Tag Archives: Horowitz

Faking Suicide To Get Healthcare And Other BOP Tales of Horror – Update for May 23, 2024

We post news and comment on federal criminal justice issues, focused primarily on trial and post-conviction matters, legislative initiatives, and sentencing issues.

FCI SHERIDAN IS POSTER CHILD FOR BOP DYSFUNCTION

IG230518The Department of Justice Inspector General released a report yesterday that found “serious operational deficiencies,” including “alarming staffing shortages” at the Bureau of Prisons facility in Sheridan, Oregon.

One might say that BOP dysfunction is trending.

FCI Sheridan, a medium-security men’s prison with an adjacent detention center and prison camp, was Inspector General Michael Horowitz’s third unannounced prison inspection since the IG began the program at FCI Waseca (a women’s facility) last May. That report was followed by last November’s findings on a surprise inspection at FCI Tallahassee, another women’s facility. Now, after inspecting two female facilities, the IG has focused on the other 92% of inmates, the men.

IG Horowitz is taking Jan and Dean to heart: Two girls for every boy.

The dominant theme of the Sheridan report is staffing shortages and the effect the problem has on healthcare. providing a glimpse into the depth of inmates’ frustrated enterprise:

For example, we found that, just prior to our inspection, an inmate feigned a suicide attempt in order to receive medical attention for an untreated ingrown hair that had become infected. When finally examined after the feigned suicide attempt, he required hospitalization for 5 days to treat the infection.

gottaso240523No doubt the prisoner was punished for his desperate caper, but only he got out of the hospital. The BOP is unlikely to have acknowledged that it shared any responsibility for turning the simple ingrown hair removal into a $50,000+ medical expense. The inmate was right: you gotta do what you gotta do, and that includes doing what it takes to get urgent healthcare from an overtaxed and uncaring bureaucracy.

The Sheridan findings are plenty harrowing, even without the illustration of the faked suicide attempt. The IG summarized them as:

Healthcare Worker Shortages: Because of short staffing in the Health Services Department, a backlog existed of 725 lab orders for blood draws or urine collection and 274 pending x-ray orders at the time of the inspection. “These backlogs cause medical conditions to go undiagnosed and leave providers unable to appropriately treat their patients,” the report said.

High Correctional Officer Vacancy Rate: A shortage of correctional officers meant that “inmates must routinely be confined to their cells during daytime hours and are therefore often unable to participate in programs and recreational activities.” What’s more, the shortage meant that “FCI Sheridan did not always have available Correctional Officers to escort inmates to external medical providers.”

Psychology Services and Education Department Staffing Shortages: “[S]erious shortages among drug treatment program employees prevented the institution from offering its Residential Drug Treatment Program (RDAP) to inmates… We also found long waitlists, some exceeding over 500 names, for other trauma-related mental health, anger management, and work skills classes.”

Sexual Misconduct Reporting: FCI Sheridan did not centrally track the number of all allegations of inmate-on-inmate sexual misconduct reported to employees. The failure “undermines the ability of… the BOP to collect data consistent with Prison Rape Elimination Act (PREA) standards that would allow them to assess and improve the effectiveness of sexual misconduct prevention efforts.”

understaffed220929

NPR reported that the staffing shortages “are among the biggest obstacles facing the federal prison system, according to this report, and contribute to other challenges at Sheridan and the more than 120 facilities like it.” Horowitz told NPR that “[i]t’s a problem that is at least 20 years in the making. It’s not going to get fixed overnight. But what these inspections show us how serious the problem has now become.” Horowitz said. “It is deeply concerning when you go to a facility like Sheridan and you hear from the staff, correctional officers, health care workers, educators, that they can’t do the jobs that they’re there to do and they want to do.”

After this third IG inspection, a trend is developing:

• Both the Tallahassee and the Sheridan inspections found “serious operational deficiencies” and “alarming” problems. At FCI Tallahassee, the alarming conditions were with the facility’s execrable food service. At Sheridan, staff shortages were “alarming.” The IG is able to be frugal, reusing the same descriptors for multiple prisons.

• All three inspections included the same disclaimer: “We did not make recommendations in this report because in our prior work we have recommended that the BOP address many of these issues at an enterprise level.” In other words, the IG was reporting on endemic BOP problems that exist throughout the system. The Sheridan report parrots the prior reports, conceding that “[m[ost of the significant issues we found at FCI Sheridan were consistent with findings the OIG has made in other recent BOP oversight work, which we have reported on publicly.”

Nothing new here, either folks.

• We’re starting to suss out the inspection tempo. The Waseca report was last May, the Tallahassee report was in November 2023, and Sheridan was this week. It looks like the IG is inspecting about two facilities a year. Certainly, there are resource considerations: it takes people to kick open the prison doors. Horowitz told a National Press Club audience last March that “[m]y 500 personnel [are] comprised mostly of auditors and law enforcement agents. We also have evaluators and inspectors. One of the things we’re doing now, by the way, is unannounced inspections of federal prisons, and those are much smaller groups compared to the auditors and the agents.”

• All three inspections found serious staffing problems, which is hardly news. The Waseca and Sheridan inspections found long delays in providing First Step Act and drug abuse programming to inmates, which the Sheridan report said resulted in inmates having “limited opportunities to prepare for successful reentry into our communities. “ All three reports found that shortages of Healthcare staff had “negatively affected healthcare treatment” (as the Tallahassee report put it). The Waseca findings were that “staff shortages in both FCI Waseca’s health services and psychology services departments… have caused delays in physical and mental health care treatment.”

• The IG reports all seem to come with some sexy news hook. Waseca’s was inmates living in basements and under leaky pipes. Tallahassee’s was moldy food and rat droppings in the chow hall. Sheridan’s was the feigned suicide attempt to get healthcare.

suicide240523“What we’ve seen over and over again, in our unannounced inspections of the Bureau of Prisons is the challenges they face in meeting their mission of making prisons safe and secure, and preparing inmates for reentry back into society,” Horowitz told NPR in an interview reported yesterday. “And this is another case where we’ve seen severe challenges that they face in fulfilling those missions.”

DOJ Inspector General, Inspection of the Federal Bureau of Prisons’ Federal Correctional Institution Sheridan (May 22, 2024)

NPR, Lack of staffing led to ‘deeply concerning’ conditions at federal prison in Oregon (May 22, 2024)

National Press Foundation, ‘The Truth Still Matters’: Justice Department Inspector General Highlights Non-Partisan Work (March 15, 2024)

– Thomas L. Root

Peters May Be The One – Update for March 5, 2024

We post news and comment on federal criminal justice issues, focused primarily on trial and post-conviction matters, legislative initiatives, and sentencing issues.

PETERS BLUNT WITH SENATORS ABOUT BOP TROUBLES

No one who’s ever had a beef with what I publish in this blog – and there surely are a lot of people who have complaints – has ever accused me of being an apologist for the Federal Bureau of Prisons. But here goes…

cucumber240305Watching BOP Director Colette Peters testify before the Senate Judiciary Committee last week was a refreshing departure from her previous appearances and a downright treat after enduring years of painful appearances by her clueless predecessor Michael Carvajal.

“The Feds survey says the Federal Bureau of Prisons is the worst place to work in federal government, so we have a lot of work to do,”  Peters candidly told the Committee last Wednesday during the hearing Committee Chairman Richard Durbin (D-IL) called in response to a DOJ Inspector General report on inmate deaths in federal prison.

That report, issued two weeks before, found that systemic and operational failures contributed to scores of prisoner deaths over the years. Durbin convened the hearing to underscore the report findings that – among others – suicide accounted for over half of the deaths reviewed by the IG.

Sharing the witness stand with DOJ IG Michael Horowitz, Peters was the target of most of the senators’ questions. But unlike her stumbling performances in prior Congressional hearings, Peters was confident, direct and armed with facts and numbers during the 2-hour session. And when Sen John Kennedy (R-LA) hectored her in one of the most bizarre barrage of questions in recent memory, she cooly stared him down while undoubtedly controlling the urge to ask him who tied his shoes for him every morning.

But back to the hearing.

Paters laid most of the blame for the issues raised in the report on BOP’s chronic staffing shortages. She told the senators that the data on BOP correctional officers are “startling,” rattling off the stats:

One in three have symptoms of PTSD. That means more anxiety, more depression, [and] that means more reliance on substance abuse and higher levels of divorce. Over 90% are obese or in the overweight category, over 90% have hypertension or pre-hypertension… What we’re finding across the country, in some places they can leave the [BOP] and work for state corrections and make two to three times more, let alone the bonuses that we’re battling against at fast food organizations. So it is incredibly difficult… I also want to remind the committee that the average onboarding for law enforcement in this country is 21 weeks [of training] and our officers receive about six. It’s truly unfortunate.

psy170427The IG report found that a shortage of psychiatric services employees “strained the ability of staff” in facilities where prisoners died “to provide adequate care to mentally ill inmates.” This has been a chronic BOP problem, where a dearth of mental health resources has led to many people being underdiagnosed, a 2018 Marshall Project investigation found. In the Senate hearing, Horowitz noted that over 60% of people who died by suicide in federal prisons had been on the Mental Health Care Level 1, meaning the BOP had determined that they did not need regular care mental health care.

Peters and Horowitz both pointed to staffing shortages as a key driver of the problems. A lack of clinical staff like psychologists and corrections officers has been an endemic challenge in many BOP facilities, the Marshall Project reported last weekend.

Horowitz also suggested that the BOP’s problems may be more than just staffing. Talking about contraband, he that “we’ve had a staff search policy recommendation open for years that has not been implemented, the basic search policy for staff coming into the facility, that hasn’t happened, either…” Several senators cited a GAO report last month that the BOP has failed to implement 58 of 87 recommendations on improving restrictive housing (also known as Special Housing Units, or SHUs) practices.

Kennedy tried to beat up Peters with a theatrical performance accusing her of using the First Step Act to release 30,000 criminals, 12% of whom have been recidivists (as though the decision when to release prisoners is her responsibility). Punctuating his questions with dramatic eye rolls and sighs of “Wow,” Kennedy sought to blame Peters for releasing thousands of violent criminals to prey on helpless civilians.

Kennedy: “How many criminals have you released under the First Step Act?”

Peters: “We have about 30,000 individuals that have been released since the passage of the First Step Act.”

Kennedy: “All right, so you’ve released 30,000 criminals under the First Step Act, okay? . . . Before you released them, did you contact any of their victims to say, ‘We’re about to let this guy out’?”

Peters: “Senator, it’s my understanding that that notification happens through the U.S. Attorney’s Office, but I will check into that and get back to you.”

Kennedy: “You don’t know?”

Peters: “Senator, I don’t.”

Kennedy: “Wow. Okay, of the 30,000 criminals you let free, how many of them have come back, have committed a crime again, hurt somebody else?”

Peters: “So, that number is one that we’re still looking at as it relates to the recidivism rate for those that were released on the First Step Act.”

Kennedy: “You don’t have any idea?”

Peters: “No, Senator.”

The implication that Peters and the BOP should be responsible for victim notification – a duty of the US Attorneys offices – or maintaining recidivism records is risable. It’s like asking the Veterans Administration how much ammo the Defense Dept has.

tieshoes240305Beyond that, suggesting that somehow Peters was releasing BOP prisoners on her whim, rather than in response to the court-ordered sentences ending or statutory mandates requires a special kind of ignorance of the law unbecoming of a man who was Phi Beta Kappa and with years of experience as a lawyer. That makes his embarrassing performance all the more puzzling.

He did not embarrass Peters, who was calmly unfazed by his attack. Committee Chairman Richard Durbin (D-IL) finally braced Kennedy: “Don’t put your head in a bag… The First Step Act was a constructive reform of the penal system and I think it was a good idea and I stand by it.”

Sen Cory Booker (D-NJ) said the BOP has simply not been provided enough resources. “I have a lot of frustrations obviously with what’s going on. But I’ve watched you now as a professional struggle mightily to meet the demands that are put on you in a moment where Congress is not giving you the resources necessary to do your job,” Booker said.

Sen Chris Coons (D-DE) told Peters that she has “inherited a deeply troubled institution and I suspect you some days feel like your job is more akin to trying to change the direction of an aircraft carrier than lead an agile and well-resourced organization because the BOP is frankly neither and I appreciate the determination, openness and vigor with which you’ve approached this task.”

Almost half of the suicides took place in a “restrictive housing setting,” the IG Report said. Durbin told Peters that “despite the decrease in Bureau of Prisons total population since you were sworn in as director in August of 2022 the percentage and total of number of individuals and restricted housing is actually higher than it was at that time…”

shucell240212Peters said that almost 40%t of those who lived in restrictive housing did so by their own choice. Nevertheless, she admitted that “everyone who is in restrictive housing has or will suffer from some form of mental or physical damage. I think even those that are agreeing or wanting to be in restrictive housing need to be educated on the fact that that isn’t where they belong and that we need to be able to safely house them in [general population]. Just because they’re volunteering to be there doesn’t mean that the physical and mental wear and tear isn’t happening for them as well.”

“It’s time for solutions and change,” Durbin agreed. “The lives of hundreds of Americans in Bureau of Prisons custody are at risk.”

Roll Call, Federal prison director tells senators about staffing ‘crisis’ (February 28, 2024)

Capital News Service, Deaths in federal prisons draw fire from Senate panel (February 29, 2024)

DOJ, Office of Inspector General, Evaluation of Issues Surrounding Inmate Deaths in Federal Bureau of Prisons Institutions (February 15, 2024)

The Marshall Project, How Federal Prisons Are Getting Worse (March 2, 2024)

WHBF-TV, Senate Judiciary Committee grills Bureau of Prisons chief on staffing, inmate deaths (February 28, 2024)

Sen John Kennedy, Kennedy questions Bureau of Prisons on early release of criminals: “You don’t have the slightest idea how many of them committed another crime and came back?” (February 28, 2024)

– Thomas L. Root

BOP Director On Senate Judiciary Hot Seat Tomorrow – Update for February 27, 2024

We post news and comment on federal criminal justice issues, focused primarily on trial and post-conviction matters, legislative initiatives, and sentencing issues.

JUDICIARY COMMITTEE WANTS ANSWERS ON BOP INMATE DEATHS

critic160816The impact of a trio of government reports berating the Federal Bureau of Prisons continued to reverberate last week. A scheduled appearance of BOP Director Colette Peters and her new nemesis, Dept of Justice Inspector General Michael Horowitz, before the Senate Judiciary Committee tomorrow promises that the cascade of criticism will continue pouring down on the agency..

A February 6 Government Accountability Office report chastised the BOP for implementing fewer than half of prior GAO recommendations on the use of restrictive housing (such as the SHU and Communications Management Units). The report blamed the BOP for failing to “assign[] responsibility for implementing these recommendations to the appropriate officials.”

A February 15 DOJ Office of Inspector General report found that “a combination of recurring policy violations and operational failures” – including deficiencies in inmate assessments and Mental Health Care Level assignments, holding inmates at risk for suicides in single cells, lack of urgency in responding to medical emergencies, and poor after-the-fact recordkeeping – contributed to inmate deaths.

A companion management advisory also issued on February 15 advised the BOP of the OIG’s “concerns” about the “inadequacy” of BOP policies on retaining records of rounds made by SHU COs “to ensure the preservation of those original documents as evidence when allegations of misconduct are raised.”

documentretention240227A Washington Post opinion column by Joe Davidson, who covers federal government issues in the Federal Insider, flayed the BOP as “an agency in crisis.” “The Federal Bureau of Prisons has been a profoundly broken agency for a very long time now,” he quoted David C. Fathi, American Civil Liberties Union National Prison Project director, as saying.

Laura Rovner, director of the University of Denver’s Civil Rights Clinic, who has represented isolated prisoners, is quoted as saying the BOP “is lacking the ability or the will to change, possibly both of those things.”

Last week, Government Executive – a publication aimed at federal managers – reported that the IG found “wildly different document retention standards, ranging from as little as one month to the recommended six months, to as long as 10 years.” The report itself noted that “OIG has conducted numerous investigations of allegations that BOP employees falsified round documentation; thus, such documentation is often important evidence in criminal investigations and prosecutions,” Horowitz wrote. “If documentation related to potential staff misconduct, such as mandatory round logs, are only retained for six months, such evidence may be destroyed before the discovery that a crime occurred.”

bureaucraticgobbledygook24019In her response, Peters called the inspector general’s findings “troubling” and agreed with all of the report’s recommendations, though she stressed that the misconduct cited was one by a “very small percentage of the approximately 35,000 employees . . . who continue to strive for correctional excellence every day.”

Sen Dick Durbin (D-IL), who chairs the Judiciary Committee, has been a supporter of Director Peters but said this month that he was “extremely disappointed” and “disheartened” that BOP officials “have not implemented multiple recommendations to curb restrictive housing. This issue has been studied extensively, and now is the time for action.”

bureaucracybopspeed230501Committee members expressed some frustration with Ms. Peters at the BOP oversight hearing last October for the agency’s habit of being nonresponsive to their written questions, many of which have gone unanswered for over a year. It is unlikely that her effort to palm problems off onto “a very small percentage” of employees or to mouth platitudes about “35,000 employees… who continue to strive for correctional excellence every day” will let her leave the hearing unscathed.

Senate Judiciary Committee, Hearing on Examining and Preventing Deaths of Incarcerated Individuals in Federal Prisons (set for February 28, 2024)

GAO, Bureau of Prisons: Additional Actions Needed to Improve Restrictive Housing Practices (February 6, 2024)

DOJ OIG, Evaluation of Issues Surrounding Inmate Deaths in Federal Bureau of Prisons Institutions (February 15, 2024)

DOJ OIC, Notification of Concerns Regarding Federal Bureau of Prisons’ Policies Pertaining to Special Housing Unit Logs Used to Record Mandatory Rounds and the Retention Period for the Original Logs (February 15, 2024)

Washington Post, Watchdog reports cite long-standing crises in federal prisons (February 23, 2024)

Govt Executive, Federal prison employees falsified logs in case where inmate committed suicide, IG says (February 21, 2024)

– Thomas L. Root

BOP Negligence Causes Inmate Deaths, DOJ Says – Update for February 19, 2024

We post news and comment on federal criminal justice issues, focused primarily on trial and post-conviction matters, legislative initiatives, and sentencing issues.

DEPT OF JUSTICE BLASTS BOP NEGLIGENCE IN PREVENTING INMATE DEATHS

fail200526Chronic failures by the Federal Bureau of Prisons have contributed to the deaths of hundreds of inmates, the Dept of Justice’s Inspector General concluded last Thursday in a report that CNN called “blistering.”

The Report found that

a combination of recurring policy violations and operational failures contributed to inmate suicides, which accounted for more than half of the 344 inmate deaths reviewed. We identified deficiencies in staff completion of inmate assessments, which prevented some institutions from adequately addressing inmate suicide risks. We also found potentially inappropriate Mental Health Care Level assignments for some inmates who later died by suicide. More than half of the inmates who died by suicide were single-celled, or housed in a cell alone, which increases inmate suicide risk.

DOJ Inspector General Michael Horowitz said, “Today’s report identified numerous operational and managerial deficiencies, which created unsafe conditions prior to and at the time of a number of these deaths.

The media were more savage: “A combination of negligence, operational failures and a blundering workforce has contributed to hundreds of inmate deaths in federal custody,” The Washington Post wrote.

CNN said that

For years, the embattled Bureau of Prisons has been the subject of accusations by politicians, prisoner advocacy groups for mistreating or neglecting inmates.

The Justice Department itself has issued scathing rebukes against BOP, outlining serious mistakes that have led to the deaths of high-profile inmates like notorious Boston gangster and convicted murderer James “Whitey” Bulger, who was killed shortly after being transferred to a new prison, and financier Jeffrey Epstein, who died by suicide in his jail cell.

But the circumstances that led to Bulger and Epstein’s deaths are emblematic of wide-ranging and recurring issues within the federal prison system that affect hundreds of inmates across the country, the DOJ’s Office of Inspector General found in its report that outlined a system in crisis failing to protect its charges.

NPR was terser: “The BOP is a mess.”

Many of the Report’s findings have applicability beyond the suicide issue. The IG said that “some institution staff failed to coordinate efforts across departments to provide necessary treatment or follow-up with inmates in distress.” Staff deficiencies in responding to medical emergencies “ranged from a lack of urgency in responding, failure to bring or use appropriate emergency equipment, unclear radio communications, and issues with naloxone administration in opioid overdose cases.”

failuretocommunicate221027The Report found deficiencies extended to after-action documentation. “The BOP was unable to produce documents required by its own policies in the event of an inmate death for many of the inmate deaths we reviewed,” the Report said. “The BOP requires in-depth After-Action Reviews only following inmate suicides but not for inmate homicides or deaths resulting from accidents and unknown factors. The BOP’s ability to fully understand the circumstances that led to inmate deaths and to identify steps that may help prevent future deaths is therefore limited.”

The Report examined four categories of BOP non-medical deaths between 2014 and 2021, suicide, homicide, accident, and unknown factors (where the BOP could not determine the cause of death). Of the 344 non-medical deaths during that time period, 54% were suicides, 26% were homicides, 16% were accidents. Under four percent were from unknown factors. Most of the suicides occurred when inmates were locked up in single cells.

The BOP’s non-medical death count climbed 68% between 2014 and 2021 while the prison population fell 27%. In 2014, there were 38 inmate deaths by unnatural causes. In 2021, that number was 57 inmates.

The Report noted that the BOP has policies in place to prevent inmate suicides. But it found “numerous instances of potentially inappropriate” mental health assessments for inmates who later killed themselves. What’s more, BOP staff “did not sufficiently conduct required inmate rounds or counts in over a third of inmate suicides,” and they sometimes “failed to communicate with each other and coordinate efforts across departments to provide necessary treatment or follow-up with inmates in distress,” the Report found.

Many BOP facilities failed to run suicide drills mandated by policy (required three times a year, once for each shift), the Report said. Thirty-five percent of BOP facilities “were unable to provide evidence that they conducted a single mock suicide drill from 2018 through 2020.”
inmatesuicidedeath240219In one suicide case cited by the Report, BOP staff claimed to have searched a cell three times — including the day before the suicide — but found no contraband. After the prisoner died by a self-inflicted overdose, a search of the cell he had been in turned up 1,000 pills, the IG said.

The BOP continues to grapple with a severe staffing shortage, ‘which has a ripple effect across the agency’s institutions,” NBC said. Correctional Officers work multiple shifts and healthcare workers are “augmented” to serve as COs, being pulled from their regular duties. “That translates into less mental health care for inmates,” NPR reported.

“At one facility,” Government Executive reported, “psychiatric staff were reassigned daily for two months straight. In another case, a facility did not have any psychological services personnel on staff… Half of [one] facility’s nursing positions were unfilled. At another facility, employees worked double shifts for three consecutive days. Personnel on staff are often undertrained, the IG found, with the bureau’s after-action reviews identifying insufficient training as an issue in 42% of deaths. They are also improperly disciplined, with employees themselves telling the IG the process was too lengthy and ineffective.

The BOP continues to struggle to keep facilities free of contraband drugs and weapons, which contributed to nearly a third of inmate deaths in the Report.

Sen Richard Durbin (D-IL), chairman of the Senate Judiciary Committee, has scheduled BOP Director Colette Peters and DOJ Inspector General Horowitz to testify on February 28th in a Committee hearing focused on federal inmate deaths.

“It is deeply disturbing that today’s report found that the majority of BOP’s non-medical deaths in custody could have been prevented or mitigated by greater compliance with BOP policy, better staffing, and increased mental health and substance abuse treatment,” Durbin said in a statement. “Accountability across the Bureau is necessary and long overdue.”

The IG recommended several changes to BOP procedure, including developing strategies to ensure that inmate mental health is properly evaluated, that prison staff is taught to use defibrillators and naloxone, and to develop procedures that require inmate death records to be consistently prepared.

bureaucraticgobbledygook24019

A BOP spokesperson told CNN last week that the agency “acknowledges and concurs with the need for improvements” and is “dedicated to implementing these changes to ensure the safety and well-being of those in our custody.”

Sure it is, provided its staff isn’t being asked to make rounds, conduct drills or fill out reports.

CNN, DOJ watchdog report finds chronic failures by Bureau of Prisons contributed to the deaths of hundreds of inmates (February 15, 2024)

Dept of Justice, DOJ OIG Releases Report on Issues Surrounding Inmate Deaths in Federal Bureau of Prisons Institutions (February 15, 2024)

NPR, DOJ watchdog finds 187 inmate suicides in federal prisons over 8-year period (February 15, 2024)

Government Executive, Understaffing and mismanagement contributed to hundreds of deaths in federal prisons (February 16, 2024)

NBC, Bureau of Prisons failed to prevent nearly 200 deaths by suicide, DOJ watchdog finds (February 15, 2024)

Washington Post, IG report finds deadly culture of negligence and staffing issues at federal prisons (February 15, 2024)

– Thomas L. Root