New federal court filings in the Parsons v. Ryan prison health care settlement contain emails from a former Corizon employee who claims to have resigned over health care and safety issues in Arizona prisons.

Citing advice from ethics counsel in the Phoenix office of the law firm Perkins Coie, ACLU National Prison Project Director David Fathi said his office initially did not engage with the whistleblower.

“Pursuant to the Arizona Rules of Professional Responsibility, this was the most prudent approach to respond to people who currently work for Corizon and/or ADC who contact Plaintiffs’ counsel,” Fathi wrote.

Fathi, a plaintiff’s attorney in the Parsons case, said that in early March, his office received an unsolicited email from a woman named Angela Fischer, who said she worked for Corizon within the Arizona Department of Corrections.

“The message expressed Ms. Fischer’s concern about medical and mental health care,” Fathi said.

In the declaration, filed Friday afternoon, Fathi said “she was a current Corizon employee and Corizon was represented by counsel, we were unable to speak with her without the consent of Corizon’s counsel.”

Fischer responded saying she had resigned from Corizon Health and wished to share her information.

The filing from plaintiff’s attorneys contains the allegations Fischer sent to the ACLU, including many emails documenting safety and health concerns that she sent directly to leadership at Corizon Health.

KJZZ reached out to Fischer, but she has not returned emails or messages as of the filing of this story.

'A Plethora Of Evidence'

In her initial letter to the ACLU, Fischer claimed to have “a plethora of evidence that demonstrates deliberate indifference toward patient mental health and medical needs in the Arizona state prison system.”

The documents in the court filing show Fischer was a licensed professional counselor working as a psychology associate for Corizon Health at the Arizona State Prison Complex in Phoenix. In one email to Corizon leadership, Fischer says she worked in an inpatient psychiatric unit. She also claims to have worked as a “Statewide HIPAA Coordinator from 2002 – 2012.”

An Arizona Department of Administration newsletter from 2006 posted on the DOA website identifies Angela Fischer as a “State HIPAA Manager and ADOA employee.”

In a June 2017 letter to Corizon’s regional mental health director, Fischer described conditions at the Phoenix prison:

“As you know, at the Phoenix complex … we are working with the most acute mental health patients in the system. Treating patients with this level of acuity in the best of circumstances is difficult and taxing; however, we both know we are not working in ideal circumstances.”

She called the circumstances “riddled with conflict and competing priorities between the Department of Corrections and Corizon Health.” Fischer then detailed a long list of requests.

“Please staff our facility at a level that allows us to do our jobs and take time to eat our lunches or leave on time without feeling guilty,” Fischer wrote. “If we want to run a mental health treatment program, we need the resources to run a treatment program, both human and material resources.”

Fischer went on to express concern about staffing levels at the prison, which have been shown to be consistently below the agreed-upon levels in Corizon’s contract with the state.

“There has not been one single day since I joined Corizon that our facility has been fully staffed with mental health clinicians,” Fischer wrote. “The workloads that we are managing are not sustainable … we are really doing all that is humanly possible to try to meet the expectations with a skeleton crew.”

Fischer asked for things like additional time for training and clarity regarding performance benchmarks.

“Please tell us what is going on in a timely manner and explain the rationale behind decisions so we can understand them. Please write memos and instructions for important things and put dates on them so we know which is the prevailing directive,” she wrote.

Safety Concerns

In her email, Fischer told the regional director she was concerned for her safety.

“Since I joined the Corizon team I have been required to wear a safety vest daily,” she wrote. “I was informed that the Phoenix facility is considered a hazardous site.”

Fischer referenced working in the Baker and George wards as well as the Alhambra Reception at the Phoenix prison.

“An inmate threatened to kill me and my children,” she wrote. “I received notification of this threat which stated that the IM knew where I worked in the community and that it would be easy to kill me.”

“There have been numerous staff assaults in both of my units since I started,” Fischer continued. “I have been assaulted at this facility and have received death threats while working here. Corizon is fully aware of the danger involved with our work in this facility.”

In another email to the regional director in August 2017, Fischer described how conditions led to an assault.

“On February 1st, 2017 I was assaulted by an inmate on George Ward due to the insufficient lock on that door. The lock was changed to a self-latching lock the next day.”

Fischer claims she had requested the lock be changed for two months before the alleged assault.

Complaints Against ADC Staff

In the email, Fischer said concerns lodged by her and other staff members were ignored.

“Tragically, some of the mental distress patients experience is related to either neglect or overt antagonism by correctional staff. When these issues are reported no remedies are forthcoming.”

Fischer wrote that when these employees were flagged for their behavior, nothing happened.

“We strive to use the Information Report system set in place to address problems in the facility,” she wrote. “However, quite often when serious issues are written up, there appears to be no action taken to rectify the problems. The officers cited continue to come to the units often inciting and inflaming patients and otherwise disturbing the milieu, to the detriment of all the patients; and sometimes the officers begin to retaliate against us.”

In a November 2017 email, Fischer described how an inmate on suicide watch was still able to harm himself.

“He tooks strips of sheets that he found in the legs of the bed, tied them around his neck, attached it to the sink, and was found unconscious less than 30 minutes later, all while on constant suicide watch,” she wrote.

Fischer indicated that although the inmate lived, the officers guarding him should have been more vigilant.

“I routinely see officers either sleeping while posted on their constant suicide watches or they have abandoned their posts altogether and are nowhere to be found,” Fischer wrote. “I report these issues each and every time they occur, yet it happens day after day after day.”

Speaking Truth To Power

In a September 2017 letter to the Corizon board chairman, Jeff Goldberg, Fischer said concerns she raised to her direct supervisors had not been addressed.

“In keeping with my value of speaking truth to power, I recently wrote to several leaders in our organization, including my supervisor, the site clinical director, the site facilities health administrator ... to share some of my concerns,” she wrote. “Not one single person in this list responded to
my communication, not even to acknowledge having received it.”

Among other concerns, Fischer told the board director of a lack of written communication and training materials.

“There are virtually no documented processes that inform employees of their roles, the expectations, and the processes by which they need to successfully and effectively accomplish their tasks. There is no meaningful or organized site-specific training and there are no job specific training documents.”

Crisis Management And De-escalation Mode

Fischer was apparently aware of the performance benchmarks agreed to in the Parsons v. Ryan settlement, but she said the Corizon staff was not able to reach them.

“We are often without the necessary equipment and materials to accomplish our tasks, as required by our contract and the terms of the lawsuit under which we are operating (Parsons v. Ryan).

Fischer said they were unable to spend enough time with patients “to assist in their mental health recovery and spend most of our time in crisis management and de-escalation mode.”

In a separate email in February, Fischer complained of the time constraints and overbearing workload.

“How much time would you like me to spend with each patient?” she asked her supervisors about time devoted to inmates on suicide watch. “Should I be teaching them coping skills or just asking them if they want to kill themselves?”

Fischer echoed the allegations and testimony of Dr. Jan Watson, another former prison health care worker, when she described the difficulty balancing patient care and compliance with court-ordered monitoring programs.

“Do you want me to provide therapy and help patients make gains so they can move off suicide watch? Or would you just like me to get a note in eOMIS so we don’t miss our CGAR mark?”

Fischer seemed to think the task before her and her colleagues was simply too much to complete.

“The math is not hard to figure out,” she wrote. “There are a certain number of patients at the Phoenix complex and a certain number of counselors. When we add in all the other duties we have, there is no way to ethically provide care according to our contract or our licenses.”

Checking Boxes, Neglecting Patients

Fischer shared several emails documenting her attempts to get treatment for an inmate with a severe rash.

“She complains of itching and scratches at herself throughout the session,” Fischer wrote of the inmate.

Fischer reported that the inmate had not had a shower in three days and smelled like urine. It was Fischer’s understanding that the inmates had been forced to urinate in their cells and clean themselves with wet wipes.

Fischer said multiple inmates had told her there was blood and feces in their cells as well.

Regarding a separate patient, Fischer detailed the struggles of a mentally ill inmate harming himself on a regular basis.

“He had repeated incidents of self-harm,” she wrote. “Including removing his toenails several times, removing parts of his eyelids, ears, and picking at his scalp until he has large infected wounds.”

In another email, Fischer again described her concern for placing performance metrics above patient care.

“I like to think that as mental health practitioners, we came into this field to provide aid and improve the lives of the people entrusted to our care,” she wrote. “However, it feels like the overriding message is for us to make sure the boxes are checked, with little consideration for the human beings we are touching in this process.”

Fischer told her leadership the health care staff is “here to serve,” but she wrote that Corizon did not seem to share their mission. She questioned the motives of the company amid its struggles to comply with the court-ordered benchmarks in Parsons.

“If service was our mission we would be seeing patients weekly in confidential settings because we care about them, not because we are afraid we will get in trouble if we don't. We would be doing treatment planning, because it leads to better outcomes, not because it is required.”

Fischer wrote that she was aware that she wasn’t following a normal chain of command within the company.

“I am aware that this email and my previous letter crosses many lines that are not typically crossed. I am trying desperately to find a way to stay and be part of the solution to our problems, both in terms of patient care and performance measures.”

Fischer wrote that she hoped to stay at the prison to make things better, “but honestly, it is becoming more difficult day by day.”

The court filings include a resignation letter from Fischer, dated March 5, 2018.

KJZZ has reached out to the Arizona Department of Corrections and Corizon Health for a response to the court filings. This story will be updated.