11th October 2012
The Jefferson City Correctional Center (JCCC) is a maximum security prison in Jefferson City, Missouri operated by the Missouri Department of Corrections. (Category 5 of 5) It houses about 2000 inmates, with a staff of 660. The current JCCC was opened on September 15, 2004, replacing the Missouri State Penitentiary - Jefferson City which first opened in 1836.
JCCC has a well established prison industry – “Missouri Vocational Enterprises (MVE) is a program of the Division of Offender Rehabilitative Services within the Missouri Department of Corrections. Established by State Statute to create meaningful job training for incarcerated offenders, MVE utitlizes offender labor, along with supervisors and administrative staff, to provide quality products and services to state agencies and other not-for-profit entities.” - - MVE is a unique business that operates on a capital revolving fund and does not receive any tax dollars from the general revenue. The program provides excellent opportunity for inmate recreation and up skilling for future employment. http://doc.mo.gov/mve/
As JCCC is a maximum security prison, all correctional procedures and support structures are influenced by the same security level. This is a very similar situation to Long Bay Gaol (Sydney) and Port Phillip Prison (Melbourne); as such movement around and through the prison is geared around accountability for prisoners, their safety, staff safety and ultimately the safety of the public. These same structures and procedures govern the whole prison, and hence influence the surround, housing and support structures for the older cohort within the same prison walls.
Missouri State laws and sentencing influence the placement of prisoners related to their crime; as such, most of the older prisoners will serve their sentence in the maximum security environment. It is not hard to envisage that the maximum security environment presents more challenges to meet (adapt to) the aged care needs of older inmates:
Like many other State Correctional Authorities over the past several years, the Missouri Department of Corrections has seen an increase in the ageing offender population. The departments’ first “Enhanced Care Unit” (ECU) opened at the Jefferson City Correctional Centre in January 2011, to help manage the financial and logistical operations that come with the ageing prisoner population. The 36 bed ECU houses ageing and disabled offenders in wheelchairs who may require oxygen or who have early signs of dementia, or other age related illness that diminishes the capacity of the aged inmate.
The standard of the maximum security prison designs sees the ECU in a pod of 36 cells linked together over 2 stories. Inmates with ambulatory deficits were kept to the ground floor with more able bodied prisoners and / or “Daily Living Assistants” (DLA’s) housed in the upstairs cells. (There were also examples where DLA’s were housed in the same cell as the older inmate because the older inmate had greater care needs.) This design is not so different to that seen at Port Philip Prison, Victoria.
DLA’s provide complete care to assists an older prisoner with their activities of daily living. They function as a personal care attendant would in the Australian Aged Care Environment, providing assistance with activities of daily living (not skilled nursing care). DLA’s are trained by an external agency and from what was observed and discussed provide very supportive care to the older inmate. This DLA model is the first, thus far, observed where complete care is provided by a trained inmate (not shared with other professional car staff); and was developed as correctional authorities identified a need for the support of the older prisoner and sort to provide assistance in a fiscally constrained environment; and an environment where there is great scrutiny on the cost of correctional expenditure to the citizens of the State of Missouri.
Whilst there has no doubt been a fiscal benefit for the DLA model, behavioural benefits for the younger prisoners providing care are obvious: the DLA role gives an inmate purpose, a sense of responsibility as well as a sense of restorative justice and if you exclude all of the aforementioned benefits it gives DLAs something constructive to do whilst in the correctional system. The DLA model also seemed to softens a harsh environment redirecting inmates self focus to the needs and care of another. JCCC were able to demonstrate tangible improvements within the first year of introduction of the ECU: improved care received by the EC inmates, reduced security concerns, less victimisation and decreased disciplinary actions for the same population (A great success!)
(also see the video on http://www.nytimes.com/2012/02/26/health/dealing-with-dementia-among-aging-criminals.html?pagewanted=all&_r=0)
The DLA role is seen as an option for a vocation whilst younger inmates are serving sentence and fits into the previously mentioned Jefferson City Correctional industry culture. There are a certain number of paid DLA positions and many DLA volunteers. DLA volunteers have a better chance of receiving a paid DLA position when one becomes available. DLA’s are rotated between inmates with needs which shares the load of more burdensome older inmates and ensures that a group of DLA’s have awareness about any particular inmates care needs.
The DLA model is certainly one that could be considered for the Victorian justice system.
There is a strong mental health model within the JCCC with multi-skilled mental health physicians who meet regularly with case managers (mostly evolved from previous correctional staff), correctional staff and other health professionals as necessary. Case meetings review an inmate’s behaviour from either a behavioural or mental health context, with the aim of providing some governance around how to provide appropriate correctional - behavioural strategies with a focus on an inmate’s cognition. T
Given JCCC is only 7 years old, pathways are wide, doorways are wide and rooming (cells) are generally roomier than others previously seen, with good ventilation and adequate lighting. Bathrooms and toilets were found to be accessible with minimal trip hazards. There was at least one fully accessible shower and toilet area (completely level with no trip hazards) making it easier to manage the care of a more disabled aged inmate.
As an elderly inmates care needs increase to the point that they need specialist nursing care (skilled care) they are transferred to the Prison Infirmary. The Infirmary is a 29 bed hospital like facility. The infirmary also provides; post acute care, medical care for younger inmates, a very active outpatient clinic for various clinical activities as well as an XRAY and dental service.
Hospice care is provided in the infirmary and prisoners who are nearing end of life have more flexible visiting arrangements.
JCC also have an active Puppies on Parole program; the program is a partnership between the Missouri Department of Corrections and animal shelters/advocate groups. There are 18 DOC facilities across Missouri that have adopted dog programs. The program matches shelter dogs with selected offender handlers. Handlers help the dogs through socialization training to make them more readily adoptable. Having seen a similar program at the Fishkill service and the response of inmates and staff alike to the dogs in the the system, there is no doubt that such a program would be worth considering with the Victorian custodial context.
Once again I have been overwhelmed by the generosity of correctional staff. The JCCC staff demonstrated they are committed to the inmate population and have shown empathy and care in their interactions. Each experience has been uniquely humbling. There is no doubt that the custodial environments can be very challenging for all staff involved, yet staff’s disposition is one of continuously trying to find new ways to manage behavioural challenges with the prisoner cohort of interest. Thanks again to all who assisted with this review.
The Diet .....
Given the busy schedule and the lack of breakfasts with my current accommodation; I made my way to “Save A Lot” http://save-a-lot.com/ and purchased some salad items and baby carrots as well as a packet of Raisin Bran. Having said that ....
I have had two very enjoyable lunches:
• One lunch was shared with Greg and Deloise (JCCC management staff) at Prison Brews http://www.prisonbrews.com/food.php– where I had a very nice but large tortilla wrap with my first Root Beer ( a bit like sarsaparilla)
• The other delightful lunch was shared with Greg, following a morning sightseeing tour of Jefferson City, at the Arris Bistro; http://www.midmodiningguide.com/listing/arris-bistro-and-liquid-lounge.html where I enjoyed a Gyros Wrap and broccoli salad – soda water was the drink of choice.
Thanks Greg and Deloise for sharing the restaurants.
and thansk Greg for the tour of Jeff City