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NC prison agency changes policy and COVID death count following NC Health News-VICE investigation of underreporting

beyond a fence two fences, one topped with razor wire, about a dozen men play on a bleak basketball court. Many people with mental illness end up in the prison system
Men at Central Prison in Raleigh play basketball in the recreation yard at the facility in 2018. Photo credit: Rose Hoban

By Hannah Critchfield with reporting by Arabella Saunders

North Carolina’s state prison agency will now review their reporting around whether a prisoner has died of COVID-19 alongside cause-of-death determinations made by health department officials, following a North Carolina Health News and VICE News investigation that found the state failed to disclose all of the prisoners who died of COVID-19-related causes in their custody.

The Department of Public Safety, which oversees state prisons, has also adjusted their count of prisoners who have died of COVID-19-related causes to include two of the prisoners identified by NC Health News and VICE News who had not been reported to the public.

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“The website has been changed to reflect COVID deaths in the offender population for which death certificates have been completed and received by Prisons,” John Bull, DPS spokesperson, said in an emailed statement about the March 4 change.

The total number of North Carolina prisoners who have officially died of COVID-19-related causes now sits at 50.

Experts say the change could lead to greater accountability in North Carolina’s reporting of incarcerated people’s deaths during this and any future pandemics and bring clarity to families of additional prisoners who may have been uncounted by the prison system.

Underreporting prisoner deaths

Last month, NC Health News and VICE News identified three prisoners with COVID-19-related deaths who were not included in the state prison agency’s death count, according to determinations on death certificates obtained by public records requests.

Our investigation ran through mid-September – when the deadliest months for North Carolina prisoners were yet to come  – leaving open the possibility that more prisoners have been uncounted.

Death certificates are legal documents that detail the cause of a person’s death. They’re completed by county medical examiners and then reviewed by the N.C. Office of Chief Medical Examiner. After they’re finalized by the state office, they’re sent to DPS for record-keeping.

At the time of our initial investigation, the prison agency did not have a policy of adjusting their COVID-related death counts once they were in possession of these death documents. It meant people like Billy Bingham, an inmate at Albemarle Correctional Institution whose death certificate and medical examiner investigation both said he died of “pneumonia due to COVID-19 virus,” were not counted.

Following our reporting on these discrepancies, DPS engaged in conversation with the Department of Health and Human Services and will now use death certificates to update their reporting, according to Bull.

“It’s very important that there be transparency in this –  for the health of people who work in prisons and live in prisons, and for community public health,” said Susan Pollitt, attorney at Disability Rights NC, one of the plaintiff organizations in a recently settled lawsuit over the state’s ability to protect incarcerated people in its custody during the pandemic.

“We can’t ensure that the prison is taking all the steps it needs to take unless there is acknowledgement and accurate reporting of people who are getting sick and dying,” she added. “I’m very glad to see that they adjusted their data.”

A policy change

The prison system’s chief medical officer, Dr. Les Campbell, will continue to make initial determinations about whether the death of an incarcerated person in the custody of the statewas COVID-19 related. That determination will trigger a press release announcing the death, and the person’s death will be added to the agency’s “COVID-19 Related Offender Deaths” count.

But now, “adjustments will be made if additional pertinent information is received that changes the status of a decision, in conjunction with discussions with DPS,” said Bull. DHHS did not respond to requests for comment.

These discussions between the prison agency and the state health department will happen behind closed doors, signaling that DPS will still operate with some degree of opacity.

Bingham, who died on August 3, 2020, and another man, Daryl Washington, who died on September 20 of last year, appear to have been added to the list of official COVID-19-related deaths among state prisoners.

Luther Wilson, another prisoner identified in our investigation who died of “complications of COVID-19 due to end stage renal disease” at Maury Correctional Institution on August 5 of last year, has not. DPS did not comment on the reason for his continued omission from the count.

“The chart and the total offender COVID deaths numbers were updated on March 4, 2021 to reflect final determinations of cause of death made in two cases by the North Carolina Office of the Chief Medical Examiner,” the correction on the DPS “Prisons Info on COVID-19” dashboard reads. “One offender had been housed at Albemarle Correctional (male in early-60s, death in August 2020), and the other had been housed at Central Prison (male in early-50s, death in September 2020).”

Catching future undercounts

North Carolina joins states such as Illinois, Arizona, Ohio, Wisconsin and Texas, which already have policies of checking their prison agency’s COVID-19 death determinations alongside death certificates or medical examiner cause-of-death investigations.

For families of prisoners like Thurman Mosley, it could make all the difference.

NC Health News has identified at least two additional prisoners who may be counted following this policy change, according to their death documents and medical examiner investigations.

Mosley, 61, a prisoner at Alexander Correctional Institution died of “acute and chronic respiratory failure due to Coronavirus-19” on December 19. Another, Oliver T. Johnson, 37, died of “Sepsis (S. aureus, candida, COVID-19) due to complications of bowel perforations.”

Currently, neither death appears to be counted by DPS or announced in press releases the agency issues for each COVID-19-related death.

“It absolutely matters if he’s not a part of that statistic,” said James Mosely, Thurman’s brother, who said the family was informed he had COVID-19 by staff at Catawba Valley Medical Center, the hospital where he died. “Whatever happened to my brother, investigatively, I don’t know where to go. I’m planning on sending the prison his funeral brochure – I want them to see he wasn’t just a number. He had a family that loved him.”

The prison agency declined comment on whether the deaths of these two men will be added.

“As you know, state law prohibits me from releasing or commenting on offender medical information,” said Bull. “If there are future changes to previous decisions on the COVID deaths in the offender population, the expectation is the website will be changed after review and consultation with DHHS.”

Room for more transparency

Michele Deitch, attorney and director of the COVID, Corrections, and Oversight Project at the University of Texas School of Public Affairs, said the new policy increases accountability – but there’s more North Carolina’s prison system could do to be transparent about how these determinations are made.

“The one thing that I would strongly encourage is the publication of what’s known as a data dictionary on the website that explains what the metrics mean and how they’re counted,” said Deitch. “That provides real accountability and allows for apples-to-apples comparisons between different states.”

Currently, DPS does not publish the full names of prisoners who die of COVID-19, citing their interpretation of state law. The practice has made it difficult for the public to know exactly who is being counted as a COVID-19-related death.

Deitch said that if the state believes it cannot publish full names, they should opt to publish more demographic information of prisoners who die, including racial and ethnic data.

“At a grandiose policy level, for anybody looking at this system, whether it’s the media or a policy analyst or policymakers, you want to see whatever information you can gather about the people who died – their age, their demographic characteristics – so that we can analyze that and figure out who is most at risk of the most extreme consequences from COVID in this environment,” she said. “Still, providing [prisoner] names is the best way to hold the prison system accountable  – and I believe that it’s denying someone dignity to not acknowledge that they lived or died in this facility.”

DPS currently publishes racial data for state prisoners who have been vaccinated, but not for those who have died of COVID-19.

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