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Reeves County Detention Center, Pecos,
Texas
January
3, 2010 Midland Reporter-Telegram
El Paso attorneys are almost finished preparing a lawsuit against the
company that operates Reeves County Detention Center in Pecos and a Lubbock
physicians' group in the case of an epileptic 32-year-old inmate who died
on Dec. 12, 2008, one of the attorneys said. Representing the wife, three
children and parents of Jesus Manuel Galindo, Miguel "Mike"
Torres said he will file suit against the Geo Group of Boca Raton, Fla.,
which operates the 2,400 inmate lockup for the U.S. Bureau of Prisons, and
Physicians Network Association of Lubbock, which had been providing the
inmates medical care when Galindo was found dead in an isolation cell in
the prison's Security Housing Unit. Efforts were unsuccessful last week to
reach Wayne Calabrese, Geo's president-CEO in Boca Raton, Fla., and Dr.
Vernon "Trey" Farthing, PNA board chairman. Torres said he and
co-counsel Leon Schydlower and defense lawyers have sought documents and
conducted extensive witnesses' depositions since the 7 a.m. discovery of
Galindo's body started a prison riot in which the recreation center was
burned, three inmates were hospitalized and 25 were charged with assault
and other crimes. Galindo, of Ciudad Juarez, Chihuahua, Mexico, was serving
30 months for illegal entry into the U.S. Torres said the petition will be
filed in Judge Bob Parks' 143rd District Court in Monahans. "We're
very close to filing and it is a significant claim we're going to
make," he said. "It's a very wrongful death and we want to do our
homework and be absolutely ready. A big part of this case has been
obtaining documents. PNA will also very likely be a party." Torres
said Galindo's relatives believe his medical needs were inadequately
attended to because they had been prevailing on prison officials to give
him full doses of his medicine, Dilantin, and administer it at the
prescribed intervals. "We really want to get justice for the
family," said Torres, who had told of attending the man's funeral at
an "overflowing" south El Paso funeral home. "There are a
lot of layers to this case, but for us it's simple. They should have
provided medical care right there and treated him decently and they
didn't."
October 12, 2009 Texas Observer
Last Dec. 12, on the outskirts of Pecos, Texas, the immigrants doing
time in the world’s largest privately run prison decided to turn the tables
on their captors. It was the Day of the Virgin of Guadalupe, an important
religious holiday in Latin America. But the inmates were in no mood for
celebration. The motin, as the overwhelmingly Spanish-speaking inmates
called their uprising, began in the Reeves County Detention Center’s
Special Housing Unit (SHU), better known as solitary confinement, with two
men—a Honduran and a Mexican—using the wires in an electrical outlet to set
a mattress on fire. They broke out the windows of their cell, and when
prison guards tried to extinguish the fire by sticking a fire hose through
a port in the door, the two broke the sink off the wall and held it up as a
shield. One brandished, but didn’t use, a “shiv,” a crude jailhouse knife.
Meanwhile, the two men yelled for other inmates to join in the uprising.
Soon, at 12:45 p.m., a lockdown order went out across the prison. Staff
tried to hustle prisoners on their way to lunch or the recreation center
back to their cells. Inmates in one of the housing areas refused, and they
forced the guards to release friends from their cells. “Open the doors or
we will take your keys,” the prisoners demanded, according to an FBI
account. “We’ll see who has control in a bit,” one inmate told a guard. The
prison’s emergency-response team deployed an arsenal including rubber
bullets, pepper spray, expulsion grenades and bean-bag guns. To little
avail. The insurrection quickly spread to the other housing areas. The
rioters assembled in the outdoor recreation yard armed with rocks,
concrete, and steel poles as well as horseshoes, hammers and box cutters
they had pilfered from the recreation building. Many of them, aware of the
prison’s extensive surveillance system, hid their faces with T-shirts, hats
and bandanas. Some wore sunglasses. Two prison employees were taken
hostage. (Neither was harmed.) With more than 1,200 inmates milling around
outside and hordes of law enforcement officials, the prison must have
looked like a war zone. It was not mere anarchy, though. By midafternoon,
members of the FBI, Texas Rangers, DPS and the Odessa Police Department
arrived at the prison. As the crisis negotiators quickly found out, the
riot had not been prompted by gang infighting, racial tensions or a
spontaneous outburst of violence. The men incarcerated at the Pecos prison
are considered “low-security”; most are serving relatively short sentences
for immigration violations or drug offenses. All are set to be deported at
the end of their sentences. Leaders of the rebellion were demanding a
meeting with the Mexican Consulate, the FBI and the warden to discuss a
number of grievances that they said GEO Group, the prison company that
manages the 3,700-bed facility, had refused to address. The evening of the
uprising, the inmates sent a delegation of seven men—a Venezuelan, a Cuban,
a Nigerian, and four Mexicans—to meet with the authorities. They explained
that the uprising had erupted from widespread dissatisfaction with almost
every aspect of the prison: inedible food, a dearth of legal resources, the
use of solitary confinement to punish people who complained about their
medical treatment, overcrowding and, above all, poor health care. The
delegates pointed to a string of deaths (according to public records, five
men died in Reeves between August 2008 and March 2009, including two
suicides) they attributed to the prison’s inattention to medical needs. The
riot had been sparked by the death of Jesus Manuel Galindo, an epileptic,
who had been carried out of the prison’s Special Housing Unit in a body bag
that same day. “Suspect(s) are talking about the guy being out of the shoe
[SHU],” the FBI report said. “Someone should have been there with him.
Special housing was not the place for [him].” The authorities jotted down
the concerns and promised to take them seriously. Twenty-four hours after
it began, the uprising was over. More than $1 million worth of damage had
been done to the prison. Less than two months later, on Jan. 31, the prison
would be under inmate control again—and this time the rioting would last
for five days and end with one building destroyed and some $20 million in
damage. To critics of GEO and other for-profit prison companies, the two
huge riots in as many months—rare, especially in low-security prisons—were
the logical consequence of the largest experiment in prison privatization
to date. *** The story of the death of Jesus Manuel Galindo is the story of
a death foretold. For weeks, Galindo, a 32-year-old epileptic Mexican
citizen who had lived in the United States since he was 13, had been
complaining to anyone who would listen that something terrible was going to
happen to him because of poor medical care. In May 2007, Galindo was found
illegally crossing the border in El Paso. Galindo, nicknamed “Negro” for
his dark complexion, was sentenced later that year to 30 months for illegal
re-entry (crossing into the U.S. after being deported). Ten years ago, he
would likely have been quickly deported, not prosecuted. But the Bush
administration piloted a “zero-tolerance” policy in Texas that eventually
spread across the border: All illegal border crossers would be arrested,
detained and, if possible, prosecuted in federal court. Prosecutions
surged, as did the need for detention centers, jails and prisons to hold
the tens of thousands of newly minted criminals. The Obama administration
has more than embraced the policy. The number of prosecutions for
immigration crimes—almost 68,000—during the first nine months of 2009 is on
track for a 14 percent increase over 2008. More than half of those
prosecutions took place in Texas. The result has been a system swamped with
low-level immigration cases and prisons bursting at the seams with illegal
immigrants. Rather than build and run the facilities themselves, federal
agencies have turned in large part to private prison companies, such as
Corrections Corporation of America and GEO Group. In 2008, GEO reported
more than $1 billion in revenue, an 80 percent increase over 2005. Privatization
has been less profitable for others. GEO’s Texas facilities have been
plagued with suicides, filthy conditions, sexual abuse scandals, hunger
strikes, riots and lawsuits. Jesus Galindo became another case in point.
According to his family, Galindo had had seizures before his incarceration
but they grew worse and more frequent under the care of the Physicians
Network Association, a Lubbock-based medical services provider that serves
17,000 inmates in 24 facilities across the nation. In 2002, Reeves County
hired PNA to run the prison’s health care, attracted by its promise to
improve services and cut costs. (The county pays PNA $6.03 per inmate per
day, about $8 million a year at full capacity.) Four months into their
contract, then-warden Rudy Franco lauded PNA at a county commissioners
meeting for drastically reducing the number of surgeries, X-rays, outside
visits and other medical services, the latter of which had dropped from
3,148 to 222. On Nov. 12, Galindo was locked up in the Special Housing
Unit. The mostly Spanish-speaking inmates call it la celda de castigo, the
punishment cell. Prisoners and others say the SHU was frequently used to
isolate and punish men with health problems who complained about their
medical care. According to Galindo’s family, the prison authorities said
they put him in the SHU to keep an eye on him. “That’s not true,” says
Jesus Galindo Sr., his father. “It was to punish him.” Galindo pleaded with
prison officials to return him to the general population where he had
friends who woke him up to take his pills and took care of him during his
frequent seizures. “He would say he was really afraid because if he got
sick who was going to help him?” says his mother, Graciela Galindo. She
begged officials to look after her son. “They told me he was in a high
security place; that was what the warden said, and that I should not worry
about him. They told me they were taking good care of my son.” Galindo did
what he could to reassure his family, singing love songs to his mother over
the phone. “He had hope,” his brother Jesus Galindo Jr. said. “He was real
strong. The only thing that bothered him was his condition. I saw him on
his birthday [Nov. 29]. I said, ‘Hey, hang in there. Think of us like we
think of you.’” Judy Madewell, the public defender in charge of Galindo’s
criminal case was so worried that she sent an investigator to the prison on
Dec. 4. The investigator, Octavio Vasquez, urged the authorities to put
Galindo back into the general population. On Dec. 9, Graciela talked to her
son on the phone. “He told me to tell Belinda [his daughter] to do a dance
to the Virgin because he’s getting out of the SHU on Friday [Dec. 12] ...
and that if he wasn’t, to contact the jail.” The following day, Dec. 10,
Galindo wrote a letter to his family saying that he felt bad and had asked
the doctor and warden to do something. The letters begins in the morning,
with Galindo noting that a nurse had promised him that she would return
later that day to take his blood. Two days later, on Dec. 12, Graciela
called to see if her son had been released from the SHU. “I called and to
my surprise he was dead. They kept me on the phone for an hour. They said
we have to wait for the doctors. I told them please do something. But my
son was already dead.” “Mama, the day already passed and nothing,” he
writes later that same day. “All they did was walk up and down but here,
where I am, no one even stopped. We’ll see what happens tomorrow.” *** When
Galindo was found in his cell, rigor mortis had already set in. His body
was purple and stiff. The El Paso County medical examiner ruled the cause
of death as epileptiform seizure disorder. A toxicology report found
“below-therapeutic levels” of Dilantin, a cheap anti-epileptic drug, in
Galindo’s blood and urine. The drug is only effective at certain dosages,
and a patient’s blood must be checked regularly to make sure it’s not too
high or low, says Robert Cain, an Austin neurologist who reviewed the
autopsy. “With multiple seizures, inadequate levels of medication and left
in isolation without supervision, he was set up to die,” Cain says.
Galindo’s experience was strikingly similar to those of other inmates under
PNA’s care. In 2003, the Justice Department investigated the Santa Fe
County Jail in New Mexico, which was then run by Management & Training
Corp. (MTC). Just as it does at Reeves, PNA had a subcontract to provide
health care there. The Justice Department found nearly non-existent medical
and mental health care, and specifically noted PNA’s inattention to properly
calibrating dose-sensitive medications, especially anti-epileptics. “We
found several instances in which PNA failed to monitor inmates on these
types of medications, even when inmates reported experiencing side
effects,” the report states. In one case, blood testing showed that an
inmate with a seizure disorder did not have enough of the anti-seizure drug
to be effective. The PNA medical staff did nothing, and seven days later
the inmate attempted suicide and then suffered a seizure. “Even with all
the attention from medical staff due to his suicide attempt, his seizure
medication blood level was not measured until four days” later, the report
says. No such authoritative report has been done for the Pecos prison. But
in interviews and correspondence, prisoners, their relatives, attorneys and
immigrant rights advocates describe a facility overrun with corruption and
dangerous cost-cutting measures. Prisoners writing to the Observer have
made allegations ranging from physical abuse to tacit arrangements between
guards and prisoners to traffic drugs and other contraband inside the
facility. (GEO Group declined to comment.) A prisoner we’ll call Juan, who
asked that his real name not be used for fear of retribution, describes an
environment of fear where hardened criminals serving long sentences live
side by side with men who are there solely for crossing the border
illegally. Juan says that prisoners in the jail are divided into groups
based on their home state in Mexico with the tacit approval of the guards
and the warden. Prisoners who have money and can buy influence and
authority run these groups. These bosses dole out punishments and determine
with the guards who gets sent to the punishment cell, Juan says. “We are
threatened and beaten if we complain. While [the prison bosses] can have
cell phones and other benefits that are forbidden.” Another prisoner,
Jose—who also asked that his name be changed—writes that he has hepatitis.
“I begged for medicine and they sent me a bottle that was unsealed and only
half full,” Jose writes. “I haven’t received treatment for my hepatitis
since December 2008.” “The problem with Reeves is that there are no medical
services,” says Graciela Arredondo, the mother of a man who served part of
his sentence at Reeves. “They won’t bring a doctor if you are sick. They
don’t want to spend the money, but these are human beings and they deserve
medical services.” After the riots in December and January, the ACLU of
Texas called on the Department of Justice’s Office of the Inspector General
to investigate the prisoners’ charges. This wouldn’t be the first time the
OIG was asked to look into reports of abuse at the Reeves facility. In
2006, an investigation resulted in the arrests of five employees at the
jail for smuggling drugs into the facility and having sex with inmates.
Because it hasn’t received an answer from the OIG, the ACLU is starting its
own investigation. “Riots are relatively rare, and are an indicator of
serious problems at a facility,” says Lisa Graybill, legal director for the
ACLU of Texas. ”We continue to receive complaints that the Bureau of
Prisons and its contractors, GEO and Physicians Network Association, are
systemically failing to address life-threatening and chronic medical
conditions of detainees.” None of this is surprising to longtime prison
activist Bob Libal, co-coordinator of Grassroots Leadership, an Austin
nonprofit that fights private prisons. “Conditions at GEO facilities have
been horrendous, and it stretches across every type of facility,” says Libal.
“It’s case after case after case. Whether Coke County, Val Verde, Dickens
County, Reeves, Pearsall, it’s one horrendous thing after another.” In
2007, the Texas Youth Commission removed 197 youths from GEO Group’s Coke
County Juvenile Justice Center after inspectors found deplorable conditions
including filthy cells that reeked of feces and urine, insects in the food,
and inmates only being allowed to shower and brush their teeth every few
days. A year before, the family of 23-year-old LeTisha Tapia sued GEO Group
after Tapia killed herself at the Val Verde County Jail, which the company
runs. Tapia had told her family that she was raped, beaten, sexually
humiliated and deprived of psychological and medical treatment in
retaliation for telling the warden about guards allowing inmates to have
sex with each other. The suit was settled out of court. In the past two
years, the state of Idaho has pulled out of contracts at two GEO-operated
jails—the Dickens County Correctional Center, near Spur, and the Bill Clayton
Detention Center in Littleton—citing chronic understaffing, a lack of
required treatment programs, and suicides linked to squalid conditions. In
a lawsuit set to go to trial in March, two detainees at the GEO-run South
Texas Detention Complex in Pearsall claim that the company “intentionally
and systematically violates the rights of mentally disabled detainees.”
Echoing the Reeves County allegations, both of the plaintiffs, Miroslava
Rodriguez-Grava and Isaias Vasques Cisneros de Jesus, allege that instead
of treating them for their mental disabilities, GEO put them in segregation
for extended periods of time. “I think that any time you insert profit into
the equation that care and also the rehabilitative elements of corrections
goes out the window,” said Libal. “They try to do things as cheap as
possible. You get what you’re paying for in a lot of ways.” *** The Pecos
prison, a remote, austere correctional campus flanked by farmland and a
weirdly out-of-place cemetery, sprawls across several acres a few hundred
yards from Interstate 30. To travelers zipping by at 80 mph, the facility
is little more than a blur of barbed wire and guard towers. But to the
people of Reeves County (population 13,137), it’s an engine of progress. In
the mid-1980s, with the regional economy devastated by the Texas oil bust,
local business and government leaders decided to move into a
recession-proof industry that was exploding in an increasingly criminalized
America: prisons. In 1986, the county built a 300-bed prison. The prison
filled rapidly with federal inmates, pumping revenue into the county’s
budget and adding decent-paying jobs to the local work force. By 2002,
Reeves had 2,000 beds. In 2003, the county completed construction on a $39
million, 960-bed unit only to find that the feds had no interest. “They
built a $39 million prison on speculation,” said Jon Fulbright, a reporter
for the Pecos Enterprise. While the prison sat empty, payments on the
bonds, reduced to junk status, were coming due. On the verge of default,
county officials begged the Bush administration to send prisoners and hired
Randy DeLay, former House Majority Leader Tom DeLay’s brother, to lobby in
Washington, D.C. That’s when Wackenhut Corrections Corp., now GEO Group,
rode to the rescue. In November 2003, GEO agreed to take over management of
the whole 3,000-bed prison complex and soon struck a deal with the Bureau
of Prisons to fill the new unit. Despite the troubles at the Pecos prison
under GEO management, local officials are grateful. “A lot of people
criticize GEO but I don’t,” says Sheriff Arnulfo “Andy” Gomez. “We had a
hard time and they pulled us out. They’ve got lobbyists and all that.”
Besides, he says, “You’re going to have trouble in every prison.” Some more
than others. On Jan. 31, a month and a half after the first uprising,
prisoners at the Reeves County Detention Center rose up again. Prison and
law enforcement officials have released little information on the
disturbance, but inmates, advocates and family members say it began when Ramon
Garcia, 25, was forced into solitary confinement after complaining of
dizziness and feeling sick. “We spoke with the warden and we told him to
take our countryman out of the punishment cell and take him to the hospital
because he needs medical attention,” an inmate told Laura Rivas, an
advocate with the National Network for Immigrant and Refugee Rights. “We
told them that if they were not going to do it then we would do it, we
would take him out, because we have more strength, and they laughed at us.
And that’s when it all started.” Lana Williams, a friend of Garcia’s
family, told KFOX-TV in El Paso that Garcia had been put into solitary
confinement whenever he complained of feeling sick. “He’s gotten to the
point where he can’t walk down the hall without holding on to the wall, and
this has been going on and getting progressively worse,” Williams said.
During the five-day takeover, the inmates drafted another list of demands:
better medical treatment, adequate food (especially for those who are ill
or have diabetes) and no guard retaliation against any person. “To them, we
don’t matter,” the inmate told Rivas. “If we die, it doesn’t matter to
them. The only thing that interests them is money—nothing more.”
June 17, 2009 Midland Reporter-Telegram
The death of a 32-year-old epileptic inmate in solitary confinement at
Reeves County Detention Center last Dec. 12 touched off the first of two
riots that saw fires set and hostages taken, said an attorney who
represents the inmate’s family. Some of the privately-run federal lockup’s
2,400 inmates, many of them illegal immigrants, had complained of woeful
health care after the riots west of Pecos on Dec. 12-13 and Jan. 31-Feb. 1.
But the story now centers on 32-year-old Jesus Manuel Galindo of Ciudad
Juarez, Chihuahua, Mexico, who El Paso lawyer Miguel “Mike” Torres” claims
was improperly treated. Representing Galindo’s wife, three children and
parents with co-counsel Leon Schydlower, Torres said Wednesday that a
doctor with a Lubbock physicians’ group that contracts with the prison
examined Galindo just before his death. “The doctor said Jesus had an
attitude problem because he was complaining about the lack of medical
treatment that killed him three days later,” said Torres. “He had no
business being in the SHU (Security Housing Unit) because he was only in
for minor infractions, not fighting or worse. His mom had been calling
almost daily to say he was not feeling well and was having seizures. “She
mailed the prison his medical records, but they sent them back with a curt
note that said, ‘Don’t send these again.’ When they found him at 7 a.m.
Dec. 12, rigor mortis had set in, which meant he had been dead for three to
five hours. I attended his funeral and the small neighborhood funeral home
in south El Paso was filled to overflowing. It was tragic because he was a
young man.” Torres, who is taking steps toward a civil lawsuit against the
company operating the prison, said Galindo’s former cell mates touched off
the riot because they had feared that result. “Everything we learned is
that they were worried sick about this guy,” he said. “They tried to
contact the administration and say, ‘Bring him back and we will watch him.’
You have to take this type of medication (Dilantin) at precise times at
well-monitored therapeutic levels.” Judy Madewell, a federal public
defender in San Antonio who was handling Galindo’s appeal of a 30-month
term for illegal re-entry into the U.S., said she has “had concerns for a
long time because RCDC has had a number of problems with inmates getting
proper medical attention. “My secretary translated a letter in which Jesus
said, ‘I’m afraid I’m going to die and no one will find me!’” Madewell
said. “We feel horrible about what happened and feel like there is a lot of
responsibility on the facility’s part.” She reported sending Octavio
Vasquez, an investigator with the federal defender’s office in Alpine, to
spend three hours with Galindo on Dec. 4. “He was in the SHU for minor
disciplinary infractions,” Madewell said. “Octavio went to the authorities
and said, ‘He needs removing from solitary,’ and they said, ‘Yes, we will
move him out by this weekend.’ He was still there when he died eight days
later. “Jesus told Octavio the prison was not giving him his meds often
enough and lowered the dosage. He was a gentle person — not a problem
client and as far as I know not a problem inmate.” Assistant Federal
Defender Charlotte Harris of Alpine, whose office represented Galindo after
his arrest, said the Geo Group of Boca Raton, Fla., runs RCDC with support
from Reeves County. “It’s better for the government to run prisons, rather
than private companies, because corners can be cut if you have a profit
motive,” said Harris. A call to the prison last week was referred to Geo’s
Florida headquarters, where a spokesman asked questions be submitted in
writing by e-mail. The questions had not been answered Wednesday. Geo also
operates Lea County Correctional Facility at Hobbs, N.M., according to
references. Two prison recreation specialists were released unharmed after
the first riot. The rec center was torched during that melee, and smoke
poured from a housing unit during the second, broadcast by CNN, after which
three inmates were hospitalized, one missing a finger. Charged with assault
and other crimes, 25 inmates will be tried in Pecos and Midland, a court
official said. Six former RCDC employees — four guards, a life skills
teacher and a case manager — have been indicted since March for accepting
bribes to smuggle marijuana, tobacco and cell phones. Four pleaded guilty,
one was convicted by a jury and the sixth awaits trial, according to
records. Reeves County Hospital Administrator Al LaRochelle said Wednesday
that his hospital has not worked at the prison in at least nine years, if
ever, and he is not interested in it doing so. Noting RCH occasionally
treats prisoners in its emergency room and does some pre-arranged
surgeries, LaRochelle said, “You need experience running an inmates’ health
care facility. “Anytime you start looking at low bid contracts, that’s not
my cup of tea. I’m not a fan of that type of arrangement. If I can’t
provide the quality, I don’t want to do the work.”
February 15, 2009 Trans Border Project
Complaints about medical care at the Reeves County Detention Center
aren’t new. In 2007 an inmate went on a hunger strike protesting inadequate
medical care. When inmates protested after the death of an inmate in
solitary confinement on December 12, 2008, they alleged that medical
deficiencies and malpractice were widespread. Six weeks later the immigrant
inmates rioted again with the same demands that they be provided with
decent medical care. Juan Angel Guerra, a South Texas attorney who was the
former district attorney in Willacy County, says some 200 inmates at the
immigrant prison have enlisted his services to address their concerns about
medical and other abuses. During the week of the Jan. 31 disturbance, the
county kept the prison on “lockdown,” denying access to reporters and all
others, including Guerra. Neither the county, which owns the prisons, nor
GEO Group, which runs the immigrant prison, released any information about
the concerns of the rioting prisoners, simply saying in brief releases that
the “issues” were being resolved. Similarly, the Bureau of Prisons, which
contracts with Reeves County, to hold the immigrant prisoners, ignored
public requests for information. A full week after authorities said that
they restored control over the prison, County Attorney Alva Alvarez sent a
letter to Guerra denying his request to meet with his clients. "We are
doing everything possible to meet your request," Reeves County
Attorney Alva Alvarez wrote. "However, since the facility was
destroyed, there is no secure place for you to meet with your clients at
this time." Reeves County Detention Center is not a maximum-security
prison. It has been variously described by prison officials as a minimum or
low-security facility – hence the “detention center” designation. The
immigrants detained at the Pecos prison are not violent criminal offenders
but rather immigrants, often legal ones albeit noncitizens, who have been
convicted generally of nonviolent felonies like drug possession and various
immigration violations. In the name of guaranteeing public safety, Reeves
County officials have kept the prison off limits to reporters and
attorneys. And in an apparent effort to keep the story about inmate
protests from gaining momentum in the media and to keep it away from the
view of state and federal officials, county officials and the private
prison contractors have refused to comment on prison conditions. Among
those who have declined to comment about the state of medical care at the
detention center is the private contractor that is responsible for this
care. Leader in Correctional Healthcare -- Physicians Network Association
(PNA), a Lubbock-based company that calls itself a leader in correctional
healthcare,” has subcontracted with Reeves County since 2002. As the owner
of the prison, Reeves County has a contract with the Bureau of Prisons to
hold fedeal immigrant prisoners. But rather than run the facility itself,
the county subcontracts its responsibilities to GEO Group to operate and
manage the prison and to PNA to provide medical and dental care. (See
Medical Claims Part One) In its presentation as part of the negotiations
over its current contract with the county, PNA assured the county that “as
a subcontractor, PNA has fourteen years’ experience assisting operators
exceed expectations.” It emphasized the “cost-effective” character of its
medical services, and promised that it would “work as your partner to
ensure appropriate healthcare without compromising operations.” “We are
recognized for our responsiveness to the needs of our customers,” boasted
PNA, referring as “customers” to the private prison firms like GEO (with
which it has ten contracts) and counties like Reeves that own prisons not
to the inmates it cares for. PNA included GEO Group and Management and
Training Corporation (MTC) among its references, and it told the county:
“PNA has never had a contract canceled or been removed from a facility.” It
noted that it was “proud of its record of no substantiated grievances in
any facility.” The Dec. 12 prisoner protest at Reeves County Detention
Center started when inmates saw the body of Jesus Manuel Galindo removed
from solitary confinement. Inmates contend that Galindo did not receive
medical attention for his epileptic seizures. The Galindo family says it
has filed a lawsuit against the Reeves County Detention Center. David
Galindo, the dead inmate’s brother, told a reporter after the second riot
that started Jan. 31, “The reason they’re having riots is because their
personnel is doing the wrong thing just like they did to my brother.” After
the second disturbance started, an inmate called the media. The Pecos
prisoner said that the protest began when prison officials placed Ramon
Garcia, 25, in solitary confinement after he complained of dizziness and
feeling ill. “All we wanted was for them to give him medical care and
because they didn't, things got out of control and people started fires in
several offices,” said the inmate, who declined to give his name for fear
of reprisals by officials. Lana Williams, a family friend of Garcia, told
KFOX TV in El Paso that his medical neglect had been a problem since August
2008. "He's gotten to the point where he can't walk down the hall
without holding on to the wall, and this has been going on and getting
progressively worse," said Williams. Garcia told her was being been
placed in solitary confinement whenever he complained about feeling ill.
PNA’s Medical Gulag -- It shouldn’t be surprising that long-running
complaints about medical cars abuses sparked the inmate protests at the
Reeves County Detention Center. Six years ago the Justice Department found
widespread medical abuses at another county-owned, privately run adult
detention center, where the same subcontractor, Physicians Network
Association, was also the the medical services provider. Concerned about
civil rights violations at the detention center, the Justice Department
sent a study team from its Civil Rights division to investigate the jail in
May 2002 to determine if there were violations that could be prosecuted
under the Civil Rights of Institutionalized Persons Act (1997). On March 6,
2003 the Justice Department sent a letter and a long report of its findings
to Santa Fe County, which owned the jail and contracted with Management and
Training Corporation (MTC), a private prison firm, to operate the jail. The
county had an intergovernmental services agreement (IGSA) with the Justice
Department to hold detainees waiting trial who were under the custody of
the U.S. Marshals Service and the Bureau of Indian Affairs. MTC
subcontracted the medical services part of the IGSA contract to PNA. Summarizing
its findings, the Justice Department stated: “We find that persons confined
suffer harm or the risk of serious harm from deficiencies in the facility’s
provision of medical and mental health care, suicide prevention, protection
of inmates from harm, fire safety, and sanitation.” In its report, the
Justice Department team specified 52 actions that were needed “to rectify
the identified deficiencies and to protect the constitutional rights of the
facility’s inmates to bring the jail into compliance with civil rights
standards. Thirty-eight of the 52 identified deficiencies related to
medical services. The Justice Department report concluded: “The Detention
Center, through PNA, provides inadequate medical services in the following
areas: intake, screening, and referral; acute care; emergent care; chronic
and prenatal care; and medication administration and management. As a
result, inmates at the Detention Center with serious medical needs are at
risk for harm.” The Justice Department’s investigation was sparked by the
suicide of Tyson Johnson in January 2002 at the Santa Fe County Detention
Center. Johnson, who was awaiting a hearing on charges of stalking, was a
longtime sufferer of severe claustrophobia. In a New York Times (June 6,
2004) story on the Justice Department’s investigation and MTC, Suzan
Garcia, Johnson’s mother, said that had tried to contact the jail because
she was concerned about her son’s psychological condition. ''I called the
jail and asked to speak to a doctor, but they said they didn't have a
doctor,'' Ms. Garcia said. ''When I asked to speak to the warden, they just
put me on hold and then the phone would disconnect.'' According to the
Justice Department’s finding and associated reports, Johnson had asked to
see a psychologist, but the 580-inmate jail didn’t have a doctor let alone
a psychologist or a psychiatrist. So Mr. Johnson tried slitting his wrist
and neck with a razor, and when that failed, as the New York Times
reported, he told the jail's nurse, Sheila Turner, “Today I am going to
take myself out.” A guard, Crystal Quintana, told investigators that the
nurse replied, ''Let him.'' Ms. Turner denies this, her lawyer said. As the
New York Times recounted: “Ten minutes later, Mr. Johnson, 27 and with no
previous criminal record, was found hanging from a sprinkler head in a
windowless isolation cell where he was supposedly being closely watched.”
Despite being placed on suicide watch, Johnson hung himself with a
supposedly “suicide-proof” blanket inside the isolation cell. His family
contends that instead of tending to his psychological problems, the medical
staff neglected him and taunted him. The NYT story by Fox Butterfield
described the state of mental healthcare for which PNA was responsible:
“The nearest doctor on contract was in Lubbock, Tex., a two-hour plane
flight away, and he visited the jail on average only every six weeks,
seeing only a few patients each time, the report found. The nurse had an
order in her file to spend no more than five minutes with any inmate
patient, which the report said was not enough time. “There was no
psychologist or psychiatrist, and although the nurse had no mental health
training care, she was distributing drugs for mentally ill inmates, the
report said. “The jail did have a mental health clinician, Thomas Welter,
who was employed by Physicians Network Association, a subcontractor. But he
never did any evaluations of mentally troubled inmates, the report said.
Instead, he boasted to them about his own history of drug use, according to
a recent deposition by Cody Graham, who was then warden of the Santa Fe
jail. Not long after Mr. Johnson hanged himself, Mr. Graham escorted Mr.
Welter to the gate and told him not to come back.” Pattern of PNA Medical
Malpractice -- The Justice Department found a pattern of gross medical care
deficiencies at the Santa Fe jail. Among its findings were the following: ·
“PNA’s intake medical screening, assessment, and referral process is
insufficient to ensure that inmates receive necessary medical care during
their incarceration.” · “Even when PNA staff identify inmates with serious
medical needs during the intake process, they fail to refer them for
appropriate care.” · “Chart review revealed that of those inmates in our
sample who did receive the initial health screening, none were referred to
the Health Services Unit for the medical attention they needed.” · “The
grievance system does not provide an avenue for resolving problems of
access to health services. The grievances we reviewed included a complaint
from one inmate who was supposed to have an x-ray, but had received no
response from the Health Services Unit despite having filed two grievances
in three weeks.” Seven Suicide Attempts, One Completed in Seven Months of
MTC/PNA -- · “As of the time of our visit, during the seven months since
MTC assumed management of the facility, there had been one completed
suicide and seven attempted suicides. A review of these incidents reveals
that the Detention Center staff fail to respond appropriately to inmates’
indications of mental health crises and possible suicidality.” · “For
example, one inmate answered several of the initial mental health suicide
screening questions in the affirmative, including that he had recently
experienced a significant loss, that he felt that he had nothing to look
forward to, and that he ‘just didn’t care.’ He reported that he had been
diagnosed with Post Traumatic Stress Disorder and that he was taking an
antidepressant for this condition. He also stated that he felt that he
needed to see a psychologist. Despite these indicators, the screening nurse
concluded that the inmate needed only a routine mental health referral, as
opposed to an immediate mental health evaluation and determination whether
mental health services were necessary.” · “Another incident involved an
inmate who cut her wrists with a razor and was placed on a 15-minute
suicide watch in the medical unit. According to the subsequent
investigation of the incident, the inmate was upset because her medications
were stopped. The inmate was treated for lacerations to her wrists and
released from suicide watch without ever receiving a mental health
evaluation or mental health clearance.” An inmate placed on watch status in
a medical unit cell for his own safety due to mental illness and seizure
disorder was able to cut both of his wrists with a razor blade within 5
minutes of his arrival in that cell. The only way that staff knew that the
event had occurred was when blood began running down the floor from his
cell." Five Minutes Per Patient -- · “The nurse practitioner’s
personnel file included a memo from the Vice President of Operations of PNA
instructing her to see one patient for each five minutes of scheduled
clinical time. Many inmates, particularly those with acute or chronic
conditions, require significantly more clinical attention to ensure that
their needs are adequately addressed.” · “PNA does not test for sexually
transmitted diseases (STDs). STDs are prevalent in jail populations. Left
untreated, STDs can cause brain and organ damage and damage to fetuses.
PNA’s failure to screen for STDs places the inmates and the community at
risk.” · “PNA fails to provide timely access to appropriate medical care
for inmates when they develop acute medical needs. Medical care is
unreasonably and unnecessarily delayed and, even when provided, often
inadequate.” · “Even once inmates succeed in getting to the Health Services
Unit, they frequently receive substandard care. We reviewed the medical
records of ten inmates seen for primary care by the nurse practitioner
within a one-month period. Six of the ten inmates received substandard
care.” PNA’s Failure to Respond to Acute Medical Needs -- “Additional
chart reviews confirmed PNA’s failure to respond to inmates’ acute medical
needs. For example, one inmate reported breast lumps and lumps in her
armpit, chest pain, and swelling in her legs and feet. Although a mammogram
was ordered in October 2001, it had not been done by the time of our visit
to the Detention Center seven months later.” · “At the time of our visit,
the only physician providing supervision or care at the Detention Center
was the doctor who is the Chief Executive Officer (CEO) of PNA and is based
in Lubbock, Texas. As the CEO of PNA, this doctor has numerous
responsibilities, including supervising the medical care at each of the
facilities at which PNA provides care throughout the south and southwestern
United States. This physician was visiting the Detention Center an average
of once every six weeks, and saw only a few patients during each visit.
While he is available by telephone for consultation, he does not visit the
Detention Center frequently enough to provide adequate supervision. Given
the deficiencies in care and other problems identified in this letter,
additional physician supervision at the Detention Center is necessary.” No
Pre-Natal Care, Improper Treatment for Seizures -- · “PNA fails to provide
inmates with needed medications in a timely manner, and fails to monitor
medication in inmates with serious medical needs.” · “The Detention Center
fails to provide for continuity of medications for inmates upon arrival at
the facility. Several files we reviewed revealed that the nurse
practitioner does not continue the same medications for inmates that were
prescribed for them prior to their incarceration. Sometimes the nurse
practitioner simply discontinues the medication, and sometimes she changes
the inmate’s prescription to older, less expensive medications which are
significantly less effective.” · “PNA fails to provide adequate prenatal
care for pregnant inmates. Of the four pregnant women at the Detention
Center at the time of our visit, none had any prenatal visit with an OB/GYN
during their incarceration documented, despite the fact that two of the
women were in their third trimester of pregnancy and near term.” · “An
inmate had been prescribed a medication for his seizure disorder, in
addition to several other medications, and his blood levels of the seizure
medication had been measured. Although the laboratory results showed that
the amount of this drug in his system was not enough to achieve the
intended therapeutic effect, there was no reference to this finding
anywhere else in his medical record. Moreover, staff failed to respond
appropriately, such as adjusting his medication. Seven days later, the
inmate attempted suicide by cutting his wrists, then suffered a seizure.”
Keeping it Cost-Effective -- · “PNA’s formulary does not contain effective
medication for inmates with serious medical needs such as hypertension,
heart failure and diabetes. In addition, the formulary includes many less
expensive, less effective medications than are currently available for the
treatment of some diseases.” · “Some inmates at the Detention Center are
currently provided with less effective medications with greater side
effects than they had received prior to incarceration, which can lead to
deterioration in inmates with mental illness and end-organ damage in
inmates with diseases such as hypertension and diabetes.” · “Even when
staff did monitor medication levels, they failed to respond to indications
that an inmate’s dosage was inappropriate. Although the laboratory results
showed that the amount of this drug in his system was not enough to achieve
the intended therapeutic effect, there was no reference to this finding
anywhere else in his medical record. Moreover, staff failed to respond
appropriately, such as adjusting his medication. Seven days later, the
inmate attempted suicide by cutting his wrists, then suffered a seizure.”
PNA and MTC Leave Town -- Neither MTC nor PNA stuck around Santa Fe to help
the country resolve its problems with the Justice Department. Both MTC and
PNA said they had to terminate their contracts because they were losing
money. Soon after the Justice Department issued its findings in March 2004
on medical care and other problems at the Santa Fe County Detention Center,
PNA pulled out of its contract with MTC. A year later in April 2005, MTC
announced that it had “chosen to end this contract because it has not been
possible to operate profitably. Under two different contracts and with two
different medical providers, MTC and both medical providers have lost
money.” Before the private prison companies terminated their unprofitable
contracts, their personnel left town. MTC asked Warden Cody Graham to leave
his job in Santa Fe, and he transferred to another MTC county jail in
Gallup, New Mexico. According to a heart-rending investigative story in the
Santa Fe Reporter (April 2, 2003)on the death of a jail inmate because of deficient
medical care, PNA’s regional medical consultant left at the same time as
the warden. That PNA supervisor was Katherine Graham, wife of the MTC
warden. A story in the Albuquerque Journal (June 28, 2004) on the “tough
negotiations” following “state and federal audits slamming the facility for
inadequate medical services” reported, “PNA will not return if and when the
county and MTC reach a new agreement, jail administrators have said.”
County Commissioner Paul Duran recommended that the county would do a
better job running the jail. He noted that the Utah-based MTC – a
for-profit company – was not providing enough medical staffing or case
managers to deal with inmate needs. “I think it’s the profit element that
is the root of all these problems.” The county did take over management of
the jail after MTC left, and worked with the Justice Department to rectify
its findings of deficiency. Judith Greene, director of Justice Strategies,
echoed Commissioner Duran’s observation. She told the New York Times, ''This
goes to the heart of the problem in the private prison business,'' Ms.
Greene said. ''You get what you pay for.''
Santa Fe County Adult Detention Center, Santa Fe, New
Mexico
February
15, 2009 Trans Border Project
Complaints about medical care at the Reeves County Detention Center
aren’t new. In 2007 an inmate went on a hunger strike protesting inadequate
medical care. When inmates protested after the death of an inmate in
solitary confinement on December 12, 2008, they alleged that medical
deficiencies and malpractice were widespread. Six weeks later the immigrant
inmates rioted again with the same demands that they be provided with
decent medical care. Juan Angel Guerra, a South Texas attorney who was the
former district attorney in Willacy County, says some 200 inmates at the
immigrant prison have enlisted his services to address their concerns about
medical and other abuses. During the week of the Jan. 31 disturbance, the
county kept the prison on “lockdown,” denying access to reporters and all
others, including Guerra. Neither the county, which owns the prisons, nor
GEO Group, which runs the immigrant prison, released any information about
the concerns of the rioting prisoners, simply saying in brief releases that
the “issues” were being resolved. Similarly, the Bureau of Prisons, which
contracts with Reeves County, to hold the immigrant prisoners, ignored
public requests for information. A full week after authorities said that
they restored control over the prison, County Attorney Alva Alvarez sent a
letter to Guerra denying his request to meet with his clients. "We are
doing everything possible to meet your request," Reeves County
Attorney Alva Alvarez wrote. "However, since the facility was
destroyed, there is no secure place for you to meet with your clients at
this time." Reeves County Detention Center is not a maximum-security
prison. It has been variously described by prison officials as a minimum or
low-security facility – hence the “detention center” designation. The
immigrants detained at the Pecos prison are not violent criminal offenders
but rather immigrants, often legal ones albeit noncitizens, who have been
convicted generally of nonviolent felonies like drug possession and various
immigration violations. In the name of guaranteeing public safety, Reeves
County officials have kept the prison off limits to reporters and
attorneys. And in an apparent effort to keep the story about inmate
protests from gaining momentum in the media and to keep it away from the
view of state and federal officials, county officials and the private
prison contractors have refused to comment on prison conditions. Among
those who have declined to comment about the state of medical care at the
detention center is the private contractor that is responsible for this care.
Leader in Correctional Healthcare -- Physicians Network Association (PNA),
a Lubbock-based company that calls itself a leader in correctional
healthcare,” has subcontracted with Reeves County since 2002. As the owner
of the prison, Reeves County has a contract with the Bureau of Prisons to
hold fedeal immigrant prisoners. But rather than run the facility itself,
the county subcontracts its responsibilities to GEO Group to operate and
manage the prison and to PNA to provide medical and dental care. (See
Medical Claims Part One) In its presentation as part of the negotiations
over its current contract with the county, PNA assured the county that “as
a subcontractor, PNA has fourteen years’ experience assisting operators
exceed expectations.” It emphasized the “cost-effective” character of its
medical services, and promised that it would “work as your partner to
ensure appropriate healthcare without compromising operations.” “We are
recognized for our responsiveness to the needs of our customers,” boasted PNA,
referring as “customers” to the private prison firms like GEO (with which
it has ten contracts) and counties like Reeves that own prisons not to the
inmates it cares for. PNA included GEO Group and Management and Training
Corporation (MTC) among its references, and it told the county: “PNA has
never had a contract canceled or been removed from a facility.” It noted
that it was “proud of its record of no substantiated grievances in any
facility.” The Dec. 12 prisoner protest at Reeves County Detention Center
started when inmates saw the body of Jesus Manuel Galindo removed from
solitary confinement. Inmates contend that Galindo did not receive medical
attention for his epileptic seizures. The Galindo family says it has filed
a lawsuit against the Reeves County Detention Center. David Galindo, the
dead inmate’s brother, told a reporter after the second riot that started
Jan. 31, “The reason they’re having riots is because their personnel is
doing the wrong thing just like they did to my brother.” After the second
disturbance started, an inmate called the media. The Pecos prisoner said
that the protest began when prison officials placed Ramon Garcia, 25, in
solitary confinement after he complained of dizziness and feeling ill. “All
we wanted was for them to give him medical care and because they didn't,
things got out of control and people started fires in several offices,”
said the inmate, who declined to give his name for fear of reprisals by
officials. Lana Williams, a family friend of Garcia, told KFOX TV in El
Paso that his medical neglect had been a problem since August 2008.
"He's gotten to the point where he can't walk down the hall without
holding on to the wall, and this has been going on and getting
progressively worse," said Williams. Garcia told her was being been
placed in solitary confinement whenever he complained about feeling ill.
PNA’s Medical Gulag -- It shouldn’t be surprising that long-running
complaints about medical cars abuses sparked the inmate protests at the
Reeves County Detention Center. Six years ago the Justice Department found
widespread medical abuses at another county-owned, privately run adult
detention center, where the same subcontractor, Physicians Network
Association, was also the the medical services provider. Concerned about
civil rights violations at the detention center, the Justice Department
sent a study team from its Civil Rights division to investigate the jail in
May 2002 to determine if there were violations that could be prosecuted
under the Civil Rights of Institutionalized Persons Act (1997). On March 6,
2003 the Justice Department sent a letter and a long report of its findings
to Santa Fe County, which owned the jail and contracted with Management and
Training Corporation (MTC), a private prison firm, to operate the jail. The
county had an intergovernmental services agreement (IGSA) with the Justice
Department to hold detainees waiting trial who were under the custody of
the U.S. Marshals Service and the Bureau of Indian Affairs. MTC
subcontracted the medical services part of the IGSA contract to PNA.
Summarizing its findings, the Justice Department stated: “We find that
persons confined suffer harm or the risk of serious harm from deficiencies
in the facility’s provision of medical and mental health care, suicide
prevention, protection of inmates from harm, fire safety, and sanitation.”
In its report, the Justice Department team specified 52 actions that were
needed “to rectify the identified deficiencies and to protect the
constitutional rights of the facility’s inmates to bring the jail into
compliance with civil rights standards. Thirty-eight of the 52 identified
deficiencies related to medical services. The Justice Department report
concluded: “The Detention Center, through PNA, provides inadequate medical
services in the following areas: intake, screening, and referral; acute
care; emergent care; chronic and prenatal care; and medication
administration and management. As a result, inmates at the Detention Center
with serious medical needs are at risk for harm.” The Justice Department’s
investigation was sparked by the suicide of Tyson Johnson in January 2002
at the Santa Fe County Detention Center. Johnson, who was awaiting a
hearing on charges of stalking, was a longtime sufferer of severe
claustrophobia. In a New York Times (June 6, 2004) story on the Justice
Department’s investigation and MTC, Suzan Garcia, Johnson’s mother, said
that had tried to contact the jail because she was concerned about her
son’s psychological condition. ''I called the jail and asked to speak to a
doctor, but they said they didn't have a doctor,'' Ms. Garcia said. ''When
I asked to speak to the warden, they just put me on hold and then the phone
would disconnect.'' According to the Justice Department’s finding and
associated reports, Johnson had asked to see a psychologist, but the
580-inmate jail didn’t have a doctor let alone a psychologist or a
psychiatrist. So Mr. Johnson tried slitting his wrist and neck with a
razor, and when that failed, as the New York Times reported, he told the
jail's nurse, Sheila Turner, “Today I am going to take myself out.” A
guard, Crystal Quintana, told investigators that the nurse replied, ''Let
him.'' Ms. Turner denies this, her lawyer said. As the New York Times
recounted: “Ten minutes later, Mr. Johnson, 27 and with no previous
criminal record, was found hanging from a sprinkler head in a windowless
isolation cell where he was supposedly being closely watched.” Despite
being placed on suicide watch, Johnson hung himself with a supposedly
“suicide-proof” blanket inside the isolation cell. His family contends that
instead of tending to his psychological problems, the medical staff
neglected him and taunted him. The NYT story by Fox Butterfield described
the state of mental healthcare for which PNA was responsible: “The nearest
doctor on contract was in Lubbock, Tex., a two-hour plane flight away, and
he visited the jail on average only every six weeks, seeing only a few
patients each time, the report found. The nurse had an order in her file to
spend no more than five minutes with any inmate patient, which the report
said was not enough time. “There was no psychologist or psychiatrist, and
although the nurse had no mental health training care, she was distributing
drugs for mentally ill inmates, the report said. “The jail did have a
mental health clinician, Thomas Welter, who was employed by Physicians
Network Association, a subcontractor. But he never did any evaluations of
mentally troubled inmates, the report said. Instead, he boasted to them
about his own history of drug use, according to a recent deposition by Cody
Graham, who was then warden of the Santa Fe jail. Not long after Mr.
Johnson hanged himself, Mr. Graham escorted Mr. Welter to the gate and told
him not to come back.” Pattern of PNA Medical Malpractice -- The Justice
Department found a pattern of gross medical care deficiencies at the Santa
Fe jail. Among its findings were the following: · “PNA’s intake medical
screening, assessment, and referral process is insufficient to ensure that
inmates receive necessary medical care during their incarceration.” · “Even
when PNA staff identify inmates with serious medical needs during the
intake process, they fail to refer them for appropriate care.” · “Chart
review revealed that of those inmates in our sample who did receive the
initial health screening, none were referred to the Health Services Unit
for the medical attention they needed.” · “The grievance system does not
provide an avenue for resolving problems of access to health services. The
grievances we reviewed included a complaint from one inmate who was
supposed to have an x-ray, but had received no response from the Health
Services Unit despite having filed two grievances in three weeks.” Seven
Suicide Attempts, One Completed in Seven Months of MTC/PNA -- · “As of the
time of our visit, during the seven months since MTC assumed management of
the facility, there had been one completed suicide and seven attempted
suicides. A review of these incidents reveals that the Detention Center
staff fail to respond appropriately to inmates’ indications of mental
health crises and possible suicidality.” · “For example, one inmate
answered several of the initial mental health suicide screening questions
in the affirmative, including that he had recently experienced a
significant loss, that he felt that he had nothing to look forward to, and
that he ‘just didn’t care.’ He reported that he had been diagnosed with
Post Traumatic Stress Disorder and that he was taking an antidepressant for
this condition. He also stated that he felt that he needed to see a
psychologist. Despite these indicators, the screening nurse concluded that
the inmate needed only a routine mental health referral, as opposed to an
immediate mental health evaluation and determination whether mental health
services were necessary.” · “Another incident involved an inmate who cut
her wrists with a razor and was placed on a 15-minute suicide watch in the
medical unit. According to the subsequent investigation of the incident,
the inmate was upset because her medications were stopped. The inmate was
treated for lacerations to her wrists and released from suicide watch
without ever receiving a mental health evaluation or mental health
clearance.” An inmate placed on watch status in a medical unit cell for his
own safety due to mental illness and seizure disorder was able to cut both
of his wrists with a razor blade within 5 minutes of his arrival in that
cell. The only way that staff knew that the event had occurred was when
blood began running down the floor from his cell." Five Minutes Per
Patient -- · “The nurse practitioner’s personnel file included a memo from
the Vice President of Operations of PNA instructing her to see one patient
for each five minutes of scheduled clinical time. Many inmates, particularly
those with acute or chronic conditions, require significantly more clinical
attention to ensure that their needs are adequately addressed.” · “PNA does
not test for sexually transmitted diseases (STDs). STDs are prevalent in
jail populations. Left untreated, STDs can cause brain and organ damage and
damage to fetuses. PNA’s failure to screen for STDs places the inmates and
the community at risk.” · “PNA fails to provide timely access to
appropriate medical care for inmates when they develop acute medical needs.
Medical care is unreasonably and unnecessarily delayed and, even when
provided, often inadequate.” · “Even once inmates succeed in getting to the
Health Services Unit, they frequently receive substandard care. We reviewed
the medical records of ten inmates seen for primary care by the nurse
practitioner within a one-month period. Six of the ten inmates received
substandard care.” PNA’s Failure to Respond to Acute Medical Needs --
“Additional chart reviews confirmed PNA’s failure to respond to inmates’
acute medical needs. For example, one inmate reported breast lumps and
lumps in her armpit, chest pain, and swelling in her legs and feet.
Although a mammogram was ordered in October 2001, it had not been done by
the time of our visit to the Detention Center seven months later.” · “At
the time of our visit, the only physician providing supervision or care at
the Detention Center was the doctor who is the Chief Executive Officer
(CEO) of PNA and is based in Lubbock, Texas. As the CEO of PNA, this doctor
has numerous responsibilities, including supervising the medical care at
each of the facilities at which PNA provides care throughout the south and
southwestern United States. This physician was visiting the Detention
Center an average of once every six weeks, and saw only a few patients
during each visit. While he is available by telephone for consultation, he
does not visit the Detention Center frequently enough to provide adequate
supervision. Given the deficiencies in care and other problems identified
in this letter, additional physician supervision at the Detention Center is
necessary.” No Pre-Natal Care, Improper Treatment for Seizures -- · “PNA
fails to provide inmates with needed medications in a timely manner, and
fails to monitor medication in inmates with serious medical needs.” · “The
Detention Center fails to provide for continuity of medications for inmates
upon arrival at the facility. Several files we reviewed revealed that the
nurse practitioner does not continue the same medications for inmates that
were prescribed for them prior to their incarceration. Sometimes the nurse
practitioner simply discontinues the medication, and sometimes she changes
the inmate’s prescription to older, less expensive medications which are
significantly less effective.” · “PNA fails to provide adequate prenatal
care for pregnant inmates. Of the four pregnant women at the Detention
Center at the time of our visit, none had any prenatal visit with an OB/GYN
during their incarceration documented, despite the fact that two of the
women were in their third trimester of pregnancy and near term.” · “An
inmate had been prescribed a medication for his seizure disorder, in
addition to several other medications, and his blood levels of the seizure
medication had been measured. Although the laboratory results showed that
the amount of this drug in his system was not enough to achieve the
intended therapeutic effect, there was no reference to this finding
anywhere else in his medical record. Moreover, staff failed to respond
appropriately, such as adjusting his medication. Seven days later, the
inmate attempted suicide by cutting his wrists, then suffered a seizure.”
Keeping it Cost-Effective -- · “PNA’s formulary does not contain effective
medication for inmates with serious medical needs such as hypertension,
heart failure and diabetes. In addition, the formulary includes many less
expensive, less effective medications than are currently available for the
treatment of some diseases.” · “Some inmates at the Detention Center are
currently provided with less effective medications with greater side
effects than they had received prior to incarceration, which can lead to
deterioration in inmates with mental illness and end-organ damage in
inmates with diseases such as hypertension and diabetes.” · “Even when
staff did monitor medication levels, they failed to respond to indications
that an inmate’s dosage was inappropriate. Although the laboratory results
showed that the amount of this drug in his system was not enough to achieve
the intended therapeutic effect, there was no reference to this finding
anywhere else in his medical record. Moreover, staff failed to respond
appropriately, such as adjusting his medication. Seven days later, the
inmate attempted suicide by cutting his wrists, then suffered a seizure.”
PNA and MTC Leave Town -- Neither MTC nor PNA stuck around Santa Fe to help
the country resolve its problems with the Justice Department. Both MTC and
PNA said they had to terminate their contracts because they were losing money.
Soon after the Justice Department issued its findings in March 2004 on
medical care and other problems at the Santa Fe County Detention Center,
PNA pulled out of its contract with MTC. A year later in April 2005, MTC
announced that it had “chosen to end this contract because it has not been
possible to operate profitably. Under two different contracts and with two
different medical providers, MTC and both medical providers have lost
money.” Before the private prison companies terminated their unprofitable
contracts, their personnel left town. MTC asked Warden Cody Graham to leave
his job in Santa Fe, and he transferred to another MTC county jail in
Gallup, New Mexico. According to a heart-rending investigative story in the
Santa Fe Reporter (April 2, 2003)on the death of a jail inmate because of
deficient medical care, PNA’s regional medical consultant left at the same
time as the warden. That PNA supervisor was Katherine Graham, wife of the
MTC warden. A story in the Albuquerque Journal (June 28, 2004) on the
“tough negotiations” following “state and federal audits slamming the
facility for inadequate medical services” reported, “PNA will not return if
and when the county and MTC reach a new agreement, jail administrators have
said.” County Commissioner Paul Duran recommended that the county would do
a better job running the jail. He noted that the Utah-based MTC – a
for-profit company – was not providing enough medical staffing or case
managers to deal with inmate needs. “I think it’s the profit element that
is the root of all these problems.” The county did take over management of
the jail after MTC left, and worked with the Justice Department to rectify
its findings of deficiency. Judith Greene, director of Justice Strategies,
echoed Commissioner Duran’s observation. She told the New York Times,
''This goes to the heart of the problem in the private prison business,''
Ms. Greene said. ''You get what you pay for.''
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