HD35 - The Need For and Extension of Women, Infants and Children (WIC) Programs and Other Services to Incarcerated Women

  • Published: 1991
  • Author: Department of Corrections and Department of Youth Services and Department of Social Services and Department of Health and Department of Medical Assistance Services and Department for Children
  • Enabling Authority: House Joint Resolution 209 (Regular Session, 1990)

Executive Summary:
Background

On November 10, 1989, President Bush signed the legislation that gave states the option to provide benefits of the Special Supplemental Food Program for Women, Infants and Children (WIC) to incarcerated women who meet the Program's qualifications. Based on her concern for the health and well-being of the children of these mothers, Delegate Gladys Keating (D-Franconia) introduced House Joint Resolution 209 (see Attachment 1).

HJR-209 requests the Departments of Corrections, Youth and Family Services, Social Services, Medical Assistance Services, Health and the Department for Children to jointly study the need for and to develop regulations to extend the WIC Program and maternity case management services to incarcerated women in state, local and regional correctional institutions in Virginia.

Study Process

The Virginia Department of Health, which administers the WIC Program, was designated as the lead agency for the HJR-209 study. In a cooperative effort with the other previously referenced agencies and with other interested parties, a study committee was established to respond to the HJR-209 mandate. The committee and its subcommittees met six times from June through October, 1990 to address the issues relevant to the legislation.

The principal research tool utilized by the committee was a survey form developed jointly by staff from the Departments of Corrections, Youth and Family Services, and Health. A second research initiative involved a detailed nutrient analysis of the planned menus for pregnant women incarcerated in both adult and youth correctional facilities.

Data from both of these initiatives were reviewed by members of the study committee and were the primary basis upon which the committee built its recommendations.

Study Findings

The HJR-209 survey form was sent by the Virginia Department of Corrections (VDC) to the Virginia Correctional Center for Women, 97 jails and 46 youth facilities and homes. The responses were compiled by VDOC staff with the results summarized as follows (see Attachment 2 for more details):

1. Most facilities have small female populations: 47.9% have female populations of 6 or less. Exceptions are the Virginia Correctional Center for Women with 610, Richmond City Jail with 135, Fairfax County Jail with 106, and Bon Air School for Girls with 80 females.

2. Most facilities do not test for pregnancy as a routine, but test according to last menstrual period, other symptoms or at the female's request.

3. Most facilities report 0-5 pregnant females in a 12-month period. Exceptions were Arlington County Jail, Virginia Correctional Center for Women, Newport News City Jail, Chesterfield County Jail, and the Fairfax County Jail with a range of 18-37 pregnant females.

4. The majority of facilities are unable to provide definitive data on birth outcomes. Of 416 pregnancies during the preceding twelve months in 67 facilities, the outcomes of 321 (77.2%) were reported as unknown because of the women being released or transferred prior to delivery. Of the remaining 95 women, 69 (72.6%) were reported as having normal births, with 12 (12.6%) having miscarriages, 9 (9.5%) having newborns showing the effect of alcohol or drug exposure, 3 (3.2%) having premature births and 2 (2.1%) having stillbirths. The size of this sample of known outcomes prevents definitive conclusions about the risks of poor pregnancy outcome by incarcerated women.

5. Most facilities house pregnant females for 3 months or less, with only 2 adult and 2 youth facilities reporting an average stay of 8 months or more.

6. Generally, facilities do not have nutrition education programs at the facilities, although 33.3% report having one. However, pregnant females do receive nutrition education through consultations with medical personnel who provide prenatal care outside the facility.

7. Most facilities report that pregnant females receive a special diet as indicated by medical or nutritionist personnel. Only one facility reports that pregnant women do not receive a different diet -- 61.1% of facilities report that pregnant women receive more milk, 24.7% report more snacks, and 43 facilities report a combination.

8. Facilities usually do not have difficulty providing prenatal care; but those facilities identifying problems indicate difficulties in scheduling appointments, and determining which provider is responsible, particularly for youth.

9. Routine prenatal care is more often provided by the local Department of Health, local hospitals, and facility personnel. However, 10 adult facilities and 13 youth facilities gave more than one response, revealing that all choices given (local or state hospital, health department, private practitioners, and facility medical personnel) are used.

10. Most facilities do not have space to store food separately unless storage units are provided. If units are provided, most report having sufficient space, but approximately 33% would not have space if storage units were provided.

The nutrient data analysis (see Attachment 3) indicates that incarcerated pregnant women consume more than the Recommended Dietary Allowance (RDA) of most nutrients. Some menus were slightly low in potassium, calcium and iron. There do not appear to be any standardized prenatal diets in use in correctional facilities across the state.

Recommendations

Based on these findings the HJR-209 study committee concludes that the availability of nutritious food for pregnant incarcerated women is not a major problem in most of Virginia's correctional institutions. It does recognize, however, that certain steps need to be taken to ensure that all such individuals consistently receive a proper diet and that, where appropriate, WIC Program and maternity case management services be made available to enhance the correctional system's existing capabilities.

Toward this end the study committee proposes the adoption of the accompanying interagency agreement (see Attachment 4) which responds to the HJR-209 call for regulations to extend WIC and maternity case management services to incarcerated women. This agreement does the following:

A. Calls on VDC, VDYFS and VDH to jointly develop standardized prenatal diets.

B. Encourages all correctional institutions to use these diets.

C. Directs VDSS and VDH to jointly develop a referral system so that infants born to incarcerated women can be certified for the WIC Program within one week after birth. It also directs VDC, VDFYS and VDH to develop a similar referral system for risk assessment, WIC Program and other appropriate services such as Baby Care for pregnant women who are released before they deliver and to develop a system to track birth outcomes of women who have been incarcerated during their pregnancies.

D. Sets forth the conditions under which incarcerated pregnant women may participate in the WIC Program if the correctional institution needs to supplement its existing resources.

E. Stipulates that such participation is subject to the availability of WIC caseload slots, the WIC priority system and waiting lists.

F. Directs VDH to report annually on the number of incarcerated women who apply for and receive WIC Program benefits.

G. Encourages all correctional institutions and local health departments to provide risk-appropriate, coordinated health care for incarcerated pregnant women through the provision of maternity case management services.

It should be noted that while VDC maintains close liaison with local and regional jails throughout the Commonwealth and certifies such for safe operation in accordance with standards promulgated by the Board of Corrections, VDC exerts no direct control over the regular operation of these facilities and can only recommend diets, not require them.

It should also be noted that the interagency agreement requires an amendment to the FY 1991 WIC State Plan which must be approved by the State Board of Health and the United States Department of Agriculture.