Former medic says comments reflect attitude of prison staff
By LEE WILLIAMS,
The News Journal
Now that federal prison regulators have left the state, Young Correctional Institution Warden Raphael Williams has told colleagues he no longer cares about inmate medical needs, and he doesn't want to be bothered by health care complaints.
Williams' comments about inmate health care came during an Oct. 19 meeting of his prison's Medical Audit Committee, which was held after U.S. Department of Justice investigators had inspected his prison.
In addition to the warden and senior members of his staff, representatives from Correctional Medical Services, the St. Louis-based firm contracted to provide inmate health care for the Department of Correction, attended the monthly meeting.
"Since the DOJ was here, I don't even bother with medical any more," Williams told the group, according to the official minutes taken by former CMS Health Services Administrator William Joyce, a licensed physician assistant and the top CMS official working at the prison.
Williams, who started as a guard and has been assigned to Young prison since it opened in 1982, said he "no longer cared about medical," and explained he had "backed away" from health care issues in his prison and that he "doesn't get CMS," the minutes say.
Regarding two doctors who were hired by CMS but hadn't yet obtained Delaware licenses, Williams said: "So, really, you didn't do anything, since there is no guarantee that either doctor will get a license. I don't even deal with medical any more."
Two months later, Joyce's original version of the minutes were revised by a CMS official, who removed all of the warden's quotes, paraphrasing some of them.
The meeting minutes containing Williams' comments surfaced two months after the U.S. Justice Department announced that Delaware was violating the civil rights of prison inmates because of inadequate health care. Delaware promised in a settlement to address 87 specific problems in the prisons.
In interviews, three former members of the Young prison's medical staff said the warden's comments are indicative of a prevailing attitude at the prison. They described tensions between medical personnel and the prison staff; they said staff members interfered with patient care and, in at least one case, physically abused a patient.
No response
Williams did not respond to numerous phone calls and e-mails this week seeking his views on inmate health care.
Correction Commissioner Carl C. Danberg, after being contacted by The News Journal, questioned Williams and others present at the meeting about what took place.
"He doesn't believe he made those comments," Danberg said.
The other attendees offered "conflicting information," Danberg said. Some remembered the warden making the statements. Others didn't.
"The individuals present at that meeting disagree about what was said," he explained.
Danberg said the statements attributed to Williams do not sound like the warden he knows.
"My personal experience shows me he does believe that medical care is important, and I have personally seen him attempting to hold the medical provider's feet to the fire to get an inmate the treatment he deserves," Danberg said.
Joyce stands by the accuracy of the minutes he wrote in October.
"Those type of comments were common," Joyce said in an interview. "This was typical behavior; however, this particular month Warden Williams crossed all boundaries of propriety, which is why I recorded them verbatim."
Young Correctional Institution, formerly called Gander Hill Prison, processes more than 60 percent of all new admissions into the state's correction system. The facility was designed to hold 1,380 inmates, but averages around 1,800.
Civil rights violations
Serious health care problems have long plagued Young and other prisons in the state. After The News Journal documented abuses in a special report, a subsequent investigation by the U.S. Department of Justice last fall found "substantial civil rights violations" in Delaware prisons.
Cynthia Magnuson, a Washington spokeswoman for the U.S. Department of Justice, said federal officials will "look into the matter."
"We are committed to actively monitoring compliance by the state, and the state has been cooperating," Magnuson said. "However, if we find that the state is not meeting the requirements of the settlement, we will not hesitate to take appropriate action when and if it becomes necessary."
Danberg said his views on inmate care are clear, and the warden's comments, as reported in the minutes, are not indicative of any attitude within his department.
"I've made it very clear in my confirmation hearing and before the Joint Finance Committee that medical care is one of the foremost issues I have to address," he said.
During the Oct. 19 meeting, Joyce told the group that an inmate assigned to work in the infirmary was not properly supervised by the guards and was not doing his job. The inmate was eating food belonging to the medical staff, and was often found alone and unsupervised with female employees -- a major safety violation.
The Justice Department investigators had noted "the medical area was dirty" and referred to the area as "appalling," the minutes state.
Warden Williams told the medical staff the inmate wasn't his responsibility.
"It's medical's job to supervise the inmate," Williams said, according to the original minutes. "Just let me know if you want me to remove the inmate worker and you can clean the place yourself."
After the October meeting, Joyce disseminated copies of the minutes to the other participants and to his superiors at CMS regional headquarters in New Jersey. His original minutes included all of Williams' comments.
Two months later, Carolyn Cook, the CMS regional manager in New Jersey, sent out a different version of the meeting minutes, in which all of the warden's quotes were removed.
'Proper format'
Ken Fields, the corporate spokesman for CMS, said the "changes that were made in the updated summary retained the substance of each issue raised during the meeting, while reflecting the proper format of meeting minutes."
As to how Cook was able to revise the minutes of a meeting she did not attend, Fields said, "The revised minutes were based solely upon the original draft of the minutes, but finalized in proper form."
Danberg said he didn't ask anyone to make any changes.
"It doesn't reflect on whether the comments were true or false, but that's not the type of thing that CMS usually keeps in their minutes," he said.
A week after the meeting, Joyce was ordered to report to the warden's office.
The warden, Joyce said, grilled him about the minutes, which he said contained Joyce's "opinion."
"I told him when he makes a statement like that, in a room full of people, during a public meeting, it's fact, not opinion," Joyce said.
Williams stripped Joyce of his badge, which effectively barred him from entering any Department of Correction facility, and escorted him from the building. Days later, Joyce resigned from CMS.
Williams told Danberg another version.
"The barring of the employee of CMS was not related to the meeting minutes," Danberg said. "It was related to an outburst that the individual had in front of the warden and several other people regarding another employee. That's when his access was terminated."
Joyce, who has more than 25 years of experience in health care, including work overseeing health care in a Philadelphia detention center, is the fourth health service administrator assigned to Young prison since CMS took the contract in 2005.
He said Williams never supported his medical staff.
"He'd ask what he could do to help. We'd tell him what we needed, and nothing would happen."
Fields described the relationship between the prison officials and CMS differently.
"We have a cooperative, professional working relationship," he said. "Both CMS and the Department of Correction are focused on providing quality services to inmate patients and effectively utilizing taxpayer resources."
Other problems
In addition to the warden's comments about inmate health care, the minutes document other problems in the facility.
Joyce said he and other CMS staffers often complained to the warden about a guard assigned to the infirmary.
The minutes indicate that the guard was "manipulating the sick call lists" to lessen his workload.
Instead of bringing down the usual 12 to 18 inmates to the infirmary, Joyce said, the guard would decide who would be treated and would instead bring down only a couple of patients per shift.
The minutes say Williams instructed one of his captains to reassign the guard. As of last week, the guard remains assigned to the infirmary.
Danberg was aware of the allegations about the guard, but not sure of "where that stands."
"Correctional officers should not have that kind of role in determining who goes to medical," Danberg said. "That determination should be made by the medical care provider. We're making sure that is being done in all the facilities."
On Jan. 8, nine days after the settlement was reached between the state and the U.S. Department of Justice, which ended the federal investigation into Delaware prisons, Michael Senisch said he watched a guard drag one of his patients out of an infirmary cell and beat him with a shoe.
Senisch, who like Joyce is a physician assistant with decades of experience, worked for CMS in Young prison from June until his resignation Feb. 12.
"I almost jumped the guy," Senisch said of the guard. "It was completely uncalled for. The patient wasn't a threat to anyone. He was alone, locked in a cell."
The inmate, who suffered from a mental disorder, had been banging on the door of his cell for hours, angering the guard, Senisch recalled.
"Some inmates bang on doors. It happens all the time. You can't take it personally," Senisch said. "You've got to let it roll off you."
The guard didn't.
"He dragged him out of the cell by his feet, pulled off a shoe and beat him with it." Senisch said. "The CO was mumbling incoherent words. The patient was trying to block the blows, but they were hard to block. He was getting hit in the face and head."
After the beating, the guard picked up the inmate, who was larger than the guard, and threw him into the cell, Senisch said.
"He landed hard." Senisch said. "He could have broken bones."
Allowed to resign
Even though several guards were present, Senisch, a contract employee, was the only person to report the incident. Once he submitted a statement, the guards were ordered to report what they had seen.
During an interview with internal affairs investigators, Senisch was told the guard had been allowed to resign. No criminal charges were filed.
"The guard should have been charged, and there should be some civil restitution for the victim," Senisch said.
Danberg, who was not yet acting as Correction Commissioner when the assault occurred, confirmed that the guard had resigned, and that he was not charged with a crime.
"If the facts of a case can be established, it should be prosecuted," he said.
Contact investigative reporter Lee Williams at 324-2362 or lwilliams@delawareonline.com.
