Friday, May 21, 2010

Walls Won't Protect Us from Bombs

“Everybody wake up
If you’re living with your eyes closed
See the man with a bomb in his hand
Everybody wake up

Oh baby it's not easy sometimes
They build these walls ever higher and hide behind them
Seems an odd way to try and make things right
Oh I feel like I go crazy sometimes

Our finest hour arrives
See the pig dressed in his finest fine
The believers stand behind him and smile
As the day lights up with fire

Everybody wake up
If you’re living with your eyes closed
See the man with a bomb in his hand
Everybody wake up

I remember the words of the misguided fool
Do unto others as you'd have them do
Not an eye for an eye is the golden rule
Just leaves a room full of blind men

And the finest hour arrives
See the pig dressed in his finest fine
Don't believe him leave and stand behind him and smile
As the day lights up with fire"

©Dave Matthews Band

Dave’s words strike a particularly strong chord within me. “We build these walls ever higher to hide behind…” and it does seem an odd way to try and make things right, does it not? Everywhere we turn these days we seem to encounter ever higher and more divisive walls that swallow people inside the shadows of their tyranical, towering, industrial, grayness.

We seem to hold the belief that somehow walls will protect us from all of the evils, darkness and ill winds that the world can blow our way. We learn that solid walls are good from our earliest fairy tales; only the piggy who builds a big brick house can defend himself and defeat the huffing and puffing big bad wolf. Build walls, stay safe.

Good will stay only on the light side and all evil will be contained within secure brick storage containers surrounded by the tallest of walls. If we can push and shove everything dark and ‘evil’ behind brick walls we then will have nothing to fear, right? So we build walls…first with our houses, surrounded by walls and fences…but wait! Two sets of walls can still be penetrated so we build walls around entire neighborhoods. Walls and fences around our schools, our cars, our communities but still we are vulnerable so we expand the walls to surround the country…

As we continue madly building and constructing walls within walls surrounded by…walls, we seem to have forgotten one very important piece of the picture; we have forgotten that every time we build up more walls, we trap people within them, outside of them – divided by them, conquered by the solitariness that comes from living in the shadows of so many damned walls!

For every four new prison walls that are constructed, thousands of lives will ultimately end up decimated and de-constructed. We have built so many walls that it is an inevitable law of gravity and nature that the walls will crumble and start to collapse around us; history bears this lesson out thousands of times over. How many millions of Americans are already being crushed by the weight of these monstrous and inhumane walls? How many more must be destroyed before we come to our senses and realize that instead of building more walls, what we need to do is to work on building bridges that span the distance and division that the walls have created?

No one could argue that some degree of separation from society does keep us safe from ‘the worst of the worst’ of our offenders. But the majority of people sitting behind towering walls in this country right now are not ‘the worst’ – in fact, they are a far cry from it. They are mothers who need drug treatment or safe shelter from an abuser; they are sisters who sold fifteen minutes and a piece of their soul in an alleyway in order to afford their next meal. They are our little brothers who found family and acceptance in neighborhood gangs since mom OD’d and dad is doing a dime for dealing pot…they are fathers, grandfathers and yes, grandmothers. What they are not is 3-headed boogeymen with fangs and claws and all of the other images the screaming, fear-mongering media heads try to portray them as.

Since we cannot see over the walls it is easy to forget that these are people who are just on the other side of them. We remove ourselves and distance ourselves from them in any and every possible way up to and including the subtle shift in lingo we use for all things prison, er, I mean ‘corrections’ affiliated. Political correctness and the softening and blurring of the edges of reality know no bounds. We have replaced a ‘prison system’ with a ‘department of corrections’. We do not put people in prison cells anymore; we now apparently house them in ‘dorms’ inside ‘correctional facilities’ or ‘institutions’. Last but not least, we are not housing prisoners or convicts but rather, inmates and offenders. As though changing the wording somehow removes them from our realm of responsibility…

People need to wake up and start seeing beyond the thinly sugar encrusted walls our politicians talk us into believing in and realize that we are all responsible for what happens to the millions of American citizens that are held prisoner behind the seemingly impenetrable walls that we feel so comforted and protected by. What is going on behind the walls, out of our view; the abuse, the neglect…the downright shameful and torturous conditions is doing anything but keep us safe.

Until there is real and genuine transparency and accountability in our prisons, we are all going to be continually exposed to “the man with the bomb in his hand” as more and more of our brothers and sisters are being driven to violent, drug induced, sensory deprived and unnecessary madness before being set free to navigate through the mad maze of walls that our society has become.

We can’t wait much longer; we’ve been living with our eyes closed for far too long now and it is high time we “see the man with the bomb in his hand” and take the practical and necessary steps to diffuse the bomb or else risk the fallout when hundreds of thousands of people pushed beyond human limitations finally explode, “the day lights up with fire” and our precious walls crash down upon us all.

Rebecca McFarland
©2010

Tuesday, May 18, 2010

Scott Watch: Unconstitutional Living Conditions

Unconstitutional Living Condition ~ Unedited ~By Jamie Scott ~ Please Forward to Media Outlets
 
April 20, 2010

Jamie Scott # 19197
CMCF/2A-B-Zone
P.O. Box 88550
Pearl, MS 39288-8850


The living condition in quickbed area is not fit for any human to live in. I have been incarcerated for 15 years 6 months now and this is the worst I have ever experience. When it rain out side it rain inside. The zone flood like a river. The rain comes down on our heads and we have to try to get sheets and blankets to try to stop it from wetting our beds and personnel property. Because the floors are concrete and it have paint on it, it makes it very slippery when it rain and there have been numerous of inmates that have broke their arms and hurt there self do to this. Above our heads there are rows and rows of spiders as if we live in the jungle. There are inmates that have holds in there bodies left from spider bites, because once they are bitten it take forever to get to the clinic for any help. There are mold in the bathroom ceiling and around the walls and toilets. The toilets leak sewage from under them and they have the inmate men to come in and patch them up occasionally. The smell is awful. The showers are two circular poles with five shower heads on each pole. The floor in the shower is also concrete and slippery. There is nothing to hold on to when you exit the shower so there have been many inmates that have hurt there self in the process. Outside the building there is debirs where the unit is falling apart. Each day we are force to live in these conditions. The staph infection is so high and we are force to wave in toilet and sewage water when we have to go to the bathroom. I have witness to many inmates die at the hands of this second rate medical care. I do not want to be one of them. When this is brought to the health department or anyone attention. The MDOC tries to get the inmate to try to pamper it up so if someone comes in it want look as bad as the inmates said it did. I am fully aware that we are in prison, but no one should have to live in such harsh condition. I am paranoid of catching anything because of what I have been going throw with my medical condition. We are living in these harsh conditions, but if you go to the administration offices, they are nice and clean and smell nice because they make sure the inmates clean their offices each day. They tell us to clean the walls. Cleaning the walls will not help anything. Cleaning the walls will not stop the rain from pouring in. it will not stop the mold from growing inside the walls and around us. It will not stop the spiders from mating. They have 116 inmates on each wing, and we live not five feet from each other in order to pack us in. We have the blowers on the ceiling and if the inmates are acting crazy or the staff come in mad they use the blowers as a form of punishment. The taxes payers really are lead to believe we are been rehabilitated. That is a joke. All we do is sit in this infected unit and build up more hate. Rehabilitated starts within you. If you want to change you will change. One thing about MDOC, they know how to fix the paper work up to make it seen as if they are doing their job. You can get more drugs and anything else right here. I have witness a lot in my time here. Do I sound angry, I am not I am hurt and sick. Because they have allowed my kidney to progress to stage five which been the highest. They told me years ago I had protein in my urine, but I went years without any help. Now, it seen the eyes are on me because my family are on their case. Every inmate is not without family. Yes, you do have many inmates that family have giving up on, but my sister and I are not them. I do not want special attention; I want to treat, and to live how the state says on paper we are living. The same way when it is time for the big inspection we are promised certain food if we please clean up to pass this inspection. So I beg of anyone to please understand Mississippi Department of Correction is a joke. They will let you die or even kill yourself. We are told when visitors come into the prison do not talk to them. Well I have the right to talk to anyone and if the health department or anyone comes I will talk to him or her, because this is my life and I should or anyone else should be force to live like this. They use unlawful punishments to try to shut us up. I need help. I need a inmate to help me, but for some reason they will not allow me to move with my sister, so she can help me. There are mother and daughter, aunties, and nieces housed together and also there are a total of 12 inmates acting as orally for others inmates. I have all the names of the inmates acting as a orally if need to be giving. However, the subject of my sister is been danced around. A form of discrimination. My sister (Gladys Scott) and I were housed together for over ten years and not once have we ever caused any problem. We were spit up because in 2003 the Commissioner came with the order to separate all family members. Because its payback because my family is holding them accountable to do what they are paid to do. Also, do to the fact Mr. Daniels on it’s a New Day & Grassroots are keeping the supports inform that is been pointed out to me in a negative way. Now that I am sitting everyday because of my sickness I have time to use my typewriter. MDOC have gotten away with to much. In addition, some of the things that go on here I truly believe that Mr. Epps do not know.

Saturday, May 15, 2010

Gray-Haired Witnesses for Justice: Hunger Strike!

The Gray-Haired Witnesses for Justice are conducting a Hunger Strike  at the Department of Justice Headquarters in Washington, DC  on June 21, 2010.



Contacts:  Ruby Sales / B.J. Janice Peak-Graham


1-706-323-0246            
   - spirithousedc@gmail.com

We, who are three strikes removed from the center of the power structure of this country, want to raise the political consciousness of the nation while standing as the moral soul of the nation. We are Gray-Haired Witnesses who have struggled from time immemorial within the Black community.  We are building towards a movement in history and we need all people of good will to be a part!  

When Ida B. Wells stood up, she set in motion a resistance movement where many Americans broke their silence against lynching and said NO. She stood for a race of people bereft of political power or resources.  More than 100 years later Gray-Haired Witnesses, Black women with a new Freedom Movement calling on this nation, stand in the spirit of those proud men and women who won hard-fought for victories in struggle and blood.  We speak to the totality of the struggle of the Black woman who is debased regularly as uneducated, immoral, subhuman, whore, bad mother, and welfare queen. We also recognize the systemic racism that leads the police to even arrest the Black woman in
the first place, the racism during sentencing, during incarceration, in dealing with social services, education, health discrimination, and beyond.

Over the last 20 years, the women’s population in US prisons has more than tripled.  Most women are in prison as a result of drug selling, addiction, domestic violence and criminal acts mostly related to men.  Too many are victimized by biased and negligent lawyers and judges. The evidence of oppression against Black and poor women significantly increased and continues to mount. Our Sisters are victimized, and subsequently our families, by enormous health care disparities, and emotional degradation through corporate media demonization of our image and place in our community. We now see a coalition of corporate, cultural and political wars fully embracing a White supremacist culture of domination and terrorism.

Our primary focus is the case of the Mississippi Scott Sisters, Jamie and Gladys, whose almost 16 yrs of unjust incarceration is a shocking revelation of the pure nothingness with which our lives are deemed in the eyes of this society and world, where such egregious travesties of justice are heaped upon our women with hate-filled arrogance and in plain view!  In 1994, the State of Mississippi sentenced Jamie and Gladys Scott  to consecutive double-life terms each for two counts of armed robbery they did not commit.  They did not have prior criminal records, vigorously maintained their innocence, approximately $11 was said to have been netted, no one was harmed or injured and no weapon was ever recovered.

In January, 2010, Jamie Scott suffered failure of both kidneys.  The combination of absymal health care under deplorable conditions has culminated in her steep decline to stage 5 (end stage) kidney disease. 
 Jamie Scott has now effectively been sentenced to death.  We must address this specific issue with urgency and demand that an Inspection and Observation Team be allowed into the Pearl, MS prison where Jamie Scott is being held for independent evaluation, as well as call on this government to free Jamie and Gladys Scott, wrongfully convicted and with no business being incarcerated in the first place!  The case of the Scott Sisters is a horrific representation of the cases of countless other Black and poor women who have been denied the benefits of true justice and been incarcerated wrongly and in the process punishing, injuring and destroying Black families and children across the nation.

The Gray-Haired Witness are calling on all people of good will to fast and strike and resist with us across the nation on this day. The greatest asset we have is our body, mind and spirit and our willingness to step out of the daily flow of life and stand tall for what is right and just.  In the tradition of race women throughout history and our survival, we declare our presence and we will not be silent and we are not afraid.
 Our lives have prepared us to come to this place, at this time.


STAND WITH US IN WASHINGTON, DC AND HELP TO BUILD THIS EVENT.  


WE ASK THAT YOU STAND IN SOLIDARITY WITH US:

1.
Organize attendees to come to the event on June 21.
2. Sign your organization/club/church/mosque/temple, etc. on in solidarity with the event.

3.
Put a statement in support on your website and link to our blogspot.  Send a mailing to your email list and memberships.

4.
Assist in distributing literature for this event to build it to the maximum level.  

5.
Assist in garnering press now and at the event.
6. Organize a local fast where you are and send a press release to local news outlets about the hunger strike and your local support efforts.

7.
Dress and wear buttons in solidarity with us on that day.

8.
Assist with donations towards expenses earmarked "Gray-Haired Witnesses" at http://www.spirithouseproject.org/donation.cfm.


We call on our Sisters, our Brothers to join with us to demand what is right.  We must speak loudly and clearly to the devaluation of Black women's bodies and lives.  We want people of all colors to wage a struggle and stand with us on these issues because none of us are free until we are all free.


SHAKEERAH ABDUL AL-SABUUR, Paralegal

FATIRAH AZIZ, ICFFMAJ, African American Freedom & Reconstruction League, Quba Institute
MAE JACKSON, Art without Walls
MARPESSA KUPENDUA, M'Backe House of Hope, Inc.
DEBRA D. NAPIER, PhD.
BJ JANICE PEAK-GRAHAM, OUR COMMON GROUND Communications, Inc., Progressive Alternative Talk Radio 
RUBY NELL SALES, Founder and Co-Director of SpiritHouse project - Public theologian, educator and long time runner for justice
JAMIA SHEPHERD, Founder/President of S.O.P.E. - Support Our People's Efforts 

The SpiritHouse Project
100 6th Street
Columbus, GA  31901

Friday, May 14, 2010

Phillip Gibbs, James Green, and the colors of Resistance.



Those of us who know Vietnam protest history at all know about the white kids murdered by the Ohio National Guard while protesting  at Kent State in 1970. Look again at all our history books: the anti-war movement is usually given a righteous young white face - despite the fact that the black community was in overwhelming opposition to the expanding  war, since their young men made up most of the US Army's front line fodder. In fact, Martin Luther King was beginning to vociferously challenge both the racism of the war and US imperialism when he was assassinated two years earlier.

So, today the story is about the kids killed in Mississippi at Jackson State College during their own uprisings just ten days after Kent State - the kids that even our leftier history teachers often forget to mention. They were 21-year old Phillip Lafayette Gibbs, and 17-year old high school senior James Earl Green. I was going to post the Democracy Now transcript on it - which isn't bad - but you'll have to Google if that's what you want. Here's the link to Jackson State College's Gibbs-Green Memorial page instead. Like the pages missing from our history books - the whole chapters left out - this school's page was strangely hard to find.

Thursday, May 13, 2010

Jackson Co. NAACP Celebrates Oppressors: The Resistance Responds.

No Banquets! Free Jamie and Gladys Scott!
Represent Our Resistance

By Dr. Lenore J. Daniels, PhD
BlackCommentator.com Editorial Board
May 6, Issue 374

We, the Black masses, don't want these leaders who seek our support coming to us representing a certain political party. They must come to us today as Black Leaders representing the welfare of Black people. We won't follow any leader today who comes on the basis of political party. Both parties (Democrat and Republican) are controlled by the same people who have abused our rights, and who have deceived us with false promises every time an election rolls around.
-Malcolm X

Jamie Scott suffers from kidney disease. She receives inadequate medical care, but the Jackson County Branch of the NAACP in Mississippi last month (April) held a banquet, “NAACP: One Nation, One Dream,” to honor individuals and organizations for their outstanding service to the community. Christopher Epps, commissioner for the Mississippi Department of Corrections was recognized for his - work.

Epps (Black American) is the “longest serving commissioner in the history of the agency,” according to MDOC’s website. Appointed by Gov. Ronnie Musgrove in 2002 and then reappointed by Gov. Haley Barbour in 2004, Epps must have done his work quite well.

Mrs. Evelyn (Rasco), Jamie’s mother, spoke to Epps in March of this year on behalf of her daughter. Jamie, she told him, is very ill; she needs serious medical care. Jamie and her sister Gladys were wrongfully convicted and sentenced to double life each for an $11 dollar robbery. The wallet re-appeared with the money. The accusers admitted to supplying false testimonies against the young women then. But its 15 years latter and now Jamie is ill.

Epps told Mrs. (Rasco) that he would do “everything in his power” and work to have the Scott sisters released from prison, according to legal analyst Nancy Lockhart. Now it seems that Epps isn’t so sure this is his work - securing medical care for Jamie or securing the release of Jamie and Gladys. Maybe Jamie isn’t so ill. Maybe she isn’t so truthful about her experiences with the prison’s medical personnel.

“I’ve talked with Jamie many times. I know Jamie. I can’t imagine Jamie would lie. I have never known Jamie to lie,” Lockhart told me.

No, I can’t imagine that any woman in the end-stage of kidney disease, receiving inadequate treatment, living in a cell with spiders and moldy walls would lie about her condition. No, not many could imagine a woman lying about the pain and bleeding of 4-5 caterers that had been placed in her neck or the bleeding from the caterer (placed in her groin) that fell out. No human being would imagine another would be lying while they suffer from a life-threatening disease.

But Epps seems to have doubts. Something is wrong with this story!

I agree. Something is strange about this story!

The Jackson County Branch rewards Christopher Epps for his outstanding community work! People have to be congratulated for their community work - in this post-racial era! That’s strange considering that surveillance teams are watching and recording a good many of them!

Immigrant communities, particularly Latino/as and Haitian communities, are working to organize resistance to the legalization of racial profiling and racial terror. Native Americans are working to organize resistance to the effort of the government to run bulldozers over their lands and their lives. Muslim communities are working to organize resistance to the targeting of their mosques and community organizations.

While community organizations, focusing on the fallout of war waged against Black Americans, organize to tackle housing, unemployment, gentrification of neighborhoods, and high infant mortality rates, the Black community isn’t organized to confront the U.S. Empire that perpetuates these conditions. On the contrary, mainstream Black organizations fear losing their credibility with Empire and, in turn, they fear losing economic and political support.

These organizations can’t identify themselves as critics of the U.S. Empire. So banquets - out of reach of Jamie, her sister, and their mother - are organized to do what? Honor whom? Collaborators, obedient servants - who are also intended to serve as symbols of Black success? Look at the number of Black Americans who can afford to attend the awards banquet! Look at the “exceptional,” outstanding professional Blacks honored for their work.

In the meantime, NAACP representatives aren’t knocking on Black residents’ doors to urge them to come out, stand together to engage in civil disobedience. The NAACP won’t organize troops of people from the communities of Red, Black, Brown, and Muslim to appear in Washington D.C. and demand an end to the laws and policies that have incarcerated 2.3 million Americans.

Be practical! How could we remain the NAACP without government funding?

But the question should be - how do members of the NAACP continue to tell themselves that its organization represents Black Americans, including the poor, imprisoned, and working class in the tradition of Black solidarity?

Do they know that the Black community is collapsing from without and well as from within? Or is the NAACP an organization that does what is safe for the NAACP to sustain its life. It’s safe to honor Epps, but it’s not safe to free the incarcerated like Jamie and Gladys.

When the NAACP planned a study on the effects of prison in the lives of juveniles, Nancy Lockhart approached the regional director about the Scott Sisters’ case. Lockhart was told that the Sisters “didn’t qualify” for the study, but he would refer their case to the “criminal division of the NAACP” and recommend that the division treat the case in the same manner they are treating the Troy Davis case! Lockhart: “How long was Troy Davis in prison before the NAACP responded to his wrongful conviction?” Other legal organizations did the work to free Davis long before the NAACP took note of his imprisonment.

Is it that Davis’ case like Mumia’s case has received international support and it is therefore safe enough for the NAACP?

As Michelle Alexander writes in The New Jim Crow: Mass Incarceration in the Age of Colorblindness, “mass incarceration depends for its legitimacy on the widespread belief that all those who appear trapped at the bottom actively chose their fate.” No group believes this fallacy more than the Black middle class. While a few more Blacks per year are seated at banquet tables, oblivious to the day-to-day plight of Blackness in the U.S., there’s a steady increase of Black children and young people hurdled into the criminal justice system each year. Unfortunate environment! Wrong parents! The judgment of a divine mind! Jamie and Gladys Scott are just not - exceptional--they’re just common.

Overlook them! They can’t vote! They don’t count!

The system has regulated our relations with one another to its benefit and our detriment.

Consequently, we no longer, as a collective, heed Martin Luther King's warning that, to quote from Alexander, “racial justice requires the complete transformation of social institutions and dramatic restructuring of our economy, not superficial changes that can [be] purchased on the cheap.” Work that contributes to the continuation of U.S. Empire’s practice of aggression can’t transform or dramatically restructure the institutions that enslave the majority of humanity.

The horrors of Empire are more easily recognized when on display over there. But the horrors of U.S. Empire are here. Palestine is here. The West Bank and Gaza are here in the U.S. in the barrios, on the reservations, in urban communities, and in rural prisons. We don’t see it, but the War on Drugs and immigrant laws lock away Black and Brown people here. Unarmed young men are shot 20, 30, and 41 times for being Black while they hold a cell phone, or ride a subway, or attend a bachelor’s party.


The re-settlement scheme, otherwise known as gentrification, forces people to sleep on park benches and in public library sitting rooms. Systemic unemployment and low wages create conditions of impoverishment for thousands of children here. Racial profiling and militarized borders and neighborhoods subject people to fear and shame. Here in the U.S., millions of people for whom the political and economic domestic policies resemble the foreign policies enforced over there, these conditions are too close for Americans to see.

It’s sad to see Black organizations lacking the will and desire to break free and work on behalf of those abused, tortured, imprisoned, killed by the Empire. It’s hard to see how such organizations can direct a movement that would bring about structural transformations in the U.S. Consequently, we can’t put the spotlight on the kind of work that only strengthens aggressive strategies, except to condemn that work as inhumane.

But we shouldn’t have to see Jamie die before we remember that the U.S. has never played fair with Black Americans. If we recall our ancestors, we’ll remember the meaning of work. Let Malcolm and King be pleased for a change!

Mrs. (Rasco) isn’t getting any younger. “She’s an elderly woman, and Gladys needs to be able to care for her sister,” Lockhart said.

Let’s give Jamie Scott the spotlight and honor her with compassion. Free Jamie and her sister Gladys!

 
--------------------------------------------------
 
SEE:

Appeals Court Affirms that Mississippi Death Row Conditions are Unconstitutional http://www.aclu.org/prisoners-rights/appeals-court-affirms-mississippi-death-row-conditions-are-unconstitutional
Civil Rights Lawyers and Mississippi Department of Corrections Agree to Overhaul Violent Supermax Unit http://www.aclu.org/prisoners-rights/civil-rights-lawyers-and-mississippi-department-corrections-agree-overhaul-violent-
Contact:

www.freethescottsisters.blogspot.com

Mrs. Evelyn Rasco - rqueenbee2222@yahoo.com
Nancy Lockhart thewrongfulconvictions@gmail.com or call 843 217 4649
Christopher B. Epps, Commissioner cepps@mdoc.state.ms.us (601) 359-5600
BlackCommentator.com Editorial Board member, Lenore Jean Daniels, PhD, has been a writer for over thirty years of commentary, resistance criticism and cultural theory, and short stories with a Marxist sensibility to the impact of cultural narrative violence and its antithesis, resistance narratives. With entrenched dedication to justice and equality, she has served as a coordinator of student and community resistance projects that encourage the Black Feminist idea of an egalitarian community and facilitator of student-teacher communities behind the walls of academia for the last twenty years. Dr. Daniels holds a PhD in Modern American Literatures, with a specialty in Cultural Theory (race, gender, class narratives) from Loyola University, Chicago. Click here to contact Dr. Daniels.

Wednesday, May 12, 2010

Scott Watch: Jamie's Health Deteriorating

---------update on Jamie from Free the Scott Sisters-----------------

Jamie Scott did not receive dialysis today as the fistula in her armed has clogged up! It is my understanding that it may be unclogged at this present time.

After passing out today, Jamie was rushed to the hospital by ambulance, from prison. At the hospital she was given an antibiotic shot. Jamie has many boils over her body which are running pus and blood. The doctors at the hospital cleaned the boils and Jamie was sent back to the prison.

Jamie does not sound well at all.

Please contact these officials and let them know that Jamie Scott, #19197, needs to be hospitalized ASAP as she has infections throughout her body that need immediate treatment! Please ask the individuals below to ensure that Jamie Scott remains in the hospital until the infection clears totally.

 
-------------------------


Attorney General Eric Holder
U.S. Department of Justice
950 Pennsylvania Avenue, NW
Washington, DC 20530-0001
HOTLINE: 202-353-1555
PHONE: 202-514-2000
202-307-6777 fax
AskDOJ@usdoj.gov

Dr. Gloria Perry, Medical Department (601) 359-5155
gperry@mdoc.state.ms.us

Christopher Epps
601-359-5600
CEPPS@mdoc.state.ms.us
723 North President Street
Jackson, MS 39202

Governor Haley Barbour
P.O. Box 139
Jackson, Mississippi 39205
1-877-405-0733 or 601-359-3150
Fax: 601-359-3741
(If you reach VM leave msgs, faxes, and please send letters) 

============

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Legal Transcripts: 
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Thursday, May 6, 2010

Gray-Haired Witnesses Hunger Strike – June 21, 2010 Washington, DC for the Scott Sisters

WE ARE THE GRAY-HAIRED WITNESSES
We Stand in wisdom and with courage as the moral consciousness of a Nation

The Call
In 1896, Ida B. Wells, the African American crusader for justice and defender of democracy, said these words, “One had better die fighting against injustice than die like a dog or a rat in a trap.” Her proclamation was a rallying cry for the nation to stand up against lynching and the right of Black men and women to live and move freely with white vigilante groups desecrating and torturing our bodies. When Ida B. Wells stood up, she set in motion a resistance movement where many Americans broke their silence against lynching and said NO. She stood for a race of people bereft of political power or resources. More than 100 years later Gray-Haired Witnesses, Black women with a new Freedom Movement calling on this nation, stand in the spirit of those proud men and women who won hard-fought for victories in struggle and blood. Thousands of ordinary Black people joined with thousands of people of all races to stand with courage to fight for the rights and liberties that are inherent in the Constitution. On the other hand, other people worked relentlessly to move the nation backwards by building an America where only one race and their freedom and bodies mattered. Truth be told, people of color have always lived under the weight of a lockdown society that use laws, torture, and incarceration to attempt to hold us in our places. Like Ida Wells Barnett, we did not back down despite economic, political and social reprisals.

We stand on this history today. We stand before you as Gray-Haired Witnesses asking freedom-loving people of all colors who believe in the dream of Ida B. Wells, of a just, safe and open America for all peoples regardless of our different social locations to break the veil of silence and stand strong in a renewed spirit of moral consciousness for this country. The greatest asset we have is our body, mind and spirit and our willingness to step out of the daily flow of life and stand tall for what is right and just. The jagged tears in the social and cultural infrastructure of Black and poor communities and families are unconscionable and unacceptable to us. We come ready to repair them. In the tradition of race women throughout history and our survival, we declare our presence and we will not be silent and we are not afraid.

Who We Are
We come from a long line of women who refused to bend under the lash of chattel slavery from the time we were first dragged upon these shores until the 21st century slavery of today's prison industrial complex! We witnessed a people living under severe oppression, and with limited resources create the capacity to win without ever discharging the first shot. We were present and part of the crossover from Jim Crow laws into a better place and with some protection. Out of that experience, and of that wisdom, we cannot remain silent and insist on pressing forward for ourselves and our people. Our history and the whispers of ancestral pleadings will not allow us to not meet our obligations to raise up our voices calling for justice and restoration of our people. We are the elder women, the daughters of the American slave system, Jim Crow oppression and the American Freedom Movement. We are gray-haired witnesses who have struggled from time immemorial within the Black community. We who are three strikes removed from the center of the power structure of this country. Our lives have prepared us to come to this place, at this time.

The Mission
Over the last 20 years, the women’s population in US prisons has more than tripled. They are our Sisters. Too many are victimized by biased and negligent lawyers and judges. The evidence of oppression against Black and poor women significantly increased and continues to mount. Our Sisters are victimized, and subsequently our families, by enormous health care disparities, and emotional degradation through corporate media demonization of our image and place in our community.

We speak to the totality of the struggle of the Black woman who is debased regularly as uneducated, immoral, subhuman, whore, bad mother, and welfare queen. Since 80% of women in prison are Black women, all forms of media promote the idea that Black women are worse than other women. Most women are in prison as a result of drug selling, addiction, domestic violence and criminal acts mostly related to men. We also recognize the systemic racism that leads the police to even arrest the Black woman in the first place, the racism during sentencing, during incarceration, in dealing with social services, education, health discrimination, and beyond.

We want to raise the political consciousness of the nation while standing as the moral soul of the nation. We assume this posture because we are ‘bridgers’ and remnants. Many of us lived through segregation and worked to dismantle it through various movements for human dignity, equal rights and justice. We now see a coalition of corporate, cultural and political wars fully embracing a White supremacist culture of domination and terrorism. They use their power and resources to lock down-out and up people of color, especially Black people. They seek to weaken our defenses and power to resist by attacking the strongholds that carried us through enslavement, segregation, and Northern oppression. As part of this campaign they slander and dehumanize the entire Black community in the media and other public spaces.

This is perfectly illustrated by the case of the Mississippi Scott Sisters, Jamie and Gladys, whose almost 16 yrs of unjust incarceration is a shocking revelation of the pure nothingness with which our lives are deemed in the eyes of this society and world, where such egregious travesties of justice are heaped upon our women with hate-filled arrogance and in plain view!

In 1994, the State of Mississippi sentenced Jamie and Gladys Scott to consecutive double-life terms each for two counts of armed robbery they did not commit. They did not have prior criminal records, vigorously maintained their innocence, approximately $11 was said to have been netted, no one was harmed or injured and no weapon was ever recovered. Witnesses testified that they were coerced and threatened to lie on the Scott Sisters and their unbelievable convictions rest entirely on a combination of contradictory, coerced, and potentially perjured testimony by the victims and two other people charged with the crime who were offered lighter sentences for their cooperation. Even if the Scott Sisters were guilty of this crime, the sentence is absolutely unheard of and draconian, at best, and is cruel and unusual punishment without a doubt!

We call on our Sisters, our Brothers to join with us to demand what is right, to require that our government and people of goodwill climb aboard our open train to democracy. We must speak loudly and clearly to the devaluation of Black women's bodies and lives. We want people of all colors to wage a struggle and stand with us on these issues because none of us are free until we are all free. .

The Declaration
We declare that we will act, do what we must, what is required to protect our community, our families and our children from systemic harm which results in their destruction. We will not be pressed down. We will witness from our rich history, in wisdom and with courage.

Immediate and Urgent Plan of Action
Sadly, there is truly a sense of urgency as in January, 2010, both of Jamie Scott's kidneys shut down and during her nightmarish roller-coaster ride of attempting to get competent and effective medical care has suffered so much maltreatment that she has quickly declined to stage 5 (end stage) kidney disease. Jamie Scott has now effectively been sentenced to death.

We must address this specific issue with urgency. It is now a matter of life or death for Jamie Scott. We cannot allow her to further endure inadequate and incompetent medical care which assures her death.

· GRAY-HAIRED WITNESSES HUNGER STRIKE – JUNE 21, 2010 Washington, DC

WE WILL BE HUNGER STRIKING AT THE DEPT. OF JUSTICE IN WASHINGTON, DC DURING JUNETEENTH TO DEMAND FREEDOM FOR JAMIE AND GLADYS SCOTT!

We are demanding an Inspection and Observation Team be allowed into the Pearl, MS prison where Jamie Scott is being held.
More information to come.

Please contact us at: spirithousedc@gmail.com

Please visit: http://freethescottsisters.blogspot.com/search/label/Case%20Summary for complete information on the horrific case of the Mississippi Scott Sisters and Jamie Scott's fight for life.

Wednesday, May 5, 2010

Scott Watch: Jamie's friend passes away.

Mrs. Rasco received word that last evening a 13 yr. friend of Jamie Scott's took a few steps toward her and fell down dead. The guards ran to her aid and tried CPR and everything that they could, but the woman had passed away.


Jamie became hysterical, vomited blood and began losing breath. The guards there ...calmed Jamie, prayed with her, and stayed with her until her heart rate returned to normal. This woman had issues with her medication and health care in the prison for years, and was just questioning her medication earlier that day. The consensus among the inmates was that this woman's death was just another example of the poor medical care in that hellhole.


The issue remains of Jamie vomiting blood, as well as reporting that there are large, infected knots spread in various parts of her body which are painfuland full of pus and blood. Jamie is terrified that she will be the next one to die and reports that her body is again full of infection. She has also been told that she has become anemic and that her blood sugars are only checked on a once weekly basis!


Please support by participating in two action requests!--



1. ACTION

Jamie needs to be hospitalized and cleared of these infections! There also needs to be a determination about the level of medical care she is receiving as it is apparent that she is not being monitored carefully as these infections continue to thrive and remain untreated until there is a demand from the outside.


Please contact these officials and let them know that Jamie Scott, #19197, needs to be hospitalized ASAP as she has infections throughout her body that need immediate treatment!


Attorney General Eric Holder
U.S. Department of Justice
950 Pennsylvania Avenue, NW
Washington, DC 20530-0001
HOTLINE: 202-353-1555
PHONE: 202-514-2000
202-307-6777 fax
AskDOJ@usdoj.gov


Dr. Gloria Perry, Medical Director
(601) 359-5155
gperry@mdoc.state.ms.us


Christopher Epps, Commissioner MDOC
601-359-5600
CEPPS@mdoc.state.ms.us
723 North President Street
Jackson, MS 39202


Governor Haley Barbour
P.O. Box 139
Jackson, Mississippi 39205
1-877-405-0733 or 601-359-3150
Fax: 601-359-3741
(If you reach VM leave msgs, faxes, and please send letters)

2. ACTION
Please e-mail, the following persons at The American Bar Association in support of the Scott Sisters. Please blind Copy (bcc) and paste in all e-mail addresses. A 1-800 number is also included below. Our goal here is to have thousands contact the ABA as there is power in numbers.

PilchenI@staff.abanet.org
KEnglehart@staff.abanet.org
CurdB@staff.abanet.org
windsorp@staff.abanet.org

American Bar Association
Attention: President Carolyn Lamm
321 N. Clark St.
Chicago, IL 60654-7598
800.285.2221

Dear President Lamm:


I would like to bring your attention to the Case of The Scott Sisters. In the state of Mississippi, Jamie and Gladys Scott were convicted of armed robbery. A jury found the sisters guilty in 1994, transcripts conflictingly state that $11 dollars was netted. The sisters received double life sentences each for this crime, had no prior criminal records, and no one was injured in any way.


A 14 year old testified that he was coerced and threatened to be sent to Parchman Penitentiary if he did not lie on the sisters by signing a statement. Other witnesses stated that the sisters were not involved in this crime. Jamie and Gladys Scott were convicted with no physical evidence. The sisters are in need of a pro bono criminal law attorney.


Currently, an attorney is handling Jamie Scott’s medical issues as she has had kidney failure and is receiving sub standard medical care via the MDOC and Wexford Health Sources, Inc.. Jamie Scott is in stage 5 of kidney failure, which is the final stage.


I am requesting that you assist in securing a criminal attorney to review their prior appeals process and determine additional ways to re enter state or federal court. Above all, the sisters should be immediately exonerated. Thank you for your attention in this matter.


Sincerely,


(Your name)

Case Summary: http://freethescottsisters.blogspot.com/search/label/Case%20SummaryLegal Transcripts: http://www.scribd.com/doc/21748820/Scott-transcript


============


Jamie and Gladys want to thank all of the supporters so much for everything that's being done on their behalf, they are so happy to receive mail and to know that we are out here fighting for them and want to make sure that you know how grateful they are!

See More

Tuesday, May 4, 2010

Diabetes: Invest now or pay big later. Patient education essential.

NCCHC CorrectCare

Pay Now or Pay Later: Why the Goal Is Control With Diabetes
By Rebecca B. Jones, RN, BSN, CDE

An epidemic is sweeping the United States. Diabetes affects over 20 million people, almost a third of whom do not know that they have the disease. People with this disease often find out only when an organ has already sustained damage.

The impact extends beyond health. From 1997 to 2002, the annual cost for this disease in medical expenditures and lost productivity rose 35% and the average per capita cost for treatment rose more than 30%.

At any given time, nearly 80,000 people with diabetes are incarcerated. Most of those have type 2 diabetes, which for years was erroneously thought to be a less serious form of the disease. Although any inmate health problem has associated costs for practitioner visits, medications and adjunct therapy, the price tag is even higher for unrecognized and uncontrolled diabetes.

Controlling Complications
Numerous studies, the most familiar being the Diabetes Control and Complications Trial, offer convincing evidence that good control of diabetes, as shown by a lower hemoglobin A1C level, can prevent or reduce the complications (and their related costs) of the disease.

What are those complications? It is well-documented that people with diabetes are two to four times more likely to have a heart attack or stroke. They are 10 times more likely to have an amputation; in fact, comprehensive foot care programs can reduce amputation rates by as much as 85%, according to the American Diabetes Association. Diabetes also is the leading cause of new cases of blindness and of kidney failure in the United States.

The ADA Position Statement on Diabetes Management in Correctional Institutions reflects these findings and provides a framework of preventive and therapeutic interventions that can save health care dollars and achieve better inmate health. The statement addresses such issues as initial and ongoing screening for diabetes, frequency of testing for complications, diabetes management plans, and preventive and educational measures.

ADA clinical practice recommendations also form the basis of the National Commission on Correctional Health Care’s clinical guidelines on diabetes, which are tailored to care in correctional settings.

Although the details of these position statements and guidelines may seem formidable at first glance, good diabetes care primarily requires two things: good understanding of diabetes and knowledge about current therapies, and an organized, methodical approach to management of the inmate’s diabetes care.

One of the most challenging aspects of care is simply staying on top of who gets what test when! For me, an invaluable tool is a spreadsheet of all inmates with diabetes. It notes the required testing and the last results, making it easy to see at a glance who has elevated A1C levels or other out-of-range test results. Another plus of organizing the data this way is that it prevents unnecessary repeats of costly lab work as well as the dreaded FTC (fell through the cracks) syndrome.

Easy as A-B-C
Especially in a correctional facility, the goal is control. All inmates with diabetes should have a management plan that monitors and optimizes their glycemic control. The management plan should focus on three key components, labeled as the ABCs of diabetes management:

A — The A1C test, which measures the average blood glucose level over the past 60 to 90 days, is the gold standard for how well a person’s diabetes is managed overall. Although the goal should be individualized, the management plan should strive for the near-normal A1C goal of less than 7%.

Good glycemic control is achieved through therapies of diet, exercise and medication (if needed). Regular finger-stick blood glucose tests are necessary because they measure the daily effects of the therapies and give practitioners the information needed to make adjustments. Daily blood glucose tests tell us how to fine-tune the therapy; A1C tests tell us the overall success of those adjustments.

B — Blood pressure control is essential in diabetes management. People with diabetes are at especially high risk of coronary artery disease and kidney disease. Blood pressure should be controlled to less than 130/80 mmHg.

C — Cholesterol and triglyceride control are especially important for people with diabetes because of the increased incidence of coronary artery and other blood vessel disease. Often, lipid control follows normalization of blood glucose levels.

I also focus on two other components:

D — Diet, more correctly referred to as medical nutrition therapy, focuses on a healthy way of eating. MNT, by the way, could benefit all inmates in reducing their risk for chronic diseases.
There is no such thing as the “diabetic diet,” at least not any more. Instead, diabetes MNT considers the timing and amounts of carbohydrate intake and choosing “good” fats. It also seeks to add fruit and vegetables to meals and increase fiber intake. This can be very challenging in correctional institutions, but it can be done. Often, there is an almost complete lack of understanding by inmates of making better food choices and portion control.

Which leads to the last, and surely the most important, element of any diabetes management plan:

E — Education. For 25 years I have taught thousands of patients and professionals about diabetes management, and I have learned a valuable lesson: The more you know about diabetes and its management, the better the outcomes.

Knowledgeable health professionals provide better care for patients. And knowledgeable patients make better choices, communicate more effectively with the providers and self-manage their disease better. Diabetes self-management training (DSMT) is a standard of care in the free world, and it can improve the care and cooperation of inmates.

Staff education for both the health care staff and correctional officers should be ongoing to ensure that they have the information and skills to effectively manage inmates with diabetes.

The Bottom Line
Diabetes management really comes down to this: Pay me now or pay me later. You can invest in staff and inmate education, take the necessary steps to follow the standards of care, and make the effort to organize and optimize the medical management of inmates with diabetes, resulting in better outcomes. If you don’t, you most likely will find yourself continually throwing money after the medical problems that plague those with poor diabetes control.

Better glycemic control reduces the complications of diabetes. Fewer complications reduce the health care dollars spent. In the words of Dr. Robert A. Rizza, in an address at the 2006 annual scientific sessions of the ADA, “It costs less to properly treat diabetes than it does to treat the complications that you get if you don’t properly treat diabetes. It’s a wise investment no matter how you look at it.”

About the author: Rebecca B. Jones, RN, BSN, CDE, is a nurse consultant in Wetumpka, AL. To contact her, send an e-mail to thrive.survive@gmail.com.
The position statements and clinical guidelines cited above may be accessed online. For the ADA documents, visit www.diabetes.org. The NCCHC guidelines are posted at the Resources section of our Web site. Additional resources are available from the American Association of Diabetes Educators, www.aadenet.org.

[This article first appeared in the Fall 2006 issue of CorrectCare.]

Diabetes care in prison: American Diabetes Association

This long article about managing diabetes in prison is from the American Diabetes Association's journal, "Diabetes Care", January 2008. Clicking on the title will give you the pdf version with charts and all the footnotes.

Also, a new widget has been added to the left margin of this blog, with the link to the National Commission on Correctional Health Care's standards on diabetes management. Click on the large "Diabetes" sign for that pdf.

--------------------------------

Diabetes Management in Correctional Institutions

  1. American Diabetes Association

At any given time, over 2 million people are incarcerated in prisons and jails in the U.S (1). It is estimated that nearly 80,000 of these inmates have diabetes, a prevalence of 4.8% (2). In addition, many more people pass through the corrections system in a given year. In 1998 alone, over 11 million people were released from prison to the community (1). The current estimated prevalence of diabetes in correctional institutions is somewhat lower than the overall U.S. prevalence of diabetes, perhaps because the incarcerated population is younger than the general population. The prevalence of diabetes and its related comorbidities and complications, however, will continue to increase in the prison population as current sentencing guidelines continue to increase the number of aging prisoners and the incidence of diabetes in young people continues to increase.

People with diabetes in correctional facilities should receive care that meets national standards. Correctional institutions have unique circumstances that need to be considered so that all standards of care may be achieved (3). Correctional institutions should have written policies and procedures for the management of diabetes and for training of medical and correctional staff in diabetes care practices. These policies must take into consideration issues such as security needs, transfer from one facility to another, and access to medical personnel and equipment, so that all appropriate levels of care are provided. Ideally, these policies should encourage or at least allow patients to self-manage their diabetes. Ultimately, diabetes management is dependent upon having access to needed medical personnel and equipment. Ongoing diabetes therapy is important in order to reduce the risk of later complications, including cardiovascular events, visual loss, renal failure, and amputation. Early identification and intervention for people with diabetes is also likely to reduce short-term risks for acute complications requiring transfer out of the facility, thus improving security.

This document provides a general set of guidelines for diabetes care in correctional institutions. It is not designed to be a diabetes management manual. More detailed information on the management of diabetes and related disorders can be found in the American Diabetes Association (ADA) Clinical Practice Recommendations, published each year in January as the first supplement to Diabetes Care, as well as the “Standards of Medical Care in Diabetes” (4) contained therein. This discussion will focus on those areas where the care of people with diabetes in correctional facilities may differ, and specific recommendations are made at the end of each section.

INTAKE MEDICAL ASSESSMENT

Reception screening

Reception screening should emphasize patient safety. In particular, rapid identification of all insulin-treated persons with diabetes is essential in order to identify those at highest risk for hypo- and hyperglycemia and diabetic ketoacidosis (DKA). All insulin-treated patients should have a capillary blood glucose (CBG) determination within 1–2 h of arrival. Signs and symptoms of hypo- or hyperglycemia can often be confused with intoxication or withdrawal from drugs or alcohol. Individuals with diabetes exhibiting signs and symptoms consistent with hypoglycemia, particularly altered mental status, agitation, combativeness, and diaphoresis, should have finger-stick blood glucose levels measured immediately.

Intake screening

Patients with a diagnosis of diabetes should have a complete medical history and physical examination by a licensed health care provider with prescriptive authority in a timely manner. If one is not available on site, one should be consulted by those performing reception screening. The purposes of this history and physical examination are to determine the type of diabetes, current therapy, alcohol use, and behavioral health issues, as well as to screen for the presence of diabetes-related complications. The evaluation should review the previous treatment and the past history of both glycemic control and diabetes complications. It is essential that medication and medical nutrition therapy (MNT) be continued without interruption upon entry into the correctional system, as a hiatus in either medication or appropriate nutrition may lead to either severe hypo- or hyperglycemia that can rapidly progress to irreversible complications, even death.

Intake physical examination and laboratory

All potential elements of the initial medical evaluation are included in Table 5 of the ADA’s “Standards of Medical Care in Diabetes,” referred to hereafter as the “Standards of Care” (4). The essential components of the initial history and physical examination are detailed in Fig. 1. Referrals should be made immediately if the patient with diabetes is pregnant.

Recommendations

  • Patients with a diagnosis of diabetes should have a complete medical history and undergo an intake physical examination by a licensed health professional in a timely manner. (E)

  • Insulin-treated patients should have a CBG determination within 1–2 h of arrival. (E)

  • Medications and MNT should be continued without interruption upon entry into the correctional environment. (E)

SCREENING FOR DIABETES—

Consistent with the ADA Standards of Care, patients should be evaluated for diabetes risk factors at the intake physical and at appropriate times thereafter. Those who are at high risk should be considered for blood glucose screening. If pregnant, a risk assessment for gestational diabetes mellitus (GDM) should be undertaken at the first prenatal visit. Patients with clinical characteristics consistent with a high risk for GDM should undergo glucose testing as soon as possible. High-risk women not found to have GDM at the initial screening and average-risk women should be tested between 24 and 28 weeks of gestation. For more detailed information on screening for both type 2 and gestational diabetes, see the ADA Position Statement “Screening for Type 2 Diabetes” (5) and the Standards of Care (4).

MANAGEMENT PLAN—

Glycemic control is fundamental to the management of diabetes. A management plan to achieve normal or near-normal glycemia with an A1C goal of less than 7% onmouseout="___yoonoLink.onYoonoOut(this)" onmouseover="___yoonoLink.onYoonoOver(event,this)" onclick="___yoonoLink.onYoonoClick(this)" keywords="diabetes management" class="yoono-link-hover yoono-link-active-link">diabetes management at the time of initial medical evaluation. Goals should be individualized (4), and less stringent treatment goals may be appropriate for patients with a history of severe hypoglycemia, patients with limited life expectancies, elderly adults, and individuals with comorbid conditions (4). This plan should be documented in the patient’s record and communicated to all persons involved in his/her care, including security staff. Table 1, taken from the ADA Standards of Care, provides a summary of recommendations for setting glycemic control goals for adults with diabetes.

People with diabetes should ideally receive medical care from a physician-coordinated team. Such teams include, but are not limited to, physicians, nurses, dietitians, and mental health professionals with expertise and a special interest in diabetes. It is essential in this collaborative and integrated team approach that individuals with diabetes assume as active a role in their care as possible. Diabetes self-management education is an integral component of care. Patient self-management should be emphasized, and the plan should encourage the involvement of the patient in problem solving as much as possible.

It is helpful to house insulin-treated patients in a common unit, if this is possible, safe, and consistent with providing access to other programs at the correctional institution. Common housing not only can facilitate mealtimes and medication administration, but also potentially provides an opportunity for diabetes self-management education to be reinforced by fellow patients.

NUTRITION AND FOOD SERVICES—

Nutrition counseling and menu planning are an integral part of the multidisciplinary approach to diabetes management in correctional facilities. A combination of education, interdisciplinary communication, and monitoring food intake aids patients in understanding their medical nutritional needs and can facilitate diabetes control during and after incarceration.

Nutrition counseling for patients with diabetes is considered an essential component of diabetes self-management. People with diabetes should receive individualized MNT as needed to achieve treatment goals, preferably provided by a registered dietitian familiar with the components of MNT for persons with diabetes.

Educating the patient, individually or in a group setting, about how carbohydrates and food choices directly affect diabetes control is the first step in facilitating self-management. This education enables the patient to identify better food selections from those available in the dining hall and commissary. Such an approach is more realistic in a facility where the patient has the opportunity to make food choices.

The easiest and most cost-effective means to facilitate good outcomes in patients with diabetes is instituting a heart-healthy diet as the master menu (6). There should be consistent carbohydrate content at each meal, as well as a means to identify the carbohydrate content of each food selection. Providing carbohydrate content of food selections and/or providing education in assessing carbohydrate content enables patients to meet the requirements of their individual MNT goals. Commissaries should also help in dietary management by offering healthy choices and listing the carbohydrate content of foods.

The use of insulin or oral medications may necessitate snacks in order to avoid hypoglycemia. These snacks are a part of such patients’ medical treatment plans and should be prescribed by medical staff.

Timing of meals and snacks must be coordinated with medication administration as needed to minimize the risk of hypoglycemia, as discussed more fully in the medication section of this document. For further information, see the ADA Position Statement “Nutrition Principles and Recommendations in Diabetes” (7).

URGENT AND EMERGENCY ISSUES—

All patients must have access to prompt treatment of hypo- and hyperglycemia. Correctional staff should be trained in the recognition and treatment of hypo- and hyperglycemia, and appropriate staff should be trained to administer glucagon. After such emergency care, patients should be referred for appropriate medical care to minimize risk of future decompensation.

Institutions should implement a policy requiring staff to notify a physician of all CBG results outside of a specified range, as determined by the treating physician (e.g., less than 50 greater than 350 mg/dl).

Hyperglycemia

Severe hyperglycemia in a person with diabetes may be the result of intercurrent illness, missed or inadequate medication, or corticosteroid therapy. Correctional institutions should have systems in place to identify and refer to medical staff all patients with consistently elevated blood glucose as well as intercurrent illness.

The stress of illness in those with type 1 diabetes frequently aggravates glycemic control and necessitates more frequent monitoring of blood glucose (e.g., every 4–6 h). Marked hyperglycemia requires temporary adjustment of the treatment program and, if accompanied by ketosis, interaction with the diabetes care team. Adequate fluid and caloric intake must be ensured. Nausea or vomiting accompanied with hyperglycemia may indicate DKA, a life-threatening condition that requires immediate medical care to prevent complications and death. Correctional institutions should identify patients with type 1 diabetes who are at risk for DKA, particularly those with a prior history of frequent episodes of DKA. For further information see “Hyperglycemic Crisis in Diabetes” (8).

Hypoglycemia

Hypoglycemia is defined as a blood glucose level less than 60

Security staff who supervise patients at risk for hypoglycemia (i.e., those on insulin or oral hypoglycemic agents) should be educated in the emergency response protocol for recognition and treatment of hypoglycemia. Every attempt should be made to document CBG before treatment. Patients must have immediate access to glucose tablets or other glucose-containing foods. Hypoglycemia can generally be treated by the patient with oral carbohydrates. If the patient cannot be relied on to keep hypoglycemia treatment on his/her person, staff members should have ready access to glucose tablets or equivalent. In general, 15–20 g oral glucose will be adequate to treat hypoglycemic events. CBG and treatment should be repeated at 15-min intervals until blood glucose levels return to normal (less than 70 mg/dl).

Staff should have glucagon for intramuscular injection or glucose for intravenous infusion available to treat severe hypoglycemia without requiring transport of the hypoglycemic patient to an outside facility. Any episode of severe hypoglycemia or recurrent episodes of mild to moderate hypoglycemia require reevaluation of the diabetes management plan by the medical staff. In certain cases of unexplained or recurrent severe hypoglycemia, it may be appropriate to admit the patient to the medical unit for observation and stabilization of diabetes management.

Correctional institutions should have systems in place to identify the patients at greater risk for hypoglycemia (i.e., those on insulin or sulfonylurea therapy) and to ensure the early detection and treatment of hypoglycemia. If possible, patients at greater risk of severe hypoglycemia (e.g., those with a prior episode of severe hypoglycemia) may be housed in units closer to the medical unit in order to minimize delay in treatment.

Recommendations

  • Train correctional staff in the recognition, treatment, and appropriate referral for hypo- and hyperglycemia. (E)

  • Train appropriate staff to administer glucagon. (E)

  • Train staff to recognize symptoms and signs of serious metabolic decompensation, and immediately refer the patient for appropriate medical care. (E)

  • Institutions should implement a policy requiring staff to notify a physician of all CBG results outside of a specified range, as determined by the treating physician. (E)

  • Identify patients with type 1 diabetes who are at high risk for DKA. (E)

MEDICATION—

Formularies should provide access to usual and customary oral medications and insulins necessary to treat diabetes and related conditions. While not every brand name of insulin and oral medication needs to be available, individual patient care requires access to short-, medium-, and long-acting insulins and the various classes of oral medications (e.g., insulin secretagogues, biguanides, α-glucosidase inhibitors, and thiazolidinediones) necessary for current diabetes management.

Patients at all levels of custody should have access to medication at dosing frequencies that are consistent with their treatment plan and medical direction. If feasible and consistent with security concerns, patients on multiple doses of short-acting oral medications should be placed in a “keep on person” program. In other situations, patients should be permitted to self-inject insulin when consistent with security needs. Medical department nurses should determine whether patients have the necessary skill and responsible behavior to be allowed self-administration and the degree of supervision necessary. When needed, this skill should be a part of patient education. Reasonable syringe control systems should be established.

In the past, the recommendation that regular insulin be injected 30–45 min before meals presented a significant problem when “lock downs” or other disruptions to the normal schedule of meals and medications occurred. The use of multiple-dose insulin regimens using rapid-acting analogs can decrease the disruption caused by such changes in schedule. Correctional institutions should have systems in place to ensure that rapid-acting insulin analogs and oral agents are given immediately before meals if this is part of the patient’s medical plan. It should be noted however that even modest delays in meal consumption with these agents can be associated with hypoglycemia. If consistent access to food within 10 min cannot be ensured, rapid-acting insulin analogs and oral agents are approved for administration during or immediately after meals. Should circumstances arise that delay patient access to regular meals following medication administration, policies and procedures must be implemented to ensure the patient receives appropriate nutrition to prevent hypoglycemia.

Both continuous subcutaneous insulin infusion and multiple daily insulin injection therapy (consisting of three or more injections a day) can be effective means of implementing intensive diabetes management with the goal of achieving near-normal levels of blood glucose (9). While the use of these modalities may be difficult in correctional institutions, every effort should be made to continue multiple daily insulin injection or continuous subcutaneous insulin infusion in people who were using this therapy before incarceration or to institute these therapies as indicated in order to achieve blood glucose targets.

It is essential that transport of patients from jails or prisons to off-site appointments, such as medical visits or court appearances, does not cause significant disruption in medication or meal timing. Correctional institutions and police lock-ups should implement policies and procedures to diminish the risk of hypo- and hyperglycemia by, for example, providing carry-along meals and medication for patients traveling to off-site appointments or changing the insulin regimen for that day. The availability of prefilled insulin “pens” provides an alternative for off-site insulin delivery.

Recommendations

  • Formularies should provide access to usual and customary oral medications and insulins to treat diabetes and related conditions. (E)

  • Patients should have access to medication at dosing frequencies that are consistent with their treatment plan and medical direction. (E)

  • Correctional institutions and police lock-ups should implement policies and procedures to diminish the risk of hypo- and hyperglycemia during off-site travel (e.g., court appearances). (E)

ROUTINE SCREENING FOR AND MANAGEMENT OF DIABETES COMPLICATIONS—

All patients with a diagnosis of diabetes should receive routine screening for diabetes-related complications, as detailed in the ADA Standards of Care (4). Interval chronic disease clinics for persons with diabetes provide an efficient mechanism to monitor patients for complications of diabetes. In this way, appropriate referrals to consultant specialists, such as optometrists/ophthalmologists, nephrologists, and cardiologists, can be made on an as-needed basis and interval laboratory testing can be done.

The following complications should be considered.

  • Foot care: Recommendations for foot care for patients with diabetes and no history of an open foot lesion are described in the ADA Standards of Care. A comprehensive foot examination is recommended annually for all patients with diabetes to identify risk factors predictive of ulcers and amputations. Persons with an insensate foot, an open foot lesion, or a history of such a lesion should be referred for evaluation by an appropriate licensed health professional (e.g., podiatrist or vascular surgeon). Special shoes should be provided as recommended by licensed health professionals to aid healing of foot lesions and to prevent development of new lesions.

  • Retinopathy: Annual retinal examinations by a licensed eye care professional should be performed for all patients with diabetes, as recommended in the ADA Standards of Care. Visual changes that cannot be accounted for by acute changes in glycemic control require prompt evaluation by an eye care professional.

  • Nephropathy: An annual spot urine test for determination of microalbumin-to-creatinine ratio should be performed. The use of ACE inhibitors or angiotensin receptor blockers is recommended for all patients with albuminuria. Blood pressure should be controlled to less than 130/80

  • Cardiac: People with type 2 diabetes are at a particularly high risk of coronary artery disease. Cardiovascular disease risk factor management is of demonstrated benefit in reducing this complication in patients with diabetes. Blood pressure should be measured at every routine diabetes visit. In adult patients, test for lipid disorders at least annually and as needed to achieve goals with treatment. Use aspirin therapy (75–162 mg/day) in all adult patients with diabetes and cardiovascular risk factors or known macrovascular disease. Current national standards for adults with diabetes call for treatment of lipids to goals of LDL ≤100, HDL >40, triglycerides less than 150

MONITORING/TESTS OF GLYCEMIA—

Monitoring of CBG is a strategy that allows caregivers and people with diabetes to evaluate diabetes management regimens. The frequency of monitoring will vary by patients’ glycemic control and diabetes regimens. Patients with type 1 diabetes are at risk for hypoglycemia and should have their CBG monitored three or more times daily. Patients with type 2 diabetes on insulin need to monitor at least once daily and more frequently based on their medical plan. Patients treated with oral agents should have CBG monitored with sufficient frequency to facilitate the goals of glycemic control, assuming that there is a program for medical review of these data on an ongoing basis to drive changes in medications. Patients whose diabetes is poorly controlled or whose therapy is changing should have more frequent monitoring. Unexplained hyperglycemia in a patient with type 1 diabetes may suggest impending DKA, and monitoring of ketones should therefore be performed.

Glycated hemoglobin (A1C) is a measure of long-term (2- to 3-month) glycemic control. Perform the A1C test at least two times a year in patients who are meeting treatment goals (and who have stable glycemic control) and quarterly in patients whose therapy has changed or who are not meeting glycemic goals.

Discrepancies between CBG monitoring results and A1C may indicate a hemoglobinopathy, hemolysis, or need for evaluation of CBG monitoring technique and equipment or initiation of more frequent CBG monitoring to identify when glycemic excursions are occurring and which facet of the diabetes regimen is changing.

In the correctional setting, policies and procedures need to be developed and implemented regarding CBG monitoring that address the following.

  • Infection control

  • Education of staff and patients

  • Proper choice of meter

  • Disposal of testing lancets

  • Quality control programs

  • Access to health services

  • Size of the blood sample

  • Patient performance skills

  • Documentation and interpretation of test results

  • Availability of test results for the health care provider (10)

Recommendations

  • In the correctional setting, policies and procedures need to be developed and implemented to enable CBG monitoring to occur at the frequency necessitated by the individual patient’s glycemic control and diabetes regimen. (E)

  • A1C should be checked every 3–6 months. (E)

SELF-MANAGEMENT EDUCATION—

Self-management education is the cornerstone of treatment for all people with diabetes. The health staff must advocate for patients to participate in self-management as much as possible. Individuals with diabetes who learn self-management skills and make lifestyle changes can more effectively manage their diabetes and avoid or delay complications associated with diabetes. In the development of a diabetes self-management education program in the correctional environment, the unique circumstances of the patient should be considered while still providing, to the greatest extent possible, the elements of the “National Standards for Diabetes Self-Management Education” (11). A staged approach may be used depending on the needs assessment and the length of incarceration. Table 2 sets out the major components of diabetes self-management education. Survival skills should be addressed as soon as possible; other aspects of education may be provided as part of an ongoing education program.

Ideally, self-management education is coordinated by a certified diabetes educator who works with the facility to develop polices, procedures, and protocols to ensure that nationally recognized education guidelines are implemented. The educator is also able to identify patients who need diabetes self-management education, including an assessment of the patients’ medical, social, and diabetes histories; diabetes knowledge, skills, and behaviors; and readiness to change.

STAFF EDUCATION—

Policies and procedures should be implemented to ensure that the health care staff has adequate knowledge and skills to direct the management and education of persons with diabetes. The health care staff needs to be involved in the development of the correctional officers’ training program. The staff education program should be at a lay level. Training should be offered at least biannually, and the curriculum should cover the following.

  • What is diabetes

  • Signs and symptoms of diabetes

  • Risk factors

  • Signs and symptoms of, and emergency response to, hypo- and hyperglycemia

  • Glucose monitoring

  • Medications

  • Exercise

  • Nutrition issues including timing of meals and access to snacks

Recommendations

  • Include diabetes in correctional staff education programs. (E)

ALCOHOL AND DRUGS—

Patients with diabetes who are withdrawing from drugs and alcohol need special consideration. This issue particularly affects initial police custody and jails. At an intake facility, proper initial identification and assessment of these patients are critical. The presence of diabetes may complicate detoxification. Patients in need of complicated detoxification should be referred to a facility equipped to deal with high-risk detoxification. Patients with diabetes should be educated in the risks involved with smoking. All inmates should be advised not to smoke. Assistance in smoking cessation should be provided as practical.

TRANSFER AND DISCHARGE—

Patients in jails may be housed for a short period of time before being transferred or released, and it is not unusual for patients in prison to be transferred within the system several times during their incarceration. One of the many challenges that health care providers face working in the correctional system is how to best collect and communicate important health care information in a timely manner when a patient is in initial police custody, is jailed short term, or is transferred from facility to facility. The importance of this communication becomes critical when the patient has a chronic illness such as diabetes.

Transferring a patient with diabetes from one correctional facility to another requires a coordinated effort. To facilitate a thorough review of medical information and completion of a transfer summary, it is critical for custody personnel to provide medical staff with sufficient notice before movement of the patient.

Before the transfer, the health care staff should review the patient’s medical record and complete a medical transfer summary that includes the patient’s current health care issues. At a minimum, the summary should include the following.

  • The patient’s current medication schedule and dosages

  • The date and time of the last medication administration

  • Any recent monitoring results (e.g., CBG and A1C)

  • Other factors that indicate a need for immediate treatment or management at the receiving facility (e.g., recent episodes of hypoglycemia, history of severe hypoglycemia or frequent DKA, concurrent illnesses, presence of diabetes complications)

  • Information on scheduled treatment/appointments if the receiving facility is responsible for transporting the patient to that appointment

  • Name and telephone/fax number of a contact person at the transferring facility who can provide additional information, if needed

The medical transfer summary, which acts as a quick medical reference for the receiving facility, should be transferred along with the patient. To supplement the flow of information and to increase the probability that medications are correctly identified at the receiving institution, sending institutions are encouraged to provide each patient with a medication card to be carried by the patient that contains information concerning diagnoses, medication names, dosages, and frequency. Diabetes supplies, including diabetes medication, should accompany the patient.

The sending facility must be mindful of the transfer time in order to provide the patient with medication and food if needed. The transfer summary or medical record should be reviewed by a health care provider upon arrival at the receiving institution.

Planning for patients’ discharge from prisons should include instruction in the long-term complications of diabetes, the necessary lifestyle changes and examinations required to prevent these complications, and, if possible, where patients may obtain regular follow-up medical care. A quarterly meeting to educate patients with upcoming discharges about community resources can be valuable. Inviting community agencies to speak at these meetings and/or provide written materials can help strengthen the community link for patients discharging from correctional facilities.

Discharge planning for the patients with diabetes should begin 1 month before discharge. During this time, application for appropriate entitlements should be initiated. Any gaps in the patient’s knowledge of diabetes care need to be identified and addressed. It is helpful if the patient is given a directory or list of community resources and if an appointment for follow-up care with a community provider is made. A supply of medication adequate to last until the first postrelease medical appointment should be provided to the patient upon release. The patient should be provided with a written summary of his/her current heath care issues, including medications and doses, recent A1C values, etc.

Recommendations

  • For all interinstitutional transfers, complete a medical transfer summary to be transferred with the patient. (E)

  • Diabetes supplies and medication should accompany the patient during transfer. (E)

  • Begin discharge planning with adequate lead time to insure continuity of care and facilitate entry into community diabetes care. (E)

SHARING OF MEDICAL INFORMATION AND RECORDS—

Practical considerations may prohibit obtaining medical records from providers who treated the patient before arrest. Intake facilities should implement policies that 1) define the circumstances under which prior medical records are obtained (e.g., for patients who have an extensive history of treatment for complications); 2) identify person(s) responsible for contacting the prior provider; and 3) establish procedures for tracking requests.

Facilities that use outside medical providers should implement policies and procedures for ensuring that key information (e.g., test results, diagnoses, physicians’ orders, appointment dates) is received from the provider and incorporated into the patient’s medical chart after each outside appointment. The procedure should include, at a minimum, a means to highlight when key information has not been received and designation of a person responsible for contacting the outside provider for this information.

All medical charts should contain CBG test results in a specified, readily accessible section and should be reviewed on a regular basis.

CHILDREN AND ADOLESCENTS WITH DIABETES—

Children and adolescents with diabetes present special problems in disease management, even outside the setting of a correctional institution. Children and adolescents with diabetes should have initial and follow-up care with physicians who are experienced in their care. Confinement increases the difficulty in managing diabetes in children and adolescents, as it does in adults with diabetes. Correctional authorities also have different legal obligations for children and adolescents.

Nutrition and activity

Growing children and adolescents have greater caloric/nutritional needs than adults. The provision of an adequate amount of calories and nutrients for adolescents is critical to maintaining good nutritional status. Physical activity should be provided at the same time each day. If increased physical activity occurs, additional CBG monitoring is necessary and additional carbohydrate snacks may be required.

Medical management and follow-up

Children and adolescents who are incarcerated for extended periods should have follow-up visits at least every 3 months with individuals who are experienced in the care of children and adolescents with diabetes. Thyroid function tests and fasting lipid and microalbumin measurements should be performed according to recognized standards for children and adolescents (12) in order to monitor for autoimmune thyroid disease and complications and comorbidities of diabetes.

Children and adolescents with diabetes exhibiting unusual behavior should have their CBG checked at that time. Because children and adolescents are reported to have higher rates of nocturnal hypoglycemia (13), consideration should be given regarding the use of episodic overnight blood glucose monitoring in these patients. In particular, this should be considered in children and adolescents who have recently had their overnight insulin dose changed.

PREGNANCY—

Pregnancy in a woman with diabetes is by definition a high-risk pregnancy. Every effort should be made to ensure that treatment of the pregnant woman with diabetes meets accepted standards (14,15). It should be noted that glycemic standards are more stringent, the details of dietary management are more complex and exacting, insulin is the only antidiabetic agent approved for use in pregnancy, and a number of medications used in the management of diabetic comorbidities are known to be teratogenic and must be discontinued in the setting of pregnancy.

SUMMARY AND KEY POINTS—

People with diabetes should receive care that meets national standards. Being incarcerated does not change these standards. Patients must have access to medication and nutrition needed to manage their disease. In patients who do not meet treatment targets, medical and behavioral plans should be adjusted by health care professionals in collaboration with the prison staff. It is critical for correctional institutions to identify particularly high-risk patients in need of more intensive evaluation and therapy, including pregnant women, patients with advanced complications, a history of repeated severe hypoglycemia, or recurrent DKA.

A comprehensive, multidisciplinary approach to the care of people with diabetes can be an effective mechanism to improve overall health and delay or prevent the acute and chronic complications of this disease.

Facing South