Jacob Pizzo was sick when he entered the Oregon State Penitentiary a year ago — and he only became sicker.
His hypertension ran unchecked as his blood pressure reached dangerously high levels and he showed signs of organ damage, court documents state. He experienced worsening rashes and lost three fingernails and toenails.
Prison administrators offered to pull his rotting teeth, but denied him dentures because he had less than two years on his sentence, documents state. The daily distress from his teeth prompted Pizzo, 57, to file a grievance in June. He wrote that he felt anguish every time he looked in the mirror or spoke. He said he choked on food and struggled to talk.
In court this summer, the Oregon Department of Corrections defended its treatment of Pizzo, saying treatment of his hypertension was “ongoing” and he declined an offer to remove his teeth. Meanwhile, its leadership promised to improve prisoners’ access to medical care after a string of troubling headlines.
Around the same time, lawmakers shelved bills that would have set minimum standards for the prison medical system. That’s left questions about who will ensure prison officials follow through.
“The problem with prisons is always oversight,” said Tara Herivel, the lawyer who represented Pizzo and other prisoners in similar cases. “If it’s serious, it can’t be left to the DOC.”
Herivel said her case shows that the department is still “hardily defending” practices they have publicly disavowed.
As Pizzo’s lawsuit was unfolding, the department announced in July that it had begun overhauling its dysfunctional medical services system that is responsible for the care of about 12,000 incarcerated people who are growing older and more medically fragile.
Those promises came after years of media reports, outside investigations and lawsuits highlighting how the prison system has thrown up roadblocks to adequate medical care and, at times, shown indifference to prisoners’ suffering.
An independent accreditation group last year found a backlog of 600 health care appointments for women at the Coffee Creek Correctional Facility, including annual wellness exams and preventative screenings. The department fired its top two medical leaders in February after a blistering investigation by Street Roots found they mismanaged care and retaliated against staff who spoke up.
Since then, the department hired a consultant to recommend ways to streamline care for prisoners. It also hired Kevin Bovenkamp to oversee health services and Dr. Michael Seale as chief of medicine.
Earlier this year, Gov. Tina Kotek appointed Kristina Rice permanently to the ombuds position, a spokesperson for the governor said.
Rice has since cleared the backlog of complaints, streamlined the review process and is tracking inquiries to find areas of concentration, they said.
Even so, incarcerated women at Coffee Creek still report delays in care and being blocked from accessing outside specialists, according to Angela Kim, a policy associate at the Oregon Justice Resource Center’s Women’s Justice Project.
Department spokesperson Amber Campbell said in an email that prisoners have many ways to request care. They can report concerns about not getting care through the grievance process as well as other written communications, she said. Prisoners can report abuse, staff misconduct, waste and more serious concerns through a hotline.
State Sen. Deb Patterson, D-Salem, who chairs the Senate Health Care Committee, said she is hopeful that new leadership at the department will result in reform. But a pair of bills aimed at improving prison health stalled last session, and she said that will delay needed oversight for the state agency.
“We can’t just set the boat a-sail, and say, ‘Go down the river,’” she said.
‘You were not sentenced to the death penalty’
Carolyn Kerleine recalled how one day in 2019 she was changing her clothes when her dorm mate at Coffee Creek noticed a strange nickel-sized lump on her back between her shoulder blades. Kerleine, who was released after serving 25 years for murder, said a prison doctor told her there was nothing they could do about it.
But the lump grew to the size of a grapefruit, Kerleine said. She said it was tender, ached no matter what she did and drew embarrassing questions.
“It felt like there was a pinching in my back all the time,” she said.
She said a nurse ignored her complaints, telling her it was “all in your head.” Eventually, a nurse practitioner pushed for her to have an MRI, revealing three tumors, one of which was cancer that she later underwent surgery to have removed, she said. The ordeal lasted almost three years.
In July, prison officials released a report by consulting firm Falcon Correctional and Community Services. Department Director Michael Reese said it would serve as a strategic guide for reforms that would be enacted by its new health services director. The report described health care in Oregon prisons as “fragmented, disorganized, and inefficient” that was reactive to prisoner’s medical needs, resulting in “fragmented care.”
The report prioritized making it easier for prison health care providers to make referrals to outside specialists as well as other requests without a committee called Therapeutic Levels of Care, which critics say has served as a roadblock. The department also promised to centralize scheduling for offsite care while hiring additional staff to address the backlog of outside medical trips.
But Kim pointed to several department policies that keep patients from needed care. An ODOC policy document, provided by Kim, states that medical staff are not required to follow recommendations from outside providers. It also states that a committee of medical staff can consider how much longer a prisoner has in their sentence when determining whether to approve a procedure. They can also consider a prisoner’s pre-existing conditions and if they had obtained treatment before entering prison.
“You shouldn’t have to be at risk of dying because your pre-existing condition isn’t being taken care of,” Kim said. “You were not sentenced to the death penalty.”
Campbell, the department’s spokesperson, replied that if a prisoner has “a need for medically necessary care it would be addressed.”
‘A little bit skeptical’
Lawmakers advanced a bill earlier this year intended to address these policies, but it didn’t pass, instead languishing in the Legislature’s budget-writing committee.
Senate Bill 293 would have prohibited the department’s policies on pre-existing conditions and considering the length of a prisoner’s sentence when determining their care. It also would have required staff to document reasons for denying care and guaranteed prisoner access to a minimum list of prescription drugs.
State Sen. Lisa Reynolds, D-Washington County, seemed incredulous during a Senate Health Care Committee to hear that “humane and proper care” of prisoners needed to be mandated.
“We really have to do a bill for this?” she said.
However, the bill’s cost remained undetermined because of its ambiguous language. State Sen. Cedric Hayden, R-Fall Creek, remarked that the way the bill was written could mean prisons spending thousands to replace a prisoner’s missing tooth or other care that was not medically necessary. The Falcon report, released after the session ended, stated that while the bill seemed logical, the way it was written “would create more problems than it would solve.”
Patterson, the committee’s chair, said Senate Bill 293 stalled because of the state’s tightening financial circumstances and likely got stuck in legislative machinery as lawmakers churned through an avalanche of bills.
She said she will bring back a version of the bill, but it will have to wait until the 2027 long session because she expects next year’s short session to focus on federal health spending cuts.
Kim, whose group spearheaded the bill, said its failure means “things will continue as they have all along.”
A related bill, Senate Bill 24, would have set minimum health care staffing levels in prisons and directed the department to evaluate staff pay. Prison medical staff described feeling burnt out and overwhelmed during a committee hearing. But that bill also remained stuck in the budget-writing committee.
Liz Sabin, a registered nurse at Coffee Creek represented by Oregon AFSCME, told Street Roots she was encouraged that the Falcon report recommended a quality improvement program and making it easier for prisoners to access care, which she said can be “buried” in process. Prisoner requests for medical care and charting systems are still paper-based, which she said is inefficient. The department is currently moving to an electronic health records system.
She said there is an “honest commitment” from department leadership to change and she has seen some improvements, like prisoners being able to line up to be seen by medical staff.
“I’m a little bit skeptical,” she added. “Because I’ve been here under so many different leadership changes.”
‘It’s your fault for being in prison’
Herivel, the lawyer, said that the department has grown complacent in denying care to prisoners to save money, and because Oregon has had less robust prison litigation compared to states like California or Washington. She said the attitude toward prisoners has often been, “It’s your fault for being in prison.”
The department’s lawyers argued in a brief that Pizzo, who had been sentenced to over a year in prison for unauthorized vehicle use, had not been diagnosed while in prison with a lytic lesion at the base of his skull, nerve damage, PTSD, depression and other ailments. They also stated that he declined the prison’s offer to remove his teeth and did not participate in a program offering medications to help with his opioid use disorder.
Herivel wrote in a brief that the department’s defense is “profoundly contradictory with ODOC’s stated goals and leadership.”
She argued that prison management ignored Pizzo’s signs of nerve damage. He complained in a request for medical help that his left armpit was swollen and extremely painful after being bitten by a police dog. “I got out of shower and put deodorant on and my left arm burn bad,” he wrote.
Herivel further argued that he should have been referred to a specialist for his pain issues, and records were not clear if he had been given medications for opioid use disorder.
As of press time, a judge was finalizing an order directing the prison to make dentures for Pizzo. The department declined to comment, citing the litigation.
‘Like razors in your guts’
Before incarceration, Laurie Price said she had her Crohn’s disease and ulcerative colitis, two inflammatory bowel diseases, under control with the right mix of medications.
But by the end of her five-year sentence at Coffee Creek in 2018 for Medicaid fraud (a conviction later overturned), she said her conditions deteriorated to the point where she had to have her colon removed.
“It’s like razors in your guts,” said Price, 61, of what she experienced after her bowel diseases flared up when the prison took her off her medicines.
She said she spent most of her time in prison in the prison infirmary where she regularly filled out requests for medical care, which she said prison staff often ignored.
In 2016, Price was suffering from a urinary tract infection, a staph infection in her lungs and her deteriorating colon, she said. She said she was not given oxygen and was instead told by a nurse to breathe in deeply, breathe a little more and then let it all out.
But her infections turned septic and she was taken to a hospital where a doctor she knew before entering prison removed her colon along with a quarter of her right lung. She credits doctors working outside the prison system for advocating for her to get care she needed.
Prisons are “totally insular” and are modeled on military organizations to keep scrutiny out, Herivel said.
The Oregon Department of Corrections Ombuds is responsible for investigating complaints about civil rights violations of prisoners. However, Adrian Wulff was fired from the position last year. He later told media outlets he was doing the job alone and his requests to Gov. Tina Kotek’s office for staffing and resources fell on deaf ears.
Kotek is receiving updates on the prison reforms and is monitoring them closely, a spokesperson said in an email. The governor is confident in the leadership of Reese, the department’s director.
More than half of states (excluding Oregon) have faced court orders compelling them to improve prison medical care, according to research from the Prison Policy Initiative think tank.
Prisons are usually set up to address prisoners’ medical crises while avoiding liability, and are not good at providing caring for chronic physical conditions or mental health, said Wanda Bertram, spokesperson for the think tank. That’s because prisons are siloed from health or social service agencies while being barred from receiving federal Medicaid dollars, she said.
Kim, of the Oregon Justice Resource Center, said that the most success in reforming prison health has occurred in states like Rhode Island that have brought in universities or other outside organizations to help care for prisoners.
She said that while prisoners are kept away from the rest of society, most will eventually return. In Oregon, about 95% of currently incarcerated inmates are expected to be released.
“You want an engaged, healthy neighbor who’s going to come out and live next to you,” she said.
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This article appears in September 24, 2025.
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