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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Loretta Rush, Chief Justice of the Indiana Supreme Court, has released the 2023-24 annual report for the state's courts.

The report shows Indiana's judicial system is taking big steps to tackle the mental health crisis. The Supreme Court recently launched the Office of Behavioral Health and hired Brittany Kelly as its behavioral health specialist, making Indiana the tenth state in the country to embed a mental health professional within its judiciary.

"She's off and running. She's had hundreds of inquiries from around the state. She's meeting with judges," Rush outlined. "She's helping with things like competency evaluations, access to Medicaid, how do I get somebody who's going through dementia through the court system?"

Rush pointed out Kelly will help the courts manage the mental health and substance use issues flooding Indiana's courtrooms daily. The latest report shows more than 1 million cases passed through the courts this past fiscal year, including almost 20,000 involuntary mental health hearings and a sharp rise in protective orders for domestic violence.

Rush highlighted the strain on local courts, noting about 70% of people in jail have behavioral health issues.

"How do we make sure we have diversion programs in place? How do we make sure that the services we're ordering for people to do are the right services?" Rush asked. "We've done a lot at the national level with regard to substance abuse and mental health, realizing programs that are working."

The judiciary is working with state agencies to reform policies and address the impact of mental health issues on the system. Kelly has training in both social work and law, and helps judges connect with treatment resources to get people the support they need and keep them out of jail.


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Survivors of crime are speaking out against Proposition 36, which goes before California voters in November.

The ballot measure would increase penalties for some theft and drug crimes - and undo parts of Proposition 47, which took savings from decreased incarceration and put the money into harm-reduction programs.

Tinisch Hollins, executive director of Californians for Safety and Justice, spoke Wednesday at the opening of a new trauma recovery center in Oakland.

"It's pushing the state to move back towards 'tough-on-crime.' We are pushing back on that. You need to prioritize resources to create trauma-recovery centers because this is the way to create safety in our community." Hollins said.

Supporters of Prop. 36 say current laws are too lenient, particularly concerning retail theft. But the state legislative analyst has suggested Prop. 36 will send many more people to jail, increasing criminal-justice costs anywhere from tens of millions to the low hundreds of millions of dollars each year.

Hollins said that would mean less money for programs that actually address poverty and desperation - the root cause of crime.

"Folks who have been touched by incarceration, folks who are experiencing homelessness, folks who are experiencing barriers to employment, they can actually get a full range of services to stabilize," Hollins added. "Think about how impactful this will be if we're able to continue expanding this model."

Advocates of Prop. 36 project that it would mean $850 million less over the next decade for trauma recovery centers, mental health, drug treatment, victim services, re-entry and crime-prevention programs.

Groups across Alabama are joining forces to advocate for big changes to what they see as the state's flawed parole system.

In a panel discussion led by the group Alabama Values, speakers focused on improving the parole process and addressing its broader impact.

John Woods, who spent 10 years repeatedly being denied parole, shared his story. He said the system creates a sense of hopelessness, not only for those behind bars but also their families and shared a recent conversation with another person still waiting for a chance at parole.

"He said, 'I'm going out into society every day working a real a job,'" Woods explained. "He said, 'I go home every other week.' He said, 'I haven't did nothing and I've been there for seven years.' He said, 'What more can you get out of me in a work release?'"

Despite work release programs proving many individuals are not a threat to public safety, panelists noted few are granted parole. The latest Alabama Department of Corrections report showed state prisons are holding more than twice their intended capacity. The overcrowding, combined with rising violence, has heightened concerns.

Katie Glenn, policy associate for the Southern Poverty Law Center, cited the parole board's inconsistent application of its own guidelines as a major issue.

"The guidelines that the parole board uses, if they actually followed them, something like 70% of people who are up for parole would be paroled," Glenn contended. "I think now, we're seeing numbers as high as maybe, like, in the 20%."

Alison Mollman, interim legal director for the ACLU of Alabama, suggested borrowing parole models from other states to make improvements, including offering virtual attendance for parole hearings and reducing the lengthy wait times between hearings.

"In Alabama, you can be set off -- or you can have to wait for another parole hearing -- up to five years," Mollman pointed out. "That's a really, really long time, and I think a lot of times we hear, in the legislature, them wanting to move things so that everybody has to wait five years. But in states like Louisiana, most people wait one year."

Mollman also favors gradual release programs to reintegrate people through structured stages, as well as restorative justice practices, which allow some offenders to seek reconciliation with victims. The Alabama Legislature's next opportunity to address parole system issues is in its 2025 session.