DENYING deliberate indifference: DOC/ACLU settlement reached, RYAN denies wrongdoing...

 EDITED OCT 14, 2014 3:48pm

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

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


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

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

Say what??? No way!!!

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

----------

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

For Immediate Release
October 14, 2014

CONTACT:

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

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

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

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

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

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

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

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

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

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

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

For more information about Parsons v. Ryan:

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

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

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

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

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

ARIZONA DEPARTMENT OF CORRECTIONS

1601 W. JEFFERSON

PHOENIX, ARIZONA 85007

(602) 542-3133

www.azcorrections.gov    

JANICE K. BREWER                                                  CHARLES L. RYAN GOVERNOR                                                                            DIRECTOR

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

Tuesday, October 14, 2014

Parties reach settlement agreement

and seek to vacate Parsons v. Ryan trial

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

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

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

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

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

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

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

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

ACLU-AZ on Parsons v Ryan: 9th Circuit affirms AZ DOC prisoner class action may proceed.

FOR IMMEDIATE RELEASE

Thursday, June 5, 2014

CONTACT:
Alexandra Ringe, ACLU National, 212-549-2666, media@aclu.org
Steve Kilar, ACLU of Arizona, 602-492-8540, skilar@acluaz.org
Don Specter, Prison Law Office, 510-280-2621, dspecter@prisonlaw.com

 

33,000 Arizona Prisoners Now Can Sue State Over Health Care, Solitary Confinement

 

SAN FRANCISCO – Today the U.S. Court of Appeals for the Ninth Circuit unanimously ruled that the American Civil Liberties Union (ACLU), ACLU of Arizona and the Prison Law Office can move forward with a lawsuit against the state of Arizona on behalf of all 33,000 prisoners in the state’s 10 prisons and all future prisoners. The ruling is critical to obtaining necessary systemic changes to conditions of confinement in the Arizona Department of Correction (ADC), and is a key victory for civil rights plaintiffs throughout the country.

"The State of Arizona has long ignored the basic needs of people confined in its prisons, including the constitutional mandate to provide adequate health care. Prisoners have suffered unnecessarily and even died while waiting for basic care," said David Fathi, Director of the National Prison Project at the ACLU, who argued the case for the prisoners in the Court of Appeals. "This ruling brings us closer to requiring the executive and legislative branches to end their neglect and indifference once and for all."

The groups filed the federal lawsuit in 2012, challenging years of inattention to the health needs of state prisoners and improper and excessive use of solitary confinement, resulting in serious harms and unnecessary deaths. Judge Neil V. Wake of the U.S. District Court in Phoenix certified the case as a class action in March 2013; today’s decision affirms that ruling.

The Court of Appeals listed failing to hire enough medical staff, failing to fill prescriptions, denying inmates access to medical specialists, adopting a de facto “extraction only” policy for dental issues, and depriving suicidal and mentally ill inmates access to basic mental health care.

The Court allowed the ACLU and the Prison Law Office to represent the prison population in Arizona as a class because all the prisoners shared a common interest in not being subjected to a "substantial risk of serious harm resulting from exposure to the [ADC’s] policies and practices governing health care." "The Court rejected the state’s arguments that the prisoners don’t have enough in common to warrant class action status, adding that the state had a "fundamental misunderstanding" of the law:

“[G]iven that every inmate in ADC custody is likely to require medical, mental health, and dental care, each of the named plaintiffs is similarly positioned to all other ADC inmates with respect to a substantial risk of serious harm resulting from exposure to the defendants’ policies and practices governing health care.”

In addition to seeking adequate medical, mental health, and dental care for Arizona’s prisoners, the lawsuit challenges the state prisons’ use of solitary confinement.

"Among our plaintiffs are the seriously mentally ill and other prisoners whose mental health has markedly deteriorated in solitary confinement – weeks, months, sometimes years of extreme isolation and sensory deprivation," said Don Specter, Director of the Prison Law Office. "Sometimes the damage is permanent. Arizona must stop this cruel and unusual punishment."

The case, Parsons v. Ryan, is scheduled to go to trial in October 2014.

In addition to the ACLU and the Prison Law Office, other attorneys on the case are Perkins Coie LLP, Jones Day, and the Arizona Center for Disability Law.

Click here to read the Ninth Circuit opinion.

Click here to learn more about Parsons v. Ryan.

AZDOC: Violent prisoners or violent places?

The following article gives us a good starting point for discussing the increase in prison violence in AZ. It's authored by the director of the Prison Law Office in California, which is one of the entities suing the AZ DOC right now for gross medical neglect and the abuse of the mentally ill in solitary confinement (see  Parsons v Ryan)

 I've been getting a lot of mail lately from prisoners fleeing gang violence at the AZ Department of Corrections - the gangs appear to control the mileu on virtually all medium and close custody yards these days, and it's unclear just what the DOC is doing about it, short of punishing those who are speaking out against it. The detention units are full of prisoners seeking protective custody for fear of being hurt or killed, rather than being full of those who are assaulting and extorting them. Maximum security cells are also filling with low-risk prisoners who are being repeatedly ticketed for "refusal to house" - which means they are too afraid to enter general population yard. That jacks up their security score and custody/classification. 

Chad, here, a non-violent burglar who is now treated as a maximum security risk, is just one example of who we're building that new Supermax for - NOT the "worst of the worst", as the DOC would have everyone believe. It's being built because Charles Ryan's crew ceded total control to the gangs, and prisoners are intentionally getting ticketed to get maxed out - losing all their good time in the process - just to find a safe place in the system to finish their sentences. That or they're assaulting other prisoners who get too close to them simply because they are so afraid that they will be hurt first. Then there are those who kill themselves to avoid what they fear is a worse fate.

The AZ DOC wants us to believe that the prisons are just getting more violent people committed these days - but their own data shows only a fractional increase in prisoners committed for violent offenses over the past few years, which may well be because there's an increase in repeat offenders coming through as well. That's just another sign, in addition to the violence, that the DOC has been failing at its rehabilitative mission as well as it's duty to protect the public - all that's happening now is that vulnerable people are being thrown in with the real bad guys to give them a little target practice until they come home to act out their rage on the rest of us. Something really needs to change in the way Arizona is running its prisons...

 Community mural remembering the victims of prison violence, 

neglect and abuse at the AZ Department of Corrections.

Firehouse Gallery (June 2012).

Making Prisons Safe: Strategies for Reducing Violence

Donald Specter

Journal of Law & Policy 2006 (Vol. 22:125)

This article is based on testimony to the Commission on Safety and Abuse in America’s Prisons, April 2005. Donald Specter, J.D. is the Director of the Prison Law Office, a nonprofit public interest law firm located near San Francisco, California. The Prison Law Office provides free legal services to California state prisoners related to the conditions of their confinement. During the past thirty years the office has successfully sued California adult and juvenile facilities over virtually all prison conditions, many of which directly relate to the safety of prisoners, the excessive use of force, and the state’s response to prison gangs. More information about these cases is available at the Prison Law Office website. See Prison Law Office, http://www.prisonlaw.com (last visited July 8, 2006).

INTRODUCTION

Most people assume that prisons are dangerous because they house violent convicts. In California, for example, the union representing prison guards emphasizes the danger by calling the job “the toughest beat in the state.”1 Yet, in the last twenty years in only one California prison guard has been killed by a prisoner, but hundreds of prisoners have died from medical neglect, suicide, or guard brutality. Prisons are dangerous, but they are far more dangerous than they need to be.

If prison administrators provide humane conditions and require strict adherence to commonly accepted and nationally recognized techniques for regulating the unnecessary use of force, prisons can be reasonably safe for both prisoners and staff. Although the threat posed by gangs presents special problems, the traditional approach to correctional safety—suppression and isolation—has not been successful. The experiences of some innovative programs around the country, as  discussed below, suggests the success of a radically different approach: closely monitored integration coupled with incentives and tools to help prisoners leave the gangs.

THE CAUSE AND CONTROL OF PRISON VIOLENCE

The Supreme Court recently stated that “[p]risons are dangerous places.”2 The Court implied that prisons are dangerous because prisoners are violent.3 Some prisoners are violent and will be violent no matter what the circumstances, but the degree of institutional violence is not dependent on the prisoners. It is a direct product of prison conditions and how the state operates its prisons.

American prisons promote violence and abuse by their design and operation. The anti-social nature of the prisoners themselves is not solely responsible for violent and abusive behavior. In the Stanford Prison Experiment otherwise psychologically healthy, normal Stanford college students changed dramatically after spending six days as guards and prisoners in a mock prison.4 The “prisoners” began to perceive each other as the guards perceived them and progressively expressed more frequent intentions to harm others: The guards, too—who also had been carefully chosen on the basis of their normal-average scores on a variety of personality measures—quickly internalized their randomly assigned role.

Many of these seemingly gentle and caring young men, some of whom had described themselves as pacifists or Vietnam War “doves,” soon began mistreating their peers and were indifferent to the obvious suffering that their actions produced. Several of them devised sadistically inventive ways to harass and degrade the prisoners, and none of the less actively cruel mock-guards ever intervened or complained about the abuses they witnessed.5

The conclusions of this experiment have profound implications for the control of violence in our prisons: The negative, anti-social reactions observed were not the product of an environment created by combining a collection of deviant personalities, but rather the result of an intrinsically pathological situation which could distort and rechannel the behaviour of essentially normal individuals. The abnormality here resided in the psychological nature of the situation and not in those who passed through it.6 In other words, the Stanford Prison Experiment teaches that prisons, as an institution, tend to promote aggressive and violent behavior by correctional personnel.7

The state is responsible for controlling that type of behavior. The elements necessary to control the use of force in prisons are well known. To prevent abuse, the use of force must be controlled through (1) clear policies; (2) meaningful and constant supervision of all uses of force; (3) timely and truthful reporting of all uses of force by the officer involved and anyone who witnessed the incident; (4) an accurate and unbiased investigation into allegations of excessive force; and (5) the consistent imposition of progressive and proportional discipline when excessive force is used or when it is not reported.8 A breakdown in any one of these components will inevitably lead to abuse.9

Unfortunately, it is not uncommon for correctional supervisors to lose control over the use of force, resulting in abuse. Abu Ghraib,10 Pelican Bay State Prison in California,11 the entire prison system of Texas,12 and Rikers Island in New York City13 are prime examples of prisons that became more dangerous not because of the prisoners, but because of management breakdowns that let guards mistreat and dehumanize their captives.

The abuse at Abu Ghraib is especially important to consider because two factors distinguish it from other situations. Like the Stanford Prison Experiment, and unlike maximum security prisons where prisoners are considered extremely dangerous, in Abu Ghraib there was no public suggestion that the prisoners were especially threatening or that their conduct caused the guards to act abusively. This is a clear demonstration that the situation, rather than the prisoners themselves, was responsible for the guards’ misconduct.

The United States Army’s investigation into the abuses at Abu Ghraib revealed another factor that can cause an institution to spiral out of control: the injection of an external rationale for mistreatment.14 In addition to finding the usual management breakdowns in the control of force the Army investigators also recognized that the “war on terror” and the corresponding need to obtain intelligence were perceived by the soldiers at Abu Ghraib as a license to exceed the bounds of sanctioned conduct.15

A similar license was granted to guards in California that led to even more serious abuse, often causing permanent injury and death. At Pelican Bay, guards were led to believe that extreme force was justified by the need to punish and control the “worst of the worst.”16 As soon as the prison opened, officials let the guards know that the standard rules of conduct would not apply at Pelican Bay. What followed were not only individual instances of brutality, but a deliberate practice of using violence and pain to control prisoners’ behavior.17

Ruling on a constitutional challenge to the excessive use of force at Pelican Bay, the Federal District Court for the Northern District of California catalogued unnecessary and excessively violent cell-extractions, hog-tying of prisoners, caging of naked prisoners outside for long periods of time in cold and rainy weather, and staff beatings of prisoners.18 It concluded that violence was used by staff “not only in good faith efforts to restore and maintain order, but also for the very purpose of inflicting punishment and pain.”19

This attitude pervaded other California maximum security prisons as well. In the mid-1990s California was confronted with the gruesome spectacle of guards in the Security Housing Unit at Corcoran State Prison purposefully releasing rival gang members in small exercise yards and betting on which of the “gladiators” would be victorious.20 And in 2004 a videotape showed “counselors” at the California Youth Authority’s maximum security prison mercilessly beating wards as they lay passively on the day room floor.21

These and other scandals that have plagued California’s prison system for the last fifteen years were not hidden, nor were they accidents. They were known and tolerated by high-level correctional administrators who showed complete indifference to the lives and well-being of prisoners. Their utter failure to strictly and appropriately regulate the use of force in a manner consistent with nationally recognized principles of correctional administration was responsible for untold suffering.

The regulation of force is, by itself, insufficient to prevent abuse. Prison conditions can and do breed violence. Many prisoners have committed violent crimes, and many suffer from mental illnesses that inhibit their ability to control their own behavior.22 When such inmates are placed together in overcrowded, antiquated facilities with inadequate mental health services and nothing constructive to do violence is inevitable.23

The California Inspector General made clear the connection between conditions and violence when he found that deplorable conditions and poor management practices contributed to the murder of a correctional officer at the California Institution for Men.24 The Inspector General found that the prison violated basic classification procedures by permitting the prisoner, who was incarcerated for attempting to kill a police officer and had a history of recent and serious assaultive behavior, to remain in the general population.25 Poor maintenance and tool control procedures permitted prisoners to obtain and conceal weapons.26 The victim failed to follow specific security directives initiated after a race riot, the stabbing of a prisoner, and the discovery of weapons in the same unit.27 Additionally, the warden and her subordinate supervisory staff failed to ensure compliance with those directives.28 Finally, nobody addressed the prisoner’s clearly identified need for immediate mental health treatment.29

The Inspector General’s findings express in detail what is common sense to most correctional administrators: well-run prisons are relatively safe, while those that are poorly managed are not. The control of violence, therefore, depends not only on executing accepted policies for regulating the use and supervision of force, but also on the overall management of the facility. All of the prison’s operations, including mental health care, must be integrated and functioning properly if prisons are to perform their primary purpose of incarceration and not subject their inhabitants—both prisoners and officers—to an unacceptable risk of injury or death.

GANG PREVENTION

The problem of gang-related violence in America’s prisons is both well known and well documented. Both prison and street gangs are reportedly responsible for drugs, violence, and intimidation within prison walls.30 The traditional prison response to gang behavior is suppression and isolation. Gang members are forced to spend long, indefinite terms in segregated housing units in maximum or super maximum (supermax) security prisons and their misconduct is often
targeted for administrative or criminal prosecution.

While the success of these strategies in reducing violence is uncertain, it is clear that they have not succeeded in eliminating gangs or their influence. It is commonly understood that, while locked in segregation, gang leaders continue to control the illegal activities of their members both within the prison and in the outside community. Perhaps the most graphic example of this is the fact that several California prison gang leaders are now facing the death penalty for federal criminal charges arising from their activities while imprisoned in the Security Housing Unit (SHU) at Pelican Bay, a supermax facility.31

Prisoners in restricted units such as Pelican Bay’s SHU are not provided any form of meaningful recreation, education, vocational training, or rehabilitative services.32 They are left in their cells every day for up to twenty-three hours, with the remaining hour being spent either alone or with their cellmate in a small enclosed space that approximates a dog run.33 In this environment normal social relationships are impossible and these inmates are left to associate with other gang members. It is not surprising, therefore, that they will continue to perpetuate the gang and its activities; they have nothing else to do.

Recently, some correctional systems have developed successful programs that use the opposite approach. Instead of using extreme forms of isolation these programs actively promote integration. Their aim is to reintegrate the gang member into the general prison population. In the few programs that take this approach, the strategy has proven surprisingly successful. 

These programs—utilized in Connecticut,34 Missouri’s Division of Youth Services,35 and the Pelican Bay Transitional Housing Unit36—have several things in common. First, they create housing units that are relatively small, consisting of between fifteen and twenty prisoners. Second, the adult programs allow the prisoner to choose to participate, although one program conditions that choice on the decision to inform against his former gang. Third, they create a set of expectations that include mandatory integration with prisoners of other races and gangs, and a very low tolerance of misbehavior. Fourth, prisoners are given extensive orientation about these expectations. Fifth, prisoners are provided with counseling services to help them control anger and violence and foster healthy relationships.

These services come in the form of formal group sessions, but also informally through guidance provided by specially selected staff in the units. Finally, prisoners are provided with real and substantial incentives to complete the program. This may include contact visits with their family, jobs and a safe environment when they return to the general population.

The success rate in each of these three programs is reportedly very high. Connecticut and Missouri report that the recidivism rate of gang members is under 10%.37 In California, prison officials report that only 5% of prisoners fail to complete the program, the recidivism rate sent back to segregation for gang-related activities.38 These successful programs place the prisoner or ward in a culture where violence is not “business as usual” and provide them with the tools they need to succeed. They prove to prisoners who have never had a meaningful conversation with a rival gang member or a prisoner of another race that they can live a different, less violent, and more meaningful life. Instead of creating a culture of suppression and isolation, they provide a transition to a more normal way of life, even if it is limited to the confines of the prison. Given time and help, the prisoners adapt to this culture and recognize its value.

These promising programs should be studied, evaluated, and replicated. They offer positive alternatives to the traditional reaction to prison gangs. It is an approach that uses the institution of a prison to create positive change rather than to promote further violence.

CONCLUSION 

It is easy to blame prisoners for prison violence. But, the lessons of the last few decades of court intervention and academic research have demonstrated that the amount of violence in a prison is a function of its culture, the effectiveness of its management, and, at times, the political reality that excuses the mistreatment of prisoners. No prison illustrated this better than Pelican Bay in the early 1990s. It suffered from an administration that condoned and perpetuated violence, it opened at a time when being tough on crime meant brutalizing prisoners and there was no effective management of the prison. The violence in that institution has largely subsided through better management required by intensive court intervention, and promising inroads have been made into gang membership through the Transitional Housing Unit program, demonstrating clearly that it is not the prisoners but the prison as an institution that is the key to safety in correctional facilities.

Footnotes:

1. See California Correctional Peace Officers Association, http://www.CCPOA.org (last visited July 8, 2006).

2. Johnson v. California, 543 U.S. 499, 515 (2005).

3. Id. Threats to the safety of prisoners also spring from other, less obvious sources. In our experience, the single biggest threat to prisoners’ lives is the absence of adequate and appropriate health care. Neglect and malpractice kills more prisoners than do guards or other prisoners. Although difficult to quantify, death and serious injury due to medical neglect, preventable suicides, and mental decompensation far exceeds the harm caused by the more overt uses of force. For example, in 2003 only fourteen California prisoners were killed by other prisoners or staff. CALIFORNIA DEPARTMENT OF CORRECTIONS, INMATE INCIDENTS IN INSTITUTIONS: CALENDAR YEAR 2003, at 15 (2004), available at http://www.cdcr.ca.gov/ReportsResearch/OffenderInfoServices/Annual/Beh1Archive.html (follow “December 2003”hyperlink). In a recent independent review of 193 recent deaths in California’s prisons, court-appointed medical experts found eleven cases of terrible medical care in 2003. A review by a court appointed special master of suicides within California’s prisons in 2003 found that out of thirty five suicides, twenty-five (74%) received inadequate treatment and were foreseeable or preventable. Coleman v. Wilson, Special Master’s Report on Suicides Committed in the California Department of Corrections in Calendar Year 2003, at 8 (2004). Therefore, although it is beyond the scope of this presentation, any analysis of safety failures and abuse must consider the effects of ineffective prison health care systems.

4. Craig Haney & Philip Zimbardo, The Past and Future of U.S. Prison Policy, 53 AM. PSYCHOLOGIST 709 (1998).

5. Id. at 709.

6. Id. at 710 (citation omitted).

7. Craig Haney et al., Interpersonal Dynamics in a Simulated Prison, 1 INT’L J. CRIMINOLOGY & PENOLOGY 69, 93–94 (1973).

8. See, e.g., Madrid v. Gomez, 889 F. Supp. 1146, 1199 (N.D. Cal. 1995), rev’d and remanded by 150 F.3d 1030 (9th Cir. 1998); U.S. ARMY SPECIAL REPORT, INVESTIGATION OF INTELLIGENCE ACTIVITIES AT ABU GHRAIB 2–5 (2004), available at http://www4.army.mil/ocpa/reports/ar15-6/ar15-6.pdf (citing lack of effective leadership, ambiguous policies, inadequate resources, and ineffective supervision and discipline as reasons for the abuses).

9. This was proven true in California by the special master appointed by the federal court to monitor the conditions at Pelican Bay who conducted an inquiry into the code of silence within the California Department of Corrections. Madrid v. Gomez, Special Master’s Report Re Department of Corrections “Post Powers” Investigations and Employee Discipline (Jan. 15, 2004). The inquiry arose from the decision of the director of the Department of Corrections to terminate the investigation of perjury by several correctional officers in a federal civil rights trial for excessive force against prisoners. The special master concluded, A minority of rogue officers can establish a code of silence, threaten the majority, damage cars, isolate uncooperative co-workers, and create an overall atmosphere of deceit and corruption. And if the minority are supported by a powerful labor organization, and the union as well as management condones the code of silence, the consequences are severe. Id. at 99.

10. See, e.g., U.S. ARMY SPECIAL REPORT, supra note 8.

11. See Madrid, 889 F. Supp. 1146.

12. See Ruiz v. Estelle, 503 F. Supp. 1265, 1302 (S.D. Tex. 1980).

13. See Fisher v. Koehler, 692 F. Supp. 1519 (S.D.N.Y. 1988).

14. U.S. ARMY SPECIAL REPORT, supra note 9, at 5.

15. The army acknowledged this problem in typical bureaucratic and understated fashion: “Demands on the Human Intelligence (HUMINT) capabilities in a counterinsurgency and in the future joint operational environment will continue to tax tactical and strategic assets.” Id. at 6.

16. Madrid, 889 F. Supp. at 1155.

17. In one instance, guards placed an African American mentally ill prisoner in a bathtub so hot that it caused third-degree burns and made his skin peel off parts of his body and hang in large clumps around his legs, which had turned white. Id. at 1166–67. This was in retaliation for the man biting a guard one week earlier. Id. at 1166. A prison nurse overheard a guard remark, “[L]ooks like we’re going to have a white boy before this is through . . . .” Id. at 1167.

18. Id. at 1162–78.

19. Id. at 1200.

20. AMNESTY INT’L, CALIFORNIAN PRISONS: FAILURE TO PROTECT PRISONERS FROM ABUSE (2000), available at http://origin2.amnesty.org/library/Index/ENGAMR510792000? open&of=ENG-USA.

21. See S.F. Gate: Multimedia, http://www.sfgate.com/cgi-bin/object/article?o=0&f=/chronicle/archive/2004/04/02/BAGLV5VDLL1.DTL  (last visited Oct. 15, 2006).

22. A recent survey by the United States Department of Justice found that more than half of the nation’s state prisoners had a mental health problem. DORIS J. JAMES & LAUREN E. GLAZE, BUREAU OF JUSTICE STATISTICS, U.S. DEP’T OF JUSTICE, NCJ 213600, MENTAL HEALTH PROBLEMS OF PRISON AND JAIL INMATES 1 tbl.1 (2006). An older survey found that 16% of prisoners were mentally ill. PAULA M. DITTON, BUREAU OF JUSTICE STATISTICS, U.S. DEP’T OF JUSTICE, NCJ 174463, MENTAL HEALTH AND TREATMENT OF INMATES AND PROBATIONERS (1999).

23. For the connection between overcrowding and violence see, for example, KATHERINE BECKETT & THEODORE SASSON, THE POLITICS OF INJUSTICE 177 (2004); ALEXIS M. DURHAM, CRISIS AND REFORM: CURRENT ISSUES IN AMERICAN PUNISHMENT 48–49 (1994); CRAIG HANEY, REFORMING PUNISHMENT: PSYCHOLOGICAL LIMITS TO THE PAINS OF IMPRISONMENT 202, 205 (2005).

24. OFFICE OF THE INSPECTOR GEN., SPECIAL REVIEW INTO THE DEATH OF CORRECTIONAL OFFICER MANUEL A. GONZALEZ, JR. ON JANUARY 10, 2005 AT THE CALIFORNIA INSTITUTION FOR MEN 3–4 (2005), available at www.oig.ca.gov/reports/pdf/Review_03-17-05.pdf. The California Institution for Men is a large, overcrowded intake center located near Los Angeles. See California Institute for Men (CIM), http://www.cdcr.ca.gov/ Visitors/fac_prison_CIM.html (last visited July 8, 2006).

25. Id. at 16–17.

26. Id. at 37.

27. Id. at 5.

28. Id. at 19–24.

29. Id. at 79. The independent panel of experts appointed by the California State Board of Corrections also noted the “deplorable” conditions at the prison and the fact that the reception center was overcrowded and serving more prisoners than it could safely process. CAL. STATE BD. OF CORRS., INDEPENDENT OPERATIONS AND INCIDENT REVIEW PANEL ON THE CALIFORNIA INSTITUTIONS FOR MEN 12 (2005), available at http://www.bdcorr.ca.gov/special_reports/ operational_incident_review_cim/final%20report.pdf.

30. See, e.g., GEORGE F. COLE & CHRISTOPHER E. SMITH, CRIMINAL JUSTICE IN AMERICA (2005).

31. Press Release, Thom Mrozek, Pub. Affairs Officer, U.S. Attorney’s Office, Cent. Dist. of Cal., Racketeering Indictment Targets Aryan Brotherhood (Oct. 17, 2002), available at http://www.usdoj.gov/usao/cac/pr2002/152.html.

32. Madrid v. Gomez, 889 F. Supp. 1146, 1229 (N.D. Cal. 1995), rev’d and remanded by 150 F.3d 1030 (9th Cir. 1998).

33. Id.

34. See Connecticut Department of Correction, http://www.ct.gov/doc/ (follow “Recidivism” hyperlink) (describing Connecticut’s Gang Management Program).

35. See Missouri Division of Youth Services, http://www.dss.mo.gov/dys/ (last visited Oct. 15, 2006).

36. See Pelican Bay State Prison, http://www.cdcr.ca.gov/Visitors/fac_prison_PBSP.html (last visited Oct. 15, 2006).

37. Department of Correction, supra note 34. Recidivism in these states is measured differently. In Connecticut, the test is whether the prisoner is redesignated as a gang member.

Id. Missouri uses the more traditional measure of whether the person reoffends. 38. Telephone interview with Ted Roberts & Chris Hizer, Mgmt. Staff, Transitional Hous. Unit, Pelican Bay State Prison (Apr. 8, 2005).

38. Telephone interview with Mark Steward, former Dir. of Mo. Div. of Youth Servs., Mo. Dept. of Soc. Servs. (2004).

Prisoners file class-action suit against Arizona Department of Corrections

Arizona Department of Corrections - Central Office
Phoenix (November 22, 2011)

Please, families, tell your loved ones behind bars that help is really on the way. It's going to take a long time for anything to change through the courts, though, so you need to tell prisoners to be patient and "No more suicides!" At least have them write to me before they give up for good... 

--------from the National ACLU's website, at long last. Thanks to all the partners taking this state to task for their abuse and neglect of our most vulnerable prisoners-----

PHOENIX – Prisoners in the custody of the Arizona Department of Corrections receive such grossly inadequate medical, mental health and dental care that they are in grave danger of suffering serious and preventable injury, amputation, disfigurement and even death, according to a federal class-action lawsuit filed today by a legal team led by the American Civil Liberties Union and the Prison Law Office.

The lawsuit also charges that thousands of prisoners are routinely subjected to solitary confinement in windowless cells behind solid steel doors, in conditions of extreme social isolation and sensory deprivation, leading to serious physical and psychological harm. Some prisoners in solitary receive no outdoor exercise for months or years on end, and some receive only two meals a day.

“The prison conditions in Arizona are among the worst I’ve ever seen,” said Donald Specter, executive director of the Berkeley, Calif.-based Prison Law Office. “Prisoners have a constitutional right to receive adequate health care, and it is unconscionable for them to be left to suffer and die in the face of neglect and deliberate indifference.”

Specter was the lead counsel in Brown v. Plata, a similar case from California in which the Supreme Court last year reaffirmed that prisoners have a constitutional right to adequate health care.

“Courts have consistently ruled that solitary confinement of people with mental illness is unconstitutional because it aggravates their illness and prevents them from getting proper treatment,” said David Fathi, director of the ACLU National Prison Project. “Even for those with no prior history of mental illness, solitary confinement can inflict extraordinary suffering and lead to catastrophic psychiatric deterioration.”

Critically ill prisoners have begged prison officials for medical treatment, according to the lawsuit, only to be told to “be patient,” that “it’s all in your head,” or that they should “pray” to be cured. Arizona prison officials have repeatedly been warned by their own medical staff of the inadequacy of the care, echoing complaints from prisoner advocates and families that prisoners face a substantial risk of serious harm and death. Yet, they have failed to ensure that minimally adequate health care is provided as required by the Constitution.  

In one particularly tragic case, a prisoner at the state prison complex in Tucson died last year of untreated lung cancer that spread to his liver, lymph nodes and other major organs before prison officials even bothered to send him to a hospital. The prisoner, Ferdinand Dix, filed repeated health needs requests and presented numerous symptoms associated with lung cancer. His liver was infested with tumors and swelled to four times its normal size, pressing on other internal organs and impeding his ability to eat. Prison medical staff responded by telling him to drink energy shakes. He died in February 2011, days after finally being sent to a hospital but only after his abdomen was distended to the size of that of a full-term pregnant woman. A photograph of Dix shortly before his death appears in the lawsuit.

Jackie Thomas, one of the lawsuit’s named plaintiffs who is housed in solitary confinement at the state prison complex in Eyman, has suffered significant deterioration in his physical and mental health as a result of being held in isolation, where he has become suicidal and repeatedly harmed himself in other ways. Prison staff have failed to treat his mental illness, improperly starting and stopping psychotropic medications and repeatedly using ineffective medications that carry severe side effects. Last November, Thomas overdosed on medication but did not receive any medical care.

“Faced with such gross indifference on the part of prison officials to the needs of prisoners with mental illness in their care, it was essential we get involved,” said Jennifer Alewelt, staff attorney with the Arizona Center for Disability Law, one of the plaintiffs in the lawsuit. “Prisoners with mental illness can be particularly vulnerable, and we must do everything we can to ensure their mental health needs are met while incarcerated.”   

Filed in the U.S. District Court for the District of Arizona against Charles Ryan, director of the Arizona Department of Corrections, and Richard Pratt, the department’s interim director of the division of health services, the lawsuit asks, among other things, that constitutionally adequate health care be made available to prisoners, that medications be distributed to patients in a timely manner, and that prisoners not be held in isolation in conditions of social isolation and sensory deprivation that put them at risk of harm. The lawsuit does not seek monetary damages.

“Arizona has used the absence of transparency to callously ignore the basic needs of persons entrusted to its care, at times with deadly results,” said Daniel Pochoda, legal director of the ACLU of Arizona. “Absent court intervention the health and well-being of thousands of prisoners will continue to be sacrificed to economic expediency.”

According to the U.S. Bureau of Justice Statistics, Arizona has the sixth-highest incarceration rate in the nation.

Other attorneys on the case are Daniel C. Barr of Perkins Coie LLP and Caroline Mitchell of Jones Day.
A copy of the lawsuit is available here and here.

Women's health in prison: Breast Cancer Behind Bars

The following article was just published on Truthout by Vikki Law, author of "Resistance Behind Bars: The struggles of incarcerated women," and editor of Tenacious, a national zine written by and for women in prison.

In light of some of the distressed correspondence I've been receiving lately from women at Perryville prison complaining of serious medical neglect, I'll be making a point of researching and posting more on women's health in prison here in coming weeks.

In the meantime, for a first-person account on women's health care in Arizona state prisons, see Sue Ellen Allen's book "The slumber party from hell."

Thank you for this, Vikki. Can't wait for this state to finally be sued. What they've done to our people is criminal.

----from Truthout---

Breast Cancer Behind Bars: How a Prison Sentence Can Become a Death Sentence

Wednesday 25 January 2012

by: Victoria Law, Truthout

  .

Imagine finding a lump in your breast. Imagine that your efforts to schedule a medical check-up are stymied and you have to wait weeks, if not months, for that initial exam. In the meantime, the lump continues to grow. Imagine that, when you finally do see a doctor, you are told that you have breast cancer. When you walk out of the office, you are locked into your prison cell with no more information or sympathy than when you walked in. This is the daily reality for women in prison

In 2006, a Department of Justice (DOJ) study found that women in prison are at significantly greater risk for cancer than their male counterparts. Out of every 10,000 incarcerated women, 831 had cancer, compared to 108 per 10,000 men. Of those, 91 of every 10,000 women behind bars reported having had or currently having breast cancer. Given that 114,979 women were behind bars at the end of 2009, this would mean that over 1,000 women have had or currently have breast cancer. 

Despite these numbers, prevention, screening, diagnosis, care, pain alleviation and rehabilitation for breast cancer remain virtually nonexistent in prisons. In 1998, a study at an unnamed Southern prison found that, although many were at high risk because of family histories, women were not provided with a clinical breast exam, information or basic education on self-examination upon admittance. Seventy percent of women who should have had mammograms under standard medical procedure had never been tested. [Williams, Roma D, Terry D. Mahoney, and R. M. Williams, Jr, "Breast Cancer Detection Among Women Prisoners in the Southern United States," Family & Community Health 21.3 (1998): 32.]  Even women who enter prison already diagnosed with cancer must fight to receive lifesaving medical care.

Fifty-two-year-old Margaret DeLuca had already been diagnosed with stage 3A breast cancer and undergone a left-breast mastectomy before arriving at Clinton Correctional Facility in New Jersey. "She knew exactly what she needed, but was unable to get it," stated Bonnie Kerness, a human rights advocate and coordinator of the American Friends Service Committee's (AFSC) Prison Watch Project, who helped DeLuca fight for proper medical care. Their advocacy resulted in incremental improvements in DeLuca's medical care but did not change the prison's health care system. [Interview with Bonnie Kerness, December 28, 2011]

Like DeLuca, 57-year-old Sue Ellen Allen entered Arizona's Estrella Jail with a diagnosis of breast cancer (hers was Stage 3B). She had also undergone six sessions of chemotherapy and was awaiting a mastectomy. Two and a half months later, she was awoken at midnight, then handcuffed, shackled and transported to another jail. At 9 AM, she was moved to the hospital for the mastectomy.

"I am locked in a room alone, freezing. I ask for a blanket. No, they snarl. Why is everyone so nasty?" she recounted. "I haven't eaten in twenty hours, I haven't slept, I'm freezing and facing surgery alone." After the mastectomy, Allen should have begun chemotherapy, but the jail delayed it to avoid shouldering the costs. Allen did not receive chemotherapy until she was transferred to the Perryville prison three months later.

The chemotherapy made Allen sick.

"On my way back to my yard, I collapse, vomiting. A guard comes and asks if I can walk the three blocks to medical. There are no wheelchairs." Allen collapsed and vomited twice while walking to the medical unit. Staff watched her, but the only acknowledgment she received about her condition was when a sergeant asked, "What's the issue, Allen?" 

Allen made it to the medical unit, where she continued to vomit into a wastebasket. The prison's doctor was not available to administer the shot that would stop Allen's vomiting. Allen continued to vomit for an hour. "Even the nurse is frustrated. She says there is no other emergency. He's doing paperwork." When the doctor arrived an hour later, Allen recounts, he was obviously irritated. "He acts like I'm faking and reluctantly administers the shot. Eventually, I am sent back to my room alone. I am dismissed."

Allen underwent three more chemo treatments. "Despite the rigid schedule, never is the medication ready on time, nor is the newly discovered chemo diet ready. I have to spend my sickest days walking to Medical, begging for what I'm missing. When I'm supposed to be healing, I'm worn out battling for proper treatment."

Allen is one of the more fortunate; she survived the ordeal. When 36-year-old Christina found a lump in her breast in April 2002, Perryville's medical staff ignored her concerns. By the time she was taken to the hospital in September, the lump had grown so large that the hospital skipped the chemotherapy and performed an immediate mastectomy. By then, however, the cancer had already spread to her other breast. Christina died the next year, three months after being released from prison. "If her cancer had been diagnosed and treated when she discovered her lump, maybe she'd still be alive," Allen wrote.

While breast cancer survivors and advocates outside prison would be horrified at these obstacles and delays, Allen received relatively prompt treatment under what passes as current standards for prison health care. Sherrie Chapman, a woman incarcerated in California, waited much longer.

In 1985, Chapman, who had a family history of breast cancer, found a lump in her right breast. She alerted the prison's doctor, who dismissed her concerns. Chapman persisted in demanding that the lump be further examined. In 1994, when the lumps were visibly protruding from her right breast, she finally received a mammogram. The radiologist at the outside hospital found "extremely dense breast parenchyma" and recommended a follow-up mammogram within one year. Chapman was unable to convince the prison's medical department that she needed the follow-up mammogram until late 1994. This time, the radiologist recommended immediate follow-up tests. The prison's doctor, however, refused to order a biopsy, ultrasound or fine needle aspiration. The prison labeled her a "drug seeker" for her repeated requests for something stronger than Motrin for the pain in her breast.

In 1995, Chapman was examined by a different prison doctor, who immediately ordered a biopsy. By that time, the cancer had spread to both breasts and metastasized in her neck, forcing her to undergo two mastectomies. Post surgery, guards signed her out against medical advice to return her to the prison. Staff ignored chemotherapy appointments. In addition, her uterus began to hemorrhage. Medical staff allowed her to bleed for 18 months before performing a hysterectomy. In 2000 and 2001, Chapman discovered other growths in her neck and shoulder areas. The prison doctor's response? "You've just got swollen glands. Don't worry; they're not cancerous." 

Chapman appeared before the parole board in June 2002. The board rejected her and admonished her to use the self-help available in the prison, ignoring the fact that, by then, she was too ill to participate in groups that required regular attendance. She died on December 12, 2002, at the age of 45, under the custody of the California Department of Corrections and Rehabilitation (CDCR), with a prison guard posted in her room.

Women have not quietly accepted this gross medical neglect and failure. They have attempted to advocate for themselves and draw attention to the issue. In California, Chapman testified before the legislature about the dangerous medical care in the state's women's prisons. She also filed a lawsuit against the CDCR and the prison doctor for ignoring her initial complaints about painful breast lumps. Chapman won and was awarded a $350,000 settlement. Her efforts also led to several magazine articles exploring the failures of the prison health care system to address the needs of those battling cancer. [See: "A Cancer Grows," in The Nation, and A. Clay Thompson, "Cancer in the Cells," San Francisco Bay Guardian February 24, 1999 (not available online)]

Breast cancer survivors imprisoned in other states have had less success in finding advocates and attorneys to help them push for change. Allen wrote letters to numerous lawyers, all of whom declined to file suit. "Most firms don't have the resources to fight the state," she noted.

Allen did not allow the lack of legal support to deter her from trying to change the culture of prison indifference and isolation. Recognizing that each woman battled both breast cancer and the prison's life-threatening and indifferent medical care, Allen began a cancer support group. The process of starting such a group would be simple enough on the outside, but behind bars, nothing is ever straightforward. "It took me a year of begging," Allen recounted, "but I finally got permission." The group, which quickly grew to include 14 other women, met once a month with an outside volunteer from the American Cancer Society.

Allen remembered that women were initially reluctant to attend: "They didn't expect anyone to help them or care. They didn't know how to talk about their fears." The support group provided them with a space to talk - and to vent. "There is no place in prison to vent," said Allen. The volunteer also brought information about cancer, enabling the women to understand the protocols and procedures of cancer treatment and to know what questions to ask. Given that women are told nearly nothing about their illnesses, treatments and recuperation, such information is invaluable. [Interview with Sue Ellen Allen, December 27, 2011]

Looking back, she notes that, with the exception of Christina, all of the support group members were white. Although white women are more likely to get breast cancer (125 per every 100,000), African-American women are not far behind, with 116 per 100,000 diagnosed. Latinas, who make up the largest proportion of Arizona's women's prison population, have a rate of 91 per 100,000. Given these statistics, Allen wonders how many women of color remain undiagnosed.

Although Allen was unable to find an attorney or legal group to help file suit against the Arizona Department of Corrections, other prisoners' attempts to change the prison's medical care system over the years finally sparked outside action. In October 2011, Prison Law Office, a legal advocacy group for prisoners nationwide, sent a letter to Arizona Corrections Director Charles Ryan. The letter listed dozens of specific allegations of deliberate indifference to prisoners' health needs and asked Ryan to agree to a court injunction to address problems as a way to avoid a lawsuit in federal court. On November 17, 2011, Arizona's Department of Corrections signed an agreement to investigate the medical claims. Prison Law Office and the American Civil Liberties Union (ACLU) of Arizona agreed to delay any lawsuit for three months.

In New Jersey, DeLuca reached out to the AFSC to help her advocate for the care she needed. "It was a partnership between inside and out, which is often the most effective way to obtain change," Kerness remembered. Although their efforts did not improve the overall quality of prison medical care, it did have a ripple effect within the circle of women around DeLuca. Through her example, other women became aware of the power of advocacy and their ability to help outside supporters advocate on their behalf. [Interview with Bonnie Kerness, December 28, 2011] Sadly, many women battling breast cancer and other serious medical issues lack outside support. Breast cancer survivors and advocates need to recognize that, for women with breast cancer and other life-threatening illnesses, a prison sentence may mean a sentence to death by neglect. Then they need to speak out and take action to help women inside successfully fight for their lives.

ADC threatened with class action suit for gross medical and psychiatric neglect.

This article about the Prison Law Office and ACLU taking the ADC to court has been a long time in coming for survivors of prison suicides and gross neglect, and for those prisoners still inside - thank you Bob Ortega and AZ Republic. Here's the actual letter that was sent to Chuck Ryan listing all the allegations against his department.

In the first 2 1/2 years of his tenure, Chuck Ryan presided over 28 suicides. That's almost one per month. During that time the prison population remained relatively stable - even dropping a bit last year. In the 2 1/2 years that preceded Ryan, under Dora Schriro, there were only 12 suicides - less than 1 every two months.

Additionally, both Shannon Palmer and James Jennings were murdered by their cellies because Shannon and James were psychotic and isolated with intolerant cellies (in Shannon's case, his cellie was also psychotic). 

Then there are the cases of outrageous neglect: Marcia Powell was left to die in her feces with burns on her body in an outdoor cage while on a 10-minute suicide watch; Huberta Parlee died after two days of begging for treatment for a perforated ulcer; Brenda Todd sought medical attention repeatedly before being found dead in her cell one morning last winter. The list goes on.

These are not just isolated incidents or the consequences of budget cuts made years ago. Chuck Ryan decides how to distribute resources, and sets the tone for how prisoners are to be treated through his policies, practices in disciplining staff, and promotions of bullies like himself. His administration has reduced rehabilitative programs to negligible levels, has increased medical co-pays while decreasing prisoner earnings, has eliminated things like a suicide prevention program that trained prisoners as aides, has compromised positive community and family support to prisoners by implementing fees for visitors, and has allowed rates of violence to skyrocket unchecked...

It is no wonder that so many prisoners have grown so demoralized that they've killed themselves in his custody in record numbers. One of many questions is why there's such a racial disparity in those suicides.

AZ Department of Corrections 

November 22, 2011 

These are the victims of our collective indifference, by gender, race and age: 

Jan - June 2009 (5 suicides in 6mos): Angela Soto (MexAmer, 28) Harvey Rymer (W, 33), Angel Torres (MexAmer, 32) Dung Ung (AsnAmer, 32), Caesar Bojorquez (MexNatl, 37)

July - June 2010 (9 suicides in 12 months): Erick Cervantes (MexAmer, 30) Douglas Nunn (W, 33), Hernan Cuevas (MexAmer, 18) Monte McCarty (W, 46), Patricia Velez (MexAmer, 24), Jerry Kulp (AfAmer, 17), Jessie Cota, (MexAm, 28) James Adams (W, 46),Eric Bybee (W, 32)

July - June 2011 (14 suicides in 12 months): Tony Lester (NA, 26), Robert Medina (MexAm, 29), Geshell Fernandez (NA, 28) Patrick Lee Ross, (AfAmer, 28), Lasasha Cherry (AfAmer, 23) Rosario Bojorquez-Rodriguez (MexNat, 29), Duron Cunningham (AfAmer, 40) James Galloway (W, 54), Ronald Richie (W, 42) Susan Lopez (MexAmer, 35), Michael Tovar, (MexAmer, 20) Carey Wheatley (AfAmer, 49), Michael Pellicer (AfAmer, 35) Luis Moscoso-Hernandez (MexNat, 28)

Condolences to all the loved one's of AZ state prison violence, neglect, and suicide...
 

-----------------from the AZ Republic-------------------

Prison inmates in Arizona crying foul over medical care

State to investigate medical allegations

Bob Ortega

Dec. 5, 2011 11:06 PM

The Arizona Republic

To stave off a lawsuit, Arizona's Department of Corrections has agreed to investigate scores of complaints by inmates that they are routinely denied medical care for weeks or months even for severe, life-threatening conditions. Inmates who have lost sight, had body parts amputated or been severely disfigured, among other gruesome examples, say proper medical care could have prevented needless suffering.

Based on those allegations, a legal coalition has accused the state of chronically and systemically denying medical and mental-health care to inmates, violating state and federal laws and the U.S. Constitution.

The Prison Law Office, a legal-advocacy group for prisoners nationwide, also charges that lack of care may contribute to a prison suicide rate in Arizona that is more than double the national average, with 14 reported suicides in the fiscal year that ended last June.

Interviews with current and former prisoners and dozens of inmate letters of complaint obtained by The Arizona Republic raise similar concerns.

Corrections officials say they have found no evidence of systemic problems, although they say that pending plans to privatize prison health care have made it harder to fill medical-staff vacancies and that rule changes two years ago that cut payment levels to outside contractors also crimped access to care.

But prisoner advocates say the problems are longer-standing.

Allegations made by inmates, prisoner advocates and attorneys include:

A diabetic prisoner, while waiting months for insulin, lost sight completely in one eye and partially in the other.

An epileptic who wasn't given his medications suffered repeated seizures for weeks.

A man with a growth on his penis was denied medical treatment for two years. Doctors ultimately diagnosed a cancerous tumor on his penis; the organ had to be amputated, and doctors told him the cancer had spread to his stomach.

An inmate with a cancerous growth on his lip waited seven months for treatment. Most of his lip and mouth were removed, leaving him permanently disfigured.

Prison medical staff members have repeatedly denied treatment to Tucson inmate Horace Sublett for Kaposi's sarcoma, a cancer, despite documentation, including from the VA hospital in Phoenix and other outside doctors confirming that the Navy veteran, 82, has the disease.

Prisoners with emphysema, end-state renal disease and other illnesses reported being denied treatment or medication, leading to complications and permanent side effects.

Corrections officials maintain that they provided appropriate care in these cases. Karyn Klausner, the department's general counsel, said inmates' loss of sight, amputation of the penis and disfiguring facial surgery were not related to any delays in treatment.

Donald Specter, executive director of the San Quentin, Calif.-based Prison Law Office, described his group's concerns in an Oct. 12 letter to state Corrections Director Charles Ryan.

"State prison officials are deliberately indifferent to the serious health-care needs of prisoners and to the prisoners' unnecessary and significant pain, suffering and even deaths," Specter wrote.

That letter, which lists dozens of specific allegations without naming the inmates affected and which has been obtained by The Republic, asked Ryan to agree to a court injunction to address problems as a way of avoiding a lawsuit in federal court.

In May, Specter and the Prison Law Office won landmark litigation against the California Department of Corrections. In a 5-4 decision, the U.S. Supreme Court required California to release about 30,000 prisoners to alleviate unconstitutional prison overcrowding.

On Nov. 17, Arizona's Department of Corrections signed an agreement to investigate the medical claims, and the California group agreed to delay any lawsuit for three months.

But, so far, Ryan said, "We don't see any systemic indication of problems or evidence of deliberate indifference."

Ryan added that the department demanded the group provide inmates' names so it could verify or disprove the claims.

Specter said his group is asking inmates whether they are willing to be identified. Many prisoners fear retaliation for speaking out.

The department doesn't deny there are problems.

"Are there instances where an inmate didn't receive medications or treatment in a timely fashion? Yes," Klausner said. "But is it systemic? No."

The Prison Law Office noted that in 2009, the Arizona State Prison Complex-Eyman in Florence had only one half-time psychiatrist for more than 1,000 patients who were on mental-health medications. As of last month, that position was vacant.

Earlier this year, inmates at the Arizona State Prison Complex-Perryville often weren't seen by mental-health staff for six months or more, according to staff quoted in the group's letter.

"We're out of compliance with our own policies," Michael Breslow, then- deputy medical director for psychiatry, warned Ryan in a Sept. 13, 2009, e-mail obtained by the law group through an Information Act request. "The lack of treatment represents an escalating danger to the community, the staff and the inmates," Breslow said.

Staff shortages also affect medical care. Both the Arizona State Prison Complex-Tucson and the Eyman unit, which house more than 5,100 prisoners each, are supposed to have five doctors on staff. In April, Eyman had two doctors and a third working half-time; Tucson had two, according to department staffing reports.

Ryan and Klausner said Corrections has improved mental-health and medical care in recent months. Ryan said Corrections provided six hours of training in suicide prevention, crisis intervention and emergency response to 8,806 staff members who have direct contact with inmates.

That training follows, among other incidents, the July 2010 suicide of Tony Lester, a mentally ill inmate at the Tucson prison. An internal investigation found that officers stood by for 23 minutes without intervening after Lester slit his throat, wrists and groin with razor blades that he wasn't supposed to have.

Ryan also said Corrections has filled 172 health-care and mental-health positions since June 23 -- including vacancies for doctors at the Eyman and Tucson prisons.

However, the overall medical-staff vacancy rate has barely budged. In April, 23 percent of positions were unfilled. As of the end of November, 22 percent were unfilled, according to staffing reports.

Ryan said the department also has reduced the waiting time for inmates who require medical treatment outside the prisons -- from an average of 77 days early last year to an average of 49 days as of this month.

But inmates say months-long waits for care and denials of prescribed medicine and medical supplies continue to be routine.

"It's a real big problem, and they're keeping it hush-hush," former inmate Eric Wright said in an interview. Wright was released from the state prison in Tucson last month after serving more than four years on drug charges. Wright said a doctor prescribed back surgery in 2008 for an injury he suffered in prison.

"Nothing in my sentence called for the death penalty," said former inmate Martin Feldman, 67, who also had difficulties receiving timely prison medical care for osteomyelitis (a chronic bone infection) and obstructed coronary arteries. Feldman recently was released after serving nearly two years for a drug violation.

Corrections spokesman Barrett Marson declined to comment on Wright's and Feldman's cases, saying Corrections had to retrieve their medical records from archives.

Some of the shortfall in medical care stemmed from legislation lawmakers advocated as cutting costs.

In mid-2009, the Republican-led Arizona Legislature passed laws requiring Corrections to privatize prison medical care and to pay providers at a rate no higher than that paid by the Arizona Health Care Cost Containment System, the state's Medicare provider.

According to Corrections officials, within months of that law's passage, there were negative repercussions:

Health-care employees, figuring their jobs were on the chopping block, started leaving in droves. Corrections spent $5.3 million less on full-time health-care staff salaries this past fiscal year than two years earlier, a 13.5 percent drop. The department has used temporary, part-time workers to partially close that gap. And many contract providers such as Carondelet Health Network stopped doing business with Corrections, saying the reimbursement rates were too low. Ryan said the department eventually found other providers.

These issues are not new. In January 2009, well before lawmakers acted, more than one in four health-care positions was vacant, and the waiting time for outside medical care averaged 11 weeks, according to the department.

In the fiscal year ending last June, Corrections spent $111.3 million, or an average of $3,258 per inmate, on health care, down 27 percent from $140.5 million, or an average of $4,482 per inmate, two years earlier.

In recent years, inmates have reported scores of incidents to prisoner advocates such as the Arizona Justice Project, which helps inmates with wrongful convictions; Middle Ground Prison Reform, a prisoner-rights group; Lynn Nau, who runs a prison ministry for Faith Lutheran Church in Phoenix; Margaret Plews, a Phoenix activist who monitors treatment of prisoners; and Rep. Cecil Ash, a Republican lawmaker from Mesa who is involved in sentencing and correctional issues.

Ash said some of the letters he has received "really give me cause for worry ... that the state could have some serious lawsuits on its hands."

Many alleged incidents also suggest that often, denying basic care not only causes prolonged pain and suffering but makes it far more expensive once doctors treat the patients.

Carlos Archuleta, a Tucson inmate, said he begged repeatedly for help after being bitten in the groin by a spider last June. After four days, he was transported to a hospital for an emergency operation to remove infected fluid and tissue. Doctors had to resuscitate him after his heart stopped during the operation, and Archuleta was kept in the hospital six days.

"The doctor said if they'd left it one more day, he'd be dead. Just because they're inmates doesn't mean you should treat them this way," said his mother, Guadalupe Lopez. She added, "If he'd gotten proper medical care on day one, taxpayers wouldn't have had to pay for an emergency surgery and the hospital stay."

Corrections' spokesman Marson said "appropriate care was provided" to Archuleta.

The bottom line isn't just that prisoners, like anyone else, should have access to adequate medical care, said Caroline Isaacs, director of the American Friends Service Committee's Tucson office, which monitors state prisons. "Ninety percent of them will get out of prison, so treating HIV or hepatitis C or whatever they have prevents a public- health risk, or they'll get out and get on AHCCCS and we're paying for it anyway."