritize cost-cutting over nutrition.

The most problematic correlations between prison food and health include:

• Weight: The most obvious link between food services and health is weight. The Bureau of Justice Statistics reports that three quarters of people incarcerated in state and federal prisons are overweight or obese. Other researchers have found that each period of incarceration increases an individual’s Body Mass Index, which is a measure of overweight and obesity. Prison food is part of the reason why: as we’ve seen, menu analyses have found that prisons and jails serve highly processed, unwholesome food, and offer primarily high-fat and sugary options for purchase. Even when the menu fits nutritional guidelines on paper, it is often prepared in ways that make it less healthy: Prison Voice Washington reports that food service workers “attempt to fry” ingredients, so entrees like meatloaf end up “literally soaked in oil and margarine.”
• Chronic diseases: In addition to excess weight, incarcerated people suffer disproportionately from chronic health conditions. 30% of incarcerated people have hypertension, 10% heart problems, and 9% diabetes — all higher rates than the general population. As the American Heart Association’s diets for heart disease and hypertension make clear, conditions like these can be prevented or even reversed to some extent by a nutritious diet. Instead, they are made worse by menus with too much sodium and fat and not enough fiber and essential nutrients from fresh fruits, vegetables, and whole grains.
• Racial health disparities: African Americans are more likely to suffer from hypertension and diabetes, and research points to disproportionate incarceration of African American men as a cause of these health disparities. “Incarceration may help structure obesity disparities,” according to one study, and “part of the reason African American men suffer worse health is that they spend more time on average in prison, a place that undermines health,” concludes another. By ignoring the negative effects of the unhealthy prison diet on this vulnerable population, states are willingly putting them at greater risk for premature death. Each year of incarceration reduces life expectancy by two years, and this is especially true for black men.

To be sure, prisons do provide “therapeutic” or “medical” diets, prescribed by health services staff. Unfortunately, the Washington study reveals that even the “lighter fare” diet would do little to help someone with a chronic illness; it includes an extra serving of vegetables, but even less protein. In any case, when half of the incarcerated population has a chronic illness, it would make sense for a nutritious, health-services-approved diet to be the norm, not the exception. (Thankfully, some agencies have figured this out for themselves: Pennsylvania uses the Academy of Nutrition and Dietetics’ diabetic diet for its regular menu standards, and Massachusetts has created a healthier menu to minimize the number of special dietary menus needed.)

The budget is no excuse

The fact is, serving decent food is cheaper than serving unhealthy and unappetizing food in the long run. Considering the additional costs associated with poor food quality, the cost-cutting measures correctional agencies have taken around food services are fiscally short-sighted. For one thing, deteriorating food quality causes frequent security problems: when incarcerated people see that they are getting worse — or less — food than before, they protest in various ways — from dumping bad potatoes on the floor to strikes. Additional guards may be required to manage food service, not to mention the risks associated with large-scale protests like the coordinated prison strikes in the fall of 2016.

Food costs are also dwarfed by healthcare costs in prisons, so improving the nutritional quality of prison food would be a cost-effective way to improve inmate health. In our recent analysis of criminal justice costs, we found that correctional agencies spend almost six times more on health care than on food. Prison Voice Washington found that food costs make up less than 4% of the daily cost of incarcerating a prisoner — compared with healthcare, which accounts for 19% of the cost.

As the Washington authors note, even doubling the state food budget wouldn’t cost very much for the total budget and would be well worth it considering the additional healthcare costs related to chronic illness. The American Diabetes Association, for example, estimates that healthcare costs are 2.3 times higher for incarcerated people with diabetes. And overall, 86% of healthcare spending is for people with at least one chronic condition. As Prison Voice Washington concludes, “In the short run, healthy food does cost a little more — but unhealthy people cost a great deal more.”

Moreover, some states have begun to recognize that even “cost saving” moves toward industrialization and privatization aren’t worth the problems with food quality, security, and long-term health consequences. An audit of Florida’s Aramark contract found that its food costs were lower, quality was better, and more inmates actually ate the food when the Department operated its own food services program. And after struggling with a private contractor, Minnesota decided to return food services to in-house control in 2015, “providing real food for inmates even if it costs more money.”

Before long, incarcerated people’s health problems become community health problems

People who believe prison should be as punishing as possible may see little reason for facilities to serve much more than bread and water. But there is a practical reason to care about the food served in prisons: people incarcerated in state prison return to our communities sooner than you might think. As we found in an analysis last year, the median time served in state prison is 16 months and the average is 29 months. That’s more than enough time for a poor diet to cause long-term health effects. Research shows just four weeks of eating an unhealthy, high-calorie diet can lead to long-term increases in cholesterol and body fat.

When people are released from prison, their health problems become community health problems — and a financial burden on the local public health system. Preventing and helping treat chronic illnesses by serving nutritious food is cheaper than medical treatment, both during incarceration and after release.

As the Washington report demonstrates, prison food has managed to get even worse over time — and more and more people have been forced to subsist on it as the prison populations have exploded. And now, states and communities must face the long-term health consequences — and resulting healthcare costs — of feeding large numbers of incarcerated people unhealthy food. Far from a frivolous complaint, unhealthy prison food is actually a public health concern likely costing states and taxpayers far more than it saves.

Evading regulation, some in-state phone calls from jails cost over $1.50 a minute

The first ever national survey of in-state jail phone rates finds some jails charge more than $1.50 a minute.

by Aleks Kajstura, January 19, 2017

Two recent submissions to the FCC shed new light on the high cost of in-state phone calls from jails. While the campaign to make phone calls from prison and jail more affordable for family and friends of incarcerated people has made significant progress, the new filings underscore how private companies continue to avoid regulation while charging unconscionable rates.

These submissions present new research which reveals that some in-state calls cost over $1.50 a minute, and finds pricing structures that “bear a remarkable similarity” to practices prohibited by the FCC.

In order to “highlight the current ICS [Inmate Calling Service] landscape” for the FCC, Lee Petro, counsel for the Wright Petitioners, and the Prison Policy Initiative (thanks to members of our Young Professionals Network) conducted a survey of jails served by the major ICS providers.

The most significant discovery made from reviewing the current pricing policies of the ICS providers was that several ICS providers have imposed a rate structure for intrastate ICS calls that bear a remarkable similarity to the now-prohibited “connection fee” which was prohibited in the 2015 Second Report and Order, and memorialized in Section 64.6080 of the Commission’s rules.

These pricing schemes have resulted in 15 minute calls that would cost $24.95 from the Arkansas County Jail via Securus and $17.77 from the Douglas County jail in Oregon via Global Tel*Link.

You can find the summary of the Comments submission findings in the Ex-Parte submission, and the rates for all of the jails surveyed in exhibits B and C of the Comments submission (starting on page 82), and exhibits A and D in an updated filing reflecting Legacy’s correction of their advertised rates.

Our best data visualizations in 2016

2016 was another big year for powerful data visualizations from the Prison Policy Initiative. These are our 10 favorites.

by Peter Wagner and Wendy Sawyer, December 30, 2016

2016 was another big year for powerful data visualizations from the Prison Policy Initiative. These are 10 of our favorites:

1. The “whole pie”

We updated our most famous data visualization for 2016, Mass Incarceration: The Whole Pie:

This year’s report included four slideshows of additional detail on different parts of the carceral system and some of the state-to-state comparisons.

Perhaps the most exciting addition was the report’s detailed dive into the population of people confined in jails, most of whom are legally innocent:

In a major update to our graph first produced last year, we powerfully illustrated that virtually all of the growth in the jail population has been in the number of legally innocent people who are detained in jails:

2. Every U.S. state is out step with the rest of the world

The Governors of 49 states can look at Louisiana and feel like their state is an enlightened bastion of moderation, at least on incarceration. But how do each of the 50 states compare to the countries of the world? Badly.

On the theory that comparing Iowa to El Salvador (a country that recently endured a civil war and now has one of the highest homicide rates in the world) might not be fair, the report includes a graphical comparison of the U.S. incarceration rate to that of its closest allies, the founding members of NATO:

3. Looking at probation

Some of the seemingly less punitive states are actually the most likely to put their residents under some other form of correctional control, finds our report Correctional Control: Incarceration and supervision by state. The report builds off Mass Incarceration: The Whole Pie, to provide the big picture of mass incarceration to produce versions of the pie chart for each state.

The centerpiece of the report is an interactive chart that ranks each state and D.C. by rate of total correctional control, which includes incarceration, probation, and parole.

The report also includes an animation that illustrates just how dramatic the differences are between the states:

Thinking of the U.S. criminal justice system as one system can be a mistake. There are 50 state systems, plus one in each of the approximately 3,000 counties and often separate systems in the approximately 30,000 municipalities. These differences matter a great deal.

4. Bail perpetuates poverty

In May, Bernadette and Dan unlocked rare government data to show that the ability to pay money bail is impossible for too many defendants because it represents eight months of a typical defendant’s income. Detaining the Poor also showed how much harder it is for women and people of color to afford bail.

People in local jails unable to meet bail are concentrated at the lowest ends of the national income distribution, especially in comparison to non-incarcerated people. As this graph shows, 37% had no chance of being able to afford the typical amount of money bail ($10,000) since their annual income is less than the median bail amount.

The report also includes a very helpful illustration of the path from arrest to pretrial detention:

Since the 1980s, there has been a significant, nationwide move away from courts allowing non-financial forms of pretrial release (such as release on own recognizance) to money bail, although this does vary substantially depending on jurisdiction. This chart illustrates the possible paths from arrest to pretrial detention. Almost all defendants will have the opportunity to be released pretrial if they meet certain conditions, and only a very small number of defendants will be denied a bail bond, mainly because a court finds that individual to be dangerous or a flight risk. The only national data on pretrial detention that we are aware of comes from the Bureau of Justice Statistics’ Felony Defendants in Large Urban Counties series. Nationally, in 2009, 34% of defendants were detained pretrial for the inability to post money bail. This report focuses on this important population: those who are detained pretrial because they could not afford money bail.

5. Probation fees

Court-ordered fines and fees have expanded dramatically as states have realized their revenue potential. But for the low-income people who are caught up in the system, these costs mean a greater risk of financial strain and even incarceration. In December, Wendy compared probation rates and incomes across Massachusetts and found that low-income communities are hit hardest by probation fees:

The District Court locations were grouped by the per capita income of the towns and cities they each serve. Probation rates are higher in court locations that serve populations with lower incomes.

In the appendix of the report, we created a interactive scatterplot comparing each District Court’s probation caseloads and per capita income:

6. Shining a light on jail suicides

To cast light on the avoidable epidemic of jail suicides, we updated last year’s graph with a new article:

Bernadette’s article on the life-threatening reality of short jail stays also includes a graph illustrating groundbreaking data collected by the Huffington Post showing that most suicides occur in just the first few days of detention in jail.

7. A crime wave?

The President-elect says there is a crime wave. Is there? We looked:

For most cities, murder is much lower now than during the 1980s or 1990s. The data for 1985-2014 comes from the FBI. The FBI has not published the 2015 full year data yet, so we relied on data from the Major Cities Chiefs Association, which historically is very similar if slightly higher than the FBI’s figures. For that reason, this graph may overstate the increase in murder in 2015 in these cities.

For more on the need for city-specific crime data, see Wendy Sawyer’s analysis Making a mountain out of a molehill.

8. Public vs. private prisons

We’ve long argued that prisons owned and run by corporations that contract with state governments get far more attention than they deserve. But another huge provider of contractual prison services gets almost no attention whatsoever: local jails.

Since 1999, private prisons and local jails have housed roughly the same number of those serving state and federal prison sentences. But when those interested in justice reform talk about profiting off of mass incarceration, they almost always leave local jails out of the conversation.

For more on this topic, see our article: Some private prisons are, um, public.

9. Beyond the crime bill

During the Democratic primary, many people blamed the Clintons for mass incarceration by pointing to the 1994 crime bill. But that was perhaps the least important of seven major bills. One of the most harmful, and the least discussed, was the Antiterrorism and Effective Death Penalty Act. In May, we made this data visualization of data collected by law professor Margo Schlanger for her article Trends in Prisoner Litigation, as the PLRA Enters Adulthood to make the magnitude of this change clear:

The filing rate by incarcerated people dropped significantly after the passage of the Prison Litigation Reform Act. And ironically, despite Congress’ fears of a prison lawsuits flooding the courts, this data that controls for the size of the prison population shows that in 1996, when the Prison Litigation Reform Act was passed, fewer lawsuits per 1,000 incarcerated people were being filed than during the ten year period of 1979-1988.

10. The Crippling Effect of Incarceration on Wealth

A fascinating study by Khaing Zaw, Darrick Hamilton, and William Darity Jr. shows that incarceration has a staggering effect on the accumulation of wealth over the course of a lifetime. To accompany our blog post on the original article, we made a data visualization of the data — including detail by racial group — published in the original article:

Our favorite criminal justice research from 2016

2016's most useful and under-exposed research that contributed to our movement's understanding of key issues in criminal justice.

by Wendy Sawyer, December 29, 2016

As 2016 comes to a close, the Prison Policy Initiative wanted to highlight some of our colleagues’ research that we thought was the most useful and the most under-exposed and contributed to our movement’s understanding of key issues in criminal justice:

• Growing Up Locked Down
  ACLU of Nebraska
  January 2016
  The psychological and physical harms of solitary confinement are so much worse for children who are still developing. The ACLU of Nebraska finds that the state overuses “the most inhumane correctional practices” of solitary confinement in every one of its juvenile justice facilities. Children there were placed alone in cells as punishment for minor offenses, like talking back or having too many books. The report calls attention to the “serious mental health impacts of solitary confinement for vulnerable youth” and the pressing need for policy reform.
• The Gavel Gap: Who Sits in Judgment on State Courts?
  by Tracey E. George and Albert H. Yoon for the American Constitution Society
  June 2016
  In a democratic society, the courts should reflect the communities they serve. This report is the first to give a crystal clear picture of just how un-representative state court judges are by gender, race and ethnicity. To support further research and advocacy, it provides a new dataset of biographical information about state court judges. The report makes the case that if courts’ want to increase both their understanding of the communities they serve and public confidence in their decisions, courts must close these wide gender and racial “gavel gaps.”
• America’s Top Five Deadliest Prosecutors: How Overzealous Personalities Drive the Death Penalty
  Fair Punishment Project
  How is it possible that five prosecutors were responsible for 440 death sentences? The Fair Punishment Project details the bloodlust, racism and willful misconduct that made it possible for each of these notorious prosecutors to win scores of death penalty sentences. This report shows that the death penalty is an unusual punishment sought by a small number of zealots in just a few parts of the country.
• Paying the Price: Failure to Deliver HIV Services in Louisiana Parish Jails
  Human Rights Watch
  March 29, 2016
  Recognizing that the populations at risk of HIV and the incarcerated populations overlap, this report illustrates the urgent need for reform in Louisiana, which it describes as “‘ground zero’ for the dual epidemics of HIV and incarceration.” An accompanying video on the website gives voice to stakeholders by including interviews with formerly incarcerated people, HIV and health services providers, and representatives of the criminal justice system.
• Punishment Rate Measures Prison Use Relative to Crime
  Pew Charitable Trusts
  March 23, 2016
  This report looks beyond imprisonment to offer a new metric, “the punishment rate,” with which to gauge punitiveness. By comparing the size of prison populations to the frequency and severity of crime reported, rather than to the number of residents, Pew shows that the U.S. has become more punitive than traditional analysis suggests. Extending this analysis to individual states, Pew finds that Connecticut, New Jersey, New York, Pennsylvania, South Dakota, Vermont, Virginia, West Virginia, Wisconsin and Wyoming are all significantly more punitive than their imprisonment rates suggest.
• Race, Wealth and Incarceration: Results from the National Longitudinal Survey of Youth, Race and Social Problems
  Originally published in Race and Social Problems, Vol. 8, Issue 1, 2016. The final publication is available at Springer Link
  By Khaing Zaw, Darrick Hamilton, and William Darity, Jr.
  March 2016
  The authors of this study examine the wealth disparity between young men who experience prison and those who never do, using a survey that follows a group of young men for 27 years. They find that the men who are incarcerated have less wealth to begin with and, over time, accumulate only a small fraction of the wealth accumulated by their peers who are never incarcerated. (This is consistent with our findings that pre-incarceration incomes of incarcerated people are 41% lower than their peers.) We blogged about this report and produced two graphics based on it: The Crippling Effect of Incarceration on Wealth.
• Get To Work or Go To Jail
  By Noah Zatz, Tia Koonse, Theresa Zhen, Lucero Herrera, Han Lu, Steven Shafer, and Black Valenta at UCLA Labor Center
  March 2016
  Work at a terrible job, or go to jail. Those are the two choices for many people on probation and parole, as outlined by this research brief. Probation and parole conditions, as well as court orders to find work to pay court debts or child support, can force people to choose between bad (or unpaid) jobs and jail time. The threat of jail depresses labor standards and legal protections, which create cascading effects on all workers. The report provides estimates of incarceration for “failure to work” and links this threat to the practice of incarcerating people who fail to pay court fines and fees – something we discussed in our report on probation fees.
• Roadblocks to reform: District Attorneys, Elections, and the Criminal Justice Status Quo
  ACLU of Oregon
  April 2016
  District Attorneys have the power to make the justice system more progressive. But this report concludes that uncontested elections and appointments in Oregon lead DAs to block progressive criminal justice reform and maintain the status quo for their own self-interest. The ACLU makes a powerful case for why the national movement needs to pay more attention to DA races.
• Unlicensed & Untapped: Removing Barriers to State Occupational Licenses for People with Records
  by Michelle Natividad Rodriguez and Beth Avery with the National Employment Law Project
  April 2016
  Not only do people with criminal records face discrimination from employers, they also often face barriers in obtaining occupational licenses to work as a barber, hairdresser, health care worker, or teacher – even decades after their sentence ends. This report evaluates the effectiveness of state laws intended to ensure fairness for applicants with records and it provides recommendations for states, including a model law.
• Louisiana Death Sentence Cases and Their Reversals, 1976-2015
  Originally published in The Southern University Law Center Journal of Race, Gender, and Poverty, Vol. 7, 2016.
  by Frank R. Baumgartner and Tim Lyman
  April 26, 2016
  An analysis of 241 death sentence cases in Louisiana since Gregg v. Georgia reinstated the death penalty in 1976 finds that the death penalty is still applied in discriminatory ways, and the frequency of reversals suggests the death penalty process is rife with errors and ultimately arbitrary in application.
• Correcting Food Policy in Washington Prisons: How the DOC Makes Healthy Food Choices Impossible for Incarcerated People & What Can Be Done
  Prison Voice Washington
  From Washington state, a troubling example of how incarcerated people suffer when states try to cut costs. By eliminating all fresh, natural food in favor of processed products from a single prison food factory, the state has created “food deserts” in its prisons, failing to provide food that meet minimum standards for nutrition and increasing healthcare expenditures. This report shows how a nation that recognizes nutrition as a public health issue continues to neglect its incarcerated population.
• Incarceration Trends
  Vera Institute of Justice
  December 2015
  Vera’s Incarceration Trends project was technically launched in 2015, but it came out after we wrote last year’s list of best reports and it is too useful to ignore. A combination of two written reports and an interactive data tool, Vera’s research involved aggregating county-level data from 1970 to the present so that local incarceration rates can be compared over time and across jurisdictions. While also calling attention to racial and gender disparities, Vera’s Trends project is an incomparable resource that sheds historical light on the local face of mass incarceration.

2016’s Criminal Justice Victories

2016 was a year of big victories for the Prison Policy Initiative. Read about some of the biggest wins in our campaigns this year.

by Kim Cerullo, December 23, 2016

2016 was a year of big victories for the Prison Policy Initiative. Our campaigns took some big steps forward and, in some cases, those victories culminated in major policy changes.

Here are some of the biggest wins in our campaigns this year:

Prison Gerrymandering

• A federal Judge declared prison gerrymandering in rural Jefferson County, Florida to be an unconstitutional violation of the principle of “one person one vote.” Our staff were expert witnesses in the case.
• In April, Tennessee passed legislation to allow rural counties to avoid prison gerrymandering.
• We organized 100,000 people to submit comments to the Census Bureau demanding an end to prison gerrymandering. This movement was also supported by a letter from 13 U.S. Senators. We are awaiting a decision from the Census Bureau about where incarcerated people will be counted in the 2020 Census.

Driver’s License Suspensions

• Common sense prevailed in Massachusetts this year. Armed with our Suspending Common Sense report, our friends at EPOCA led a campaign that resulted in the elimination of a law which automatically suspended the driver’s licenses of people convicted of drug offenses wholly unrelated to driving. This law, a relic of the War on Drugs, made it harder for people with drug convictions to fulfill family, economic, and court obligations.
• Encouraged by this victory, we are expanding our campaign beyond Massachusetts. This month we released our new report Reinstating Common Sense: How driver’s license suspensions for drug offenses unrelated to driving are falling out of favor. This report exposes the 12 states and Washington, D.C. which still suspend licenses for drug offenses unrelated to driving and is already winning major editorial board support.

Protecting Letters from Home

• We followed up on our previous report on postcard-only mail policies in jails this year with Protecting Written Family Communication in Jails, A 50-State Survey.
• Supported by our reports, the movement to end letter bans grew this year. Sheriffs in Macomb County, Michigan and Flagler County, Florida agreed to lift postcard-only policies, and lawsuits are underway to challenge postcard-only policies in Knox County, Tennessee and Wilson County, Kansas.

Other research

We also published a record number of ground-breaking reports to push the national conversation about mass incarceration and over-criminalization. Our most notable reports include:

• Correctional Control: Incarceration and supervision by state
  Prison is just one piece of the correctional pie, and we often overlook the leading type of correctional control: probation. This report is the first of its kind and aggregates data on all of the types of correctional control: federal prisons, state prisons, local jails, juvenile incarceration, civil commitment, Indian Country jails, parole, and probation.
• States of Incarceration: The Global Context 2016
  Our report and infographic directly situate individual U.S. states in the global context. This updated version reveals that the use of incarceration in every state – even those with relatively progressive policies – is out of step with the international community.
• Detaining the Poor: How money bail perpetuates an endless cycle of poverty and jail time
  Detaining people because they are poor is an offensive idea, but until this year it was difficult to prove that this is exactly what the American system of cash bail does. This report uses an obscure and underutilized government dataset to show that the typical bail amount in the U.S. is equivalent to eight months of income for the typical defendant. Our report not only proved the obvious, but we helped reframe the debate to show why modest changes in bail amounts won’t be enough to reverse the tremendous rise in the population of people detained before trial.
• Punishing Poverty: The high cost of probation fees in Massachusetts
  In Massachusetts, probation is a much bigger part of the correctional control pie than incarceration. Our new report reveals that being on probation comes at a price: probation service fees in the state cost probationers more than $20 million every year, a cost that largely falls on those who are too poor to pay.

The life-threatening reality of short jail stays

New BJS data shows suicide is still the leading cause of death in local jails. And most suicides occur shortly after jail admission.

by Bernadette Rabuy, December 22, 2016

As we wrote last year, suicide in jails is an overlooked national crisis. The rate of suicide in local jails — which generally hold people detained pretrial or convicted of low-level offenses — is far greater than that of state prisons or the American population in general.

According to Bureau of Justice Statistics data released last week, the rates of suicide for 2014 were the highest rates of suicide in either prisons and jails in the fifteen years since the Bureau of Justice Statistics started collecting mortality data. Distressingly, suicide continues to be the leading cause of death in local jails.

In comparison to prisons, local jails experience far higher proportions of unnatural deaths, which include suicides, drug/alcohol intoxication, homicides, and accidents. For example, in 2014, 11% of deaths in state and federal prisons were due to unnatural causes while almost half (49%) of deaths in jails were unnatural. There are a number of reasons for why this could be true such as the disproportionate number of people in jails suffering from mental health challenges or substance abuse or because people are sometimes being booked into jails in their most desperate state.

One positive consequence of Sandra Bland’s tragic 2015 death in a Texas jail has been increased attention on jail deaths. For example, the Huffington Post began a groundbreaking project gathering names, cause of death, dates of arrest and death, and other key details for more than 800 people who died in jails and police lockups in the year following Bland’s death. The Huffington Post’s jail deaths database builds on the Bureau of Justice Statistics annual reports to provide more in-depth information on this national crisis. The data shines light on the particular jails in the U.S. with above average numbers of deaths and tells the stories of the people whose deaths might have been initially missing from the mainstream media.

While the Bureau of Justice Statistics reports that 41% of jail deaths occurred within the first week of a person’s jail stay, the Huffington Post’s data goes further, to show that even a few days in jail can be life threatening. The Huffington Post found that 26% of jail suicides occurred within just three days.

Studying the datasets raises urgent questions about the way that jails function such as whether jails are adequately evaluating mental health during intake, how jail staff communicates with family members of the incarcerated during periods of incarceration and when a death occurs, and whether there is appropriate oversight of the thousands of local jails in the U.S.

The data also raises broader, but just as pressing, questions about the dehumanizing experience of incarceration. The high rate of jail suicide should prompt our country to consider whether increasingly popular jail visitation policies that replace in-person visits with video will only increase the isolation of incarceration. The data also supports the idea that mental health services could be more effectively delivered in the community and renews the call for more programs that divert people with mental illness from going to jail in the first place. Further, the high number of suicides that occur within the first few days since jail admission emphasizes why the detention of those awaiting trial, even for a few days, should be treated as a human rights crisis.

Jail suicides are yet another example of how interactions with our criminal justice system can become questions of life or death.

New report finds Massachusetts charges monthly probation fees to people who can’t afford them

The state brings in over $20 million in revenue from monthly probation fees each year. The problem? Probation rates are highest in the lowest-income communities.

December 8, 2016

FOR IMMEDIATE RELEASE: December 8, 2016

Contact:
Wendy Sawyer
wsawyer [at] prisonpolicy.org
(413) 527-0845

Easthampton, MA – The state brings in over $20 million in revenue from monthly probation fees each year. The problem? Probation rates are highest in the lowest-income communities, according to a new report by the Prison Policy Initiative. Punishing Poverty: the high cost of probation fees in Massachusetts analyzed probation cases and income data for the state’s 62 District Court locations.

“The state is charging monthly probation fees to the people who can least afford to pay them,” said Wendy Sawyer, the author of the report, “and setting them up for failure.”

In Massachusetts, there are currently about 67,000 people on probation who are charged a monthly fee of $50-65. The report explains that it is harder for people who cannot afford these monthly probation fees to succeed in meeting the conditions of their probation. When someone on probation fails to pay their fee, it counts as a “probation violation,” which can lead to more fees, license suspension, arrest, and can even land them back in jail.

The Prison Policy Initiative’s report adds to the growing body of research on the harms of the state’s court-imposed fines and fees. The report follows on the heels of two recent reports by the Trial Court and by the Senate, which explain the problems with court-imposed fines and fees that can lead to incarceration for people who fail to pay.

Punishing Poverty offers a comprehensive look at probation fees, including their roots in 1980s “tough on crime” politics and the problems they cause for probationers and courts.

The report unearths a long-forgotten legislative research brief from 1988 that explains how this policy came to pass. Probation fees were instituted as a misguided attempt to plug a budget in crisis, passed by legislators capitalizing on the “tough on crime” political climate. The 1988 brief also reveals that legislators understood the inherently coercive nature of probation fees.

The state faces a budget shortfall again in FY 2017, but Sawyer argues that charging probationers fees they cannot afford is no solution. “The state needs to recognize that the people in the criminal justice system are among the state’s poorest,” she says. “Fines and fees just make their situations worse, not to mention making more work for the courts.”

Punishing Poverty provides recommendations for far-reaching reforms for the legislature, judiciary, and probation. An appendix includes detailed information comparing each court location’s probation and income data. The most striking findings from the report’s analysis of probation and income data are large disparities between the probation rates of the state’s wealthiest and poorest communities:

• The courts serving the populations with per capita incomes below $30,000 have probation rates 88% higher than in those serving the populations with incomes over $50,000.
• Just ten court locations where the population has below-average incomes account for a full third of District Court probation cases.
• Residents of Holyoke are sentenced to probation at a rate more than three times higher than in Newton. But Holyoke’s probationers can scarcely afford to pay this regressive tax; the average income in that area is $21,671.

The Easthampton, Massachusetts-based Prison Policy Initiative was founded in 2001 to expose the broader harm of mass criminalization. The organization is most well known for sparking the movement to end prison gerrymandering and for its big picture data visualization “Mass Incarceration: The Whole Pie.”

The new report, Punishing Poverty: the high cost of probation fees in Massachusetts, is available at: https://www.prisonpolicy.org/probation/ma_report.html

A partial victory: release cards included in CFPB’s new regulations

Consumer Financial Protection Bureau’s new regulations increase protections for people released from prison and jail, who are often forced to use release cards.

by Aleks Kajstura, October 5, 2016

Today, the Consumer Financial Protection Bureau issued a final rule on prepaid debit cards. Last year, the Prison Policy Initiative and other groups urged the CFBP to use this rulemaking to address abusive practices related to prepaid debit cards issued to people upon their release from prison or jail. The CFPB’s decision today is a partial win, but more work remains to be done.

The good news is that release cards will be covered by the new consumer protections contained in the final rule. Specifically, correctional facilities will have to provide clear fee disclosures, card issuers will have to provide reliable access to account histories, and cardholders will have some ability to dispute inaccurate charges.

Prison Policy Initiative had argued that correctional facilities should be prohibited from requiring that people receive their money on prepaid cards. The CFBP declined to impose such a prohibition at this time. Instead, the Bureau acknowledged the concerns about release cards, but said more research would need to be done before it could consider taking action.

Finally, the CFPB ruling clarified that at least some release cards should be conforming to existing (and new) regulations:

[T]o the extent that… prison release cards are used to disburse consumers’ salaries or government benefits…, such accounts are already covered … and will continue to be so under this final rule.

As the CFPB proceeds with the “additional public participation and information gathering about the specific product types at issue”, correctional facilities are increasingly using these expensive cards to repay people they release — money in someone’s possession when initially arrested, money earned working in the facility, or money sent by friends and relatives.

Before the rise of jail release cards, people were given cash or a check. Now, they are instead given a mandatory prepaid Mastercard, which comes with high fees that eat into their balance. These cards charge for basic things like:

• Having an account (up to $3.50/week)
• Making a purchase (up to $0.95)
• Checking your balance (up to $3.95)
• Closing the account (up to $30.00)

To put this into perspective, if someone is released with $125, a $2-per-week maintenance fee is equivalent to a finance charge of 77% per year. If that same hypothetical cardholder makes ten purchases of $12 each, then a $0.50 per-transaction-fee would amount to $5, or 4% of the entire card balance (on top of maintenance fees). If the cardholder wishes to convert a prepaid card into cash, he or she must pay $10 to $30 (8% to 24% of the entire deposit amount) merely to close the account.

But while the new CFPB regulations take a more robust stance on fee disclosure, allowing many people to avoid predatory pricing, they won’t help incarcerated people, who have the cards foisted on them with no choice.