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This Mother's Day, 120,000 incarcerated mothers will spend the day apart from their children. The good news is, this year, you can take action to help reconnect children to their mothers.

by Wendy Sawyer, May 8, 2017

This report is has been updated with a new version for 2022.

This Mother’s Day, 120,000 incarcerated mothers will spend the day apart from their children. Over half of all women in U.S. prisons – and 80% of women in jails – are mothers, most of them primary caretakers of their children. An estimated 9,000 women are pregnant upon arrival to prison or jail each year. Yet most of these women are incarcerated for non-violent offenses, and many are held in jail awaiting trial because they can’t afford bail. The good news is this year, you can take action to help reconnect children with their mothers.

National Mama’s Bail Out action

During this week, a collection of over two dozen local and national organizations will bail out as many mothers as possible, who would otherwise spend Mother’s Day in a cell simply because they cannot afford bail. This effort focuses on bailing out Black mothers (including birth, trans, and other women who mother); Black children are seven times more likely than white children to have a parent incarcerated. Over a dozen cities are participating across the country. You can donate bail funds here (link no longer active).

Bills to keep primary caretakers out of prison

In Massachusetts, the “Primary Caretakers” bill (S. 770) would allow parents and other primary caretakers convicted of nonviolent crimes to request a non-prison alternative. Once enacted, courts would make written findings about caregiver status and availability of alternatives before sentencing. Tennessee’s HB 825 and SB 919 follow the model of the Massachusetts bill. If you live in one of these states, you can find your legislator to weigh in on these bills.

Harms to children caused by parental incarceration

Keeping parents out of jail and prison is critical to protect children from the known harms of parental incarceration, including:

Incarceration punishes more than just individuals; entire families suffer the effects long after a sentence ends. Mother’s Day reminds us again that people behind bars are not nameless “offenders,” but beloved family members and friends whose presence – and absence – matters.


Thank you for making Valley Gives 2017 a success!

by Wendy Sawyer, May 3, 2017

Yesterday, we raised over $2,500 in individual donations through Valley Gives, an annual giving event in western Massachusetts. We are grateful to all of our supporters: our neighbors in the Pioneer Valley and allies across the country that sustain us year after year, and new friends who have just recently discovered our work. Together with a generous donor who offered a matching gift of $2,500, we raised over $5,000, exceeding our Valley Gives goal.

Over the years, individual donor support has allowed us the flexibility to take on critical emerging issues, like the exploitation of incarcerated people and their families and bail practices that punish the poor. The Prison Policy Initiative has a small staff but accomplishes so much because we are able to draw on a broad network of dedicated reform-minded folks who are generous with their time, thoughts, and resources. We are thrilled to welcome some new supporters to the movement through Valley Gives, and thank you all for helping make it such a success!


We estimate that more than 44,000 people 45 and older experience solitary in state prisons each year. As prisons continue to get grayer, policymakers must understand that denying older incarcerated people access to sunlight, exercise, and interaction with other people and spaces is both inhumane and fiscally irresponsible.

by Lucius Couloute, May 2, 2017

Recently released research finds that thousands of older incarcerated people are being forced to live in some form of solitary confinement on any given day. The practice of cutting human beings off from human contact is widely condemned, but this practice is particularly troubling since it means we are subjecting a large number of older adults to living conditions that can cause or exacerbate serious medical conditions. As prisons continue to get grayer, policymakers must understand that denying older incarcerated people access to sunlight, exercise, and interaction with other people and spaces is both inhumane and fiscally irresponsible.

While the total rate of imprisonment has been going down since 2003, the rate for those 45 or older has been increasing steadily.

‘Solitary confinement’ is, in fact, a highly contested term; some prison systems deny that they employ solitary confinement and prefer lighter, more administrative-sounding phrases such as SHUs (special housing units) or SMUs (special management units). Terminology aside, these units mean segregation from the rest of the prison population and people are typically forced to remain in their cells for over 22 hours a day with minimal human interaction. Solitary confinement is used at the discretion of correctional staff for a variety of reasons, ranging from punishing (or protecting) individuals, to housing people when other, normal, cells are not available.

Whatever name it’s given, and whatever the reasons for putting people there, the evidence is clear that solitary confinement causes undeniable harm and can create a host of negative psychological issues for all people including:

  • Anxiety
  • Hallucinations
  • Withdrawal
  • Aggression
  • Paranoia
  • Depression; and even
  • Suicidal behaviors

From academics to Supreme Court Justices, and even the United Nations, the use of solitary confinement has drawn substantial criticism and is widely considered inhumane, especially for vulnerable groups such as the mentally ill and juveniles. But there’s another group whose lives are put in danger when they are forced to live in extreme isolation – older incarcerated people.

Because older adults are more likely to have chronic health conditions such as heart disease, Alzheimer’s disease, diabetes, and lower respiratory disease, solitary confinement puts their long-term physical and mental wellbeing in danger. For the 73% of incarcerated people over 50 who report experiencing at least one chronic health condition, solitary confinement is especially hazardous.

Until now it’s been difficult to pin down exactly how many older adults are forced into solitary confinement each year, but a new report provides some answers. Based on survey data from 41 states, researchers from Yale and the Association of State Correctional Administrators find that over 6,400 men and women age 50 and older are living in some form of restrictive housing on any given day. (The survey’s definition of restricted housing includes all individuals housed in their cells for 22 hours per day or more for at least 15 days.)

But while 6,400 people is substantial, this number is just a snapshot and doesn’t reflect all of the older incarcerated people who have experienced the harm of solitary during a particular year. Using two Bureau of Justice Statistics reports, I estimate that more than 44,000 people 45 and older experience solitary in state prisons each year.1 This is more than the entire prison populations of countries like Canada, Australia, and El Salvador.

The obvious conclusion is that solitary isn’t some rarely used method of punishment, only used for younger, more threatening “offenders”. It’s the norm – even for older folks.

The effects of solitary on older people can be dangerous. According to Dr. Brie Williams of the University of California, solitary confinement increases the risk that older incarcerated people will develop or exacerbate chronic health conditions:

  • A lack of sunlight can cause vitamin D deficiencies and greater risk of fractured bones
  • Sensory deprivation from prolonged confinement in an empty room can worsen mental health and lead to memory loss
  • Limits on space hinder mobility, which is crucial for maintaining health through exercise.

Unfortunately, there is no publically available data on why people are put into solitary, nor do we have good information on specific conditions and outcomes related to the practice. This data shortage is, in large part, because prison officials do not want their widely-used strategy to be studied in the light.

Luckily, people are beginning to take notice. Last year, spurred by public campaigns against the practice, President Obama banned the use of solitary confinement for juveniles and people who commit low-level infractions in federal prisons. But these limited reforms have not translated into widespread changes in the way we treat incarcerated people who are older and thus more susceptible to health problems.

We know that around 2,000 people age 55 and over die in state prisons each year and that upon release the formerly incarcerated are at greater risk of death due to cardiovascular disease and suicide compared to non-incarcerated individuals. Putting a population that is less likely to recidivate in conditions that contribute to these statistics is counterproductive at best. Going forward, it’s crucial that we think about how practices such as solitary confinement contribute to mortality statistics and poor health outcomes both within prisons and during the reentry process.

For the 95% of incarcerated people who will eventually return to communities across the nation, solitary confinement almost guarantees that they do so as less healthy individuals. This affects state and local resources beyond the costs of incarceration; the health costs of older adults are expected to rise substantially in the coming years, most of which will be paid for through taxpayer funded health programs. Viewed from a public health perspective, subjecting thousands of aging individuals to prolonged periods of immobility and isolation is dangerous and strains our medical infrastructure.

It’s time that state prison officials consider abolishing solitary, especially for older incarcerated people, similar to what lawmakers in New Jersey intended with S51 last year. The people we imprison aren’t lab rats (although treating animals this way is widely considered immoral), they are human beings who will be released back into society someday. Abandoning the practice of solitary is the next crucial step to chip away at the human and public health costs of mass incarceration.

 

Footnotes

  1. Unfortunately, the available data required me to count people who are 45 and above as “older”, whereas the Yale/Liman study defined “older” adults as those people above 50. In order to calculate the estimate I used two Bureau of Justice Statistics reports (“Aging of the State Prison Population, 1993–2013” and “Use of Restrictive Housing in U.S. Prisons and Jails, 2011–12”). According to the National Inmate Survey 2011-12, 13.1% of incarcerated people between 45-54 years old report spending time in restrictive housing at some point in the last 12 months or since admission to the facility, if shorter. For incarcerated people 55 and older that number is 8.9%. By multiplying these percentages with the total number of people in state prisons of equivalent ages in 2013 I was able to produce an estimate of 44,295 people in state prisons who experience some form of solitary each year. This number is a rough approximation, since multiple survey instruments are involved, but due to the lack of available systematic data, it provides us with a useful glimpse into the practice of solitary confinement for older adults.  ↩

It’s time to recognize that if we really care about taxpayers’ dollars, public safety, and the wellbeing of all communities, prisons and jails should be the last places we want to put people suffering from addiction.

by Lucius Couloute, April 28, 2017

Last year, as part of the Obama Administration’s agenda on criminal justice reform, acting Attorney General Loretta Lynch declared April 24th-30th National Reentry Week. Unfortunately, the current administrations seems to have shelved the idea, in favor of appearing tougher on crime and cracking down on drugs in the “inner-city”. But we want to take the opportunity to join grassroots leaders across the country in drawing attention to the importance of reentry today.

At a time when the future of mass incarceration is unclear, it is important to recognize that our criminal justice policy decisions have real and lasting consequences for millions of people across the country. And although the current administration appears to be interested in reframing the debate, history suggests that the ‘tough-on-crime’ strategy, especially as it pertains to drug use, is a flawed one.

As a sociologist examining the difficult road of reentry for formerly incarcerated people, I’ve listened to countless stories about the harms of addiction.
Very frequently I hear from formerly incarcerated people about how ordinary tasks like going to work, taking care of kids, or taking classes are made much more difficult when contending with a present or past dependence on drugs.

But it isn’t just that addiction makes life difficult. Even when formerly incarcerated people feel they’ve kicked their habit, the effects of having been formally criminalized because of an addiction can actually work against recovery.

When I asked about his robbery convictions and their connection to his decades-long struggle with heroin, Alex, a 49 year-old Latino man told me:

“[My crimes] are a means to keep getting money to keep getting high … And in my case I get so messed up that I say, ‘you know something? Time for me to go back in and clean myself up, gain some weight and try [to stay sober] again.’ But that place is only going to mess you up more, mentally. Because … addiction services in prison are almost nonexistent.”

Alex isn’t exaggerating about the lack of drug treatment available to incarcerated people. Despite the fact that an estimated 80% of incarcerated people are dealing with some form of addiction, only about 11% of the people who need treatment actually receive it in prison or jail.

The good news is that states are beginning to recognize that addiction is a medical issue and should probably be addressed outside of correctional facilities. Unfortunately, though, the criminalization of drug dependence has wreaked havoc on communities of color for years and continues to shape the lives of people like Alex.

Alex spends most of his time now looking for jobs, safe places to stay, and fighting off the urge to use – but having a criminal record makes each of these tasks difficult. He believes people like him are alone in their battle for a better life. But as he puts it, “We did that to ourselves. Because we keep repeating the same mistakes so many times that people lose faith in us. People give up.” Having constantly been told that his personal choices led to his criminal record, Alex’s cynicism reflects an institutional-level inability to address the source of his criminal behavior – a dependence on heroin.

By misrecognizing crime as a function of character our criminal justice system does little to help people like Alex lead law-abiding lives.

And confounding the causes of crime, in this way, occurs more than we think. Current estimates suggest that about 20% of incarcerated people are locked up because of a drug offense, but drugs probably play a role in a far greater number of criminal offenses than the statistics imply. People in prison for multiple offenses are reported in official records only for the most serious ones, so some people incarcerated for “violent” offenses might have also been charged with a drug offense too. Not to mention that about 1/3rd of people who commit crimes are estimated to have been using drugs at the time of their last offense.

In many cases that don’t appear to be driven by drug-seeking behavior (like Alex’s robbery convictions), addiction very well may have played a significant role. Yet as Alex points out, few people receive holistic long-term services before, during, or even after their incarceration.

Effective treatment is costly, yes, but compared to the cost of incarceration, drug treatment is a bargain. If we fail to provide people suffering from addiction the resources they need to function, the criminal justice system will continue to squander taxpayer dollars in an endless cycle of incarceration, release, and re-incarceration.

As National Reentry Week 2017 comes to an end, it’s time to recognize that if we really care about taxpayers’ dollars, public safety, and the wellbeing of all communities, prisons and jails should be the last places we want to put people suffering from addiction.


On Tuesday, May 2, we'll be participating in Valley Gives, a 24-hour online giving event for nonprofit organizations located in western Massachusetts.

by Wendy Sawyer, April 25, 2017

On Tuesday, May 2, we’ll be participating in Valley Gives (link no longer available), a 24-hour online giving event for nonprofit organizations located in western Massachusetts. And this Valley Gives Day, a generous supporter will match the first $2,500 given to the Prison Policy Initiative.

In the past year, we have had historic successes in our major campaigns:

  • We organized an unprecedented 100,000 people to submit comments to the Census Bureau demanding an end to prison gerrymandering, including 13 U.S. Senators and 39 civil rights organizations.
  • Following the success of last year’s campaign in Massachusetts to eliminate an outdated law suspending driver’s licenses for drug offenses unrelated to driving, we expanded our campaign nationally. So far, we’ve seen progress in D.C., Florida, Mississippi, Texas, and Virginia, and just this month legislation was introduced in Congress that would repeal the federal law.
  • Local jails are allowing private companies to replace in-person visits with expensive, low-quality “video visitation,” as our research has shown. Fortunately, policymakers in Illinois and New Jersey have stepped up to protect crucial in-person visits, and we continue to fight this damaging and exploitative practice.
  • We’re also pushing for criminal justice reform in our home state of Massachusetts. In a recent report, we showed that probation fees hit the state’s poorest communities hardest. Legislation introduced this year would eliminate probation fees for more people under community supervision, and ensure that no one is locked up because they can’t afford a fee.

Together with individual supporters like you, we’ve been able to accomplish so much in the past year. The need for criminal justice reform – and to protect the reforms we’ve achieved – has never been more urgent. So please donate by May 2nd to double the impact of your gift. As always, we thank you for your support.

You can visit our Valley Gives page here: https://valley-gives.org/designee/prison-policy-initiative-inc-1 (link no longer available)


We are thrilled to see the ACA support the common sense idea that emerging technologies should supplement, not replace, in person visits.

by Lucius Couloute, April 24, 2017

ACA policy on family-friendly communication and visitationAs we mentioned in our January 2015 report, in four conferences going back to 2001, our nation’s leading professional organization for correctional officials, the American Correctional Association, has consistently declared that “visitation is important” and “reaffirmed its promotion of family-friendly communication policies between offenders and their families.”

Last August, the American Correctional Association went further by explicitly declaring that emerging technologies (like video visitation) should only be used to supplement existing in-person visitation.

The ACA isn’t the only national association to take a stand; the American Bar Association’s standards state that video visitation should not replace in-person visitation.

These resolutions are important because they tell the hundreds of jails that have replaced in-person visits with video visitation that these jails are violating correctional best practices.

Since jails incarcerate people who tend to be extremely poor, video visitation can come at a great cost to their families. At up to $1.50 per minute, a single 15-minute video visit can be the difference between buying a day’s worth of food, or forgoing groceries to speak with a loved one. The American Correctional Association understands this economic reality, urging correctional facilities to “not place unreasonable financial burdens upon the offender or their family and friends.”

As a supplement to in-person visits, video visitation can help connect families who are far apart. We are thrilled to see the ACA include in their Public Correctional Policies the common sense idea that emerging technologies should supplement – not replace – in person visits.

For more information on this issue and to see country wide press coverage, see our report and organizing on the for-profit video visitation industry in prisons and jails.


Are providers of prison communication services allowing unrestricted access to the personal computers and conversations of incarcerated people and their loved ones?

by Stephen Raher, April 24, 2017

The apparent suicide of former NFL player Aaron Hernandez has received much media attention, due to Mr. Hernandez’s celebrity status. While many news reports noted that Mr. Hernandez was recently acquitted of additional murder charges, I wanted to highlight one of his experiences while awaiting trial: a civil lawsuit against prison telecom company Securus.

What happened?

While he was awaiting trial, Hernandez was held in the Suffolk County Jail in Massachusetts. The county has chosen Securus as the exclusive provider of telecom services for people incarcerated in the jail. According to a document we received, Securus has determined that an unauthorized person (or people) accessed recordings of Mr. Hernandez’s phone calls. Securus later informed the federal court that the recorded calls were between Hernandez and his fiancée.

Mr. Hernandez sued Securus in Massachusetts state court, alleging invasion of privacy and other related claims. Securus tried to move the case to federal court, but in March 2017, the U.S. District Court for Massachusetts concluded that the lawsuit did not implicate federal law, and sent it back to state court, where it is still pending.

What does this mean for incarcerated people and the loved ones they talk to?

Securus’s self-serving “Integrity Pledge (link no longer available)” claims that the company understands and honors “confidentiality of calls.” But as with so much corporate PR, when something actually goes wrong, Securus’s commitment to stated principles is nowhere to be found. In response to Mr. Hernandez’s lawsuit, Securus argued that Hernandez couldn’t sue for unauthorized access to call recordings, because “inmates have no expectation of privacy in their communications” and thus Hernandez “suffered no cognizable privacy injury.”

Notably, Hernandez was not suing because jail officials listened to his calls, but rather because he believed that Securus didn’t take adequate steps to prevent a hacker from breaking into the database of recordings and listening to private conversations. Most people realize that law enforcement can listen to non-privileged jail phone calls (Securus has also been accused of illegally taping privileged attorney-client phone calls, but this did not appear to have happened in Hernandez’s case); however, this should not mean that private phone calls can be shared with anyone in the world. Nonetheless, this is basically what Securus is arguing when it says that Hernandez doesn’t even have a right to go to court.

What additional concerns does this raise for families and friends of incarcerated people?

The same privacy concerns discussed above also apply to family and friends who call or video-chat with incarcerated people. But folks on the outside have another potential source of worry: they are often granting Securus access to their personal computers.

In the case of video visitation, Securus requires users to install a Java applet that—according to Securus—allows the transmission of audio and video. When users install the applet, they receive a warning that the applet “run[s] with unrestricted access which may put your computer and personal information at risk.” Screenshot of Securus unrestricted access applet This warning suggests that Securus’s applet can potentially access unrelated information on a customer’s computer, like photos, emails, or other private files. This, in turn, raises several concerns, given the terms and conditions that customers must agree to.

First, Securus’s privacy policy states that customers agree that Securus can “receive[] and store[] certain information whenever [the customer uses video visitation].” But “certain information” is never defined. Are customers unwittingly granting Securus permission to snoop through their files or eavesdrop through their computer’s microphone? Probably not, but Securus’s confusingly-written contract doesn’t provide any assurances to the contrary.

Of greater concern is Secrurus’s language about monitoring by law enforcement. Securus forces its customers to agree to the following language:

Securus assumes no responsibility for the activities, omissions or other conduct of any member of Law Enforcement (a “Law Enforcement Official”). Relative to [video visitation], Securus acts solely as a portal for the online distribution and publication of electronically distributed information and has no obligation to screen communications or information in advance and is not responsible for screening or monitoring electronic communications sent via this Service.

If the Java applet does create a backdoor into a user’s computer (either intentionally or accidentally), then law enforcement could exploit this backdoor (either on their own or at Securus’s invitation), and access private information on a user’s computer. In such a scenario, Securus has set itself up to disclaim any liability—an argument that is foreshadowed in the Hernandez lawsuit.

Securus is able to charge high prices because it knows it can exploit the desire of families who want to maintain contact with their loved ones. Adding insult to injury, Securus now argues that its customers have no privacy rights whatsoever. And making matters even worse, Securus’s terms of service don’t clearly tell customers what information they are surrendering.

While Aaron Hernandez had the resources to fight back, most incarcerated people do not. This situation illustrates an increasingly obvious fact: as prisons adopt new technologies (like video visitation, electronic fund transfers, and electronic messaging), incarcerated people and their families will be unfairly exploited unless lawmakers get serious about extending consumer protections inside the prison walls.


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.

Graph showing how much minimum wage earners in each state would pay if a single co-pay took as many hours to earn as a co-pay charged to an incarcerated person does. The average equivalent co-pay is about $200 and in West Virginia, it's over $1,000. 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.

This table includes co-pay fees for non-emergency, patient-initiated visits with medical staff. The co-pay average excludes Texas, which charges on a yearly basis rather than per-service. For details and sourcing information on co-pays, see the Appendix. For information on wages, see “How much do incarcerated people earn in each state?” State minimum wage information was obtained from the National Conference of State Legislatures. Exceptions: for states with no minimum wage law or minimum wages below the federal law, I used the federal minimum wage. For states with two tiers of minimum wages for free-world workers, I used the higher wages that apply to larger businesses (Minn., Mont., Ohio, and Okla.). For Nevada, I used the lower of the two minimum wage tiers, which applies to jobs with health benefits.
Co-pay or fee Prison job minimum wage Hours of work required to afford one co-pay State minimum wage Equivalent co-pay at minimum wage
(hours x minimum wage)
Alabama $4.00 $0.00 n/a $7.25 n/a
Alaska $5.00 $0.30 16.67 $9.80 $163.33
Arizona $5.00 $0.15 33.33 $10.00 $333.33
Arkansas $3.00 $0.00 n/a $8.50 n/a
California3 $5.00 $0.08 62.50 $10.50 $656.25
Colorado $3.00 $0.13 23.08 $9.30 $214.62
Connecticut $3.00 $0.13 23.08 $10.10 $233.08
Delaware $4.00 n/a n/a $8.25 n/a
Florida $5.00 $0.00 n/a $8.10 n/a
Georgia $5.00 $0.00 n/a $7.25 n/a
Hawaii $3.00 $0.25 12.00 $9.25 $111.00
Idaho $5.00 $0.10 50.00 $7.25 $362.50
Illinois4 $5.00 $0.09 55.56 $8.25 $458.33
Indiana $5.00 $0.12 41.67 $7.25 $302.08
Iowa $3.00 $0.27 11.11 $7.25 $80.56
Kansas $2.00 $0.09 22.22 $7.25 $161.11
Kentucky $3.00 $0.13 23.08 $7.25 $167.31
Louisiana $3.00 $0.04 75.00 $7.25 $543.75
Maine $5.00 n/a n/a $9.00 n/a
Maryland $2.00 $0.15 13.33 $8.75 $116.67
Massachusetts $3.00 $0.14 21.43 $11.00 $235.71
Michigan $5.00 $0.14 35.71 $8.90 $317.86
Minnesota $5.00 $0.25 20.00 $9.50 $190.00
Mississippi $6.00 $0.00 n/a $7.25 n/a
Missouri $0.00 $0.05 0.00 $7.70 $0.00
Montana $0.00 $0.16 0.00 $8.15 $0.00
Nebraska $0.00 $0.16 0.00 $9.00 $0.00
Nevada $8.00 n/a n/a $7.25 n/a
New Hampshire $3.00 $0.25 12.00 $7.25 $87.00
New Jersey $5.00 $0.26 19.23 $8.44 $162.31
New Mexico $0.00 $0.10 0.00 $7.50 $0.00
New York $0.00 $0.10 0.00 $9.70 $0.00
North Carolina $5.00 $0.05 100.00 $7.25 $725.00
North Dakota $3.00 $0.19 15.79 $7.25 $114.47
Ohio $2.00 $0.10 20.00 $8.15 $163.00
Oklahoma* $4.00 $0.05 80.00 $7.25 $580.00
Oregon $0.00 $0.05 0.00 $9.75 $0.00
Pennsylvania $5.00 $0.19 26.32 $7.25 $190.79
Rhode Island $3.00 $0.29 10.34 $9.60 $99.31
South Carolina $5.00 $0.00 n/a $7.25 n/a
South Dakota $2.00 $0.25 8.00 $8.65 $69.20
Tennessee $3.00 $0.17 17.65 $7.25 $127.94
Texas5 $100.00 per year $0.00 n/a $7.25 n/a
Utah $5.00 $0.40 12.50 $7.25 $90.63
Vermont $0.00 $0.25 0.00 $10.00 $0.00
Virginia $5.00 $0.27 18.52 $7.25 $134.26
Washington $4.00 n/a n/a $11.00 n/a
West Virginia $5.00 $0.04 125.00 $8.75 $1,093.75
Wisconsin $7.50 $0.09 83.33 $7.25 $604.17
Wyoming $0.00 $0.35 0.00 $7.25 $0.00
Federal $2.00 $0.12 16.67 $7.25 $120.83
Average* $3.47 $0.14 25.09 $8.30 $208.25

 

Footnotes (including updates)

  1. This was updated April 28, 2017 with information from a new source on wages for Oklahoma’s regular prison jobs (non-industry). The source used when this was first posted did not state a minimum prison wage, only a maximum. According to DOC policy, however, the minimum wage for regular jobs is $7.23 per month, or about 5 cents per hour. A $4 co-pay for someone earning that much is the equivalent of a $580 co-pay charged to a non-incarcerated minimum wage earner in Oklahoma. The table, text, and graphs in this post have been updated to reflect Oklahoma’s updated information.  ↩
  2. As of 2019, the Texas legislature had made progress by replacing the notorious $100 fee Texas had charged incarcerated people with a $13.55 per-visit fee. While this change marks a substantial improvement, incarcerated people in Texas – who earn nothing for their labor – continue to be charged the highest medical co-pay in state prisons nationwide.  ↩
  3. In 2019, California passed legislation ending medical co-pays in prisons and jails.  ↩
  4. In 2019, Illinois passed legislation ending medical co-pays in state prisons and juvenile residential placement facilities.  ↩
  5. As of 2019, the Texas legislature had made progress by replacing the notorious $100 fee Texas had charged incarcerated people with a $13.55 per-visit fee. While this change marks a substantial improvement, incarcerated people in Texas – who earn nothing for their labor – continue to be charged the highest medical co-pay in state prisons nationwide.  ↩

Stephen Raher reviews Cathy O’Neil's book, Weapons of Math Destruction: How Big Data Increases Inequality and Threatens Democracy.

by Stephen Raher, April 18, 2017

Weapons of Math Destruction book coverCathy O’Neil has a Ph.D in math, and has worked in academia, finance, and data analytics. Fortunately for everyone, she recently decided to use her skills to write an informative and accessible exploration of “Big Data” in her book Weapons of Math Destruction: How Big Data Increases Inequality and Threatens Democracy.

Referencing the collateral damage caused by weapons of mass destruction, O’Neil coined the term “weapons of math destruction” (WMDs). She defines WMDs as opaque mathematical models that embed human prejudice, misunderstanding, and bias into the software systems that automate numerous aspects of our lives. Her book covers several types of these models and the frustrating injustices they can perpetrate. In addition to case studies about credit scoring, online advertising, employment, and insurance, O’Neil discusses the use of WMDs in the criminal justice system. In particular, the book considers models used to deploy police, predict a defendant’s chances of recidivism, and calculate prison sentences.

Weapons of Math Destruction covers a lot of ground, but four distinct themes emerge in connection with the criminal justice system’s use of WMDs.

1) Fairness

The book repeatedly points to the unfairness that results from WMDs. O’Neil gives examples of algorithms that map crime so that police can predict crime hotspots, as well as models that take demographic information about a criminal defendant and calculate a “risk score” purporting to predict the likelihood that the defendant will recidivate. Although the creators of such WMDs usually claim not to consider race as a factor, facially neutral data like neighborhood can act as a highly accurate proxy for race. As a result, mathematical models, which are marketed as supposedly removing human bias from the system, often perpetuate racial discrimination.

WMDs also work to the disadvantage of low-income people. Crime-mapping programs direct police to focus on poor neighborhoods with high crime rates, leading to increased arrests in those areas (usually for “quality of life” non-violent offenses), thus reinforcing the initial data that led to heavier policing of poor neighborhoods. Residents from these localities who are convicted of crimes are—because their friends and neighbors are more likely to have criminal records—more likely to be flagged by risk-scoring models as high recidivism risks and receive longer sentences. As other researchers have noted, this faulty logic shifts responsibility for community-wide problems to individuals who have no control over neighborhood conditions like racial profiling, inadequate job opportunities, limited educational opportunities, and lack of access to mental health care. In O’Neil’s words, because WMDs have no way of considering fairness, “the result is massive, industrial production of unfairness. If you think of a WMD as a factory, unfairness is the black stuff belching out of the smoke stacks. It’s an emission, a toxic one.”

It’s also important to remember that unfairness isn’t always an unintended byproduct of WMDs. After publishing Weapons of Math Destruction, O’Neil has written about the current presidential administration’s intentional steps to distort data in an effort to criminalize immigrants.

2) Legality

In addition to the broader issues of fairness, O’Neil points to narrower questions of legality. Even though recidivism risk scores are problematic from the outset (as discussed above), they could arguably be useful as one of several factors in making certain decisions (for example, identifying people who could benefit from intensive education or therapy programs). But grave legal issues are implicated when these models are used in determining a criminal sentence (a practice that is currently used in nine states, according to a 2016 ProPublica report, and which seems to be gaining in popularity). The U.S. Constitution guarantees that a criminal defendant can confront witnesses and challenge the evidence presented against him or her. But O’Neil explains that recidivism risk scores, unlike witness testimony, cannot be recorded and challenged in court, but instead “are tucked away in algorithms, intelligible only to a tiny elite.” Moreover, risk scores can be based on information that would not be admissible in a court proceeding, such as the criminal background of a defendant’s friends and family members, or the crime rate in his or her neighborhood.

3) Garbage in, garbage out

Ever since the early days of computer programming, programmers have acknowledged that inaccurate input data will produce inaccurate results. In the criminal justice context, this arises when deciding what type of crime statistics to feed into a WMD. When discussing crime-mapping, O’Neil posits that if a model is built on data about burglary, car theft, and violent crime, then perhaps the results could be useful in deploying limited police resources (although, even then, she acknowledges that crime reports and arrest records aren’t particularly reliable proxies for the true amount and nature of criminal activity). The big problem comes when nuisance offenses like vagrancy, panhandling, and simple drug possession are fed into models. These data distort crime calculations, fueling the proliferation of “broken windows policing” and ever-growing numbers of arrests.

On the flip side of the coin, plenty of harmful crime is not incorporated into WMDs. Financial firms defraud customers (sometimes nearly bringing the global economy to a halt) and industries violate environmental laws—but these harmful activities are not included in crime-prediction models, and the algorithms do not dispatch battalions of police to look for violations in wealthy suburbs and gated communities. As O’Neil writes, “[t]he result is that we criminalize poverty, believing all the while that our tools are not only scientific but fair.”

4) Using data for good

Finally, O’Neil expresses her frustration with the fact that sophisticated mathematical models can be used to improve society, but such deployment is not common because it would threaten entrenched powers. For example, she notes that prisons collect massive amounts of data on incarcerated persons, yet this information is not used to tackle questions like: what are the impacts of solitary confinement, what are effective tools for combatting sexual assault in prison, and what types of prison experiences (big or small) effectively reduce recidivism. Data that could be used to address issues like these are either not held in a usable format, or are purposely withheld from researchers. According to O’Neil, prison administrators “use data to justify the workings of the system but not to question or improve the system.”

Food for thought

I found Weapons of Math Destruction to be a good read because it provides an expert’s insight into how WMDs impact all of us. But this is a huge topic, and at roughly 200 pages, O’Neil’s book can’t cover all the ground, particularly in regards to criminal justice. There are many topics that remain lurking in the background, including three that come immediately to my mind.

First is the proliferation of data sources that can potentially feed WMDs. When discussing criminal-justice WMDs, O’Neil frequently mentions data comprised of arrest records, court records, and other public documents, but doesn’t explore the growth of “alternative” datasets that could be sucked up into risk-scoring algorithms. There is cause to worry on this front. In a report that I wrote for the Prison Policy Initiative last year, I noted that some prisons are embracing electronic messaging as an alternative to mailed correspondence to and from incarcerated persons. These services are typically operated by private contractors that provide users with little or no privacy protections. This raises the all-to-real possibility that years’ worth of correspondence between an incarcerated person and their family could be used as data in a risk-scoring WMD. As another example, the federal Bureau of Prisons is trying to weaken financial privacy protections so that it can collect banking information on people who send money to people in prison (the Prison Policy Initiative and other groups have formally opposed this move, and BOP has not yet finalized the draft rule).

Second, the ease with which data travels can mean that it’s harder for formerly-incarcerated people to escape the stigma attached to a criminal record. As more businesses and government agencies rely on WMDs to automate decision-making, criminal records will inevitably flow through more databases, thus ensuring an ever widening net that prevents formerly incarcerated people from meaningfully participating in economic, civic, and social life. Communities must start discussing fair ways to honor public access to information without condemning formerly incarcerated people to a permanent diminished tier of citizenship.

Finally, there is the fact that opaque and unfair WMDs developed in the criminal justice system today are likely to be applied to society-at-large tomorrow. News reports recently indicated that about half of the adult population of the U.S. is unwittingly contained in an FBI facial-recognition database that has a reported 15% inaccuracy rate (and is far more likely to misidentify Black people). While we can expect to see more expansion of such systems, the real question is where this leads: will experiments such as the FBI’s catalyze a thoughtful discussion of privacy, fairness, and expectations about risk; or, will they hasten a Minority Report-style society where people are punished because they might commit a crime in the future?


Some legislators are beginning to take notice of the abusive video visitation industry. Policymakers across the country should consider adopting legislation so that incarcerated people and their families are not prevented from face-to-face contact during difficult times.

by Lucius Couloute, April 10, 2017

As our research has shown, local jails are increasingly replacing in-person visits with expensive and poorly implemented video visitation systems.

Fortunately, some policymakers are taking notice. Illinois State Rep. Carol Ammons introduced a bill earlier this year that would protect in-person visitation from being eliminated in Illinois correctional facilities and limit the cost of video visits. There is also active legislation in New Jersey that would guarantee face-to-face family visits for incarcerated individuals, cap video costs at 11 cents a minute, and ban fees on professional video visits from lawyers and clergy.

Policymakers across the country should consider adopting similar legislation so that incarcerated people and their families are not prevented from in-person contact during difficult times. Preserving face-to-face visitation is not just humane, it’s good policy because contact between incarcerated people and their loved ones is proven to reduce the likelihood that an individual will re-offend after release.

For more information on this issue and efforts to protect in-person visitation, see our report on the video visitation industry.




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