Corizon HealthScare: Meet me in St. Louis...

The article below was posted from the AP to the St. Louis Post-Dispatch today. This was the comment I left for their readers: 

Corizon has been nothing but disastrous to Arizona state prisoners, ignoring too many to death and leaving their families devastated. We've had a whistleblower speak out and a class action lawsuit here (Parsons v Ryan), exposing how evil they are - as well as numerous protests by prisoners' loved ones and interviews with survivors, but it has been to no avail. 

Some think that's due to Good Old Boy Terry Stewart's influence in AZ (he's the former AZ DOC director - Chuck Ryan's mentor - now in bed with the folks at Corizon Healthscare), but I can't explain why other states still have contracts with them. Voters should really scrutinize things closely if their jails or prison systems are going with these folks and renewing contracts year after year, there's probably something dirty going on that keeps them sucking your tax dollars up for their profits at the expense of some of your most vulnerable citizens. Stop the privatization all together, if you can. It doesn't deliver what it promises, and you'll end up paying more after too many die in the end.

Posted as Peggy Plews

God only knows why the new governor, Doug Ducey, has retained Chuck Ryan after the embarassment his administration was to Brewer - must have something on that guy, too. It's like the whole Republican party here just dug their heads in the sand when it comes to the AZ DOC, though, not just the chiefs. Their mascot should be an ostrich, not an elephant. Elephants are, after all, thoughtful, compassionate, and wise...

By the way, if you're fighting these bastards on behalf of a loved one at the AZ DOC, follow the links to these older pieces, but be sure to be current on the relevant AZDOC policies (Department Orders) and send them the right copies - the docs and links in these old posts have probably expired.

 Corizon's Cruel and Unusual Greed: Follow the Money with Prison Legal News

Corizon and the AZ DOC: Prisoners & Families, Know Your Rights.

 

Corizon's deliberate indifference: fighting back.

 

artwork is mine....

------------from the St Louis POST-DISPATCH--------

Country's biggest for-profit prisoner health care provider under increased scrutiny

St Louis Post-Dispatch

Janaury 20, 2014 

By ADAM GELLER Associated Press

Months after he landed in Florida’s Manatee County Jail, Jovon Frazier’s pleas for treatment of intense pain in his left shoulder were met mostly with Tylenol.

“I need to see a doctor!” he wrote on his eighth request form. “I done put a lot of sick calls in & ya’ll keep sending me back and ain’t tell me nothing.”

Four months later, after Frazier’s 13th request resulted in hospitalization and doctors diagnosed bone cancer, his arm was amputated, according to a lawsuit by his family.

But the cancer spread. Frazier died in 2011 at age 21, months after his release.

As an inmate, his medical care had been managed not by the county sheriff’s office that runs the jail, but by a private company under contract.

That company, Corizon Health Inc., is under growing pressure after the loss of five state prison contracts, downgrades by analysts and increasing scrutiny of its care of inmates held by some of its largest customers, including New York City.

Corizon, responsible for 345,000 inmates in 27 states, including Missouri, is the country’s biggest for-profit correctional health provider, but it’s just one of many firms vying for billions of public dollars spent on prisoner care.

Corizon was established in 2011 when privately held Valitás Health Services Inc., the Creve Coeur-based parent of Correctional Medical Services Inc., acquired America Service Group Inc., a Tennessee-based provider of prison health services.

With corporate headquarters in Brentwood, Tenn., Corizon touts Creve Coeur as home to its operational headquarters.

For-profit prison care raises questions about ceding public responsibilities to private companies. It turns, though, on a thornier issue: How do you ensure care of people who society mostly would prefer not to think about?

Inmates “are still human beings. I think some people forget that, I really do. They’re somebody’s child,” said Shirley Jenkins, Frazier’s grandmother.

PRIVATIZED CARE

States spend $8 billion a year, a fifth of their corrections budgets, on prison health care, according to the Pew Charitable Trusts and the MacArthur Foundation. Local jails spend millions more.

Some critics fault the idea of privatizing the job.

“The problem is a structure that creates incentives to cut corners and deny care to powerless people that have no other options,” said David Fathi, director of the American Civil Liberties Union’s National Prison Project.

Others say deficiencies with prison care go beyond whether it is privatized.

“I don’t have a great love for private health care ... but I don’t think that they’re the source of the problem,” said Dr. Marc Stern, former health services director for Washington state’s prisons. Stern, who once worked for a Corizon predecessor in New York state, issued a 2012 report criticizing the company’s care of Idaho prison inmates while serving as a court-appointed expert.

“I think the problem is how much money and effort we are willing to put into correctional health care,” Stern said.

Some critics, though, say Corizon is notably problematic.

“We get letters from prisoners about medical care not being provided, and the list is endless. And it’s increased tremendously since Corizon took over,” said Randall Berg, executive director of the Florida Justice Institute, who represents inmates petitioning for care.

Corizon says it strives to provide quality care.

“We are always troubled by any questions on the care provided to our patients and view this as an opportunity to reconfirm our commitment to operational ethics and professionalism,” company spokeswoman Susan Morgenstern said in a written statement. The company declined to answer questions.

The criticism surrounding Corizon isn’t new. Correctional Medical Services, or CMS, which later became Corizon, was the main subject of a 1998 Post-Dispatch investigation of for-profit prison health care providers. Looking at CMS and other firms, the investigation found more than 20 cases nationwide in which inmates died as a result of alleged negligence, indifference, understaffing, inadequate training or cost-cutting.

In 2012, Corizon was sued for alleged medical missteps in the death of Courtland Lucas, an inmate in the St. Louis jail. He died May 25, 2009, from complications of a heart problem, congenital aortic valve stenosis, while under the care of CMS. The lawsuit was settled in the fall of 2014, but the terms were not disclosed.

Corizon’s struggles are widespread.

Its care of the 11,000 inmates at New York City’s Rikers Island is under “comprehensive review” by officials, who say they are concerned about problems including at least 16 deaths since 2009.

Arizona hired Corizon last year to replace Wexford Health Sources Inc. after its care came under fire. But an advocacy group warned that “if anything, things have gotten worse” in state prisons. Arizona and the ACLU recently reached a settlement calling for more monitoring of inmate care.

Meanwhile Corizon has lost long-standing prison contracts in Minnesota, Maine, Maryland, Tennessee and Pennsylvania since 2012. Auditors in three states documented problems, including slowness to address poor recordkeeping and inmates’ urgent requests for off-site care.

Corizon, which generated $1.4 billion in revenue in 2013 and is owned by a Chicago private equity firm, has battled stiffening competition. In recent months, Moody’s and Standard & Poor’s have downgraded Corizon’s holding company, citing financial underperformance, contract losses and competition that has squeezed profits.

The connection between Corizon’s contract losses and questions about the quality of care it provides is not clear.

But the challenges are evident in Florida, where a year after the state privatized prison care and awarded Corizon a $1.2 billion contract, news reports point to rising inmate deaths. If the company does not address substandard care, the state’s corrections commissioner wrote to Corizon’s CEO in September, Florida may begin withholding payment.

In Minnesota, an audit last year found that inadequate communication between prison staff and Corizon doctors during overnight hours “may have been a contributing factor to inmate deaths.”

But in announcing Minnesota’s change of contractors, the corrections commissioner said Corizon had provided “excellent” service. In a written response to questions, the state corrections department said its decision was not related to the audit. It would not comment on inmate deaths.

Corizon’s work in local jails also has come under scrutiny.

In October, Volusia County, Fla., officials questioned Corizon executives about lawsuits and its financial stability before voting unanimously to switch contractors. The hearing was held in the shadow of a lawsuit filed locally by the family of Tracy Veira, an inmate who choked to death in 2009 in a cell where she was supposed to be under watch while detoxing from painkillers.

A nurse working for one of the companies that merged to form Corizon saw an ailing Veira in the jail’s clinic the afternoon before she died. She told a supervisor the inmate looked as if she needed hospitalization, but Veira was instead sent back to her cell, according to an affidavit filed in the case.

When the commissioners questioned Corizon’s executives, there was no mention of Veira. But Commissioner Deb Denys said she was mindful of the case, scheduled for a July trial.

“I think everybody was,” Denys said. “Sometimes you don’t state the obvious.”

Jennifer Mann of the Post-Dispatch contributed to this report.

Confronting deliberate indifference: Parsons v Ryan settlement reached.

 EDITED OCT 14, 2014 3:48pm

This first press release is just in from the ACLU of Arizona. I think the DOC is getting off easy without having a public trial, but it saves money and time to do this instead. They were definitely going to lose...

The second press release is from the head of the AZ DOC, Charles Ryan, the guy who was named in the suit. Sounds like he won the lawsuit or something. These are vastly different accounts of the settlement. My bet is that the AZ DOC put the most spin on their version, but it concerns me that they say the following:


" “This is positive news,” said ADC Director Charles Ryan.  “On the eve of trial, the plaintiffs in this case have essentially agreed that the department’s current policies and practices, along with recent enhancements to programming opportunities, adequately addresses the plaintiffs’ concerns relating to constitutional healthcare and conditions of confinement for maximum custody and mentally ill inmates. "

AND:
 
" ADC will monitor its own compliance, thus avoiding costly court oversight, and the Plaintiffs’ attorneys, through record review and on-site tours will confirm compliance, as well."

Say what??? No way!!!

I'm going to have to read the settlement docs myself and get back to you all with another analysis..

----------

Arizona Agrees to Major Improvements in Prison Health Care, Crucial Limits on Solitary Confinement in Landmark Settlement

For Immediate Release
October 14, 2014

CONTACT:

Alexandra Ringe, American Civil Liberties Union, media@aclu.org, 212-549-2666
Steve Kilar, ACLU of Arizona, skilar@acluaz.org, 602-773-6007
Don Specter and Corene Kendrick, Prison Law Office, dspecter@prisonlaw.com and ckendrick@prisonlaw.com, 510-280-2621

PHOENIX – The American Civil Liberties Union, the ACLU of Arizona, the Prison Law Office, and co-counsel today filed a settlement agreement in their class-action suit on behalf of more than 33,000 prisoners in Arizona’s state prisons. Under the settlement, the Arizona Department of Corrections must fix a broken health care system plagued by long-term and systemic problems that caused numerous deaths and preventable injuries. The settlement will also allow prisoners in solitary confinement who have serious mental illnesses to have more mental health treatment and time outside their cells, and will make other critical reforms in prison conditions.

“The Arizona Department of Corrections worked with us on a settlement that shows a commitment to protecting prisoners’ physical and mental health,” said David Fathi, the Director of the ACLU’s National Prison Project. “We hope other states will now find ways to provide adequate medical, mental health, and dental care to their prisoners.”

“The Arizona Department of Corrections has agreed to changes that will save lives,” said Don Specter, Director of the Prison Law Office. “This settlement will bring more humane treatment for prisoners with serious health care needs, and the potential for their conditions to improve rather than worsen.”

The settlement in Parsons v. Ryan requires the Arizona Department of Corrections (ADC) to meet more than 100 health care performance measures, covering issues such as monitoring of prisoners with diabetes, hypertension, and other chronic conditions; care for pregnant prisoners; and dental care.

The settlement also requires ADC to overhaul the rules for prisoners with serious mental illnesses in solitary confinement. Instead of spending all but six hours a week in their cells, such prisoners will now have a minimum of 19 hours a week outside the cell, and this time must include mental health treatment and other programming. ADC must also restrict guards’ use of pepper spray on these prisoners, using it only as a last resort when necessary to prevent serious injury or escape.

The settlement provides for ongoing monitoring and oversight by the prisoners’ lawyers to make sure the state is complying with its terms.

The groups filed the federal lawsuit in 2012, challenging years of inattention to the health needs of state prisoners and improper and excessive use of solitary confinement, resulting in serious harm and unnecessary deaths. Judge Neil V. Wake of the U.S. District Court in Phoenix certified the case as a class action in March 2013, and the U.S. Court of Appeals for the Ninth Circuit affirmed that ruling in June 2014. Last month, the groups filed reports by nationally recognized experts in corrections and in medical, mental health, and dental care, showing system-wide problems with the prisons’ health care and excessive use of solitary confinement.

In addition to the ACLU and the Prison Law Office, other attorneys on the case are Perkins Coie, Jones Day, and the Arizona Center for Disability Law, which is also a plaintiff in the case.

Click here for a copy of the SETTLEMENT stipulation filed today with the court. 

Click here for a copy of the EXHIBITS to the stipulation.

For more information about Parsons v. Ryan:

aclu.org/prisoners-rights/parsons-v-ryan

For information about the ACLU’s National Prison Project:
https://www.aclu.org/prisoners-rights

For information about the Prison Law Office:
www.prisonlaw.com

For information about the Arizona Center for Disability Law:
http://www.acdl.com/

---now for the official state version----

ARIZONA DEPARTMENT OF CORRECTIONS

1601 W. JEFFERSON

PHOENIX, ARIZONA 85007

(602) 542-3133

www.azcorrections.gov    

JANICE K. BREWER                                                  CHARLES L. RYAN GOVERNOR                                                                            DIRECTOR

For more information contact: Doug Nick dnick@azcorrections.gov Bill Lamoreaux blamorea@azcorrections.gov

Tuesday, October 14, 2014

Parties reach settlement agreement

and seek to vacate Parsons v. Ryan trial

PHOENIX (Tuesday, October 14, 2014) – The Arizona Department of Corrections (ADC) has reached a settlement agreement in collaboration with the ACLU, Prison Law Office and ACDL prior to the pending trial.

The parties have agreed to approximately 100 performance measures applicable to medical, mental health, dental and conditions of confinement.

“This is positive news,” said ADC Director Charles Ryan.  “On the eve of trial, the plaintiffs in this case have essentially agreed that the department’s current policies and practices, along with recent enhancements to programming opportunities, adequately addresses the plaintiffs’ concerns relating to constitutional healthcare and conditions of confinement for maximum custody and mentally ill inmates.

“In regards to those issues, the settlement notwithstanding, it’s unfortunate that the plaintiffs continue to use rhetoric such as ‘solitary confinement’ to describe housing for some inmates.  No such confinement exists in our institutions.  The Department of Corrections has always followed nationally-accredited standards for housing single-cell inmates that include requirements for natural daylight and contact with others, and out-of-cell time.

“Additionally, it should be noted that Arizona’s inmate mortality rates, including incidents of suicide, are within the national average for corrections departments.  In 2012, the most recent year for which statistics are available, Arizona reported 215 deaths per 100,000 inmates, compared to the national average of 254 per 100,000.  Additionally, Arizona averaged 17 inmate suicides per 100,000, which is in line with the national average of 16 per 100,000.

“By avoiding a costly trial, the Department saves significant resources that can be further directed towards continuing to provide constitutional healthcare and structured programming to support successful community reintegration.  This is especially relevant in light of the fact that despite the state of California spending nearly $18,000 per inmate for health care costs due to two decades of litigation by the same plaintiffs in the Parsons case, California is still under court supervision and the inmate mortality rate there exceeds that of Arizona. 

By contrast, Arizona spends nearly $3,800 per inmate in health care costs.

ADC will monitor its own compliance, thus avoiding costly court oversight, and the Plaintiffs’ attorneys, through record review and on-site tours will confirm compliance, as well. ADC, through its contracted vendor, must meet specific compliance thresholds at its facilities. Within two years, monitoring of performance measures automatically terminates when those performance measures meet agreed-upon thresholds.  ADC can petition the court to terminate the entire settlement agreement after four years.

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."

Execution by Deliberate Indifference: Killing Robert W. Murray.

UPDATED JULY 1 2014: There's nothing new about this, sadly - the AZ DOC has been executing prisoners all along by way of failing to treat their critical  medical and psychiatric conditions. Three death row prisoners in just over  a year have also committed suicide...

You must be a subscriber to see Gary Grado's newest article at the Capitol Times  about the above notice of Robert Murray's death -  if you can afford it,  check it out. Below is the original piece on Murray's cancer last fall, also by Grado, along with my post at the time. Not sure anything more needs to be said, except condolences to anyone who might have cared about this prisoner, as well as to the loved ones of his victims, for whom this will be an emotional time as well. 

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

SOS from Arizona's living dead: 
Deliberate indifference to life on death row
(originally posted to arizonaprisonwatch.org on September 26, 2013 7am)

 one of many letters received at AZ Prison Watch re: 

prisoner frustration over difficulty accessing medical care.

A big thanks goes out to Gary Grado at the AZ Capitol Times for interviewing this prisoner, and to the publication for making this particular article accessible to non-subscribers. Prisoners don't make sympathetic news subjects - especially not those on death row. A lot of folks would just as soon let Murray die of throat cancer untreated, in favor of putting those health care resources into the community (as if the state would actually re-direct "savings" there, instead of into the private pockets of profiteers). 

All I can say is that withholding medical care from Murray because the state plans to kill him anyway is akin to choosing to execute him by applying acid to his throat in small doses over the course of  9 months or so, letting it eat slowly away at his ability to  swallow, speak, and breathe, knowing this will not only kill him, but will make him suffer horribly as he dies. This has nothing to do with one's feeling about the death penalty - it's a question of whether or not you are for the constitution and against torture. If you believe in the rule of law, and that we should not torture our prisoners, then you have to support the provision of a basic standard of medical and mental health care to them.

The other thing is that prisoner health IS public health, and if we don't treat them inside, they come out with high rates of chronic illness, infectious disease, psychiatric disability, and so on. The imprisoned population is especially high-risk, medically, and many live marginally once back in the community, where they are more likely to lack access to health care than most non-felons. In prison they're frequently exposed to things like Hepatitis C (at least 40% of prisoners are believed to be infected), but as a captive patient population, they would be more likely than not to follow up on treatments and regimens that lower their mortality and long term health risks considerably, if their dietary plans and health care provider will offer them.

But that's not what appears to be happening. Deliberate indifference to human suffering is the absolute worst cancer there is in a society, and it's metasticized from the head of the AZ DOC to the agency's extremities. I hear stories like Murray's all the time, sadly - and it's not just the guys on death row. Remember Benny Joe Roseland? I've written to him a few times, but haven't heard back from him since writing that post. DOC says he's still alive, but that's all I can get from them.

Furthermore, as Dan Pochoda points out below, how we treat our prisoners says a lot about our society. The conditions in Arizona's prisons - from the medical neglect to the prevalence of heroin, the dominance of criminal gangs, and the rampant racialized violence - are among the worst in the country. There was a brief spell of progressive vision a the AZ DOC while Dora Schriro was director, under then-governor Janet Napolitano, but she was often mocked as being a "thug-hugger" for favoring rehabilitative programs over punishments, and her efforts were frequently undermined by the Good Old Boys network of DOC administrators and officers.

According to prisoners and former employees, things at the AZ DOC got dramatically worse as soon as Jan Brewer became governor, bringing Charles Ryan out of retirement to be her chief disciplinarian at the AZ DOC. The culture of contempt for prisoners and human rights that permeates that institution has actually been decades in the making, much of it under the direction of the younger Chuck Ryan, so all the bad stuff began to flourish again once he took over the reins there. 

I don't understand that man at all, I have to say. He's spent his career climbing that ladder, but now there, he appears to have utterly ceded control of his prisons to the gangs and profiteers - either that, or he's knowingly and intelligently aiding and abetting them. In either case,  his directorship  should be an embarassment to the Governor's office - for some reason Jan still stands by her man, though. 

Check out the other work the Capitol Times has been doing on the prison system here. If you're a subscriber, this is a pretty good piece that just came out about the class action lawsuit over health care, also by Gary Grado:

Exhibit in class-action lawsuit details failings of prison health system

-------from the AZ Capitol Times (9/16/13)--------

Prison ordeal

Death row inmate struggles with cancer

By Gary Grado

Published: September 16, 2013 at 8:41 am

A lab discovered death-row inmate Robert Murray had cancer the same day a Scottsdale surgeon removed his tonsils, but his disease went unknown to him and untreated for seven more months.

As Murray, 48, and his lawyers try to figure out what went wrong with his medical treatment, one thing is certain. The breakdown coincided with the turmoil surrounding the Department of Corrections’ transition to a private health care provider for Arizona prisoners, and his situation didn’t improve after the first company parted ways with DOC and a new company came under contract.

Murray endured long, painful delays between doctor’s appointments, a misdiagnosis, and a time in which blood from a burst abscess on his tonsil gushed from his mouth. He came to learn he had cancer when the surgeon he hadn’t seen in months asked him if he was finished with radiation to treat the illness, a treatment he never had.

Despite the delays, the cancer didn’t spread. Murray said an oncologist told him that although the situation could have become grave, he should have a full recovery with proper treatment.

“It was prayer, luck it just didn’t explode like it could have,” Murray said in a 21-minute interview from death row in Arizona State Prison Complex-Florence, where he’s been locked up since October 1992.

Such allegations aren’t unusual. A class-action lawsuit alleging DOC has provided inadequate health care for years offers other medical horror stories. And a suit recently filed by the survivors of an inmate who died in October 2012 alleges employees of Wexford Health Sources Inc. of Pittsburgh refused to treat him while he convulsed on the floor. Wexford is a company that provides prisoner health care in Arizona and elsewhere.

“We get weekly at least one letter that is equivalent, literally, to this fellow on death row,” said Dan Pochoda, the legal director for ACLU-Arizona.

Pochoda is one of more than 20 lawyers involved in the class action suit. He said the medical hardships of prisoners don’t resonate with the public, but they should because the state has a heavy obligation to provide adequate health care once it takes control of someone’s life.

“To paraphrase Dostoevsky, the test of a society is how they treat persons in prison,” Pochoda said.

Pleas for help

Murray and his brother, Roger Murray, are on death row for convictions in the May 14, 1991, robbery and murders of Dean Morrison, 65, and Jacqueline Appelhans, 60, at their store in Grasshopper Junction in Mohave County.

Morrison and Appelhans were found face down in their bathrobes, shot several times each in the head with shotguns and handguns. Appelhans was clutching Morrison’s arm.

Murray wrote a book titled “Life on Death Row” in which he denied committing the murders.

He has contended with an assortment of health problems during his 21 years in prison, and it was during an examination in February 2012 that he first complained of a lump in his throat.

Murray’s tonsils were becoming swollen and sore by April 2012, which was one of the final months that DOC provided medical care. Murray saw a DOC doctor in May and was diagnosed with an infected tonsil and given antibiotics.

Just days before his appointment, DOC and Wexford Health Solutions announced the company had been awarded a five-year contract to provide onsite medical, dental, pharmacy and mental health care, as well as the administration of third-party services.

Murray claims in a nine-page affidavit that the antibiotics had no effect and his many requests over the next month to see a doctor went unfulfilled as the swelling worsened and swallowing became difficult.

“His neck and face were visibly deformed,” said Murray’s attorney, Jennifer Garcia, a deputy federal public defender.

Wexford took over on July 1, 2012, and the company informed Murray he was on a waiting list to see a doctor, even as he continued to submit medical requests pleading for help.

“At least once during this period I overheard RX delivery nurses state that ‘Wexford has no available doctors for (the infirmary),’” Murray wrote.

In a Cure Notification, a letter to Wexford to outline how it wasn’t complying with the contract, DOC said the company’s staffing shortage created “inappropriate scheduling gaps in on-site medical coverage.”

In his requests to see a doctor, Murray writes about shooting pains in his ear, choking and coughing and difficulty breathing. He saw a nurse practitioner on July 20, 2012, who became alarmed by his condition and prescribed “magic mouthwash,” a formula of various medicines used to treat ulcers in the mouth.
Four days later the abscess burst.

“A warm fluid gushed into my mouth, I thought I may be vomiting and hurried to my sink,” he wrote.

He was rushed to the hospital, but he didn’t see a surgeon until September and wasn’t on the operating table until Nov. 19, 2012.

DOC, meanwhile, was already unhappy with Wexford’s performance, stating in the Cure Notification that the company was inadequately staffed, administered medication incorrectly, inconsistently and incompletely, and lacked a sense of urgency in addressing crisis situations.

DOC referred to several incidents in which it said Wexford did not comply with the terms of the contract, including not giving medication to a mentally ill inmate who hanged himself and a nurse who contaminated diabetes insulin with syringe tainted with Hepatitis C and continued to inject inmates with it.

Wexford responded with a letter of its own explaining that “the majority of the problems Wexford now faces are long-standing issues, embedded into (DOC) health care policy and philosophy, and which existed well before Wexford Health Sources assumed responsibility of the program.”

Wexford also alleged that DOC kept key information hidden during the procurement process.

An aggressive form of cancer

Dr. Joel Cohen of the Allergy Ear Nose and Throat Center in Scottsdale removed Murray’s tonsils on Nov. 19 and sent them to a nearby lab. The lab confirmed he had cancer and phoned the results to Cohen the next day, according to the pathology report.

Dr. Sun Yi, a University of Arizona professor who specializes in cancers of the head and neck, said that after diagnosis, blood work and scans would be done to determine the severity, or stage, of the cancer, a process that generally takes a few months.

From there, the patient would be referred to various oncologists.

“With malignancy, the more time you wait the more time the tumor has to continue to populate and grow,” said Yi, who is not involved in the case. “The worst case scenario is the cat’s out of the bag situation where it metastasizes and becomes phase four and for most cancers incurable at that point.”

Yi said cancer in the throat is extremely aggressive.

There are no records of any of the steps Yi described in Murray’s medical file.

Murray said Cohen wanted to see him 14 to 21 days after the surgery, but “ADOC-Wexford failed to take action.”

Cohen said he reported the cancer by telephone to a doctor at DOC on Nov. 20, 2012, and recommended treatment.

The doctor said he regularly treats prisoners and he understands there are all sorts of prison protocol that must be followed for each visit. He typically wants to see a patient for post-operative visit in 10 to 14 days.

“The prisoners can’t always come back when they’re told to come back,” Cohen said.

He said it is not his responsibility to prescribe the cancer treatment.

A spokesman for DOC and spokeswoman for Wexford declined to comment for this story. The agency and company agreed Jan. 30 to end the contract and DOC signed a new one with St. Louis-based Corizon Health Inc., which took over services on March 4.

Murray’s throat was still irritated and swollen in the meantime, and he got an appointment with Cohen on May 14.

“He’s talking to Corizon all the time about this problem and no one seems to be addressing them for months either,” Garcia said. “It doesn’t seem to me things have been measurably better under Corizon.”

Murray said Cohen asked him about his radiation treatment, which he never had, but the doctor still didn’t tell him about the cancer.

Records indicate Murray was prescribed radiation and a CT scan that day, but there is nothing in the record explaining why. When Murray returned to the doctor’s office on June 7 he saw Lee, Cohen’s associate.

“He said, ‘You have cancer, you didn’t know,’” Murray said. “It was kind of an astounding moment, surreal.

I kind of expected something was not right.”

Ray Norris, a medical malpractice attorney with the firm Gallagher and Kennedy, said medical negligence is determined by whether a doctor fell below the standard of care.

Norris, who is not involved in Murray’s case, said standard of care is measured by what an ordinary, prudent, and reasonable health care provider would do under the same circumstance.

“If there was a breach of the standard of care, the question then becomes causation, or in other words, what difference did it make,” Norris said.

Murray’s theory is he thinks Cohen expected him to return for a follow up visit within a few weeks and was going to inform him then about the cancer, but when Wexford failed to schedule the appointment Cohen never followed up. “I think it was probably just an accident, but an accident can be easily overlooked,” Murray said.

Murray is still undergoing treatment, and while it isn’t going at the pace he would prefer, he said he’s been assured it is normal pace for treating such a cancer. He said he is still considering his options on filing a lawsuit and looking for a civil lawyer.

Health Decline

May 2012: Inmate Robert Murray diagnosed with possible infected tonsils and given antibiotics. Wexford Health Solutions is awarded $349 million contract to provide health services to Arizona prisoners.

June 2012: Swelling in neck worsens.

July 1, 2012: Wexford takes over medical services.

July 24, 2012: Abscess in neck bursts and Murray rushed to hospital.

Aug. 17, 2012:  In an incident not related to Murray, Wexford nurses are accused of improperly administer medication by making inmates lick powdered medication from hands.

Aug. 23, 2012: Mentally ill inmate who didn’t receive psychiatric medication for weeks found hanged in cell.

Aug. 27, 2012: Wexford nurse allegedly contaminates diabetes insulin with syringe tainted with Hepatitis C.

Sept. 21, 2012: Arizona Department of Corrections informs Wexford of assorted contract breaches.

Nov. 19, 2012: Murray, whose face is deformed from swelling, undergoes tonsillectomy and lab results show he has cancer.

January 2013: Murray’s requests for follow up with surgeon unfulfilled, problems and pain with neck persist. Wexford and DOC agree to cancel contract. Corizon becomes new contractor.

June 7, 2013: Murray informed he has cancer that went untreated for seven months.

ASPC-Eyman Suicide in Custody: Mark Moore, 57.

Sad to report there's been another suicide in the AZ DOC's supermax prison, ASPC-Eyman; that prison is a death trap for people prone to self-destruction. This one isn't the usual prisoner suicide, though - which has been male, young and facing life, on death row, or just about to be free, for the most part these past 5 years. This fellow had been at the AZ DOC since 1986, had a decent job, was only medium custody (which meant he had more privileges and programming opportunities then most guys I hear from have), and he apparently hadn't had any disciplinary write-ups in over a year. Yeah, he was in for life, but he'd made some kind of life in there and adapted to it...look at his work record.

Latest Supermax suicide victim, 

Mark Moore, 57

The only clue to something changing I can see on his AIMS, which is public info on the DOC website, is that he had just been re-classed a week ago, likely to a lower  custody level. Based on letters I've gotten from other prisoners who were old-timers being re-classed, its possible he was told he'd be moved to another General Population yard, despite his apprehensions about being there given his history as a sex offender. But, given his history as a sex offender, I doubt the DOC would put him back in GP. I think they would be prohibited from it, in fact....except that that's not what he was doing time for, this time around. So they may well have told him he was not getting protective custody and would have to make it in GP. That probably kills more guys than any other single thing at the AZ DOC.

Given the possibility that he was already in Protective Custody and remaining there, though,  I wondered what else might have been going on to cause him to take his life. He didn't appear to be severely mentally ill, based on his steady employment history as a barber (they don't like giving the SMI guys scissors). Maybe he got a terminal diagnosis he couldn't deal with, or was sexually assaulted and the DOC didn't appropriately counsel him (all too often the case, the victim is put in the hole while the perpetrator remains free on the yard. The victim is then repeatedly humiliated by officers, especially those victims who are known to be gay, and moved from GP yard to GP Yard while begging to be placed in protective custody....). Both Jesse Cabonias and Duron Cunningham committed suicide in the wake of no or poor institutional response to their sexual victimization - those are just the two I know about, anyway.

The standard psychiatric evaluations offered to Eyman prisoners by Corizon leave a lot to be desired, as you can see here. Basically, the medium security folks are rounded up, chained to each other, and transported to a maximum security yard where they are then herded into a room together to have their telephonic appointment with the shrink. Reports from prisoners are that these meetings have been held while they were  still chained to other prisoners - the DOC flatly denies this. In any case, the prisoners only get a few minutes of doctor time and the experience they have to endure for the sake of it has discouraged many from seeking psychiatric care or continuing with treatment.

In order to maximize profits - which is what the legislature wanted DOC to hire them to do, to make a profit at taxpayer and prisoner expense -  Corizon has slashed staff time available to ill prisoners, and discontinued many psychiatric medications switching prisoners who were functioning well on one drug to older, less effective meds with more severe side effect profiles, which many prisoners understandably no longer wish to take. These are the drugs that pharmaceutical companies typically sell extremely cheap in developing countries for institutionalized people, because hardly anyone in the US uses them anymore due to the side effect profiles - some - even at low doses, can cause high rates of Tardive Dyskinesia, a serious neurological syndrome. Here, in fact, is another letter of concern from Donna Hamm to the DOC Director, Chuck Ryan, about psychiatric and health care at Eyman under Corizon.

Similarly, to save money, Corizon discontinued a good many prisoners, if not all, from their pain management medications when they took over the medical care contract. Even many of those who managed to get their doctor to start them on another medication found they were ineffective for the diabetic neuropathy, or back pain, or bone cancer they were dealing with, and felt compelled to resort to heroin for pain management instead - far easier to get on a prison yard these days than a single tablet of Tylenol 3. Some, facing unbearable pain, day in and day out, with no compassion or relief from medical providers who would just as soon let them die in agony, might even choose to end their lives themselves, the one thing they have ultimate control over when all else is controlled by the state.

Not all DOC medical staff are heartless or gutless, though - at least Teresa Short walked away and came forward about the ethical dilemmas she experienced at Corizon over the past year, working in the intensive care unit at Tucson prison. And some legislators wonder why there's a class action suit complaining about the "free" medical care prisoners are so lucky to get - they think the ACLU has nothing better to do. The legislature's willingness to turn a blind eye is a large part of the problem at the AZ DOC

Anyway, my condolences go out to anyone who cared about this man - as well as to the survivors of his murder victim, for whom his suicide will bring up a lot of feelings, I would imagine. If anyone has any hard info about how and why he killed himself, I'm Peggy Plews - contact me at 480-580-6807 / arizonaprisonwatch@gmail.com or PO box 20494 PHX 85036.

AL JAZEERA's America Tonight: Another whistle blown on Corizon.

Blessings to former Corizon employee and whistleblower Teresa Short. What she did here took both courage and compassion. How sad that it has become an extraordinary thing these days to simply do the right thing and tell the truth.


Thanks to Abby Leonard and Adam May at Al Jazeera America Tonight for this coverage last week, too. They've been super.


Families, if you're advocating for an imprisoned loved one needing medical or mental health care, check out these posts below, and feel free to contact me: peggy plews 480-580-6807 / arizonaprisonwatch@gmail.com.

Corizon and the AZ DOC: Prisoners & Families, Know Your Rights. http://www.arizonaprisonwatch.org/2013/03/corizon-and-az-doc-prisoners-families.html

 Corizon's deliberate indifference: fighting back.

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

A word of advice - if you need help and cant hire an attorney, you'll need to drag your AZ state legislators into it to get anywhere - start filling them in  now, and make sure the DOC knows that you're cc'ing them on everything you have to write to Director Ryan in order to get your loved one taken care of. They can be found here: http://www.azleg.gov/alisStaticPages/HowToContactMember.asp

Please make sure your loved one in prison is doing the grievance process properly so they can sue these bastards if they still don't treat them right. Keep an eye on the DOC policy page, too, so you can see when things change and send copies inside.

 ---------------------------------

Whistleblower: Arizona inmates are dying from inadequate health care

An “America Tonight” investigation found dozens of cases of neglect in Arizona'€™s privatized prison health care system

 Watch parts one and two of Adam May's report.

May 28, 2014 3:45PM ET

 

by Abigail Leonard  & Adam May @adammaytv

 

SAFFORD, Ariz. — Regan Clarine found out she was pregnant just two days before she was sentenced to two and a half years behind bars for possessing a narcotic for sale. Giving birth to her baby daughter while she was incarcerated at the state prison complex near (Phoenix) was an experience she says nearly killed them both.

Clarine says her first indication things were not right with her health care was when she asked prison officials for an ultrasound. She was worried she wasn't gaining enough weight, but they never gave her one. Instead, Clarine said that after about nine months, prison doctors sent her to the hospital to induce labor, but when the baby still didn’t come, they performed a cesarean section against her wishes.

When Clarine went back to her cell, her C-section wound re-opened.

“It was big enough for me to put my fist in there,” she said. “It was the worst pain I’d ever been through in my life.”

Clarine said she alerted guards, but they refused to let her see a doctor, leaving her on the prison yard with a gaping wound for two weeks. When she finally saw medical staff, she said they told her that she was lucky to be alive. They treated her with a wound vacuum. Then, she said, they employed an antiquated medical treatment.

“They decided to use sugar … like McDonald’s sugar,” she said. “They would open it and pour it inside [the wound] and put gauze over and tape it up. And I had to do that for like three weeks.”

Clarine’s story is one of dozens. Like many other states, Arizona privatized its prison health care system two years ago. In a six-month investigation, “America Tonight” found disturbing cases of inadequate treatment, and evidence that Wexford Health Sources, the first private company Arizona contracted to provide prison health care, was aware that it was violating prisoners’ constitutional rights.

Arizona’s system is currently run by Corizon Health, the largest private prison health care provider in the country. Now, for the first time ever, one of its former employees is blowing the whistle about its failures.

Going unfed

Teresa Short was a patient care technician for Corizon, but lost her job in late March for refusing to go to work while suffering from a case of scabies she caught from a prisoner. Short said she thought it would be unethical to treat patients while she was still contagious. She had already infected a family member, she said, and feared her son could contract it and bring it to his high school. According to Short, Corizon and Arizona prison officials have been trying to cover up the outbreak, which now includes the original prisoner and seven staff members. (Read Corizon's response.)

But the most persistent problem at Corizon, Short said, was staffing.

“We have a lot of dementia patients that take time in feeding,” she said, “and because of the short staff we'd have to stand there for hours to try to feed them and it was just not permitted.”

Sometimes, those patients would go unfed, she said. Others who were incontinent would sit for hours in their own feces, she said. And still others died.

Short described one dementia patient who had a vascular catheter in his arm for dialysis treatments. He didn’t understand what it was and kept playing with it, she said, so she repeatedly told senior staff he needed additional supervision. Instead, they sent him back to his cell, alone. At 5 a.m., she went in to check on him.

Former Corizon patient care technician Teresa Short said some Arizona prisoners have died because there weren't enough medical staff on duty.

 

“[I] could smell blood before I even went into the room,” she said. “And when I turned on his light, it looked like somebody had been murdered. There was blood all over the room. I screamed for help.”

Short said the man had unplugged the catheter and quickly bled out. If Corizon had employed more staff to monitor patients, she said, he might still be alive.

There are some numbers to back up Short’s claims. Since the state privatized its prison health care, medical spending in prisons dropped by $30 million and staffing levels plummeted, according to an October report from the American Friends Services Committee, a Quaker social justice organization. It also found a sharp spike in the number of inmate deaths. In the first eight months of 2013, 50 people died in Arizona Department of Corrections custody, compared with 37 deaths in the previous two years combined.

According to a 2012 lawsuit filed by the American Civil Liberties Union, the health care in Arizona’s prisons now amounts to cruel and unusual punishment, with prisoners at serious risk of "pain, amputation, disfigurement and death.” The suit cites examples of Arizona health officials telling prisoners to pray to be cured and drink energy shakes to alleviate cancer symptoms.

“People are often sent to prison for two-year, three-year sentences that have turned into death sentences because of the absence of the basic minimal care,” said Dan Pochoda, legal director for the ACLU in Arizona. He said in his 40-year career, he’s never seen a worse prison health care system.

In an emailed statement, Corizon spokeswoman Susan Morgenstern said that the company could not discuss individual cases because of privacy laws, but that “the vast majority of our current staff levels exceed contract requirements,” and that their care follows the guidelines of the National Commission on Correctional Health Care and the American Correctional Association.

“Our goal is always to provide quality care while being good stewards and making the best use of public funds,” she wrote.

“As for lawsuits, we treat hundreds of thousands of patients in millions of healthcare encounters each year,” she added. “… The majority of lawsuits are brought by inmates without an attorney representing them and are dismissed or resolved prior to trial.” (Read the company’s full statement.)

'He had plans'

After his cancer, inmate Tony Brown's pain medication was switched from morphine to less-powerful Lortab.

America Tonight

Tony Brown is another inmate who died since Arizona privatized its prison health care. He was serving a 10-year sentence for aggravated assault and was due to be released last September.

“They were supposed to come down for Thanksgiving this year,” his daughter Jenna Jumper said. “He never got to meet my husband and he wasn't there when I got married, so they were going to come visit.”

Brown was in remission from esophageal cancer, according to his medical records, and had been prescribed morphine for the pain. But in October 2012, the prison ran out of the drug. Medical staff switched him to Lortab, a weaker painkiller.

In a video taken by prison guards and obtained by “America Tonight,” Brown is seen just after he was put on the new medication, writhing in pain while handcuffed to a gurney. His medical records show that guards told nurses his condition was worsening and that he "needed to be checked out." But there is no record of medical staff visiting his cell.

In another video taken two days later, a prison chaplain checks on Brown at his wife’s request.

“Inmate Brown, I spoke with your wife earlier today,” the chaplain is heard saying. “Can you communicate with me please? I’d like to speak with your wife later on. Is there something I can tell her?”

Brown, face down on a bunk, barely moves and doesn’t respond. A guard can be heard saying, “Is it me or does this just not feel right to anybody else?”

The guards started CPR and nurses came to assist, but 40 minutes passed before they realized no one had called an ambulance.

He died in a hospital the next day. Two days later, his widow Jami Brown said she finally received a call back from Wexford, the private prison health care company in charge at the time.

“My biggest thing is that if people would stop to realize that he did have family,” his daughter said, “and that he did have a child and he did have a wife and he had plans.”

The official cause of death was listed as complications from cancer. But Brown's family is suing Wexford, claiming he died from lack of adequate medical care.

In a statement, Wexford attorney Ed Hochuli said he couldn’t discuss details of the case because of the lawsuit and health care privacy laws, but wrote: "Based on the limited information we have at this time, though, I am very confident Wexford Health and its employees acted appropriately, and further investigation of this claim will demonstrate and prove the lack of any wrongdoing or negligence by Wexford Health.”

But there are signs that Wexford was aware of problems.

“America Tonight” obtained a copy of a PowerPoint presentation written by top Wexford executives for a meeting with the Arizona governor's office in November 2012 – four months after the company started providing care in the state. It warned that the care it and the Department of Corrections were providing was "not compliant with … requirements" and that "the current class action lawsuits are accurate." It recommended an overall operational cleanup, staffing reassessment and the appointment of a governor’s office liaison.

The PowerPoint presentation also says that the department's "transparency" policy with the media could "encourage negative press."

'A grain of sugar'

State Rep. John Kavanagh said Clarine’s story about being treated with sugar didn’t seem like a “true allegation,” adding that it “sounds ridiculous.”

 

 

Prison officials deny any problems with privatized care. Richard Pratt, the interim director of the health services division of Arizona’s Department of Corrections, told “America Tonight” that staffing levels since privatization were “basically the same.”

“Corizon staffing levels have been coming up on a monthly basis to the point even last month the hours that they were working with their existing staff exceeded the contract requirements,” he said.

He also denied there was a scabies outbreak, as Teresa Short had charged.

But Pratt emphasized that privatizing health care wasn’t a decision made by the Department of Corrections.
“It was legislated and mandated and it was the law,” he said. “So we were forced to do this.”

Legislators who supported the privatization promised that it would save taxpayers money, while maintaining adequate levels of care for inmates. The majority of states have privatized prison health care, rewarding private companies for keeping costs down.

“I mean, people die in prisons,” said state Rep. John Kavanagh, who wrote the legislation that privatized the state’s prison health care. “I receive a lot of handwritten notes from prisoners. I receive emails from prison families with all sorts of allegations of crazy behavior. And then, you call the prison people up and they usually have a reasonable explanation for it.”

Kavanagh said Clarine’s story about being treated with sugar didn’t seem like a “true allegation,” adding that it “sounds ridiculous.”

“You know prisoners have 24/7 to think up allegations and write letters,” he said. “I'm not saying that some of them can't have a basis in fact. But you got to take them with a grain of salt or in the case of the hospital, with maybe a grain of sugar.”

Kavanagh was also dismissive of the ACLU lawsuit. “I think most people who get into [class-action lawsuits] wind up with nothing and the lawyers walk away in limousines with their trunks full of cash,” he said.

No bid, nothing

Richard Pratt, interim health services director for Arizona’s Department of Corrections, denies that there’s a scabies outbreak in prison and says that Corizon’s staffing levels have exceeded the requirements of the contract.

 

 

Before Tony Brown’s death, Wexford was already coming under fire after a contract nurse exposed more than 100 inmates to hepatitis C by using dirty needles to deliver medication, according to the Department of Corrections. Four months later, Arizona severed ties with Wexford and awarded the three-year, $369 million contract to Corizon, which has similar contracts in 28 states, according to its website. But it has faced problems in many of them; in the last five years, Corizon has been sued for malpractice 660 times.

Arizona Democratic House Minority Leader Chad Campbell said the Legislature didn't properly vet Corizon before signing the contract.

“No bid. Nothing,” he said. “It was deemed an emergency situation by Department of Corrections so they didn't have to go through the normal process.”

Campbell also noted that Corizon had just hired the former head of the Department of Corrections, who was the mentor of the current head of the department.

That’s not the only tie that members of the state government have to private prisons. Charles Coughlin, the former campaign strategist for Gov. Jan Brewer, runs a lobbying firm called HighGround Public Affairs Consultants, which represented one of the country’s largest private prison companies. HighGround donated $5,000 to Jan PAC, Brewer's super PAC.

Then in late March, Kavanagh allocated $900,000 in state funding to the private prison company GEO Group Inc., even though the Department of Corrections said it wasn’t needed, according to the Arizona Republic.

“They're profiting on taxpayer dollars and to me, if I'm going to hand out money to a private entity, I want to make sure it's being spent wisely,” said Campbell, who is now calling for an investigation.

The governor's office declined a request from “America Tonight” for an interview and referred us back to Kavanagh, who said the allegations that Brewer accepted bids because of personal relationships were “baseless.”

“I think they're propaganda,” he said. “I mean, people say to me I've gotten campaign contributions from private-prison people. Well, yeah. I got from a lobbyist who represents them but that lobbyist also represents 40 other clients in different industries. It's smoke and mirrors. It's a façade.”

In the meantime, allegations of wrongdoing continue to mount. According to the American Friends Service Committee report, an inmate at the Whetstone Unit of the Arizona State Prison Complex tested positive for tuberculosis in August. But Corizon did not test other prisoners, even those who were doing community service outside the complex.

A healthy baby

Clarine walks out of prison, escorted by her father

 

 

Earlier this month, Regan Clarine completed her sentence. “America Tonight” met her as she was released into the waiting arms of her father, Paul.

“It’s one of the happiest days of our life,” he said. “Hopefully we’ll never have to do this again.”

They drove to a nearby hotel to reunite with the rest of the family, including her 11-month-old daughter, Rylan.

They’d met a handful of times on brief prison visits, but Rylan didn’t recognize her mother. Still, Clarine was happy to see her so healthy.

She responded to Kavanagh’s allegation that she was probably making up her story with a laugh, saying, “That’s crazy. I don’t think I could even come up with something like that … Sugar?”

To add insult to injury, her mother, Lori, said the prison has billed her $2,000 for Rylan’s birth. She is disputing the charges but fears it could hurt her credit if she doesn’t pay them. She says privatized prison health care simply isn’t working.

“You know, she got her just punishment,” Lori said. “But, oh my goodness, they're still human beings. Take care of them.”