In this file photo from July 2014, a group tours a dormitory at the Louisiana State Penitentiary, which is also known as Angola. (Photo by Jarvis DeBerry)
The Louisiana Department of Corrections is giving a $5 prison-canteen credit to inmates who get the flu shot in its state facilities this year — an incentive that is rare, if not unprecedented.
“[G]iven the COVID-19 pandemic, it is critical we go above and beyond to urge all inmates, who are otherwise able, to take the influenza vaccination during this flu season,” wrote Jimmy LeBlanc, the department’s secretary, in a letter to prison wardens that outlined the incentive program on Oct. 26.
Any inmate in a state facility who has gotten a flu shot since July will be eligible for the $5 credit. It cannot be garnished or swallowed up by an existing prison debt or canteen balance, LeBlanc wrote. At the canteen, prisoners can purchase a wide variety of goods — from candy and soda to toothpaste and stamps.
The prison system is prioritizing “high risk” inmates — those who are 65 and older, pregnant and living with chronic health conditions — for the flu vaccine before opening the program up to others, according to LeBlanc’s letter.
Earlier on in the health crisis, the agency was having difficulty getting enough flu shots for the state’s prisons, but it now has enough of a supply to meet the expected demand, officials said.
The flu vaccine program takes place every year and is voluntary. The Department of Corrections is hoping the $5 credit will drive up participation. It has a goal of vaccinating 80 percent of the inmates in state facilities this year, said Thomas Bickham, undersecretary for the corrections department.
Bickham and other corrections officials couldn’t say what percentage of the prison population receives the flu shot in a typical year, but they suspect it is under 50 percent. He expects the program will cost around $55,000 to $60,000. The money will come from an existing inmate welfare fund.
Thousands of inmates who live in local jails run by sheriffs won’t be eligible for the flu vaccine incentive, though. Louisiana houses a little less than half of its state prison population — 13,000 people — in local facilities. The canteen credit is only being offered in state prisons, where about 14,500 state inmates stay.
Louisiana has been pushing the flu vaccine in the general public for months. There’s a worry that a double wave of flu and COVID-19 could deplete medical resources and overwhelm hospitals in the months to come. The Centers for Disease Control has described the flu shot as being “more important than ever” so the country can “conserve scarce medical resources for the care of people with COVID-19”.
Prisons are hot spots for spreading both the flu and COVID-19 because they rely on communal living. People sleep, shower and eat together regularly in groups of over 100 people. Social distancing is difficult, and diseases can move through a prison population faster than they would the outside world, health experts have said.
Still, it is out of character for Louisiana prisons to offer a financial incentive for participating in a health program. Bickham described it as “unusual” and inmate advocates said they aren’t aware of any similar, previous efforts.
“No one has ever heard of it before,” said Bruce Reilly, deputy director of Voice Of The Experienced (VOTE) in New Orleans, which supports people who are incarcerated.
An official at the corrections agency said the agency got the idea to offer a reward for getting the flu shot after speaking with other state prison systems in the South. Virginia announced in September it would give prisoners who got their flu shots a gift basket that includes snacks.
“I think it’s an extraordinary measure, but it’s definitely warranted,” said Natalie LaBorde, general counsel for the corrections department.
Health experts were also cautiously supportive of the strategy. Financial incentives for participating in a public health initiative is common in the private sector and doesn’t pose an ethical problem, as long as people don’t feel forced to participate, they said.
“I’d say five dollars is probably not coercive. An incentive of 500 dollars would be coercive, and 50 dollars might be for prisoners as well, ” wrote Chris Beyrer, a professor at John Hopkins University’s public health school, in an email. “This seems justifiable to me.”
Five dollars may not seem like a lot of money to the general public, but it adds up to about a week’s worth of pay for several inmates in Louisiana, who can make pennies for an hour of work.
The prison system may have good intentions, but Reilly said inmates are still distrustful of the flu shot program, especially after the $5 credit was put on the table.
His organization, VOTE, has received emails from prisoners concerned that the prison system is trying to experiment on them. Some have expressed the thought that the agency is trying to test an unproven COVID-19 vaccine on them and encouraged their fellow prisoners not to participate, Reilly said.
Reilly said prison officials should have talked to leaders within the prison community about the canteen credit plan before rolling it out if they wanted better buy-in from the rest of the inmates.
“Of course they are skeptical. Any of us would be,” he said. “It should surprise nobody that it seems suspicious.”
The United States doesn’t have a particularly good track record with prisoners and health care. The federal government conducted dozens of medical experiments on people in prison and mental institutions in the early and middle twentieth century, according to reporting by the Associated Press.
Louisiana’s prison system received criticism last year for launching a voluntary, drug-addiction treatment program that relied on a medical implant which hadn’t been approved for use by the U.S. Food and Drug Administration. The prison system has also been criticized for not testing enough or providing adequate treatment during the coronavirus pandemic — a characterization that prison officials dispute.
The Promise of Justice Initiative, which is suing the prison system over health care-related issues, is supportive of the new flu shot incentive program. It encourages its incarcerated clients to participate, said Mercedes Montagnes, the organization’s executive director, but there is still a lack of trust among the inmates about the prison system’s intentions.
“Unfortunately, because of a history of poor medical care and hostile attitudes from medical staff, many people who are incarcerated are skeptical and refuse flu vaccinations out of fear that they are being experimented on or will have serious side effects and not receive any treatment,” she wrote in a text.
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