Parsons v Ryan: AZ AG/DOC seeks settlement talks, as CORIZON treats cancer with antacids.

Condolences to the family of Glen Huggins and every other AZ DOC prisoner who has died from the violence of deliberate indifference under this governorship. May we soon see an end to the drug war, and the beginning of the end to our legislature giving blessings to those who would maximize profit by stealing public resources from the sick and dying. The prisoners, the ACLU-AZ and the Prison Law Office, among others, are doing their part to fight the parasites our state does business with, having filed Parsons v Ryan (which goes to trial in October, unless it's settled first). Please do your part as well, and honor Glen's dying wish that no more have to suffer as he did. Demand that your legislators launch an investigation into the DOC's ineffective leadership, high number of unnecessary prisoner deaths, and poor oversight of contract agencies. You can find them here:

http://www.azleg.gov/alisStaticPages/HowToContactMember.asp

Arizona State Legislature
Capitol Complex
1700 West Washington
Phoenix, AZ 85007-2890

Also call on Governor Brewer's office to sack AZ Department of Corrections' Director Charles Ryan for this mess, and insist that a new director improve health care as a top priority - Ryan's DOC has only sought to grow prisons and the profits of folks like Corizon. 

Her contact info is here:

http://www.azgovernor.gov/Contact.asp

The Honorable Janice K. Brewer
Arizona Governor
Executive Tower
1700 West Washington Street
Phoenix, AZ 85007
(602) 542-4331

 

Thank you to CH 12/KPNX and Wendy Halloran, from the prisoners and the family members I've spoken to about Corizon and the AZ DOC's complicity in depriving state prisoners of the most basic things they need to survive - which begins with recognizing their humanity, as well as our own.

If you are the loved one of a prisoner of the AZ DOC who is suffering without care, contact Arizona Prison Watch. I will provide what resources I can to help - including a list of attorneys who have sued the state prison system and don't give me kickbacks for referrals (likewise, if you know of any good lawyers who may help other families, please let me know). I can be reached at:arizonaprisonwatch@gmail.com or 480-580-6807

Here are a couple of other blog posts that give concrete info about fighting the AZ DOC on medical issues.

http://azprisonsurvivors.blogspot.com/2013/03/corizon-and-az-doc-prisoners-families.html

http://www.arizonaprisonwatch.org/2013/05/corizons-deliberate-indifference.html

Please also contact KPNX/AZ Republic's parent company, to tell them we need more stories like the one below, because prisoners' lives matter. Cut and paste this email to reach them at connect@ad.gannett.com

 

-------------from CH12/KPNX-----------

Costs up, no improvement in prison healthcare quality

Wendy Halloran, 12 News | azcentral.com 

 10:50 p.m. MST August 1, 2014

First they refused to admit there's a dire problem. Now, after a 12 News investigation, the Arizona Department of Corrections is offering to settle up with inmates in a class-action lawsuit filed in 2012.

We first brought you the story of inmates not getting proper healthcare, even though taxpayers are footing the bill, in May. Our reporting revealed there were at least 16,000 delays in medical care to Arizona inmates in 2013.

So far, the only action taken has been imposing fines on Corizon, the company contracted to provide healthcare for inmates in the state.

HEALTHCARE RATE INCREASE 

The state has paid Corizon $130 million a year to provide healthcare for inmates. Arizona taxpayers have paid, on average, $348,000 per day.

In July, a rate increase went into effect, from $10.10 per inmate per day to $10.42, due to changes made by ADC. According to Corizon's contract, the increase is to pay for 34 more staff positions to hand out medications. This followed an ADC policy change regarding what medications inmates were allowed to self-administer after multiple suicides and overdoses.

So costs have gone up, but newly released records obtained by 12 News show the problems inside the state's prisons are getting worse.

ADC-employed monitors routinely document Corizon's performance in monthly reports known as MGARs. In our review of the new batch of reports covering November of last year through April, we found numerous cases of delay, lack of treatment, noncompliance with the terms of the contract, ADC monitors noting staff shortages, and lack of medication and psychiatric care for mentally ill prisoners.


THE STORY OF INMATE GLEN HUGGINS

On December 15, 2013, Glen Huggins had 72 hours left to live.

Huggins was serving a 12-year prison sentence on drug convictions at the state prison in Tucson. He had already served eight years when he suddenly became gravely ill.

In August of 2013 Huggins complained to prison staff in Tucson about abdominal pain. He filled out what is known as an HNR, a Health Needs Requests inmates are required to fill out to get medical care. He complained he had not been able to swallow his food and keep it down since June, and had been losing weight.

More than a week later, a nurse saw Huggins. His symptoms were documented but his case was deemed "not urgent."

At the end of August, a nurse practitioner saw Huggins and, thinking the pain was due to Hepatitis C and acid reflux, gave him an antacid.

"That wasn't doing anything," Huggins' son, Cody, told us. "Meanwhile he's still losing weight, he can't swallow."

Huggins' family provided 12 News his medical records, which show he had a family history of cancer.

We asked Dr. Palav Babaria, a primary-care physician in Oakland, California to review the documents and give her opinion on whether the family's allegations of delays in care were accurate.

Dr. Babaria has done work for the Prison Law Office, one of the plaintiffs in the class-action lawsuit against the Department of Corrections.

"For someone like Mr. Huggins, who had the medical history that he had, any complaints of not being able to swallow accompanied by profound weight loss he was talking about, I think any competent physician would have worried about cancer until proven otherwise," said Dr. Babaria.

On September 17, Huggins wrote in an HNR the antacids he was taking weren't working and his condition was getting worse.

In an October request, Huggins wrote a nurse had seen him eight times and an abdominal X-ray was normal, but still no doctor was assigned to examine him.

He filed more HNRs complaining of continued difficulty swallowing food and keeping food down. He wrote that the antacids were not helping with his pain.

Dr. Babaria says an abdominal X-ray was not an appropriate test.

"The two easiest ways of doing that are getting X-rays called a barium swallow, and see if liquid that shows up on the X-ray is passing or not, or just doing an endoscopy, going down with a camera to get a really good look and do biopsies," she said.

Dr. Babaria says, in Huggins' case, it seems that none of that was done when he first complained of the symptoms. Instead he was treated as if he only had acid reflux.

According to records obtained by 12 News, Huggins was just one of several inmates at the Tucson prison who suffered from a lack of medical care.

The Department of Corrections' own monitors documented long delays for inmates to be seen by outside specialists. Only nine patients out of 33 received urgent consultations in a timely manner. The requirement is that urgent consultations are done within 30 days, which goal Corizon met only 27% of the time.

A SON'S STRUGGLE 

Reading his father's HNRs was upsetting for Cody Huggins.

"You see a man that is just pleading for help and asking for help practically begging for help there at the end," he said.

According to Huggins' prison records, on October 23, 2013 a possible diagnosis of cancer is noted after a mass extending from Huggins' chest to his navel was discovered. This was made by the Corizon nurse practitioner.

Only then did Corizon approve sending Huggins to an outside hospital. The first time Huggins was seen by a doctor was when he arrived in the emergency room. According to Huggins' medical records, within an hour, he was diagnosed with Stage 4 esophageal cancer.

The cancer spread from his esophagus to other parts of his body. The doctors could not put a stint in to open up his esophagus because of the size of the tumor. Instead, they inserted a feeding tube in his stomach so he could get some nourishment.

His medical records show he lost almost 40 pounds in the months he kept requesting treatment and reporting problems.

On December 5, 2013 the Arizona Board of Executive Clemency recommended his sentence be commuted due to "imminent danger of death."

Gov. Jan Brewer signed a clemency order on December 11. Huggins was medically paroled the next day. His family took him home to die.

Huggins died on December 18, less than a week after his release.

Cody Huggins called it inhumane and hopes this doesn't happen to any other inmates or their families.

Dr. Babaria says the degree of suffering was preventable.

Now, Huggins' family plans to file suit against Corizon, accusing the healthcare provider of denying Huggins adequate and competent care.

Corizon denies any wrongdoing in Huggins' death. The company issued this statement:

"State and federal privacy laws forbid disclosure by Corizon of any identifiable patient medical information, let alone argument of factual claims regarding patient care in the news media. We can state that the allegations made by Ms. Halloran related to the patient's access to nursing staff and medical providers are not supported by the medical record. The inmate patient received timely, appropriate and professional care. The onset and advance of the patient's condition were unfortunately rapid and aggressive, just as they are often so among other similarly stricken patients. Allegations to the contrary are misleading and untruthful."

Cody Huggins struggles with his father's death. He thought his dad would be released from prison for the last time and they could rebuild their relationship and start a new one with Cody's young daughter.

Over the last two quarters, Corizon has been sanctioned by the state for a total of $71,000 based on its performance. An ADC spokesman emailed us this statement:

"The MGAR reports are valuable tools to document compliance with identified performance measures. Corrective action plans are implemented to hold Corizon accountable for those measures. ADC has imposed financial sanctions on Corizon as part of the company's contract with the state.

"As with any such contract, Corizon's agreement is subject to the state Procurement Code as well as adherence to the Department of Corrections Department Order 302, Contracts and Procurement, to ensure transparent, fair and equitable practices and has the approval of the Attorney General's Office and State Procurement Officer."

Meanwhile, the class-action lawsuit filed by the ACLU of Arizona, ACLU National Prison Project, and the Prison Law Office is scheduled to go to trial this October in Phoenix. It accuses the Department of Corrections of providing inadequate medical care, mental healthcare and dental care that has led to deaths.
Defending against the suit is private law firm Struck, Wieneke & Love PLC of Chandler. So far, billing records reveal taxpayers have paid this firm approximately $3.4 million to defend the Arizona Department of Corrections against the lawsuit.

Meanwhile, the Prison Law Office has confirmed via email that settlement talks are underway to avoid a trial, issuing the following statement:

"The AG's office filed a request seeking a settlement conference, and after preliminary discussions with the AG's office we agreed to that request. A court-supervised settlement conference is scheduled for August 5."

Arizona Prison Watch Newsletter: February 2013.

Dear AZ Prisoners...

Just wanted to update you all on what's been happening out here lately – and some of what's been happening in there. Forgive me if I'm all over the map with this one, but I want to get this out to you all in time for Valentine's Day, so I won't be doing much editing.

First, as many of you know, I was out of town for most of the holidays and am only now catching up to folks. If you wrote to me and your letter came back undeliverable, I apologize - my PO box is just having problems, so be persistent and try again. If you're waiting to hear back from me on something, write to me again – it will bring your file to the top of the pile, and sometimes letters get lost – just don't think I'm ignoring you for some reason – I don't work that way.

While I was out of town I had a lot of help keeping up with stuff here from a couple of friends, including one who has stayed on to help me on an on-going basis – Margie Diddams. She's pretty cool and I trust her implicitly; if she answers a letter from you to me or AZ Prison Watch, rest assured she probably chatted about it with me first. We do a lot of good strategizing together. She's my more organized half, too, so if you have a really complex situation or a lot of paperwork, you'd better hope she's the one on top of it.

One of the things Margie's helping me work on is confronting the high rate of homophobic and transphobic violence behind bars. As many of you know, my good friend Kini Seawright's son, Dana, was murdered at Lewis in July 2010 by the West Side City Crips for being gay (and for loving a Mexican while Black). Since then, I've received a lot of correspondence from prisoners subjected to violence due to their sexual orientation and/or gender identity. Because there are so many intersecting issues they deal with that affect others, when root causes for violence against minorities are addressed, other societal violence tends to abate as well, so this is in everyone's interet in the long run. Therefore, if you or a loved one behind bars is LGBT (or, as I tend to identify myself, just plain Queer) get in touch with us and become part of a more collective effort to change things in there.

I've also been working to build support in the community for the women of Perryville. The Sun City West Valley NOW (National Organization for Women) Chapter had me speak there in November and is really interested in figuring out how they can help women prisoners with health care and conditions of confinement. Don't pass up this chance - If there are any women in Perryville willing to risk institutional harassment for reaching out to them, please ask the NOW women how prisoners can become members (or start your own chapter) at:

Sun City/West Valley NOW, 10015 W Royal Oak Rd #256, Sun City, AZ 85351.

Now, let me just remind you all that I'm no lawyer, nor is Margie. She's still a student (albeit a radical like me), and I'm a college drop-out. I'm a prison abolitionist and human rights activist who happens to blog, which has resulted in quite a bit of contact with state prisoners and their families over the past few years, which compelled me to try to figure out how to help with some of your dilemmas. The best we can do is give you access to things that will empower you to help yourselves. This is our own little way of fighting back against hetero-patriarchy and state violence and all that crap, which is one reason our help comes to prisoners and their families for free. If you have money, though, don't settle for Margie and me – get professional help.

Good intentions alone can sometimes really screw people up, so make sure you access whatever other resources you can if you need help fighting the state- they are pretty formidable.

On to the other news: I'm sure you all know by now that Wexford has bailed on their contract to provide medical care to you all, so Corizon will be taking over beginning March 1. All I can say is that I'll be surprised if it's much of an improvement, so you need to keep arming yourselves with knowledge of civil rights law.

Please be filling out medical grievances per policy (check to see if it changes after March 1, too) if your HNRs aren't being responded to; don't just fill out new HNR's repeating yourselves. The prison library is supposed to give you access to the DOC policy manual, but write to me if they don't cooperate (and send me their note of refusal, so we can nail anyone violating your access to the courts).

Ask your librarian for the DO 902 policy. Look at Attachments A and B. From B, request the packets for filing Section 1983 civil rights complaints, as well as for the rules and forms to file civil actions in state court. You need those documents so you know what they'll be asking you to do later with the grievances you're filing now. It's not enough for the courts to see that you simply wrote grievances – they need to be relevant to the civil suit itself, if you have to go that far to get action from the DOC or medical.

Your grievances show the judge that you had a complaint and made a good faith effort to get the prison administration – all the way up the chain of command - to hear and respond to it BEFORE anyone gets sued. So if you do end up suing after exhausting your administrative remedies, you should still be asking for pretty much the same remedy over the same grievance you started out with in your first inmate letter to your COIII about it. Be clear describing your issue and reasonable in your requests for relief (including disciplinary action against errant officers, compensation for medical care, etc.)

From DO 902 Attachment A, ask your librarian for the Rights of Prisoners, 4th Ed, too – see what they let you see of it, anyway. You may have to pay for them to print up pages for you to keep on you – let me know how they deal with that if you are indigent.

Don't leave it to your family to get action from Central office for you – but if you have family who can raise hell for you, give them my info and I'll help them strategize dealing with the DOC. Just be mindful that no matter what they say or even if they bring an attorney into it for you, you must be filling out those grievances per policy.

On to more news: On January 25, David Fathi from the ACLU-National Prison Project argued in front of US District Court Judge Neil Wake that parsons v. Ryan should be given class status and allowed to proceed as a class action suit. Wake pretty much gave our side a hard time, expressing both annoyance and skepticism, arguing with David about the merits of the case itself (since he already set guidelines about solitary and food rations in recent county jail complaints, for example) instead focusing on the issue at hand...but what do I know about the law? Anyway, he was taking it all under advisement and we're still waiting to hear his decision.

By the way, about that Botulism at Eyman – don't believe everything you hear: the first batch for sure wasn't hooch. The guys say they were coerced into saying it was before they would be provided medical attention, and will be filing suit. If you were affected by the second batch, get a lawyer. Botulism is so incredibly rare that it's like lightning for it to strike twice in the same place...which means there's something fishy going on there.

Please tell me how you manage keep your head up, a smile on your face, or your soul intact through all you must survive in there, my friends. And let me know if yours is a story I can share with others, as well. In the meantime, take care of eachother and yourselves.

Hang in there,

Peg

CLASS ACTION: 'Parsons v Ryan' - Medical neglect and suicide at the AZ DOC

Join us to support 14 prisoners suing Charles Ryan, Director of the Department of Corrections and Richard Pratt, Director of Health Services for gross negligence, deliberate indifference, and unconstitutional conditions of confinement. 

CLASS ACTION Memorial Mural
Friday, Jan 25, 7:30-9:30am 
Sandra Day O'Connor Federal Courthouse 
401 W. Washington St. PHOENIX

We will make a chalk mural outside the Sandra Day O'Connor court house in solidarity with these 14 prisoners who are fighting to change the criminal neglect of health care of Arizona prisoners. The mural will remember those who have been lost under this administration.

These are the stories of those still fighting for their lives:

Victor Parsons has ADHD and bipolar disorder. In June 2010, his medication was abruptly discontinued without explanation. When he began to experience psychotic symptoms, he submitted a request for treatment. His medication was restarted abruptly without titrating, placing him at high risk for severe side effects. When his tooth filling fell out, they gave him a temporary filing which fell out weeks later. Each time he was seen, he was given a temporary filing again, forcing him to restart the process.

Shawn Jensen had an elevated score on a Prostrate Antigen Test and a nodule on his prostrate in November 2006. The prison doctor ordered a prostrate biopsy in 2007, but Shawn did not receive the biopsy until 2009. By that time, he had Stage 2 prostrate cancer, an aggressive form. He experienced delays of two months in getting medication prescribed by his urologist. He was not taken for surgery until July 2010, and as a result, suffered permanent injuries.

Stephen Schwartz was assaulted by another inmate in February 2010. He suffered eye injuries and extensive facial fractures, but was not referred to an opthamologist until January 2011, almost a year later. He filed numerous health care grievances for his pain, but waited months to learn whether pain medications would be approved. He was also diagnosed with bipolar and major depressive disorder, but has received inadequate mental health care while on suicide watch.

Dustin Brislan has bipolar disorder, schizo-affective disorder, and borderline personality disorder, with a designation of SMI (Serious Mental Illness). He engages in severe self-injurious behavior, including cutting, head banging, and self-starvation. As a result of his mental illness, he experiences depression, hallucinations, sucidal ideation, and paranoia. Despite the severity of his condition, the Dpt of Corrections has failed to provide him with minimally adequate mental health care. He has had medications delayed, has not been regularly monitored by a psychiatrist, and has been on suicide watch for excessive lengths of time without adequate supervision, where he committed repeated acts of self-harm.

Sonia Rodriguez is also designated as SMI, and experiences depression, anxiety and hallucinations. The Dpt of Corrections has failed to provide therapeutic treatment and has kept her in cruel and inhumane confinement in Perryville's and on suicide watch. The harsh conditions and extreme isolation of the Special Management Unit (SMU) and on suicide watch. On multiple occasions, her medicine has been abruptly changed without explanation. As a result, she has severe side effects, including uncontrolled shaking, difficulty sleeping, and worsening of her mental health symptoms.

Christina Verduzco is diagnosed with paranoid schizophrenia, bipolar disorder, and borderline personality disorder. She experiences auditory and visual hallucinations, anxiety, paranoia, and self-harm by cutting herself. She is confined in Perryville SMU and placed on suicide watch on several occasions. While on suicide watch, Christina is forced to wear a smock that barely comes up to the top of her thighs. The lights are kept on 24 hours a day, and she is subjected to 'safety checks' every 10-30 minutes a day where correctional officers wake her if she is asleep. She has minimal human contact, cannot go outside, cannot brush her teeth or bathe regularly. Outside of suicide watch, her experience is similar: extended isolation, limited exercise, and limited therapeutic treatment. Christina has asthma, but has been pepper sprayed repeatedly by correctional officers. After being sprayed, she has been dragged out of her cell, hosed down, and thrown back into her cell.

Jackie Thomas is diagnosed with depression and seizure disorders. Although Jackie did not have suicidal ideation when he first arrived at the SMU, his mental and medical health conditions have deteriorated during his isolation in the SMU. He was placed on suicide watch many times, where he received minimal mental health care. He has experienced many failures of his medical treatment, including improper cessation and initiation of psychtropic medications, failure to administer prescribed medication, repeated use of ineffective medications with severe side effects, lack of informed consent, and long delays in follow up and psychiatric evaluation.

Jeremy Smith has depression, aggravated by interruptions in his mental health treatment and prolonged isolation in the SMU. His medications have been abruptly discontinued without explanation and restarted at inappropriate times and after lengthy delays. Jeremy has also been prescribed powerful medications not indicated for depression.

Robert Gamez suffered a childhood head injury and was diagnosed with borderline IQ, possible Post-Traumatic Stress Disorder, and possible frontal lobe dysfunction, symptoms of which include major depression, panic and anxiety. Although his symptoms are consistent with frontal lobe dysfunction, the Dpt of Corrections never conducted follow-up tests to confirm his diagnosis. He has experienced multiple interruptions in care, received improper medications, and was not given psychological services for his pronounced mental health deterioration during his prolonged isolation in SMU. In August 2009, Robert began experiencing intense paranoia, anxiety, panic, and psychosis, asking to be taken off his medication and out of isolation. Despite his severe condition, he was not seen for five months.

Maryanne Chisholm has been diagnosed with hypertension but was not referred to a cardiologist for eight months, despite experiencing chest pain and shortness of breath. She has bipolar disorder, Obsessive Compulsive Disorder, and depressive disorder. Maryanne has experienced significant delays in psychiatric care, medications, and follow-up, which has contributed to worsening symptoms. In April 2011, she had a nervous breakdown and requested an adjustment of medication; she was not seen for a month. Her mental health condition is exacerbated by guard harrassment. She has been subject to repeated and frequent room searches, and her art supplies, which she relies on to manage metal health symptoms, were confiscated.

Desiree Licci has a family and personal history of cancer. In 2010, she observed multiple masses growing on her breasts, mouth, and arms. In December 2010, Desiree requested testing. In April 2011, the prison doctor referred her to an oncologist. However, she was not seen for a CT scan until September 2011. In the interim, she began experiencing diarrhea, nausea, exhaustion, weight loss, and pain. Desiree did not receive an MRI until December 2011 and it was not properly administered. She had to submit a grievance and wait another month until a proper MRI was done, confirming multiple masses on both ovaries.

Joseph Hefner's vision rapidly deteriorated after a Dpt of Corrections nurse gave him expired eye drops. In 2006 and 2008, Joseph did not receive timely doctor-prescribed eye medication following eye surgery. Although he has submitted numerous health care requests for eye pain and his doctor has referred him to the opthamologist, he has been waiting to see an opthamologist for over three years.

Joshua Polson has been diagnosed with bipolar disorder, mood disorder, and psychosis. He has a family history of suicide and has attempted suicide three times. Nonetheless, he is in isolation, where he has minimal human contact, which results in increased suicidal ideation. He has experienced repeated gaps in his medication and sporadic monitoring of his medication levels. Additionally, he has chronic ear infections, and permanent hearing loss in his right ear following significant delays in care. After losing hearing in his right ear, Joshua submitted health care requests for pain in his left ear, but was not seen for over a month.

Charlotte Wells has a history of heart disease and high blood pressure and suffered a heart attack prior to being incarcerated. She arrived in custody complaining of chronic chest pains, and continued to experience dizziness and high blood pressure, but was not seen by a cardiologist until she was hospitalized for a blocked artery four months later. Charlotts was not seen by a doctor or returned to the hospital thereafter, despite her history and the high risk of heart attack following the placement of a stent. Additionally, Charlotte experienced broken fillings in two of her teeth in 2010. She complained of pain and requested fillings be repaired, but was told the only option was to have the teeth pulled, or wait months to have the filling approved. She did this, and endured pain for several months before her fillings were replaced; however, when she got the filling, the dentist cracked an adjacent tooth.

The hearing will be in Judge Neil Wake's courtroom at 3 pm. The mural will take place the morning of the hearing, at 7:30 - 9:30 am.

Wexford arrives in AZ: Welcome to Gamez v. Ryan.

For some reason I didn't post this piece in April when it first came out in the Arizona Republic, so am doing so now, as July 1 was Wexford's first day on the job in Arizona's state prisons. Be sure to let them know, folks, that we'll be watching them...

This lawsuit is now known as PARSONS v RYAN

-----------END--------

Wexford's Phoenix HQ. 

Approximately 40% of AZ state prisoners are infected with Hepatitis C, 

an epidemic spilling over into or communities unchecked as well, 

since most of those infected are being denied treatment...

-----------------------------

Critics cast doubt on new Ariz. prison health-care contractor

Arizona Republic

Bob Ortega
April 6, 2012


The private contractor taking over health care in Arizona's prisons promises significant improvements in care while saving money, in effect saying it will do more with less. But critics charge that Wexford Health Sources' record elsewhere suggests that sometimes it fails to live up to its promises and may do less with less.

Arizona's Department of Corrections, fighting a federal lawsuit that accuses it of providing grossly inadequate health care, issued a contract to Wexford this week as part of the state Legislature's attempts to save money by privatizing prison health care.

See the Wexford contract 
 
Wexford, which is due to take control of operations by June 1, said in its contract with the state that it will:
Hire the equivalent of at least 781 full-time health-care workers, a number that is a 30 percent increase from Corrections' current health-care-staffing level.

Offer the 600 current correctional health-care employees first crack at the jobs and won't cut the salaries of any of those workers it hires.

Have nursing staff on hand at every state prison 24 hours a day, seven days a week, which is not currently the case.

Provide every correctional officer in the system 40 hours of training on dealing with mentally ill inmates.
Have its medical staff monitor inmates in isolation daily and have mental-health staff see those inmates at least weekly, representing a significant increase in frequency.

The company promises to do all this for $116.3 million a year, which is more than the $111.3 million the Department of Corrections spent on health care last fiscal year. In that year, 20 to 25 percent of health-care positions were unfilled, with the department slow to replace employees who left before the pending privatization.

But Wexford's budget would be less than the roughly $120 million the department projected spending this fiscal year. Wexford plans to keep $5.4 million as profit and spend $2.7 million on out-of-state administrative expenses. It is headquartered in Pittsburgh.

Some prison-system observers are raising questions about whether the company can provide the savings the state hopes for while providing significant improvements in service.

"There are reasons for great skepticism" that Wexford can deliver what it promises, said Caroline Isaacs, director of the Tucson office of the American Friends Service Committee, a prison-watchdog group. "One is that Wexford has a clear pattern of not living up to its commitments in other contracts," and another, she said, is that the Department of Corrections has a history of failing to hold other contractors, such as private-prison operators, accountable when they haven't lived up to the terms of their contracts.

Lowering expenses

Wexford spokeswoman Wendelyn Pekich said the company is still identifying, in cooperation with Corrections, where it can cut costs and improve efficiencies while providing what she termed "an industry-standard quality of care." As possible areas for improvement, she cited more efficient staffing patterns, improved training and record keeping, and use of telemedicine -- diagnosing patients remotely via video.

Rep. John Kavanagh, House Appropriations Committee chairman, who led the push in the Legislature for privatizing correctional health care, said he expects the company will cut costs and save the state money by, for example, bringing into the prisons some services for which inmates are now transported.

The switch to privatization comes at a time when the state is fighting a lawsuit over allegations of inadequate prisoner care and defending itself against accusations by Amnesty International of inhumane treatment of prisoners.

A federal lawsuit, filed against the Department of Corrections last month by the American Civil Liberties Union and the Prison Law Office of San Quentin, Calif., alleges that inmates have died, been disfigured or permanently harmed by poor medical care in state-run prisons and that mentally ill inmates held in isolation often go months without seeing a psychologist or getting counseling.

If privatization improves care, that's a bonus for Kavanagh, R-Fountain Hills. "The caliber of service wasn't an issue" in the state prison system at the time lawmakers voted to privatize prison health care, he said. Lawmakers weren't aware of the allegations -- which he stressed are not yet proved -- in the ACLU lawsuit.
The impetus for privatization, Kavanagh said, "was always to save money in tough economic times."

In the contract, Wexford offered some specific examples of ways it may save money: for example, hiring an oral surgeon who will travel a circuit of the prisons to extract teeth and perform other procedures for which inmates currently must be taken to outside providers, escorted and transported by correctional officers.

Wexford noted in the contract that it and the state also will save money beginning in 2014, when the majority of inmates will become Medicaid-eligible and reimbursement rates for Medicaid will increase by half because of changes related to the Patient Protection and Affordable Care Act.

However, the contract and bid documents provided to Corrections by Wexford raise questions about how fully the company disclosed performance issues elsewhere. Wexford lists 20 contracts it said ended either because the company lost a rebid or didn't rebid, among other reasons.

Some problems

In one example, Wexford said it opted not to renew a contract with Clark County, Wash., that expired at the beginning of 2010. Wexford noted that an independent audit "cited several instances of poor operations, which were already in effect when Wexford Health took over the contract" in 2007.

Although there were pre-existing problems, that audit, by the Institute for Law and Policy Planning, was more critical than Wexford admitted. It concluded that "Wexford has systematically failed to comply" with its contract and had failed to provide adequate staffing, properly licensed staff, and adequate and timely medical service.

The auditors, who said they examined Wexford's record elsewhere, wrote that "past experience in other counties reveals that jail administrators typically put up with Wexford's cost cutting and substandard level of care until the problems become too egregious to be borne."

Wexford disputed the allegations.

In Mississippi, Wexford said that a 2007 audit by a state legislative committee made "recommendations related to documentation and record keeping."

Wexford didn't disclose that the audit was harshly critical of both the company and state corrections officials for failing to provide timely, adequate medical care. Nor did it disclose that the audit said Mississippi's Department of Corrections failed to collect $931,310 in fines its chief medical officer recommended against Wexford after the company charged the state for more staff members than it actually provided.

Mississippi's Department of Corrections didn't respond to requests for comment. In its bid documents, Wexford said that it addressed the audit's concerns and that Mississippi renewed its contract. Wexford said that, in Mississippi, it collaborated with the American Civil Liberties Union to get a consent decree lifted last year that had been imposed by a federal court, requiring that state to improve its correctional medical care.
ACLU officials in Mississippi did not respond to requests for comment.

Wexford's bid noted a $12,500 fine by New Mexico's Department of Corrections in 2006 "for infirmary rounds/physicals not conducted within contracted time frames," an issue it said it corrected. Wexford didn't mention that a 2007 audit by a state legislative finance committee reported extensive medical-staff shortages and long delays in reporting inmate deaths, among other problems.

Wexford disclosed that it was fined $106,000 by Ohio's Correction Department in 2009 for contract violations for what it described as "non-critical incidents," such as failing to fill a vacancy or comply with procedures for disposing of used "sharps." In its bid document, Wexford said it addressed the problems and has been in compliance with its Ohio contract ever since.

Wexford listed other fines, including $50,000 by Chesapeake, Va., in 2006 for staffing shortages; three fines totaling $273,000 by Florida's Department of Corrections in 2005 for what it described as "service-delivery issues that were resolved" before the contract's end; and a $68,000 fine by the Broward Sheriff's Office in Florida in 2003 for delays in providing medical services.

The company also noted in its bid document that, over the five years ending Sept. 1, 2011, it received 794 formal or informal legal claims, including many that it termed "frivolous 'alleged deliberate indifference' " suits. The company said it settled 18 claims confidentially for a total of $252,425 and won six claims in court.

Arizona's contract

Arizona's contract with Wexford took effect Tuesday and goes into full operation June 1. It gives the Department of Corrections authority to impose fines or suspend or terminate the contract for violations of its terms. The fine amounts vary according to the severity and extent of the violation, from $10,000 for an act of deliberate indifference that risks an inmate's health or safety to those of $25,000 a day or more. Corrections also will have on-site monitors at every prison and will conduct quarterly audits, according to the contract.

One state health-care employee, who asked not to be identified, said that whatever happens with Wexford, "the only way to go is up." According to allegations in the ACLU/Prison Law Office suit, Corrections systematically and unconstitutionally fails to provide adequate care to inmates and has done so for years. The department has not filed a legal response to the allegations.

Prisoners file class-action suit against Arizona Department of Corrections

HOORAY!!!!

Arizona Department of Corrections - Central Office
Phoenix (November 22, 2011)

Please, families, tell your loved ones behind bars that help is really on the way. It's going to take a long time for anything to change through the courts, though, so you need to tell prisoners to be patient and "No more suicides!" At least have them write to me before they give up for good... 

--------from the National ACLU's website, at long last. Thanks to all the partners taking this state to task for their abuse and neglect of our most vulnerable prisoners-----

PHOENIX – Prisoners in the custody of the Arizona Department of Corrections receive such grossly inadequate medical, mental health and dental care that they are in grave danger of suffering serious and preventable injury, amputation, disfigurement and even death, according to a federal class-action lawsuit filed today by a legal team led by the American Civil Liberties Union and the Prison Law Office.

The lawsuit also charges that thousands of prisoners are routinely subjected to solitary confinement in windowless cells behind solid steel doors, in conditions of extreme social isolation and sensory deprivation, leading to serious physical and psychological harm. Some prisoners in solitary receive no outdoor exercise for months or years on end, and some receive only two meals a day.

“The prison conditions in Arizona are among the worst I’ve ever seen,” said Donald Specter, executive director of the Berkeley, Calif.-based Prison Law Office. “Prisoners have a constitutional right to receive adequate health care, and it is unconscionable for them to be left to suffer and die in the face of neglect and deliberate indifference.”

Specter was the lead counsel in Brown v. Plata, a similar case from California in which the Supreme Court last year reaffirmed that prisoners have a constitutional right to adequate health care.

“Courts have consistently ruled that solitary confinement of people with mental illness is unconstitutional because it aggravates their illness and prevents them from getting proper treatment,” said David Fathi, director of the ACLU National Prison Project. “Even for those with no prior history of mental illness, solitary confinement can inflict extraordinary suffering and lead to catastrophic psychiatric deterioration.”

Critically ill prisoners have begged prison officials for medical treatment, according to the lawsuit, only to be told to “be patient,” that “it’s all in your head,” or that they should “pray” to be cured. Arizona prison officials have repeatedly been warned by their own medical staff of the inadequacy of the care, echoing complaints from prisoner advocates and families that prisoners face a substantial risk of serious harm and death. Yet, they have failed to ensure that minimally adequate health care is provided as required by the Constitution. 

In one particularly tragic case, a prisoner at the state prison complex in Tucson died last year of untreated lung cancer that spread to his liver, lymph nodes and other major organs before prison officials even bothered to send him to a hospital. The prisoner, Ferdinand Dix, filed repeated health needs requests and presented numerous symptoms associated with lung cancer. His liver was infested with tumors and swelled to four times its normal size, pressing on other internal organs and impeding his ability to eat. Prison medical staff responded by telling him to drink energy shakes. He died in February 2011, days after finally being sent to a hospital but only after his abdomen was distended to the size of that of a full-term pregnant woman. A photograph of Dix shortly before his death appears in the lawsuit.

Jackie Thomas, one of the lawsuit’s named plaintiffs who is housed in solitary confinement at the state prison complex in Eyman, has suffered significant deterioration in his physical and mental health as a result of being held in isolation, where he has become suicidal and repeatedly harmed himself in other ways. Prison staff have failed to treat his mental illness, improperly starting and stopping psychotropic medications and repeatedly using ineffective medications that carry severe side effects. Last November, Thomas overdosed on medication but did not receive any medical care.

“Faced with such gross indifference on the part of prison officials to the needs of prisoners with mental illness in their care, it was essential we get involved,” said Jennifer Alewelt, staff attorney with the Arizona Center for Disability Law, one of the plaintiffs in the lawsuit. “Prisoners with mental illness can be particularly vulnerable, and we must do everything we can to ensure their mental health needs are met while incarcerated.”  

Filed in the U.S. District Court for the District of Arizona against Charles Ryan, director of the Arizona Department of Corrections, and Richard Pratt, the department’s interim director of the division of health services, the lawsuit asks, among other things, that constitutionally adequate health care be made available to prisoners, that medications be distributed to patients in a timely manner, and that prisoners not be held in isolation in conditions of social isolation and sensory deprivation that put them at risk of harm. The lawsuit does not seek monetary damages.

“Arizona has used the absence of transparency to callously ignore the basic needs of persons entrusted to its care, at times with deadly results,” said Daniel Pochoda, legal director of the ACLU of Arizona. “Absent court intervention the health and well-being of thousands of prisoners will continue to be sacrificed to economic expediency.”

According to the U.S. Bureau of Justice Statistics, Arizona has the sixth-highest incarceration rate in the nation.

Other attorneys on the case are Daniel C. Barr of Perkins Coie LLP and Caroline Mitchell of Jones Day.
A copy of the lawsuit is available here and here.