~~~Caged ~~~

~~~Caged ~~~
Gorillas Fighting 4 Change

Friday, July 13, 2012

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Monday, July 9, 2012

Solitary Confinement, the inhumanity of it?


The inhumanity of solitary confinement



For the past eighteen months or so, I have been reading intense stories, articles and speculative narratives about solitary confinement and its impact on imprisoned human beings. As a former deputy warden of such an “inhumane” Special Management Unit in the Arizona State Prison Complex Eyman in Florence, I was the chief administrator of this unit. During my term of assignment within this most restrictive tonnage of concrete blocks filled with rebar and steel gates, doors and windows, I observed what society declared to be the “worst of the worst” inside Arizona prisons. I was fortunate to have a team of excellent professionals to keep this assignment afloat and avoid minimum collateral damage while assigned there.

For an outsider to attempt to understand “solitary confinement” one must first step back and acknowledge that solitary confinement is a condition of confinement termed erroneously as men are not solitary in housing but rather segregated from general population prisoners for reasons we will discuss later on. In reality, this housing assignment is known as maximum custody or Level 5 in most prison agencies either state or federal.

It is true prisoners are locked alone inside their cells for about 22 – 23 hours a day. It is true their food is delivered through a food port designed for restraining the prisoner but serves a dual purpose of safely handing the food trays to the prisoner without the need to open the cell doors. The walls are unpainted concrete walls and their cells are windowless to allow no direct sunlight into their cells. 

In addition to being locked up alone, the Special Management Units have expanded their bed counts to allow double bunking in both units adding approximately 300 additional beds [at a taxpayer’s cost of approximately $234,000 dollars] to maximum custody housing. Double bunking maximum custody increase the rate of violence (gladiator wars inside the cells) and put more staff in danger because of the imminent threat of opening the cell doors with two prisoners inside them rather than just one.  

Assaults and use of force incident have increased and more staff are getting hurt today than ever before inside these darkened and hollow gladiator pits where it is a “us versus them” mentality that created the hostilities and mistrust in operations.

Today, many prison officials in Arizona are asking for $ 50 million dollars to expand this system even further. Expanding maximum custody while still engaged in a flawed method of managing those existing SMU facilities where death runs rampant and medical and mental health care is direly needed making it a recipe for total failure within time.

Their cells are approximately 80 square feet with a steel bed to sleep on. They have a combination stainless steel toiler, sink and shelve to put their personal hygiene items on and a faded small steel mirror to groom themselves. The steel inside these maximum custody cells are corroding and are in need of replaced steel plates as time is wearing down even the strongest metal designed for such a purpose.

This corrosion was mainly created through neglect and lack of preventive maintenance that doesn’t happen within such a dangerous place. One reason was the removal of essential maintenance staff and the other was lack of funding to conduct such repairs.  Thus it is suspect that the ventilation, sewer and electrical systems are also in dire need of maintenance but none such work will be done as there isn’t sufficient staff to take care of these things and the end result will be ignoring these problems until they hit critical mass and the systems shut down.

It has already been demonstrated more than once that the locking devices are failing and old and only a steel pin keeps the door from opening allowing the prisoner to escape his cell and attack an unaware officer walking his or her beat. 





One maximum custody prisoner managed to carve into to stainless steel sink combo [with a 14 inch steel sharpened weapon] and escape his cell through the wall into a mechanical room and attacked an officer from behind as he planned a hostage taking after making several statements he would kill a correctional officer if he had the opportunity to do so. His efforts took many weeks to complete thus was evidence or indicative of the lack of security rounds made due to his intentional hostilities towards staff and staff’s willingness to leave him alone and not check on him or his cell for the duration it took him to cut a hole in his maximum security wall and attacked an officer as a plan to take a hostage.

There is rare human contact through actual touching of skin or person. They are restrained in upper and lower mechanical restraints often referred to as shackles. Then, after being stripped searched, they are escorted in these chains to and from locations such as the infirmary, visitation [again non-contact and via window and phone] and other appointments [off-site medical or court appointments] it us usual for two officers to conduct such an escort if the prisoner has a history of assaultive behaviors or unwillingness to abide by institutional rules.

Maximum custody is staff intensive and is the most expensive kind of housing in any prison system.

They do have contact with other prisoners or human beings but it is not personal contact; it is impersonal and often delivered with shouting or yelling across the pods of cells into the recreation boxes or areas nearby in shouting range. They “fish” their hand delivered messages and contraband from cell to cell and communicate more elaborately than those of us that use the internet as their confidentiality levels exceed those of any firewall or webmaster.

They are kept in conditions that are difficult to describe unless you worked there, lived there or been there for any prolonged period of time. The place has a smell of its own (like dirty feet or socks) and is drab in color and hollow in reverberating sounds as the noise bounces off the walls endlessly.

They are allowed to read books [they can exchange book via the library], write letters, watch television and engage in conversations with other prisoners through the cell doors (perforated with holes to allow maximum air flow) made of steel and double locked with safety pins to avoid accidental opening of these doors allowing two prisoners out at the same time which would violate the policy of one prisoner out of the cell at a time.

They do live in a state of idleness. They are prevented by statutory law to seek higher education opportunities but are allowed to engage in attaining their GED or meet mandatory literacy act conditions. They have access to a phone and share an informal schedule agreed upon by all inside that pod and often call those who will accept their collect calls with premium rates attached to them.

When they are allowed out of their cells, they are placed in a large concrete box void of any exercise equipment and covered with a huge steel rail welded with heavy gauge steel mesh to allow the sunshine to pour through. They are allowed two hours of recreation and shower three times a week. Many engage in this opportunity to leave their cell area but a quarter of the population tends to refuse to leave their cells because of the heavy security requirements before and after such an activity. Secondary, it is practice that when a prisoner goes to recreation his cell area is searched for contraband and inspected for any tampering of equipment that may have occurred within the time he is there alone and not under any supervision. If they leave, they stand a chance of losing some of their unauthorized property either altered or attained through unauthorized means.

Special Management Units are designed for isolation and control. This is the primary design and it serves this purpose well. It has been an expectation by society that every prison system has a designated unit for such purpose and in Arizona there are three maximum custody units that fit that purpose and design. Special Management Units (SMU) are seriously understaffed. This has been a grave flaw of these control units as staffing patterns have been altered and downsized by budget and agency needs to re-allocate staff [especially shift supervisors] to other facilities throughout the state leaving the SMU without good leadership capabilities and decision making tools.

Since 2009, the staffing patterns of these Special Management units have been cut severely impacting their daily operation in such a manner, many of these mandated services are limited or short cuts must be taken to meet the daily schedule or agenda for the day. This is one of those conditions that lead to “perpetual incapacitation” or incarceration without relief of fresh air / sunshine.

It is nearly impossible to allow every prisoner his time in the shower or rec cage as there aren’t enough hours in the day to meet these conditions of confinement as outlined by their own policies. Make up days are Saturday and Sunday and they are never caught up leaving approximately a quarter of the population without recs or showers on any given week. The rotation makes is bearable that most get their showers and exercise but nevertheless, there isn’t enough time in the day to do them all.

Another grave flaw of these Special Management Units is the placement of those severely mentally ill (SMI) prisoners. The mixing of these SMI prisoners with anti-socially behavioral misfits inside these walls creates bedlam and chaos for both prisoner and staff.

It is true that “people go crazy here in lockdown” and it is for certain that many of those who weren’t mentally ill before their placement here are now teetering on being borderline insane because of these environmental influences that strips their humanity away day by day as they are incapable of doing anything about it and frustrated that they are kept in such dismal conditions of confinement when many are in denial they need to be there for a specific purpose or reason based on their own misconduct or behavior prior to arriving at the SMU.

It is also truthful to say that those who are non-violent can become violent and those who are already violent exceed their own limits of tolerating violence and thrive, plan and participate in extreme violent acts perpetrated through scheming and wanting to harm or kill a correctional officer.



To say the word “hate” doesn’t exist would be a lie. Hate is rampant and drives the environment on any given day that often results in the deployment or discharge of chemical agents, stun guns or even the K 9 cell extraction dogs. Hate exists on both sides of the cell door. Those who wish to harm these officers walking in front of their cells and attempt to spear, dart, and spit or throw feces and urine to assault them carry out their mission with amazing accuracy.

It is most hazardous to walk within the front of any cell without the fear of being smeared with bio hazard substances or drenched in someone else’s urine. Society must know that these are indeed “gladiator pits” and an underworld of pain and violence.

On the contrary of what people think what goes on in there, it is the staff that protects this environment with deliberate silence but also with pure dedication to get the job done no matter how short handed they are. Silence is taken as a sign of loyalty to the individual or persons in charge who works there and endures the harassment and hate within this place. Silence allows behavioral modification models to reinforce positive means due to negative behaviors.  This is where this type of environment is most volatile and subject to variances not written in any policy or procedure related to the management of prisoners inside the SMU. Silence condones the acts of officers who deal with the kind of working conditions nobody else could even imagine as they adapt, improvise and overcome both personal and physical structures and barriers to get the job done anyway they can.

The physical plant layout is effective as there is a structural separation between the control rooms above and the cell areas below. This prevents hostage situations and access to exit doors. Computer enhanced programs maintain the doors to all entrances and the control room officer has a birds eye view of the officer below at all times. The problem with these SMU control rooms is they are often vacant due to staff shortages thus an officer below cannot enter the cell area to make a unit check unless the officer above is present to punch the computer keyboard and observe.

This shortage leaves adjacent control rooms empty and without observation for hours at a time leaving the cell area unsupervised and without officer presence either on top or on the bottom.

The SMU such as the Browning Unit have wings. Each wing has a designated purpose. For example, every wing has common clusters with pods within those clusters. Ten men cells and six pods make a cluster. There are long wings and short wings.

Long wings have four clusters e.g. A, B, C and D clusters. Short wings have two clusters, E and F wings. These are either designated for general population prisoners or the containment of the Behavioral Unit or Enhanced Security Unit. On the other side we have more wings. These wings are the Security Threat Group wings where we have I, J, K, L clusters and death row wing has G and H clusters.

Needless to say, all wings are overflowing creating a mixture of non death row and validated gang members being in adjoining cells and with no physical separation except concrete and steel. In addition some such as E and F clusters have been double bunked with no staff increase on the rosters and tax the staff tremendously when it comes to feeding, recreation or showers.

While there at the Browning Unit, we housed prisoners that were violent and non-violent; escape risks and those serving extreme long sentences. Then there are the severe mentally ill and behavioral misfits that can’t or won’t follow institutional rules and have committed serious acts of violence with or without weapons and committed other state crimes within the prison setting including homicide.

There are over 240 gangsters housed there and validated to be incarcerated at maximum custody levels commonly referred to as Level 5.  Some have been there for over ten years and some are there because of recent gang activity that involves moving drugs on the streets as well as inside the prison walls as they control drugs and divide their profits according to those by laws established by the heads of each gang that is divided by race and ethnicity.

In addition there are protective segregation prisoners who have committed crimes that are unacceptable by their own prison standards and need protection from being killed by other prisoners. There are also those individuals who have perpetrated acts against the administration or correctional officers and are housed there to closely monitor their behavior and conduct while serving the remaining time on their sentences.

During my assignment at the SMU II or now renamed Browning Unit, there was dedicated staff who worked hard to maintain a safe and orderly environment. They carried out their orders, their tasks and their duties without so much a whimper of complaint and have exceeded any administrator’s expectation to be professional and to the best of my knowledge performed life saving acts e.g. CPR and other first aid tasks to keep prisoners on suicide watches alive and did so in the finest standards possible.

One could not keep count of the numerous times they saved lives and prevented a self-inflicted death attempt either by hanging or cutting themselves with unauthorized razors smuggled in after a shower was completed but not searched thoroughly (in the  mouth) when returned to the cell.

These SMU units are considered to be the “end of the road” for those assigned there and often released from there once they do their time. They are punitive in nature and design. Solitary confinement is a misnomer for it is actually maximum custody with all the legitimate tools available to manage prisoners at such a high level.

However, solitary confinement is a condition that has invaded or contaminated these maximum custody units because of their mismanagement of time housed there, reasons for being kept there for prolonged periods of time and the lack of attention to detail and operational needs that creates chaos and misdeeds in a very relative short period of time if allowed to fester and left untreated.  

It is true that some administrators misuse this placement to impose punishment upon punishment. It was not designed for that purpose nor was it meant to be long term for those who needed protective custody, SMI or other administrative needs. It was designed for gang control, homicide perps (cop killers and correctional officers especially) suspects and extremely violent and uncooperative prisoners that have an extension history of assaultive behaviors on staff and other prisoners.

A legitimate gang step down program was put into place in 2007-2008 to allow those identified to be gang members to go to a lower custody level based on positive participation of the program and staying away from gang activities. There are also debrief options on the table that allows prisoners to renounce their gang membership and go into protective custody after sharing gang intel and passing a polygraph to confirm their information.  Between these two programs, many gang members are eligible to reduce their custody levels and function in a less restrictive environment until their time is done.

The trend to fill solitary confinement must be reversed. Government leaders must insist in reducing their population within numbers staff can effectively and safely managed. Classification for such placement must be justified and reviewed and revised to allow timely reviews to be conducted to allow release or programming while in such a status within an SMU.

Placement terms must become shorter with viable alternatives attached or available for those eligible to reduce their custody levels based on program compliance and clear conduct for an expressed time period since their arrival within this custody level.

Administrative oversight should not end at the warden’s office but rather be subject to review by an independent board of inquiries composed of a medical employee, mental health staff, a case manager and an administrator with a civilian appointee as the chair person to ensure independent thinking and problem solving.

Grievances and due process procedures must be scrutinized for patterns of behavior or misbehavior by staff as well as those who abuse the grievance procedures to make a mockery of their rights to express concern or discrepancies.

The use of maximum custody commonly referred to as solitary confinement must be selective and handled with professionalism and objectivity rather than the opposite manner it is being handled today.  The manner of neglect and inattention to details resulted in a mission creep that leaves us with mayhem today.

More information has revealed that extreme isolation can and does impact a human being in a most negative manner.  Just how much is left up to the individual impacted but nevertheless, it creates more treatment care and drives up the costs of such placements. It also puts many correctional employees is harm’s way as this environment is both hostile and dangerous for all that enter there without the proper protective or safety equipment.

The removal of the severely mentally ill alone will reduce deaths, self harm and other acts that are created by this environmental structure as it destroys the prisoner’s hopes to being well again and touch [have human contact] with someone again like they did before they were placed inside this condition called “solitary confinement.”

Source:

http://www.sunjournal.com/news/columns-analysis/2012/07/09/colin-dayan-inhumane-world-solitary-confinement/1220009


Friday, July 6, 2012

Destroying the soul

Destroying the soul

Colin Dayan is Robert Penn Warren professor in the humanities at Vanderbilt University and the author of “The Law Is a White Dog: How Legal Rituals Make and Unmake Persons.”
We as a nation are guilty of the most horrific treatment of prisoners in the civilized world. In March, 400 prisoners in California’s Security Housing Units, as well as a number of prisoners’ rights organizations, petitioned the United Nations asking for help. Since then, the Center for Constitutional Rights has filed a federal lawsuit on behalf of prisoners at California’s Pelican Bay State Prison who have each spent between 10 and 28 years in solitary confinement. A class-action suit in Arizona challenges inadequate medical and mental health care that subjects prisoners to injury, amputation, disfigurement and death — especially in prolonged solitary confinement.
Supermax detention is the harshest weapon in the U.S. punitive armory. Once, solitary confinement affected few prisoners for relatively short periods. Today, most prisoners can expect to face solitary, for longer periods and under conditions that make old-time solitary seem almost attractive. The contemporary state-of-the-art supermax is a clean, well-lighted place. There is no decay or dirt. And there is often no way out.

This is not the “hole” portrayed in movies. As a sign of professionalism and advanced technology, extreme isolation and sensory deprivation constitute the “treatment” in these units. Supermaxes modify inmates’ spatial and temporal framework, severely damaging their sense of themselves: a terrible violence against the spirit and a betrayal of our constitutional and moral responsibilities.
More than a decade ago, I began visiting the “Special Management Units” at the Arizona State Prison Complex-Eyman in Florence. I completed a series of interviews in an attempt to understand this new version of solitary confinement. Prisoners there are locked alone in their cells for 23 hours a day. Their food is delivered through a slot in the door of their 80-square-foot cell. They stare at unpainted concrete walls onto which nothing can be put. They look through doors of perforated steel, what one officer described to me as “irregular-shaped Swiss cheese.” Except for the occasional touch of a guard’s hand as they are handcuffed and chained when they leave their cells, they have no contact with another human being.
In this condition of enforced idleness, prisoners are not eligible for vocational programs. They have no educational opportunities; books and newspapers are severely limited; post and telephone communication virtually nonexistent. Locked in their cells for as many as 161 of the 168 hours in a week, they spend most of the brief time out of their cells in shackles, with perhaps as much as eight minutes to shower. An empty exercise room — a high-walled cage with a mesh screening overhead, also known as the “dog pen” — is available for “recreation.”
These are locales for perpetual incapacitation, where obligations to society, the duties of husband, father or lover are no longer recognized. An inmate wrote me, “People go crazy here in lockdown. People who weren’t violent become violent and do strange things. This is a city within a city, another world inside of a larger one where people could care less about what goes on in here. This is an alternate world of hate, pain, and mistreatment.”
Situated on 40 acres of desert, Special Management Unit 2 is surrounded by two rings of 20-foot-high fence topped with razor wire, like a nuclear-waste storage facility. During my visits, I learned that those who have not violated prison rules — often jailhouse lawyers or political activists — are placed apart from other prisoners, sometimes for what is claimed to be their own protection; sometimes for what is alleged to be the administrative convenience of prison officials; sometimes for baseless, unproven and generally unprovable claims of gang membership.
We citizens are proud of our history. We are a nation of laws. But what kind of laws? Laws that permit solitary confinement, with cell doors, unit doors and shower doors operated remotely from a control center, with severely limited and often abusive physical contact. Has society’s current attention to the death penalty allowed us to forget the gradual destruction of mind and loss of personal dignity in solitary confinement, including such symptoms as hallucinations, paranoia and delusions?
The philosopher Jeremy Bentham came to believe that solitude was “torture in effect.” Other 19th-century observers, including Charles Dickens and Alexis de Tocqueville, used images of premature burial, the tomb and the shroud to represent the death-in-life of solitary confinement. Some 25,000 inmates are languishing in long-term isolation in America’s supermax prisons, with as many as 80,000 more in solitary confinement in other facilities.
A Senate Judiciary Committee panel heard testimony last month on solitary confinement. I hope that someone reminded lawmakers of Justice William Douglas’s words nearly 40 years ago: “Prisoners are still ‘persons.’ ”

Tuesday, July 3, 2012

Man Alone

It has been said that it isn’t good for man [or woman] to be alone. In fact, the Bible makes several references to it but yet, sometimes, man needs to be alone to gather his thoughts and find his soul. Mankind and its associated ideology have long been established as being either ethically right or wrong. Their moral values and their basic views on human rights and humane treatment of prisoners has always been a controversy among many with no end to the conflict and less reasons to change the practices that have been established by modern penologist in the United States. Thus we have a concept called “solitary confinement” that is most harmful to human beings and their body, spirit and mind.


Ethically based individuals struggle daily on the subject of isolating men from mankind. The practice of incarceration was designed to separate the good from the evil. It has always been a practice that the worst of those in society should be locked up and those locked up and still misbehaving or incorrigible in their conduct must be isolated to prevent harm either to others or themselves. Hence the concept of solitary confinement was designed to handle those who required such isolation and control from others even while incarcerated within the tall prison walls and sharp razor wire.

 This is a reflection of modern penology and obviously a conscious decision among many prison administrators to decide how long they remain isolated; under what conditions they must live and survive and for reasons justified to segregate and treat them different than other populations less restrictive and much more humane in nature and operations.  There must be exception to this penology theory for the mentally ill. There must be accommodations made that are different from those identified to be anti-social or anti-personality disorder in manner. Segregation of the mentally ill is unfair to the disabled persons who is already stressed and in crisis mode dealing with the incarceration within a predatory world and confusion with rules and regulations that may be easier to follow by those not identified to be disabled or confused in state of mind or manner.

 This is where the humane and preservation of humanity must step in and plea for chances that will allow better coping opportunities and better functional decision making conditions that allows these conditions of confinement to be rational and reasonable given their disabilities and coping abilities within such a hostile world. Segregating the mentally ill from the behaviorally disruptive and manipulative anti social persons will allow them an opportunity to manage their lives better with their individual handicaps and allow progress to be made in their treatment, their programming and their eventual release back into society once their term or sentence has been completed.

 Correctional staff and support services employees, whether intentionally or unintentionally contribute to the continuation of harm and damage to those mentally ill persons isolated for security reasons beyond comprehension or justification. Here through the legitimization of isolation practices, they must realize the harm that is being done while such a person is kept there for any prolonged period of time.  

It is fair to say that such a condition could in fact be cruel and unusual punishment for those mentally disabled as their access to services, care and treatment are severely limited by concept and design. Correctional administrators must make allowances for such limitations and review their practice of placing mentally ill persons inside these isolation areas or cells. They must do what is appropriate to keep staff and the public safe but it is reasonable that such a mission can be fulfilled without the use of isolation practices or confinement conditions.

 What they must do is step out of the box and recognizes this paradigm of human rights violations and constructs another plan to rectify this condition and reverse the trend today inside maximum custody prisons. They must treat these mentally ill prisoners with dignity and provide ethical and decent treatment standards of care in order to provide whatever services they are entitled to under our standards of care and civil rights laws.  As an advocate for the severely mentally ill persons, I realize that publically exposing this isolation practice as well as urging change is most difficult and sometimes too many, a significant waste of time. It is also reasonable to say that nobody from within such an entity e.g. the prison management components, whether an administrator, correctional officer or nurse, case manager or department head, will step up to the plate and report such atrocities for the fear of losing their jobs or in fear of falling out of favor for future career opportunities and promotions.

If there is to be a change in prison management it must come from public servants that are true rightful leaders, and individual professional practitioners within the system that have to deal with these violations of human rights daily but are afraid to report them for reasons already discussed.

It must be delivered via the media with credible and reliable information and come from community organizations, associations and supportive networks that can carry the message with ethically defensible grounds to make change of the way prisons treat our severely mentally ill persons incarcerated today inside our prisons and kept inside isolation cells in a practice that is now called “solitary confinement.”


Syria's 20 ways to torture

Rights group: Syria's 20 ways to torture prove its crimes against humanity

Human Rights Watch
Human Rights Watch commissioned a Syrian artist to produce sketches based on statements received from former detainees and security force defectors. They depict some of the most commonly used torture methods in detention centers across Syria. They are not representations of any specific individuals.
Syrian intelligence agencies are running torture centers where detainees are beaten with batons and cables, burned with acid, sexually assaulted and their fingernails torn out, Human Rights Watch said in a report released on Tuesday.
The New York-based rights group identified 27 detention centers across the country that it says intelligence agencies have been using since President Bashar Assad's government began a crackdown on pro-democracy protesters in March 2011.


Human Rights Watch documented more than 20 torture methods that "clearly point to a state policy of torture and ill-treatment and therefore constitute a crime against humanity."It conducted more than 200 interviews with people who said they were tortured, including a 31-year-old man who was detained in the Idlib area in June and made to undress.
 


"Then they started squeezing my fingers with pliers. They put staples in my fingers, chest and ears. I was only allowed to take them out if I spoke. The staples in the ears were the most painful," the man told Human Rights Watch.
Human Rights Watch
Detainees described being beaten on the soles of their feet with sticks and whips to the point that their skin was raw, their feet swollen and bleeding, making it impossible to walk.
"They used two wires hooked up to a car battery to give me electric shocks. They used electric stun-guns on my genitals twice. I thought I would never see my family again. They tortured me like this three times over three days," he said.
Another man, named “Elias” in the report, described how he was tortured by Syrian intelligence officers in Damascus.
“The guards hung me by my wrists from the ceiling for eight days. After a few days of hanging, being denied sleep, it felt like my brain stopped working. I was imagining things,” he said.
“My feet got swollen on the third day. I felt pain that I have never felt in my entire life. It was excruciating. I screamed that I needed to go to a hospital, but the guards just laughed at me,” he added.
Women, children, elderly people
The report found that tens of thousands of people had been detained by the Department of Military Intelligence, the Political Security Directorate, the General Intelligence Directorate, and the Air Force Intelligence Directorate.
So many people have been arrested that the authorities had used sports stadiums, schools and hospitals as detention centers, the report said.
From the front line in what looks ever more like a fight for Syria's capital Damascus, members of the Free Syrian Army appear to be closing in on President Assad's stronghold, at a terrible cost to both sides. NBC's Bill Neely reports.
The report said while most of the torture victims who spoke to the group were men aged 18 to 35, they also spoke to a number of women, children and elderly people who had been tortured.
“Interrogators, guards, and officers used a broad range of torture methods, including prolonged beatings, often with objects such as batons and wires, holding the detainees in painful stress positions for prolonged periods of time, often with the use of specially devised equipment, the use of electricity, burning with car battery acid, sexual assault and humiliation, the pulling of fingernails, and mock execution,” the report said.
It added that several former detainees told Human Rights Watch that they witnessed people dying as a result of torture.
'Mildest form of torture'
A former Syrian intelligence officer told the campaign group that the “mildest form of torture is hitting people with batons” on their arms and legs and “not giving them anything to eat or drink.”
“They used … and electroshock machine … it is a small machine with two wires with clips that they attack to nipples and a knob that regulates the currents,” he said. “In addition, they put people in coffins and threatened to kill them and close the coffin.”
 
Syrian helicopters strike Damascus suburb
The group called for the U.N. Security Council to refer the issue of Syria to the International Criminal Court (ICC) and to adopt targeted sanctions against officials carrying out abuse.
"The reach and inhumanity of this network of torture centers are truly horrific," Ole Solvang, emergencies researcher at Human Rights Watch said. "Russia should not be holding its protective hand over the people who are responsible for this."
PhotoBlog: On the road with Syria's rebel motorcycle army
Russia -- an ally of Syria -- and China have already vetoed two council resolutions that condemned Damascus and threatened it with sanctions and French U.N. Ambassador Gerard Araud told reporters on Monday that reaching a Security Council consensus to refer Syria to the ICC would be difficult.
"As France is concerned it's very clear we are very much in favor of referring Syria to the ICC," Araud said.
"The problem is it will have to be part ... of a global understanding of the council and I do think that for the moment we have not yet reached this point," he said.
U.N. human rights chief Navi Pillay on Monday reiterated her position that the issue of Syria's conflict should be referred to the ICC in The Hague because crimes against humanity and other war crimes may have been committed.
She said both sides appear to have committed war crimes.
The United Nations has said more than 10,000 people have been killed during the 16-month Syria conflict.
Reuters contributed to this report.

Monday, July 2, 2012

Wexford Medical Care - Sufficient Care?

Critics cast doubt on new Ariz. prison health-care contractor

Arizona Republic

Bob Ortega
April 6, 2012


The private contractor taking over health care in Arizona's prisons promises significant improvements in care while saving money, in effect saying it will do more with less. But critics charge that Wexford Health Sources' record elsewhere suggests that sometimes it fails to live up to its promises and may do less with less.

Arizona's Department of Corrections, fighting a federal lawsuit that accuses it of providing grossly inadequate health care, issued a contract to Wexford this week as part of the state Legislature's attempts to save money by privatizing prison health care.

• See the Wexford contract

Wexford, which is due to take control of operations by June 1, said in its contract with the state that it will:
• Hire the equivalent of at least 781 full-time health-care workers, a number that is a 30 percent increase from Corrections' current health-care-staffing level.

• Offer the 600 current correctional health-care employees first crack at the jobs and won't cut the salaries of any of those workers it hires.

• Have nursing staff on hand at every state prison 24 hours a day, seven days a week, which is not currently the case.

• Provide every correctional officer in the system 40 hours of training on dealing with mentally ill inmates.
• Have its medical staff monitor inmates in isolation daily and have mental-health staff see those inmates at least weekly, representing a significant increase in frequency.

The company promises to do all this for $116.3 million a year, which is more than the $111.3 million the Department of Corrections spent on health care last fiscal year. In that year, 20 to 25 percent of health-care positions were unfilled, with the department slow to replace employees who left before the pending privatization.

But Wexford's budget would be less than the roughly $120 million the department projected spending this fiscal year. Wexford plans to keep $5.4 million as profit and spend $2.7 million on out-of-state administrative expenses. It is headquartered in Pittsburgh.

Some prison-system observers are raising questions about whether the company can provide the savings the state hopes for while providing significant improvements in service.

"There are reasons for great skepticism" that Wexford can deliver what it promises, said Caroline Isaacs, director of the Tucson office of the American Friends Service Committee, a prison-watchdog group. "One is that Wexford has a clear pattern of not living up to its commitments in other contracts," and another, she said, is that the Department of Corrections has a history of failing to hold other contractors, such as private-prison operators, accountable when they haven't lived up to the terms of their contracts.

Lowering expenses

Wexford spokeswoman Wendelyn Pekich said the company is still identifying, in cooperation with Corrections, where it can cut costs and improve efficiencies while providing what she termed "an industry-standard quality of care." As possible areas for improvement, she cited more efficient staffing patterns, improved training and record keeping, and use of telemedicine -- diagnosing patients remotely via video.

Rep. John Kavanagh, House Appropriations Committee chairman, who led the push in the Legislature for privatizing correctional health care, said he expects the company will cut costs and save the state money by, for example, bringing into the prisons some services for which inmates are now transported.

The switch to privatization comes at a time when the state is fighting a lawsuit over allegations of inadequate prisoner care and defending itself against accusations by Amnesty International of inhumane treatment of prisoners.

A federal lawsuit, filed against the Department of Corrections last month by the American Civil Liberties Union and the Prison Law Office of San Quentin, Calif., alleges that inmates have died, been disfigured or permanently harmed by poor medical care in state-run prisons and that mentally ill inmates held in isolation often go months without seeing a psychologist or getting counseling.

If privatization improves care, that's a bonus for Kavanagh, R-Fountain Hills. "The caliber of service wasn't an issue" in the state prison system at the time lawmakers voted to privatize prison health care, he said. Lawmakers weren't aware of the allegations -- which he stressed are not yet proved -- in the ACLU lawsuit.
The impetus for privatization, Kavanagh said, "was always to save money in tough economic times."

In the contract, Wexford offered some specific examples of ways it may save money: for example, hiring an oral surgeon who will travel a circuit of the prisons to extract teeth and perform other procedures for which inmates currently must be taken to outside providers, escorted and transported by correctional officers.

Wexford noted in the contract that it and the state also will save money beginning in 2014, when the majority of inmates will become Medicaid-eligible and reimbursement rates for Medicaid will increase by half because of changes related to the Patient Protection and Affordable Care Act.

However, the contract and bid documents provided to Corrections by Wexford raise questions about how fully the company disclosed performance issues elsewhere. Wexford lists 20 contracts it said ended either because the company lost a rebid or didn't rebid, among other reasons.

Some problems

In one example, Wexford said it opted not to renew a contract with Clark County, Wash., that expired at the beginning of 2010. Wexford noted that an independent audit "cited several instances of poor operations, which were already in effect when Wexford Health took over the contract" in 2007.

Although there were pre-existing problems, that audit, by the Institute for Law and Policy Planning, was more critical than Wexford admitted. It concluded that "Wexford has systematically failed to comply" with its contract and had failed to provide adequate staffing, properly licensed staff, and adequate and timely medical service.

The auditors, who said they examined Wexford's record elsewhere, wrote that "past experience in other counties reveals that jail administrators typically put up with Wexford's cost cutting and substandard level of care until the problems become too egregious to be borne."

Wexford disputed the allegations.

In Mississippi, Wexford said that a 2007 audit by a state legislative committee made "recommendations related to documentation and record keeping."

Wexford didn't disclose that the audit was harshly critical of both the company and state corrections officials for failing to provide timely, adequate medical care. Nor did it disclose that the audit said Mississippi's Department of Corrections failed to collect $931,310 in fines its chief medical officer recommended against Wexford after the company charged the state for more staff members than it actually provided.

Mississippi's Department of Corrections didn't respond to requests for comment. In its bid documents, Wexford said that it addressed the audit's concerns and that Mississippi renewed its contract. Wexford said that, in Mississippi, it collaborated with the American Civil Liberties Union to get a consent decree lifted last year that had been imposed by a federal court, requiring that state to improve its correctional medical care.
ACLU officials in Mississippi did not respond to requests for comment.

Wexford's bid noted a $12,500 fine by New Mexico's Department of Corrections in 2006 "for infirmary rounds/physicals not conducted within contracted time frames," an issue it said it corrected. Wexford didn't mention that a 2007 audit by a state legislative finance committee reported extensive medical-staff shortages and long delays in reporting inmate deaths, among other problems.

Wexford disclosed that it was fined $106,000 by Ohio's Correction Department in 2009 for contract violations for what it described as "non-critical incidents," such as failing to fill a vacancy or comply with procedures for disposing of used "sharps." In its bid document, Wexford said it addressed the problems and has been in compliance with its Ohio contract ever since.

Wexford listed other fines, including $50,000 by Chesapeake, Va., in 2006 for staffing shortages; three fines totaling $273,000 by Florida's Department of Corrections in 2005 for what it described as "service-delivery issues that were resolved" before the contract's end; and a $68,000 fine by the Broward Sheriff's Office in Florida in 2003 for delays in providing medical services.

The company also noted in its bid document that, over the five years ending Sept. 1, 2011, it received 794 formal or informal legal claims, including many that it termed "frivolous 'alleged deliberate indifference' " suits. The company said it settled 18 claims confidentially for a total of $252,425 and won six claims in court.

Arizona's contract

Arizona's contract with Wexford took effect Tuesday and goes into full operation June 1. It gives the Department of Corrections authority to impose fines or suspend or terminate the contract for violations of its terms. The fine amounts vary according to the severity and extent of the violation, from $10,000 for an act of deliberate indifference that risks an inmate's health or safety to those of $25,000 a day or more. Corrections also will have on-site monitors at every prison and will conduct quarterly audits, according to the contract.
One state health-care employee, who asked not to be identified, said that whatever happens with Wexford, "the only way to go is up." According to allegations in the ACLU/Prison Law Office suit, Corrections systematically and unconstitutionally fails to provide adequate care to inmates and has done so for years. The department has not filed a legal response to the allegations.