Weekly Pulse: The Push for the Public Plan

Lindsay E. Beyerstein

This week, the AMA warned Obama that a public plan could restrict patient choice. But for millions of Americans, getting a choice between healthcare and no healthcare would represent a 100% increase in their healthcare options.

Healthcare reform is back in the news, as legislators and interest
groups spar over the promised public component of Obama’s healthcare
plan.

In very simple terms, this is a fight between groups with a vested
interest in expensive healthcare and everyone else. This week, the
American Medical Association warned Obama that a public plan could
restrict patient choice. But for millions of Americans, getting a
choice between healthcare and no healthcare would represent a 100%
increase in their healthcare options. Obama’s public plan would also
give people the choice of keeping their private health insurance. The
public plan is an additional option, not a diminution of options.

The AMA is a powerful interest group, but it doesn’t speak for all
physicians. Several prominent groups representing doctors and medical
students, including the American Association of Family Physicians, co-signed a declaration supporting Obama’s push for a public plan this week.

Expect the health insurance lobby to fight the public option tooth and nail, says economist Dean Baker in AlterNet.
It’s smart business from their perspective. Platitudes about the free
market aside, no real capitalist welcomes competition. As Baker points
out, a public plan represents competition to health insurance
companies. For every dollar Medicare pays to providers, it spends two
cents on administration. Whereas private insurers spend about fifteen
cents on the dollar in administrative costs. Baker estimates that if a
public plan were available, insurance profits would drop by 20-30%, all
things being equal.

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Former president Bill Clinton invited about 20 progressive bloggers
to his Harlem office on Monday for a seminar-style discussion about the
work of the Clinton Foundation. Several staff from Media Consortium
member organizations were in attendance, including yours truly.
Healthcare was a major topic of conversation. Emily Douglas of Rewire, who also attended the meeting, writes:

The former President observed that the
country, emerging from a "post-9/11 emotional straitjacket" has become
"more communitarian" – and that President Obama has fewer budget
issues, and less Republican opposition, to content with when attempting
reform.  But, most importantly, "everything is worse now" – health care
spending has doubled, more are uninsured, and disposable income,
adjusted for inflation, is down.

Clinton said that he’s optimistic about the prospects for healthcare
reform this year, but he encouraged Obama to drive a hard bargain with
congressional Republicans. All things considered, the former president
said, it would be better to pass healthcare with 60 votes for the sake
of the Obama administration’s long-term relations with congress. The
alternative would be to pass healthcare through budget reconciliation,
which would require only 51 votes, but which would incur a lot of
ill-will among Republicans. However, Clinton cautioned against writing
a weak bill to avoid reconciliation. In Clinton’s opinion, if we don’t
contain healthcare costs by moving to outcomes-based medicine and
making our healthcare delivery systems more efficient, the system will
be unsustainably expensive.

James Ridgeway of Mother Jones
has also been mulling the challenge of writing a bill that’s acceptable
to enough Republicans to avoid a budget reconciliation fight. Ridgeway
fears that sweeping structural reform will take a back seat to
political expediency. He fears that by trying to please everyone, Obama
could end up pleasing no one:

One disturbing possibility is that
health care could become a replay of the credit card legislation. The
pattern goes something like this: First, we get a propaganda blitz
heralding sweeping changes. But although the final legislation corrects
some of the most egregious abuses, it doesn’t change the system’s
underlying flaws. So, for example, insurance companies may be required
to cover people with preexisting conditions-a need Obama illustrated
vividly in his AMA speech with moving references to his mother’s battle
with cancer. We might see what the president called "more efficient
purchasing of prescription drugs," which presumably means faster
approval of generics and giving the government greater power to haggle
with Big Pharma over drug costs. We will likely see incentives for
health care providers to offer more cost-effective-and, hopefully,
better-treatment. These things are not meaningless, and they will
provide a modicum of relief to some struggling Americans. But they do
virtually nothing to strike at the deeper problems of the for-profit
health care system. And they offer only a fraction of the savings that
a single-payer system would provide.

If the healthcare debate sounds vague and abstract, that’s because
it is. There are several competing bills coalescing, but at this point,
there’s no overall vision for reform. Everything is up for grabs. Never
afraid to think big, Sen. Bernie Sanders (I-VT) is circulating a
petition for single-payer healthcare, with an assist from Chelsea Green.

Surely the weirdest healthcare story of the week comes from Tracy Clark-Flory of Salon: An
anti-choice blogger who claimed to be carrying a non-viable pregnancy
to term out of pro-life principle was exposed as a hoaxster when an
alert reader identified her "dead baby" as a doll. It’s not clear why
the 26-year-old social worker perpetrated the hoax. Jessica Valenti of Feministing injects a note of compassion for the perpetrator, "Though as angry as this makes me, I’m with Sadie at Jezebel
on this: ‘It’s tempting of course to use this as a chance to take an
easy bash at anti-choice, and revel in anything that makes them look
foolish, but frankly, I’m just sad for this woman.’ As am I."

Roundups Politics

The House Freedom Fund Bankrolls Some of Congress’ Most Anti-Choice Candidates

Ally Boguhn

With the 2016 election cycle underway, the political action committee seems to be working tirelessly to ensure the House Freedom Caucus maintains a radical anti-choice legacy.

In its short existence, the House Freedom Caucus (HFC) has made a name for itself through endless efforts to push Congress further to the right, particularly when it comes to reproductive health. Now with the 2016 election cycle underway, the caucus’ political action committee, the House Freedom Fund, seems to be working just as tirelessly to ensure the caucus maintains a radical anti-choice legacy.

Since its founding by Rep. Jim Jordan (R-OH) in January 2015, the group of ultra-conservative lawmakers that make up the caucus has ballooned from just nine members to at least 36 members, as of October 2015, who have confirmed their own inclusion—though the group keeps its official roster secret. These numbers may seem small, but they pack a punch in the House, where they have enough votes to block major legislation pushed by other parts of the Republican party.

And now, the group is seeking to add to its ranks in order to wield even more power in Congress.

“The goal is to grow it by, and I think it’s realistic, to grow it by 20 to 30 members,” Rep. Matt Salmon (R-AZ), one of HFC’s founding members, told Politico in April. “All new members.”

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While the caucus itself reportedly does not endorse candidates, its unofficial PAC has already thrown money behind defending the seats of some of the group’s most notoriously anti-choice members, as well as a few new faces.

According to OpenSecrets.org, the Center for Responsive Politics’ campaign finance database, thus far in 2016, the House Freedom Fund has invested in seven congressional candidates currently vying to keep a seat in the House of Representatives: Rep. Rod Blum (R-IA), Rep. Dave Brat (R-VA), Rep. Tim Huelskamp (R-KS), Rep. Mark Meadows (R-NC), Rep. Scott Desjarlais (R-TN), Rep. Scott Garrett (R-NJ), and Rep. Paul Gosar (R-AZ). The PAC’s website also highlights two candidates hoping to move from their state legislatures to the House: Republican Indiana state senator Jim Banks and Georgia state Senator Mike Crane. The PAC is also backing the Republican candidate for Florida’s 2nd Congressional District, Mary Thomas; and Republican candidate for North Carolina’s 13th Congressional District, Ted Budd.

Rep. Warren Davidson (R-OH), who won a special election in early June to replace former House speaker John Boehner, also received funding from the PAC. He joined the House Freedom Caucus that same week.

The Republican Party actively works to deny access to virtually all forms of reproductive health care, so it is not surprising that the candidates supported by the House Freedom Fund, whose confirmed members are all members of the GOP, share similarly radical views on reproductive rights and health.

Here are some of the House Freedom Fund’s most alarming candidates:

Rep. Rod Blum

Rep. Blum, a freshman congressman from Iowa, considers his opposition to reproductive choice one of the “cornerstones” of his campaign. “It is unconscionable that government would aid in the taking of innocent life. I strongly oppose any federal funding for abortion and I will vote against any of our tax dollars flowing to groups who perform or advocate abortions on demand,” asserts Blum’s campaign site. The Hyde Amendment already bans most federal funding for abortion care.

Blum spent much of his first year in the House attempting to push through a series of anti-choice bills. The representative co-sponsored the medically unsupported Pain-Capable Unborn Child Protection Act, which would have enacted a federal ban on abortion at or beyond 20 weeks of pregnancy, in January 2015. He signed on as a co-sponsor for the failed Life at Conception Act, a so-called personhood measure that would have granted legal rights to fetuses and zygotes, thus potentially outlawing abortion and many forms of contraception, in March of that year. That July, Blum co-sponsored the Defund Planned Parenthood Act of 2015, which would have stripped the reproductive health organization of all federal funding for one year so that Congress could investigate it in the wake of the Center for Medical Progress’ (CMP) discredited videos smearing the provider. 

Blum’s co-sponsorship of anti-choice legislation was accompanied by a long series of like-minded votes throughout 2015, such as a January vote in favor of the No Taxpayer Funding for Abortion Act and Abortion Insurance Full Disclosure Act of 2015, which, among other things, would have made the Hyde Amendment’s annually renewed ban on most federal funding for abortion care permanent. He also voted to block Washington, D.C.’s Reproductive Health non-discrimination law, and in favor of a measure allowing states to exclude from Medicaid funding any health provider that provided abortions, as well as other anti-choice measures.

Blum’s brief time in Congress has been marked by such extremism that Emily’s List, an organization that works to elect pro-choice women, put Blum on their “On Notice” list in July 2015, signaling their intention to prioritize unseating the Iowa Representative. “In less than five months into the 114th Congress, we have seen Representative Blum lead the crusade to restrict women’s access to healthcare, most notably when he cosponsored a national abortion ban,” explained the organization in a press release on its decision to target Blum. “It’s clear that Congressman Blum is more focused on prioritizing an extreme ideological agenda over enacting policies that benefit more women and families in Iowa’s First Congressional District.”

Rep. Dave Brat

Rep. Dave Brat gained notoriety for his win against incumbent representative and then-House Majority Leader Eric Cantor in 2014, a victory considered one of “the biggest political upset[s] in recent memory.” Like many of his HFC colleagues, Brat has co-sponsored several pieces of anti-choice legislation, including the Pain-Capable Unborn Child Protection Act in 2015 and the Conscience Protection Act of 2016, which claimed to “protect” against “governmental discrimination against providers of health services” who refuse to provide abortion care. Brat’s voting record in Congress earned him a 100 percent rating from the National Right to Life Committee.

In April of this year, the Virginia representative signed on to a letter with Senator Ted Cruz (R-TX) and other anti-choice legislators, such as House Freedom Fund candidate Rep. Meadows expressing “serious concerns” about the Food and Drug Administration’s decision to update the label of abortion drug mifepristone to bring it in line with scientific research and evidence-based medicine. Though medication abortions are safe and result in complications in fewer than 0.4 percent of patients, the lawmakers nonetheless claimed that the regulation change could be dangerous, noting that the drug was originally approved during the Clinton administration and demanding a list of information about it.

In the wake of the deadly shooting at a Colorado Springs Planned Parenthood facility in November, when the alleged shooter parroted the same violent rhetoric about the reproductive health organization popularized by the CMP’s discredited videos, many in Congress called for the panel investigating Planned Parenthood to be disbanded and for lawmakers to distance themselves from the videos. Brat, however, saw no reason the anti-choice violence should affect the conservative crusade to shut down access to reproductive health care. “Principles are principles,” Brat said at the time according to the Huffington Post. “They don’t change on a news cycle.”

Rep. Tim Huelskamp

Kansas Rep. Tim Huelskamp has been an anti-choice advocate since graduate school, when, according to the biography provided on his website, he was “active in assisting women in crisis pregnancies” while working toward a doctoral degree at American University. His advocacy continued as he made his way to Congress, eventually leading him to become the congressional “Pro-Life Caucus” whip.

Though he has cast plenty of anti-choice votes, the congressman’s most notable moment when it comes to reproductive rights may be a 2012 speech on the House floor, in when he compared abortion to slavery and accused Planned Parenthood and the Obama administration of being racist. “Perhaps the biggest war against our liberties is the war that is being waged against those that are not here today, the unborn,” claimed Huelskamp. “Besides slavery, abortion is the other darkest stain on our nation’s character and this president is looking for every way possible to make abortion more available and more frequent. And he wants you to pay for it. Even if you disagree with it.”

Huelskamp went on to falsely accuse Planned Parenthood of targeting people of color. “I am the adoptive father of four children, each of them either Black, Hispanic, Native American, and I am incensed that this president pays money to an entity that was created for the sole purpose of killing children that look like mine; a racist organization and it continues to target minorities for abortion destruction,” said the congressman. “Shame on this president and shame on that party.”

It wouldn’t be the last time Huelskamp exploited race in order to promote his anti-choice agenda. In 2015, the Kansas Representative lashed out at those who accepted awards from Planned Parenthood, tweeting that they were supporting a “racist” agenda.

Rep. Mark Meadows

Rep. Mark Meadows, who has a 100 percent rating from the National Right to Life Committee, co-sponsored anti-choice measures such as the House’s 2015 fetal pain bill, the 2015 Life at Conception Act, and the Prenatal Nondiscrimination Act of 2016 (PRENDA). He also once badgered a pregnant doctor testifying during a House committee hearing about the importance of offering maternity coverage through the Affordable Care Act. However, the congressman’s recent vendetta against Planned Parenthood stands out the most.

In July 2015, in the wake of CMP’s deceptively edited videos, Meadows latched onto the discredited films in order to justify defunding Planned Parenthood. “In addition to cutting funding for abortion providers, I strongly urge Congress to investigate the legality of the practices engaged in by Planned Parenthood,” said Meadows at the time.

In September, as Congress faced the looming threat of a possible government shutdown if they didn’t pass a budget bill, Meadows exploited the opportunity to push for Planned Parenthood to be defunded, no matter the cost. With the South Carolina congressman leading the charge, pressure from conservatives to pull funding for the reproductive health-care provider played a role in prompting then-House Speaker John Boehner to resign his position. Meadows was a co-sponsor of the Defund Planned Parenthood Act of 2015, which passed in the House as part of a compromise to narrowly escape the shutdown. 

But Meadows’ quest to attack Planned Parenthood didn’t end there. In September, the congressman also participated in the House Oversight and Government Reform Committee’s hearing to “examine the use of taxpayer funding” by Planned Parenthood and its affiliates, a sham hearing used by the GOP to repeatedly push misinformation about the organization.

Rep. Scott Desjarlais

Rep. Scott Desjarlais, a medical doctor, is perhaps best known for his attempt to pressure his patient, with whom he was having an affair, into having an abortion when she became pregnant. While the congressman has repeatedly run on his anti-abortion credentials, his divorce papers also revealed he had supported his wife in having two abortions. Politico‘s Chas Sisk labeled DeJarlais  “the biggest hypocrite in Congress.”

Desjarlais made headlines again in 2015 for voting for a later abortion ban. A spokesperson for the Tennessee Republican told the Times Free Press that the vote was in accordance with the congressman’s record:

“Congressman DesJarlais was proud to vote in favor of this legislation,” said his spokesman Robert Jameson, who added that DesJarlais has maintained a “100 percent pro-life voting record” during his five years in Congress and “has always advocated for pro-life values.”

Indiana State Sen. Jim Banks

Indiana state Sen. Jim Banks (R-Columbia City) is one of the few candidates backed by the House Freedom Fund that has yet to win federal office, but his time in the state legislature has given him more than ample opportunity to demonstrate his opposition to reproductive health and rights.

Banks’ campaign website highlights the candidate’s “pro-life” position as a key issue for his race for the House, providing an extensive record of his anti-choice credentials and claiming that he is “running for Congress so that northeast Indiana continues to have a strong voice for innocent lives in Washington, D.C.” That page includes a laundry list of campaign promises, including amending the U.S. Constitution to give a fetus legal human rights, which could outlaw abortion and many forms of contraception; banning federal funding for abortion, though such a ban already exists; eliminating federal funding for any organization that performs abortions domestically or abroad; and opposing any change to the Republican platform on abortion.

The state senator’s site goes on to suggest that “it has been far too long since the Supreme Court discovered that women have a ‘right’ to have an abortion,” lamenting that much of the anti-choice movement’s work to shutter access to abortion in state legislatures hasn’t been replicated on a federal level and promising to address the issue if elected.

Included in his anti-choice resumé is a note that both Banks and his wife have been working in the movement to oppose choice since graduating college, when the two joined Focus on the Family, an organization that has spent millions of dollars promoting its extreme agenda, even devoting $2.5 million to run an anti-abortion ad during the 2010 Super Bowl. The two also worked together on the Allen County Right to Life Board of Directors, and Banks’ wife, Amanda, remains the board’s vice president.

But most extreme of all was the legislation Banks spearheaded while in the state legislature, which included several targeted regulation of abortion providers (TRAP) measures. Most recently the state senator sponsored Indiana’s SB 144, a bill that would modify the state’s 20-week abortion ban to outlaw the procedure once a fetal heartbeat could be detected, typically around six weeks’ gestation. In a statement on the bill, Banks claimed the law was needed because it “would protect unborn Hoosiers’ right to life and also includes important women’s health protections.”

Analysis Human Rights

Erika Rocha’s Suicide Brings Attention to the Dire Need for Mental Health Care in Prison

Victoria Law

Erika Rocha's was the first suicide of the year at Corona's California Institution for Women (CIW), which is currently at 130 percent capacity. CIW's suicide rate, however, is more than eight times the national rate for women behind bars.

On April 14, 2016, one day before her parole hearing, Erika Rocha committed suicide. The 35-year-old had spent 21 years behind bars. But what should have been a day of hope for Rocha, her family, and her friends instead became a day of mourning.

Rocha’s was the first suicide of the year to rock Corona’s California Institution for Women (CIW), which is currently at 130 percent capacity. CIW’s suicide rate, however, is more than eight times the national rate for women behind bars. The prison had four suicides and 16 attempts in 2014. In 2015, it had two suicides and 35 attempts. And in the first two months of 2016, CIW had four additional suicide attempts.

These numbers, advocates say, display the consequences of the lack of mental health resources for women in prison, some of whom have been behind bars for decades.

The need for comprehensive mental health care has long plagued California prisons. In 1990, advocates filed Coleman vs. Wilson, a class-action civil rights lawsuit alleging unconstitutional medical care by the California Department of Corrections and Rehabilitation (CDCR). In 1995, a U.S. District Court ruled in Coleman that mental health-care access in the state prisons violated the Eighth Amendment prohibition against cruel and unusual punishment; the following year, it appointed a special master to review California’s prisons and to monitor mental health care. That special master is still monitoring CDCR’s mental health care.

In 2013, Lindsay Hayes, a suicide prevention expert, audited all of the state’s prisons for their suicide prevention plans. In 2015, he re-audited 18 of those prisons. In the report he released in January 2016, he noted that, while some prisons had made progress on the issue, “CIW continued to be a problematic institution that exhibited numerous poor practices in the area of suicide prevention.” These poor practices, Hayes wrote, included low completion of suicide risk evaluations, inadequate treatment planning, low compliance rates for annual suicide prevention training, and multiple suicides during the calendar year.

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“This Seemed To Be the Only Way”

No one will ever know what pushed Rocha over the edge. But others at CIW say that those who need mental health treatment there, both before and after their suicides, face a lack of preventive treatment, including counseling, and almost no follow-up.

Amber, who asked to be referred to by a pseudonym, noted that the prison lacks available mental health programming. She had already spent 14 years at another prison when she was transferred to CIW. There, she found that nearly every self-help and support group had a long waiting list.

In addition, mental health treatment was sparse. “I would only see mental health [staff] every 90 days, and that was only about five minutes,” she recalled in an interview with Rewire. “As time went on and I became more and more frustrated by the lack of anything to take my mind off my emptiness, I got more lonely and hopeless.” She stopped talking to her friends, stopped eating, lost interest in her appearance, and began losing weight. No one noticed these red flags. She told mental health staff that she wanted to stop taking medication. No one, she said, questioned her decision.

In July 2014, Amber and her friend Mindy (also a pseudonym) decided to end their lives together. Once they made their decision, Amber remembered feeling a sense of relief: “I was happy. I knew my misery and pain were ending. … This seemed to be the only way.” The two slit their throats, losing consciousness. But someone found them, alerted staff and they were transported to the hospital. How they were treated next, they said, didn’t make them feel any more hopeful about life.

After being released from the hospital, both women were placed in a mental health crisis bed, commonly referred to as “suicide watch” among people in prison. Amber described suicide watch as a place “where they strip you naked and put a hard gown on you, basically a life jacket. They give you a blanket made of the same material and have a bright light on with a nurse watching and recording [on paper] your every move. … You are not allowed anything for the first week. Then you can ‘earn’ a book. And maybe a muumuu gown if you are calm and cooperative. You aren’t even allowed a roll of toilet paper. When you need to use the toilet [in your cell], they hand you a tiny bit and watch you use it.”

Mindy spent 11 days in suicide watch; Amber was there for two weeks. Both were then placed in the prison’s specialty care unit, where they were able to have human interactions and access to group programming, which Amber described as 14 hours a week of coloring, watching movies, singing karaoke, and walking.

However, suicide watch is frequently full. In those cases, people are placed in an “overflow unit” in the prison’s Security Housing Unit (SHU), an isolation unit where people are locked in their cells for 23 to 24 hours each day. This kind of isolation can cause myriad mental health issues, including anxiety, panic, depression, agoraphobia, paranoia, aggression, and even neurological damage.

Krista Stone-Manista is an attorney with San Francisco-based Rosen Bien Galvan & Grunfeld, which co-litigated the Coleman case. She is also part of the team now monitoring compliance. She notes that, when a person reports feeling suicidal, she is supposed to be moved to a mental health crisis bed. But, because there aren’t enough mental health crisis beds, California prisons utilize what’s known as “alternative housing,” which might include isolation until a bed opens up. “What we’re seeing is that people are repudiating their suicidal ideation to get out of alternative housing,” she told Rewire. That means that they don’t receive counseling or any other type of mental health treatment.

But even when they are placed on suicide watch, the special master, in his 2015 review of CIW, found that “patients were discharged from the mental health crisis bed as soon as they reported they were no longer suicidal, with little effort to determine the underlying causes of their initial reports of suicidality.”

People incarcerated at CIW report that its environment has not improved in the two years since Amber and Mindy attempted to take their lives. In March 2015, Stephanie Feliz hung herself. Mindy, who was in the mental health unit at the time, said that Feliz walked in and requested services for a mental health crisis. Despite having a history of suicide attempts and self-mutilation, Mindy said staff told her that she had already been seen the day before. According to Mindy, Felix returned to her cell, where she was found dead two hours later. This treatment is not unusual, Mindy noted, writing to Rewire in a letter that she too has requested mental health services only to encounter delays and, at times, outright dismissal.

But no matter what changes the institution makes, Stone-Manista pointed out, “There’s only so much CIW can do for someone who is chronically suicidal. They’re not a hospital.”

CDCR did not respond to queries about the numbers of suicides and suicide attempts at CIW or about its suicide prevention practices.

Rocha’s Years in Prison

When Rocha was 14 years old, she and several older teens were arrested for an accidental shooting. Rocha was charged as an adult and, without a parent or guardian present, questioned by police and, according to advocates, pressured to plead guilty by the prosecutor. She did and was sentenced to 19 years to life. Rocha was initially sent to a juvenile prison, where she spent two years. At age 16, she was transferred to the adult Valley State Prison in Chowchilla. There, prison officials placed her in solitary, ostensibly for her own protection due to her age. She stayed in isolation for one year.

Windy Click is now program coordinator for the advocacy group California Coalition for Women Prisoners (CCWP). She was imprisoned at Valley State when Rocha arrived and met the girl shortly after she had turned 19. Rocha was looking for something positive to do and asked how to get to the prison library. While Click, then in her 30s, and Rocha never became close friends, each time Rocha was released from solitary, she sought the older woman out.

“She was a funny girl,” Click recalled in an interview with Rewire. “She liked to joke and be light-hearted.” One of the topics that Rocha frequently joked about was growing old in prison. “She’d say she would be an old lady in prison.”

Other times, however, the girl had a hard time coping with prison. “She would be very shaky, trembling almost,” Click recalled. “‘I can’t do this no more,’ she’d tell me.” During those times, Click said, Rocha would tell prison staff that she was afraid for her life and request to be placed in administrative segregation, a form of isolation commonly known as ad-seg, where she would be locked in a cell for 23 to 24 hours each day. Prison staff obliged and Rocha would be placed in isolation. When she returned to general population, Click remembered that the girl would seem better but “after a day or so, she’d be back to that shakiness.”

Click recalled one conversation in which she told Rocha, “This place isn’t the last place you’ll ever be.” But, she remembered, the younger woman couldn’t see the light at the end of the tunnel.

It didn’t help that Rocha spent more than a decade without seeing her family, who lived nearly 300 miles in the Los Angeles area. Lacking a car, they could not make the trek to Central Valley. It was not until Rocha was moved to CIW, 15 minutes from their home, that they could visit. By then, Rocha’s father had died; her stepmother Linda Reza brought her three daughters as soon as Rocha was allowed to receive visits.

“She was still the same little kid that left us,” Reza remembered of that first visit in an interview with Rewire.

That was how Geraldine, Rocha’s half-sister, saw it as well: “She’s nine years older than me. But it was like I was the big sister.”

Rocha got along best with her teenage sister Freida, who was born after her incarceration and whom she met for the first time in the CIW visiting room. When the family visited, Reza remembered that Rocha and Freida would head to the visiting room’s play area and play on the swings. Reza recalled that, when Rocha received news of her upcoming hearing, she and Freida made plans to share a room at Reza’s house, clipping magazine pictures and envisioning how to decorate the room.

Colby Lenz, a volunteer legal advocate with CCWP, saw a different, more vulnerable side, one that Rocha did her best to keep from her family. “She was the most fragile and traumatized person I had ever met in prison,” Lenz recalled about their first meeting less than two years ago. It was only partway through the legal visit that Rocha began to open up. “She went back to [age] 14 or 15 and talked about her early years—how much time she had done in solitary, how they treated her.”

Under California’s SB 260, which passed in 2013 and went into effect in January 2014, Rocha became eligible for a youth parole hearing for youth sentenced as adults to long prison sentences. As part of the hearing process, she was given a psychiatric evaluation. But, said Lenz, no one explained to her why she was undergoing a psychiatric evaluation. The process brought her back to the police interrogations she had gone through at age 14 without a parent or guardian present. Frightened and retraumatized, Rocha not only waived her hearing, but also attempted to take her own life.

In 2015, Rocha learned she was scheduled for another youth parole hearing on April 15, 2016. In the weeks before, Reza recalled that Rocha was excited. The last time she called, Reza wasn’t able to answer her phone. The message Rocha left was hopeful. “Tell my sisters I know they’re going to kick my ass when I get home,” she said. “But that’s okay, I’ll take it.”

“In a Hopeless Place, Most Don’t Make It”

Since Rocha’s death, CCWP has reported that at least 22 people in CIW have been placed on suicide watch for attempting suicide or stating that they felt suicidal.

Mariposa, who asked to go by her stage name, is one of those 22 placed on suicide watch. She is the co-author of the one-woman play Mariposa and the Saint about her own time in solitary. She was also Rocha’s cellmate and fiancée. After Rocha was found hanging in their shared cell, Mariposa was immediately placed in suicide watch, where she was not allowed regular visits, phone calls, or mail. She was, however, allowed a legal visit with CCWP, but, advocates told Rewire, kept in a treatment cage the entire time.

Those inside the prison report that the lack of programs and activities contributes to the feeling of hopelessness. “People have way too much time to think and be in their heads,” wrote another woman at CIW to Rewire one month before Rocha’s death. “A lot of us are only hanging on by hope alone. In a hopeless place, most don’t make it.”

Krista Stone-Manista noted that CDCR is working on new policies and procedures to move people who need more care or longer-term care to inpatient care rather than keeping them inside the prisons, which are often inadequately staffed with mental health professionals. She also pointed to CDCR’s reduction of the use of solitary confinement, noting that studies have shown the damage to mental health and that suicides and suicide attempts often occur in segregation. In addition, she says, CDCR is working on how to respond to reports of suicidal thoughts before they become attempts or actual suicides.

All of these efforts are too late for Rocha. “When I get out, I want you to take me to the park,” Reza remembered her stepdaughter telling her and her sisters during one visit. “I want to play on the swings and the slide and run in the grass.”

Reza plans to honor that wish. “After her cremation, we’re going to have a reception in the park,” she said. “We’re going to put her on the swings.”