In Michigan, the Department of Corrections must provide adequate healthcare to all incarcerated individuals. But inside the state’s only women's prison, getting medical attention means fighting through a wall of institutional skepticism. Even after five women died at the facility this year.
One of those women was 28-year old Khaira Howard. Days before she was scheduled to leave Women's Huron Valley Correctional facility, she was wheelchair bound and in the infirmary.
Tina Stoll is one of the Prisoner Observation Aides (POA) within the facility who watched over Howard. POAs are assigned to watch over their peers who the prison believes need to be monitored.
She remembers Howard locked up in the infirmary, yelling for help to get around.
“She said that she had no feeling in her legs. They kept calling her a liar," Stoll recalled. "This girl couldn't get out of her wheelchair. She slept in her wheelchair. She stayed in her wheelchair. They just kept telling her she was faking.”
Stoll added that while she was working an observation shift, she noticed Howard acting particularly odd.
“She was sounding like she was hallucinating. And I said, 'that's weird. What's happening in there?' And then the very next day, she was deceased.”
Howard passed away on May 13, days before her scheduled release.
The autopsy proved she wasn't faking it. Her claims of paralysis in her legs was caused by a blood clot lodged in her right lower leg that broke free, traveled to her lungs and killed her.
Her blood-oxygen levels had also plummeted into the 70s when normally they should be close to 100. Those “hallucinations” Stoll overheard were Howard’s brain being actively suffocated.
The autopsy ruled her death a "natural" one. Though, women inside believe it was caused by indifference.
The state Corrections Department, which oversees Michigan’s prisons, said it’s investigating the events that led up to Howard’s death. The department also said it's committed to "transparency" and when the investigation is complete, it will become public.
Four more women died. One of them was an elderly woman whose death was not unexpected.
Autopsies are pending for the other women.
Institutional skepticism
In October of 2023, Stoll underwent surgery for her kidney. She recalls crying in pain after the surgery, only for staff to say she was being a "wimp" who just wanted pills.
"It doesn't help that they believe everybody in here is drug seeking. Everybody," Stoll said. "Every day I was complaining, 'my stomach really, really hurts.' 'No, no, you're just looking to go to the hospital. You just want pain meds.'"
The Corrections Department said its medical staff are trained to identify signs of drug use and drug-seeking behaviors in their patients. It said staff are “expected to use their expertise to assess all patients without bias.”
But women at the Huron Valley prison say the medical staff missed what should be clear symptoms of other problems.
Two weeks after Stoll's surgery, she was rushed to a hospital to find out she had a urine bubble under her right kidney that had become infected.
Another woman inside Women's Huron Valley, Renyatta Hamilton, suffered for years with irregular periods and heavy bleeding that medical records obtained by Michigan Public show she first reported her symptoms in 2014.
“I'm going to the OBGYN and really going through this process with them," Hamilton said. "But it's really not coming up with a solution.”
After 12 years of doctor visits, birth control shots and an IUD to try to solve her menstrual issues, this year, doctors at a hospital outside the facility found a lump of tissue in her uterus.
Doctors believe this could be the cause of her excessive bleeding.
"The healthcare staff is horrible," Hamilton said. "They'll talk to you the same way that the correctional officers talk to you, as if you're not here to help me."
Jamie Hein, a Ph.D. candidate at the University of Michigan who studies women’s resistance in prisons, said that attitude from staff is taught. Her perspective stems from more than just academic research. Hein spent ten years incarcerated herself while managing a hereditary lifelong illness.
"Medical staff inside is kind of trained to assume that prisoners are lying and trying to... seek drugs," Hein explained. "If I didn't have my family to advocate for me on the outside, I don't know if I would have made it."
Privatization
Hein believes the root of the crisis at Women's Huron Valley is privatization. Nearly 30 years ago, Michigan privatized its prison healthcare operations, shifting from state-run medical teams to private, for-profit corporations.
"Their goal is not to deliver quality healthcare," Hein said. "It's to provide the least possible amount of care and make the most profit. And that obviously is a huge, huge problem."
To drive down operational costs, private companies restructured the medical workforce.
Rather than employing higher-salaried Registered Nurses (RNs), private contractors shifted toward hiring Licensed Practical Nurses (LPNs) and Resident Care Aides, which is incarcerated women providing basic medical care to fellow inmates.
The Michigan Department of Corrections stated that all inmate care requests are triaged by nursing staff and that prisoners have multiple channels to file reports if their needs are unmet.
According to a 2017 study led by University of Michigan professor Roland Zullo, private contractors could pay nearly $10,000 less per year in compensation by employing an LPN instead of an RN.
Medical care across Michigan's prisons is currently contracted to VitalCore Health Strategies, a private vendor that has faced lawsuits in multiple states over allegations of medical negligence and malpractice.
VitalCore took over the state contract in 2024 after previous healthcare vendors, including Grand Prairie and Wellpath, defaulted on payments to local medical contractors and ambulance crews before filing for bankruptcy.
"They may be under a different private equity umbrella, but they are ultimately the same group of people running the show," Hein noted.
MDOC officials maintain that the state conducts regular oversight over VitalCore and that the state's Chief Medical Officer retains final authority over all clinical decisions.
With VitalCore’s multi-million-dollar state contract set to expire in September and state officials holding the option to renew, the women at Women's Huron Valley continue to wonder what it will take for their basic medical needs to be taken seriously.
