The Alaska Department of Corrections has had at least 67 people die in-custody of state prisons and jails since 2020, with at least 17 deaths reported as suicides, according to the department.
There were at least 14 deaths last year. Two deaths were reported so far this year, with one investigated by the Alaska State Troopers and reported as a suicide.
On average, 4,500 people are incarcerated each year in Alaska’s 13 facilities, which includes individuals under arrest and awaiting trial or sentencing, known as pretrial, and those who are serving sentences. Of those in custody, an estimated 42% of men and 60% of women are pretrial, according to state data.
Alaska state medical and corrections officials pointed to “natural causes,” including acute and chronic disease and illnesses, as the leading cause of in-custody deaths – or 68% of reported deaths since 2015.
State officials gave a presentation to lawmakers with the House State Affairs Committee on March 4, describing causes of death from 2015 to 2024, as well as demographics and mitigation efforts.
“We do see a higher number of people who may have never seen a doctor,” said Travis Welch, director of the Division of Health and Rehabilitation Services for the Department of Corrections.
As a result of mental illness or substance use disorder, they may “lack the ability to make a doctor’s appointment and go in and see a doctor or a dentist. So the population that we’re serving is acute, and probably one of the more acute populations within the state of Alaska,” Welch said.
Officials presented data on the causes of in-custody deaths. Of the 68% of in-custody deaths reported as natural causes, 43% were reportedly from heart or lung diseases, 22% cancer, 13% infectious disease, 10% unknown, 6% liver disease, 4% kidney disease, and 2% substance related.
The health issues within state prisons mirror Alaska’s health trends, Welch said. “When we have high rates of heart disease, for example, in the state of Alaska, we’re going to see a concentrated amount of heart disease within our facilities and those we’re caring for,” he said.
Rep. Kevin McCabe, R-Big Lake, asked about expedited release processes for those who are sick or nearing end of life, like medical parole. Welch said that is ultimately up to the courts.
“We always try to house people in the least restrictive environment,” Welch said. “And when people are towards the end of their life, statute does allow for people to be released if they meet certain statutory requirements… we’re the information providers to the courts, and then the courts actually make the decision on people being released.”
There have been at least 114 deaths from 2015 to 2024, according to department data. According to the department, 78 were due natural causes, 30 were suicides, four due to accidental causes, two were homicides, and one cause of death from 2024 is still pending.
Of those, DOC reports 102 men, and 12 women died in custody, reflecting the larger statewide prison demographics. According to department data, 47% were white, 37% Alaska Native, 7% Black, 4% Native American, 2% Hispanic and 2% Asian.
“Every year, there are anywhere from four deaths up to 18 deaths,” said Dr. Robert Lawrence, Alaska’s state chief medical officer, who was the former chief medical officer for the Department of Corrections. “There’s somewhere between 11 and 12 individuals who will die during the period that they are in custody. That average has not changed. What has changed over time are the causes of death.”
Lawrence said that prior to 2015, about a quarter of deaths were due to overdose or related to symptoms of substance withdrawal. He said after the department deployed new screening and withdrawal treatment protocols, those deaths decreased substantially. “From 2017, for the next five years, there were zero deaths in that early withdrawal period,” Lawrence said. “Because of identifying the problem, coming up with a mitigation strategy, and then training staff to address that.”
He said fentanyl is still a problem in the prison system, “but even still, those numbers (of deaths) remain quite low.”
In 2022, a record 18 reported deaths sparked public outcry, an investigation by the ACLU of Alaska, and a wrongful death lawsuit against the department. Seven of the 18 deaths were reported as suicides.
Rep. Ashley Carrick, D-Fairbanks and state affairs committee chair, asked whether the department sees suicide rates also increasing.
Dr. Tim Ballard, current chief medical officer for DOC, said the suicide rate has been going down “slightly,” and that staff training and awareness for suicide prevention is ongoing.
“One of the key things that we looked at was training, and what can we do to better prepare our staff to identify folks that may be at risk, and how to respond and do appropriate referrals,” said Adam Rutherford, deputy director for health and rehabilitation services. “We also increased scenario-based training within our facilities as well. We use tools to replicate suicide attempts and how to respond appropriately from both the security side of the house and medical side of the house as well.”
Rutherford listed mitigation efforts, including adding medical bags and more cameras across facilities; installing jump barriers; and implementing larger windows for “segregation” units or solitary confinement, for suicide watch.
“So we want to be able to see folks. We want visibility. We want folks to be able to see out. We don’t want them to feel like they’re enclosed,” he said.
Rutherford said aging prison facilities are also an issue. “Our facilities are old, and let’s face it, corrections (facilities) nationally weren’t built to be behavioral health treatment facilities, and that’s really what our systems have become,” he said.
In the presentation, officials reported that 65% of the prison population are living with a mental illness, and 80% have a substance use disorder.
Rutherford said the department reviews each in-custody incident, either suicide attempt or death, in order to make improvements. “And it really is a process of looking at that continuous quality improvement, what changes can we make, and encouraging our staff to have that input and that feedback. And that’s had a significant impact,” he said.
Carrick asked about the protocol for notifying loved ones of those who have died, citing complaints from bereaved family members. “A lot of times people feel like it was a void,” she said. “They didn’t know what was going on. They didn’t know there was a problem, and then all of a sudden, their loved one is gone.”
“Full transparency, we often struggle because we often don’t necessarily have a point of contact,” Rutherford said, and that the department has to adhere to the federal Health Insurance Portability and Accountability Act privacy laws.
“It’s very difficult to make sure that we can navigate through what we’re legally allowed to disclose and what we can’t,” Lawrence added.
Rep. Andi Story, D-Juneau, emphasized it would be good practice for the department to have contact information for family members and release of information agreements in place. “If that is not a standard practice, can that be a standard practice?” she asked.
Lawmakers had more questions around suicide watch, solitary confinement, detoxification protocols, and other issues as the hourlong hearing time ended, and planned to submit those questions to the department.
“It is a very sensitive subject, and very, very close to home for a lot of Alaskans,” said Carrick in a phone interview after the hearing. “And I was grateful we were able to talk about it respectfully, and to have the Department of Corrections in front of us.”
Carrick said she sees deferred maintenance and facilities upgrades as a priority for improving prison conditions, safety and mental health services.
“Inmates have access to certain mental health services, and they have rights for health care while they’re in custody,” Carrick said. “However, that pretrial population doesn’t necessarily have any established, ongoing, mitigating mental health care.
“It’s unclear to me how accessible to the sentenced population, even long-term ongoing mental health services are,” she said. “I think the department is trying to offer what services it can, but I do think that our budget’s not reflective of the number of staff we need” to provide needed services.
Carrick said she’s concerned about the high number of suicides, and support services available.
“I don’t think any person in state custody should ever be dying of suicide,” she said.
Carrick noted that Department of Corrections health care costs are expensive, and she wants to see better management of those services to meet prison population needs.
“I think the public should be aware of what the real costs are for incarceration,” she said. “And at the same time, I’m someone who firmly believes that taking care of every individual that is in state custody is the state’s responsibility, and we should not have lacking medical or mental health care for these individuals while they are incarcerated.”
The hearing took place one day after another in custody death was reported on March 3: 42-year-old Reginald Childers Jr. of Kodiak was found dead in his cell at the Anchorage Correctional Complex. The Alaska State Troopers announced the death was a suicide.
State officials did not address any individual death incidents, investigations or outstanding lawsuits against the department at the hearing.
Carrick said she plans to hold more hearings with corrections officials on in-custody deaths, and contributing issues across the state’s prison system, like prison wages, living conditions, “access to meaningful activities or employment while in corrections, access to other services, like class services, visitation services,” she said. “A lot of these are major challenges in an understaffed and overcrowded prison system.”
Carrick said there are clear improvements to be made across facilities, and the department.
“I want folks that are incarcerated to actually come out of that experience with the tools and the skills needed to productively reenter society,” she said. “We’re not really setting any trends for extraordinary success right now, and I’d really like to see us, even potentially in the future, be a leader in what successful rehabilitation and reentry can look like.”