Lancaster Prison ends handcuffing for opioid meds; 'welfare fund' used to buy toilet paper

Lancaster County prisoners will no longer be handcuffed when receiving medication to treat withdrawal symptoms and opioid addiction, the Lancaster County Prison warden announced Thursday.

Why it matters: Federal courts and the U.S. Department of Justice have increasingly made clear that denying medication for drug withdrawal violates the Americans with Disabilities Act. Withdrawal from opioids especially can be painful and medically dangerous, studies have found.

Since 2022, Lancaster County has taken advantage of state and federal funding streams to offer drugs like buprenorphine and naltrexone to prisoners, including through the 2021 American Rescue Plan Act.

What led to the change: On Thursday, Warden Cheryl Steberger said cuffing each prisoner participating in the program was time-consuming. "Through team collaboration in the facility, we feel as though with the amount of individuals provided, there's a chance for less diversion," the warden said.

County officials on Thursday did not reference a local public health advocate who had pressured the county for months to review the policy.

Gail Groves Scott, the Lancaster-based founder of the public health advocacy group Health Policy Network, asked to meet with Lancaster County officials back in March to discuss whether the prison was restraining prisoners when giving them medication-assisted treatment, according to emails she provided.

That did not happen, according to Scott, but prison officials spoke about the policy at an April prison board meeting.

Steberger said at that meeting that the prison had found evidence of medication being smuggled back to prisoners' cells by participants in the MAT program.

"Security is going to be first and paramount in what we do here, and there is nothing inhumane at all about what we're doing at the facility, and I'm confident in the program that we're running there," Steberger said.

Also back in April, Commissioner Josh Parsons, chair of the prison board, defended the prison's commitment to addressing security concerns, but said later in the meeting that the county is open to looking at any suggestions of best practices.

A touchy subject: In subsequent meetings as recently as last month, Parsons told prison officials not to respond to specific questions about the program from Scott. Parsons accused Scott of trying to find litigants to sue the county over the matter and that not answering her questions was protecting the county from a potential lawsuit.

Scott denied she was working to sue the county, but was instead urging the county to change the handcuffing practice in order to avoid a future civil rights lawsuit.

The public health advocate did reach out to state officials and other advocates about the county's policy, according to emails Scott provided, including to a state official at the Department of Drug and Alcohol Programs who confirmed Scott was working on the issue with the Pennsylvania Department of Crime and Delinquency.

The PCCD has provided grant funding to the county for the prison's medication-assisted drug treatment program, often called MAT.

TP for prisoners: The prison pays for toilet paper used by its prisoners through an "Inmate General Welfare Fund," set up for expenses that are meant to benefit prisoners, County Controller Lisa Colón acknowledged after Thursday's meeting.

The fund gets its revenue from commissions with vendors who charge prisoners for various services and items, such as commissary food and the use of personal tablets for things like phone calls and movies.

Criticism: Kent Kroehler, member of the local advocacy group Have a Heart for Persons in the Criminal Justice system, questioned the county's use of the fund to pay for basic services.

"They're far outside the original intent and definition of what is 'inmate general welfare,' Kroehler said.

The prison also uses the welfare fund to pay for educational programs, chaplain services and "catastrophic billing" to its medical contractor PrimeCare Medical. Fund proceeds also cover the cost of some services for prisoners who are deemed unable to pay for items themselves.

"Sewage cleaning": One service paid for with money from the funds is sewage cleaning – the clearing out of traps in the prison's plumbing, so inappropriate objects flushed down the toilet don't get into the larger public sewage system, officials said Thursday.

The county's policy on the welfare fund specifically allows for that use. Officials said the cleaning is needed because prisoners flush trash to jam up the sewage system.

"It's not really a regular maintenance item that should occur and was occurring because of inmate conduct," Parsons said.

As for the toilet paper purchased with proceeds from the fund, it goes to prisoners "for their sole use [versus] staff bathrooms or (staff) use," Colón said in an email. "Because the purpose of the [welfare fund] is to support the inmates and their needs, it is covered under this policy the way it is written."

The welfare fund paid $21,823 for toilet paper in 2023, according to a Right-to-Know request filed by a county resident.