Delaware's
Deadly Prisons
Accountability
for deadly prisons?
Critics
say Delaware has little oversight. Is the solution national
accreditation?
BY
LEE WILLIAMS AND ESTEBAN PARRA
The News Journal
09/28/2005
There
were two Jermaine Wilsons doing time at Gander Hill prison
in Wilmington. They were young black men who were
unrelated.
One, in prison for a robbery charge, had served about three
years and was due to be released in February of this year.
His mother was picking him up.
The other, doing time for violating parole stemming from
drug charges, was facing new charges associated with a
cocaine bust. He was scheduled in February to be
transferred to the maximum security wing of the Delaware
Correctional Center near Smyrna -- the state's roughest
prison, built for the most incorrigible offenders.
But corrections officials sent the wrong Jermaine Wilson to
Smyrna.
And days later -- when he should have been free, guards
found 20-year-old Jermaine Lamar Wilson dead, hanging from
a bedsheet in his cell.
Because he had a cut on the back of his head, his family
suspects he was murdered.
"There was blood all over his clothes," said Laretta
Wilson, Jermaine Lamar Wilson's aunt. "There was blood in
his underwear and all over his pants. Maybe someone hit him
on the back of his head?"
The Delaware Medical Examiner's Office called the wound
"superficial" and ruled the death a suicide.
Wilson's family received little information from the
Delaware Department of Correction. No apology. No excuse.
Just Wilson's blood-soaked clothes. Correction Commissioner
Stan Taylor declined to comment on specific inmate deaths,
including Wilson's.
During a six-month News Journal investigation, a former
doctor and two nurses who worked in Delaware prisons and
dozens of inmates and their families claimed prison health
care in Delaware is dangerously substandard -- leading to
needless deaths, prolonged suffering and the spread of
infectious diseases inside and outside prison walls.
Wilson's death raises a larger question: Are standards
throughout Delaware's prison system too low?
There are few safeguards in Delaware prisons:
•Dr.
Janet Kramer, of Wilmington, an expert in prison health
care, said inmates should be screened for hepatitis C and
HIV -- but pretrial and convicted inmates are not routinely
screened when they are sent to prison or when they leave.
Delaware prisons have become incubators for new strains of
the AIDS virus, creating a public health crisis, experts
say.
•Former
prison doctor Ramesh Vemulapalli says a private medical
company ordered him to treat inmates for HIV or hepatitis
C, but not both. Delaware led the country in two of the
past four years in the rate of inmates dying of AIDS.
•Inmates
in Delaware kill themselves at twice the national rate. Dr.
Carol A. Tavani, a neuropsychiatrist and executive director
of Christiana Psychiatric Services, said new inmates should
be counseled in person about suicidal tendencies, not
simply given a "contract" to sign promising not to kill
themselves.
•Unlike
Pennsylvania and other states, Delaware does not have a
medically trained state employee overseeing contract health
providers. Maryland has its own statewide correctional
accrediting agency, Delaware does not.
•The
prison's grievance system is overseen by the medical
vendor, not prison officials or an independent medical
professional.
•Commissioner
Taylor awarded the current $25.9 million medical contract
-- signed this year with Correctional Medical Systems (CMS)
of St. Louis -- without putting the contract out for bid.
Gov. Ruth Ann Minner approved the decision, but insisted it
was a contract extension even though CMS replaced First
Correctional Medical of Tucson, Ariz., a different company.
•The
state occasionally discharges convicted inmates early so
neither the state nor its prison health care contractor has
to pay medical costs, leaving the payments to families or
the federal Medicaid program. Neither federal prison
regulators nor the public is told about inmates who die
after such discharges.
•The
state does not routinely conduct autopsies on inmates who
die in prison or those hospitalized at the time of their
death, a policy the president of the National Association
of Medical Examiners believes prevents evaluation of the
quality of prison medical treatment. And if it does conduct
autopsies, the results are sent to the medical vendor --
not the prison.
•Dr.
Robert Cohen, an expert in prison health care whom state
and federal courts have appointed to monitor prisons in
five states, said the state should investigate medical
malpractice claims. Instead, the state's medical board
occasionally takes complaints from inmates and their
families about prison health care professionals, but it is
only an advisory panel. The board's findings are
confidential and given to the private medical vendor.
Jermaine Wilson's transfer
The American Correctional Association mandates thorough
psychological screening upon entry into prison. If any
abnormality -- such as thoughts of self-harm -- is
discovered, an inmate is immediately sent for a
comprehensive mental health exam, said Joey R. Weedon, the
ACA's director of government affairs. And the ACA requires
inmate movement and release dates to be closely monitored,
a process that broke down in Delaware when Wilson was
shipped to hard time in Smyrna, rather than freedom at
home.
"That's an assumption written into numerous standards,"
Weedon said. "A patient's medical records and their files
should be updated, and good time credited, so they're
released properly."
In an effort to conform to these best practices -- and
expose problems in prison medicine and management -- many
U.S. prisons have sought accreditation through the ACA,
which conducts a series of inspections and audits.
Delaware has not.
"We have not gone down the ACA road," Taylor said. "We just
have not done it."
Pennsylvania prison standards
Other prison systems have found accreditation to be useful.
In a performance and accountability report in 2003, the
Department of Justice said that "it strives to maintain
facilities that meet the accreditation standards of several
professional organizations, including the American
Correctional Association."
According to the report, 90 percent of federal prisons were
accredited in 2003. State prisons, like those in
Pennsylvania, also have found success in accreditation.
"Accreditation shows you're running a safe, humane
institution that meets all the standards," said Martin
Dragovich, superintendent of the Pennsylvania State
Correctional Institution in Chester. The prison, built on
part of the old Pennsylvania Shipbuilding Company site
along Chester's crime-ridden waterfront, has a capacity of
1,175 inmates and was just 15 inmates short of that in
August.
"It shows you're doing something right," Dragovich said of
accreditation. "It's clear you're following nationally
recognized procedures. I have a sense of pride in being
accredited."
For the Pennsylvania Department of Corrections,
accreditation is mandatory. Every state corrections
facility in Pennsylvania, except two recently constructed,
is ACA-accredited -- including all 15 community corrections
centers and the department's central office.
The ACA began offering accreditation in 1978 and has
accredited more than 1,500 correctional facilities,
including more than 80 percent of all state departments of
corrections and youth services, and facilities operated by
the Federal Bureau of Prisons and the U.S. Parole
Commission. In addition to national recognition,
accreditation benefits include improved management as well
as increased accountability and more credibility with the
public.
Thomas A. Rosazza is a corrections consultant based in
Colorado Springs. His corrections career has included work
with federal and state agencies, including the National
Institute of Corrections and the American Medical
Association Jail Standards Project.
"There are a lot of benefits to accreditation," Rosazza
said. "Specifically, what it helps people do is impose a
management construct on the system. The standards reflect
the best practices, establish a safe environment from
things like fire and environmental conditions to staff and
inmate safety."
The ACA standards cover administration, disease prevention,
AIDS care, training and a host of other areas.
"There are 531 standards," Dragovich said. "They're not
site-specific. The same standards apply to every facility
seeking ACA accreditation."
No oversight
Every institution in the Pennsylvania Department of
Corrections has a correctional health care administrator
whose role is to oversee the medical vendors and
investigate grievances and other complaints made against
the state's medical vendor -- Prison Health Services.
Shirley Laws-Smith -- a registered nurse -- is the
correctional health care administrator at SCI Chester. She
has counterparts at every facility in the state. If she
questions a vendor's procedure, she can take immediate
action.
"If they make a decision and I don't agree with it, I will
contact the central office at the Bureau of Health Care
Services," she said.
Delaware's inmate grievance process is quite different. In
Delaware, no one with any medical training oversees the
actions of the medical vendor, and the vendor controls any
complaints. When an inmate files a grievance about poor
care, it goes straight to the vendor. When an inmate
appeals the decision, the grievance eventually goes back to
the vendor.
Pennsylvania officials say it is vital to have someone
medically trained in the oversight role.
"You have to have someone watch the hen house," said
Dragovich, the Chester superintendent.
At the Chester prison there's an infection control nurse,
two dentists and two psychologists who work for the state
-- not the medical vendor.
All mental health workers in Delaware prisons are contract
workers employed by medical vendors.
The Chester infirmary has 23 rooms and 30 beds with call
buttons for the patients -- something not seen in Delaware.
While guiding a tour of the infirmary last month, Louisa
Perez noticed a Latino inmate in a cell holding an ice pack
to a bloody nose.
She took the time to calm him down, speaking Spanish
through the cell door.
"They're not going to hurt you. They're going to take care
of you," she said. "You just have to learn to behave."
In Delaware, only the juvenile facilities operated by the
Department of Services for Children, Youth and Their
Families have achieved ACA accreditation -- and the best
practices and rigorous oversight that accompanies it. The
Delaware American Civil Liberties Union strongly supports
accrediting the state's prisons.
"Absolutely! Please. Please," said ACLU Delaware Executive
Director Drewry Fennell. "We need it. The biggest issue
here is a systemic failure, a failure of oversight and a
failure of transparency."
Tough process
But the accreditation process, according to the ACA, would
involve a tough look at "services, programs and operations
essential to good correctional management, including
administrative and fiscal controls, staff training and
development, physical plant, safety and emergency
procedures, sanitation, food service, and rules and
discipline."
Serious issues about prison management -- a key component
of the accreditation process -- most recently were raised
in Delaware after a July 2004 hostage situation in which
prison counselor Cassandra Arnold was raped by Scott A.
Miller, an inmate serving a 699-year sentence for rape,
assault and kidnapping.
Miller was shot to death following a nearly seven-hour
standoff.
In an e-mail she sent to prison officials days before her
abduction and rape, Arnold warned of security lapses.
"I was down in MHU 23 today, and due to your request a few
weeks ago I thought you might want to know this. ... I AM
NOT A SNITCH, but you asked for this stuff," her e-mail
said.
The e-mail identified a security problem at "MHU 23," which
is Building 23 of the Delaware Correctional Center's
medium-high security unit.
"When I exited 24 both sliders [doors] to 23 were all the
way open. It was 0800, so I understand that there was no
movement. The control room door was propped. I closed it,
but after I did, people continued to go in and out of the
pod, leaving it propped."
Three months after her abduction, Arnold wrote a two-page
letter to a gubernatorial task force reviewing problems in
the corrections department. "Any person who tries to tell
the truth about unsafe practices is immediately labeled a
snitch," she wrote.
The letter also said many of Arnold's colleagues continue
to work in unsafe conditions. Arnold, who is suing the
department, has not returned to work.
"And even as I try to move forward with my life despite
that awful seven hours," the letter said, "it is hard to do
so knowing that the Delaware Correctional Center continues
to work in such a dysfunctional and dangerous way."
Prison guards used the incident to urge Gov. Ruth Ann
Minner for a raise and better conditions by saying that
poor working conditions led to the standoff. The Minner
administration granted improvements, including quicker
eligibility for pensions and pay increases linked to the
number of years on the job. Since getting raises, prison
guards have been quiet and have accepted the forced
overtime they complained so much about before the raise.
Leaders for the Correctional Officers Association of
Delaware, which represents prison guards with the rank of
corrections officer up to sergeant, would not comment.
Neither would representatives with the American Federation
of State, County and Municipal Employees Local 247, which
represents corrections officers from lieutenants through
captains.
Commissioner Taylor, who started his career with the agency
in 1976 as a prison guard, said he was "not aware" of
accountability issues within his department.
Still waiting for an answer
At 17, Jermaine Lamar Wilson pleaded guilty to robbery. He
had been in custody since December 2002 and was moved to
Gander Hill when he turned 18. His mother said her son
showed absolutely no sign he was contemplating suicide.
"He was happy," Suzie Wilson said. "He called three times a
day. He was never depressed. He was happy he was getting
out. Who wouldn't be?"
He sent a letter home eight days before his death.
"Halleulah!! I'm finally coming home mom, and to stay,"
Jermaine Wilson wrote. "God is good. I was praying last
night and I know you was praying for me too, and it all
worked out."
When Suzie Wilson was told her son was sent to Delaware's
maximum security prison instead of being released from
Gander Hill, she and her sister drove to Smyrna to find out
why. Guards there told them there was no release paperwork
for Jermaine. She was told to go to dinner and return.
Maybe they'd have something for her then.
"Something very strange was going on," said Jermaine's aunt
Laretta. "When we questioned the staff, they were all
nervous."
On Feb. 17 of this year, she and Jermaine's mother waited
at the prison until 9 p.m., when they returned home angry
and frustrated.
Early the next morning, at around 2 a.m., Suzie Wilson got
a call from Smyrna's deputy warden.
"Ma'am, Jermaine is no longer with us. Jermaine appears to
have hung himself. We found him dead a little after 12,"
she recalls being told by the deputy warden.
Wilson's attorney, public defender Brian Bartley, didn't
know what happened to his client until he received a
frantic call from Wilson's mother.
Bartley researched the case and discovered there were two
Jermaine Wilsons with different dates of birth. According
to court documents, the other Jermaine Wilson has been
arrested 27 times, most recently for cocaine trafficking.
He pleaded guilty to the charges and is serving a
three-year prison sentence.
"This was a tragedy of errors," Bartley said.
Wilson's mom insists the cause of her son's death is being
covered up.
"We have not heard anything from the DOC," Suzie Wilson
said. "Not a letter. Not a boo."
Contact Esteban Parra at 324-2299 or
eparra@delawareonline.com.
Contact investigative reporter Lee Williams at 324-2362
or
lwilliams@delawareonline.com