Lawmakers hear concerns, ways to improve health outcomes in Mississippi’s prison system

• It was noted that representatives with the Mississippi Department of Corrections were invited to attend the Joint Committee of Public Welfare and Corrections hearing held Thursday, but the agency did not show up to speak with the committee.

Concerns over the level of care inmates in state custody are receiving was the major topic during this week’s Joint Committee of Public Welfare and Corrections hearing at the Mississippi Capitol. 

During previous legislative sessions, concerns over how inmates are provided healthcare, if at all, have been topics of contention for State Rep. Becky Currie (R), chair of the House Corrections Committee. She has consistently expressed concerns on how the Mississippi Department of Corrections and the state’s current inmate healthcare contractor has handled that task. 

For years, Currie has said she receives calls from families who allege inmates are not receiving the care and medications they need. 

During Thursday’s hearing, several stories were shared with the committee of lawmakers about prisoners’ limbs requiring amputation while incarcerated due to inadequate diabetic care and cancer diagnoses going untreated for inordinately long periods. 

While the current contracted medical provider, VitalCore, did attend the meeting to address the issues raised, there was no representation from the Mississippi Department of Corrections present. 

“The Department of Corrections was invited to this hearing,” House Public Health and Welfare Committee Chair State Rep. Samuel Creekmore (R) said. “We just wanted to have the answers to whatever questions this body asked, and they chose not to come. So we may not get all the answers today, but I think it needs to be pointed out that they were invited.”

Stories of a lack of care

Currie brought in Dr. Jacob Graham with South Central Regional Medical Center to share stories he has seen personally of the lack of proper care in Mississippi prisons.

He told of one inmate who was diagnosed with prostate cancer. The inmate had been denied treatment for so long the cancer reached his bones and caused the compression of his spinal cord, leading to paralysis in his lower extremities. Typically, spinal cord compression can result in permanent paralysis in as little as a day.

“What he reported to the neurosurgery team was a gradual development of a lower extremity weakness over the course of some months, and by the time he was evaluated at UMMC, he had progressed to a wheelchair requirement and inability to walk for a month and a half,” Graham described.

When that condition goes untreated for even a day, it is unlikely the person will ever regain the ability to walk. 

“It’s a time sensitive thing,” Graham explained. “This patient, he did get the second best thing to surgery, which surgery would have been too much to put him through with the low chance of it helping.”

After receiving treatment through radiation and steroids the inmate was still left with a lifetime disability.

Another patient of Graham’s diagnosed with lung cancer also the condition go untreated for a long period, resulting in his blood showing elevated amounts of calcium. Elevated calcium is a condition that can result in death within weeks or months. The University of Mississippi Medical Center took a biopsy and started treatment. After the patient was discharged from UMMC, MDOC was provided instructions for a follow-up within the next week. 

“Unfortunately, we did not receive the referral on this patient for a month after his discharge,” Graham said.

A third patient, also diagnosed with prostate cancer in 2025, was found to have prostate-specific antigen levels above 60. Graham said a normal level is about 4. That inmate did not see a urologist for another eight weeks after diagnosis and a biopsy did not occur until April of this year. He received treatment this August. 

“And this PSA is so high, you think almost certainly the patient’s going to have metastatic disease,” Graham said. “So you’re talking roughly a year delay on treatment on something that should have been treated as an urgent situation from the initial PSA.”

That inmate did not have metastatic disease and did survive, but Graham said he was lucky. 

“My understanding of our prison healthcare system is it’s a capitated, fixed payment, system and that kind of system can negatively incentivize a service provider from ensuring timely diagnoses and treatment of cancer, unless you have robust quality metrics and oversight,” Graham said.

Lawmakers and family also shared stories of inmates not receiving proper treatment. 

State Rep. Elliot Burch (R) was contacted by a family concerned about the care their relative received while in state custody. That inmate had undergone at least two to three amputations for complications due to diabetes.

Burch was unsure of how many amputations occurred while the man was incarcerated but did describe who when he met with the inmate after his release, the man was housed in a motel and could not walk. It was made clear the inmate had diabetes prior to being incarcerated, but his condition worsened due to a lack of proper diet and other factors. While he was tested multiple times a day while in state custody, when he was released, the man was not provided with a proper place to stay and was not provided with the means to test his blood sugar.

Tupelo resident Pearly White shared the story of her son who was incarcerated with medical needs due to an amputation of one arm. He required specific nerve pain and mental health medications, both of which she claims her son was denied during his time in prison. White added that the judge also ordered her son to undergo alcohol and drug treatment, which he did not receive. He is out of prison now and back with his mother.

“Physically, he is there. Mentally, he is so angry or he just doesn’t know how to control what goes on actually right now. I have holes in my walls at home,” White described. “So instead of hitting me he hit the wall.”

Current medical provider

Over the course of several decades there have been a number of contracted health providers for the state’s prison system. 

Ted Booth, Deputy Director of the Mississippi Joint Legislative PEER Committee, told the legislative committee that Mississippi moved to a contract model for that service in 1999 after lawsuits ensued under the state employee model. UMMC was the first contractor, providing care at a cost to the state of about $5.07 per inmate per day. 

After four years, the contract changed hands four more times until in 2020 when the current provider, VitalCore, took over the contract under an emergency status. The contract now has a rate of  $17.85 per inmate per day, said VitalCore advisor Brian Collier. 

Despite the complaints lodged earlier in the meeting, VitalCore President Viola Riggin said her organization took over the contract because it was in dire straits. They came in during the aftermath of riots occurring at the Mississippi State Penitentiary, also known as Parchman. She said her company took the contract because it has a record of turning such situations around since 2015.

“Care was dire when we came in, honestly. And it is one of the better run systems in the nation right now,” Riggins contends. “We may have failed in letting you know what’s going on.”

She believes the stories told on Thursday are the lingering results of deficiencies from the previous contractors.

“And what you’re hearing today are some of the residuals of some of those things,” Riggin said. “And we say to you six years later that we are trying to make sure that what you have is a great system that does several things.”

She argued that her company is now doing the work that was not done previously, such as regular checkups, intake screening for HIV and Hepatitis C, and mammograms. She also said the nerve pain medication, gabapentin, White said her son did not receive, is available under her company.

“We do physical exams every single year. We started that,” Riggin said. “That was not done. We do provide gabapentin in our system. We do have mammography in our system. We do provide HIV treatment to every single patient. We have a high quality of care.”

Within the last couple of years, VitalCore ramped up efforts to treat inmates with Stage 3 or 4 Hepatitis C. 

She also added that efforts are being made to ensure sufficient staffing within the contract’s specifications.

Under the contract, the company is required to be at 85% within the required nursing staff numbers and 95% compliant in the number of doctors. Currently, the company is at 100% in one criteria and 97% in the other. Riggin did not clarify which statistic correlated with those positions. 

“We don’t have open positions on purpose, we do not,” Riggins added. “And as a matter of fact we put in additional positions where we believed clinically it’s needed, and have not been reimbursed for that.”

Current state of the prison population

Today, Mississippi has about 19,000 people in the state’s prison system, of which 4,600 are 55 or older. Collier said that life in the prison system is harder than the general public, so a person who is 55 is really 65 years old, medically speaking. 

“So we pay a very close attention to those who are 55 and older, because just like in all correctional systems across the country, Mississippi you have an aging population,” Collier said.

Of that total population, nearly half – 9,000 – have some form of chronic illness, with 7,297 having hypertension, 1,400 with asthma, 19 are dialysis dependent, and 1,282 having diabetes. 

About 38% of the prison population also has a form of mental illness. As such, VitalCore has put forth efforts to screen and provide care for those with that condition, Collier stated. He contends their efforts have reduced the number of suicides within the jails. This year, Collier reported there have been 2 suicides.

The company employs five psychiatrists and 167 behavior health professionals to assist the 4,471 inmates who have been diagnosed with a mental health illness.  

“Mississippi has done a phenomenal job of reducing suicides,” Collier said.

Also within the prison population, VitalCore reports there are 739 patients who have hepatitis C, of which 333 have received treatment. Collier said VitalCore is treating 50 hepatitis C cases per quarter, with a focus on those at Stage 3 or 4 first. Their plan is to have all of those inmates treated by 2029. If all of the patients were to be treated today, he said it would cost about $16 million. 

State Health Officer Dr. Daniel Edney took issue with the company only treating those in Stage 3 or 4, saying that plan will only result in reinfections since it is a sexually transmitted disease. 

“I will tell you, respectfully, treating 50 cases a year is unacceptable,” Edney told the committee. “Unless there is a carve-out in the contract. Now if there’s a carve-out, there’s a carve-out, but if there’s not standard of care nationwide, including Mississippi, is to treat Hep C, active Hep C, when you find it. You do not let it advance.”

Rep. Currie also contested the number of Hepatitis C cases Collier quoted. She said she has been told by two separate and independent sources that number is closer to 5,000, not 739. She, too, took issue with VitalCore only treating the more severe cases because by Stage 3 the patient is very ill. 

Edney suggested the committee consider engaging the Mississippi State Department of Health in the care provided to inmates, by allowing his agency to thoroughly inspect the facilities. MSDH currently only inspects the safety of the infirmary, not the other factors.

“I strongly feel the infirmary, and I would even include the clinics, should have state oversight in terms of life safety and environment of care,” Edney suggested. “I will tell you, just from the safety inspection, I wouldn’t let my duck dog be at the infirmary.” 

Edney said if his agency took over the public health in the infirmary, there would not only be better outcomes, but a cost savings to the state through the use of some federal funds.