AZ DOC denies any outbreak of scabies at ASPC-Tucson/Rincon.

So, this came into my box on Friday. Given how I raked Mr Pratt over the coals on the issue last week, I owe it to him to post this response he gave to some questions Donna Hamm raised about my previous post on Corizon. Her questions to him are in bold, his answers are in italics.

 My source still stands by her account of what has transpired at ASPC-Tucson/Rincon, however, and will be sharing it with mainstream media. They have the resources to do the fact-checking; I just amplify the voices of those who are otherwise effectively silenced by the system. If anyone out there has additional information about how ASPC-Tucson/ Rincon has been run the past year, please let me know.  My contact info is at the top of the page.

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Arizona Prisonwatch

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FOLLOWUP FROM Middle Ground: parasitic infestation of the elderly, sick and dying at Tucson/Rincon ICU...

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Arizona Prisonwatch
To: Peggy Plews
From: PRATT, RICHARD <RPRATT@azcorrections.gov> Date: Fri, May 2, 2014 at 6:54 PM Subject: RE: CORIZON's deliberate indifference: parasitic infestation of the elderly, sick and dying at Tucson/Rincon ICU.. To: Middle Ground Prison Reform <middlegroundprisonreform@msn.com> Cc: "chcampbell@azleg.gov" "atovar@azleg.gov", Governor Brewer <azgov@az.gov>, "abiggs@azleg.gov" <abiggs@azleg.gov>, "dgowan@azleg.gov" <dgowan@azleg.gov>, Daniel Pochoda , Caroline Isaacs, Peri Jude Radecic  "NICK, DOUG" , "RYAN, CHARLES"  "NORTHUP, DAWN" , Ms. Hamm: In response to your follow up: 1.      What was done to stop the spread of scabies once it was initially discovered?  Did the seven alleged cases result from staff ignoring the first case and letting it spread, or was it not discovered until several people already had it at approximately the same time?  If the first case was ignored and then it spread from that case into several cases, what is being done specifically to insure that serious attention will, in the future, be given to even a single outbreak of such a serious condition?  What safeguards are in place to insure that it is readily diagnosed and treated for an inmate who reports symptoms prior to spreading it to others? To be clear, let me reiterate, there has been no parasitic outbreak of scabies. On 03/24/14 a CNA working night shift in the IPC reported that she had a rash for approximately one week that was not resolving.  She was immediately sent to occupational health and treated for scabies.  Her diagnosis was made without confirmation by any skin scrapings.  No inmates or other staff were diagnosed with scabies at that time. The employee subsequently quit her job without notice citing personal reasons. On 04/23/14 seven IPC staff members reported a rash of varying degrees, after they were comparing symptoms with each other.  They were sent to occupational health and five of them were given a cream to treat scabies.  Again, this diagnosis for those five employees was made solely based on presentation and statements from staff regarding scabies.  The other two staff were diagnosed with contact dermatitis and a napkin rash. All seven have been cleared and have returned to full duty. One staff member also reported having a child with scabies approximately one month prior. 2.     Without violating their HIPPA privacy rights, are there in fact seven Corizon employees who've contracted scabies but were not permitted to take sick leave due to staff shortages, as is implied in Plew's original email? No. The information implied in Ms. Plew’s original e-mail is not correct. One staff was restricted from coming back to work for six days, four staff returned to work within 24 hours (full duty), and the other two staff (not diagnosed with scabies) returned without any restrictions. All of the Corizon staff were permitted to leave work upon reporting, and the only restrictions were based upon doctor’s orders. Paid time off was granted for anyone undergoing treatment or with work restrictions. No one was denied sick leave for any reason. An alternative staffing plan was put into place in the event all of the employees would have been taken off work for an extended period of time. 3.     Has someone investigated the physician assigned to that unit (Rincon) who is accused of ignoring patients presenting with symptoms of scabies?  As Plews noted, some of the individual prisoners may not have the ability (physical or mental) to file grievances or complain in any effective manner, but that does not relieve the DOC and/or Corizon of the responsibility to investigate. The doctor overseeing the infirmary has advised that with regard to the inmate population there were no confirmed cases of scabies within the IPC at any time during this period. Please note that these inmates are also seen daily by numerous nursing staff where any complaints can be voiced. 4.         With respect to the allegation that insufficient amounts of food are given or that bedsheets are not being changed in a timely manner, is there any procedure in place for you to make unannounced inspections?  If not, why not?  What can or is being done to insure that this issue, allegedly reported by a former Corizon employee, is not actually happening? I have received no reports with respect to these allegations. The medical monitoring team has full access to the infirmary 24/7 (without announcement) and inspects all aspects of patient care. Most of the inspections are unannounced, and take place many times each and every month, to include different shifts. 5.     Plews didn't identify the prisoner who allegedly died of "natural causes," but whom the Corizon ex-employee reports as having died due to neglect, so I am not sure how you can check into this, especially since no time frame was given to define "recently."  Can you somehow investigate this allegation to insure that no prisoner has died due to neglect or indifference?  Again, what active "hands on" inspections by you or someone in your office takes place at each health/medical unit -- in particular at the Tucson complex -- and how many of those inspections are unannounced?  How often do you visit the units to see things with your own eyes? There is a mortality review process for any deaths within the department which involves the monitoring bureau. I attempt to get out to the field personally whenever time permits. I also have administrators who travel regularly in the field supervising the complex monitors. 6.     The allegations regarding tampering/altering records at Tucson/Rincon ICU are especially troubling, and they originate from an ex-employee at Corizon.  What does the DOC intend to do regarding these extremely serious allegations regarding withdrawal/changing of medications,  at "other yards" (which Plews doesn't identify). Even if the ex-Corizon employee chooses not to come forward to contact you with her allegations or with more specific information, I urge you to investigate these claims on your own.  If all of her allegations are false, it will simply confirm that Corizon is doing the job they are contracted to perform and that your contract monitors are doing their jobs, too.  If any of the allegations are true, then immediate remedial measures need to be taken.  I hope I need not remind you that the bulk of the tragedy at the Kingman Prison a few years ago was a result of the DOC contract monitors not doing their job; I would hope that the Department will not allow such tragedy to repeat itself with the multi-million dollar inmate health care contract. Record reviews are just one part of the monitoring taking place in the field. It is not uncommon for a monitor to copy certain records at one point in time, and go back to the record at a later date to determine if any improper alterations have been made to the original records. We do our best to ensure that the inmates are receiving the constitutionally mandated care they deserve. Of course, specific allegations are able to be investigated more appropriately than general claims painted with a broad brush. As I have indicated in the past, I appreciate issues that are brought to my attention relating to the health care of the inmate population. Respectfully, Richard Pratt ________________________________ Interim Assistant Director Arizona Department of Corrections Health Services Contract Monitoring Bureau Office:  (602) 771-2100

DOC monitor for Corizon well-aware of conditions in ASPC-Tucson/Rincon.

So, I haven't heard back yet from Director Ryan on my email regarding neglect and scabies at ASPC-Tucson/Rincon, but I sure did hear from his staff. To be fair to him, I'm going to post his defense of his job performance here - along with my reply....

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On Wed, Apr 30, 2014 at 3:17 PM, PRATT, RICHARD; RPRATT@azcorrections.gov wrote:

Ms. Plews:

Your allegations are very serious in nature. I will also advise that your conclusions are totally unfounded.

The Department created a bureau to monitor the health care of the inmate population after privatization. I am the Interim Assistant Director of the Health Services Contract Monitoring Bureau. There are several staff assigned to cover the Tucson prison complex, and I was made aware of the scabies issue immediately by both the contracted medical vendor and one of my monitors at the site.

You ask if the “contract monitoring staff are just oblivious, deliberately indifferent, or actually complicit in hiding Corizon's crimes against the people of this state.” The question is both insulting and inflammatory. The answer is an emphatic “no.”

If your source (former Corizon employee) would like to directly bring forth specific concerns regarding the health care being provided at the Tucson complex, I will be happy to investigate them. She/he may e-mail me at any time, or call my office.

Respectfully,

Richard Pratt

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Interim Assistant Director

Arizona Department of Corrections

Health Services Contract Monitoring Bureau

Office:  (602) 771-2100

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Here's my less-than contrite reply.

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Arizona Prisonwatch	Wed, Apr 30, 2014 4:53 PM
To: "PRATT, RICHARD"
You're right that my question about the competence and culpability of the folks responsible for overseeing the contract with Corizon is an insult, Mr. Pratt - and until you prove me wrong, I offer no apology for it. But I'm wondering, now: if you've been on top of this outbreak yourself since the beginning, why is it getting worse instead of being contained and eradicated? I've dealt with scabies plenty of times managing homeless shelters, and you people have far more control over the prison infirmary environment that I did over the ones I had to deal with. Frankly, if it wasn't for the numerous complaints I've received from prisoners and their family members about the atrocious neglect occurring under your watch these past few years - not to mention that little class action suit over health care - I would have tempered my tone and remarks considerably. I'm tired of watching the most vulnerable people being exploited and neglected by companies like Wexford and Corizon, and you appear to be their chief enabler. Since informing you of patient care issues doesn't seem to have any impact on the care those patients receive, however, I have every reason to believe that either you don't really follow up on those matters, or no one at Corizon cares what you have to say because they know the DOC will let them get away with whatever they want anyway. The almost year-long deliberate indifference shown to the suffering of the late, elderly Gloria Rogers (despite her daughter's on-going correspondence with you about her kidney infections, cardiac symptoms, inappropriately discontinued meds, and other unmet medical needs) comes to mind. I can name more dying and dead prisoners, if you want me to explain further the reasons for my skepticism. If you cared at all about those patients at Rincon, you would be thanking me for the information I offered so you can investigate further instead of chastising me for criticizing your office. After all, what I just had to to say to the director addresses much more than just the persistent presence of scabies in the ICU. When you respond to such information with knee jerk reactions that have more to do with defending your ego than following up to assure patient welfare, you only reinforce my concern that you may indeed minimize critical issues in favor of reassuring the legislature that everything at the DOC is hunky dorey. You thus give them permission to ignore all the desperate letters and calls from prisoners and their families begging for help - which most legislators already do anyway. You, of all people, should be leading the charge to reverse the privatization of health care at the DOC, because you have first hand knowledge of how much patient care has suffered and how wasteful doing things this way is. Instead you condone such abuse of public resources. The patients in this particular unit are exquisitely vulnerable, as many of those guys are either too far gone to complain or will probably die before they manage to exhaust their grievances - which no one at the DOC is about to help the more seriously disabled men even file. Meanwhile, the staff who still remain in the ICU have all been threatened into remaining silent about their discontent or concerns about patient care, so who will advocate for the welfare of those men? You are clearly not the one to do so - or, if you are really in there fighting for those guys, Corizon has no respect for your insistence that prisoners receive only the best care. From everything I see, you are not an advocate for patients, you are an advocate for whitewashing their suffering in order to perpetuate the lie that contracting those services out was a brilliant idea, so men like Rep. Kavanagh can save face for demanding it. I find that pretty troubling. Given all the above - as well as a long list of the gravely ill and dead prisoners' families I've come to be quite familiar with -  I reiterate my allegation that your office has been negligent and can't be trusted to monitor the Corizon contract in the best interests of the AZ DOC's imprisoned patient population OR the taxpayers of this state. Lest anyone say I didn't give you a fair chance to respond to that accusation, however, I'll be happy to post your reply to my email to Ryan publicly as well. In fact, I'm putting this whole conversation out there. Please feel free to elaborate more, for the record, if you wish to. You know how to reach me. Margaret Plews

ASPC-Tucson/Rincon Deaths in Custody: Billy D Lee, 54.

Looks to me as if this poor fellow was recommended to the Governor for clemency just a week before he died, which suggests that his death was pretty imminent - or at least no one was expecting him to make it to the end of his  9 year sentence for what is listed in one place in his record as a marijuana violation. 

That's a lot of time for trying to sell some pot, especially if you're a sick man already. Billy Lee was also so mentally impaired when he was prosecuted for this crime that he first had to undergo competency exams - which appears to have been the case every time he was prosecuted for something. I don't know if he was mentally ill or developmentally disabled, but it looks from court records as if folks were pretty concerned about his capacity for criminality, which must have played into the recommendation to release him early from his term of imprisonment.

Right now, though, that's largely speculation.

I seldom post DOC death notices when causes are "natural", but I heard from the yard that Billy was last on that some of the other prisoners believe he died for lack of his insulin; we need to clear that up. If anyone is close to Billy and knows for sure this situation, please let me know so I can pass appropriate info on to his survivors and get back to the guys on his yard who are worried that he died from negelct.

My condolences to Bily's loved ones.

If you have any information for us on Billy's life or his death, please contact me: 

Peggy Plews 

AZ Prison Watch 

 PO Box 20494 Phoenix, AZ 85036 

 arizonaprisonwatch@gmail.com 

 480-580-6807 

 

Changes for ADC Prisoners with Medical Needs

Wilmot prison to be for inmates with health problems

By Jamar Younger

ARIZONA DAILY STAR

Published: 08.10.2009

The state prison on South Wilmot Road is being converted into a health facility for inmates throughout the state in an effort to reduce costs for the Department of Corrections, authorities said.

The conversion will require the transfer of thousands of inmates from the prison to other prisons around the state to make room for inmates with health issues.

The change to a medical facility for prisoners was accelerated after two fights resulted in lockdowns at the prison in June, Department of Corrections Director Charles Ryan said.

At least 400 inmates from the facility's Rincon Unit already have been transferred to other prisons in the state in anticipation of the conversion, Ryan said.

Those inmates will be replaced with prisoners who have mental health and medical issues, Ryan said.

Officials had developed a plan within the last four months to move inmates with medical and mental health problems to the prison, he said.

Prison officials are still calculating how much money will be saved, he said.

However, Ryan said he expects the conversion to save money because prison officials will not have to transport inmates from multiple prison sites around the state to get them to doctors or hospitals.

Inmates usually receive basic medical care at their prisons, but they're sent to specialized clinics and hospitals for emergencies, specialty care and injuries, he said. Most of those hospitals and clinics are in bigger cities such as Tucson and Phoenix.

Having the prisoners in one facility will make it easier to provide care for inmates and transport them to a specialist if needed, Ryan said. The department will monitor the cost to see how much money has been saved.

Donna Leone Hamm, executive director of Middle Ground Prison Reform, a prisoner-advocacy group, said moving ill prisoners to one location should improve medical care for inmates.

"It seems to me the Department of Corrections is constitutionally required to take care of inmates, no matter how ill they are," Hamm said. "Our hope is this would improve response times to emergency access."

Inmates who require more than just basic medical care will not have to endure traveling from their prison to another part of the state when they have an emergency, she said.

The traveling can take a toll on sick prisoners, she said.

"It's very difficult for the well-being of the patient," she said.

The Arizona Department of Corrections will add 1,000 new beds to the Wilmot facility, bringing the total to 5,756, Ryan said. The facility will keep 270 minimum-security inmates to meet labor force requirements, he said. These prisoners will perform maintenance duties, such as cooking and cleaning.

The department has been authorized to fill 115 clinical positions for its medical staff, he said. More than 80 positions have been filled.

The complete conversion may take several months, but prison officials anticipate having 1,000 new inmates by February 2010, Ryan said.

The complex currently has 4,756 beds and 4,276 general-population inmates.

Prison officials decided to begin the conversion after two fights within the same week in June injured numerous inmates and prison staff members.

The first fight occurred on June 23, when three prisoners and nine corrections officers were injured in a fight between Mexican-American and Mexican national inmates.

That fight took place in the prison's Rincon Unit, one of nine units at the prison.

Another fight between Mexican-Americans and Mexican nationals broke out in a different unit on June 26, injuring 20 inmates, including five who were hospitalized.

Ryan said the inmates were not moved because of their race.

"The general population, regardless of race, have been moved," he said.

The conversion will not cause a hardship for healthy prisoners because it is not uncommon for inmates to be transferred to different facilities during their prison terms, Hamm said.

"There is no constitutional right for prisoners to be at the location of their choosing," she said.

By the numbers

• 4,276 inmates currently at the state prison on South Wilmot Road.

• 1,000 beds will be added to the prison to accommodate inmates with medical and mental health issues from throughout the state.

• 5,756 beds for prisoners with medical and mental health issues once the conversion is completed.

• 270 minimum-security prisoners will stay at the facility and perform maintenance duties.

Contact reporter Jamar Younger at 573-4115 or jyounger@azstarnet.com