Q & A: What Would Criminal Justice Reform Look Like In West Virginia?

Some state lawmakers in West Virginia are looking at some ways to address our overcrowded prison system and help more previously incarcerated people reenter the workforce. What would criminal justice reform look like in West Virginia? Last year, several groups and non-profits went around the state to gather testimony and stories from over 200 people about their experiences with the criminal justice system. Their stories were collected through interviews, surveys and focus groups. 

Lida Shepherd works with one of the groups spearheading the project, The American Friends Service Committee. Shepherd sat down with West Virginia Public Broadcasting to share some of the results.

***Editor’s Note: The following has been lightly edited for clarity.

Q: What were some of the themes that emerged from what people talked about?

LIDA SHEPHERD: We definitely heard a lot of trauma. I think, as a society, we fall into this trap of thinking that people who are formerly incarcerated, we look at them through this one dimensional lens of they are a criminal or they are a felon. And what we heard a lot about was people who had very complex lives and had really complex challenges growing up.

Q: And how does race and things like implicit bias factor into how people are treated by the criminal justice system in our state?

SHEPHERD: Looking at the numbers of the demographics of our prison system, there is no doubt that there is racial bias at every point of the system, from policing, to arrest, to who get sent to drug court.

Q: So the people who are often offered this opportunity for treatment as an alternative to being sent to jail or prison are often white, and the people that are of color often just get funneled into the prison system?

SHEPHERD: Yep. And I think it also shows up even in sentencing, the length that somebody is sentenced. So really at every single point, you see the racial bias show up. The numbers bear that out. And then as far as women incarceration, I mean, that’s a sector of the population that has just steadily climbed. We are incarcerating more women in this state, year after year. And that is in part attributed to, of course, the opioid crisis and just everything that occurs around addiction in West Virginia. And I think it’s also attributed to women actually being perceived differently by judges. There is actually a real gender bias when sentencing occurs. It’s a little counterintuitive, you would think that women would be let off more easily. But what we actually see is that women are actually sentenced more harshly. And I think part of that is because, quote unquote “bad behavior” amongst men is a little bit more expected, and therefore a little maybe more acceptable. A woman being brought before a judge for the same crime is actually sentenced more harshly. 

Credit Courtesy Lida Shepherd/ American Friends Service Committee
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Lida Shepherd

Q: What did you hear about the types of ways that people are treated when they’re children? I know we have a high rate in the state of children being suspended, or being put into some type of juvenile justice situation. What did you hear about how people are treated as children, and how that transforms into their adult behavior?

SHEPHERD: You know, you’re listening to people’s stories. And often when you ask them to tell their story, it starts in childhood. And people talked about how situations that occurred in their childhood led them to acting out in school, that led them to getting expelled or suspended, lead them into the juvenile justice system. And we know that if you are in the juvenile justice system, your likelihood of ending up in the adult criminal justice system is very likely.

The first point of contact that kids often have with the juvenile justice system starts in schools. They end up in the juvenile justice system because of truancy, because of these really low-level status offenses.

And we are not equipping schools as much as we should be to really deal with the complex issues that these kids are facing. They’re coming into school every day bearing a lot of weight of trauma, and of adverse childhood experiences. And so I think really having those [mental health] services in schools, I think, would really go very far to keeping kids in school, not expelling them, not suspending them.

Q: So what happens next? What types of changes out of this project could occur?

SHEPHERD: Well, its legislative session, and the legislature is really taking a pretty careful look at how we can address and reduce incarceration. I think there is growing consensus that this is a really expensive way of dealing with very complex social problems. So we’re seeing a big effort to look at our money bail system, so that people aren’t being held in regional jails who have not been convicted of a crime, but simply cannot afford to make bail.

There’s also an effort to basically look at our parole system and make sure that people are being released earlier who pose no threat to public safety. Once they are parole eligible, they are paroled. And that we are providing as much support to them upon release, because definitely one of the things we’ve heard over and over again is that the barriers to people who are released from jail are often insurmountable barriers to employment: housing, transportation, food. And while we’ve been tackling some of those barriers, we have a long way to go.

Lida Shepherd works with with the American Friends Service Committee and was one of the people involved in the Criminal Justice Listening Project, which compiled the testimonies of people across West Virginia. The majority of those interviewed have experienced incarceration or have had family members behind bars.

DHHR Staff Estimate State Is Spending Millions On Committing ‘Forensic Patients’

State staffers and advocates for people with disabilities say the state likely is spending “millions of dollars” on involuntarily committing people to inpatient mental health facilities for unnecessarily long periods of time.

In a presentation to the Joint Standing Committee on the Judiciary on Monday, Michael Folio — assistant general counsel for the state Department of Health and Human Resources — said that it’s been 12 years since the state last updated its laws for involuntary commitment. 

Folio says several pharmacological solutions have emerged in the last decade to treat people with various mental illnesses and cognitive disabilities.  

“Since 2007, there have been at least five therapies that have been developed. They are proven effective, safe pharmacological therapies that can treat people with psychosis, schizophrenia and chemical dependency,” Folio said. “And if those [therapies] are administered, these people then could possibly be discharged.” 

Folio had no bills for the committee to consider on Monday during its December interim meeting. For the time being, he said the DHHR is studying ways it can update state law, to minimize the number of people in its care who have involuntarily been placed in a psychiatric ward.  

“The goal is to ensure that the clinical director can exercise appropriate clinical discretion, and that we can minimize the number of inpatient patients in the state,” Folio said.  

West Virginia had 317 ‘forensic patients’ earlier this month, according to a report from the state Office of Health Facilities. Forensic patients refers to individuals who were found not guilty of a crime, due to a mental, development or intellectual disability.  

The OHF reported on Dec. 11 that 240 of those individuals were placed in a mental health facility. Seventy-seven are still classified as forensic patients, but the state has connected them to other treatment options.   

  Overspending On Health Care   

Considering the range of modern therapies available to forensic patients, Jason Parmer with the group Disability Rights of West Virginia said the state is likely overspending in this area.  

“Doing the math, this is millions of dollars we’re spending to keep people in hospitals, when they’re not presently dangerous,” Parmer said.  

Folio estimated that treatments outside of state-run facilities, sometimes called community placements, could cost $350 per individual, per day, whereas placing an individual in a state-run facility costs approximately $850 a day.  

“And then we pay even more to place people in the private psychiatric hospitals, because we have patients in our state hospital that should be in the community, taking up that space,” said State Forensic Medical Director John Justice.  

Financial disclosures with the West Virginia Health Care Authority show that in 2018 the state spent $925 daily on each patient it sent to Highland Clarksburg Hospital, a private facility. The state spent $1,300 per patient per day at another private facility, River Park Hospital in Huntington. 

Anticipating Legal Dilemmas  

According to Parmer, the number of forensic patients in West Virginia has been rising since updates to state code in the 1990s, when legislators agreed to give courts the authority to discharge forensic patients, instead of hospital physicians.  

“The effect of this change has been that some courts order patients to stay in a hospital even when they are not currently mentally ill and dangerous,” Parmer wrote in an email. He added that the amendment violates the U.S. constitution.  

“I think the current code … is vulnerable to a legal challenge,” Folio told the Judiciary Committee. “There have been a number of class action suits that have been filed around the country that have challenged other statutes.” 

An Update on Sharpe Hospital

Bob Crouch, Secretary of the DHHR, told another joint committee later Monday that changes at the William R. Sharpe, Jr., Hospital in Weston, Lewis County, may also change the way the state deals with its forensic population.  

Sharpe is a 200-bed, state-run facility that exclusively treats involuntarily committed forensic and civil patients, the latter of which are not involved with the criminal justice system.  

In late 2017, the federal Centers for Medicare and Medicaid Services found the hospital had been providing inadequate treatment to the people committed there. CMS ultimately revoked the hospital’s ability to bill the Medicaid or Medicare for services.  

The decision from CMS that year has led the state-run hospital to spend thousands more dollars in relocating patients, many of whom would’ve otherwise used Medicaid or Medicare to cover their treatment.  

Before losing Medicaid, the state spent nearly $18 million in 2016 on paying other hospitals to take 1,030 civil patients and 40 forensic patients, according to a report from the West Virginia Legislative Auditor’s office.  

By contrast, the state spent $30.8 million in 2018 to move 1,267 civil patients and eight forensic patients.  

CMS re-instated the hospital’s ability to bill Medicaid in August. Crouch said he expects this will reduce some of what the state has been spending on committing forensic and civil patients to other hospitals.   

According to Crouch, the ordeal “caused us to focus on these issues, on that forensic population, and make some significant changes at that hospital.” 

Going forward, he told lawmakers he looks forward to focusing more on the state’s forensic population, and ways to minimize their stays at state-run facilities.  

Federal Opioid Strikeforce Indicts More Than a Dozen Ohio Valley Doctors

The U.S. Department of Justice announced on Wednesday more than a dozen indictments against doctors in the Ohio Valley on charges relating to the illegal…

The U.S. Department of Justice announced on Wednesday more than a dozen indictments against doctors in the Ohio Valley on charges relating to the illegal distribution of opioids. These are the first major indictments from the Appalachian Regional Prescription Opioid Strike Force, which started work in December.

“The opioid epidemic is the deadliest drug crisis in American history, and Appalachia has suffered the consequences more than perhaps any other region,” Attorney General William P. Barr said in a statement. 

Opioid overdose rates in Kentucky, Ohio, and West Virginia are among the highest in the nation, and death rates in the region due to opioids are twice what most of the rest of the country experiences. 

The indictments charge 60 people, including 53 medical professionals, across seven states with illegally prescribing and distributing opioids and with health care fraud.

The indictments allege a range of wrongdoing related to distribution of opioid painkillers, including unnecessary medical treatments, kickbacks and fraud. Justice officials said the charges involved over 350 thousand prescriptions and over 32 million pills which contributed to the Ohio Valley’s opioid crisis.

“Opioid misuse and abuse is an insidious epidemic, created in large part, by the over-prescribing of potent opioids nationwide, and unfortunately, Appalachia is at the center,” said Drug Enforcement Agency Assistant Administrator John Martin. “Today’s announcement sends a clear message that investigations involving diversion of prescription drugs have been, and continue to be, a priority for DEA.”

West Virginia Charges

Chad Poage, an orthopedic surgeon from the Northern District of West Virginia, faces charges including fraudulently obtaining acetaminophen-codeine for his own use.

He allegedly wrote out prescriptions for relatives using his DEA number and used a driver’s license that he had stolen from a colleague to obtain the pills from pharmacy in Morgantown, West Virginia.

Dr. Marc Spelar, a Huntington, West Virginia psychiatrist working in the state’s Southern District, is accused of distributing narcotics to a patient who did not have a medical need for them and whom the doctor had never examined.

Kentucky Charges

In eastern Kentucky, a total of five people face charges.

Among them is a dentist charged for allegedly writing prescriptions for opioids that “had no legitimate medical purpose,” according to the Justice Department. The indictment alleges the dentist also engaged in activity outside the usual course of professional practice, including “removing teeth unnecessarily.”

In another case from that district, Dr. Mohammed A. H. Mazumder is charged with healthcare and controlled substance fraud.

As owner and operator of Appalachian Primary Care, LLC, in Prestonsburg, Kentucky, he is alleged to have had employees see patients despite not having proper licenses, and for distributing and dispensing oxycodone, hydrocodone, and other controlled substances outside the scope of professional practice and not for legitimate medical purpose.

Investigators in the Western District of Kentucky brought forward three indictments.

Assured RX, LLC, a Florida compounding pharmacy, and its owner, Nitesh Patel, are charged with a scheme that involved the payment of alleged kickbacks in return for writing prescriptions for personalized medication that included controlled substances. Patel is alleged to have worked with Bluegrass Pain Consultants in Louisville and its owner Christopher Nelson.

Investigators claim the two organizations also fraudulently inflated the costs for prescriptions that were billed for reimbursement by Medicare and TRICARE.

Dr. Ijaz Mahmood, the owner of Mahmood MD in Elizabethtown, Kentucky, is charged with controlled substance and health care fraud in another case. Mahmood is alleged to have left pre-signed, blank prescriptions to office staff who then used them to prescribe controlled substances when he was out of the office.

He is also alleged to have directed his clinic’s staff to see patients, even if they were not licensed to practice medicine.

Ohio Charges

Six people in the Southern Ohio District have been named, including a doctor who is alleged to have at one point been the highest prescriber in the state.

Justice officials said several pharmacists are also charged along with the physician for operating an alleged “pill mill” in Dayton, Ohio. According to the indictment, between October 2015 and October 2017 alone, the pharmacy allegedly dispensed over 1.75 million pills.

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