Donna Hamm calls it: "The inmates are running the asylum..."

The following email from Middle Ground Prison Reform founder Donna Hamm was sent to the AZ Senate Appropriations Committee after the AZ DOC director, Charles Ryan, presented his Dumb on Crime Budget. Donna and I don't exactly see eye to eye on a lot - I think privatizing the prison business is unethical and dangerous, myself - but she really nailed it with this email about protective custody. 

Frankly, I think the prisoners could do a much better job running the prisons than the Good Old Boys at the DOC are - it's just that the wrong prisoners are in charge right now. See When the Prisoners Ran Walpole for more on that theme...

----1/23/14 email from Donna Hamm to AZ Senate appropriations chair Don Shooter--

From: middlegroundprisonreform@msn.com
To: dshooter@azleg.gov
Subject: Appropriations Hearing Follow-up
Date: Thu, 23 Jan 2014 08:25:11 -0700

Senator Shooter and Members of the Senate Appropriations Committee:

First, thank you for taking public testimony at the hearing on January 21, 2014.  I am aware that these types of hearings usually do not include opportunity for public testimony.

Second, during my remarks to the committee, I misspoke regarding one fact.  The Does v. Stewart litigation that was mentioned by myself and by Charles Ryan was initially a lawsuit that began in the district court as Does 1-5 v. Lewis.  Hence, it was former DOC Director Sam Lewis, not Terry Stewart, who arbitrarily decided to limit the number of beds that would be available to prisoners requiring protection custody (PC).  When Terry Stewart took over as Director, the litigation caption was changed to Does v. Stewart.  I apologize for the error and I advised Terry Stewart that I would inform you of my mistake.

Thank you for requesting that I put my notes taken at the hearing into an email to you and assuring me that you would distribute my comments to the rest of the committee members.  Since the DOC budget is one of the largest in state government, it is important that legislators make informed decisions about all aspects of that budget.

Middle Ground Prison Reform, by the way, does not oppose private prisons per se.  In fact, of the many letters we receive each month from prisoners located in prisons throughout the state, few come from prisoners housed in private prisons.  Prisoners tell us, for the most part, that private prisons have newer, better infrastructure; more polite and professional guards; better food; better, more effective programming; and more relaxed visitation.  Of course, we acknowledge that the prisoners confined in private prisons are better behaved than maximum and close custody prisoners housed in state facilities, and that their crimes are usually less serious.  Although there are many arguments back and forth about whether the private prisons save money or are a good bargain for the state, we believe that the better service they provide is worth the extra cost, if they cost more.  We do disagree with the fact that the contracts require a 90% guaranteed occupancy rate and that it is much more difficult to obtain information (public records) from a private facility.  Still, we don't oppose the use of private prisons to provide relatively quick provision of prison beds when needed.  Many functions of government are privatized and we do not object to privatized prisons as long as they are held strictly accountable to their negotiated contracts and that proper and diligent monitoring of their operations is consistently maintained.

With respect to some of the discussion that took place at the hearing and with regard to some of the questions asked by committee members and the responses provided by Director Ryan, we provide the following observations/opinions for the committee's consideration.

Director Ryan spoke of the huge increase since 1998 in protective custody population (432 in 1998; 3,553 (9.5% of the population) as of 12/13).  We believe this must raise alarm bells for legislators -- what on earth is causing all these inmates to require protection?  Remember, Director Ryan did not provide you with the number of inmates who are currently in the 805 process (which refers to Department Order 805, the internal management policy which governs the process for obtaining protective custody).  Those 3,553 inmates who are already assigned to PC as of December 2013 have already been thoroughly investigated by the DOC and have been determined to have a genuine state-wide security issue.  That is to say, whatever security issue or issues have developed for them has been determined by DOC administrators -- all the way up to the Central Office where the final decisions are made, and not by the prisoner himself -- to be an issue so serious that he cannot be placed in any general population unit of any prison in the Arizona system.  That's the only way a prisoner obtains PC classification.

We were dismayed to hear Mr. Ryan's somewhat cavalier description of the reasons why inmates "need" PC and his implying that many inmates arrive on the doorstep of DOC and immediately request PC because they want to be housed in a one-man cell.  Clearly, of the 3,553 already investigated and approved for PC (admittedly, by Charles Ryan, the largest PC population of any state prison in the USA), there are none of these malingerers in the count.   The Director testified that either as of 12/13 or during the month of 12/13, 358 inmates requested PC.  How many of that number were granted during the relevant time frame?  The actual number granted PC out of the 358 requesting PC will demonstrate that the DOC is not over-using PC and is not granting it to malingerers.  Inmates who are being investigated for potential classification to PC should not be counted in the 3,553 number mentioned by the Director; instead, they are in the "805 process" (referring to Department Order 805, which is the policy governing protective custody).

Prison officials don't like to admit it, but there is an aspect to prison life that fits the "inmates are running the asylum" theory.  Here's why.

When an inmate arrives on any DOC yard/unit, a prisoner who represents the gang that runs the yard (for prisoners of the same ethnic group as the new arrival) will approach the newly arrived inmate and perform what is referred to as a "roll call." " Roll call" is the process of determining whether the new arrival has "bad paperwork."  The new arrival will be asked for his "paperwork."  His paperwork consists of police reports on his case, his Presentence Report, his Sentencing Minute Entry, his Plea Agreement, etc.  The prisoner is expected to produce these documents so that the "head" of the yard (for his race) can determine if there are any obvious problems with the paperwork, such as the prisoner having turned over the names (snitched off) any other co-defendant (even if that other person was never charged with a crime); testified against anyone; committed a crime that involved or occurred in the presence of children or against a young female; or anything that calls into question the person's "loyalty" to the unwritten convict code, which includes certain "rules" that all inmates are expected to follow.

If the paperwork is determined to be "bad paperwork," most of the time the inmate is advised by someone that he should get himself rolled up off the yard (that is, go to PC/805 investigation) by the next morning or he will be removed from the yard in a helicopter (implying that he will be injured badly enough to require air evacuation to a hospital).  Even if this act would not actually be carried out, the threat alone constitutes ample reason for an inmate to request an 805 investigation.  Sometimes the threat is, in fact, carried out, with resultant injuries to the targeted inmate -- sometimes serious; sometimes not.

Checking the paperwork in the first step in roll call.  For example, if the inmate arrived from another yard on a bus with other inmates, one of the yard leaders will pick up a (contraband) cellphone and call his counterpart on the other yard and will ask if there are any known "problems" with the inmate (problems include such things as drug or gambling debts, previous requests for PC, other known issues with that inmate, or any suspicions or unresolved issues on that other unit).

Inmates who are perceived to be weak, often young or young-looking-for-their-age, small in stature; naïve, first-time-in-prison offenders (which, according to DOC documents presented to you, comprise 51.9% of the total current population), are often approached and advised that they must pay protection money or they will be beaten. Many of these inmates are very fearful and pay "taxes" or "respect money" to gang members and others in order to avoid being assaulted or having their property or commissary items stolen.

Some prisoners fall prey to the wide variety of drugs that are readily available in every prison unit (albeit, they are more expensive in prison due to the risk involved in securing them either through visitors or staff).  As the DOC noted in its materials presented to you, 75% of prisoners at intake have significant substance abuse histories.  Despite what you were informed about all the programs available, there are long waiting lists for substance abuse programs, and such programs are not available on every prison yard, nor are AA or NA groups available on every yard.  Once a prisoner begins using drugs in prison, it is almost a sure bet that he will eventually owe debts for the drugs, in addition to "tax" when he doesn't pay his drug supplier on time, and "respect" money that is paid to the gangs just because they demand it.  Middle Ground frequently assists family members pleading for their son's placement in PC who have paid thousands of dollars in extortion monies which began as paying off debts for their son, etc. and end up with just paying money because they become a ready source of cash.

Recently, the DOC implemented a policy whereby only a person on the prisoner's visitation list may send a Securepak (i.e., items that may be sent as a gift box to an inmate, which includes everything from specialty food items to toiletries).  This policy was implemented because extortionists were ordering extortion victims to have the victim's family member send a Securepak to the extortionist.  However, money orders can still be sent to any prisoner by any free world person.  Hence, when extorting an victim, an inmate can simply have the victim's family send a money order to the extortionist's inmate account.  If he wishes to avoid having the money come to his account, or if the DOC passes a policy to prohibit money orders except from someone on the prisoner's own visitation list, the extortionist will simply demand that his victim's family send a money order to a girlfriend, parent, etc. who lives in the community, and that person, on the extortionist's visitation list, will have the money forwarded to his inmate spendable account.

The point is:  What is the DOC doing about this serious problem?  How much do these problems affect prison operating budgets?

Case law abounds from the U.S. Supreme Court, which is binding in Arizona, and from the Ninth Circuit Court, and even from Arizona courts, formally holding that prisoners have a constitutional right to be safe from harm and that prison officials must take steps to protect an inmate when prison officials know or should know that a credible security issue exists.  Prison officials must protect a prisoner from harm even if he has never actually been assaulted (a credible threat of assault is sufficient to trigger constitutional protections) and even if the security issues are of his own making.

Legitimate Questions for the DOC:

1.  How/why are drugs so readily accessible in prison?

2.  What are you doing to prevent introduction by visitors?  By staff?
           By private vendors entering the prisons?

3.  How are cell phones being introduced in the prisons?

4.  How many visitors/fiscal year are arrested on site with illegal contraband?

5.  How many staff members of all types (uniformed/non-uniformed) are caught in illegal activity involving facilitating the introduction of illegal contraband?

6.  How many staff and visitors are prosecuted for activity in Questions 4 and 5?

7.  What types of security procedures are in place for each shift of  workers/seven days/week at each prison unit to prevent introduction of illegal contraband?

8.  How does Arizona's prison system compare with other states with similar sized populations with respect to contraband and prosecutions?

9.  What is Arizona doing to affirmatively control and/or moderate the prolific influence of gangs and gang activity on all prison yards?

10. Why is Arizona's PC population the largest in the USA?

With respect to the paperwork/colorful handouts provided by the DOC to your committee members, it is important  to understand that much very valuable information is excluded, or, more precisely, presented in a format that is of little use to the Legislature.  For example, the DOC presented a chart on the subject of Assaults on Staff (presented in a red column) and Assaults on Staff With Injuries (presented in a blue column), and presented it for Fiscal years 2009 through 2014.  Three things seem important for the Committee.  First, there is no breakdown of the two types of assaults by prison unit, which would provide the Committee with truly significant information by identifying the actual prison units that have high numbers of assaults and therefore enable targeting for the purpose of increasing staff safety, investigating why the numbers are so high for those units, and enabling additional questions and information for those units (High staff turnover?  Questionable policies? High numbers of inmate grievances? Lack of educational or treatment programs or other positive activity available on that unit?  Excessive gang activity?  High numbers of inmate-on-inmate assaults as well?  High numbers of positive drug tests? High staff vacancy?)  In contrast, the information presented in the current DOC document ("Corrections at a Glance") is virtually useless for any genuinely meaningful purpose.

For a second example, the DOC presented a pie-chart on the 9,891 inmates admitted to DOC to date in FY 2014, and the chart states that 70% were new court commitments, 14% were county probationers revoked, and 15 percent were parolees revoked.  Since parole was eliminated for offenses committed on or after January 1, 1994, and replaced by Community Supervision, it is unlikely that absolutely no Community Supervision revocations occurred  and similarly unlikely that there were that many persons revoked on parole.   The DOC should clearly know the legal difference between "parole" (which is a release status granted by a vote of the members of the Board of Executive Clemency) and "community supervision" (which is a release status that is automatically granted to most prisoners who serve 85% of their imposed sentence).  This lack of clarity is important for policy and budgetary considerations.  The DOC supervises both those on parole and community supervision, but the Board is only involved in release decisions for old-code inmates who are still eligible for parole.  It would be useful for legislators to know how many parolees are revoked, versus how many on community supervision.  This knowledge might even form the basis for consideration of reinstating parole eligibility at some time in the future.  Also, and importantly, what were the committing offenses for those returnees to DOC (if the numbers are unusually high for one or two types of offenses, perhaps a targeted program would reduce the recidivism rate).  It also would be very important to know if there is overlap between the groups.  That is, how many of the new court commitments were releases who committed new offenses (or how many of the release revocations were for committing new crimes as opposed to technical violations).  The data as presented does not provide this type of detailed and useful information.  Similarly, Arizona law allows a judge to waive community supervision if the person has a probation term to serve following release from prison, which raises the question of how many of the probation revocations were for persons who had completed a prison term and were serving a consecutive probation period?  While seemingly providing useful information, the pie-chart on FY 2014 admissions fails to break out the data into more detailed, more meaningful, and more useful slices instead of three very general categories.

With regard to the presentations regarding the ADC Census (by prison complex) and the presentations regarding "Bed Capacity and Population Detail," one is left in the dark about how many inmates are in beds that were created as "temporary beds" long ago and have never been upgraded to permanent beds.  One example would be the East Unit of the Florence Complex, an entire unit consisting solely of Quonset huts installed about 30  years ago.  Are these beds now considered "rated" beds, or are they "temporary" beds?    When is this Unit going to be upgraded with permanent facility construction?

As you can see from the above information, we simply don't think that Legislators are being provided sufficiently detailed information in order to make informed decisions about the budget for one of the largest state government agencies in Arizona.

Again, thank you for the opportunity to present our views.  We would be happy to answer any questions of any member or provide additional information.

Donna Leone Hamm, Judge (Ret.)
Executive Director

GEO Group/ CACF corruption & retaliation: business as usual...

The following information showed up in my email box this afternoon, after Donna Hamm disseminated it to her listserve. It refers to the Central Arizona Correctional Facility (CACF) run by GEO Group under contract with the AZ Department of Corrections. It will be interesting to see how far this goes. I hear about staff corruption so often and yet they are so seldom busted or punished when they are caught - the prisoners are the ones who are always disciplined when they try to speak out about these kinds of employees, as you can see below.

Prison staff LIE all the time, just like cops like Armando Saldate do - and they seldom ever have to suffer consequences for it, while the prisoners pay and pay. Note that prisoner Josh Lunn ended up getting reclassed to a higher custody level and shipped out to the Supermax, ASPC-Eyman after his boss wrote him up for refusing to participat ein his criminal enterprise. Please remember this the next time you look at a prisoner's disciplinary record and think "yeah, look at all that bad stuff he's been up to inside -he should be in Supermax".

Remember this the next time you find yourself assuming that just becuase someone wears the uniform of the state and a badge they must be some kind of noble public servant, too, and therefore can always be trusted to tell the truth.

This guy Lewis is poison - and most of the staff working around him probably knew he was lying about those prisoners when he wrote them up, but they went along with it anyway. This infuriates me not because it's so outrageous, but because it's way too common that prisoners get treated this way by the people who hold the keys to their cages and chains...they are the far more dangerous criminals, I think - the ones who will take their power and run over whomever they want with it.

Glad you jumped on this one, Donna. Now the DOC needs to make things right for those prisoners who were so wrongfully treated in all this.

JUNE 12, 2013: The document below has been edited since the original posting to protect innocent prisoners. The main suspects need to answer to the community for this, though, for violating the public trust, so their names are out there. 

I hope the media picks this one up...

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

From: middlegroundprisonreform@msn.com
To: Charles Ryan, Director
Subject: Theft, Corruption, Retaliation
Date: Wed, 12 Jun 2013 16:38:18 -0700

Mr. Ryan:

The following information has been submitted to Middle Ground.  In italics, I have quoted the information  exactly as it has been provided to me.

During the first week of May 2013, two Central Arizona College employees were fired at Florence  for their part in stealing from the college and providing gifts to corrections employees/officials in exchange for favors.  Brad Ellsworth, the former Director of Prison Programs, was arrested on Tuesday, April 30, 2013, on theft-related charges stemming from over five years of mis-appropriating tools intended for prison vocational programs and stealing materials to build furniture and other items for his personal use, and to give as gifts to Florence wardens and staff.

Chris Lewis, a former Arizona DOC ADW, hired by Ellsworth, to manage the welding program at South Unit, was terminated May 2, 2013, after CAC officials discovered him returning tools previously reported as  missing/stolen.  Lewis is apparently cooperating with authorities in their investigation.

Ellsworth was known for having fine furniture and welded goods produced in the vocational schools within the prison, then rewarding correctional staff who "looked the other way," with these items as gifts in exhange for their blind eye.  Ellsworth was fond of specialty woods such as dark walnut and he built kitchen cabinets and living room furniture using CAC-purchased materials.  Other items, such as a gun tote box for his truck, were also built using CAC purchased materials.

The investigation into Ellsworth began after CAC administrators learned of over $1,300 in purchases by Ellsworth on CAC accounts for Corvette car parts.  When questioned about these purchases, Ellsworth attempted to explain their purchase by stating that the parts were purchased for his "work vehicle." Ellsworth also purchased tools for the various prison vocational schools, often purchasing the same item twice and keeping one for his personal use.  Sometimes these tools were given as reward or gifts to corrections staff or friends or sold to them at discounted prices.

Lewis began his tenure as the welding instructor in January 2013 by making immediate changes to the school's curriculum and program design.  He spent thousands of dollars remodeling the welding area from a student-oriented teaching environment to a production line for "special projects," built by inmate workers.  Students' welding time was reduced from 5 days/week to less than 2 days in order to accommodate the building of mini-smoker grills, bumpers for off-road vehicles, and vehicle gas tanks being built by the inmate workers for Lewis' friends and family.  

The cash paid for these items went directly into Lewis' pocket.  Several of the mini-smoker grills were given as gifts to corrections administrators or employees to facilitate the changes Lewis made to the vocational program.  Lewis came to the attention of CAC administrators after numerous complaints were made by inmate-students and when stolen tools were placed back into the college's inventory at the prison.  A fellow instructor discovered the tools and learned from Lewis that these tools were given to him by Ellsworth to "hide."  The instructor...alerted his superiors at the college.

Lewis also used his position and his knowledge of internal DOC procedures to retaliate against inmates who refused to assist in the illicit activities, while rewarding those inmates who were compliant with perks -- such as food and jobs.  Prior to Lewis' tenure, only one inmate had been removed from the CAC vocational area in the previous two years, while six (6) were removed in the four months that Lewis was an instructor.  Lewis rewarded inmate-students who assisted his activities by calling in favors with staff and having the inmates assigned as workers who would receive higher pay ($.40/hour instead of $.15/hour).

Lewis used his relationship with staff to push through disciplinary actions or have inmates transferred to other prison units if they refused to aid his activities.  When inmate student AE complained about not getting enough welding time, Lewis erupted and screamed at AE to leave the class.  Lewis then wrote a disciplinary violation claiming AE was "confrontational" and that AE "threatened him."  AE is stick-thin and probably weighs 130 lbs or less.  Lewis is over 6'3" and weighs about 260 lbs.  AE was found guilty of the disciplinary, despite witnesses testimony about what really happened, and AE was removed from the welding school.

Inmate "MW" was written up by Lewis for "refusing to attend" when a Warden at "MW's" previous facility called Lewis and complained about "MW".  Despite attending every class, "MW" was removed from the welding school and reduced in privileges due to Lewis' write-up.

A third inmate, "JL", signed up as a student and was almost immediately promoted to worker status by Lewis.  When JL discovered Lewis' illicit activities and began documenting them, Lewis caught him and wrote a disciplinary violation stating that JL was writing disparaging things against him.  Lewis called in a favor with staff and the violation was handled as a Major disciplinary ticket.  JL was found guilty, lost all privileges, was removed from the welding school, and transferred to a higher custody unit.

Lewis also targeted inmate workers who refused to help him by getting them transferred.  Lewis enlisted the help of CO Gxxxxxx, who was assigned as South Unit's SSU.  SSU is tasked with identifying gang activity and illegal behavior, and thus has wide lattitude to transfer troublesome inmates between prison units in isolated moves called "one - for - ones."  The first inmate targeted was "SC".  SC is a high profile inmate who worked in the CAC carpentry program.  Lewis asked SC to produce wooden handles for the mini-smoker grills.  SC refused because the CAC carpentry program teaches general construction and SC did not want to participate in any illicit behavior.  A few days after refusing, SC was transferred to (another) Unit in a one-for-one movement.

The second inmate targeted by Lewis was SH.  SH is a high profile inmate due to an escape almost 13 years ago, and he had been working in the CAC vocational programs as a porter for over 2 years.  Lewis knew of SH's past history, including SH's involvement in facilitating staff theft of state property prior to his escape, because Lewis had worked at Eyman Complex while SH was incarcerated there and prior to his escape.  

Lewis asked SH to work for him, but SH declined, citing over 8 years of a clean record.  Lewis attempted to have SH transferred, but (SSU officer Gxxx) was unable to do so because SH's past history requires any move to be approved in advance by Central Office.  When the transfer failed, Lewis instructed Ellsworth to send an email, dated February 8, 2013, to Florence Complex Warden Lance Hetmer, targeting SH's past history of escape (emphasizing the escape). Ellsworth used his position with the college to make it seem that SH's presence in the program threatened the college's reputation, and the college did not want him there.  Reacting to this email, Hetmer removed SH from the CAC vocation program area and banned him from all good jobs in the prison.  SH was jobless for over a month before being assigned to a lower paying, less skilled position.

Lewis then approached inmate CM.  CM was asked to falsify DOC documents he had access to as the Inmate Hazmat Clerk. CM refused and a week later was transferred to (another) Unit in a one-for-one move.

The actions of Brad Ellsworth and Chris Lewis were brought to the attention of CAC President Doris Helmich.  An investigation was commenced and strong measures to end this spree of theft and unprofessional behavior.  Ellsworth and Lewis were dismissed from the college.  At this time, DOC has taken no action to rectify the harm caused to those inmates that Lewis targeted for retaliation.   Warden Hetmer seems oblivious to both his manipulation by Ellsworth and the illegal activity that occurred under his watch.  

Mr. Ryan, my question is:  Isn't it a crime of bribery or conspiracy for a contract employee to provide gifts or sell items that are the fruits of stolen property to a state employee?  What investgation, if any, has taken place regarding the above incidents as they implicate your own employees?  Please provide all investigative reports.   

What is particularly noteworthy is what happened with high-profile inmate SH.  He apparently was able to escape 13 or more years ago (I remember the intensive news coverage) by using insider-corruption and information to facilitiate his escape....  Now, after learning his lesson -- which is what we all hope he would do -- and refusing to participate in corrupt and illicit activities, he is punished for his appropriate, lawful conduct.   Do you find this ironic?  Inmates are, after all, "students of (DOC's) behavior."

There needs to be a full-scale investigation into this matter if it has not already taken place. If it has taken place, then I want to examine the entire record of the investigation pursuant to public records law.

Please advise when the investigative reports are ready for my review at the Central Office.   

Corizon's deliberate indifference: fighting back.

 The Ghosts of Jan Brewer, from Arizona's Other Death Row...

Firehouse Gallery Sidewalk, Phoenix (July 2012)

 

Hey friends and families of AZ DOC prisoners:

I received this piece of correspondence aboout Corizon's recent performance at the AZ DOC from someone on Donna Hamm's (of Middle Ground Prison Reform) email list. Corizon has the contract to provide health care to prisoners now. 

I encourage friends and family members of prisoners to contact your legislators with alarm about this information, as well as the persistently high rate of prisoner suicides and homicides under this administration (both are twice the rate as under the previous director), the gangs dominating the yards and the high level of violence, the class action suit over prisoners' shoddy medical and mental health care, and the deliberate indifference that DOC Director Charles Ryan's staff have shown to prisoners who are suffering terribly (like marcia powell, tony lester, ferdinand dix, anthony brown). They are just some of the Ghosts of Jan Brewer...

If you have a loved one at ASPC-Eyman, legislators for their prison (as well as for ASPC-Florence) get all sorts of bonuses for having so many prisoners in district #8, so put them to work protecting their constituents' rights. Send them an email as well as a personal, hand-written note asking for their intervention - which you will probably have to folllow up with a phone call to their office. Don't wait for them to call you, in any case. They are: Senator Barbara McGuire  and Representatives Frank Pratt and TJ Shope. Their snail mail addy is:

AZ State Legislature

 1700 W. Washington St

Phoenix, AZ 85007

Senate
(602) 926-3559

House

(602) 926-4221 

Please also print and send this post to your loved one, and send them copies of the AZ DOC health care access policy (DO 1101)  and the grievance process (DO 802). That's the language they'll have to fight in if they are to survive their sentences. There's a pretty good prisoner's guide for handling grievances here, and my February newsletter touched on the issue of grieving problems accessing health care as well. 

Here is the Jailhouse Lawyer's Manual that I send parts of to prisoners: download and print chapter 23 if your loved one is struggling to get adequate (or any) medical care. Send them chapters 14 and 16, too, if they plan to sue the DOC themselves.

Here's a list of attorneys I know are capable of suing the DOC as well. If your loved one in prison has suffered actual harm,  has done the grievance process properly, and can make a compelling argument of deliberate indifference (which is a higher standard than simple negligence), you may find a lawyer willing to take it on contingency.


Here is the actual complaint which forms the basis of the current class action suit agaisnt the DOC, "Parsons v Ryan". It's a good read for understanding what the ACLU does and doesn't think is unconstitutional in re: medical and mental health care in prison, in case you're trying to figure out how to gauge and respond to what your oved one is experiencing. Contact the ACLU-AZ, too, to report human rights abuses and deliberate indifference to prisoner physical and mental health - they're in on the class action.

The people who are being prosecuted via  Parsons v Ryan  are AZ DOC Director Charles Ryan and DOC Health Services Division Director Richard Pratt. Their email addys are: cryan@azcorrections.gov and rpratt@azcorrections.gov. Those are the guys whose desks the buck is supposed to stop at, anyway. The AZ DOC street address, for registered, return-receipt mail (better than certified, I'm told), is 1601 W. Jefferson St. PHX, AZ 85007. Make sure the prisoner you care about is following the grievance policy to the letter, but nothing stops you from hitting up those guys for help if corizon isn't doing their job - it will take less time to pressure them with your legislators in tow than it will to sue them into compliance.

You may also want to hit Corizon's compliance office if their help-line people at 1-855-276-5416, or InmateHealthInquiry@corizonhealth.com don't respond in a timely or approprite manner (preferably use email so you have a written record of all future exchanges with them). The Corizon compliance office email is compliance@corizonhealth.com

 I can usually be reached at arizonaprisonwatch@gmail.com or 480-580-6807 if you nee dmore help than this - just keep in mind that I'm just a civilian - I'm certainly no lawyer.  I just believe in mutual aid and have figured out some ways to help prisoners and their families help themselves, so I'm willing to share. Please also feel free to contact me with your own stories and tips for survival for me to share with others, as well.

Good luck and take care.

---------------from Middle Ground Prison Reform-------------

Middle Ground Prison Reform
139 East Encanto Drive
Tempe, Arizona 85281
480 966-8116

Donna Leone Hamm
Executive Director
James J. Hamm
Director of Program and Advocacy Services

May 22, 2013

Mr. Charles Ryan, Director
Arizona Department of Corrections
1601 West Jefferson
Phoenix, Arizona 85007

In re: Serious Concerns/Contract Violations Corizon Healthcare

Dear Mr. Ryan:

As you know, I have many contacts within the Dept. of Corrections, both among the staff and the inmate population. It has recently come to my attention that there are serious concerns about the delivery of healthcare to inmates throughout the entire prison system as contracted with Corizon. In particular, there are special concerns about the treatment being afforded to mental health patients.

While my specific comments below are focused on conditions and practices at the Eyman Complex (which consists of SMU I and II, Meadows, Rynning, and Cook units), I strongly suspect that the same problems exist system-wide. Therefore, this letter is intended to address problems on a system-wide basis that are similar to the specific ones that I will mention in this letter regarding the Eyman Complex. It will not be acceptable to conduct an investigation into what is happening at the Eyman Complex; it is necessary to learn if the same problems and issues are taking place throughout all facilities under contract with Corizon.

As reported to me by reliable sources who have requested to remain anonymous, there is presently only one psychiatric nurse in the entire Eyman complex. As of April 30, 2013, the Eyman Complex housed over 5,100 prisoners. Prior to when Wexford took over the medical care for inmates, there were 4 to 5 such nurse positions at Eyman. The Wexford contract mandated that all inmates with Mental Health classification scores of Level 3 or above were required to be seen at least once/month by a Mental Health provider. Such provider could be an RN, a Psych Associate, a Psychologist or a Psychiatrist. Psychiatrist appointments were scheduled every 3 months or sooner if deemed necessary through referral or via an inmate’s own HNR request.

This deliverable, under the present contract with Corizon, has been deleted and services are now set at the level of what the Department mandated of itself prior to Wexford, which is a Psychiatrist visit once every 6 months, and a Psych RN visit every 3 months. Notwithstanding the obvious implication that this deliverable was reduced in contract negotiations with Corizon simply to save money, it will be impossible for one Psychiatric Nurse to accomplish even every three months. Who will screen the HNR’s that refer to medications or negative side effects?

Apparently, Corizon functions in other states with no psychiatric nurses at all; instead, they allow regular medical nurses to assume those duties even though psychiatric nurses have special training to deal with psychiatric patients. RN’s without psychiatric training or experience cannot assess psychiatric symptoms.

At the Meadows Unit, and very likely at other units as well, nurse positions (medical nurses) are being slashed by Corizon. The staff at Meadows have been advised that they will have 2 nurses with 1 supervisor. The unit has, as of April 30, 2013, about 1,200 men, including an 80-bed CDU. On Meadows Unit, there are approximately 330 inmates who have MH scores of at least Level 3.

A supervisor, Nicole Bradfield, resigned about a week ago because she was working 60 hours/week at a salaried position (no overtime) and saw no reprieve to this schedule. There are apparently several LPN’s on the unit, but they are not qualified nor licensed to make assessments and must function under the supervision (on site) of an RN. As noted above, they cannot assess psychiatric symptoms due to lack of training and experience, not to mention not being qualified by licensing to do so.

The Meadows Unit has about 60 insulin dependent diabetics. Glucose tabs are now non-formulary and a paste has been substituted (to save money?) With the paste, it is much more difficult for the nurse to know how much to use to augment the sugar levels. Also, the unused paste is discarded after the package is opened. This would seem to be an expensive, waste.

Medical nurses are unable to complete their tasks and this directly and negatively affects patient care. Supervisors have been getting prescription renewals with verbal orders without readbacks.

A readback is essential to insure that the specific information communicated has been accurately understood. Noting orders are not being completed. Once orders are written, they have to be implemented. They have to be noted, sent to the pharmacy, etc. My sources advise that on one day recently there were three stacks of charts (total number unknown) that had been sitting on the desk for two days. The nurses have to make a decision about whether to do the nurse line or note the orders. On some days, there can be as many as 5 ICS’s. These emergency incidents obviously halt all other duties the nurses are doing in the health unit.

The Meadows Unit has a psychologist who does watches every morning at Browning Unit. This severely dilutes the time she is available for direct patient care or consultation.

It has been reported to me that the Meadows yard has many elderly patients who are medically compromised. New policies are issued by word-of-mouth. Outside consultations with specialist are not being scheduled. Suicides at the Eyman Complex seem to be increasing in frequency (1). The list goes on.

It is my understanding that there is an assigned Contract Monitor who is employed by ADOC whose job is to insure contract compliance. What is this person doing? Clearly, the Department must avoid similar problems to the ones you had with the Contract Monitor who utterly failed to do his job at the Kingman private prison facility, which ended in tragedy and enormous liability for the State of Arizona.

We are calling for a full-scale investigation/audit of the contract with Corizon. Audits need to be conducted of contract compliance in each unit of every prison where Corizon provides medical care. All prisoners have a well established constitutional right to the community standard of care for their serious medical needs. The Department has both a legal and ethical duty to provide mandated medical care.

I hope to hear from you that an investigation/audit will be ordered, and please consider this as a public records request, pursuant to A.R.S. 31-121 et seq., for any/all records you may have (written, electronic, audio, video, telephonic) or which you produce within the next 90 days which deal with Corizon’s contract compliance.

Your immediate attention will be appreciated.

Sincerely,

Donna Leone Hamm

Director

1. Within the last month, there have been three suicides at Eyman Complex (Joaquin Tamayo # 106163; Paul Henderson # 247636 and Milo Stanley # 064794) which lend credibility to the fact that mental health care is wholly inadequate.

Wexford, human rights causing riot fears at ASPC-Perryville?

My mail has been hung up for a few weeks now, beginning with a mailing I sent to women correspondents at Perryville prison about their health care rights. A copy of the latest version is below - all but one or two copies appear to have been intercepted by prison authorities, though. One of the men I sent the second of the two letters below to said his copy was seized by officers and marked "riot material". After not hearing back from over 70 prisoners I'd written to in the past few weeks, by this weekend I felt pretty sure that the DOC was intercepting most of my mail going into their prisons, and are preventing those who had previously corresponded with me from getting word out. 

Unfortunately, since Director Ryan still hasn't responded to the following email I sent him 5 days ago, I don't know if any of those allegations I've made are true. For all I know, I'm about to be arrested for attempting to incite a riot or for promoting prison contraband. Or perhaps the DOC just made a huge mistake by messing with my free speech rights and diverting the US mail inappropriately. 

We'll soon see. I'll keep you posted here...

 Remembering victims of neglect and suicide at ASPC-Perryville 

(Phoenix, AZ : November 2011)

----from my email account-----

On Sat, Oct 20, 2012 at 4:48 PM,
Arizona Prisonwatch <arizonaprisonwatch@gmail.com> wrote:

Director Ryan:

While we're on the subject of rioting, I thought you should see these other two letters yourself and tell me if they warrant confiscation as well. I've hardly heard a word out of Perryville since mailing them to about 30 women there - nor much from the 40 men to whom I sent the one with Donna's emails - and suspect that either these letters have also been diverted from the intended recipients, or their voices are being repressed. A similar problem has befallen one of your Botulism patients - his mail from me about who victimized him and what he might be able to do to assure his rights are protected has definitely been interfered with, and he'll run out of time to exhaust his remedies and access the courts if he's kept in the dark about his options much longer. I'm also concerned about the possibility that his ability to advocate effectively for himself right now could still be impaired by the neurological damage done to him after your people at Eyman refused to get him to a hospital for a week. I don't trust that they now have his best interests at heart.

Are you aware of the escalating crisis of guys trying to get into your Protective Segregation program because the gangs are totally in control on medium and higher yards? The guys all are. Your prisoners also have the right to know why - after four months of filing HNRs or going through the grievance process - they are still suffering with an untreated urinary tract infection, or have gone without their Metformin since July, who is responsible for that kind of thing, and what they can do about it.

You have the duty to Arizonans behind bars and in the community alike to assure that you are doing no harm to those people entrusted to your care for rehabilitation, because 95% of them will someday have to come home to the rest of us. We'd like them to return with better social and employment skills than when they left, not come back to us more disturbed or violent than they ever were before.

The men are already "rioting", by the way, according to Dr. D'Angelo, because they are hungry and terrified of dying horribly due to gross medical neglect in your custody. I also think the fear that one is about to be assaulted if one doesn't strike first is contributing to the escalating rate of vicious attacks on vulnerable prisoners over things that previously would have gone unnoticed on the yards, and thus creates some of your 805 backlog.

The women will be rioting soon without me too, you know. That's your doing, however, not mine.

The men and women alike in your prisons are all tired of being expected to shut up and disappear when they resist sexual violence or extortion, say no to racism, and challenge the deliberate indifference of their health care providers. Those allegations about Wexford include some of criminal misconduct, not just the heartless greed that our ALEC-laden legislature happily expected they were satisfying when they mandated you to outsource the prisoners' health care for less...you didn't put up much resistance or educate them about better options, as I recall. None that I could see evidence of, anyway.

One way to reduce the level of violence in your prisons may be to empower people to learn and use the law and civil discourse in a constructive manner to protect themselves from harm instead of reaching for a gun or a gang to alleviate their fears - the deepest of which no one here talks much about, which is rape. I haven't even begun to look at your PREA reports lately; is sexual assault and exploitation on the rise, too?

Many prisoners are waiting to hear back from me on issues related to their health and safety, Director Ryan; they write to me begging for their lives. Please get with your lawyers and get back with me soon. I need to know whether you have some rogue mailroom employees absconding with my mail, or if what I've written to your prisoners deserves to be suppressed because it's more dangerous than the conditions that you've cultivated and are now allowing to fester.

Thank you for your attention to this matter.


Margaret Plews

Again, no one but myself is responsible for the contents of this email or the attachments. Be aware that it and any response it gets (or doesn't get), is hardly going to be kept between us.
 

--------------------October 4, 2012 letter to the women of Perryville prison---------

October 4, 2012

Please read all the enclosed material carefully; I'm sending it to all the good addresses I have for women at Perryville. The Orange Gazette needs to do the bulk of the work from here, though. Spread my PO Box if nothing else, and I'll send whomever writes to me the same materials as long as I am able to. The enclosed are also posted at the Arizona Prison Watch blog, where your families can download the letter as well as info about how advocating for yourselves as prisoners, and mail it to you themselves.

If ever you were in a fight for your lives and real justice, it is now. It’s not just about you, either - you need to stand with the women suffering even more around you. I applaud those of you who have had the courage to do so already - facing certain reprisal. I know that if they don’t nail you now, they will once no one is looking at the prisons again.

I took your complaints and letters to the Sun City/ West Valley National Organization for Women last month, and their program committee is inviting me to come speak about Perryville’s conditions and the health care crisis for their November meeting. So for October I need to be kept up to date with what’s happening there - both in the way of improvements or deterioration of the situation for each of you individually and on your respective yards. If you have copies of grievances and responses you can send me, even better.

If you are willing to let me use your name and story publicly, please tell me - and be explicit if you would like me not to identify you as well… though don’t think your involvement in organizing with NOW will be a secret to the DOC if you write to me - they will no doubt be monitoring all of my correspondents, and their officers may repeatedly move you or search your cell to steal the evidence you accumulate against them. Your silence will not protect you either, though, as Audre Lourde once said. You each need to do what you have to do to survive your sentence, though. I respect that. You alone know what you can and can’t risk in there.

If you do correspond with me, please remember that I am not an attorney or a journalist - I’m just an artist and freelance writer in the community - a civilian doing my good deed before I leave this earth. Nothing you send me is privileged information, and I don’t know if the first amendment would protect my sources the way it does for the mainstream media. I sure don’t have a corporate legal team behind me to protect any of us if the state tries to harass or punish those of you courageous enough to correspond with me. But I need that information in order to get help in there to you, and it must be current and verifiable. If victims of and witnesses to abuse, neglect, and criminal activity by state or contract agents are willing to send signed statements you’ll swear by that I can publish and read aloud to the women from NOW, it would make the most impact.

Things often get worse before they get better when you are fighting people with this much power over your very right to survive. It may not even get better there before you leave - and some of you may die in the battle for women‘s rights. But the more of you who stand and speak out now, the safer it will be for others who come after you to keep up the fight, and really make a change from the inside out. You can’t count on the ACLU or the rest of us to rescue you - and we can’t do our part right without you.

So, you know where to find me. Be patient but persistent if I am slow to respond directly to your individual letters - I run out of ink and postage and have to juggle crises of varying magnitude. But I am listening, and I have friends out here who care about Perryville’s prisoners as well. So please, if you can, write to me.  Send me your poetry, too. And letters from your kids, if you want - these women need to know just who I am asking them to help and why - you need to be real people to them; touch them, please. They are willing to hear you.

Let me know if any of this is contrabanded. There are two other pieces of paper enclosed - one is an AZ Republic Article from last week, and the other is an email to Chuck Ryan from Donna Hamm, both reporting on what’s really up with this BS with Wexford Health.

In Solidarity,

Peggy Plews

-----update of October 2 2012 letter about health care rights----

REVISED October 15, 2012

AZ State Prisoners:

Sending the following letter to you is not Donna Hamm's doing – it's mine alone. Many of you will need this information for evidence and to guide your discovery for more if you (or, in the case of your death, your family) decide to file a lawsuit about your rights being violated. If you go that route, you also need an attorney – not me.

That said, please don't go threatening to sue your nurses and doctors or accuse them of criminality or complicity – save the posturing for others to do. That just pisses the wrong people off while you still have no power and need their help. This guy D'Antonio proves there are still some good people in the mix, so look for them and tell me who they are when you find them, just like you tell me about the bad guys. Don't chase the good ones away.

Even if you think following the rules of engagement with the DOC will yield nothing, you must file HNR's about your specific health care needs or complaints according to policy, which you need to ask to see if you didn't get a copy from me – don't take some guard's word for it. If the response to the HNR is unsatisfactory, don't just call home to get them to call Central Office or file another HNR asking the same thing a different way: they will appease and stall family and you will just lose your rights thinking you are getting action that way.

Follow the grievance process all the way to the top, or you stand no chance in hell if you ever take any of these people to court to sue for your constitutional rights. Follow the rule of law to the letter on this matter, or you will lose your civil case even if the DOC and Wexford cause you to lose your sight or legs, or ultimately your life. Make sure your grievances reflect what you anticipate you may have to fight for in court, too. If the grievance policy for health issues has changed since Wexford took over, get it in writing and get it out to me.

Please report to me any DOC officer or health care employee who obstructs your attempts to file any informal resolution or grievances, or anyone up the chain of command who doesn't respond in a timely fashion according to policy – I need names and dates and reasons for the grievance you attempted to file. Also report anyone to me who refuses to show you DOC policy that governs grievances and how you are able to access medical care. Just don't tell any of them you're reporting them, or you'll likely get punished for it one way or another. Assert yourselves appropriately, but keep your heads down and study up on your rights like mad – catch up with the SOBs later in court, once you know how to do it right.

Please remember that I am an artist and community activist – not an attorney. I don't know anything about the law except what I've taught myself while trying to help you folks figure it out. So, use the reference guides I send you and the resources below, and share them with others who need them too...

Donna is a former judge and a professional criminal justice consultant, and can help more with legal questions and strategy than I can, if you can afford to hire her. She's been doing this for 25 years.

Donna Leone Hamm

Middle Ground Prison Reform

139 E. Encanto Drive

Tempe, AZ 85281

Ask the ACLU-AZ for a copy of “Parsons' v Ryan” – the class action against the DOC for medical and psychiatric neglect and abuse of the mentally ill in solitary. Also file a complaint with them if you haven't already about your prison health care.

ACLU-AZ PO Box 17148, Phoenix, Az 85011

The National Lawyer's Guild will send you their complete Jailhouse Lawyer's Handbook if you send them $2 in stamps, check or money order. I can't print the whole thing up, but you need it like a bible for the duration of your sentence. Ask family to send for it (it must be mailed directly to you from the NLG), or write me if you have no one – I'll find a sponsor to order one for you.

National Lawyers Guild 132 Nassau Street, Rm 922 New York, NY 10038

Here is the address to the AZ Medical Board. Request each of their pamphlets and a complaint form – but again, don't tell Wexford or DOC what you're doing, just do it. Be prepared to document allegations well, though, or face real problems yourself.

Arizona Medical Board
9545 E. Doubletree Ranch Rd.
Scottsdale, AZ 85258

All of you need to stand together if you take these people on, don't leave it to one or two prisoners, or they'll get picked off like flies. You need to show each other solidarity, and be attentive witnesses to staff misconduct when it goes down. Write statements and have another witness them when you see things – just like the guards write incident reports - and always send copies of your statements and other evidence (HNRs, grievances, etc) out to someone you trust – preferably to the loved ones who will have standing to sue in federal court if you die from neglect. The DOC routinely ransacks cells to steal and destroy evidence against them. Just don't think you can engage in this without risks and retaliation – it may get worse before it gets better – it probably will, so study up.

Arizona Prison Watch, by the way, is just the blog I write – not an organization, per se. I have friends behind me, but not in high places – we're all pretty poor and hated by the authority in this state, no doubt. I am anti-capitalist and think the profit motive undermines human rights. I hate the drug war and the war on the poor, and the kind of mass incarceration we practice in this country has been used to destroy communities of resistance as well as liberation movements – I want to abolish the whole system and start over. I believe the prisons are the front lines in the battle to save our collective humanity. It's where the worst abuses occur because society has already exiled and silenced you for your crimes (and class, and race, and so on), and justified great harm to your lives. I don't want to live in a state that encourages cruelty and exploitation in my name, for my ”safety”. It's the public, not the prisons, I most want to reform. How we treat our prisoners is a reflection of our collective spiritual evolution, and I want this world to move forward.

So, I am here for as long as I am able, simply to serve as a counterbalance to the overwhelming power of the state to silence and oppress you, by giving you what tools I can to help you fight for yourselves, and amplifying your voice. That's basically my mission.

Be patient but persistent if we are working together on something – I''m swamped with correspondence. And take care of each other in there.

Peggy Plews

Arizona Prison Watch
PO Box 20494
Phoenix, AZ 85036


(this is all also part of that mailing. perhaps this is what they really fear will cause a riot...) 

October 2, 2012

Mr. Charles Ryan, Director
Arizona Department of Corrections1601 West Jefferson
Phoenix, Arizona  85007
 Dear Mr. Ryan:
 

Yesterday, Oct. 1, I received a telephone call from Dr. Lawrence D'Antonio, who works for a contractor who provides professional healthcare workers to Wexford.  As you know, Wexford, in turn, provides all medical care for prisoners within the Arizona Department of Corrections.  D'Antonio currently works at the Eyman Complex/Rynning.  He was originally supposed to work at Meadows, but now only works at Rynning. He says the Meadows Unit is a "lost cause."   If I understood him correctly, he believes there is no doctor currently assigned to Meadows Unit and that the Clinical Center there is essentially inoperative.  He has been a doctor (D.O.) for 27 years.  He has worked for the contractor who provides doctors to Wexford since about July 2012.

D'Antionio says that Dr. Tom Bell is the Statewide Medical Director employed by Wexford.  The Regional M.D. for Wexford is Dr. Hector F. Garcia.  He is Dr. Bell's boss.  Karen Grant is the Director of Nursing for Wexford.  D'Antonio refuses to converse with or take orders from Grant.  Grant was abusive, used obscenities with him, and was unprofessional during their initial conversation.  He believes that it is ironic that only current physican at the Eyman/Rynning Unit (D'Antonio) has no communication  with the Director of Nursing.  He has advised his own employer that either Wexford needs to obtain someone other than Grant for him to communicate with or he will not work there at all.

He says "personnel (medical) are leaving in droves."  Grant was ordering him to do things outside his training and outside of his expertise.  She was ordering him to see patients who needed specialists; he is not a specialist.  He says that Dr Bell ordered  that certain medications are to be stopped for some inmates.  When asked why the medications were to be stopped, Bell stated, "Because they are prisoners."  He asked Bell, "Is this your own medical decison-making?"  Bell replied, "This comes from Wexford."

Karen Grant has ordered D'Antonio to write prescriptions en masse for patients whom he has not seen.  He refused to do so, stating that in most cases he needs to see each patient individually before he can prescribe a medication.  He says Wexford is sabotaging everything by doing such things as excessive questioning of the doctor ("for more information") when he prescribes a medication.  When he makes a referral for a patient to have a procedure, obtain a specialist's opinion, have additional testing, etc., Wexford has a procedure which they call a "collegial" conference call.  Their staff get on a conference call and the vast majority of the time, they delay the additional procedure by requesting "additional information" from the referring doctor.  This goes on and on, back and forth, so that the procedure itself never gets done or is so delayed as to be meaningless (or dangerous) for the patient.

He says that he was told that all prior referrals (for specialists, tests, etc.) made by DOC healthcare workers prior to July 1, when Wexford took over, are cancelled, and will not be honored.  Instead, the inmate is required to go through the referral process all over again, thus further delaying what might be life-saving diagnostic testing.  D'Antonio says that many of the referrals are "shelved" and continuously cycled through the "get more information" process over and over.

D'Antonio refers to the mistakes and unethical conduct going on by Wexford employees as "staggering" and "criminal."  He says that while he does not consider himself to be soft on crime or criminals, "they are human beings and deserving of basic medical care."  He has restricted his exposure to liability for the type of care being provided to inmates by limiting the days he will work, the hours he works, and the units at which he will work.  He says what is happening at the Meadows Unit and throughout the Florence prisons is a "disgrace."

The doctor says that there are such people as what doctors refer to as "hatchet" doctors or "administrative" doctors -- they work for a corporation and have given up their ethics (and oath) to 'do no harm' by accepting a huge paycheck just to go along with corporate policies and directions.  D'Antonio says there are doctors (or nurses) such as this that work for Wexford.

He says that each time he sees a patient, he must fill out a progress note.  This is a form.  When he orders lab work, an x-ray or a prescription, each requires a separate form.  At the Meadows Unit, it was nearly impossible to find the forms needed, thus delaying and complicating the already dysfunctional process.  He says chart work is ignored and there is no review process.  He was originally hired just to do induction physical exams for incoming (new) prisoners, but that he has ended up doing everything from emergency care, chronic care, diagnostics, etc. and that they are so back-logged in reviewing charts that there is no reasonable way that each patient's chart can be reviewed in a timely manner.

He states that he has been told by Wexford employees that, "We are forbidden from talking about what happens here. . ." and that he has been advised, "Prisoners have died at the Meadows Unit due to lack of care since Wexford took over . . . ." (He was unable to provide me any names or DOC #'s of inmates who have allegedly died at Meadows Unit due to lack of medical care since Wexford took over on July 1, 2012).

He says that the Wexford formulary for approved medication is "archaic." He gave an example of the medication that Wexford has approved for hay fever.  (I can't spell it).  He says this was a medication that was being phased out in the 1980's (it was a medication that he would have taken as a child)  -- and that the standard of care in today's world for allergies is an antihistamine and/or a nasal steroid spray.  He says Wexford approves a salt water/ocean spray which is so outdated, it is laughable.  So, when he writes a prescription for a timely/updated drug (a "non-formulary" drug), Wexford can't fill it (won't fill it) because it isn't in their formulary.  So, there is a huge delay for the patient in obtaining non-formulary medication, and the formulary list itself is actually responsible for delay after delay after delay for patients to obtain a prescribed medication, including for serious medical problems.  He states that Wexford would likely claim that their formulary medications are "great" and "adequate," but many of their medications are simply not used anymore in today's real world of medicine in the USA.

He says he works a 12-hour day with no breaks and he even eats lunch while charting.  He works the hours by choice in order to get in his weekly hours in as short a time as possible to get out of there as quickly as possible.  But the workload is so far behind, it would require a full team of doctors to get caught up and would take a year.

He is concerned because many of the inmates are complaining they are not getting enough food and the doctor is concerned about the weight loss he has actually observed.  His says he has heard comments from many people that the real reason for the recent riots/disturbances at Tucson and Rynning is because of an underlying tension or stress among the inmate population due to (1) not enough food; (2) being denied medical care.  The DOC explained the reason for the riots to the media as "racial disturbances."

Dr. D'Antonio has openly discussed with Dr. Bell his concern that Dr. Bell could have a work-related breakdown over his job.  He is deeply concerned about Dr. Bell's mental well-being and feels it is possible that Dr. Bell may become "overwhelmed" by his job duties as Medical Director.  D'Antonio believes the various relevant Arizona professional medical boards and nursing board should immediately become deeply involved and investigate what is happening.  The Hippocratic Oath:  Do no harm -- is being violated directly.   He says he is witnessing "outrageous" medical neglect and actions contributing to such neglect by staff.

When a patient is referred for an outside professional test, procedure or consultation, the referral goes to the Wexford "collegial board."  He has asked, "What happens if it (the referral) is denied?"  Dr. Bell told him, "Well, it goes back to the referring doctor."  D'Antonio said, "Well, what happens if I refer the same patient a second time for the same procedure because I obviously believe he needs it?"  Bell replied, "Well, then we fire you because you keep making referrals."

He says many doctors and nurses have quit.  About 9-10 doctors have quit between the Florence and Eyman Complexes.  Describing the situation as "under-manned" or "under-staffed" is a diversionary term by Wexford.  The doctors who quit need to come forward to explain the reasons why they quit.  The under-manned situation is a result of the very problematic things that are happening.

D'Antonio says that what is happening in the Department of Corrections with respect to inmate medical care is "nothing short of outrageous."

He will agree to an interview with the media or with the ADC Director, but will only do face-to-face.  He lives in Tucson.

Mr. Ryan, on September 5, 2012, I wrote you an email expressing my concerns about the care being afforded to inmates by Wexford, and wondered why the company did not seem to be attempting to especially impress the Department during the early stages of their multi-million dollar, multi-year state contract.  You did not respond to this email.  It now appears as though Wexford sees the ADC as a cash cow for corporate profits at the expense of the very care they supposedly are contractually, legally, morally, and medically committed to providing.  This cannot be permitted to continue, and corporate assurances of corrective action are fundamentally insufficient as a response to the level, nature, and depth of the issues that now are emerging as a result of the outsourcing of inmate medical care to Wexford.

Just prior to the Sept. 5th email, I had notified you of a Wexford nurse who had ordered a female inmate to lick a powdered prescription medication from her own hand after the nurse had poured it into the hand.  The inmate protested because of the unprofessional and unorthodox method of medication administration and ended up with a disciplinary sanction and movement to another yard.  It is unknown if the nurse was sanctioned or terminated, but you did advise me that Wexford had "retrained" their nurses in the proper method of distribution of medication.

Now, with the above serious information as provided to me, I have no choice but to contact the relevant Medical and Nursing Boards of the State of Arizona.  Human lives are at stake.

While we appreciate the recent well-written noncompliance letter from Joseph Profiri, that letter does not go far enough.  For example, there is no mention that families can't get in touch with or recieve call back response from Wexford about their loved one's medical care.  Families repeatedly complain to me that Wexford's "hot line" is completely non-responsive.

Sincerely,

Donna Leone Hamm, Judge (Ret.)
Executive Director
Middle Ground Prison Reform

----------------EMAIL #2----------------

October 5, 2012

Mr. Charles Ryan, Director

Arizona Department of Corrections

1601 West Jefferson

Phoenix, Arizona  85007

Re:  EMERGENCY ACTION NECESSARY

Dear Mr. Ryan:

It is my understanding, based on information coming directly from Dr. Lawrence D'Antonio, that Dr. D'Antonio was escorted off the Rynning Unit by the Deputy Warden of the Unit and a security officer, after my recent email to you had been (apparently) forwarded to Wexford.  This is apparently the procedure applied toward whistle-blowers by Wexford.

It is also my understanding that Karen (or Caryn) Grant, Director of Nursing, resigned very recently (since my email to you).  I don't know if her resignation is connected to the fact that when I filed a complaint against her with the Arizona Nursing Board, they advised me that there is no "Karen Grant" who is licensed to practice nursing in the State of Arizona at this time, but that a "Karen Grant" was licensed up until 1991.  I believe that impersonating a nurse is a felony in Arizona.
 
Meanwhile, I have learned some additional very disturbing information from Dr. D'Antionio which, if verified as correct, amounts to an EMERGENCY situation.  The following information cannot simply be passed along to the "appropriate personnel" as you advised about my previous email.  Each and every prisoner who is incarcerated in the state Department of Corrections is entrusted to your department's care and custody, and you and your Department are ultimately responsible for their care, welfare and safety, which -- of course -- includes providing the community standard of care for serious medical needs.
 
During the time he worked at the Rynning Unit, Dr. D'Antonio personally observed that some inmates are given incorrect medications.  He also observed that some inmates are receiving medications which are contraindicated for other conditions that they have (for example; no inmate who is a diabetic should take a beta-blocker, etc.).  Some combinations are drugs which have the potential for being lethal.   He also observed that some inmates are being given double doses of prescribed medication, each dosage from a different manufacturer with a different name.  Once again, in some cases, the double dose could be fatal or seriously debilitating.  He reported to me that he advised Dr. Tom Bell of his observations, and Bell essentially shrugged him off and did not seem to grasp the import of D'Antonio's concerns.  As Dr. Bell had previously stated, "They are just prisoners."

Because you now are in possession of the above information as related to me by a licensed doctor in the state of Arizona and based upon his own personal observation, I believe that you are obligated to order an immediate audit/investigation of ALL inmate medical files for inmates housed at the Rynning Unit.  The investigation must be conducted by an independent qualified doctor or doctors who are not connected to Wexford or to the Department of Corrections in any manner.  Wexford should pay for the audit/investigation.  Other units should be audited as well because there is no reason to believe that these egregious mistakes are isolated to the Rynning Unit only.

Again, it is insufficient to simply pass this message along to Wexford. This potentially dangerous and/or lethal information must be addressed at once and I expect to receive a report of the findings in a timely manner.  A report that addresses these issues would not have to reveal HIPPA protected information because a code number could be assigned to each case.  It is imperative, however, that any incorrect medications, double-dose medications or contraindicated medications must be identified at once; hopefully, prior to an emergency situation induced by deliberate indifference or by gross negligence.

Please advise.

Donna Leone Hamm, Judge (Ret.)
Criminal Justice Consultant
Executive Director
Middle Ground Prison Reform
(480) 966-8116 (or contact James Hamm at (602) 339-0176
MIDDLE GROUND HAS BEEN ARIZONA'S PREMIER ADVOCACY ORGANIZATION PROTECTING THE RIGHTS OF THE INCARCERATED SINCE 1983