Big medical problems found at privatized immigrant prisons

Seth Freed Wessler, Nation - Until the 1990s, border crossing was almost always treated as a civil offense, punishable by deportation. But in the late 1980s, Congress started to change that. By 1996, crossing the border after deportation was punishable by years of imprisonment, with enhanced sentences for people previously convicted of crimes—most often drug offenses. Though federal investigators have found no evidence that criminalization has reduced the pace of border crossings over the long term, prosecutions for illegal entry and re-entry rose from fewer than 4,000 a year at the start of Bill Clinton’s presidency, to 31,000 in 2004 under George W. Bush, to a high of 91,000 in 2013 under President Obama.

By the late 1990s, the flood of inmates from this new class of prisoner, coupled with a raging War on Drugs, sent the Bureau of Prisons searching for places to put them. The BOP turned to private companies to operate a new type of facility, low-security prisons designed to hold only non-citizens convicted of federal crimes. As of June 2015, these facilities—which are distinct from immigration detention centers, where people are held pending deportation—housed nearly 23,000 people.

At least five times since 2008, inmates have rioted in the BOP’s contract prisons. The unrest has often come after medical-care complaints. Repeated federal audits and reports have found these facilities to be in crisis. Prison medical care is notoriously bad, but 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 who co-authored a 2014 report documenting the subpar conditions.

After two years of negotiations with the BOP in and out of federal court over an open-records request, I obtained more than 9,000 pages of medical records that contractors submitted to the BOP. They include the records for 103 of at least 137 people who have died in federal contract prisons from 1998 (the year after the first one opened) through the end of 2014. The records all concern men; women are sent to regular BOP-run prisons. The documents include nurse and doctor notes, records from hospital visits, psychological files, autopsies, and secret internal investigations. In their pages can be found striking tales of neglect.

Each case file—sometimes hundreds of pages long—was reviewed by at least two independent doctors who rendered opinions on the adequacy of the medical care provided. Some of the case files are meager and appear to be missing pages. But of the 77 that provided enough information to render a judgment, the doctors 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.