Renewed Calls for Monitor After 2 Deaths at Hudson County Jail

Hank Kalet | August 15, 2017 | Immigration
Advocates claim inadequate medical care led to death of Rolando Espinoza, an immigrant detainee

Hudson County Correctional Facility
The death of two inmates from the Hudson County Correctional Center, one an immigration detainee from Long Island, has advocates renewing calls for an independent monitor of the jail and stepping up efforts to get the county to end its agreements with federal immigration authorities.

Detainee Rolando Meza Espinoza, 43, died in June after collapsing at the Hudson jail. His attorney says Espinoza, a Salvadoran national, had informed ICE agents and jail officials that he suffered from anemia, cirrhosis, and diabetes, but that medical staff only treated his diabetes. He died June 10 at Jersey City Medical Center, where he was taken after he collapsed.

[img-narrow:/assets/16/0518/0120 ]Espinoza’s was not the only death at the facility this spring. A 48-year-old Weehawken woman, Jennifer Towles, who was serving a six-month sentence for driving while under the influence, died July 14, according to press reports.

The deaths have renewed efforts by advocates for an independent monitor at the jail, which they say would provide oversight and could serve as a liaison for detainees who have little trust in jail and ICE officials because they are arms of the government. Advocates say the two ad hoc committees created by the Hudson County Freeholders — one created a year ago charged with reviewing jail activities and a second just created in June in response to Espinoza’s death — have too much representation from Hudson County officials and are not likely to act independently.

Filing formal complaint

Immigration advocates have long been critical of the Hudson County Correctional Center, with a coalition of groups filing a formal complaint with ICE in 2016 on behalf of 61 detainees. A 2013 report by a national coalition of immigration groups called the Hudson facility among the worst in the nation for immigrant detainees. Detainees have complained about mold in both bathroom and living areas, lack of access to exercise, inconsistent medical care, and food issues. Critics have also pointed to medical support, which is primarily outsourced, as a key issue.

The county appointed a committee last year to review the facility, and its report called for new procedures to be put in place to better serve detainees and maintain the jail cells. A new committee, composed of members of the Freeholder board, was appointed last month to review the Espinoza case.

Deals with the feds

Hudson is one of six counties that have agreements with the federal Immigration and Customs Enforcement agency. Hudson, however, is the only county that has two separate agreements in place, a contract to provide bed space for immigration detainees at its jail in Kearney and a memorandum — known as a 287g arrangement — that essentially deputizes county corrections officials as ICE agents. Under the 287g program, county corrections officers are given ICE training and access to ICE databases so they can cross-reference the names of those arrested and those who might be sought by ICE for immigration violations. Essex and Bergen counties also have so-called bed contracts, while Salem, Monmouth, and Cape May counties have 287g arrangements. There also is a privately run facility, the Elizabeth Detention Center, that houses detainees.

Espinoza is the 10th detainee to die in ICE custody nationally since the current federal fiscal year started in October, and he is the first in New Jersey since June 2016, when a Honduran national being held at the Essex County Detention Facility was transferred to University Hospital in Newark.

Hudson County spokesman James Kennelly did not respond to requests for comment, but County Executive Thomas DeGise said in a press release issued before the Freeholders’ July 11 vote approving the ad hoc committee that they would investigate Espinoza’s death to ensure all inmates get the care they need.

“Every individual who enters our custody is entitled to all proper medical care,” he said. “We intend to find out whether that was provided — as it should have been — in this case.”

More monitoring needed

But Rev. Gene Squeo, a retired R.C. Catholic priest who volunteers with the chaplain’s office at the jail, said steps taken in the past month are not enough. More independent monitoring is needed. “We have to be empowered to visit the facility in random fashion, to go to different units, interview detainees, and ascertain what complaints they have,” he said.

Squeo, who visits the jail about twice a week to conduct services and run bible study groups, said it is difficult to gauge the quality of medical services because much of what advocates hear is anecdotal, and a more systematic review is needed.

“We really don’t know, and without an independent board or commission that is empowered to find that out I don’t think we’ll ever really know,” he said.

Sally Pillar, of First Friends of New York and New Jersey, which advocates for detainees in both states, said a “permanent oversight board in Hudson might be a platform to create similar kinds of boards in other jurisdictions.”

“It is not to say that Essex, Elizabeth, or Bergen may not have those kinds of issues,” she said of the Hudson jail. “Our goal would be to go on tours and start looking at these other facilities as well. We as advocates need to look at all of the facilities with ICE contracts and hold them accountable.”

Biography of an undocumented

Espinoza came to the United States in 1993 from El Salvador, apparently under the name Carlos Bonilla Mejia, according to Manuel Portela, the family’s attorney. He had been detained at the border in California with his first common-law wife, but had his immigration case transferred to New York. Immigration apparently did not follow up. He then filed for temporary protective status in 1999 under the name Rolando Meza Espinoza and worked under the TPO until 2015, when it lapsed. Temporary protective status is usually granted based on the circumstances in an immigrant’s home country. Portela said he could not comment on why it was issued, or why it was not extended.

Espinoza continued to work until he was arrested this past April 1 in the Long Island, NY, town of Brentwood while on a job. He was initially taken to the Varick Street immigration court in lower Manhattan, where he was ordered to be detained in the Hudson jail, where about two-thirds of immigration detainees are from New York.

Portela said the arrest was an error. Espinoza was in the country without authorization, but ICE officers approached his van seeking another immigrant who had the same name. They showed him a photograph and, despite his claims that he was not the man in the photo, he was detained, Portela said.

“The government may want to point out” that he lacked legal status, Portela said, “but we are responding that they picked up the wrong guy. Their basis for picking him up was invalid.”

Portela said the new aggressiveness on ICE’s part is making it more likely that other immigrants whose only violation is that they entered the country illegally will face detention and potential deportation.

‘Ripple effect’

“We are getting reports that ICE is going out and looking for people and if they can’t find them they are picking up others,” Portela said. “This creates a ripple effect. It frightens many immigrants who are in the country legally. It sends a message that anyone can be picked up who just reports to work.”

At Hudson, he would have undergone an intake interview that included his health history, but Portela said it’s not clear how much information the jail collected. Espinoza suffered from many ailments but only received medication for diabetes. He collapsed June 8 and died two days later from internal bleeding and hemorrhagic shock.

Portela added that Espinoza had been “communicating with his family to say he wasn’t getting proper medical care,” but that the family had not been notified of Espinoza’s death until Portela’s law firm contacted the jail.

No comment

Al Campana, chief operating officer of CFG Health Systems of Marlton, which provides healthcare in the Hudson County Corrections Center and nine other county jails in New Jersey, would not comment directly on the Espinoza or the Jennifer Towles cases. However, he said medical staff follows specific protocols to ensure the health of prisoners and detainees.

CFG was awarded a new five-year contract last year. It officially began December 1 and runs through November 30, 2021, and will cost the county $29.4 million, including $5.5 million this year.

Campana said the contract calls for CFG to provide physicians and nurse practitioners, with the county providing additional nursing. He said the facility has a prescriber on site at all times.

Medical protocols

CFG protocols call for inmates and immigration detainees to be seen within the first hour of being booked into the jail, Campana said. During that first meeting, medical staff conducts a screening, which includes an interview and medical history, the taking of vitals, and a basic checkup. Once they have been housed, they are seen by a nurse practitioner or a doctor for a full medical history, and staff will create a care plan that dictates follow-ups and medication.

“We don’t know why they are in jail or how long they will be there,“ Campana said. “Some stay a day, some a few weeks, some much longer. Most coming in are charged, but not convicted, and most who stay cannot make bail. We don’t know this when people come in, so we have to assess everyone the same way.”

He said CFG seeks to verify as much of the information they are given within 24 hours, but there are trust issues that can complicate treatment. “We have people who will tell us what is going on with them medically,” he said. “Some tell us the truth, but some are afraid to tell us because they think we work for police.”

Campana said there are protocols in place to address those inmates and detainees who develop illnesses while in the jail. They can approach nurses, who conduct rounds and distribute medicines two to three times a day; file sick-call slips requesting care; or make a request electronically at kiosks located through out the facility. Once a sick-call slip or electronic request is filed, medical staff do “triage,” prioritizing potential patients depending on the severity of their complaints, and it could take up to 24 hours to respond.

Sick call

“If someone is feeling really bad and wants to be seen right away, a sick call slip may not work, and an (corrections) officer may have to call in to medical staff,” Campana said. “We are dependent on officers to contact us — and they do contact us — but that is not something we can control.”

Hudson County and ICE pay for the medications and all offsite care costs, including hospital stays and visits to specialists.

“Some people might assume that if we withhold care, we make more,” he said. “But that does not happen and never has anyone at the county or ICE said our meds are expensive or offsite care expenses needed to be cut. We have 100 percent autonomy to determine what meds a person should get.”

Federal complaint filed

The latest CFG contract was awarded despite a federal complaint filed by First Friends of New York and New Jersey and Community Initiatives for Visiting Immigrants in Confinement, two immigration advocacy groups. The complaint, filed May 11, 2016, said that medical issues were consistently being raised by detainees in interviews with advocates, which “demonstrate(s) a pattern and practice of substandard care.” These complaints, according to the filing, included: delays in request for treatment and denials of care requests; failure to communicate properly with non-English speaking detainees; overmedication that resulted in “everything from fatigue to memory lapse to coma-like states”; use of shackles when transporting detainees to outside medical care; lack of continuity of care; failure to provide medications upon release; limitations on access to care; and sanitary issues in the facility that create health risks.

The complaint also criticized ICE oversight of the Hudson facility, due to what it called a bifurcated structure — the New York and New Jersey offices have jurisdiction over different wings.

It called on ICE to “take immediate steps to improve Hudson’s health care practices, including … appointing an independent investigator to inspect Hudson’s health care policies and practices, developing recommendations to improve the quality of care at the facility, and overseeing the implementation of those recommendations.”

‘Unsanitary conditions’

In response to the 2016 complaint, the county appointed a four-member committee, which included retired Superior Court judge Hector R. Velazquez, physicians Angelo Caprio and Saquiba Syed, and attorney John Molinari. The committee found that the jail needed a “more effective plan to eliminate mold, flies and other unsanitary conditions” in living areas and bathrooms; better communication with detainees on how to report illnesses; better access to translation services; more timely response to medical requests, including provision of medications and treatment for chronic conditions.

A 2012 Detention Watch report on broader issues at detention facilities around the country found similar complaints, adding that detainees lack access to nutritional food, exercise, and clean clothing, despite federal rules requiring that detainees be provided all three.

Hudson officials did not respond to requests for comment, but a press release announcing its review into Espinoza’s death said that the jail has been accredited by the National Commission of Correctional Health Care and that the Velazquez panel “did not substantiate the charges that detainees were deprived of adequate medical care.”

Faster access to care

The report issued by the county panel, however, did list several issues with the facility, including mold in living spaces and bathrooms, problems with kiosks used by detainees to seek medical services, issues with translation services, delays in provision of prescription drugs, and delays in provision of outside medical care. The panel recommended that changes be made to infectious disease prevention plans to improve sanitary conditions and potentially eliminate bacterial infections that had been a problem among detainees and inmates. The panel also recommended that ICE and jail officials meet to develop new protocols to speed prisoner access to care, both on site and off.

A key recommendation of the county panel, according to advocates, was a proposal to create a review group that would include representatives from detainee advocacy groups, ICE, the jail, county government, and CFG, that would meet regularly to ensure that the recommendations of the panel were implemented and provide oversight in dealing with ongoing issues involving medical care at the correctional facility.

Squeo, who serves on the review committee, said it is weighted too much in favor of county and jail officials. Only two immigrant advocates serve on the committee, he said, and they lack the power to make random visits.

“We have been advocating we need to be empowered to visit the facility in a random fashion, to go to different units, interview detainees, and ascertain what complaints they have,” he said.

Currently, Squeo said, advocates only have anecdotal information to go on, usually based on what may be an unrepresentative sample. He said that two of eight members of a recent scripture group complained of medical issues that had not been addressed. He referred the complaints to jail officials, and both were resolved.

“That to me is the reason we would need an independent group that can say ‘we are going to visit these two units this week and two every week and then when we finish we’ll start over,’” he said. “If detainees were assured this was an independent group, independent of the jail and ICE, maybe they would be open to discussing medical claims.”

Trust remains problem

This distrust remains a problem, he said, because many detainees have some kind of criminal record. They often had legal trouble in the past, sometimes seven or eight years earlier. And often these run-ins with police were for relatively minor offenses — possession of marijuana, for instance, or fighting — that resulted in probation.

“They may never have served a day in jail, but seven or eight years later, they are picked up by ICE to face deportation for that criminal history,” Squeo said. “So detainees — many appear to suffer from depression, and they feel they are being treated unfairly. It is hard to have any level of trust for ICE, for sure, but also for jail personnel.”

In the meantime, Portela said Espinoza’s family awaits answers. The medical examiner’s report has yet to be completed and, until it is released, the family will not make a decision on how to proceed, though it is considering legal action against both ICE and the correctional center, he said.