December 30, 2007
Infection Hits a California Prison Hard
COALINGA, Calif. — When any of the 5,300 inmates at Pleasant Valley
State Prison begin coughing and running a fever, doctors do not think flu,
bronchitis or even the common cold.
They think valley fever; and, more often than they would like, they are right. In the past three years, more than 900 inmates at the prison have contracted the fever, a fungal infection that has been both widespread and lethal. At least a dozen inmates here in Central California have died from the
disease, which is on the rise in other Western states, including Arizona,
where the health department declared an epidemic after more than 5,500
cases were reported in 2006, including 33 deaths.
Endemic to parts of the Southwest, valley fever has been reported in recent years in a widening belt from South Texas to Northern California. The disease has infected archaeologists digging at the Dinosaur National Monument in Utah and dogs that have inhaled the spores while sniffing for illegal drugs along the Mexican border. In most cases, the infection starts in the lungs and is usually handled by the body without permanent damage. But serious complications can arise, including meningitis; and, at Pleasant Valley, the scope of the outbreak has left some inmates permanently disabled, confined to wheelchairs and interned in expensive long-term hospital stays. About 80 prison employees have also contracted the fever, Pleasant Valley officials say, including a corrections officer who died of the disease in 2005. What makes the disease all the more troubling is that its cause is literally underfoot: the spores that cause the infection reside in the region’s soil. When that soil is disturbed, something that happens regularly where houses are being built, crops are being sown and a steady wind churns, those spores are inhaled. The spores can also be kicked up by Mother Nature including earthquakes and dust storms. “It doesn’t matter whether you’re custody staff, it doesn’t matter if you’re a plumber or an electrician,” said James A. Yates, the warden at Pleasant Valley. “You breathe the same air as you walk around out there.” The epidemic at the prison has led to a clash of priorities for a correctional system that is dealing with below average medical care and chronic overcrowding. Last fall, heeding advice from local health officials and a federal receiver charged with improving the state’s prison medical care, the Department of Corrections and Rehabilitation delayed plans to add 600 new beds out of concern that the construction might stir up more spores. Officials at the prison blame the construction of a state hospital nearby for causing a spike in valley fever. The construction was under way from 2001 to 2005, and valley fever hit its peak here in 2006, when the disease was diagnosed in 514 inmates. This year, about 300 cases have been diagnosed among inmates at the prison, which sits along a highway lined with almond groves and signs advertising new “semi-custom homes.” Felix Igbinosa, the prison’s medical director, said “the No. 1 reason” was thought to be the soil disturbance from new construction. The delayed expansion here was part of a $7.9 billion plan signed by Gov. Arnold Schwarzenegger last summer to relieve overcrowding in the state’s prisons. Pleasant Valley was built in 1994 to house 2,000 inmates. California reported more than 3,000 cases of valley fever in 2006, the most in a decade. Explanations for the spike have included increased residential development and changes in weather patterns that have resulted in increased blooms of the fungus. Other prisons in the Central Valley of California have had increases in the number of fever cases in recent years, but in none has the rate of infection been higher than at Pleasant Valley, where about one inmate in 10 tested positive in 2006. Even allowing for the nearby construction, experts say they do not know why the disease is so rampant here. “Is the soil surrounding Pleasant Valley different?” asked Dr. Demosthenes Pappagianis of the University of California, Davis. “There’s a lot we still need to know about it,” said Dr. Pappagianis, a professor of medical microbiology and immunology who has been studying valley fever for more than 50 years. Early symptoms of the disease, which is clinically known as coccidioidomycosis, mimic the flu, with symptoms that include a cough, lethargy and a fever. Most of those who become infected recover with little or no treatment and are subsequently immune. In about 2 percent to 3 percent of the cases, the disease spreads from the lungs and can attack the bones, liver, spleen and skin. For the 11,000 non-inmate residents of Coalinga, about 200 miles southeast of San Francisco, the disease has been a fact of life for generations. “We just deal,” said Trish Hill, the city’s mayor. “You don’t do stupid things like go out on windy days or dig in the dirt.” Inmates appear to be especially susceptible to the disease, in part because they come from areas all over the state and have not developed an immunity to the disease. California corrections officials are preparing new guidelines for prison design, including ventilation and landscaping. “Prisons tend to have a lot of bare dirt, and that has some security benefit,” said Deborah Hysen, the corrections department’s deputy secretary of facility planning. “But in the case of valley fever, you want to really contain the soil.” At Pleasant Valley, officials say the outbreak of valley fever places a burden on the institution, requiring guards to escort inmates to local hospitals, where stays can last months and result in medical and security costs of $1 million and more, said Dr. Igbinosa, the medical director. The disease also affects inmate morale, doctors say. Gilbert Galaviz was convicted of murder and is serving a sentence of 25 years to life. Mr. Galaviz had been at Pleasant Valley for a week or so when he started to feel sick. “I couldn’t breathe,” he said. “My chest starting hurting, I had pain all over like somebody beat me up, and I would sweat bad at night.” The cause was valley fever. After six months, Mr. Galaviz is still weak, having lost 30 pounds, and is barely able to complete a lap in the prison yard. Earlier this month, he was attacked and his jaw broken. “It wouldn’t have been like that if it hadn’t been for valley fever,” Mr. Galaviz said, his jaw still wired shut. “They wouldn’t have got me. It would have been the other way around.” Dan Barry is off. Beginning Jan. 14, the “This Land” column will appear on Mondays.
http://www.fresnobee.com/local/story/8101687p-8958147c.html Conflict in Confinement Severe overcrowding in state's prisons breeds all types of trouble. By Donald E. Coleman
(Updated Sunday, February 8, 2004, 5:35 AM)
At Pleasant Valley State Prison, inmates are housed dormitory-style
on triple bunk beds in four COALINGA -- Don't be fooled by the name. Pleasant Valley State Prison is hell on earth for many of its inmates. The reason: overcrowding. The facility, built some 10 years ago, was designed for 2,200 men; it houses almost 4,900, or 222% of its design capacity. Nowhere is Pleasant Valley's overcrowding more apparent than in its four gymnasiums, home to about 480 prisoners. The buildings never have seen a basketball game. The floors are covered with three-level bunk beds and wall lockers with photos taped to them. Men must turn sideways to pass each other among the rows of bunks. Inmates in wheelchairs often struggle amid the cramped paths to reach their destination. Joe, serving two years on a drug charge, shares one of the gyms with more than 100 men on a fall day. He is from Stockton and gives only his first name. "I'd rather be in a cell than live like this," he says. " ... This is a terrible place. How it got the name Pleasant Valley, I have no idea." Pleasant Valley is the essence of a widespread overcrowding crisis plaguing the state's prison system. All of California's 33 men's or women's prisons are above design capacity; Pleasant Valley ranks No. 4. Overcrowding itself is only a part of a wider crisis with the state's prisons. Critics allege the system is poorly managed and infested with corruption. Gov. Schwarzenegger last week said he will appoint a special commission to investigate the prisons and suggest ways to fix them. It remains to be seen whether the commission will tackle the specific problem of overcrowding and its occasionally deadly consequences. The world outside Pleasant Valley's walls learned just how deadly on Oct. 12 when an inmate was shot and killed by a guard during a riot. Prison officials gave a one-word explanation for the riot's cause: overcrowding. What they didn't explain is the cause of the overcrowding -- at Pleasant Valley and systemwide. Tougher sentencing laws, voter demands for law and order, politicians intent on pleasing voters and a cash-strapped state budget are all part of the answer. Which means one thing: There is no painless solution. The state's prison system, with a $5.3 billion annual budget, is reeling. Angry state lawmakers in January claimed the Department of Corrections was morally adrift, a charge sparked in part by a recent federal report alleging perjury by prison guards in inmate abuse cases at Folsom State Prison. Schwarzenegger and his top prison officials are promising reform. Over the past two decades, California built 21 prisons and added thousands of cells to existing ones. But the inmate population rose fivefold. The overcrowding crisis only got worse. At the end of 2003, California had 144,044 inmates in the state's 29 men's prisons -- nearly double their design capacity. The four women's prisons were only slightly less crowded: 9,659 inmates in facilities designed for 5,510 people. "Overcrowding is a major issue which leads to deterioration of the facilities and violence," says Kara Gotsch, public policy coordinator of the National Prison Project, a Washington-based program funded by the American Civil Liberties Union. "Overcrowding is one component that contributes to many different problems." Put too many prisoners in a space too small and sanitation declines. Medical costs can soar because prisoners become unusually susceptible to disease. Medical care can deteriorate, says the wife of a Pleasant Valley inmate. She says her husband contracted Valley fever while in prison. "He originally asked for medical care and was pushed through like cattle and told he had a cold," says the woman, who didn't want to be identified. "He went back again, and they said he had pneumonia. Then the blood work came back with Valley fever." She said her husband had to "fight" to get proper medical care. Valley fever, primarily a disease of the lungs, is caused by a fungus which grows in dry soils such as the San Joaquin Valley's. Infection occurs when the spores become airborne and are inhaled by people. The disease is not passed from person to person. A Pleasant Valley spokesman denies there is an outbreak of Valley fever at the prison, saying there have been several cases of staph infections, which were traced to prisoners from Los Angeles County. Department of Corrections spokeswoman Terry Thornton says inmates receive the proper medical care. She says the annual cost of housing, food, medical care and other expenses is $28,439 per prisoner. Prison experts say inmate aggravation goes hand in hand with overcrowding. Violence soon follows. The experts say prison overcrowding also figures in the state's high recidivism rate as too many ex-convicts, often angry and untrained for a new start on the outside, soon revert to a life of crime. Says Gotsch: "Prisons are very violent, unsafe and damaging places. A person goes in and is never the same." As the prison population increased over the past two decades, the prisons began running out of cell space. The state says 8,285 inmates in 20 prisons were housed in gymnasiums as of December. Authorities say they have little choice. Prisons, says Thornton, "are always going to be above design capacity." She describes design capacity as one person per cell. So-called rated capacity is two people in a cell. Maximum capacity, she adds, is putting inmates "in gyms or wherever you can." Maximum capacity is the state's current philosophy. Prison officials place inmates in four categories. Level 1 inmates are nonviolent offenders housed in open dormitories without a secure perimeter. Level 2 prisoners live in dormitories, but the buildings have fenced perimeters and armed coverage. Level 3 prisoners live in cells. Sentences are longer, and inmates have several prior prison terms or significant behavior problems. Level 4 is maximum- security. The prisoners in Pleasant Valley's gymnasiums are Level 3. "It's scary when you put Level 3s in a gym," Thornton says. Just how scary became clear last September when what Thornton calls "a huge riot" erupted late at night at Deuel Vocational Institution near Tracy. At least nine inmates were injured. Officials say the disturbance started in a huge gymnasium divided into two large dormitories that housed 420 inmates. Authorities blamed the riot on overcrowding. The Pleasant Valley riot, involving about 300 inmates in a gymnasium, erupted the next month. A guard shot and killed Alejandro Enriquez, 28, of Whittier, who was serving 15 years to life for second-degree murder. This violence reflects a trend that has been building for more than a decade. The number of inmate incidents in state prisons nearly doubled from 6,243 in 1993 to 11,610 in 2002. Nearly 60% of last year's incidents involved assault and battery. Prison staff members as well as other inmates were among the victims. The state's prison overcrowding problem wasn't always this serious. In 1982, the state had 32,152 men and women serving time in a prison system with a design capacity of 24,611 -- 131% of design capacity. Over the next 20 years, the prison population steadily outstripped new prison construction. Gotsch, with the National Prison Project, says the increase in prison population can be traced to the war on drugs, tougher sentencing laws and Three Strikes laws. Nearly half of the state's prison inmates were convicted of crimes against other people. According to the state, 24% are in for drug offenses. Longer sentences are another factor. As of Sept. 30, there were 42,445 inmates -- 27% of the total -- in state prisons for second and third strikes. "People aren't getting released as quickly," says Brant Bramer, a Fresno County Superior Court judge who handles sentencings. "Three Strikes means they have to serve 80% of their time. In the past, if they had to do two or three years, they could be out in six months. Under Three Strikes, if they are sentenced to four years, they have to serve at least three." Three Strikes, passed in 1994, defines certain violent or serious crimes as strikes. A felon with one strike who picks up a second strike must be sentenced to at least twice the usual term for the new crime. A person with two strikes who picks up a third strike must get 25 years to life. The campaign to pass the Three Strikes law was launched by Fresno's Mike Reynolds after the 1992 slaying of his daughter, Kimber. Former Fresno County District Attorney Ed Hunt says Three Strikes "was good when it passed, and it probably still is, but there are some injustices." There could be some relief to the overcrowding problem on the horizon. Sentencing reform, improvements in the parole system and a new prison in Delano are among the proposed answers. The state expects the average daily prison population to drop through parole by more than 5,000 by this summer and by nearly 15,000 at the end of the 2004-05 fiscal year. Lower prisoner populations, the governor's budget summary says, will allow the Department of Corrections "to move inmates out of gyms and appropriately place inmates in suitable housing situations. ... " The Department of Corrections' Thornton says the prisoner reductions will be achieved through reforms in the parole system. This system was called a "billion-dollar failure" by the state's watchdog agency, The Little Hoover Commission. The commission's November 2003 report says two out of three parolees in the state return to prison as compared to one out of three nationally. "Parolees are a challenge for all states," the report says. "But California's parole policies are simply out of sync with the rest of the nation. California puts a greater percentage of felons on parole. The state offers little assistance to parolees. And then it sends parolees back to prison for violations that in other states would land a parolee in drug treatment, work furlough or some other 'intermediate' sanction." The commission report's bottom line is that the correctional system costs more than it should and "does not provide the public safety that it could." Thornton says reforming the parole system means restructuring education and re-entry programs to better prepare parolees for life on the outside. If they can find jobs and fit into mainstream society, they are less likely to return to prison, thus alleviating the overcrowding, she says. Gotsch has a warning for California as it tackles prison overcrowding: "You can't build yourself out of the problem." One of her solutions is sentencing reform. She points to Proposition 36 as a prime example. Passed in 2000, Proposition 36 requires all nonviolent drug offenders who do not have a non-drug-related charge to be sent to treatment instead of jail. "We probably have 2,300 or 2,400 people under Prop. 36 who are not in prison," says Nancy Cisneros, a judge who supervises Fresno County's three drug courts. Cisneros adds that "it's too early in the process to know if [Prop. 36] is working as far as abstinence from drugs goes." Studies have shown that treatment is seven times more effective than incarceration in reducing drug use. A 2002 California study showed that drug courts, offering court-supervised treatment programs for nonviolent drug offenders, reduce arrests by 85% and convictions by 77% for graduates. The recent prison construction boom is over, at least for a while. Only one new state prison is planned: a 5,100-bed, maximum-security facility scheduled to open in Delano in 2005. Thornton says the Department of Corrections "is still projecting a shortage of 7,200 maximum-security beds for 2006-07." These efforts to reduce overcrowding are offset to a degree by other state actions. Schwarzenegger, in his proposed 2004-05 budget, says a commission will be created to recommend the closing of some prisons. The state, as part of a cost-saving effort initiated three years ago, also is closing state prisons operated under contract by private companies. For instance, Eagle Mountain Community Correctional Facility, about 55 miles east of Palm Springs, closed last month. In the fall, it was the site of a riot in which two inmates were stabbed and bludgeoned to death by other inmates. While state officials struggle for solutions to overcrowding, the men at Pleasant Valley State Prison endure. The prison sits on 640 acres in the valley near Coalinga that is the source of its name. The landscaping, thanks to the prisoners' labor, is pristine. Says prison spokesman Lt. Paul Sanchez: "With 5,000 inmates, there is no reason why this place shouldn't look like Disneyland." But this is no Pirates of the Caribbean or Splash Mountain. This is a place surrounded by 12-foot-tall fences that carry 5,100 volts of electricity. Armed guards try to scrutinize the prisoners' every movement. Inmates say they live daily with the threat of rape and death. Most of the inmates have been in prison before or have significant behavior problems. The prison is a step below the maximum-security prisons of Corcoran and Pelican Bay. There are four Level 3 units at Pleasant Valley, lettered A, B, C and D. Each unit holds about 1,200 men and has its own cells, exercise yard, workshop, cafeteria and gymnasium. Prison officials continue to call them gymnasiums, despite their current function. "This is the first prison in the state built with the intent of housing inmates in a gym," says Sanchez. "We needed bed space more than a gym." The gym floor is concrete. The backboards with rims, suspended from the rafters, are targets only for dust. "No warning shots" has been painted on the wall next to one raised basket. In other words, during a serious disturbance, the guards' first shots will be aimed at the inmates. The bunk beds, more than 100 of them, all have prison-issue blue blankets. Drying clothes are hung from clotheslines on the front of most bunks. Not all photos taped to wall lockers are family members or girlfriends. Pinups and supermodels are popular subjects, too. Prisoners segregate themselves for something as simple as watching a video: African-Americans gather in front of a small screen in one corner while whites and Hispanics congregate around another screen at the opposite end. The movie on this day is "The Hulk," about a man with green skin. Twelve toilets and two shower poles serve the scores of inmates. There is no privacy. Bodily functions are performed in front of guards and inmates. The odor of too many bodies in a confined space is matched by unrelenting tension -- tension that often gives way to rage. "It's not uncommon to have two, three or four fights in a row," Sanchez says. Prisoners and guards always seem to know when something is about to explode. "You could have 1,200 guys on the yard, and if you can hear a pin drop, it's time to get out of the way," Sanchez says. Rammal, 33, has two years remaining on a drug charge. He gives only his first name. "This place is very overcrowded," Rammal says. " ... There is dust flying all over. There are two and three to a bunk. That's ridiculous." Juan Macias, 40, on his second strike for domestic violence, says doing time at Pleasant Valley is "dehumanizing." Domestic violence. Theft. Drugs. None of the inmates portray themselves as saints. But whatever their crimes, they add, they are human. Overcrowded Pleasant Valley tests that fact every day. Says Rammal of the gymnasium: "The place is not fit for inmates." The reporter can be reached at dcoleman@fresnobee.com
or 441-6360.
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