CARE SOLUTIONS?

Not easy. Solutions never are, not even when there’s a will.

Yes, under pressure, politicians heading the relevant ministries admit “we can always do better”, but then turn to their underlings to take up the question. That’s where ‘change’ gets shuffled into committee consideration, becomes an item on management agenda, and from there too often slid into a dead file, or given summary rejection. ‘Change’ championed from the outside is anathema, a challenge to authority.

Activist bodies and their supporters face a brick wall. Why do our governments become reactionary in the face of criticism? Why do their progressive policy announcements flag and fade? Why do our elected bodies and civil service never get ahead of the curve? Why do we have to push and drag these people to peer over the horizon, to embrace positive program reforms?

These are questions that impact more than just health care in our jails and prisons. These are far-reaching riddles we’ve examined in the past and to which we will return often.

As a first step to address health care, provincial and federal agencies overseeing jails and prisons must concede there are problems with accessibility. Intransigence, obstruction, denial, and feigned ignorance are out.

How many institutional health care units are staffed 24/7, and equipped to handle inevitable night and weekend emergencies? To that point, and given the delays EMS personnel face in reaching an inmate quickly, how many health care units can respond to emergencies at any time, and stabilize a patient waiting for an ambulance?

A long ago posting referenced a male nurse at Ontario’s old Toronto West Detention Centre telling one inmate that “medication is a privilege, not a right.” That is not policy anywhere, but it’s an experience that underscores the need for dedicated provincial inmate ombudsman’s offices that report directly to their respective legislatures, and not through ‘correctional’ ministries.

Canada’s federal Office of the Correctional Investigator must likewise be able to report directly to parliament, an important privilege it hasn’t had. And, federally and provincially, transparency becomes a new watchword. That, and collaborating with community resources to fill in the gaps can only improve outcomes.

Why is this important? It points to who we are as a people and a nation to begin with. But to be practical, prioritizing the health of prisoners, subjugating risk assessment to making an offender physically and mentally ‘whole’, goes a long way to lowering recidivism, reducing costs, and living in safe communities.

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THE CARE REALITY CHECK

Canada’s provincial and federal penal systems spend tens of millions of dollars each year on health care, including funding for mental health services.

That’s how we began on April 15…….

Spokespeople for Correctional Service of Canada, and its counterparts in the provinces, have always insisted the men and women in their custody….and care….have the same access to the health care that is available to us all. What’s on paper tends to support the claim….practice and delivery say otherwise.

And, that’s how we left off last week.

So for example, how long do you wait to see your dentist when you need help? Would you be put off for more than a day? Would you be offered a speedy alternative if you couldn’t be accommodated immediately? Of course, that’s what you’d expect, and if it wasn’t forthcoming, one call and another dentist’s chair would be waiting, PDQ.

That’s how it is for us in the community, and that’s how it is for anyone and everyone who works in a jail or prison in Canada, and that’s how it is for anyone and everyone who works in a jail or prison health care unit in Canada.

That’s not how it is for inmates.

Inmates submit a request, a request that will pass through non-medical staff hands before it gets to the health care unit. Then, it’s a matter of waiting. Even ‘urgent’ requests can wait weeks for attention, if not longer.

As for dental maintenance programs which would lower costs to the system over time, is there any institution in the country that subscribes to such a service? We think not.

The attention here has focused on dental care because the discomfort of an aching tooth can easily be a worst-case scenario, aside from a life-threatening injury or medical emergency event.

Looking beyond, and to its credit, Correctional Service of Canada has seen improvements in the delivery of acceptable standards of care in some areas. This is in large part due to pressure and criticism from multiple community sources, and legal actions intended to bring practice in line with policy. Provincial agencies don’t get the same scrutiny, and a lot of work is waiting for dedicated advocates at that level.

Nonetheless, and despite changes, most federal inmates would testify that unless they are lying in a pool of their own blood, or in cardiac arrest, or showing obvious signs of severe medical distress, the mantra is……wait, wait, wait.

We like to cite the case of a long-time federal British Columbia inmate who was diagnosed with a cancer a few years ago and given an ominous prognosis, failing proper medical response. In the end, this inmate took CSC to court to access necessary surgery. He’s alive today and living in the community.

Solutions? Next week.

MORE CARE/DON’T CARE

“……no one truly knows a nation until one has been inside its jails. A nation should not be judged by how it treats its highest citizens, but its lowest ones.” NELSON MANDELA

Picking up from last week with the fate of terminally ill inmates, there is a provision in Section 121 of the Corrections and Conditional Release Act permitting compassionate parole for the terminally ill.

Of the 542 federal prison deaths between 2007 and 2017, ill health killed 366.  These inmates might/could/should have qualified for release to community hospice care under the CCRA.  However, only four or five compassionate paroles are granted each year, and the rest died before parole boards processed decisions.  Really?  A terminally ill man or woman without palliative care, and Mickey Mouse pain management, must have a parole board decision?  (Research shows that 50 per cent of prisoners in chronic or acute pain are given nothing stronger than Tylenol 3s.)

As for MAID, Correctional Service of Canada may still not have an assisted death policy, and inmates could have to secure a compassionate parole, and then await transfer to the community before applying.  According to a CSC spokesperson last fall, there have been six requests, but only one inmate met the criteria and that prisoner was already in the community.  The inmate died before the hospital could provide the procedure.  We shouldn’t be surprised by that delay, and we shouldn’t be surprised that CSC health care would prefer that no inmate meets MAID criteria.

We should be concerned….alright, we should be outraged….that our domesticated animals have greater legal safeguards around death and dying than the men and women in our jails and prisons.

As it is, dying in prison today means dying alone, dying without best care, and dying with only a few strangers lingering in the distance.

Now, turning to health care issues for the living……..

Spokespeople for Correctional Service of Canada, and its counterparts in the provinces, have always insisted the men and women in their custody….and care….have the same access to health care that is available to us all.  What’s on paper tends to support the claim….practice and delivery say otherwise.

We’ll flesh this out next week.

HEALTH CARE/HEALTH DON’T CARE

Getting sick, getting old in our “prison industry.”

In a word, DON’T!

Canada’s provincial and federal penal systems spend tens of millions of dollars each year on health care, including funding for mental health services.

So why then do complaints about health care in our federal system, as an example, top the list of what comes to the attention of the Office of the Correctional Investigator of Canada, the country’s ombudsman for offenders? There is no equivalent for our provincial jail inmates, no at-arms-length substantive recourse, and complainants who use what processes exist are basically left blowing in the wind.

The law in Canada says that although prisoners are deprived of liberty while they are incarcerated, all other human rights remain intact. Legally, mistreatment of any kind, or lack of proper treatment, is out, and that includes an entitlement to the same access to health care as the rest of us.

Available information from Correctional Service of Canada presents a best profile of conditions affecting the health and end of life issues for CSC’s roughly 14 to 15 thousand offenders. About a quarter, around 3,500, is over 50, and in the agency’s parlance they are ‘senior citizens.’ It admits a prison environment will knock up to 10 years off life expectancies, although inmate lifestyles are a contributing factor of some significance. It doesn’t add that the consequences of inmate poor health choices are exacerbated by the difficulties is accessing institutional health care.

Award winning author Sandra Miller wrote “Our aging prisoners deserve proper health care” for the Globe and Mail last October, noting she’d never considered the way prisoners die until she attended a conference on end of life issues last fall.

The number of older prisoners will rise with time and most who die in custody succumb to cancer, heart attacks or liver failure. She asks why we should care “if an inmate old enough to be somebody’s grandparent dies in a cell without adequate medical treatment, access to appropriate palliative care or medical assistance in dying? I think there are three reasons: compassion, equality and autonomy.”

…….continuing next week……….

“…..no one truly knows a nation until one has been inside its jails. A nation should not be judged by how it treats its highest citizens, but its lowest ones.” NELSON MANDELA

‘Prison industry’ talking points

….a few words for CORRECTIONAL SERVICE OF CANADA

“If you believe that all persons are born free and equal in dignity and rights, then that belief must also apply to those who are less fortunate, less privileged and even so to those deprived of their liberty.”

That is Ivan Zinger speaking to the Toronto Star’s Donovan Vincent for his feature article in the paper’s Sunday, February 4th edition, profiling Canada’s new Correctional Investigator.

Zinger has targeted Canada’s federal prison industry for the “self-serving and unreflective” way it scrutinizes inmate deaths, to the “unnecessarily stark and foreboding environment for human habitation” in most segregation and isolation units in federal penitentiaries, to a call for an external assessment of CSC food services. Food is “foundational to health and safety in a prison setting,” he says, as inmate grievances mount after the previous federal government cut $6.4 million in food costs. CSC has said it will do an internal audit. Zinger wants the tattoo program brought back, prison farms reopened, and argues that visitors to penitentiaries “aren’t always treated with courtesy and respect,” amid delays in having visits approved.

Baz Dreisinger, an American who runs programs in U.S. prisons, travelled the world visiting penal institutions in a number of selected countries. Her 2016 book, “Incarceration Nation” is the result of her work and research.

An Australian inmate’s comments stand out. “….intellectually knowing the circumstances of your oppression and being powerless to do anything about it – that’s torture.” Or, “education makes one unfit to be a slave.”

One of the highlights the author underscored in concluding her experiences is: –
“The United States spends $54 billion a year on the prison industry. The burden of proof to support the status quo falls on those who are in favour of it. Because if any other system had a 60 percent failure rate – that’s the U.S. recidivism rate, and in much of the world the numbers don’t look much better – we’d dismantle that system right away and go right back to the drawing board.”

Robert Clark began working with Correctional Service of Canada in 1980, first as a volunteer while a student at Queen’s University in Kingston, and then progressed through the ranks to hold several management positions in the agency. He retired when the Harper government’s tough-on-crime agenda conflicted with what his experience taught him were prison best practices.

He’s written “Down Inside – thirty years in Canada’s prison service”, published last year. One paragraph from the last chapter, “Conclusion: A Culture of Collective Indifference” is relevant to the plight of our penal institutions.

“I have no idea what lies in store for Correctional Service of Canada. Although I would like to believe that significant positive changes are possible. I have my doubts. The culture of this organization is so deeply entrenched and so pervasive that I remain skeptical of its capacity for genuine introspection. The people I know who still work in the system tell me it’s worse now than it was when I was around. The increasing reliance on closed-circuit security cameras and electronically operated doors has further eroded the human contact that is essential to humane treatment and ultimately the chances of rehabilitation.”

And finally, turnoverarocktoday has a message for Correctional Service of Canada, and each, every, and all its employees…..from Commissioner Don Head down the line to the newest entry-level recruit.

Ladies and gentlemen, your one overriding and singular priority is to put yourself out of a job! Yes, this is a fantasy beyond the realm of possibility, an unattainable state of perfection in this world, and within the social order we know. Nonetheless, perfection is that goal on the horizon to which you set your course, as it is for us all. Otherwise, you’re just surrendering to the status quo…..and how’s that working for you?

Soleiman Faqiri – another comeback

On December 4, the day after we posted “A comeback – No-Fault Murder?”, a letter arrived over MCSCS Minister Marie-France Lalonde’s signature responding to ours of November 6, published here on November 12 in “No-Fault Murder?”

“…..regarding the death of Mr. Soleiman Faqiri,,,, ,” she began, “….as you know, the police investigation has concluded. Questions about this decision and the police investigation should be directed to the Kawartha Lakes Police Service. Although the police investigation has concluded, the ministry’s internal investigation of the circumstances surrounding Mr. Faqiri’s death remains active. As such, it would be inappropriate for me to comment on specific details of the internal investigation, including staff discipline, while it is underway.

On November 3, 2017, Dr. Paul Dungey, Regional Supervising Coroner for East Region, Kingston Office, announced that an inquest will be held in the death of Mr. Faqiri. The inquest will examine the events surrounding his death. In addition, the jury may make recommendations aimed at preventing similar deaths. Details regarding the date and location will be provided at a later date when the information becomes available.”

Minister Lalonde ended by asking for our patience “while the ministry’s investigation and the inquest into the death of Mr. Faqiri continue.”

Do you know how often a provincial or federal minister overseeing a part of Canada’s prison industry has said much the same as Ms Lalonde? Do you know how many millions of dollars have been spent to come up with “recommendations aimed at preventing similar deaths?” Do you know how little has ever been done to implement inquest recommendations?

That’s worth repeating to the minister:

February 2, 2018

The Honourable Marie-France Lalonde,
Minister of Community Safety & Correctional Services,

Re: Soleiman Faqiri

Dear Minister Lalonde:

Your December 4, 2017 letter in response to mine of November 6th is appreciated, and I accept that its composition was the only pathway you had. However, you underpin the status quo.

You suggested I question the Kawartha Lakes Police Service about its investigation into Mr. Faqiri’s death. A police spokesperson contacted me after receiving a copy of my letter, referring me to the Office of the Independent Police Review Director to pursue a complaint. That is a waste of good paper.

As for an inquest, do you know how often provincial and federal ministers overseeing Canada’s prison industry have claimed these will make a difference? Do you know how many millions have been spent to come up with “recommendations aimed at preventing similar deaths?” Do you know how little is done to implement inquest recommendations?

Minister, when did you last execute an unannounced and unheralded inspection of a penal institution, be it at 2pm on a Monday, 8pm on a Friday, or 3am on a Sunday? When did any of your senior staff, or any minister in your position or senior staff in this country do likewise? We need that, and we need progressive unambiguous legislation, coupled with at-arms-length authorities to prioritize compliance.

Without that, we are simply peeing into the wind.

Yours truly,

Charles H. Klassen

We copied Kathleen Wynne, Nasir Naqvi, and Renue Mandhane.

Meanwhile, Fatima Syed, a Toronto Star staff reporter, published “Family of man who died in jail looking for answers a year later”, on December 15 of last year. “Why is the government so afraid to tell us the truth?” asks Soleiman’s father, Ghulam.

The family is pro-actively insisting on accountability and transparency, asking the same questions over the last year. “Why was Soleiman killed while in government care? Why was he found with 50 injuries on his body? Why haven’t any of the guards been held accountable for the three-hour confrontation that was caught on a video they still haven’t seen?”

The government denied the family and their lawyers’ request for information about Soleiman’s final moments before he died. A month before, the Kawartha Lakes Police Service advised them by email that no criminal charges would be laid. “It is very difficult to not feel like the family is being stonewalled,” said one of their legal team.

The “Justice for Soli” campaign, a group of Ontario university students, along with the family, held a vigil on that day at Yonge-Dundas Square in Toronto to mark the anniversary of Soleiman’s death. 50 people laid 50 white roses on his photo for the 50 bruises on his body. Earlier in the day, the family gathered at Soleiman’s grave in Ajax in remembrance. He would have turned 31 at the end of December.

And then, along came another Star Fatima Syed entry on Wednesday, February 7th, with a front-page headline, “Jail guard tag team involved in subduing mentally ill inmate,” and a deck, “Reports obtained by the Star detail what happened in the hours leading to Soleiman Faqiri’s death after a fight with correctional officers in 2016.”

The long and detailed account is based on documents the paper received through a freedom of information request, and is material from the police investigation of Soleiman’s death, and the files of the ministry, jail, and members of its staff.

Lawyers for the Faqiri family call what they’ve read ‘very troubling,’ but what is most telling for seasoned observers of the country’s penal systems is this extract from Ms Syed article: “Interviews (by the Kawartha Lakes police) of other inmates didn’t provide much information, said the report, as jail guards had closed the hatches to the doors of each inmate’s cell, thus preventing them from looking out into the common hallway or getting involved.”

We’ve passed a comment on to the Star’s reporter.

The Ontario government’s priority is to get past this, pursue a quiet and expedient resolution, and move on……’til next time.

Canada killed Matthew Hines….

….just as we said last June.

A persistent and distressed family, along with CBC News, and journalists like the Toronto Globe and Mail’s Patrick White would not accept Correctional Service of Canada’s explanation that Matthew Hines died from a drug-induced seizure, and died despite the efforts of CSC staff members to save him.

Correctional Service of Canada lied. Our prison industry killed this man, and then tried to cover it up.

33 year-old Matthew Hines died in Dorchester Penitentiary on May 26 in 2015. Since then, we’ve published “What say you, Minister?” September 25, 2016, “Matthew Hines died. Chapter the second.” October 2 of 2016, and “Matthew Hines’ death was a homicide…..” on June 4, 2017.

On Wednesday, January 3 of this year, New Brunswick RCMP charged two prison guards with manslaughter and criminal negligence causing death. Alvida Ross, 48, and Mathieu Bourgin, 31, had been on administrative leave since the investigation began, but the two men will not appear in Moncton Provincial Court until the end of February.

The particulars around Matthew’s ordeal will not be reviewed again here, but after 2 ½ years, four investigations, and a determined Hines’ family, the death was ruled a criminal act. A spokeswoman for Correctional Service of Canada said the agency co-operated with the investigation and is committed to “learn from Mr. Hines’ death and continually work to improve our response to individuals in medical crisis.” This is CSC’s necessarily politically correct position, and it’s not the first time it has made this statement, and it’s not the last.

Correctional Investigator Ivan Zinger released his own report on this death-in-custody last May, citing numerous “staff errors and omissions”, and criticized all levels of CSC, from correctional officers to senior staff for releasing misleading information and denying accountability. “Nearly everything that could have gone wrong in a use of force response went wrong,” the CI report said.

The Hines family is grateful for the work done to get at the truth, but rightly suggests that responsibility for Matthew’s death goes well beyond the two men accused. That includes, for example, an inexperienced duty nurse who did not even check the inmate’s vital signs, in spite of the man’s obvious medical distress. The family nonetheless accepts the decision to charge only two employees, but “we trust that all who saw Matthew before and during his death look in the mirror every day with the knowledge of what they did and did not do.”

And, as we’ve noted twice before, the family has a lawyer. This is going to cost every Canadian taxpayer.

Remember that Matthew had to die for this to get so much attention. What would we know if he had survived this assault? What do we know about the experience of other inmates who’ve been subject to the same treatment?