When the Supreme Court hands down landmark rulings regarding DNA testing and sentencing laws and advancements in medicine provide new and different means for treating communicable diseases like HIV and Hepatitis C, corrections, along with the rest of society, evolves accordingly.  In 2003, corrections saw several developments in the legal and medical fields and moved ahead in other areas, like re-entry and forming partnerships.

In the second of a two-part series, The Corrections Connection Network News will revisit some of the topics we covered during 2003, with a particular focus on:

Re-Entry
Partnerships
Healthcare
Legal Issues

Re-Entry

For many years, the issue of offender re-entry has challenged the corrections field and 2003 was no different. Corrections agencies strove to put mechanisms in place to prepare inmates for their eventual return to the community through programming, education and partnerships with community-based providers.

"The [issue of re-entry] is nothing new - what's new is the scale of it," said Michael Thompson, Director of Criminal Justice Programs for the Council of State Governments (CSG).  "[There are] 600,000 people coming out of prison each year returning to the community. [The statistic that grabs the attention] of legislators is that a number of these people are coming out without any post-release supervision whatsoever. They 'max out' [their sentence] or because the state has done away with any kind of post-release supervision or parole, [they are reintegrating alone]."

Further complicating the issue is the fact that many states are faced with a budget crisis, creating not only a gap in transition services, but the early release of offenders who need such services.

"There are cases...across the country where simply, the corrections department is being told one way or another, you have to save money," said Thompson. "And corrections is saying 'there are no more services to cut.' The only way we can save money is to shut down a housing unit or a whole facility or at least control the growth of [the] system. That means population reduction - that means making sure that when these people go out, something is watching them in the community, that the communities are aware these people are coming back."

To help clarify the various issues facing both agencies and inmates, the CSG established the Re-Entry Policy Council in 2002 to assist state government officials in presenting solutions to the growing number of individuals returning to the community each year.  By bringing together representatives from the executive branch, judiciary and legislature, the council worked together during 2003 to find a common solution.

"There are some areas where people are just not going to agree," said Thompson, one of three Project Coordinators.  "We are not going to agree about lifetime commitment for sex offenders, it's just too complicated. We're not going to agree about whether certain people should spend their life in prison, whether they should be executed, or whatever. But frankly, those are only .0005 percent of the cases we're talking about, so let's not get distracted by those cases, but instead, let's focus on the lion's share that are producing the numbers [leaving prisons each year]."

In Ohio this year, they focused on these types of cases and embraced a new philosophy that looks at what the Department of Rehabilitation and Correction (DRC) can do to better prepare offenders for their release and continue the strides they made while incarcerated.  To cut off those efforts made in substance abuse treatment and academic pursuits just because they leave a facility is the wrong way to go, according to Susan Renick, Re-Entry Administrator for the DRC.

"Let's say an offender is not doing a long sentence, [begins a program] and doesn't finish," said Renick.  "We owe it to the offender and to the community to link that person to [community-based] services to promote a more successful transition."

With these linkages in place before an offender is released, there are numerous benefits to all involved. For the corrections agency, for example, parole officers supervising the offender can utilize a number of resources to meet an individual's needs. By simply making a phone call or holding a meeting, a community partner can aid the offender's reintegration.

On the other side of that equation, for the community, they get the assistance of corrections personnel who come equipped with a detailed history of the person seeking assistance.

"One way or another - and the community may not realize this - that [ex-offender] will show up on [a provider's] doorstep sooner or later," said Renick.  "If they work with [corrections], they have a little more information and planning and budgeting time to prepare to help."

In Ohio, both corrections and community-based organizations began to recognize these benefits as they embarked on a new re-entry strategy together called The Ohio Plan for Productive Offender Re-Entry and Recidivism Reduction.  The plan, which was developed in August of 2002, is comprised of 44 recommendations from reception to release where the agency and its partners assist offenders returning to the community. During 2003, the DRC had six teams working to implement these recommendations into the agency's day-to-day operations and community partnerships.

"This is changing the way we do business," said Renick.
 
Another organization that focused on assisting ex-offenders this year was Washington D.C.'s Court Services and Offender Supervision Agency (CSOSA). The agency, which operates probation, parole and pre-trial services for the District, created numerous collaborative interventions to help those returning to the community from prison, including one that involved members of the area's faith-based organizations.

"A lot of what we are dealing with is [ex-offenders] coming back to the community and not having pro-social involvement - they might continue their involvement with the anti-social [groups they knew before incarceration]," said Jasper Ormond, Associate Director of Community Justice Programs for CSOSA.  "We have a large faith-based community in D.C. and [the mentoring program] matches these people with ex-offenders and also puts services around them."

Since 2002, the CSOSA/Faith Community Partnership has trained and formally certified over 40 faith institutions as mentor centers for ex-offenders and made 100 mentor/mentee matches.

Sex Offenders

Like Washington D.C., Canada's correctional system also found great success in partnering with the faith-based community to help ex-offenders.  In this case, however, the population that volunteers are working with have an added stigma than simply being former inmates - they are sex offenders.

Ten years ago, Canada passed detention legislation that required high-risk sex offenders be detained until the end of their sentences. This meant they were released back into the community with no supervision, a fact many found troubling.

"When they were being released, there was no supervision nor accountability [mechanism] in place - they were free just like anybody else," said Rev. David Molzahn, Ph.D., Special Advisor to the Director General of Chaplaincy for Correctional Services of Canada (CSC).  "With high-profile sex offenders, the media and community became upset about the return [of these individuals] with significant histories of sex offending."

So, the Circles of Support and Accountability (COSA) program began, matching sex offenders with volunteers to help them transition back into the community.

"[The CSC] doesn't drive the program, it is a partnership," said Molzahn.  "We rely heavily [on volunteers], so we don't impose COSA on either the offender or the community. This concept is truly volunteer-driven and professionally supported. It wouldn't exist without [the community]."

Mentally Ill Offenders

While re-entering society after a period of incarceration is a difficult process for offenders from the general prison population, those with mental health issues face an even tougher transition.

Offenders with mental illness and other mental health problems not only need housing and other support systems in the community, but they need to be sure they have access to their medications, medical benefits and clinical treatment. Without those, they will be headed toward committing additional crimes and recidivating.

In the last year, this issue resonated with national leaders and those in the criminal justice system, leading to the development of new policy in this area.

On the federal level, in June U.S. Sen. Mike DeWine and U.S. Rep. Ted Strickland, both of Ohio, introduced the Mentally Ill Offender Treatment and Crime Reduction Act of 2003 that would direct up to $100 million in grants to state and local criminal justice agencies to address problems related to mentally ill offenders.

And the CSG, in conjunction with the National Institute of Corrections, began developing a technical assistance plan for jurisdictions interested in creating mental health partnerships to address the needs of this population.

Also, in January 2003, New York City settled a case (Brad H. V. City of New York) agreeing to provide discharge planning services for city jail inmates with serious mental illness. As of June, services had begun to be provided, according to Ellen Harris, staff attorney for the Bazelon Center for Mental Health Law, which was involved in the case.

"The case was based on state law. It was important because it was a recognition of the inmate's right to continuity of care, just like they have a right to discharge planning when they are released from a state psychiatric center," said Harris.

The new pre-release services, Harris said, include planning to help offenders obtain public benefits, such as Social Security (SSI), Medicaid, and treatment in the community. Prior to the settlement, released offenders were transported by bus to a central location, given a few dollars, subway tokens and no community connections.

"[These] decisions are important and when you put the legal basis in with the reality of what folks experience, we see that correctional systems are looking at better ways to manage people with mental illness, and reducing recidivism is very helpful to them," Harris said.  "If you can avoid having those who really need treatment coming in, you don't have to set up systems that don't blend with the correctional mission.  Plus, it serves the individual better."

Re-entry for offenders with mental health problems was an issue in Colorado this year, too.  There, corrections practitioners began to bridge the communication gap between parole officers and mental health services.

Oliver Gysin, Coordinator of Community Mental Health Services for Clinical Services for the Colorado Department of Corrections, said that parole officers were frustrated that they knew little about the offenders coming onto their caseloads, so he set out to create an outline for the successful transition of these offenders.

"At each facility there is a mental health coordinator who manages the mental health services in the facility. When I established the regulations, they were designated to be responsible for a release plan. Along with that, [the offenders] get a 30-day supply of meds and an appointment when they leave the prison facility," said Gysin.

Each mental health coordinator is responsible for a transition plan for each offender, Gysin said, that goes to the parole board and officers in the community.

"What I'm looking for here is a continuity of care," he said.

Youth

For juvenile offenders, the minute they walk out the door from incarceration can mark a milestone in their lives. From that moment, they see themselves as either ex-offenders or first-time inmates. To ensure that their first time behind bars is their last, juvenile justice agencies around the country worked on aftercare and transition services to meet the various needs these young people have when they return to the community.

"I think [re-entry] is probably the most important issue we are working on now because when a resident is committed to our system, we give them structure, character building, build their self-esteem and there is always someone who cares about him or her and the majority of the time, the child responds well," said Howard Beyer, Executive Director of the New Jersey Juvenile Justice Commission (JJC).  "[Then] they go back home and that's where the difficulty lies. While we've worked on rehabilitation [while in custody], the reality of the real world sets in [upon their release]."

This reality, said Beyer, can include going back to a neighborhood or even a home where drug and alcohol problems still exist, despite the juvenile's efforts to denounce these habits during incarceration.

"One of the issues that has plagued us is housing," he said.  "A lot of these kids don't have a place to go, so sometimes we have to stick kids where we really don't want them to go and that's not in their best interest. All we did [through programming] can go down the toilet if they are not in the appropriate situation."

And providing kids with programming and a safe and stable place to go after incarceration is important to preventing juveniles from returning to the justice system.
 
"I think we have to start on the front end versus the back end," said Ron Anderson, Director of Juvenile Services for the Indiana Department of Correction (IDOC). "[Corrections has] worked more with adults than juveniles in wanting to give them the tools and skills [to use] when they leave [incarceration], but if we get their attention when they are kids - before they can become felons - we'd have a better advantage. We can have a long-term solution to a big problem."
 
In light of this, the IDOC worked throughout 2003 to provide greater support systems to juveniles leaving their system.

Juveniles committed to the IDOC have the unique opportunity to have their re-entry needs addressed not only as they return home to the community, but also once they walk into a facility. This is possible through a partnership between the agency and Indiana University-Purdue University Indianapolis (IUPUI) that began in 1996 and provides these youths with mentors to guide them along the way.

"[Juveniles] don't naturally plan on their own," said Roger Jarjoura, Associate Professor in IUPUI's School of Public and Environmental Affairs.  "If you ask them 'What are your plans?' they have none and are more interested in their freedom versus staying on track."

To assist both these juveniles and the IDOC, Jarjoura created the Aftercare by IUPUI through Mentoring (AIM) program to create transition planning for youthful offenders with help from volunteer members of the community. The program is voluntary, yet Jarjoura says many juveniles take advantage of it.

AIM begins as soon as youths set foot into one of Indiana's 10 juvenile correctional facilities. There, volunteers from the Indiana Mentor Corps -created through the nationwide AmeriCorps initiative - identify the juvenile's needs, run life skills courses and also work to begin a re-entry plan in preparation for the juvenile's release, including securing referrals to community-based services.

During their incarceration, juveniles are also connected to a mentor who will be available in the community to help them access needed services as well as a shoulder to lean on in tough times.

Like Indiana, New Jersey officials also utilized partnerships and the centralized convenience of one-stop centers to aid juveniles coming home from incarceration.

Through grant funding from the Office of Justice Program's Serious and Violent Re-entry Initiative, the N.J. JJC began to transform two of its day reporting centers in Camden and Newark into one-stops where juveniles can go to access all the services they need in one location. To do this, however, the JJC recognized it needed to bring to the table the people who oversee these services and other support systems to provide the best for young people.

"We realize[d] we cannot do this alone," said Beyer.  "We need[ed] help from the faith-based community, local organizations, civic groups [and others] to help us help a young man or woman be successful when they come out and re-enter the community."

To emphasize the importance of partnerships, Beyer says that William Curry, the agency's Director of the Division of Juvenile Parole and Transitional Services, spends nearly 70 percent of each day building relationships with community members to pool services and support for reintegrating juveniles.

"Juvenile corrections is about rehabilitation and about returning kids home - that is ultimately where the success of the individual is," said Curry.

Another component of this success the JJC wholeheartedly believes in is education. The agency works closely with the state Department of Education and local schools to ensure that a young person can continue his/her educational pursuits once they complete their sentence.

"One of the most important things the JJC does is education and building [a foundation] around education while [juveniles] are with us," said Beyer.  "This is because most people who are successful or who are going to be successful are going to do so built on the educational process, so we view education as very, very important to the success of a child leaving our system."

Victims

For many years, victims were often forgotten by the criminal justice system once an offender had been sentenced. But, that has changed, especially in 2003, as many corrections agencies feel a growing responsibility to educate victims about the system and inform them of an offender's release date and other information.

This trend is helping to protect victims from further victimization, and in some cases, is educating the offender about the harm they bring to others through their actions. In more intensive victim-offender programs, this typically leads to reduced recidivism and prevents more harm to the victim.

In North Carolina, the DOC operates under the requirements of the Crime Victims Rights Act, which went into effect in 1999. The law provides victims with access to information and the opportunity to be involved in the criminal justice system, and provides rights to victims through the various phases of the criminal justice system.

Tim Moose, Chief of Special Operations and Programs for the N.C. Division of Community Corrections, said 14 victim advocates and notification coordinators are dispersed in 14 different geographic locations throughout the state to provide information and support to victims. The victims must notify the district attorneys in their area that they want to receive notification and services. That information is then passed onto the victim advocates.

Also, as corrections agencies are focusing more energy on the victims of crime, restorative justice has gained more attention in recent years.  These practices range from victim-offender family conferences, where each party has support from family members or others, to victim offender mediation, where an agreement is worked out to restore or heal the victim.  Restitution by the offender to the victim is often worked into the dialogue and may range from actual monetary compensation to community service work.

Several agencies across the country are trying variations on these restorative programs, like the Boulder County, Colo., Sheriff's Office, which provides a range of services through victim advocates and victim-offender conferences.

According to Jessica Oldham, Restorative Justice Case Manager for the Sheriff's Office, statistics from the three years the conferences have been running are positive. Eighty percent of those offenders involved in conferencing have not committed another crime within a year of the conference, she said.

"We've had a lot of successful stories. A lot of times offenders want to participate as a community member after the conference. They feel all-around they are a better person," she said.

Partnerships

Corrections officials have discovered that it takes more than one agency to help an offender be successful after release. As a result, partnerships between corrections and community organizations are becoming more and more commonplace.

Volunteers

In one sentence in the President's State of the Union speech this year, the entire nation learned about a small, but vitally important facet of volunteerism in corrections. The President spoke of support for mentoring programs for the children of incarcerated parents as an example of giving back to those in need.

What he did not mention is that these types of programs have been ongoing in corrections departments for many years and are representative of the work that volunteers perform inside and outside of prisons and jails every day.

Volunteers are critically important to corrections because they provide that one ingredient that a paid staff member cannot: caring and love on an unconditional basis.

A program in Georgia called Aid to Children of Incarcerated Mothers (AIM) was created 15 years ago focusing primarily on mothers behind bars. An attorney working with this population in the Georgia prisons founded the non-profit group in Atlanta after realizing that in order to succeed after release, these women needed support on the outside.

Then, that concern shifted toward their children.

"The main issue is nobody knows about them; they won't talk about their moms being in prison," said Josita Hartman, Deputy Director of AIM.

Today, AIM has a host of volunteer-based programs centering on the children of incarcerated mothers, but also provides indirect support to the moms and the interim caretakers on the outside.

The services include after school programs for children, summer camps, teen leadership projects, prison bus trips once a month as well as support groups for caregivers and legal seminars for the incarcerated mothers.

Like Georgia, Virginia put stock in volunteer programs in 2003, too.  There, a federal grant helped corrections officials to bring the needs of the offender population to the community's attention and build new relationships.

While many of the 4,000 community volunteers who work inside the Virginia prisons do so through religious programming, there is a small group of 24 volunteers who are playing a special role in offenders' lives through Project SOAR (Supporting Offenders After Release), which was created along the lines of President Bush's faith-based initiatives.

"We have 24 inmates with mentors. We've had 82 graduates and none of the 82 has returned. We think it is a very effective program," said Dr. Louis Cei, Manager of Special Programs for the Virginia DOC.

As opposed to traditional religious volunteer programs, the department works directly with churches and different faiths to recruit mentors to go beyond a faith focus to help offenders prepare for release.

"I'm really proud that Virginians are taking the time to do this when others are playing golf and boating. It's very inspirational," Cei said.

In Texas, community members got involved with corrections as well this year.  There, youth who are adjudicated in one of the many state schools have the opportunity to interface with volunteer community members in a number of ways. Administrators at the Texas Youth Commission believe that these volunteers provide a unique service to the offenders.

"We believe that community volunteers can expand what our staff already do. They don't replace our staff, but they bring in an aspect and resources that the state cannot provide," said Tammy Vega, Administrator of Community Relations for the Texas Youth Commission.

Volunteers work with the youth through mentoring programs as well as through programs set up by local Community Councils.

"I think these citizens recognize that the state can only do so much and state budgets can only go so far and that the children inside of the schools need more. Their primary purpose is to bring resources," said Vega.

Workforce Development

Corrections professionals have long understood the relationship between employment and staying out of jail or prison, but this year that concept has evolved into a new philosophy: offenders need more than a minimum wage job, they need to be able to see a new future for themselves.

"The culture in the past has been to get offenders a job, any job, but that doesn't work.  We wanted to impact as many as we can in the correctional environment to shift it to career: get a job, retain the job and plan for advancement. That's how people will become self sufficient," said Carla Laughlin, lead trainer for the National Institute of Corrections' Workforce Development Specialist Training.

Corrections officials in Vermont have supported the idea of connecting offenders to work both inside the facility during incarceration and outside in the community after release in many ways. The Vermont Offender Work Program (VOWP), which is part of the DOC, provides a number of opportunities and outlets for offenders to connect to jobs ranging from traditional work training inside the facility to workforce development through community justice centers. Those centers connect offenders who have been released to employers as well as other resources in the community.

In 2003, the department received a federal grant that enabled offenders to receive additional workforce placement services in the community and enhanced programs that have been working for years.

According to Bert Senning, Director of the VOWP, the grant is designed to link the department's offender population with a community base through community justice centers through a number of different programs and approaches.

"Even before they go out the door there will be community re-entry panels that begin working with offenders as they begin to come back to the community," he said.

Like Vermont, creating a pathway to the community for offenders has been a focus of the Minnesota DOC for many years. One of those programs, Sentencing to Service (STS), began in 1985 as a cooperative effort between counties and the state to connect inmates with community service projects.

According to Mark Seimers, a DOC Regional Supervisor, the inmates from local jails, are assigned a team leader and go out in a crew to various locations to complete the services needed.

Some of the projects include work in local parks trimming trees or demolition work.

Like similar work programs in other states, the offenders involved are all non-violent and many are sentenced to the service program from the court as an alternative to incarceration. If the offenders are incarcerated when they start the program, then they get credit off of their sentences.

A more recent take-off on the STS program is the state's Institution/Community Work Crew program.

This program began in 1995 for minimum custody inmates in the prisons. Organizations in the community can hire out the crew for a variety of jobs - most for a year at a time. The cost of the 12-man crew, plus a crew leader, is $65,000 a year, which Siemers said is a bargain, considering what an agency would have to pay to hire a single individual for a year.

To make these types of work programs truly successful, however, it takes more than having an impact on the offender. It takes a shift in how corrections agencies view offender job placement. That is what the NIC tried to impact through its training in 2003 and hopes to affect in coming years.

Healthcare

In 2003, healthcare remained an important issue for corrections practitioners, as both physical and mental health problems persisted among inmates in the nation's prisons and jails.

Hepatitis C

While it is still true that correctional agencies have differing approaches to the evaluation, testing and treatment of prisoners with hepatitis C (HCV), guidelines and standards are emerging as the profile of the disease is raised and this will likely translate to new correctional policy.

Aside from the sheer number of infected offenders that correctional agencies are housing - estimates are that anywhere between 12 and 35 percent of inmates have HCV  - correctional health care practitioners are also being pushed to action by recommendations from the Centers for Disease Control (CDC).

And, beyond that, inmates have regularly begun to sue correction agencies for HCV treatment, all making for an increased need to address this disease among the inmate population.

In early 2003, the CDC issued recommendations for the prevention and control of hepatitis virus infection in corrections. The recommendations cover hepatitis A, B and C and discuss risk factors, statistics for prevalence in adult and juvenile correctional facilities and epidemiology as well as strategies for prevention and management. (See http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5201a1.htm)

In relation to hepatitis C, the document outlines the CDC's national strategy to prevent infection including risk-reduction counseling, appropriate medical management of infected persons, screening to eliminate transmission and improved infection reduction practices.

"The high prevalence of HCV infection and risk associated with HCV infection among inmates requires inclusion of HCV prevention activities in correctional settings.  To be effective, risk reduction among this population often requires a multidisciplinary approach to address drug use as well as other medical, psychological, social, vocational, and legal problems," the recommendations say.

With specific regard to prevention, the recommendations stated that those chronically infected with HCV can benefit from health education including substance abuse treatment, clean needle and syringe use, risks of sharing drug paraphernalia and condom use.

With testing, the CDC recommended that HCV testing be conducted routinely to identify infected persons.

The recommendations also listed the three FDA-approved antiviral therapies for treatment of chronic HCV in persons aged 18 years and older: alpha interferon, pegylated interferon, and alpha or pegylated interferon in combination with ribavirin. The period of time in which the medications are administered and the response rates for those medications were also listed.

The document also addressesed coinfection of HCV and HIV and the decision to treat these persons. The CDC stated that if CD4 counts are normal or minimally abnormal then, treatment responses to interferon monotherapy are similar to non-HIV-infected persons. Also, the efficacy of ribavirin/interferon combination therapy (for HCV) among HIV-infected persons has been tested in only a limited number of patients. As a result, the CDC stated that each patient should be evaluated by a physician familiar with the treatment of patients with HCV infection and HIV infection when appropriate, and indications for therapy should be reassessed at regular intervals.

While the CDC formulated these recommendations for correctional agencies to follow and consider, the document's authors also realize the challenges that corrections departments, like the Pennsylvania DOC, faced in providing testing and treatment for HCV.

While the DOC has been testing offenders for HCV and treating those who show advanced signs of the disease for more than a year, it altered its protocols in 2003.

According to Susan McNaughton, spokesperson for the DOC, the agency's guidelines changed as of September 1, based on lessons the department has learned and the release of CDC guidelines.

One important change was the addition of pegylated interferon to the DOC's drug formulary for HCV treatment because if its efficacy and that the drug requires fewer injections for the offender.

Additionally, the DOC began conducting liver biopsies to determine which offenders who test positive are in fact at risk for liver failure.

HIV

HIV treatment was once again a hot topic in corrections in 2003.  Correctional health care practitioners from across the country got a substantial dose of HIV education in September in Rhode Island at the HIV Mini Fellowship Program for correctional health care providers sponsored by the University of Texas Medical Branch at Galveston and the HIV Education in Prison Program at Brown University.

The three-day program featured HIV treatment experts, correctional mental health care providers, infectious disease experts and ethicists who all discussed various aspects of correctional health care, primarily relating to HIV.

David Paar, M.D., Program Director for the fellowship and Director of AIDS Care and Clinical Research for the Division of Infectious Diseases at UTMB, explained early on in the program that those who are infected with HIV have shifted from "men who have sex with men" to intravenous drug users, which has caused the concentration of HIV-positive prisoners to rise.

"The shifting has put these people into prisons," Paar said, emphasizing the importance of HIV treatment education to corrections. UTMB, where Paar is also an assistant professor of medicine, provides health care for a large portion of offenders in the Texas Department of Criminal Justice.

Underlying the discussions was the realization of the unique role correctional health care providers play in comparison to physicians and health care providers on the outside.

"There are conflicting values associated with treating in corrections. Corrections may confine, deprive and punish, but doctors diagnose, comfort and treat. We have an ability and a right to be there," said Paar.

The mini fellowship offered providers a variety of information about HIV disease, from its beginnings and biology to its interactions with other prevalent diseases in corrections, such as HCV, and suggestions for treatment.

In terms of behavior, Paar noted one change that has affected the prison population -- the increase of injection drug use among minority populations and among women. As state and federal laws have focused on sentencing drug users for longer periods of time, more infected people have become incarcerated.

Paar also reported that as physicians and correctional agencies have become more familiar with HIV treatment and as drugs have improved, the number of deaths related to HIV has decreased.  In the TDCJ, for example, about 120 HIV-positive offenders died in 1995 versus fewer than 10 in 2000.

Post-Exposure Prophylaxis

HIV transmission is believed to be a rare consequence of blood or body fluid exposures in the correctional setting.  However, if transmission occurs, the consequences are permanent and potentially deadly.  Likewise, hepatitis C and hepatitis B transmission can lead to lifelong illness and sometimes a shortened life expectancy.  Fortunately, post-exposure interventions that might reduce the transmission risk, and thereby diminish the consequences of an exposure, do exist and appear to be effective. 

Post-exposure prophylaxis (PEP) protocols that incorporate such interventions have been implemented in many settings, particularly for health care staff.  However, few correctional institutions have implemented blood or body fluid post-exposure protocols for inmates exposed to bloodborne pathogens by any route (injection-drug use, consensual sex, or sexual assault).  This deficit is especially noteworthy given recent calls for PEP implementation in jails and prisons.  Given the acceptance of PEP outside the correctional setting, adoption of PEP protocols in the correctional setting may help reduce the legal, emotional, and medical ramifications of an exposure event for this vulnerable population.

Of course, prevention of blood or body fluid exposures is preferable over post-exposure interventions since such post-hoc measures are not completely effective, are costly, and carry the potential for adverse side effects.  However, not all exposures can be prevented, particularly in jails and prisons. It therefore is advisable that both pre- and post-exposure bloodborne pathogen transmission preventive measures be enacted in correctional settings. 

Legal Issues

In 2003, a variety of legal issues and Supreme Court rulings affected corrections agencies and their daily operations.

Sentencing

Mandatory minimum sentencing statutes that exist in many states triggered a national debate in 2003 over whether people who have been convicted of crimes should be sentenced pursuant statute or by a judge who can use his or her own discretion to evaluate the circumstances of each case. 

While the dispute between legislators and judges raged on within individual states, a similar controversy over who yields ultimate sentencing power erupted at the federal level.

With federal sentencing guidelines in place and an act passed this year by Congress requiring judges to account for any departures they make from those sentencing standards, a struggle involving the federal judiciary, the legislature and the Department of Justice emerged in 2003.

The fighting continued on both battlefronts throughout the year, while the courts, Congress, corrections and the general public tried to make sense of sentencing.  Some of this year's court cases and legislative decisions helped to frame the issue and sort out its intricacies, though.

Mandatory sentencing advocates recorded a victory earlier this year when, in Ewing v. California, the United States Supreme Court upheld California's "Three Strikes Law."

Gary Ewing had previously been convicted of several crimes, including four serious or violent felonies, when he was convicted of felony grand theft for stealing golf clubs.  That was Ewing's third "strike" and it earned him a lengthy prison sentence, which he appealed on the grounds that it was disproportionate to his crime and a violation of his constitutional rights. 

On March 5, 2003, the Supreme Court ruled against Ewing, holding that his sentence was not was grossly disproportionate to his crime. 

While the U.S. Supreme Court found that California's "Three Strikes Law" did not violate the Eighth Amendment in the Ewing case, the high court in Arizona this year came to a different conclusion in a case there that challenged state sentencing laws.

In Arizona v. Davis, the state Supreme Court ruled that the 52-year prison sentence Charles Davis received for having consensual sex with two teenage girls was disproportionate to his crime.  The Court remanded the 20-year-old's case to Superior Court for retrial and resentencing.

Meanwhile, in Michigan, tough mandatory sentencing laws lost favor this year.  New laws became effective in March and changed the state's traditionally harsh mandatory minimums for drug-related crimes.

Prior to the enactment of the laws reforming Michigan's sentencing requirements, anyone convicted of possession of between 50 and 224 grams of narcotics or cocaine, even with no prior offenses, faced a mandatory minimum sentence of 10 years.  Under the new legislation, however, judges are no longer required to abide by the 10-year minimum; sentences can now vary up to a maximum of 20 years.

While judges in states like California, Arizona and Michigan tried to find room for their own voices amidst the sea of mandatory sentencing laws, judges at the federal level also grappled with issues related to sentencing.

In April, Congress passed the Protect Act, legislation that primarily addresses the sentencing of people who commit offenses against children.  A small section of the Act, known as the Feeney Amendment, however, originally required judges to justify to the Department of Justice all sentences they imposed on any criminals that were less than the federal sentencing guidelines mandated for a particular crime.  Although the Feeney Amendment was changed to pertain only to "downward departures" from the guidelines made in cases involving offenses against children, that provision, before it was amended, created some tension between judges and lawmakers and the Department of Justice.

"I think that there certainly is an effort to take discretion away from judges in the Feeney Amendment," said Former New York District Judge John S. Martin, Jr., now of Debevoise & Plimpton.

DNA Testing

With more than 130 inmates nationwide being exonerated of their death penalty crimes through DNA testing, the public shifted its position this year on the level of proof that is needed for a death penalty conviction.  Lawmakers are part of that group.

If a bill currently before Congress is passed, then federal legislators will have made major inroads toward improving access to DNA testing for federal and state offenders, expanding training for prosecutors and defense attorneys on handling death penalty cases, increasing funding for completing DNA tests and increasing compensation for those found innocent post conviction.

"All of us, victims and potential victims, juries, police who have to do the arrest, the corrections officers who have to deal with overcrowded prisons and questions of innocence, are affected.  This legislation would help inject a sense of confidence in the system.  I think corrections officers most want to see the guilty guys in jail and innocent people on the street," said Peter Loge, Director of The Justice Project's Campaign for Criminal Justice Reform, which is a major supporter of the legislation.

As corrections agencies are often charged with carrying out the testing of certain offenders and are the gatekeepers for those on death row who seek DNA testing, the bill could mean some changes in how staff accomplish these tasks.

Originally presented to Congress in 2001 as the Innocence Protection Act, the legislation has since been re-worked and included as one part of the Advancing Justice Through DNA Technology Act, which was introduced to Congress on October 1, 2003.

Overall, the legislation has received high praise from inmate advocate groups and those concerned with DNA testing, as well as lawmakers.

Sex Offender Registration

The Supreme Court decided its first case involving a convicted sex offender who was required to publicly register on the Internet in 2003.  In Connecticut Department of Public Safety v. Doe, the question posed to the Court was whether the Due Process Clause of the 14th Amendment prevented a state from listing convicted sex offenders in a publicly disseminated registry without first providing offenders with individualized hearings and assessments regarding their current level of dangerousness.

After weighing the public's right to know versus the offender's privacy the Supreme Court upheld the constitutionality of online sex offender registration.

According to Justice Ruth Bader Ginsburg, due process does not require the opportunity to prove a fact, especially not one that is "not material to the State's statutory scheme." It was also noted in the case that the purpose of such Internet registries was to make information easily available and accessible, "not to warn about a specific individual."

"There will always be the controversy of personal privacy versus public safety," said William "Bill" Sturgeon, Principal for Institute for Adult Education and Training whose institute helps correctional agencies draft new policies, implement procedures and train staff.  "And when it comes to these individuals [sex offenders] the citizens perceive public safety as their right to know."

Visitation

In June 2003, the Supreme Court decided Overton v. Bazetta, a case brought about by a group of inmates and their prospective visitors against the Michigan DOC.  The suit claimed that imposed visitation restrictions were a violation of the First, Eighth, and Fourteenth Amendments.

The Supreme Court's ruling stated that all persons in the United States, including convicted offenders, are guaranteed rights under the Constitution.  Understanding these rights not only affords the agency protection but also provides guidelines for managing and supervising offenders in a manner that promotes a safe and secure environment in a cost effective manner. 

The ruling mentioned on many occasions that it is important to remember that visitation is a privilege and not a right, provided that alternative means of communication are available and access to clergy and defense is obtainable.  The ruling said that methods need not be convenient but available; vehicles such a correspondence and telephone calls were acceptable alternatives according to the Justices.

In the opinion syllabus, Justice Anthony Kennedy stated, "Visitation variables need not to be ideal; they need only be available."

As we look ahead to 2004, different legal issues will emerge, more medical advancements will be made and corrections will undoubtedly continue to implement new programs and policies to aid offenders in their transitions back into the community.  The Corrections Connection Network News will follow these developments into the new year and keep an eye on the changing face of corrections. 

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