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Ombudsman investigation finds ‘systemic deficiencies’ in DOC dental services program

Published: Mar. 9, 2021 at 7:43 PM AKST
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ANCHORAGE, Alaska (KTUU) - A man in Department of Corrections custody reported he was in extreme pain from a tooth with an unfinished root canal that was abscessed, causing facial swelling and difficulty eating and sleeping.

He waited eight weeks to receive emergent dental care.

The man’s experience is detailed in a recently released report which presents the findings of an investigation into the DOC’s dental services program by the Alaska ombudsman’s office.

‘Extremely painful’

The 22-page report outlines an investigation prompted by a complaint from a man incarcerated at Lemon Creek Correctional Center in Juneau.

He reported a tooth with an unfinished root canal was abscessed, the nerve was “exposed and extremely painful” and that he worried the infection could become life threatening.

According to the report, he first requested dental care on July 3, 2019. In multiple subsequent requests, he continued to report extreme pain, facial swelling and difficulty eating, swallowing and sleeping, and a medical provider at the facility noted he was in “acute distress.”

The facility’s contract dentist position has been vacant since June 2019, according to the report. The DOC relies on its Anchorage-based team to travel to the facility on a monthly basis to provide services, but during the team’s visits in both July and August 2019, the man still did not receive treatment.

Medical staff responded to his requests for care by telling him that he was on a waiting list.

Finally, two months after the onset of his condition, the report states the man was referred to an outside dentist on August 30, 2019 to have his tooth extracted.

“The law requires the delivery of services, and that didn’t happen here,” said Alaska Ombudsman Kate Burkhart.

The investigation found the man’s complaint to be justified.

Systemic deficiencies

The report details an overwhelmed dental program with long wait lists and unreasonable delays in care that is required both by law and the department’s own policies, but notes that the delays are not deliberate or in bad faith the report points to systemic deficiencies within the program and identifies roadblocks to correcting the situation.

“This wasn’t a deliberate withholding of care,” Burkhart said. “This is a systemic problem that resulted in this person going eight weeks with an abscessed tooth.”

The report was released in February, nearly two years after the complaint. Burkhart said before the report was released, her office verified that information, data and wait times collected during the investigation still paint an accurate picture of the program today.

“The Department of Corrections provided their waitlist information, which really hasn’t changed a whole lot since they provided it, and even for the most emergent dental care, folks can wait up to two weeks. In this case, the complainant waited eight weeks,” she explained. “For urgent but maybe not emergent care, people can wait up to six months, and then for just routine care like you and I, you know, go get our teeth cleaned, that’s years.”

Despite challenges presented by a growing prison population, shortages in dental staff and budgetary constraints, the DOC has a duty to provide timely access to dental health care, the report states, noting “Inmates do not have the ability to seek treatment elsewhere. They are wholly reliant on DOC to meet their dental care needs. The complainant and all inmates have a right to necessary dental health care services that are timely and prevent needless suffering.”

Recommendations

Ombudsman complaints and investigations are confidential by law. Public reports, beyond success stories, are rare and generated only when there is a systemic issue, a problem requiring action by the Legislature or executive branch, or when an agency declines to address an issue, according to Burkhart.

Burkhart said it’s important to acknowledge that the DOC has cooperated and attempted to address the issues identified through investigation, but ultimately will require additional funding to implement all six recommendations from her office.

“The Department of Corrections is trying to improve the access and the timeliness of their dental services. They have dealt with some of the obstacles, but in the end, a lack of staffing, a lack of qualified dental professionals, is a root cause of the lack of access, and in order to do that they need additional resources,” Burkhart said.

The report highlights steps the DOC has already taken toward improving the situation, including upgrading equipment and modernizing its facility dental clinics, implementing pay increases for its dentist and dental hygienist positions and becoming a participating site in a federal program that offers repayment of loans and other incentives to eligible health care providers.

The DOC would not provide an interview, but spokesperson Sarah Gallagher wrote in an email, “DOC has been actively working to address every concern identified. DOC has already begun auditing our statewide dental program to determine where improvement can be made, where policies may need to be adjusted and where additional staffing and/or contracting may assist in the delivery of dental care. In absence of a local dental contractor, the Division of Health & Rehabilitative Services has implemented a travelling dental team to visit Lemon Creek on a regular basis. Additionally, the department continues to actively recruit for local contractors as well.”

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