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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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