March 13, 2012 Testimony

SCDC presented three witnesses in support of its case today. 

First, Martha Roof was called to testify regarding budgetary issues related to SCDC over the past several years.  She testified that during fiscal years 2009-2011, there was a 31 percent drop in the cost of psychotropic medications.  During that same time period, however, there was a 33 percent increase in the number of inmates needing intensive mental health services.

Janine Wrecsics testified from a nursing perspective regarding medication issues at the department, admitting that medication administration records were not accurately kept when she began at SCDC. She suggested that improvements to the record-keeping and administration of medications have occurred over the past couple years.  She discussed the administration of formulary and non-formulary medications.  She explained that certain drugs such as Seroquel, Neurontin and Wellbutrin are no longer on the formulary due to their potential for abuse.

During cross-examination, she was asked about the importance of continuity of care as it pertains to accurately monitoring medication compliance.  She agreed that it is important for treating clinicians to know a patient's treatment history in order to ensure that continuity of care remains in tact.

 She suggested that the current 34 percent nursing staff vacancy rate creates problems for SCDC nursing staff in delivering health services.

Wrecsics admitted that there are inconsistencies in the medication administration forms used to track compliance.  Specifically, the codes used to track compliance on the MARs are inconsistent with those set forth in policy.  She stated that she has raised this issue in the past.  The inconsistency, however, remains.

Dr. Pamela Crawford has worked at SCDC as a part-time psychiatrist since 2006.  She primarily works for the Department of Mental Health, but she works eight hours per week with mentally ill women inmates at Camille Graham and Leath correctional institutions.

Dr. Crawford testified that she has a caseload of 175-200 patients.  She testified that her duties have changed over the past couple years.  One of the changes, which she testified occurred in 2011, involved a new directive requiring a psychiatrist to change the mental health classifications for inmates on the mental health case load, as opposed to internal medicine practitioners.  

Dr. Crawford explained that continuity of medication administration is extremely important for some patients, who she stated would get very sick and need hospitalization if they miss medications.  For others, she suggested daily compliance is not as critical.

She discussed Geocare, an independent mental health provider contracted to provide in-patient services to female inmates.  Dr. Crawford explained that an extremely low number of women are sent to Geocare because she does whatever she can to treat her patients on location.  She explained that she is usually able to provide the needed treatment safely and effectively because she knows the patients, the counselors know the patients, and the institution is essentially home for them.  Dr. Crawford testified that she has created a rapport with the women on her case load, which she said has improved her ability to treat her patients.  She also stated that in her experience women are less likely than men to engage in serious self-injurious behavior because they have a stronger support system.