Teeth Extraction Policy for CA Women Prisoners Rescinded

by John E. Dannenberg

As part of a bizarre medical policy, the California Dept. of Corrections and Rehabilitation (CDCR) has for years imposed a rule that requires women prisoners who apply for alternative community incarceration programs, where they can live with their infant children, to remedy any “pre-existing health problems” before they can participate. This includes decayed teeth, for which the only timely option is having them pulled by prison dentists.

Even though alternative community programs cost taxpayers far less than for regular prison beds, CDCR is not providing prompt dental care – a pound-foolish decision that requires otherwise qualified candidates for community programs to disfigure themselves by having their teeth removed under a policy known as “dental clearance.”

Relatively few women prisoners qualify for the community incarceration programs that let them serve their sentences with their children. Limitations include security and legal custody concerns. However, after clearing those hurdles prisoners must also pass a CDCR medical screening exam. The resolution of “health problems” is pitted against the women’s desire to bond with their babies. When the purported health problem is bad teeth, many mothers eschew the year-long wait for restorative dental work in favor of much quicker – but disfiguring – tooth extractions.

Rotting teeth, in turn, are often the result of lower socio-economic status women suffering from combined pre-prison effects of methamphetamine use, poor hygiene and unaffordable dental care. They thus desperately need the drug rehabilitation and skill-building courses offered in the alternative community programs. Yet when they get into the programs by having their teeth pulled, the resulting disfigurement only worsens their chances of success upon release, as it decreases their employability.

In April 2008, state Assemblywoman Sally Lieber introduced Assembly Bill 2877 to shorten the waiting list for women prisoners who need to have their teeth repaired, calling their dilemma “unconscionable.” Lieber noted that despite a requirement for vastly improved dental care imposed upon CDCR through litigation (Perez v. Tilton, U.S.D.C., N.D. Cal., Case No. 3:05-cv-5241 [See: PLN, April 2007, p.16]), women’s prisons were relegated to the bottom of the scheduled improvement plan.

The anguished decision by women prisoners to abandon their teeth rather than their children is chilling, Lieber stated, observing that some women were having 16-18 teeth pulled in order to qualify for the alternative community programs. Lieber was sensitive to the fact that such dental disfigurements greatly diminished the prisoners’ future job prospects.

Sarina Borg was faced with the daunting prospect of over a year’s wait to have her decaying teeth fixed by prison dentists. When she learned that she otherwise qualified to live with her infant daughter, she opted to have four teeth pulled so she could serve the remainder of her sentence with her baby in the East Bay Recovery Project, a dormitory-style minimum security facility.

CDCR officials defended the policy, saying the same health screening process applies to male prisoners to qualify for community programs, which have no on-site doctors or dentists. But the 71 women housed in three mother-child community facilities are more desperate to participate, even if it means having their teeth pulled, due to the need for mother-child bonding. Another 800 women prisoners who live in other community incarceration programs are also affected.

The reality, however, is that the gaps in these women’s teeth prove more problematic when trying to get jobs after they are released than the gaps in their employment records due to their incarceration. “It’s probably almost as big a deal as having a criminal record,” said Allyson West, director of California Reentry Program. “They’re going to be pigeonholed because of their appearance.”

Adding to this problem is the loss of self-esteem suffered by women who have lost their smiles as a result of tooth extractions. Borg reported that she had three teeth on the bottom right side of her mouth removed, and now finds it hard to chew. “Being a woman, I just feel degraded, really bad,” she lamented. Another community program prisoner, 31-year-old Michelle Filby, hopes to have the gaps from her pulled teeth fixed after her release, assuming she can find a good job. “I’d rather lose a tooth than not have my baby, so to me it was worth it,” she said.

Rachel Roth, an independent national expert on women prisoners’ health issues, called the CDCR’s dental clearance policy “inhumane.” Nor is the problem insignificant. California prison officials reported that 9,000 teeth are extracted annually from the state’s 12,000 women prisoners.Following coverage of this issue by the San Jose Mercury News, the CDCR quickly backpedaled. On June 13, 2008, the dental screening policy that led women prisoners to agree to tooth extractions so they could live with their infant children was rescinded. The change occurred just days after a state Senate Rules Committee hearing to confirm Jeffrey D. Thompson as CDCR’s new health care operations director was delayed due to concerns about the policy. Senators reportedly called the policy “outrageous” and “terrible.”

“I want to make it absolutely clear that our objective here is to ensure that dental is not a barrier to accessing these programs,” Thompson stated. The mother-child program and another community program for women prisoners will no longer require dental clearances.
Assemblywoman Lieber said the policy change “brought tears to [her] eyes” to know that women prisoners would no longer have to sacrifice their teeth to have the opportunity to be with their children.

Source: San Jose Mercury News

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