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Article

28 Jan 2016

Author:
Seth Freed Wessler, Senior Fellow at Schuster Institute for Investigative Journalism, in The Nation (USA)

 ‘This Man Will Almost Certainly Die’

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Dozens of men have died in disturbing circumstances in privatized, immigrant-only prisons. The Bureau of Prisons itself says there’s a problem. And yet the privatization scheme continues...

[P]rosecutions for illegal entry and re-entry rose...to a high of 91,000 in 2013 under President Obama... [The US Federal] Bureau of Prisons...turned to private companies to operate a new type of...prisons designed to hold only noncitizens convicted of federal crimes. As of June 2015, these facilities...housed nearly 23,000 people...[and are run by] GEO Group,...Corrections Corporation of America, and...Management & Training Corporation...

The BOP’s contracts with these facilities are meant to cut costs. Though the prisons are part of the federal infrastructure, the companies that run them operate under a different—and less stringent—set of rules in order to allow cost-cutting innovations...  Repeated federal audits and reports have found these facilities to be in crisis... [For] years, immigrant- and prisoner-rights advocates have sounded the alarm about these sites in particular, describing them as separate and unequal, segregated on the basis of citizenship. “These prisons operate without the same systems of accountability as regular Bureau of Prisons facilities, and prisoners suffer,” said Carl Takei, an ACLU attorney...

 Yet the full scale of the medical neglect at these immigrant-only contract prisons has remained opaque—until now... [In the case files for] 77 [deaths in custody] that provided enough information to render a judgment, the doctors [reviewing the files for this investigation] found that 38 contained indications of inadequate medical care. In 25 of these—a third of the total—the reviewers said the inadequacies likely contributed to the premature deaths of the prisoners. In only 39 cases did at least one reviewer find indications that the care had likely been in accordance with recognized medical standards...

[The] files tell the story of men sick with cancer, AIDS, mental illness, and liver and heart disease, forced to endure critical delays in care. They show prison medical units repeatedly failing to diagnose patients correctly despite obvious and painful symptoms, as well as the use of underqualified workers pressed to operate on the borders of their legal scope of practice. The files also show men dying of treatable diseases—men who very likely would have survived had they been given access to adequate care...

Over two years, [inmate Claudio] Fagardo-Saucedo went to the clinic 18 times. He was seen...by one of a rotating group of licensed vocational nurses, or LVNs. Usually, the LVN sent him back to his bed with a prescription for Tylenol or ibuprofen. Meanwhile, his body was signaling a fatal breakdown, something that doctors who reviewed his case said should have been caught by the facility’s care providers.

The training for LVNs...takes only a year. They are taught to change dressings, check blood pressure, help patients bathe, and gather basic information. They’re often hired to provide routine care in nursing homes or to assist registered nurses... Unlike the RNs, who provide patients with substantive medical care and perform triage and evaluations, LVNs are intended as support staff... Yet in the BOP’s immigrant-only contract prisons, LVNs often appear in the files as the sole caregivers that sick prisoners see for days or weeks. [Article details multiple additional cases of prisoners who contracted serious and sometimes fatal diseases but received what doctors reviewing their cases considered inadequate medical care, and suicides by prisoners who were known to have, or showed clear signs of, mental illness.]

[One facility's] medical contractor..., Correctional Healthcare Companies, had failed to meet contractual staffing obligations in the medical unit for at least 34 of the 37 months from 2010 to 2013. The BOP may have incentivized the understaffing: The financial penalties for failing to fill open LVN positions were so modest that it cost CHC less simply to leave them vacant.

The GEO Group says that, in practice, it follows the same rules as BOP facilities. In a statement, GEO wrote that its prisons “adhere to strict contractual requirements set by the FBOP [Federal Bureau of Prisons] as well as all of the same policies and program statements enforced at FBOP-operated facilities…. All medical standards, policies, and practices in place at GEO-operated facilities strive to meet those in place at FBOP-operated facilities.”

GEO’s medical subcontractor, Correct Care Solutions, said it provides a “comprehensive scope of healthcare services per our contractual obligations.”

Neither MTC nor CCA responded to questions about their operations or particular deaths at their sites...

I asked Robert Trestman, a professor of psychiatry at the University of Connecticut and a national expert on correctional mental health, to review...[the files of] two men [who committed suicide]... “The care here was at best incredibly lackadaisical,” he said. “This is by no means an acceptable standard of care.”