"When she first got there, she was issued two pairs of underwear, which had been worn by someone else," Rae told Truthout. So Rae sent her daughter money to buy her own underwear, bras and socks as well as tennis shoes and a TV set. "It was $300 for the TV," she recalled.

Her daughter earns 35 cents an hour cleaning inside the prison. Although the prison supplies some necessities, like one roll of toilet paper each week and a limited number of tampons or pads, Rae's daughter relies on the money from home to get her through each week. These money orders enable her to buy the additional toilet paper and feminine hygiene supplies she needs each month. It also enables her to buy Tylenol and cold medicine as well as pay the $4 co-pay on each medical visit. "Occasionally she can splurge and buy herself a candy bar, but that's rare," Rae said.

On October 15, 2014, however, Arizona changed the way family members like Rae can send money. Now, instead of paying $1.25 for a money order at the post office, Rae must use one of three companies - JPay, Global TelLink or Keefe - to send her daughter money. To send $50 through Keefe, Rae also needs to pay a $4.75 internet transaction fee. Families without internet access can deposit money by phone - for a fee of $5.75 - or in a storefront transaction for $5.95. (Global TelLink and JPay have different fee structures.)

Despite the added cost, Rae is determined to send her daughter the same amount of money. "I'm going to have to eat the fees and make up the money somewhere else," she said. "I'll have to give something up. So will my husband." The couple has already had to sell their camper to cover the cost of visiting their daughter once a month. They've cut down on going out and other activities that cost money. On occasion, they've also had to choose between sending money to their daughter in prison or helping their son, who is not. "I feel bad that I can't help him because all our money is going to his sister," Rae said.

Only 8 percent of the nation's prison population is held in private prisons. But, as Rae's experience and recent news stories have demonstrated, private companies have found other ways to profit from bodies in government-run prisons. Services that had previously been provided by the jail or prison, such as medical care, transportation, phone and communication services, food, and even money exchanges, are increasingly handled by private companies.

Sending in Money Costs Money

As Rae's story shows, prison systems have contracted with private companies to handle money sent by family members to their loved ones inside. In the federal prison system, the contract was awarded to Bank of America. In 32 state systems, the contract belongs to private company JPay.

In February 2014, New Jersey prisons began utilizing JPay to handle these monetary transactions. "Before, it would only cost a stamp and the cost of the money order," said "Pam," currently incarcerated at the Edna Mahan Correctional Facility for Women. "Now, it cost our families or friends $4.95 in addition to whatever amount they send us." Loved ones also have the option of mailing a money order to JPay, but the money takes seven to 10 days to be credited to a woman's account. Pam's mother balked at paying an additional $7 and mailed a money order. The money was not credited to Pam for 14 days.

At Edna Mahan, commissary - or the prison store - is only available every other week. For women like "Pam" whose family chooses to save money and mail money orders, the delay means missing the chance to buy necessities, such as shampoo and feminine hygiene supplies.

"Gwen" has also experienced delays of up to four weeks when her family mails a money order to JPay. She told Truthout that, while women can order from commissary every two weeks, certain items, such as photos, clothing and beauty supplies, are only available once a month. In addition, many women rely on food items at commissary to supplement the prison's meals, which she described as "truly inedible."

Daily wages at Edna Mahan range from $5 at the top-paying commissary job to $2.40 for working in the kitchen or cleaning housing units. If a woman is sick or unable to work, as in Gwen's case, she must either learn to go without supplies or rely on money from family. "It isn't a lot of money, but $28 can mean a whole commissary for me," Gwen explained.

California is another state that has instituted JPay to handle money sent to prisoners. But the fees make sending money an exorbitant expense for many family members. "Samantha," for instance, must send her son twice the amount of money that he needs. "If a person owes restitution, the prison takes 55 percent of whatever money he receives," she told Truthout. Thus, to put $56 in his prison account so that he can buy food, she had to send $125. And that's not including JPay's service fees, which vary depending on the amount of money sent. "There's no readily available list of charges," she told Truthout. "I literally had to call and hunt down how much would be charged."

JPay provides money transfers to more than 1.7 million people or nearly 70 percent of the US prison population. It charges state prison systems nothing for handling payments and, for every payment processed, it sends between 50 cents and $2.50 back to the prison. According to an exposé in Time, JPay sent approximately $4,000 each month to the Illinois Department of Corrections in 2013.

"Jill"'s daughter has less than two years on her sentence at Arizona's Perryville prison. When Arizona announced the switch to electronic money transfers, Jill decided to skip the fees and send a money order for the total amount her daughter would need during her last year behind bars. But, she told Truthout, many of the family members she has met cannot afford that option. "Many families have to budget in order to send money," she said. "If you put money in a couple of times a month, you pay that fee a couple of times a month. Families with the least amount of money get hit the hardest."
 
The Kick-Out Fee - and the Fees That Go With It

A person leaving the Arizona prison system for the first time is given $100 upon her release. The money, saved from the wages earned at prison jobs, is called the "kick-out fee."

Until 2013, people released from Arizona's prisons were given the kick-out fee in the form of a check. However, banks often refused to cash the check with a prison ID, usually the only form of identification many women have after years in prison. Thus, accessing their only $100 first required a trip to the Department of Motor Vehicles for identification or finding a friend willing to deposit the check for them.

Now, they are issued a debit card through Bank of America. "If women are coming out after a long time, they don't know how to use debit cards," Jill explained. "They're scared to death about using them." In addition, Bank of America charges a $1.50 monthly maintenance fee and, like many other banks, charges a $1.50 withdrawal fee if a person uses a non-Bank of America ATM and a 25 cent point-of-sale fee for every transaction.

No staff member explains the various fee structures, which means that people are unaware that they deplete their funds each time they use the card. If a person chooses to withdraw the entire amount from her debit card, she is charged a $5 fee.

In addition, if she loses the card, no replacement is issued. Her money is simply gone. For a woman in a halfway house, shelter or other temporary living situation, this means sleeping with the card tucked into her bra or panties.

Arizona is not alone in utilizing this new method. The Center for Public Integrity recently reported on Bank of America's contract with the Federal Bureau of Prisons to issue debit cards to people upon release. Under that contract, they've issued cards to nearly 50,000 people. The Center's report has spurred a government audit into the contract.

Privatizing Health Care - But at What Cost?

Handling prisoner accounts is not the only service that has been privatized. Across the country, jails and prisons have been contracting with private, for-profit companies to provide medical services to people inside.

Cecily McMillan experienced this firsthand during her 58 days on Rikers Island, New York City's island jail complex. When she arrived, she was denied her prescribed medications for mild anxiety and ADHD. Instead, jail medical staff gave her BuSpar, the same medication, McMillan says, that every woman was prescribed regardless of her actual needs. After three weeks of fighting for her proper medication, a fight that included help from sympathetic city councilmembers, McMillan had her medications reinstated. But that was not the only medical horror she encountered.

She recalled making an appointment to see a gynecologist. Warned that the jail's male gynecologist was "kind of handsy," she requested to see the jail's female gynecologist only to be told that she wasn't available for six weeks. When she saw the doctor, he informed her that she needed to undergo a gynecological scrape even though McMillan had had a check-up before entering Rikers. "He scraped me until I was bleeding," she recalled. When he finished, McMillan realized that his fly had been open the whole time.

During her 58 days on the island, McMillan also saw how medical care could be deadly: Judith had been prescribed low-dose methadone pills for back pain, McMillan recalled. But when Judith arrived at Rikers, the doctors insisted that she take methadone in high-dose liquid form. Taking higher dosages of methadone induced intense vomiting in Judith, who had hepatitis C. McMillan recalls seeing her friend vomit blood and what she described as "chunks of her liver." The women in the housing unit demanded that the officers call the doctor. When medical staff failed to respond, they physically carried Judith to the clinic. Days later, Judith was dead.

Judith's death is only one of a string of recent deaths on Rikers Island. In 2013, 19-year-old Andy Henriquez died from a tear in his aorta after his pleas for medical attention were ignored. That same year, 46-year-old Carlos Mercado and 39-year-old Bradley Ballard died after their medications were withheld. The families of all three men are suing Corizon, the private medical provider that has held the contract for medical services at Rikers since 2003. However, according to DNAinfo, Corizon's contract with New York City stipulates that the city will represent the firm in lawsuits arising from its care. It also ensures that the city will cover costs arising from medical malpractice or civil rights violations.

New York is not alone in turning to privatized health care for people behind bars. In 2011, Florida governor Rick Scott contracted with Corizon to provide medical care in its state prison system for $1.2 billion. Corizon took complete control in 2013. According to an investigation by The Palm Beach Post, three months later the number of deaths "shot to a 10-year high," with 30 deaths in four of the past seven months.

Corizon currently holds contracts in 27 states with approximately 345,000 people under their care. (In October 2013, Therese Brumfeld, vice president of Corizon's provider operations and purchasing, stated that Corizon had contracts in 29 states with over 400,000 people.) From 2008 to 2013, Corizon has been sued 660 times for malpractice.

In Alabama, the Southern Poverty Law Center filed a federal suit against the state's prison system for ignoring the medical and mental health needs of its prisoners. (Corizon provides medical care only. MHM, another private company, holds the contract for mental health care.) Unlike its contract with New York City, Corizon's 34-month, $224 million contract with Alabama requires it to pay for any legal work in the event of a lawsuit, even if it is not named in the suit.

Arizona recently settled class-action suit Parsons v. Ryan. The suit, filed by the American Civil Liberties Union (ACLU) in 2012, charged that the state ignored the basic needs, including medical needs, of people in its prison system for years. Corizon took over the state prison's health care system in March 2013 after the state terminated its contract with private health care provider Wexford following multiple deaths and accusations of medical neglect.

However, medical caredid not improve under Corizon and the ACLU continued its suit. On October 14, 2014, Arizona settled the suit, agreeing to meet more than 100 health care performance measures, including monitoring people with chronic conditions, such as diabetes and hypertension as well as improving pregnancy and dental care.

Before the court decides whether to approve the settlement, however, each of the 33,000 people in Arizona state prisons must receive notice of the settlement and an opportunity to submit comments to the court. David Fathi, director of the ACLU National Prison Project and co-lead counsel on Parsons, estimated that the process would probably take two months. The settlement does not become effective until the court grants its approval.

In the meantime, health care needs continue to go unaddressed. The day after the settlement was announced, Jill spoke with her daughter who told her that her yard had no health needs request forms, which every person must fill out to start the process of receiving medical attention.

"We live by violence, but we die by neglect," a woman told McMillan when she entered Rikers.

After hearing stories from her daughter, Jill doesn't dispute this. She recalls her daughter telling her about a woman on her yard whose complaints about bleeding and pain were ignored. She was finally taken to the hospital where she was diagnosed with ovarian cancer. She died in her 30s.

"My daughter went in a very healthy 25-year-old," Jill said. "She was not given a life sentence or death. She should be given enough medical care so that when she comes out, she can resume living a normal life."

This article was originally published by Truthout.org  on November 1, 2014. Copyright, Truthout.org. Reprinted with permission.