Dwight Reception and Classification Center
Dwight Reception and Classification Center
The Dwight Reception and Classification (DRC) served as the intake, classification and processing center for all adult female inmates in Illinois. The facility was housed within Dwight Correctional Center (Dwight), a maximum security adult female correctional center. It is now closed.
The complex process of receiving, identifying, screening, and classifying adult female inmates at the Dwight Reception and Classification Center (DRC) is substantially the same as the process of receiving and classifying adult male offenders at Stateville’s Northern Reception and Classification center (NRC), with some key differences. The most obvious distinction is that there are far fewer female inmates than male inmates in Illinois, making DRC smaller and more logistically manageable.
This is not to suggest that DRC’s challenges are insubstantial. The dramatic increase in the female prison population over the last 20 years, fueled largely by harsher drug sentencing laws, continues to put increased strain on DRC’s ability to safely and reliably screen, classify, and place inmates. A recent study by the Illinois Criminal Justice Information Authority provides some good news, insofar as admissions of female inmates for drug offenses are decreasing in Illinois prisons. However, this same study found that the average age of female inmates has increased along with the number of inmates with children, making this population’s healthcare and social service needs even more complex and demanding.
JHA’s inspection of DRC revealed a clean, orderly and well-maintained facility. We were impressed by the knowledge and dedication of DRC’s administration and staff, who were not only frank and forthcoming about challenges facing the facility, but also vocal about the importance of treating inmates with dignity and compassion. In general, JHA found the living conditions at DRC to be less harsh than at NRC, with inmates being provided with more generous out-of-cell time, recreation, and privileges. During the initial one to two week period while inmates are awaiting medical clearance, however, conditions at DRC are arguably as difficult and isolating as at NRC because inmates are essentially housed under lockdown with meals served in-cell, no recreation time, minimal out-of-cell time, and very limited privileges, visits, and phone calls.
One feature that likely helps to reduce stress for DRC’s inmates while they are awaiting medical clearance is having access to reliable information about the reception and classification process. JHA was impressed by the thoughtful design of DRC’s Inmate Orientation Manual, which gives inmates thorough, easy to understand information about institutional procedures that might otherwise seem inexplicable. The manual sets out in simple, concrete terms all of the steps in the reception and classification process, what inmates should expect while they are awaiting medical clearance, and the services they will be able to access once they are medically-cleared. Providing inmates with such information at time of intake is vitally important, as this helps to reduce their fear and apprehension and facilitate their adjustment to prison. Studies show that the more personal control an inmate feels over conditions of incarceration, generally the more successful her adjustment to prison life will be.
At DRC, as at NRC, one of the most pressing problems JHA found was the absence of a reliable, modernized system for transmitting inmates’ medical and mental health records and medications to DRC when inmates are transferred from the county jails. Because inmates’ medications and medical records rarely accompany them to DRC, staff must assume that inmates can and will reliably and accurately report and remember all medications as well as medical and mental health issues. Further, it is the policy of DOC to only accept prescriptions written by doctors at other DOC facilities. Accordingly, even if inmates arrive at DRC with legally valid prescriptions or full bottles of medication, they are required to discard them.
The lack of a reliable system for tracking and transferring inmates’ medical data and medications to reception and classification centers presents a serious risk of harm to inmates’ health and well-being. Self-reporting of medical and mental health diagnoses, treatment, and medications is an unreliable means to ensure that inmates receive continuity of care and uninterrupted medication. Indeed, staff at DRC reported that many inmates cannot remember the names of their medications. Lack of continuity of care in the administration of medications presents particular risks for mentally ill inmates, given that sudden discontinuation of psychotropic medication can have serious and debilitating physical and mental health consequences.
Standard 23-6.5(a) of the American Bar Association’s Standards on the Treatment of Prisoners provides: “A correctional agency should ensure each prisoner’s continuity of care, including with respect to medication, upon entry into the correctional system, during confinement and transportation, during and after transfer between facilities, and upon release.” Standard 23-6.5(b) provides: “Prisoners who are determined to be lawfully taking prescription drugs or receiving health care treatment when they enter a correctional facility directly from the community, or when they are transferred between correctional facilities—including facilities operated by different agencies—should be maintained on that course of medication or treatment or its equivalent until a qualified health care professional directs otherwise upon individualized consideration.”
JHA believes that a minimum standard of care requires continuity of care. Without continuity of care, effective diagnosis, management and treatment of inmates’ physical and mental illnesses becomes virtually impossible. In accord with ABA Standards, JHA believes that procedures should be instituted to ensure that inmates’ medical and mental health records and medications accompany them from the county jails to reception and classification centers, and from reception and classification centers to destination facilities. This issue, if left unaddressed, invites serious harm to inmates, as well as court intervention.
Another issue that challenges both the health of inmates and the health of the public is under-screening of inmates for infectious diseases at reception and classification centers, including DRC. At the time of JHA’s visit, DRC screened all inmates for tuberculosis at the time of intake, but did not routinely screen inmates for other serious infectious diseases, including Hepatitis C and HIV. The same practice is followed by DOC’s other reception and classification centers, including NRC.
From a public health perspective, this presents a serious oversight and a lost opportunity. Before their incarceration, most inmates had limited access to health care making them difficult to identify and treat in the general community. For many of the two million men and women incarcerated in the United States, prison thus presents a critical venue to provide diagnosis, disease management, education on prevention of transmission, and treatment to those outside the reach of the conventional healthcare system.11 A highly disproportionate number of inmates suffer from infectious disease compared with the general public. About 1.5 percent of the 2.2 million inmates incarcerated in United States’ prisons and jails have HIV or AIDS, roughly four times the rate of HIV infection in the general population. In particular, female inmates have much higher rates of HIV infection than both the general public and male inmates. Likewise, the level of Hepatitis C infection among inmates is between 12 and 31 percent, much higher than the general population. Indeed, roughly 29 to 43 percent of all persons infected with Hepatitis C in the United States pass through the correctional system each year.
When inmates return to the community, as the vast majority do, but remain undiagnosed and untreated for communicable diseases, they transmit these conditions into the community, threatening public health and greatly increasing the burden on the community’s scarce public health resources. By contrast, when inmates are effectively diagnosed and treated in prison, this not only reduces mortality and human suffering, but protects the public’s health by reducing the rate of disease transmission at great cost-savings to the state.