New research showed medical copays are preventing incarcerated people from receiving medical care.

West Virginia's $5 copay is much higher compared with those of many other states.

Wanda Bertram, communications strategist for the Prison Policy Initiative, said families do not always have the funds to cover repeated doctors visits. She contended copays are strategies states use to keep the number of sick calls down.

"That's not because people are making frivolous requests," Bertram asserted. "It's because prisons often don't have the resources and simply don't want to deal with what it would take to actually give incarcerated people the care they need."

Nearly one in five nationwide have not seen a doctor since entering state prison, according to the Prison Policy Initiative. Federal data show people who are incarcerated are more likely to have high blood pressure, asthma, cancer, arthritis and infectious diseases such as hepatitis C and HIV.

Bertram added pregnant people are no exception to the copay rule. She cited research done in 2016 showing the lack of access to prenatal care, noting while the study did not specifically look at the copay issue, it presents a serious obstacle.

"A shocking number of people were not receiving this really important care," Bertram reported. "Almost 10% hadn't received an obstetric examination. About a quarter hadn't seen any outside specialists."

According to research from Johns Hopkins University, fewer than 10 states have passed laws mandating prisons provide access to prenatal or postpartum health care for incarcerated people.


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Alabama's reliance on fines and fees to fund state services can turn minor incidents such as a traffic violation into overwhelming debt for low-income residents.

To address the issue, Alabama Values, through its Justice in Focus initiative with the Beacon Center, is working to identify solutions. During a recent virtual panel, advocates and legal experts discussed how financial penalties contribute to poverty and proposed strategies to ease the burden.

Aylia McKee, chief public defender of Montgomery County, highlighted the root of the problem: how fines and fees are assessed.

"Some of the biggest troubles with the determination of funds is the failure to provide information about an individual's ability to pay," McKee pointed out.

A survey of nearly 1,000 Alabama residents found 83% had to forgo essentials such as medical care, food or transportation to pay their legal costs.

Judge Tiffany McCord of the 15th Judicial Circuit of Alabama, said the justice system is a balancing act, which aims to deter crime while maintaining public safety. However, she stressed courts offer alternatives to ease financial burden for those who seek help. McCord added stigma and embarrassment often prevent people from sharing financial struggles, making it harder to access support.

"We want people to know or understand that you can ask for your fines and court costs to be remitted," McCord emphasized. "We want people to know and to understand that you know you can ask to do community service instead of paying fines and court costs."

Richard Williams, executive director of the Beacon Center, runs the Next Steps Program, designed to offer another alternative. He described how the initiative supports people navigating the justice system through leadership classes, therapy and real world skills.

"We have trained staff persons who are walking with them and they're walking through things around financial management," Williams explained. "They're walking around things of how do we regulate our relationships "

While the Next Steps program has seen success in Montgomery County, advocates argued similar efforts are needed statewide. Panelists also called for legislation to ensure fines and fees are assessed based on a person's ability to pay and urged efforts to rebuild trust between communities and the courts.


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More than a third of Idaho's jails have failed their inspections but consequences for failing grades are unlikely.

The nonprofit newsroom InvestigateWest has created a database of inspections for Idaho's 35 jails over the past three years, showing 14 failed in 2024.

Whitney Bryen, injustice and vulnerable populations reporter for InvestigateWest, noted the inspections are not required, as in many other states. She said the Idaho Sheriffs' Association conducts the inspections and all the jails have voluntarily agreed to them.

"There is no state agency that oversees Idaho's jails," Bryen pointed out. "There's no mandated inspection of any kind in terms of someone from the state going in and checking on jails' conditions and how detainees in those facilities are doing."

Bryen explained the jails get a report after the inspection but it is up to the jails to decide what they want to do with the information. She observed many of the failing jails said it was not possible to pass because they do not have money for things such as building upgrades or new hires. Bryen added lawmakers have reached out since the InvestigateWest database was published.

Jails fail the inspection if they do not pass any of the Idaho Sheriffs' Association's eight standards. Bryen emphasized one of the standards is to have at least two deputies on duty at all times and some jails failed because they only had one on duty at certain times of day.

"That was a very common standard that was failed," Bryen reported. "In fact, every one that failed either had too many detainees or not enough staff and some of them faced both of those issues."

Bryen added nine jails did not pass the association's recommended standards, although this did not cause them to fail the inspection. She stressed standards in jails do not just protect the people who are incarcerated.

"It's not just a rule being broken -- and again, it's not a rule because they don't have to follow it -- but these standards are designed to protect the people behind bars and the deputies who are keeping those folks safe."


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Advocates feel Connecticut and the nation can enact legal system reforms in 2025, ranging from ways to more humanely treat incarcerated people to increasing investments in communities, rather than in the criminal justice system.

In Connecticut, some advocates pushed for reforms to parole so it is not as punitive.

Wanda Bertram, communications strategist for the Prison Policy Initiative, said while similar reforms passed in New York, they have stalled in Connecticut.

"There hasn't been much movement on that in Connecticut," Bertram acknowledged. "I think that's less because these aren't winnable reforms, it's more because legislators don't see criminal justice consistently as a priority."

Overall, she feels criminal justice not being a priority for lawmakers is why reforms do not often pass in statehouses. Connecticut's 2024 legislative session ended without major criminal justice reforms passed. One of the few related bills to pass was House Bill 5524, which allocates $25 million to youth justice centers.

While many reforms were goals from previous years, Bertram noted they are reforms with long-term benefits. One is restoring voting rights for people with felony convictions who have been released from prison. Connecticut is one of several states to restore the right in recent years but she noted some of this year's defeats can affect achieving next year's goals.

"The nation's rightward turn and its election of Donald Trump and far-right congresspeople is somewhat of a defeat in and of itself," Bertram observed. "Because the ideologies that are being promulgated by those new electeds are explicitly violent with, for example, new support for the death penalty."

Despite this and other defeats from this year, she emphasized 2024 brought plenty of positives, including Massachusetts being the first state to ban life without parole for people younger than 21, the Federal Communications Commission establishing new phone rates for prisons, and several states providing funding for public defenders.


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