Roth

testimony opposing H.1434

Rachel Roth, Ph.D.

Testimony in Opposition to H.1434
An Act Relative to the Establishment of a Womens Pretrial Facility in Middlesex County
Joint Committee on the Judiciary
January 6, 2014

I submit this testimony as a concerned Massachusetts citizen, womens health policy
expert, and resident of Middlesex County in opposition to H.1434, An Act Relative to the
Establishment of a Womens Pretrial Facility in Middlesex County.

Expertise

I have been studying the impact of imprisonment on womens health and rights for more
than a decade. My research on this topic has been published in peer-reviewed journals and
law journals and cited in court briefs. In 2011, I worked with the National Womens Law
Center on public comments designed to improve access to health services under the Prison
Rape Elimination Act. In 2006-2007, I worked with the chair of the American Bar
Association Task Force on the Legal Status of Prisoners to update standards on health care
for pregnant women and new mothers. I am also the author of a book on womens rights.

Testimony

H.1434 is entitled An Act Relative to the Establishment of a Womens Pretrial Facility in
Middlesex County; however, the text states that the facility is for women serving House of
Correction sentences as well as for women awaiting trial. The purpose of the bill should be
clarified to ensure informed debate about its scope, including the size of the proposed
facility, the number of women who will be held pre-trial and the number who will be
sentenced, the initial cost of building the jail and yearly operating costs. This information is
essential for taxpayers and legislators alike to evaluate the desirability and efficacy of the
bill.1

H.1434 is proposed as a solution to the persistent overcrowding at MCI-Framingham,
which holds women from a number of counties in addition to women serving state prison
sentences.

The answer to overcrowding at MCI-Framingham isnt a new jail. Rather, it is investment in
new mechanisms to allow women to await trial in their community, especially the vast
majority of women charged with non-violent crimes.2

1 The bill reads in its entirety: There shall be established in Middlesex County, a Women's
Pretrial Facility. Said facility shall be operated, administered and staffed by the Middlesex
Sheriff. The facility shall house women convicted of a crime that provides for a house of
correction sentence and women detained while awaiting trial.
2 Erika Kates, Briefing Note #2: Pretrial Detention and Access to Bail for Women,
Massachusetts Womens Justice Network, Wellesley Centers for Women (available online).

Roth testimony opposing H.1434

Under our current system, the most disadvantaged women those too poor to pay bail
are more likely to get a jail or prison sentence by virtue of having been detained pending
trial.3 In 2010, half the women awaiting trial at MCI-Framingham couldnt go home because
they couldnt afford $50 bail.4

A history of incarceration in turn will disadvantage women further once they are released.
For the many women who are primary caregivers for young children, detention and
incarceration cause enormous disruption to their families, including the possibility of
homelessness, loss of employment, foster care placement, and loss of parental rights.5

The Commonwealth can put a stop to this domino effect by developing ways to keep
women out of jail custody in the first place.

Jail time threatens womens health

Of particular concern to me is the risk that incarceration poses to womens health.6
I have identified cases in my research of women who suffered miscarriages and even died
within the first two days of being jailed. In one case, a woman was locked overnight,
bleeding, six and a half months pregnant, because she could not make bail and the jail did not
want to pay to take her to the hospital.7 In another case, a 21 year-old woman known to be
pregnant was left to die of a ruptured ectopic pregnancy on the floor of a jail cell.8

In 2011, 885 people died in jail custody in the United States. Some died within hours or
days of being booked because the jail didnt provide basic medical care, such as insulin or
heart medication.9

3 See generally the website of the Pretrial Justice Institute for information.
4 Erika Kates, Gender and Justice Project on Female Offenders, 2009-2012, Wellesley
Centers for Women (available online).
5 See generally Marc Mauer and Meda Chesney-Lind, eds., Invisible Punishment: The
Collateral Consequences of Mass Imprisonment (New Press, 2002).
6 See generally Rachel Roth, Obstructing Justice: Prisons as Barriers to Medical Care for
Pregnant Women, UCLA Womens Law Journal vol. 18, no. 1 (2010), pp. 79-105. Elizabeth
Alexander, former director of the ACLU National Prison Project, reflects on 25 years
representing women in medical cases brought against prisons and jails in her article, The
Caged Canary, William and Mary Journal of Women and the Law vol. 14, no. 2 (2008), pp.
257-269.
7 Boswell v. County of Sherburne, et al., 717 F.Supp. 686 (U.S. Dist. Ct., Fourth Div., 1989) and
Boswell v. County of Sherburne, et al., 849 F.2d. 1117 (8th Cir. 1988), cert. denied 488 U.S.
1010 (1989).
8 Megan Coleman, Onondaga Co. to Pay $385,000 in Jailed Pregnant Woman Death, May 3,
2103, CNY Central (available online); John OBrien, Pregnant Inmate Died after Hours of
Agony in Syracuse Jail, Post-Standard, May 16, 2010.
9 Cara Tabachnick, Theres an Alarming Number of Deaths in U.S. Jails, The Guardian,
December 27, 2013 (online at thegurdian.com), discussing the most recent United States
Bureau of Justice Statistics report on deaths in jail custody.

Roth testimony opposing H.1434

Jail rules limit peoples freedom of movement. Typically, people cant go from Point A to
Point B without permission, which means they have to convince an officer that they need
medical attention or risk a disciplinary infraction for trying to get that attention without
approval. In one case where a woman tried for two days to convince the staff that she was
in labor and needed to go to the hospital, the prison clinic had a sign on the door that
warned: If you knock on this door, you will receive a write-up.10

Rigid rules, such as requiring women to stay in place during count or a lockdown, have
resulted in women miscarrying or giving birth on prison grounds including all alone in
their cells.11 Other problems that stem from the jail setting itself include injuries and the
onset or worsening of mental health symptoms.12

Another serious structural obstacle to medical care is what physicians Ross MacDonald,
Amanda Parsons, and Homer Venters call the omnipresent problem of dual loyalty, in
which doctors and nurses feel a split allegiance to their patients and to the security staff
and jail administrators. This dual loyalty compromises medical providers ethics, as when
they are asked to evaluate individuals in the jail for solitary confinement; by doing so, they
become part of the punishment apparatus of the jail. Awareness of this dual loyalty, as
well as the lack of confidentiality, can discourage people in the jail from seeking medical
attention when they need it.13

Because jails and prisons pose an inherent risk of harm to the people held in them, some
health professionals are recommending the integration of human rights practices into
correctional health operations. These experts are not just outside critics; Drs. MacDonald,
Parsons, and Venters, for example, are responsible for overseeing the medical care for at
least 12,000 people every day at the Rikers Island jail complex in New York City.

They identify patient safety, population health, and human rights as essential, interrelated
components of providing healthcare to incarcerated people and note that the failure to
address any of these areas is likely to result in harm to patients and significant costs
resulting from morbidity, mortality, and litigation.14

The examples presented here are not meant to impugn the motives of people who work in
jails and prisons. They are meant to illustrate the ways that the structure and rules of jail

10 Clifton v. Eubank, No. 00-cv-02555-JLK, 2006 U.S. Dist. LEXIS 91043, at *3 (D. Colo. Dec.
18, 2006), discussed in Roth (2010), pp. 95-97.
11 Women give birth on jail and prison grounds even when count is not taking place,
because employees disregard or dont believe women who say they are in labor (Roth
2010, pp. 97-98).
12 Ross MacDonald, Amanda Parsons, and Homer D. Venters, The Triple Aims of
Correctional Health: Patient Safety, Population Health, and Human Rights, Journal of
Health Care for the Poor and Underserved, vol. 24, no. 3 (2013), pp. 1226-1234; p. 1228.
13 MacDonald, Parsons, and Venters (2013), pp. 1229-1230.
14 MacDonald, Parsons, and Venters (2013), p. 1230, p. 1227.

Roth testimony opposing H.1434

life inevitably impede peoples access to medical care. This inevitability should give us
pause and guide our public policy to limit peoples exposure to such risks.

In the case of this specific bill, it is women who are too poor to pay bail and women who
have been sentenced to county time would be subjected to all of the risks of imprisonment,
despite the minimal threat they pose to public safety.15

Alternatives to a new jail

A new jail will not appear overnight. First, the Legislature must vote to pass this bill and to
allocate the considerable funding for it. Next, county officials must find a site and consult
with stakeholders in the community. Then, the sheriff must develop a request for proposals
and review bids. Finally, the winning contractor must build the jail.

Given how many years the process of siting, design, and construction will take, wouldnt it
be just as feasible to spend that time developing meaningful alternatives to pre-trial
detention and incarceration instead?

Rather than spend millions of dollars on a new jail, the Commonwealth can learn from
other jurisdictions about ways to limit the number of people held in pre-trial detention. We
can invest in effective, fiscally sound initiatives that will both protect public safety and
protect women from the risks of harm that are inherent to being held in jail.

For these reasons, the Judiciary Committee should not give H.1434 a favorable reading.

Sincerely,

Rachel Roth, Ph.D.
Independent Scholar & Consultant
Arlington MA 02474
rachel.roth [at] earthlink.net

15 Sexual abuse is another significant risk of imprisonment, beyond the scope of this
testimony, from which women disproportionately suffer. See Paul Guerino and Allen J.
Beck, Sexual Victimization Reported by Adult Correctional Authorities, 2007-2008 (U.S.
Department of Justice, 2011) (available online).