Surviving Hepatitis C in AZ Jails, State Prisons, and Federal Detention Centers.

Surviving Hepatitis C in AZ Jails, State Prisons, and Federal Detention Centers.
The "Hard Time" blogspot is a volunteer-run site for the political organization of people with Hepatitis C behind and beyond prison walls, their loved ones, and whomever cares to join us. We are neither legal nor medical professionals. Some of us may organize for support, but this site is primarily dedicated to education and activism; we are fighting for prevention, detection, treatment, and a cure for Hepatitis C, particularly down in the trenches where most people are dying - in prison or on the street... Join us.

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Showing posts with label maricopa county jail. Show all posts
Showing posts with label maricopa county jail. Show all posts

Monday, August 30, 2010

Conditions of confinement: Sheriff Joe's jail is our responsibility, too.

The following is a revised and somewhat more radical version of my post from AZ prison watch earlier in the night. It seemed appropriate for this blog, too. No one is listening to us at the Governor's office or ADC, so try the DOJ now. Please call or write today.



Amnesty International poster: Write a letter, save a life.

For those who missed Stephen Lemons' review of Shaun Attwood's new book, "Hard Time: A Brit in America's Toughest Jail", it's worth the read. I'd post it here but I've already packed in too much for the night. It is, of course, about the Maricopa County Hell they call a jail. Hit Shaun's blog, "Jon's Jail Journal" too, if you haven't already. He posts letters from prisoners there, and is a good friend to many who would otherwise have no audible voice.

As for the conditions of confinement in our jails and prisons: I don't understand why the Department of Justice hasn't held Arpaio criminally responsible for his abuse of so many people over the years - from medical negligence to conspiracies to deprive us of our civil rights. Their failure to do so thus far is akin to the feds' consent for every harm he's done under his tenure, and complicity with every additional prisoner he neglects or kills. I'm really starting to worry that they plan to make some kind of closed door deal with him, then pack their bags and walk away.

The Civil Rights of Institutionalized Persons Act covers prisoners precisely because the People so often end up needing protection from the sadistic cruelty of those wielding power in our name, and few in America are more disenfranchised and vulnerable than those disposed of in jails and prisons - citizens and "aliens" alike. They include our elderly, our poor, our sick, troubled youth, our mentally ill, our developmentally disabled - all those people we once institutionalized elsewhere (and have thrown out into the streets) are thrown into the stew.

Of course, the more vocal idiots in our community argue after every article about prisoner abuse or suicide that because they are in a jail or prison they deserve whatever they get, whatever that may be. Just because those readers like to stone prostitutes, though, doesn't mean they are themselves without sin. Nor do they represent all of us. Those people are twisted bullies hiding behind fake identities looking for someone to kick who's already down. They've probably commented on this blog of Stephen's, in fact.


That's a tangent I can't stop from exploring in this context. The media shouldn't give such people the platform on which to celebrate brutalization, suicide, and murder, including among prisoners, in the first place. That's not supporting freedom of speech - it's just intimidating the voices of reason and humanity into silence. Giving hateful people our shared public space empowers them to use shame to perpetrate cruelty, and it perpetuates the stigma felt by prisoners' families who read "good riddance" from the community after their loved ones die. They screen such things out of printed "letters to the editor"; why not moderate their public forums? Only abusive and rich people seem to get amplified when they speak - the rest of us get censored, even if we head the nightly news.

Frankly, most of "free" Arizona should be locked up, looking at the multitude of laws that require jail or prison for those who break them - and at how unbelievably easy it is to put someone away, especially in this state. We are just privileged or very lucky if we've escaped such a fate so far. Those who think they will never be prosecuted because they really aren't "criminals" need to check out the Arizona Justice Project. There are all sorts of innocent people behind bars.

Once in a while the law reaches out and touches us where we never thought it would - and since it's not a common occurrence in our white, middle class communities, we are sure that there is just a deviant in our midst, or it is a fluke of the justice system that will work itself out. Dad's in an accident while on painkillers following surgery and goes to prison because he had an old DUI. Presumably he will get treatment in prison, but he's already been sober for 5 years - instead he just loses time from his kids' lives and his ability to support his family. The neighbor is arrested for embezzling to save the house from foreclosure and her kids from homelessness - losing everything and everyone in the process. We pay over $20,000 a year to incarcerate her for five years - and God knows how much to put the kids in foster care - while her banker gets a bonus from the taxpayer bailout.  


I hope everyone out there finds those images as disturbing as I do. It happens all the time.

As for the wrongfully-accused: Americans don't really presume innocence, which is why Joe's jail was allowed to get so bad. We recoil from the accused as soon as they hit the news because the possibility that agents of the almighty law might be corrupt or wrong threatens our sense of social order. We sacrifice Innocence like she's the designated virgin just to maintain the illusion that the guilty among us are eventually caught, and that those who are caught are always guilty. 

People who are innocent tend to believe that the truth will prevail, and if it doesn't they end up being punished worse than the real criminals who make a deal. Real-life case in point: Courtney Bisbee, the school nurse accused of touching a 14-year old liar and branded as a child molester, was a feather in the cap of the detective who arrested her and the prosecutor who got the conviction. To assure that the rest of us got our taste of blood, the judge slammed her with 11 years for fighting it out in court instead of taking a plea bargain that would have had her back home with her child by now.

Stephen Lemons even investigated Courtney's case and advocated on her behalf (here and here, too), but no one wants to hear the new evidence that would exonerate her because it implicates incompetence - or worse. For law enforcement's ego and our sense of order, she's been in prison for at least 6 years now. Maybe Romley is the man who will have the courage to help set her free - we'll see. He was the Maricopa County Attorney when she was originally prosecuted, so if he steps up to the plate and looks at it in a new light, I'll be impressed. Andrew Thomas was too much of a political coward.

In these ways the brutality of our courts, Joe's jail, and Ryan's prisons hits home. It's not a freakish thing for families to be ripped apart by "justice" in poor and minority communities - it's all too common. The legal system works exactly as it's designed to there, oppressing resistance to white supremacy and defiance of the rules of capitalism at every turn. Justice is the sheep's clothing that America dons to promote the interests of the few, and the myth that we are a model of democracy is what blinds us - and Her - to the deceit. 

But Justice is not supposed to prey on the rest of us "ordinary Americans"- it is supposed to protect us. It only seems to be when we fall from grace ourselves (or get falsely accused and imprisoned) that we begin to see the system for what it is. We get inside and see people doomed to spend the rest of their lives in prison for charges as petty as fraud, while murderers walk away with money in their pocket after 15 or 20 years. Looking around, we also realize that the majority of the people behind bars are not a public safety threat - most are public nuisances, eyesores, "sinners" and surplus laborers who legislators thought would be better hidden away. Those still claiming their innocence are all too often out-maneuvered by the state in legal proceedings, and seldom have the luxury of an attorney to help them once appeals are exhausted. 


Look closely and you'll see that America's prisons and jails have, by and large, replaced our mental hospitals, poorhouses, and plantations. And they are major money-making machines for those in power, as long as they skimp on human rights and basic needs like food and health care. That's why the prisoners who would expose them are discredited, discounted, and silenced in every way possible.

Never mind that the desperate and vulnerable are being relegated and abandoned
in these hellholes to sociopaths who will rape and torture them for the fun of it, or even kill them just to score a new gang tattoo. To the private and public prison industries alike, each new body is just an addition to their growing empire - they have no interest in anyone's innocence or special circumstances, and no reason to help prevent or reduce the effects of crime in our communities. 

Despite lamenting about the high recidivism rate (usually as an excuse to be better funded and more brutal), jails and prisons are just as well-paid for recycling the people they chewed up once already. Buying the industry's line of BS, a terrorized public decides that parole officers and prosecutors are always professional and responsible and work in a functional system, so it must be the criminal's own fault for getting put back in - he should have learned his lesson the first time. Our perceptions are too often shaped by the expectation that what we pay nearly 10% of our state budget for includes some effort at "rehabilitation" (hence the AZ Department of Corrections' designation as such, not the "Department of Confinement"). The criminal justice system isn't rehabilitating anyone - they're spending our money lobbying the governor and legislature to pass more laws and assure more prison sentences for less serious crimes than ever.

The prison industrial complex as a whole (of which Sheriff Joe is actually just a small part) cultivates the rest of us to feel exploited and victimized, though, so that we seem defenseless and helpless without them. Then they glorify themselves as our protectors (though they usually arrive after the crime, not in time to prevent it), and we willingly pay them some other kid's lunch money to keep it up.
It's a racket. Actually reducing crime and making us all more safe would just cut into their power and profit margins.  

Anyone who believes such a system really upholds justice or promotes the public good is delusional or has been duped. Law enforcement is an integral part of the fascist decimation of our rights, not the power protecting them. We - the People - are the only power that will protect liberty and justice for the future, but only if we have our eyes wide open and are ready to risk jail, prison, defamation, and even execution in the process. If we are not, then we have surrendered that which is most important in life for nothing more than illusion. We are on a leash, instead of in a cage. At least some prisoners, with their integrity intact, mange to remain free.

The DOJ is grossly negligent for failing to act aggressively under CRIPA against the MCSO, and therefore shares the blame for emboldening our greedy, bigoted, fear-mongering lawmakers and enforcers to continue to imprison, injure, and kill those of us whose nationality or skin color or gender or politics or religion they hate.
But we are also responsible for letting this go on so long without holding either the feds or Arpaio accountable ourselves. So, here are the names and contact info for the people at the DOJ who should be investigating the real public enemies - and taking action - under CRIPA, regardless of what else they're doing. Please call or write on behalf of those fighting  a losing battle to defend their lives. Don't wait for your loved one to end up in trouble: he or she may be the next prisoner of the MCSO or Arizona Department of Corrections to die.

So could you or I.


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DOJ - Special Litigation Section

Mailing Address

Special Litigation Section

950 Pennsylvania Avenue, NW, PHB
Washington, D.C. 20530
For FEDEX: 601 D Street, NW, Washington, DC 20004

Telephone Number
(202) 514-0195
toll-free at (877) 218-5228

Fax Numbers
(202) 514-0212
(202) 514-6273


Acting Chief
Judy Preston
(202) 514-6258

Principal Deputy Chief
Tammie Gregg
(202) 616-2009

Deputy Chiefs
Julie Abbate (Acting)
(202) 353-4637
Mary Bohan (Acting)
(202) 616-2325
Luis Saucedo (Acting)
(202) 353-0299

Saturday, April 17, 2010

ARPAIO's Jail Health Care Crisis Continues.


When Bertha Oropeza was arrested last summer for marijuana possession, she didn't expect it to nearly cost her life.

But after 10 hours in Maricopa County's Fourth Avenue jail, Oropeza was unconscious, in cardiogenic shock with acute kidney failure at Good Samaritan Hospital. Meanwhile, no one at the jail could tell her family where she was. "She's been released" was their refrain.

Oropeza, 45, had been straightforward with jail personnel about needing medication, which is reflected in jail and hospital records, as well as in Oropeza's recollection.

When she was arrested, she tells New Times, she clearly remembers telling the officer who took her purse that she would need to take her pills again in an hour.

He told her to wait until she got to the jail.

As Maricopa County Sheriff Joe Arpaio's guards took her through the intake process "they asked me when I last took it, and I told them," Oropeza says. "I'm thinking, 'Okay, they're gonna give me my medication.'"

They didn't, so she tried again, telling the guard checking her into the jail that she needed her pills.
"Well, you don't need them right now," he told her. "It's your own fault. What do you think this is, a hospital?"

Oropeza's medical history is summarized in Good Samaritan Hospital records, released by Oropeza to New Times: She was in a car accident in west Phoenix in 2005 that left her disabled and with chronic back and leg pain.

Oropeza says she spent a month in a coma and five months in the hospital after she was thrown from the passenger's side of a car. Her hip "came completely out of socket," she says, and she suffered extensive head trauma after hitting the pavement.

She regularly takes the painkillers morphine and oxycodone as well as the muscle relaxant carisoprodal, according to hospital records.

Jail employees definitely knew about her condition, county records show. At 9:49 a.m. — about the time Oropeza was booked into the jail — a note was entered in her file recording that she was on medication for chronic pain in her legs and back due to a car accident.

Still, she didn't get help.

Oropeza knew what would happen next: The pain in her legs would come back, her stomach would reject anything in it, her muscles would seize up, and her lungs would tighten.

"If I don't take my medication, then I get a withdrawal right away," she says.

She had no power to stop it from coming. It did.

In the first holding cell, waiting to be fingerprinted, Oropeza asked for a bag to throw up in. A guard handed her one.

She sat on the concrete floor in the corner of the cell, vomiting into the bag until it was full, unable to move as the pain in her legs crept back and the painkillers wore off.

When she asked for a second bag, a guard told her to use the trash can on the other side of the cell. But she couldn't get up to walk over to it.

"Just don't throw up on the floor," he told her.

She was struggling to breathe and still throwing up when another woman in the cell began to kick the door to get the guard's attention. Oropeza, afraid of angering the guard, begged her not to.
"No," the woman said. "You need help. You need help now."

When the guard finally came, he walked Oropeza down a long hall and told another guard on duty there to "take her down to medical," Oropeza remembers.

Standing at the end of the hall with the new guard, Oropeza felt increasingly dizzy. She grabbed a nearby chair because she felt like she was going to faint.

"Don't touch that chair," the guard yelled.

"You don't need nothing to hold on to. You just stand there," Oropeza remembers him saying.
She asked him whether she could hold onto the wall. He told her no.

"All you're doing is putting on a show to get out of here. We get it all the time," he said.

When he took her out of the hallway, it was to yet another cell — this one right outside the medical unit, where she could see the nurses through a window.

Oropeza begged the nurses for help, miming that she couldn't breathe. She says Arpaio's guard just laughed at her. The nurses didn't come.

By about 1:30 p.m., after at least three hours of vomiting and dry heaving in a cement jail cell, Arpaio's guards finally turned her over to Correctional Health Services, the medical unit of the jail, according to records.

She was handcuffed to a gurney. When she complained of being cold, "they threw paper over me," she says.

At a few minutes before 7 p.m. on June 2, CHS staff called an ambulance to come for Bertha Oropeza. It arrived at 7:30 p.m., according to records, a full six hours after she had entered the medical unit
Healthcare in the Maricopa County jails has been the subject of a series of lawsuits, studies, and reports that have concluded the same thing: Inmates get grossly inadequate healthcare.

In September 2008, the jails' healthcare system lost its accreditation from the National Commission on Correctional Health Care. It has not been reinstated.

In an order issued just last week, U.S. District Court Judge Neil Wake gave a devastating assessment of the conditions: inadequate record-keeping, medication management, staffing and mental health treatment threaten the lives and well-being of thousands of inmates every day.

Saying that the level of healthcare is unconstitutional and puts detainees in real danger, Wake ordered the sheriff and Correctional Health Services, the county agency that administers healthcare in the jails, to fix the problems by the end of this year.

The order came on the heels of a lawsuit that alleged violations of inmates' constitutional rights, and worked its way through the court system for years. The sheriff lost that suit, Graves v. Arpaio, in October 2008. And Wake ruled that the sheriff and the county Board of Supervisors, which runs CHS, must make massive improvements to jail healthcare.

Nearly 18 months later, problems remain.

In fact, Oropeza would likely get no better care today than she did nearly a year ago — despite the court's demand for improvements. She entered jail with one of the most common serious medical conditions doctors and nurses see in the jails: dependence on drugs or alcohol. (In her case, prescribed medication.)

A court-ordered report issued last month assessing improvements — or lack thereof — at the jails, found that nearly 15 percent of patients don't get their medications as prescribed, including those who are carrying them. Oropeza says her prescription medications were in her purse when she was picked up.

But the problem is bigger than that — sometimes patients don't get the right dosage, they have adverse reactions to medications, or face other complications. Many experience withdrawal symptoms that can be "life-threatening or extremely painful," according to the report, which was written by a medical doctor assigned to monitor the jails' progress after Judge Wake's ruling.

"Maricopa County jails are not alone," says Peggy Winter, the associate director of the ACLU's National Prison Project and lead counsel on Graves v. Arpaio. Especially in the largest urban jails, officials inevitably struggle with the overwhelming medical and mental health needs of many detainees, she says.

A big part of the problem in Maricopa County is that doctors don't get timely information because the jails' medical records system is inadequate.

With so many inmates, CHS is likely unable to manage medical records or track inmates with medical needs without an electronic system, the report says. The system now is almost entirely manual, often relying on handwritten records.

CHS Director Betty Adams says her department is working to improve the records system. "If I could wave a magic wand, I would hope for some additional technology," she says.
But that is only one deficiency on a long list of things that need improvement. "I have, like, 16 top priorities," she says.

Deputy Chief Mary Ellen Sheppard of the Sheriff's Office says CHS needs to make better record-keeping its top priority. "It boils down to the lack of a tracking system that measures the care being provided and the quality of that care," she says. "It's hard to fix something that you don't have a handle on."

Hard doesn't begin to describe it.


Fixing all the problems in the jails would be a tall order for any government agency. But in Maricopa County, it's even tougher. Here, the sheriff and members of the Board of Supervisors are embroiled in an endless legal battle over seemingly every aspect of the jails — their healthcare system included.

The Sheriff's Office insists that it should have control over healthcare in the jails it runs. But that duty resides with CHS, which has been running healthcare services in the county's jails for decades.

The dispute ended up in Maricopa County Superior Court last year, with Arpaio attempting to wrest power over CHS from the county Board of Supervisors. He claimed that the board is inept and the Sheriff's Office would do a better job of providing healthcare in the jails.

The judge ruled otherwise, throwing out the case last week.

Arpaio's claims came just when evidence began to show that CHS, though far from being a model of correctional healthcare, is actually improving.

Eric Balaban, a lawyer with the American Civil Liberties Union's National Prison Project who toured the jails in September, says he saw progress.

"There certainly is movement in the right direction," he says. "But they were starting from ground zero."

The court-ordered report released in March also makes it clear that CHS employees are making some improvements: They are doing their best with an inadequate records system; more patients are getting healthcare assessments within two weeks of entering the jail, and those with chronic diseases are getting better care.

But, according to Judge Wake, the only real improvements that have been made are the ones that have cost the county little or no money.

CHS is a huge operation, with a $49 million annual budget. Imagine a constant stream of potential new patients — hundreds every day — each of whom is more than likely to be addicted to drugs or alcohol and less than likely to have seen a doctor in the past year.

On any given day, there are about 9,000 inmates in the Maricopa County jails, according to the U.S. Department of Justice. According to CHS documents, 130,000 people were admitted into the jails last year alone. The jails take in 350 new inmates on an average day.

That means CHS has about $6.39 to spend on each inmate's healthcare per day, according to the March report.

Now, imagine trying to take care of that constant stream of patients, while they are being processed and packed into concrete cells, in poor shape and facing worse conditions.

Add a healthcare system that has been plagued by problems for years, and you've got the Maricopa County jails. It's a dangerous situation for medically fragile inmates.

"We're talking about life and death here," says Winter. "So a jail stay for some offense that may be very minor, and for which you might not even have been convicted, can result in a life sentence or some terrible lifelong injury because you didn't get the access to care that you should have."


Before her eight-day stay at Good Sam, Bertha Oropeza had spent just 10 hours in jail.

Her condition that first night didn't seem critical, according to medical records. She must have appeared to be just another narcotics-addicted inmate from Fourth Avenue.

But one day later, Oropeza was rushed to the ICU, intubated, and treated for cardiogenic shock, a life-threatening condition that occurs right before your heart fails completely.

Doctors inserted a balloon pump in her throat to keep her breathing. Her kidneys failed, and she stopped producing urine because of dehydration, according to medical records.

It wasn't until close to midnight on the day she was arrested that her family tracked her down at the hospital.

"We were really worried," Bertha's eldest daughter, Blanca Oropeza, says. "And then we find out her heart's crashing and that she might not make it through the night."

Two days later, Oropeza was out of danger. It was a surprise.

"The heart doctor told us she had a 40 percent chance of living through the night," Blanca says.

Both CHS and Good Samaritan records cite withdrawal from pain medications as possible causes of her near-death. But, at least one thing wasn't the cause: Oropeza's "social history," as doctors call it.
Medical records show that she smokes a pack of cigarettes each day and smokes marijuana — the very offense that landed her in jail.

But the records state: "Social History: Noncontributory."

In other words, it wasn't anything Oropeza had done to herself that brought her so close to death.

Oropeza plans to file a lawsuit against the county but doesn't know where to begin.

"The thing is, if I wouldn't have been in jail and something like that would have happened to me, I would have started straight to the hospital," she says.
"I could have been dead."

In fact, the court-ordered report released this month makes that even more apparent. "The Fourth Avenue jail intake facility is not medically suitable," the doctor writes, for people "prone to instability due to complex acute or chronic diseases" or "those with significant physical or functional disabilities."

Clearly, the Fourth Avenue jail intake facility was not medically suitable for Bertha Oropeza.




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