Board of Health

City Council’s public safety committee will vote June 5 on legislation that would establish an independent monitoring board to review “the goals and performance” of health care in Philadelphia’s prison system. The bill may also attempt to make Prison Health Services (PHS), a private management company, more accountable by enacting performance measures.

The board would be similar to the controversial Police Advisory Commission, which hears cases of alleged police misconduct, in that it will be comprised of private citizens, such as prison activists and health-service providers.

In the meantime, personal animosities are threatening to overshadow concern for prison reform, as exemplified by several hostile letters recently exchanged between Councilman Angel Ortiz and Prisons Commissioner Thomas Costello.

The men first sparred during a May 8 hearing sponsored by Council's committees on public safety and public health and human services. Ortiz accused Costello of failing to notify District Attorney Lynne Abraham that an internal prison-investigation report concluded employees may have committed criminal neglect when they denied medical treatment to an inmate who died in September 2000.

Two outside consultants, Dr. Robert Greifinger and Dr. Raymond Patterson, issued reports urging better record-keeping, less dependence on psychotropic drugs and suicide-prevention measures. Patterson concluded that PHS staff, which cares for about 7,000 inmates, is operating "in a crisis mode."

For nearly two years, Ortiz has been trying to force the Street administration to respond to allegations that PHS is providing inadequate treatment. (Managing Director Estelle Richman automatically renewed the Tennessee-based company's contract for another year, beginning in July, to the tune of $28 million). During previous City Council hearings on prison health issues, witnesses testified that inmates receive life-sustaining AIDS medications sporadically; that prisoners are told they are "faking it" when they have seizures; that health providers ignore critical dietary needs; and that suicide watch is lax.

According to the city solicitor's office, between January 1998 and July 2001, 57 inmates died in Philadelphia prisons.

Rancor ensued during the May 8 hearing when Ortiz produced a “confidential” memo from the Philadelphia prisons’ Internal Affairs Division (IAD). Investigators concluded that the death of inmate Jose Santiago, on Sept. 16, 2000, could have been avoided if the staff at the Curran-Fromhold Correctional Facility had given him insulin for his diabetes. Instead, a nurse assumed Santiago’s vomiting was caused by heroin withdrawal and refused him medical treatment. Fellow inmates reported that Santiago drank toilet water in an attempt to stave off dehydration. The IAD report, dated March 14, 2001, suggests that criminal charges may be warranted.

“Due to the complexity of this entire collection of the evidence, the investigator has recommended further review by the District Attorney’s Office,” writes Capt. Melvin Whitaker, director of prison internal affairs.

But when Ortiz contacted Abraham’s office, she claimed not to have been notified of the investigation report. During the hearing earlier this month, Costello repeatedly said “a call” was put into Abraham’s office but she never returned it. Ortiz went ballistic, calling Costello “totally incredulous, disingenuous.”

“You’ve got a staff that doesn’t take care of business -- there’s no supervision,” Ortiz alleged.

Just days after that contentious City Council hearing, Ortiz wrote Costello asking for information about the death of inmate Lavoisier Lambright, who was found dead in his cell May 10. Costello’s reply arrived May 14. He told Ortiz that because both Lambright’s medical records and the IAD report are confidential, he could only get back to the councilman after an investigation was completed.

But the commissioner did not leave it at that. Costello also brought up the verbal exchange from the previous week.

“Finally, I believe your conduct while conducting the hearing on Wednesday, May 8, 2002, was totally unprofessional, inappropriate and counterproductive,” Costello wrote. “During my tenure for the past six years as Commissioner of the Philadelphia Prison System, I have never experienced conduct by a City Council Member such as the conduct you displayed that day.”

Ortiz wasted no time in responding to this letter. The next day, he faxed back a response accusing Costello of hindering Council’s efforts by making “misleading” statements during the May 8 hearing.

“[W]hile you may take offense that I raised my voice at you during the recent hearing, consider that I am offended by your inaction and the gross mishandling of events leading to, as well as the aftermath of, the Santiago death,” Ortiz wrote.

He went on to point out that Costello declined to testify before City Council’s public safety committee on two prior occasions and ignored requests for information.

“So I advise you to become less concerned about my public conduct and focus your attention on rectifying what are serious policy issues and procedural flaws that are clearly within your authority and responsibility,” Ortiz concluded.

Costello declined to comment on the angry exchanges with Ortiz. As for the investigation into Santiago’s death, prison spokesman Robert Eskind said it is “a legal matter that will be handled at the appropriate time.”

Cathie Abookire, spokeswoman for the district attorney, said she could not confirm or deny whether the office is undertaking a broader investigation into medical care provided in the Philadelphia prison system.

Ortiz is also searching for ways to raise $100,000 so that City Controller Jonathan Saidel can perform an audit of PHS’s operations.

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