# Banks v. Booth

> District Court, District of Columbia · January 26, 2021

URL: https://www.frixlaw.com/law-library/cases/4654795

## Case

- **Court:** District Court, District of Columbia
- **Decided:** January 26, 2021
- **Precedential status:** Published
- **Opinion:** Opinion
- **Judges:** Judge Colleen Kollar-Kotelly
- **Nature of suit:** Civil
- **Cited by:** 0 later opinions in the Frix Law Library

## Citator (automated)

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## Opinion text

ATTACHMENT B
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 1 of 51

UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF COLUMBIA

EDWARD BANKS, ef al.,
Plaintiffs,
Vv. No. 1:20-cv-849 (CKK)
QUINCY BOOTH, in his official capacity
as Director of the District of Columbia

Department of Corrections, ef al.,

Defendants.

REPORT SUBMITTED BY AMICUS CURIAE PURSUANT
TO SEPTEMBER 16, 2020 ORDER

(Table of Contents, Report Narrative, Index to Exhibits, Appendix A Exhibits 1A — 6 and
Appendix B Exhibit 1)

December 11, 2020
IL.

IIL.

IV.

Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 2 of 51

TABLE OF CONTENTS

INTRODUCTION 000i ccc ccc cece cece ceteeeeceteeeestsecsetseetseeseeseetieeseetseeeenes
METHODOLOGY 000... e cece cee tects cee ceseecesetestesesteetessetetnteteeseees
BACKGROUND 0.00.00 cccccee cece tc ceeetettee testes eeesceseeeseeeesseetsesieesseeseeseetsenseeses
A. Population 2.00. c een cree e cnet ene ebne ents eectetieeetitectieetieeieeetieee
B. Single versus Double Celling....00.0000cccccecccc cece cece ese ettttstetseeteeneey
C. Operations in Response to the Pandemic.........0..000cccccccccecceceeceteeteseetteeees
D. Staffing. ccc ce een ee ieee tse cnt ebbeeeteseceetnteniseecieeseetteesieenes 10
E. Support from the DOH... ccc ccc cece eee tent ces teesseeteeeetsteneenies 11
FINDINGS 0000.0 ce cece ee cece eens ceeeneeeseeteeseeeseeeeeseeeseetsenesteeteeteeseeeenaes 11
Requirement Ome ooo... ccc cece ete eee e tei te ttt teetteeeteeenieeees 11
A. The Sick Call Process .......0ccccccccccccecceececetecetseeeecsesseeteeeseeseetseseenes 12
B. Sick Call Data oo... eee cee ce cteeesseeseeteeeseetseeieeteeneeteeniees 16
1. Sick Call at the CDF o.....00 occ cece eects ettettetttetteestetiees 18
Table One: Summary of Length of Time to be Seen By A
Provider At CDF oo......0cccccccccccecce ete eee cce cette eseeseeteettenteenieens 20
2. Sick Call at the CTF o.....0ccccccccecc cee eet ee teeteeeteeteeteetteeiees 20
Table Two: Summary of Length of Time to be Seen By A
Provider At CTF o....0.cccccccccccccceeeeeseeseeseetsetiettetteeteeteeseeeiees 21
C. Conclusion, Requirement Ome... ccc ect cc ete etteetteetteenes 22
Requirement TW0...00.00000.000000cccc ccc ccc eect e tence eee ee ents te tebe teetteenteeenieeens 23
A. Efforts to Promote Social Distancing.......0000000.o occ ccc eceeeteeteenees 23
B. Conclusion, Requirement TWo 0.0.0.0... ccc cece cece cee teteteesetteeeites 27
Requirement Three .....0.0..0000..0000000ccccccccc ccc cece eee tee eeteeeeeeeeessteetteesesieees 28

A. The Environmental Health and Safety Vendor and

Contract Cleaning Services ......00.000ccccc ccc cee cees cents ettetetseeeeenteeenieees 28

B. Hiring Registered Sanitarian ......00.000.00 ccc ccc cc eee tee eeteeeseeteenees 31

C. Access to Cleaning Materials and Related Training.......0..0000.0000... 33
Requirement Four ......0000.00000000 ccc cece cee e ete ee eet teeeteteetteeetseenneeens 34
Requirement Five ......00000000000 cocci ccc cece eee e eee e tei te tet teetteentseenneeens 35
A. Attorney-Initiated Legal Calls 00.0000 ceccc cet ceeeenetteetseenes 35

B. Inmate-Initiated Legal Calls 00.00.00 cete ete ceteeneetteeeniees 38

C. Conclusion, Requirement Five... cece cece eee ceteetsteesseceeenees 39
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 3 of 51

Requirement Six... cece eect ee eee ite te bese ttteeetteeeteeenneeees 39
A. Testing of Newly Admitted Inmates ......000000000cccc cece eceeteereees 40
B. Testing of Inmates Transferred to Saint Elizabeths Hospital ................. 4]
C. Testing of Inmates Transferred to Federal Correctional Facilities ......... 42
D. Testing of Cellmates of Inmates Who Test Positive........000.000..0cce 43
E. Testing of Inmates Who Report COVID-19 Symptoms ...........0...00.00... 44
F. Timeliness of Testing Results 00.00.0000 ccc se ccee tee ceeetettteetees 46
G. Conclusion, Requirement S1xX oo... ccc cee ttee ce teeneetteeetseenes 46
V. CONCLUSION 0.00.00 ee cee e tees eteeeeeteteeceeeeseeiestistieteeteteteeeniees AT
Index to Exhibits ...0..00.0 ccc cece ete ce cece seeeseeseeteeteesteetseesseseetsestsestetseeteeneey Index-1
APPENDIX A
Exhibits IA — 6
APPENDIX B

App. B, Ex. 1

il
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 4 of 51

UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF COLUMBIA

EDWARD BANKS, ef al.,
Plaintiffs,
Vv. No. 1:20-cv-849 (CKK)
QUINCY BOOTH, in his official capacity
as Director of the District of Columbia

Department of Corrections, ef al.,

Defendants.

REPORT SUBMITTED BY AMICUS CURIAE PURSUANT
TO SEPTEMBER 16, 2020 ORDER

Pursuant to the September 1 , 2020 Order issued in the above-captioned matter, (D t.
Nos. 12 , 12 ),'a , traceM. opesand Mar ordan,” submit the follo in report for

consideration by the Court and the Parties.

1 The Court amended the initial order issued on September 1 , 2020 to clarify the date by hich a ere
re uired to be intheirrevie . The amended order re uired a to provide the Parties and the Court ith an oral
report no later than October 1, 2020 anda_ ritten report no later than November 1 , 2020. Thereafter, on October
2 , 2020 a Second Amended Order Appointin Amicus as entered (D t No. 129), hich as identical in all
respects to the prior order e cept, upon re uest of the a and ith the consent of the Parties, it chan ed the date
of the oral report from October 1,2020,( hich asa Saturday), to November 9, 2020, and the date for the _ritten
report from November 1 , 2020 to November 20, 2020. (D t No. 129). The Court ranted a consent motion to
further enlar ¢ the filin deadline forthe ritten report to December 11, 2020, (D t. No. 1 2), to afford a
sufficient time to complete additional unanticipated assessment activities. (D t. No. 1_ ).
> err M. . rt I a,C.A.No. 1 19-8 (D.C. Super. Ct.) is a class action la suit related to the
conditions of confinement and treatment in the District of Columbia s uvenile ustice system. race M. opes has
served as the court-appointed Special Arbiter in this la suitand Mar ordanhas or edandcollaborated ith her
on monitorin and reportin onthe District overnment s compliance ith the remedial orders issued in the case.
The plaintiff class is represented by multiple attorneys, includin counsel from the District of Columbia Public
Defender Service and the District of Columbia defendants are represented by counsel from the District of
Columbia s Office of the Attorney eneral. Pursuant to a Settlement A reement approved by the Superior Court in
uly 2020, durin ahearin conducted on December 1, 2020, the presidin ud ein err M. indicated that he found
the conditions established by the Settlement A reement had been satisfied and that he ould be issuin a
termination order later in the month. One of the conditions established by the Settlement A reement re uired the
District of Columbia s Mayor to issue a Mayoral Order establishin the Office of Independent uvenile ustice
acilities Oversi ht. A second condition re uired the Mayor to appoint Mar ordan as the E ecutive Director of
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 5 of 51

I INTRODUCTION

This is the third report submitted by a in this case. ere initially appointed
in an order issued on April 9, 2020, (D t No. 4 ), to provide specific information to the Court
re ardin medical services and environmental health and hy iene related toCO ID-19, the
disease caused by SARS-Co_ -2, the novel coronavirus, att o detention facilities operated by
the District of Columbia Department of Corrections ( DOC ), the Central Detention acility
( CD )and the Correctional Treatment acility( CT). Pursuant to that order, a
provided information to the Court and Parties durin an April 1 , 2020 teleconference and ina

ritten report submitted on April 18, 2020 (D t. No. 4 ). One day later, on April 19, 2020, the

Court issued an order rantin the Plaintiffs re uest fora Temporary Restrainin Order
( TRO )andre uirin the Defendants to ta e certain specified actions (D t. No. 48). Thereafter,
in an order issued on April 28, 2020 (D t. No. 2), a ere appointed for the second time, to
provide information to the Court re ardin certain matters related tothe TRO. ollo in
issuance of the April 28, 2020 order, a provided an oral report to the Court and Parties on
May 11, 2020, and submitted a ritten report on May 20, 2020 (D t. No. _ ).

On une 18, 2020, the Court issued a preliminary in unction in this case (D t. Nos. 99,
100). The preliminary in unction re uires the Defendants to ta e certain specified actions, hich
are described more fully in the ne t sections of this report, related to the follo in si conditions
of confinement: medical care social distancin environmental health and safety conditions in

isolation units access tole al calls and testin forCO ID-19. ere appointed for the

this oversi ht office. As re uired by the Settlement A reement, these Mayoral Orders ill become effective upon
the issuance of the termination order. At that time Mr. ordan ill become a District overnment employee, ith
uni ue authority and independence, for a three-year term sub ect to removal only for cause. The Court and counsel
for the Parties in the instant case, includin counsel for the United States, have been apprised of these circumstances.
In response, all counsel indicated that there are no ob ections to Mr. ordan s participation as an a in this
matter.
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 6 of 51

third time on September 1 , 2020 (D t. Nos. 12 , 12 ), to provide information to the Court and
the Parties re ardin the Defendants compliance ith the une 18, 2020 preliminary in unction.

Pursuant to the September 1 , 2020 Order, a provided an oral report to the Court and
the Parties durin ahearin conducted by telephone on November 9, 2020. Durin that
proceedin , the Court re uested thatin their ritten report a address certain matters hich

ere not initially contemplated by the September 1 , 2020 Order, and also provide additional

details related to some of the matters that ere the sub ect of the November 9, 2020 oral report.

This report summari es a November 9, 2020 presentation and includes the
supplemental information a ere as ed to address. In addition, this report e plains the
methodolo y a relied upon to conduct their assessment, describes relevant bac round data
re ardin the facilities sub ect to the assessment, and presents updated information concernin
identified cases of CO ID-19 atboththe CD andCT .

The Defendants have continued to cooperate fully ith a re uests for information.
Asa _ eneral matter, DOC and contract staff at every level have made substantial efforts to
respond to a re uests promptly. reco ni e and appreciate the efforts the Defendants
have continued to ma e to facilitate their revie
Il METHODOLO Y

ollo in the issuance of the September 1 , 2020 order, a conducted unannounced

and unescorted site visits on multiple shifts on October 22,2 ,29, November 1 and December
2, 2020 at the CD , and on October 2 and November 2, 2020 at the CT . Durin the course of
these site visits, a visited eneral population, ma imum and medium security housin units
as ell ashousin units desi nated for enhanced monitorin , inta e, special mana ement, and

forinmates ith mental health needs. A total of 18 housin units ere visited, some on multiple
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 7 of 51

occasions on different days or shifts (NO-1, SO-1, NO- , SO- , NW-2, NW- , SW- , SW-2,
SO-2, C2A, C4C, SMUB, E2A, E4A, E4B, D A, D4B, C2B). Observations in housin units
included cells, dayrooms and case mana er s offices. At both facilities, medical units,
administrative offices, and visitor entry areas ere visited. In addition, the case mana ement
suite, here many le al calls are conducted, as_ ell as the videoconferencin and visitation areas
that are used at the CD for attorney-client videoconferences and meetin s, ere visited.

Structured in-person and or telephone intervie s ere conducted ith members of the
DOC e ecutive mana ement team, includin the DOC Deputy Directors of Administration,
Operations, Pro rams and Case Mana ement, and Professional Development and Colle e and
Career Readiness the Audit and Compliance Mana er the Sanitation Inspection Specialist the
DOC Medical Director members of the Correctional Health Pro ram at Unity Health Care, Inc.
( Unity ), includin the Medical Director, Dental Director, Mental Health Director, ead
Dentist, Director of Nursin , and other health care staff the CD and CT Warden and the
Deputy Wardens assi ned to each facility maintenance supervisors and staff records office
staff and do ens of correctional officers and supervisory correctional staff assi ned to various
posts throu hout the facilities. In-person intervie s ere also conducted ith appro imately 80
inmates at both facilities. At the re uest of the DOC Medical Director, a also intervie ed an
epidemiolo ist under contract ith the D.C. Department of Health ( DOH ), assi ned to provide
support to the DOC and several other District a encies durin the pandemic.*

In addition to the information collected durin site visits and from intervie s, a

re uested and continued to receive access from the DOC to the electronic health records

Unity provides medical services on a contractual basis to inmates at the CD and CT .
4 Atthe re uest of the DOH eneral Counsel, this intervie as conducted ith counsel present. It as the only
intervie conducted durin the assessment in the presence of counsel.

4
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 8 of 51

( EHR ) of inmates confined at the CD andCT . Revie and analysis of samples from these
records has been conducted and the results are presented herein. The follo in data for both
facilities ere also obtained from the DOC or Unity and analy ed:

e Daily census data, includin inmate housin assi nments for the period une 18, 2020 to
October 1, 2020

e Data related to admissions and len th of stay for the period une 18, 2020 to October 1,
2020

Data related to releases and transfers for the period une 18, 2020 to October 1, 2020
Date related to inmate le al status for the period une 18, 2020 to October 1, 2020

Sic call re uests and related lo s for the period une 18, 2020 to October 1, 2020

Data related to all CO ID-19 tests conducted on inmates throu h December 1, 2020 and
Data related to DOC correctional staffin levels.

I BAC ROUND

Since the issuance of a May 2020 report, there have been a number of chan es in
population levels, housin practices, housin unit operations, staffin levels, and the support the
DOC receives from the DOH. Each of these topics is addressed belo

A Pop lation

On une 18, 2020, the day the Court issued the preliminary in unction, the combined
population of the CD andthe CT as1,249 inmates. The Defendants subse uently reported
to the Court that as of une 29, 2020, the combined population of the CD andCT as 1,2 1.

Over the four-and-a-half months bet een the issuance of the preliminary in unction and October

The team a assembled for this sta e of their or includedt o additional members. The ma ority of case
record revie s ere conducted by anet Maher, an attorney ho hase tensive e perience in or in in institutional
and healthcare settin s. Ms. Maher headed the Office of Corporation Counsel s Mental Health Division from 1992
to 2000, or edas Deputy eneral Counsel and Chief of Staff for the District s Child and amily Services A ency
from 2000 to 200 and as DO Compliance Officer at Saint Eli abeths Hospital from 200 to 2014. rom 201 to
her retirement in 201 , she headed the Hospital s Performance Improvement Department. She also has provided
consultative services to the Maryland and Pennsylvania behavioral health systems and to the Office of the Special
Arbiterin err Mo. ofr t I a,C.A. No. 1 19-8 (D.C. Super Ct.) Case records ere also revie ed by

ulia Cade, a senior parale al ith substantial e perience in similar institutional conte ts.

Durin the November 9, 2020 hearin , a incorrectly reported that the lo est population count bet een une
18, 2020 and October 1,2020 as 1,2 4. Ho ever, upon further revie , 1,248 inmates on une 18, 2020, the day
the preliminary in unction as issued, represented the lo est population count for the period.

Notice of Compliance ith the Court s Preliminary In unction(D t. No. 101) at .
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 9 of 51

1, 2020, the population of the to facilities increased by 19 percent to 1,48 inmates. Based on
an analysis of data submitted by the Defendants, this as driven primarily by increases in the
number of inmates confined on pretrial felony char es and to a lesser e tent by increases in the
number of parole violators and pretrial misdemeanants confined at the CD andtheCT °

Because population increases in secure facilities are driven by either increases in the
number of admissions, increases in the amount of time admitted inmates remain incarcerated, or
a combination of thet 0, a analy ed admission and len th of stay trends of inmates housed
atthe CD andthe CT , by le al status. The analysis revealed that after une 18, 2020,
admission rates increased each month throu h September 2020, then decreased some hat in
October 2020.’ There ere increases in admission rates for all three cohorts (.e., pretrial felons,
parole violators, and pretrial misdemeanants) that drove the population increase. _ or pretrial
felons, the number of admissions per month as si nificantly hi herin Au ust, September, and
October 2020 than in the second half of une and in uly 2020.'° Amon parole violators, after
relatively fe admissions in the second half of une, admissions increasedin uly and to a lesser

e tentin Au ust, but then nearly doubled bet een Au ust and September from to 118, before

droppin some hatin Octoberto8 .'' inally, amon pretrial misdemeanants, there ere

8 E .1A,Chart, Combined Population of CD and CT ,by Day and e al Status, une 18- October 1, 2020
E . 1B, Table, Combined Population of CD and CT , by Statusand Day, une 18- October 1, 2020. Durin
this period, the population of pretrial felons increased by 1 inmates,from48 to 4 the population of parole
violators increased by inmates, from 88 to 1 1 and the population of pretrial misdemeanants increased by 8
inmates, from 8 to 10 . The Appendi to this report is divided into t o parts. Appendi A hereinafter App. A
contains the e hibits that are cited in this report. Some of the e hibits in App. A have been redacted, as appropriate,
for filin in the public record. The updated CDC uidelines are contained in Appendi B_ hereinafter App.

B . Unless desi nated by a citation to App. B, all citations to the e hibits included in the Appendi refer to App.
A.

° E .1C, Table, Admissionto CD and CT , by Status and Month, une 18, 2020 - October 1, 2020. Monthly
admissions in Au ust ere2 percent hi her than in uly, and monthly admissions in September ere 21 percent
hi her than Au ust. Althou h admissions dropped by 1 percent durin October relative to the prior month,
admission levels ere still ht her than uly and Au ust.

10

04
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 10 of 51

increases in admissions in Au ust and September before admissions dropped some hat in
October.”
The avera elen thof stay amon all inmates housed at the CD and CT increased
bet een une 18 and October 1, 2020, albeit only sli htly, by appro imately four percent.'
Amon the three cohorts that primarily accounted for the increases in population, the chan es in
len ths of stay varied. The avera elen th of stay amon pretrial felons increased by
appro imately ei ht percent bet een une 18 and October 1, 2020. or pretrial misdemeanants,
the avera elen th of stay increased by substantially more over the same period, appro imately
1 percent, from 4 daysto days. Incontrast,amon parole violators the avera elen th of
stay dropped by appro imately 28 percent over the same period.
B_ Sin levers s Do ble Cellin
also analy ed sin le versus double cellin practices at each facility durin the
period une 18 to October 1, 2020. Asa previously reported, the CD contains 18 housin
units, most ith 80 cells.‘4 Over the period revie ed, the CDs population ran ed from alo
of 819 inmates to a hi hof 1,0 9 inmates. While there are over 1, 00 cells at the CD , over the
period analy ed the avera e daily percenta e of inmates housed in sin le cells as8 percent
(.e., 1 percent of inmates had cellmates).
The double cellin practices atthe CD ere at least in part attributable to closed
housin units and cells on open housin units that ere ta en out of service due to maintenance

issues. Durin a site visits in October and early November 2020, five housin units ere

12 d.

13 E .1D, Table, Avera e en thof Stay of Inmates Housed atCD and CT , by Status and Month, une 18,
2020 - October 1, 2020.

4 ee e rt tted rae ratt rl , et rder, filed May 20, 2020
hereinafter a, e rt at4- fora more complete description of the CD .
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 11 of 51

closed, but durin a most recent site visit to the CD on December 2, 2020, only t o
housin units ere closed: NO-2' and SE-1.' A observed numerous cells that ere
unoccupied on housin units ith double-celled inmates. Maintenance and correctional staff
reported that unoccupied cells ere out of service in some instances because the metal bun sin
the cells ere dama ed. ere told that in other instances the cells ere unoccupied
because of plumbin problems. CD staff reported thaton November 0, 2020, appro imately
4 cells on open housin units ere out of service. !

Atthe CD ,a additionally analy ed sin le versus double cellin practices in SO-2,
the Inta e unit. E cept forinmates ith acute mental health issues, ho are transferred to SO-
and omen, ho are admitted at the CT , the Defendants report that ne inta es are housed on
SO-2 until they are medically cleared follo in CO ID-19testin . Bet een une 18 and
October 1, 2020, the population of SO-2 ran ed from alo of 44 inmates toa hi h of 111
inmates. The avera e daily percenta e of inmates housed in sin le cells on that unit as
percent, lo erthan the percenta e of inmates housed on sin le cells on non-Inta e housin units.
Durin a December 2, 2020 site visit, the population of SO-2. as’. At that time,
inmates ere double celled (.e., occupyin 18 cells) hile 22 cells ere unoccupied.

Atthe CT , there are2 housin units, includin the infirmary.‘ Durin a most
recent site visit to the CT on November 2, 2020, seven housin units ere closed. The CT

houses si nificantly fe erinmates than the CD . Bet een une 18 and October 1, 2020, the

1 NO-2 is desi nated to house inmates ho test positive forCO ID-19.

1 SE-1 as closed because it as bein used forstora e. CD mana ement reported that they are considerin
openin the housin unit as part of a plan to enable them to eventually open a second Inta e housin unit else here
in the facility.

1 attempted to obtain records reflectin the number of cells out of service daily ho ever, neither of thet o
CD administrative units that a ere told maintain these data (.e., Maintenance and Countboo ), ere able to
provide precise information.

18 ee May 20, 2020 Report at - fora more complete description of the CT facility.

8
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 12 of 51

facility population ran edfromalo of Oinmatestoahi hof4 4 inmates and durin that

period, it as rare for inmates to have a cellmate. Department of Corrections records indicate

that the avera e daily percenta e of inmates housed in sin le cells atthe CT durin this period
as 99 percent.

C Operations in Response to the Pandemic

Both the CD and CT have continued toimplement a2 -hour per day loc do n. In
effect, this means that most inmates remain in their cells e cept for one hour per day hen they
are released to sho er, ma e personal telephone calls, atch television, sit in the day room,
and or ma euse of small recreation areas ithin the housin units.!? Inmates assi ned to
se re ation units areloc eddo n for 24 hours per day on ee ends.

Be innin in the fall, the DOC has made tablets available to inmates that they can use in
their cells. There aret o types of tablets, one ith paid content that includes entertainment
options such as videos and ames and another ith free educational content. Ase plained
belo, the tablets include educational materials related to CO ID-19 and also can be used for
attorney-client communications. *°

Durin a prior site visits in April and May 2020, the DOC had desi nated
numerous housin units at both facilities as uarantine or isolation units. In contrast, durin site
visits conducted from late October to early December 2020, there ere no isolation or uarantine
housin units atthe CT duetothe absence of no norsuspected CO ID-19 cases. At the
CD , there as briefly an isolation unit in November after an inmate tested positive upon

admission and another housin unit as uarantined after a reported e posuretot o staff

1° Inmates in many CT housin units also spend out-of-cell time heatin meals in micro ave ovens.
20 ee ra2 and 8- 9.
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 13 of 51

members ho tested positive for CO ID-19.7' In addition to uarantine and isolation units, the
DOC also established enhanced monitorin housin units at both facilities for inmates ho
return from in-person court appearances or face-to-face visits ith an attorney. Inmates housed
on enhanced monitorin units have their temperature chec ed by medical staff daily for up to a
14-day period.
D Staffin
previously reported that the lar e number of correctional staff unavailable for duty,
includin staff ho ere not available for reasons related to CO ID-19, hada si nificant impact
on facility operations. comparison of correctional staffin levels from mid-May to
staffin levels in early December 2020 indicates that the number of staff available to or
remains virtually unchan ed.
previously reported that as of May 9, 2020, the DOC had a total of 994 funded
correctional officer positions.” Of that total, 1 positions ere vacant, five percent. Moreover,
an additional 1 0 filled positions, 1 percent, ere encumbered by correctional officers ho
ere on unavailable for duty status. Thus, 22 percent of the funded correctional complement
as either vacant or not or in .
obtained updated data related to the correctional staffin complement from
December 2020. As of December 1, 2020, the DOC had a total of 1,014 funded correctional
positions, 20 more funded positions than on May 9, 2020. DOC mana ement reported that as of

December , 2020, 110 positions ere vacant, 11 percent, and an additional 1 _ staff in filled

*1 All of the inmates on the uarantined housin unit ere tested forCO ID-19 and none tested positive.

2 eeMa , e rtat -8 e rt tted rae ratt rl, rder, filed April
19, 2020 hereinafter r/ e rt at21.
> Ma e rtat . The total included 844 correctional officer positions, 9 lead correctional officer

positions, and — supervisory correctional officer positions.

10
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 14 of 51

correctional positions, 1 percent, ere unavailable for duty. Thus, hile the number of staff
ho ere unavailable for duty decreased, an increase in the number of staff vacancies left the

si eof the available or force essentially the same as it as in May.”

E S pport from the DOH

Startin atsome pointin une 2020,anurse or in ith the DOH be an providin
health education related toCO ID-19 to DOC staff and conductin audits, at times ona_ ee ly
basis, related to the use of personal protective e uipment ( PPE ) at boththe CD andCT .
Unity and DOC mana ers report that they have been re ularly briefed on the audit findin s and
recommendations. In early Au ust 2020, an epidemiolo ist under contract ith the DOH be an
to visit the CD and CT to ensure appropriate monitorin of CO ID-19 positive cases and the
related submission of data to public health officials provide consultation on uarantine, isolation
and testin practices and confer ith Unity s medical director on treatment in individual cases.
By all accounts, this increase in DOH support has served as a very helpful resource to both DOC
and Unity mana ers.
I FINDIN S

This section summari es a findin sre ardin the Defendants performance relative
to each of the si_ re uirements related to conditions of confinement addressed by the une 18,

2020 preliminary in unction.

Re _ irement One

Defendants shall implement a medical cares stem on _ eneral pop lation

nits that ens res inmates receive attention from a medical provider ithin
2 ho rsofreportin healthiss es Ifthiss stem contin esto sesic call
slips, Defendants shall ens re that inmates have consistent and immediate
access tos chsic call slips and that said slips are collected at re lar
intervals

24 ee raat2 -2 for additional information.

ll
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 15 of 51

The DOC and Unity have added resources to enhance the sic call system at the CD and
CT . The evidence sho s that for the most part, the Defendants areno providin inmates at
the CD andCT _ ith consistent access to sic call slips and they are collected at re ular
intervals ho ever, inmates are not consistently seen by a medical provider ithin 24 hours of
reportin health issues ina si nificant percenta e of cases. These findin s are described belo

A The Sic Call Process

The DOC relies on asic call system on eneral population housin units” to ensure that
inmates receive attention from a medical provider thin 24 hours of reportin a health issue.”
The Defendants have increased staffin for health services and made several modifications to
the business process related to sic call re uests in response to this re uirement.

The DOC s contract ith Unity Health Care, Inc. as modified to add fundin for the
hirin oft o additional nurse practitioners or physician assistants and t o medical assistants
for the period May 18 throu h September 0, 2020.2 The contract modification includes t o
contract line items to e tend the contract fort o additional time periods sub ect to fundin
availability: from October 1, 2020 to anuary 1,2021 and from ebruary 1, 2021 to April 14,
2021. Subse uent to September 0, 2020, the increased staffin levels authori ed by the

modification have remained in effect.7®

> Asa noted durin the November 9, 2020 hearin , a interpret eneral population units in this conte t to
mean housin units that have not been desi nated as_uarantine or isolation units.

> Inmates can also access medical care throu h the ur ent care and chronic care clinics.

2 E .2A, Amendment of Solicitation Modification of Contract Number CW 88 8, effective May 18, 2020. The
contract modification as si ned by a Unity representative on une 2, 2020 and by a District overnment
contractin officer on Au ust 11, 2020.

28 re uested that DOC mana ement produce documentation supportin thee ercise of the option for the
additional period that be an on October 1, 2020, and reflectin the associated availability of fundin . Accordin to
DOC mana ement, the a ency intends to maintain fundin to support the modification throu hout both additional
periods specified in the contract modification, fundin is available, and there is no need for supplemental
documentation reflectin the e ercise of the additional period and the availability of fundin .

12
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 16 of 51

Intervie s_ ith Unity staff indicate that this modification as intended to stren then the
business process related to sic call by addin clerical staff to collect and trac sic call
re uests obtained from the housin units on a more fre uent basis and by increasin the number
of clinicians available to deliver medical services.””? Under thisne system, hich as
implemented on une 2 , 2020, inmates are e pected to continue to obtain sic call re uest
forms from the correctional staff, and fill them out by enterin their name, date of birth, DCDC
number, housin unit, cell number, the date, and information about the nature of their re uest. °
The une 2020 revisions to the form add certain specific CO ID-19 symptoms and inmates are
as edtochec all that apply to them. ' The revised form does not provide a prompt for inmates
to indicate the time the re uest as made or for medical staff to note the time the re uest as
received.

Inmates are instructed to continue to place the sic call re uest forms in the secure
collection bo es that are maintained on the housin units. As part of the ne business process
the Defendants have implemented, medical assistants at each facility pic uptheformst ice
daily from each housin unit, enerally inthe early mornin and mid-day. The medical
assistants count the forms as they retrieve them and manually record the total number of slips
they have collected in ahand rittenlo before leavin each housin unit. After the medical

assistant has retrieved the re uest forms, a member of the correctional staff assi ned to the

°° Unity mana ers report that they be an pilotin thisne process on May 18, 2020.

° E . 2B, sample revised Sic Call ormused atCD and CT . Inmatesaree pected to chec one of the
follo in bo es: I. ishto be seenatsic call, dental treatment, mental health or other.

! The symptoms listed on the revised sic call re uest form are fever, cou hin , difficulty breathin shortness of
breath, headache body ache and upset stomach. d. Inan effort to ma e the forms more readily identifiable, DOC
and Unity mana ers report that the correctional staff have been instructed to print the forms on pin paper.
observations indicate that hile use of the revised forms is idespread, inmates also submit sic call re uests usin
a variety of documents, includin the previous version of the sic call re uest forms, random sheets of paper, and by
fillin out inmate re uest slips, hich are intended for initiatin case mana ement and other administrative
re uests. eeE .2C, Inmate Re uest Slip, fora copy of the form used at both facilities to ma e re uests that are
processed by case mana ement staff.
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 17 of 51

housin unit e amines the interior of the bo and documents that there are no sic call re uest
forms remainin inthebo .

In contrast to previous site visits, sic callre uest forms ere available on most of the
housin units a visited before the November 9, 2020 hearin . In fact, of the 1 housin
units a visited up to the time of the hearin , the forms ere available on every unit other
than NO-1, ahi h security housin unit ande cept for inmates confined on NO-1, inmates at
both the CD and CT did not report difficulty accessin the sic call forms. Durin a
subse uent site visit a conducted on December 2, 2020, the forms ere available on NO-1.
Moreover, lo s and intervie s_ ith correctional officers, inmates, medical providers, and
medical assistants establish that asa eneral matter sic call re uest forms have been pic ed up
t ice daily from the housin units at both facilities since une 2 , 2020. ”

After sic call re uest forms are pic ed up from all housin units inthe mornin and
mid-day, the medical assistant assi ned to each facility transfers the tally for each housin unit
into an electronic database. The sic call re uests are then tria ed for ur ency by achar e
nurse. If the re uest is deemed ur ent, the inmate ise pected to be brou ht to the ur ent care
clinic. Ifthe char e nurse determines the re uest is routine, inmates hose sic call re uest
forms are pic ed up inthe mornin are e pected to be scheduled for a same-day sic call
appointment. Ifthe sic call form as collected mid-day, the inmate is e pected to be
scheduled for ane t-day sic call appointment.

Accordin to Unity s mental health mana er, sic call re uests for mental health services
are initially tria ed by medical staff. Any that are deemed ur ent are hand delivered to mental

health staff for immediate attention. Inmates ho submit re uests that are not identified as

* Atthe CT , in an effort to ensure access to health services, medical providers al the tiers of both special
mana ement units on a daily basis.

14
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 18 of 51

ur ent aree pected to be seen by a mental health provider ithin 24 hours.

Ifa sic call re uest indicates the inmate has a dental problem a dis in pain or has
s ellin or other indication of a possible infection, the char e nurse is e pected to schedule the
inmate to be seen by a medical provider on either an ur ent basis or the ne t day at sic call. If
there is no indication of pain, sellin or other indication of a possible infection, the sic call
re uest is e pected to be referred to the dental pro ram for follo up as either a Priority One,

T oor Three. Priority One is limited to patients ho have indicated on their sic call re uest
form that they are in pain or haves ellin or some other indication of infection. It is
anticipated that they ill be seen by a medical provider ur ently or ithin 24 hours and seen by
a dental provider ithin seven days. Priority T oisidentified ith routine dental problems
and no apparent pain. These patients are not seen by a medical provider but are scheduled to be
seen by a dental provider. Priority Three includes re uests for procedures such as routine
cleanin , and li e Priority T 0, these patients are not seen by a medical provider, but are
scheduled to be seen by a dental provider.

Unity and DOC mana ers have informed a that there have been discussions about
usin thene ly adopted educational tablets as a supplemental method (.e., it ould not replace
hard copy forms) throu h_ hich inmates could directly submit sic call re uests to the health
care staff. They have described a system in hich an inmate could complete an electronic sic
call re uest form on the tablet and transmit it electronically to a desi nated electronic inbo
available only to medical staff. Department of Corrections mana ement has reported that the
sic call re uest form has been di iti ed for use on the educational tablets. As of December 2,

2020, the electronic sic call form submission process had not been implemented.
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 19 of 51

intervie ed numerous inmates atthe CD and CT re ardin sic call and access
to medical care. In contrast to earlier site visits, inmates enerally had positive impressions of
the sic call process and asserted that they e pected that if they submitted a sic call re uest
form they ould be seen by a medical provider timely.
B Sic Call Data
In order to assess the Defendants performance relative to the 24-hour re uirement, a
selected a sample of 92 sic call re uests submitted by inmates confined at the CD and CT
bet een une 18, 2020 and October 1, 2020. Thesample as selected from the ori inal hard
copies of the sic call re uest forms that are submitted by inmates. To test the completeness of
the data source provided by the Defendants (.e., hether all sic call forms submitted by
inmates durin this period ere produced for revie ), a compared the number of forms
produced by the Defendants from uly 2020 atthe CD ith the total number of sic call
re uests for the same month documented in the spreadsheet maintained by the medical assistants
ho pic upthesic call re uests atthe CD .* or the month of uly 2020, the spreadsheet
enerated by the medical assistant assi ned tothe CD indicated that atotal of 1 8 sic call
re uests ere submitted by inmates by comparison, the Defendants produced for revie by
a a total of 1,1 9 hard copies of sic call re uests atthe CD for the same period.
ere not able to reconcile this discrepancy.
dre separate samples of sic call re uests from the CD andCT . Because

medical, dental, and mental health sic call re uest forms are stored separately after they are

Durin the November 9, 2020 hearin a e plained that they had conducted arevie ofasample of sic call
re uests based on hat they believed ere allsic call re uest forms submitted by inmates bet cen une 18 and
October 1, 2020. Ho ever, a later learned that the sic callre uests from hichthey dre the sample ere
not all sic callre ueststhat ere submitted by inmates, but rather a sample selected by Unity staff. Thus, a ne
sample as selected by a

4 ee raat -14 fora more detailed description.
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 20 of 51

tria ed by the char e nurse, and because some inmates reported delays in responses to sic call
re uests concernin dental and mental health services, a structured asamplin methodolo y
that ensured sic call re uests of all three types ereincludedinthe sample. Intotal, 1 sic
call re uests ererevie edfromtheCD and4l1sic callre uests ererevie ed from the

CT . The samples from both facilities ere structured to include sic call re uests from every
month in the revie period.

Because sic call re uest forms include recorded dates, but not times, it as not possible
to calculate the number of elapsed hours bet een an inmate reportin health issues and the
inmate receivin attention from a medical provider. or this reason, a analy ed the data at
the most specific time interval possible iven the available data sources: the number of elapsed
da bet eenaninmate reportin health issues and the inmate receivin attention from a medical
provider. used the date recorded by the inmate on the sic call re uest form as the basis
for the calculation of the number of elapsed days bet een an inmate reportin a health issue and
receivin attention from a provider. ® On 21 of the 92 sic call re uest forms in the sample, 2
percent, medical staff added a notation that the date recorded by the inmate asthe ron

date. In certain cases, the reason for the notation as clear (e. ., the date recorded by the

The volume of re uests for dental and mental health care is much smaller by comparison to re uests for medical
care. In order to ensure a sufficient number of sic call re uests for dental and mental health care ere included in
the analysis, a established a minimum number of each type to include in the sample.

The difference in the sample si es as principally attributable to the fact that the Defendants produced three
mental health sic callre uests fromthe CT durin therevie period, allof hich ere included in the sample.
Atthe CD , the Defendants produced a lar er number of mental health sic call re uests and a selected a
sample of 11 mental health sic call re uests from that facility.

Dates are enerally recorded int oplacesonsic callre uest forms. irst, there is a field labelled Date echa
for the inmate to record the date s he fills out the sic call re uest form. Second, medical staff typically stamp cach
form itha Received stamp and enerally, but not al ays, hand rite a date under the stamp. There is a third
field in a portion of the form desi nated for the medical provider to fill out that also includes a date and a time field
ho ever, these fields ere not completed in any of the sampled forms a revie ed. Ho ever, the EHR provides
a record of the date and time of any clinical encounters bet een inmates and medical providers.

8 Durin the sample selection process, a observed a si nificant number of sic call re uests ith no date
recorded by the inmate. These forms eree cluded from the sample because they ould notallo a toma e
any findin sre ardin timeliness.
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 21 of 51

inmate asa month a fer medical staff collected the form) ho ever, in most other cases, there
as a difference of one ort o days bet een the date recorded by the inmate and the date
recorded as received by medical staff. In these cases, the basis forthe ron date notation as
not evident.
1 Sic Call at the CDF
sample of sic call re uests submitted atthe CD included 2 re uests for
medical care, 1 re uests for dental care, and 11 re uests for mental health care. °
analysis indicates that for all cate ories of sic call re uests combined, in 22 of Osic call
re uests, 44 percent, inmates ere seen by a medical provider on the day they submitted their
sic callre uest or the ne t day. An additional three sic call re uests, si percent, ere for
medication refills and the prescriptions ere refilled the day after the sic call re uest as
submitted ithout the inmate seein a medical provider.
Amon the 24 re uests for medical care, 1 re uests made by inmates (includin the
three prescriptions that ere timely filled ithout the inmate havin to see a provider), 1
percent, received attention from a medical provider ithin one day of the submission of the sic
call re uest.t? Amon the remainin seven sic call re uests for medical care, five of the
inmates ere seenbet eent oand five days follo in submission of the sic call re uest
form andt o ere seen more than five days follo in the submission of the re uest form.

Althou h the sample of sic call re uests a analy ed included re uests for dental and

mental health services, the sample si es for those sub roups_ ere not lar e enou h to reach

° One sic call re uest for medical care ase cluded from the sample because the date recorded by the inmate as
subse uent to the date medical staff collected the form.

4° ourteen of the 1 patients ere seen by aprovider ithin one day. In the other three instances, the inmate

re uested prescription refills for s in cream, eye ointment and nasal spray, respectively, and a provider ordered the
refill ithinone day ithout seein the inmate.

18
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 22 of 51

meanin ful conclusions about the timeliness of provider responses to those subcate ories of
re uests. Ho ever, because a number of inmates a intervie ed complained about delays in
responses to sic call re uests for mental health and dental services, a revie ed the EHR
related to1 sic callre uests for dental services and 11 sic call re uests for mental health
services atthe CD . The findin s from those revie s are summari ed belo
Ase plained above, sic call re uests for dental services are tria ed and re uests that
reflect pain, s ellin , or another indication of a possible infection are e pected to be seen by a
medical provider thin one day, or sooner if indicated.*' Amon the 1 sic call re uests for
dental careinthe CD sample, three inmates ere seen by asic call provider the day they
submitted the re uest or the ne tday.7 Amon the remainin 12 sic call re uests for dental
care that did not result in a timely provider visit, seven re uests included reference to a chipped
or bro en tooth, cavity, toothache, or a non-specific reference to isdom tooth. None of the
inmates associated ith these latter cate ories of re uests ere seen by a provider ithin one
day of submittin their sic call re uest. In the remainin five instances, the sic call re uest
forms referenced the need for a dental cleanin , fillin , or simply stated dental.
Amon the 11 sic call re uests for mental health servicesin the CD sample, the inmates
associated ith fourre uests ere seen the day the re uest as submitted or the subse uent day.
In the remainin seven instances, theinmate asseenany herefromt otosi days after

re uestin services. The table belo summari es the timeliness of sic call services atthe CD .

4 raat1 . While inmates ho indicate pain ors ellin are assi ned priority for services, the form does not

as ifthe inmate ise periencin dental painors ellin , but leaves it up to the inmate to specify these symptoms.
42 Only one of these three sic call re uests included a description by the inmate indicatin any painors ellin .

19
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 23 of 51

TABLE ONE SUMMARY OF LEN TH OF TIME TO BE SEEN
BY PRO IDER AT CDF

TYPE OF SER ICE lda of 2 das Morethan das Not Seenb
RE UESTED re est of re est of re est Provider
MEDICAL | 2 0

4 44
DENTAL 4
MENTAL HEALTH
COMBINED 24 14 8 4

2 Sic Call at the CTF

Atthe CT ,a sample included 2 re uests for medical care, 1 re uests for dental
care,t ore uests for mental health care, and one re uest for both medical and mental health
care. analysis indicates that at the CT , for2 ofall 41 ofthesic call re uests,
percent, inmates received attention from a medical provider on the day they submitted their sic
call re uest or the follo in day. Amon the2 re uestssee in medical care, inmates
associated ith 1 re uests, 0 percent, ere seen by aa medical provider thin one day of the
submission of the sic call re uest inmates associated ithsi re uests, 24 percent, ere seen
bet eent o and five days of the submission of the re uest and inmates associated ith four
re uests, 1 percent, ereseen any here from si to 20 days after the submission date noted by

the inmate on the re uest form.

‘ One of the five inmates did not appear for his appointment, hich as scheduled for 24 days after the sic call

re uest as submitted.

44 One of the four inmates asnotseen ithinthree ee sofhissic callre uest andt o inmates ere not seen
ithint o months of their sic call re uests as of December 1, 2020. The remainin inmate asreleased days

after his re uest ithout bein seen.

20
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 24 of 51

Thirteen of the 41 re uestsin the sample ere for dental services. Seven of those re uests
resulted in inmates bein seen by a medical provider ithin one day after the re uest as
submitted.* Amon theremainin si re uests for dental care, one re uest referenced dental
pain andtheinmate as not seen until three days after the re uest as submitted, three re uested
dental cleanin sandt o erenon-specific re uests for dental services.

Amon the three sic call re uests for mental health care,* one resulted in an inmate
bein seen the day after the sic callre uest as submitted. The inmates associated ith the
other t ore uests received attention from a providert o days and four days, respectively, after
the re uest as submitted.

The table belo summari es the distribution of time bet een the submission of sic call

re uest forms and inmates bein seen by a provider at the CT :

TABLET O SUMMARY OF LEN TH OF TIME TO BE SEEN
BY PRO IDER AT CTF

TYPE OF SER ICE Re vr t Ree s ' More ea s Not Seen b
RE UESTED es of ke es of Re es ovide
MEDICAL 1 4 0
DENTAL 4 2 0
MENTAL HEALTH I 1 0 0
MEDICAL AND 0 1 0 0
MENTAL HEALTH

COMBINED 2 12 0

4 Si of those seven sic call re uest forms included a specific description indicatin pain,s ellin orabro enor
erodin — tooth.
4 One of the three asthe sic call re uest that also includeda re uest for medical care.

21
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 25 of 51

C Concl sion, Re irement One

The Defendants have invested additional resources in the sic call process by au mentin
staffin in order to collect sic call re uest formst ice daily and increase the number of
providers available to assess and treat inmates at sic call. Inmates enerally had positive
impressions of medical staff responses to sic call re uests for medical services ho ever,
inmates reported delays accessin dental and mental health services throu h the sic call system.

These reports are enerally consistent iththesamplerevie edbya . AttheCD ,

1 percent of sic call re uests for medical services resulted in inmates bein seen ithin one
day and atthe CT , 1 percent ereseen ithin one day. reco ni e that there is some
inherent mar in of error in these calculations for several reasons. irst, the timeliness of the
responses to many sic call re uests could not be calculated because in identifyin a sample,

a determined that a si nificant number of inmates did not record a date (or time) on the sic
call re uest forms they submitted and therefore these forms ere automatically e cluded from
the sample since timeliness could not be determined. Second, none of the sic call re uest forms
included the time of submission and, as noted above, the form does not prompt inmates to record
the time of submission. inally, it is possible that submission dates recorded on some sic call
re uest forms are incorrect. Medical staff at times include a notation statin thatthe ron

date as entered by the inmate on the re uest form. Ho ever, it as not possible for a to
assess the accuracy of the submission date inmates recorded on the re uest forms nor the

accuracy of the staffs ron date desi nation.*

‘ An advanta ¢ of an electronic sic call re uest submission process ould be that it ould include data re ardin
the date and time of each sic call re uest submission, hich could serve as an audit trail. This ould also eliminate
the need for inmates to rely on correctional officers to provide sic callre uestforms. or some inmates, ho ever,
the use of tablets to complete an electronic form could present a barrier to submission.

22
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 26 of 51

Additionally, did not revie lar eenou h samples to reach conclusions about the
timeliness of responses to re uests for sic call related to dental and mental health needs.
Ho ever, there is some indication that at least ith respect to dental services, there are delays in
inmates accessin timely services. The dental sic call re uest system is desi ned so that
inmates e periencin pain,s ellin , or other si ns of infection are seen thin 24 hours, but in
the absence any indications of these symptoms, inmates are not scheduled to be seen on sic call.
If inmates are una are of the decision rules adopted by medical staff, inmates ho do have
ur ent dental problems may submit asic call re uest for dental services ithoutincludin the
appropriate information to be seen timely.
Re irement T o
Defendants shall compl _ ith District of Col mbia and Centers for
Disease Control re lations on social distancin in DOC facilities
Defendants shall address challen es hich have prevented the implementation of
social distancin incl din b tnot limited tolac of ed cation and staffin
shorta es Defendants shall provide the Co rtan_ pdate on their
improvements to enforcin social distancin b UNE2 , 2020
Ase plained belo, the Defendants have continued to promote social distancin , but
on oin limitations are evident. The a ency has bene unable to increase the complement of staff
that is available for duty. These matters are e plained belo
A_ Efforts to Promote Social Distancin
Current CDC _ uidelines applicable to detention and correctional facilities recommend
implementation of social distancin strate ies to increase the physical space bet een

incarcerated detained persons (ideally feet bet een all individuals, re ardless of symptoms),

and to minimi emi in of individuals from different housin units. *® District of Columbia

48 ee App. B,E .1, Interim uidance on Mana ement of Coronavirus Disease 2019 (CO ID-19) in Correctional

and Detention acilities, updated December _ , 2020, https: .cde. ov coronavirus 2019-
ncov community correction-detention inde _.html,

Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 27 of 51

re ulations related to social distancin in the conte t of the current pandemic are consistent ith
this uidance.*”

The DOC has continued to implement strate ies intended to reduce both the number of
different inmates hocome into contact ith one another (e. ., by reducin opportunities for
inmates from different housin units to interact ith one another) and the number of inmates

ho interact ith one another at any iventime(e. ., by reducin out-of-cell time). As noted
above, ° at both the CD and CT , the DOC has continued to implement a medical loc do n,
durin hich inmates are allo ed out of their cells one hour per day in small roups. !
Department of Corrections mana ers and staff report that they limit the number of inmates out of
their cells at one time in each housin unit toama imum of si inmates in addition to four
inmates on or detail, ho are responsible for certain cleanin duties throu hout the day. ”

Durin site visits, a observed variability in the number of inmates out of their cells at
any time, ran in from one inmate to as many as1 inmates. When inmates ere out of their
cells, social distancin practices ere not consistent. Often a observed inmates con re ate
insmall roupstotal ,sometimes hile not earin amas properly coverin their noses and
mouths. At other times inmates ho ereincommon areas ould communicate ith inmates

inside of cells throu h the pass throu h slot on the cell door, often hile in close pro imity and

hile not earin amas properly coverin both their noses and mouths.

4° On November 1, 2020, a as ed counsel for both parties to identify the D.C. re ulations that ould fall ithin
the scope of this re uirement. ere informed by the Defendants that on March 1, 2020, the Department of
Health issued Emer ency Rule-ma in to order persons to stay at home due to the pandemic. The re ulation
included this definition of social distancin re uirements: Social Distancin Re uirements means maintainin at
least si ( ) foot social distancin from other individuals. D.C.Re . 829- 8 (Apr , 2020) (amendin 22B
DCMR Sections 220 and 229.1). Mayor s Order 2020-0 (une 19, 2020) adopts this definitionas ell. Mayor s
Order 2020-0 at Section II. 1.

0 raat9.

! Inmates confined on se re ation housin units are loc eddo nfor24 hourson ee end days.

* The cleanin activities performed by the inmate or details supplement the cleanin performed by the
contractors ho perform daily cleanin onthe housin units.

24
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 28 of 51

DOC e ecutive staff and other mana ers have informed a that they e pect
correctional officers to enforce social distancin re uirements or potentially be sub ect to
personnel action. They have e plained that a Correctional Surveillance Center Team ( CSC
Team ) monitors video feeds from both facilities around the cloc . Team members are
responsible for, amon other matters, reportin to DOC e ecutives if social distancin on
housin units is not bein enforced. visited the CSC Team video monitorin center.
Accordin to CSC Team staff, the CSC Team as instructed in March or April 2020 to monitor
video feeds and identify instances of inmates not earin mas s and or not properly social
distancin and for staffnot earin mas s, shields, or enforcin social distancin re uirements.
CSC Team staff reported that violations of these CO ID-19-related miti ation re uirements are
fre uent and that the CSC Team may see as many as 100 e amples per shift. Information
provided to a by the DOC Deputy Director of Operations, to hom the CSC Team reports,
indicates that bet een April and November 29, 2020, appro imately 4 disciplinary actions

ere ta ena ainst staff for violations of CO ID-19 re uirements, 84 percent of hich ere
based on CSC Team observations. While less fre uent than amon inmates, durin recent site
visits a observed correctional staff at times not earin re uired mas sand or face shields
on housin units and not maintainin social distances amon themselves and hen interactin
ith inmates and other non-correctional DOC staff. 4
The DOC has ta en steps to provide additional educational materials to inmates re ardin

CO ID-19 and the importance of social distancin . Si na e has been placed throu hout both

received a summary of the DOC s analysis of the data, but not the underlyin data itself and thus a did
not independently analy e this data.
‘ ore ample, at one point durin a site visit, a observed correctional officers respond to a medical
emer ency. Aser eant ho responded to the emer ency, entered the housin unit ithout a face shield. He as
offered a shield by a collea ue, but he refused to ear it.

2
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 29 of 51

facilities remindin inmates and staff to remain at least si feet apart. Additionally, DOC

e ecutive staff report that be innin in March 2020, educational materials are distributed to
every inmate s cell every Wednesday and those materials at times include information related to
CO ID-19.

More recently, startin at the end of September 2020, the DOC idely distributed
electronic tablets intended for educational purposes to inmates at the CD and CT . Distribution
of the tablets is e pected to be completed by December 14, 2020. The tablets, hich are
available to all inmates e cept those on inta e or se re ation status, may be used daily bet een
9:00 a.m. and 11:00 p.m. Amon other content, the tablets include educational materials
re ardin CO ID-19,includin a Quic uidetoCO ID-19, a ResponsetoCO ID-19:
Survival uide, and instructions on Wearin Personal Protection E uipment.

inally, ith respect to staffin , since a last report in May 2020, the DOC received
authori ation and fundin for 20 additional correctional officer positions ho ever, ase plained
above, * as of December 1, 2020, the si e of the correctional or force that is available for duty
has remained essentially unchan ed. While the number of staff on unavailable for duty status
decreased by ,from1 Otol — staffunavailable bet een May 9 and December 1, 2020, the
number of vacant positions increased by 9, from 1 to 110 position. ? Conse uently, the
number of staff available for duty remained virtually unchan ed. The chart belo compares

staffin levels on May 9 and December 1, 2020.

E. A, Quic uidetoCO ID-19.
E . B, Response to CO ID Survival uide.
E . C, Wearin Personal Protective E uipment.
8 raat2 -2.
° T enty of the 9 positions ere ne ly authori ed positions in fiscal year 2021, hich be anon October 1, 2020.

2
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 30 of 51

Total Authorized and Funded Correctional Staffing Complement
May 9, 2020 and December 1, 2020

1200

994 Total Positions 1014 Total Positions

x 110

1000

we 133
800
600

400

200

5/9/20 12/1/20

B Filled, Available for Duty m Filled, Not Availale for Duty @ Vacant

B Concl sion, Re irementT o
Since the issuance of the preliminary in unction, the DOC has continued to adopt
operational practices to encoura e social distancin . These practices have resulted in substantial
restrictions in the time inmates spend out of their cells. While fe er inmates are out of their
cells at any time than they ould other ise be in the absence of the out-of-cell time restrictions,
inmates ho are out of their cells often do not maintain si feet of social distance. also
observed staff members not maintainin social distance on housin units and else here
throu hout both facilities. Personal protective e uipment, includin mas s for every inmate, as
idely available and ithfe e ceptionsinmates donned mas s._ re uently,ho ever, mas s
ere not properly coverin both the inmates noses and mouths. Althou ha observed some

staff not earin appropriate PPE, these incidents ere infre uent.

2
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 31 of 51

As part of their effort to miti ate the spread of CO ID-19, the DOC has made
educational materials available to inmates in both hardcopy format and, more recently,
electronically on ne educational tablets that have been idely distributed to inmates at both
facilities. Staffin limitations have persisted, creatin challen es that impede miti ation efforts.

Re_ irement Three

Defendants shall contin e the services of their ne | contracted
environmental health and safet vendor Defendants shall f rther
contin e their contract to provide CO ID 1 cleanin services on

the sec re and non sec resides of the DOC facilit , incl din the
common areas of allho sin nits Defendants shall f rther contin e
their efforts to hire a re istered sanitarian Defendants shall ens re
that inmates have access to the necessar materials to clean their cells,
incl din cleanin sol tions hich protecta ainstCO ID1 and

ade atecleanin textiles and tools Defendants shall f rther ens re
that DOC staff and inmates are informed of and trained on the proper
techni esfor mixin and preparin cleanin sol tions as necessar
Defendants shall provide the Co rtan_pdate on their improvements to
sanitation b UNE2 ,2020

The Defendants implementation of the re uirements related to environmental health and

safety is described belo

A The Environmental Health and Safet endor and Contract Cleanin Services

The DOC s contract for environmental health and safety services be an in May 2020 and

included an initial term of three months, ith three one-month options to e tend. ° The contract
included the services of a sanitarian. In mid-Au ust 2020, the Defendants e ercised an option
toe tend the contract throu h October 1, 2020, at hich point the contract e pired. !

Durin the term of the contract, a sanitarian employed by the vendor developed a

cleanin and disinfectin protocol 7 to provide uidance to the cleanin companies that the

° eeMa_, e rt,E . 10 foracopy of the contractual a reement the Defendants entered for
environmental health-related services.

! E .4A, Au ust 18, 2020 Modification of Contract CW82 ,e tendin the contract period to October 1, 2020).
> E .4B, SARS-Co -2 (CO ID-19) Disinfection and Cleanin Protocols.

28
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 32 of 51

DOC contracted ith in response to the April 19, 2020 Temporary Restrainin Order ( TRO ),
(D t. No. 48), and later conducted site visits to monitor implementation of cleanin practices
atthe CD andCT . The vendor issued a total of four inspection reports, t oin uly 2020, 4
one in September 2020, and one in October 2020.

Department of Corrections mana ement informed a that the vendor s services ere
not e tended beyond October 1, 2020 because the a ency anticipated the environmental health
and safety services provided by the vendor ould be performed by a soon-to-be-hired DOC
employee ho ould perform ob duties associated ith a sanitarian position. As discussed
belo, the individual the Defendants hired to provide these services as not are istered
sanitarian and did not have the trainin , e perience or credentials to perform the same functions
that ere performed by the contracted sanitarian. In response to the concerns raised about this
matter at the November 9, 2020 hearin , DOC mana ement recently informed a that the
a ency has decided to contract ith the environmental health and safety vendor hose contract
e pired on October 1, 2020 and reinstitute its efforts to hire a re istered sanitarian. On
December 11, 2020, the filin date of this report, the Defendants submitted documentation to

a indicatin they had entered into a contract ith the vendor for a three-month period, ith

63 An Amended Order filed on April 19, 2020 corrected an error in the initial Order that as issued. The error as
based on a typo raphical error in a initial April 2020 report, hich a corrected. The Amended Order
addressed professional cleanin services on the secure side of the facility, and in relevant part states: In addition to
en a in asanitarian, the defendants shall consider contractin for professional cleanin services on the secure side
of the facility, at least until a sanitarian is hired to bolster the e istin environmental health and safety pro ram at
both facilities. (D t. No. 0).
* E .4C, Onsite Audit Inspection Report, Environmental Conditions Inspection for SARS-Co -2 (CO ID-19)
Disinfection and Cleanin Protocols, dated uly 2020 E .4D, ollo -Up Onsite Audit Inspection Report,
Environmental Conditions Inspection for SARS-Co -2 (CO ID-19) Disinfection and Cleanin Protocols, dated
uly 2 , 2020. Althou h these reports and the t o subse uent reports are all labelled Draft, DOC representatives

informed a that they are all considered final versions of the reports.

E .4E, ollo -Up Onsite Audit Inspection Report No. 2, Environmental Conditions Inspection for SARS-Co_ -
2(CO ID-19) Disinfection and Cleanin Protocols, dated September 2020.

E .4,, ollo -Up Onsite Audit Inspection Report No. , Environmental Conditions Inspection for SARS-Co_ -
2(CO ID-19) Disinfection and Cleanin Protocols, dated October 0, 2020.

29
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 33 of 51

three one-month option periods. The Defendants report that the vendor intends to schedule an
inspection before December 2 , 2020.

The Defendants continued the contracts for cleanin services on the secure and non-
secure sides of the CD and CT ,includin common areas of the housin units. Since
e ecutin the contracts on an emer ency basis in May 2020 for an initial three-month period,
the Defendants have e tended the contracts repeatedly for short periods, typically for one to
three months at atime. Ina November 2 , 2020 e-mail communication to a DOC e ecutive,
the Chief Procurement Officer at the D.C. Department of eneral Services, the a ency
responsible for contractin on behalf of the DOC for cleanin services at the CD and CT ,
approved e tension of the DOC cleanin contracts to ebruary 2021, statin his office ould

or ith its Bud et Team to ensure fundin is secured to ensure compliance ith the Court

Order. ® In addition, he stated that the contracts should be revie ed in anuary 2021 to
ensure that the Court Order is still valid andifso e may need to prepare a competitive
solicitation in anuary if e must continue the contract beyond ebruary 2021. °

The cleanin contractors atthe CD and CT aree pectedtofollo the disinfection and
cleanin protocols developed by the DOC s environmental health and safety vendor. The
contractors ere observed and evaluated by the DOC s contracted sanitarian on multiple
occasions bet een uly and October 2020. Based on a intervie s and observations, it

appears that by and lar e the contractors clean all of the re uisite areas of the facilities every

day. Common areas and public spaces on both the secure and non-secure sides of the facilities

One of thet ocleanin contractors the DOC en a ed asreplaced. eeE .4 , Modification of Contract
DCAM-20-NC-EM-00 9C,e tendin the performance period forthe ne cleanin contractor (at the CD ) throu h
ebruary 28, 2021 E . 4H, Modification of Contract DCAM-20-NC-EM-00 9B, e tendin the term of the cleanin

contractor (at the CT ) throu h_ ebruary 28, 2021.
8 E .41, November 2 , 2020 e-mail correspondence from eore e isto itanaSte art-Ponder.
69 d.
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 34 of 51

appeared noticeably cleaner than a observed durin previous site visits at both the CD and
the CT . Department of Corrections mana ers and staff also reported a consistent
improvement in facility cleanliness attributable to the contract cleanin teams.
B Hirin Re istered Sanitarian
The Defendants posted a position vacancy announcement for a _ sanitation inspection
specialist onsi dates bet een May 21 and October , 2020. ° The ualifications and
educational re uirements for the posted position do not meet the eli ibility re uirements to sit
for the re istered sanitariane amination administered by the relevant credentialin body. !
Department of Corrections mana ement has informed a that the a ency elected to post a
sanitation inspection specialist vacancy rather than a sanitarian position vacancy in order to
e pedite the hirin process. Accordin to DOC mana ement, because the sanitarian position
did not already e ist, additional administrative or ould bere uired to develop a ob
description and classify the position and these activities ould delay fillin the vacancy.
Arevie of publicly available information concernin District of Columbia
overnment employees indicates that as of September 0, 2020, there ere District
employees ith the title sanitarian, 4o0f hom _ or ed for the Department of Health, and
t oof hom _ or ed for the Department of Youth Rehabilitation Services and the Child and
amily Services A ency, respectively. Additionally, a found a Department of Health ob

vacancy announcement for a sanitarian position that as postedin anuary 2020 *ho ever,

° E .4 , Sanitarian Inspection Specialist ob description and vacancy announcement posted on the follo in dates:
May 21,2020 unel ,2020 uly ,2020 uly 1, 2020 September 18, 2020 and September 29, 2020

! The National Environmental Health Association is the credentialin or ani ation for sanitarians. ee E . 4K,
NEHA Re istered Environmental Health Specialist Re istered Sanitarian (REHS RS) Candidate Information
Brochure at 1- forthe eli ibility re utrements to sit for the REHS RS credentials ¢ am.

> E .4 , Sanitarian ob description and vacancy announcement posted on anuary , 2020.

]
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 35 of 51

the eli ibility re uirements for that position also ere inconsistent ith the re uirements set
by the National Environmental Health Association for re istered sanitarians.

Department of Corrections representatives stated that after serially postin the ob
openin for the sanitation inspection specialist and conductin outreach to public health
net or s, thea ency did not receive any applications from re istered sanitarians from amon
those applicants ho ualified for the position. Ultimately, the DOC hired a candidate from
the pool of applicants ho asal1 -year supervisory employee of thea ency ithouta
bac round in environmental health and safety. This individual be an or in as the
sanitation inspection specialist on November 9, 2020.

intervie edthe ne ly hired sanitation inspection specialist and that person s

supervisor. The supervisor developed trainin materials that have been provided to the ne
employee. * Both the supervisor and the employee stated that trainin has be un and has
included online course or , studyin American Public Health Association Standards for
Health Services in Correctional Institutions, and on-the- ob trainin t iceper ee conducted
by a District employee ho oversees environmental health and safety pro rams in the District
of Columbia st o secure uvenile facilities. The on-the- ob trainin is anticipated to
continue for up tot o months.

As noted above, follo in the November 9, 2020 hearin , DOC mana ement informed

a that the a ency intends to post a position vacancy for are istered sanitarian. Accordin

areE .4K, ranote 1 ¢ E .4 ,supra fe 2.
4 E .4M, Trainin Plan for DOC Sanitarian.
Those facilities are operated by the District of Columbia Department of Youth Rehabilitation Services. The
individual conductin the on-the- ob trainin has the sanitarian ob title.

2
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 36 of 51

to DOC mana ement, as of December 9, 2020, a ob description had been developed and as
bein revie ed by staffin the District of Columbia s Office of Human Resources.

C Access to Cleanin Materials and Related Trainin

There asasi nificant improvement in inmate access to appropriate materials to clean
their cells since a prior site visits. The Defendants no provide inmates itha
pero ide-based cleanin and disinfectin solution and clean microfiber cloths are delivered to
housin unitst ice daily. Atthe CD , inmates and staff reported that they are re uired to
clean their cells ith these materials in the mornin at the start of the shift. Atthe CT ,
inmates reported that they had access to bottles of pero ide solution and microfiber cloths

hen they ereallo ed out of their cells. observed that an appropriate supply of clean
microfiber cloths and bottles of pero ide solution ere available on every housin unit visited
and inmates and staff consistently reported that they had access to the clean cloths and solution
on a daily basis.

The pero ide solution is purchased by the DOC in a concentrated and hi hly corrosive
form. Itis mi ed by desi nated environmental officers prior to its distribution to housin
units. The dilution of the concentrated form of the solution is performed by a machine
pro rammed to add a specified amount of ater in order to dilute the solution to levels
prescribed by the manufacturer.

DOC mana ers, detail inmates, and some housin unit staff have reported that inmate
detail or ers and correctional officers assi ned to the housin units have been trained on

cleanin protocols. Thetrainin , hich as conducted by the DOC Compliance and Revie

E .AN, Position Description (Draft) for Environmental Sanitarian CS 1801-12.
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 37 of 51

Office, as based on the cleanin protocols developed by the contracted environmental health
and safety vendor.
Re_ irement Fo r
Defendants shall ens re that conditions in isolation nits are non p nitive
This incl desens rin reliable and re lar access to le al calls, personal
telephone calls, dail sho ers, and clean clothin and clean linens to all
inmates on isolation stat s Defendants shall provide the Co rt an _ pdate
on their improvements to conditions in isolation cells bb UNE2 , 2020

Since une 18, 2020, hen the preliminary in unction as issued, there have been no
isolation units in operation at the CT ho ever, an isolation unit has operated on a limited
basis atthe CD durin this period.

Ase plained in more detail belo in the narrative related to testin re uirements, a
total of 11 inmates tested positive for CO ID-19 atthe CD bet een une 18, 2020 and
December 1, 2020. All but one of these cases ere identified as a result of testin conducted at
the time of admission, and the last one appears to have been the result of ane ly admitted
inmate ithCO ID-19 ho as placed on the mental health unit upon admission and infected
another inmate. ® DOC records indicate that upon receipt of a positive test result, each member
of this cohort as transferred to NO-2, the unit at the CD desi nated for inmates on medical
isolation status.

Since the time that the preliminary in unction as issued, there have been a limited
number of inmates on isolation status. Unli e the conditions that ere evident before the

temporary restrainin order as issued, it appears that inmates on isolation status are able to

ma e personal telephone calls, ta e daily sho ers, and receive clean clothin and clean linens

raat 9-4.
8 This matter is addressed ra at 41.
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 38 of 51

ona ee ly basis. ° Thereis,ho ever, some very limited evidence indicatin that inmates on

isolation status may not have access to confidential le al calls.*°

Re_irement Five

Defendants shall ens re that all inmates have access to confidential,
nmonitored le al calls of ad rations fficient to disc ss le al matters

Insofar as inmates access to confidential, nmonitored le al calls is

reliant onthe seofne technolo , Defendants shalls iftl implement
the seofs ch technolo

In the conte t of this re uirement,t o different cate ories of le al calls should be
considered: attorney-initiated le al calls and inmate-initiated le al calls. The various
processes and practices applicable to each cate ory are discussed separately belo

A Attorne Initiated Le al Calls

Currently, pursuant to a process initiated in April 2020 in response to the pandemic, an
attorney canre uestale alcall ithaclient confined atthe CD ortheCT by sendin an
email to the DOC case mana ement office. DOC case mana ement staff report that these
calls, hich arereferred toas emer ency le al calls, are enerally scheduled fora O-minute
period, but the duration may be e tended for up to one hour or more if the attorney re uests
additional time.*' After submittin are uest, attorneys are advised of the day they ill receive
ale al call from the client but not the precise time that the client ill contact them.

Reports from DOC mana ement related to the volume of attorney-initiated emer ency

le al calls indicate that a hi h number of le al calls are processed on a monthly basis at both

° ere only able to intervie oneinmate ho as recently on isolation status. Based on this intervie and

discussion ith medical, correctional and mana ement staff, tt appears that since the preliminary in unction as
issued, in the limited instances in hich an isolation unit has been operated at the CD , inmates have had access to
personal telephone calls, daily sho ers, clean clothin and clean linens.

8° One inmate on isolation status reported that hile he as able to spea_ by telephone to his la yer in the case
mana er s office, a correctional officer remained in the office durin the telephone call.

8 ere told that the re uest for additional time must be made in the initial email.
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 39 of 51

the CD andCT .* Bet een April 20, 2020 and October 1 , 2020, DOC mana ement
reports that case mana ers ere responsible for facilitatin 8, 02 emer ency le al calls.*
Durin this period, DOC mana ement reports that the avera e daily volume of emer ency
le al call re uests permonthran edfromalo of Ocallstoahi hof8 calls, and the
avera enumber of case mana ers ho ere present at both facilities to facilitate these calls
durin this period asl .™

Each housin unit has an assi ned case mana er. Many case mana ers are assi ned to
cover multiple housin units. As of early November 2020, the DOC had a total of — funded
case mana er positions, nine of hich ere vacant. Pursuant to the emer ency call re uest
process initiated in April 2020, each ee day mornin case mana ers receive a list of
emer ency le al calls that they are assi ned to facilitate that day. Case mana ement staff
report that most if not all of their or days are devoted to facilitatin attorney-initiated
emer ency le al calls. As a result, they are unable tore ularly perform many of their other
ob duties,® includin the timely processin of inmate-initiated re uests for le al calls, hich

are described in more detail belo °

® E . A, chart submitted by DOC Director of Pro rams and Case Mana ement, e¢ al Calls, Emer ency Calls to

Private and Public Attorneys, April 20 - October 1 , 2020 (sho in for the 10-day period bet cen April 20 and 0,

2020, attorneys re uested 448 le alcallsof hich 8 erecompleted forthe month of May 2020, attorneys

re uested 1,28 le alcallsof hich 1,0 ere completed forthe month of une 2020, attorneys re uested 1, 0

le alcallsof hich 1, 41 erecompleted for the month of uly, 2020 attorneys re uested 1, 2 le alcalls of
hich 1,410 ere completed forthe month of Au ust 2020, attorneys re uested 1,41 le alcallsof hich1, 1
ere completed for the month of September 2020, attorneys re uested 1, 2 le alcallsof hichl, 4 ere

completed and forthe 1 -day period bet een October 1 and 1 , 2020, attorneys re uested 8 Ile alcallsof hich
89 ere completed).

8 E. B, e al Calls Cont., Number of Emer ency e al Calls Re uested by Public and Private Attorneys, April

20 - October 1 , 2020 (statin , fer al a, that of the 8, emer ency le al calls re uested durin this period, 8, 02
ere the responsibility of case mana ers).

84 d.

8 Tn addition to le al calls, case mana ers are responsible for inmate classification, reclassification, and facilitatin

various types of inmate re uests for records and services.

8 raat 8- 9.
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 40 of 51

In instances in hich attorneys contact the DOC case mana ement office to re uest a
le al call, the calls are conducted in one of the follo in aysatboththeCD andCT :

1) in the case mana ers office ith the case mana er present 2)in the inmate s cell usin a
cellular telephone and )in an empty cell on the housin unitusin acellular telephone. At
the CD , these le al calls are also conducted in an office in the facility s case mana ement
suite.® received some conflictin information about hether case mana ers are present

hen ale al call is conducted in a case mana er s office. Ho ever, most of the inmates and
case mana ers intervie ed confirmed that the case mana er is present in the office hen these
calls are conducted, hichis consistent ith the observations that a have made.

As of mid-November 2020, attorney-initiated emer ency le al calls ere bein
conducted via cell phone in individual cells at both the CD and CT .** Department of
Corrections mana ers report that the introduction of the cell phones and handsets initially
presented connectivity and other challen es that have lar ely been overcome. or the most
part, inmates and staff report that the use of the cell phones in individual cells affords inmates
the opportunity to spea in aconfidential settin ith their attorneys. *

Attorneys can also re uest to spea_ to their clients atthe CD andCT via

8’ Durin anintervie a conducted in the case mana ement suite, an inmate as observed sittin in the

door ay of an open office reportedly spea in to his attorney thin audible distance of correctional and case

mana ement staff.

88 The Defendants purchased 0 cell phone and 10 ireless handsets for this purpose on May 1, 2020. All

e uipment has been delivered. ee E . C, Order Confirmation, irst Net, OrderNo. 8 40299 (cell phones) E .
D, Proof of Delivery, endorAc no led ement Acceptance orm, September 0, 2020 ( ireless handsets).

Records related to the delivery of the cell phones and the order for the handsets ere re uested but not available.

Accordin to case mana ement supervisors and staff, as of mid-November 2020, nine cell phones _ ere available for

use (si atthe CD and three at the CT ). In addition, seven ireless handsets and nine non- ireless handsets ere

also available. Department of Corrections mana ement reports that the remainin 41 cell phones ill be deployed

after the Defendants receive the supplies necessary to secure them in loc ed bo es. Department of Corrections staff

report that the bo es, hich are used for the nine phones that are in use, are intended to ensure that the cell phones

are not dama ed or used for unauthori ed purposes.

89° Some inmates reported that they could be overheard by inmates confined in ad acent cells hen spea in from

their closed cells.
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 41 of 51

videoconference. These conferences are scheduled for a specific ee day time period by staff
inthe DOC eneral Counsel s Office. The Defendants report that bet een May 18, 2020 and
October 1, 2020,the eneral Counsel s Office coordinated a total of 1,209 videoconferences
for inmates atthe CD and CT . Desi nated correctional staff have been trained to help
inmates use the videoconference technolo y. have observed and participated in these
videoconferences, hich are conducted under conditions that promote the confidentiality of
attorney-client communications.”

B_ Inmate Initiated Le al Calls

Inmates at the CD and CT caninitiatele al calls ith their attorneys by submittin
an oral or ritten re uest to the case mana er assi ned to their housin unit.?' Inmates
reported substantial delays receivin responses to these re uests. i e the attorney-initiated
le al calls, these calls can be conducted in the case mana er s office ith the case mana er
present or in a cell on the housin unit. In addition, inmates can ma e free le al calls to their
attorneys durin the one-hour daily recreation period, usin the phones mounted on the alls
in the day rooms.”” While the DOC reports that these calls are unmonitored, they are not
confidential.

The DOC Office of eneral Counsel reports that inmates at the CD have been able to

ma econfidential and free le al calls from their cells usin tablets provided by the vendor that

°° Ininstancesin hich counsel re uires aclient to revie documents or other materials, they are able to do so ona
confidential basis durin the videoconference. Additionally, DOC staff report that attorneys can send documents to
case mana ers andthe eneral Counsel s Office for transmission to inmates for revie .

* SeeE .2C, ranote 1, Sample Inmate Re uest Slip. Inmates can obtain these forms, hich are used to

re uestle al calls, amon other re uests, from correctional staff and case mana ers. After the forms are filled out,
inmates are re uired to place theminabo here they are pic ed up periodically by the case mana ement staff.
Some of the case mana ers a intervie ed reported that they had difficulty ecepin up iththese re uest forms.
°2 Defendants report that these calls are free and unmonitored as lon as the attorney s name and telephone number
have been appropriately re istered in the system.
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 42 of 51

provides telephone services at the CD .° Bet een une 18 and December , 2020, the
eneral Counsel s Office reports that 4le al calls eremadeusin these tablets at the
CD . In addition to telephone communications, inmates can use the DOC-issued educational
tablets to communicate ith their attorneys usin a confidential electronic messa in
platform. As of November 0, 2020, DOC mana ement reports that 18 inmates and 1
attorneys have used the messa in platform.
C Concl sion, Re irement Five
The Defendants have made a substantial investment inne technolo y to address the
attorney-client communication challen es that have emer ed as a result of the pandemic. In
addition, they have repurposed space in different parts of the CD and CT in order to
accommodate confidential attorney-client videoconferences. Moreover, in an effort to ensure
the technolo y is used appropriately, correctional staff assi ned tone ly created
videoconferencin posts have received trainin ons ills that ere not contemplated by their
ob descriptions. inally, case mana ement ob responsibilities have been restructured in
order to prioriti e the volume of attorney-client telephone and video communications
associated, at least in part, ith the reported and substantial decrease in attorney visits to the
CD andCT .

Re _irement Six

Finall , the Co rt notes that Defendants have increased testin for
CO ID1 ,no testin an_ resident to be transferred to Saint Eli abeths
Hospital or to a federal correctional facilit Defendants also test an

° Unli ¢ the educational tablets provided to inmates by the DOC, the tablets provided by the vendor contain paid
content. The tablets furnish inmates at the CD ith the ability to ma e telephone calls to the same approved
contacts they are allo ed to contact from the telephones in the dayrooms, includin their attorneys. Currently, these
tablets are only available in limited uantities at both facilities. Ho ever, althou h inmates at the CT also have
access to these tablets, they cannot use the telephonic functionality because a different vendor has the contract for
telephone services at the CT and these services are currently unavailable under that contract.
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 43 of 51

cell mate of an inmate ho tests positive and all ne residents pon

inta e Defendants contin e to test those inmates ho report positive for
CO ID1 s mptoms The Co rt ORDERS that Defendants contin e
implementin this increased testin The Co rtf rther ORDERS that
Defendants pdate the Co rtonan chan es to the testin protocol at
DOC facilities, incl din thef rther testin of as mptomatic inmates

The Defendants report that they administer CO ID-19 tests to inmates in the
follo in circumstances: upon admission prior to certain transports, includin transports to
court if inmates are symptomatic and, to any cellmate of aninmate ho tests positive for
CO ID-19. In addition to inmate testin , DOC representatives also reported that be innin in
October 2020, the Department of Health be anma in CO ID-19 testin available to DOC
staff on-site every t o ee s. Thetestin as made available durin hours that included the
mornin shift chan eto ma imi e the number of staff ho could ta e advanta e of the
testin .

A Testin of Ne 1 Admitted Inmates

orne ly admitted inmates, the Defendants report that their protocol is to administer a

rapid CO ID-19 test and a lab test simultaneously to each inmate upon inta e.°* An
additional lab test is administered to each inmate at least seven days later? _ hile the inmate
remains housed in the Inta e unit. Once cleared by medical staff, inmates may be moved
from the Inta e unit into other housin units. If an inmate tests positive for CO ID-19, they

are transferred to housin units desi nated for inmates on isolation status.

4 The lab test reportedly has a hi her sensitivity in detectin SARS-Cov-2 ho ever, results ta e lon er to process.

Thus, a rapid test is administered at the same time and the test results are available shortly after the test is

administered. If the rapid test returns a positive test result, the inmate is isolated sooner thans he ould other ise

be if alab test alone ere administered. Inmates ho refuse testin at the time of admission are cell restricted until

medical staff clear them.

° This process is intended to identify inmates ho may have been CO ID-19 positive upon admission, but ho
ere still in an incubation period ith viral levels that ere toolo to detect at the time of the initial test

administrations.

° Inmates ith acute mental health needs are moved to a speciali ed unit and do not remain on the Inta e unit.

Women are admitted at the CT .

40
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 44 of 51

obtained CO ID-19testin data throu h November 0, 2020 from Unity
representatives ho maintain clinical testin data. Accordin to that data, overthe 1 days
bet een une 18, 2020 and November 0, 2020, the Defendants administered 2, 1 tests to
inmates, anavera eof 1 . tests per day. Additionally, tests ere administered on 91 percent
of the days durin the period.

The testin records indicate that there ere a total of 11 positive tests durin the
period, fourin uly,t oin Au ust, four in September, none in October, and one in November.
All ereatthe CD . Tenofthe 11 positive tests ere detected by aCO ID-19 test
administered upon admission to the facility. Of those 10 inmates testin positive, nine ere
housed in SO-2 initially, the Inta e unit, or ere immediately placed in the isolation unit, NO-
2, before spendin ani ht in SO-2. The 10th case involved aninmate ho as placed on the
mental health unit, SO- , upon admission. When his initial test result came bac positive, he

as moved to the isolation unit.

The final positive case asnotane admission, but rather involved aninmate ho

as housed on the mental health unit for ane tended period. He as housed on the mental
health unit durin the period henthe ne ly admitted inmate referred to above (.e., the 10th
positive case) tested positive. The day after the ne ly admitted inmate received his positive
test result, the entire mental health unit as tested. One inmate onthe unit as confirmed
positive four days later and he as transferred to the isolation unit.

B_ Testin of Inmates Transferred to Saint Eli abeths Hospital

obtained data re ardin all transfers to Saint Eli abeths Hospital for the period

une 18 to October 1, 2020. There ere a total of 24 transfers to that facility.’

° Accordin to DOC staff, inmates may be transferred to Saint Eli abeths either as a permanent placement or ona
temporary basis pendin a mental health assessment.

4l
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 45 of 51

intervie ed DOC and Unity representatives re ardin the prerelease and CO ID-19 testin
processes applicable to inmates released to Saint Eli abeths.

Accordin to Unity representatives, inmates ho are released to Saint Eli abeths are
tested for CO ID-19 in advance of their transfer if Unity staff are notified in advance of the
transfer. Unity and DOC records office staff reported, ho ever, that they often are not
notified in advance of an inmate transfer to Saint Eli abeths. cross referenced the
names of the 24inmates ho ere transferred to Saint Eli abeths durin the revie period

ithCO ID-19testin data. T entyt oof the 24 transferred inmates ere tested for
CO ID-19 hilein DOC custody ate t prior to their transfer to Saint Eli abeths
ho ever, in most cases the testin as not conducted in close temporal pro imity to the
transfer. Department of Corrections records indicate that seven of the 20 inmates ere tested
ithin the ee prior to the transfer four additional inmates ere transferred bet een one and
t o ee spriorto the transfer andthe remainin 11 inmates ere tested bet een 24 and 128
days prior to the transfer to Saint Eli abeths. T o inmates transferred to Saint Eli abeths
durin therevie period ere not tested at all prior to the transfer.
C Testin of Inmates Transferred to Federal Correctional Facilities
obtained data re ardin all transfers to the United States Marshals Service for
the period une 18 to October 1, 2020: There ereatotal of 1 transfers.
intervie ed Unity staffre ardin CO ID-19testin practices prior to inmate transfers to
federal facilities, includin Unity staff involved in the health clearance process for inmates
ho are released to the custody of the Marshals Service. Accordin to Unity staff, there is a
defined process established by the Marshals Service for releasin inmates to their custody,

hich Unity follo s. Unity staff are re uired to complete a Prisoner in Transit Medical

42
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 46 of 51

Summary form for each inmate scheduled to be transferred.** Unity staffe plained that at

2

some point in early 2020, ane section, Section , Mandatory Symptom Screenin for
CO ID-19 Prior to Departure rom acility, asaddedtothe form. This ne section
includes a record of the inmate s temperature, three screenin —_ uestions, and criteria for a
certifyin health authority to medically clear the inmate for transfer. The form does not
re uireaCO ID-19 test prior to release and Unity staff stated that in practice, they complete
the form for each inmate released to the Marshals Service, but do not complete a CO ID-19
test as a matter of course. Unity representatives clarified that if are uest is made to
administera CO ID-19 test (e. ., by the facility to hich the inmate ill be transferred), they
ill conduct the test.
cross referenced arandom sample of ofthe 1 inmates transferred to the
Marshals Service bet een une 18 and October 1,2020 ithCO ID-19testin data.
T enty-one inmates received a CO ID-19 test at some point prior to their release to the
custody of the Marshals Service and 12 inmates did not. Amon_ this cohort, three inmates
received a CO ID-19 test ithin the month prior to their release (ran in from 14 days to 28
days prior to release) and the remainin 18 inmates received a test more than one month prior
to their release (ran in from days to 181 days).
D Testin of Cellmates of Inmates ho Test Positive
As noted above, the Defendants report that cellmates of all inmates ho test positive
forCO ID-19 are tested. Of the 11 inmates ho tested positive forCO ID-19 bet een une

18 and October 1, 2020, one inmate had acellmate. The t oinmates ere housed in a cell

in the Inta e unit. Testin records indicate that the cellmate of the inmate ho tested positive

°8 E . , Prisoner in Transit Medical Summary redacted. This formis referred toas orm

4
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 47 of 51

as tested the same day his cellmate received a positive test result and his test result as
ne ative.
E Testin of Inmates ho ReportCO ID 1 S mptoms
inally, a revie edasample of 49 sic call re uests submitted bet een une 18
and October 1, 2020 that reflected reported symptoms consistent ith CO ID-19 symptoms
identified by CDC _ uidelines and or reflected in Unity s reported symptom-based testin
practices.”? orty-three of the sic call re uests ere submitted by inmates confined at the
CD andsi — ere submitted by inmates confined at the CT . Because 1 ofthe sic call
re uest forms did not include the date the inmate submitted the form, they ere e cluded from
the analysis.
Amon_ the remainin sic callre uestsinthe sample, 2 erefrom the CD and
four erefromtheCT . ourteenofthe inmates ho submitted the sic call re uests, 9
percent, eretested forCO ID-19 at some point after they submitted their sic call re uest.
ive of the 14 tests ere administered ithint o days of the submission of the sic call
re uest and one as administered five days after the submission of the sic call re uest.!°°
The remainin ei httests ere administered bet een 20 and 2 days after the sic call
re uests ere submitted. There is no indication in the EHR maintained for these inmates that
these ei ht tests ere administered in response to the sic call re uests that reported CO ID-

19symptoms. Amon the 22inmates ho ere not tested after reportin symptoms, 1

°” ee App. B, E . 1, supra note 49 ( Symptoms of CO ID-19 include cou h, shortness of breath or difficulty
breathin , fever, chills, muscle pain, sore throat, and ne loss of taste orsmell . Other less common symptoms
have been reported, includin nausea and vomitin . ) Symptoms noted in the sampled sic call re uests included,
but ere not limited to, the follo in : cou hin shortness of breath difficulty breathin fever nausea vomitin
loss of appetite headache and or body aches chills and sore throat. Inmate re uests for CO ID-19 tests ere also
included in the sample.

100 Three sic call forms e plicitly included are uest fora CO ID-19 test: one reported shortness of breath, one
reported upset stomach and vomitin , and one reported nausea and loss of appetite.

44
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 48 of 51

received a CO ID-19 test at some earlier point in their confinement and five _ ere not tested
forCO ID-19 durin their confinement.
intervie ed Unity s Medical Director re ardin clinical e pectations for testin
inmates horeport symptoms consistent ith CO ID-19. The director pointed out that there
are some casesin hich there are sound medical e planations for the symptoms the inmate is
e periencin consistent ith somethin other than CO ID-19.'°' The director also
ac no led ed that providers have some clinical discretion in decidin hen to administer a
CO _ ID-19 test to inmates reportin CO ID-19 symptoms, but she indicated that if there is no
obvious or clear e planation for the symptoms, a CO ID-19 test should be administered.
did not assess the clinical decisions made by providers ith respect to
administerin CO ID-19 tests for reportedly symptomatic inmates, hich seemed beyond the
scope of this appointment and ould have re uired consultation ith a medical e pert.
Arevie of the EHR maintained for inmates in the sample sho sthatinsi cases, the inmate
reported durin the sic call visit that the CO ID-19-li e symptoms reflected on the sic call
re uest form as resolved and in five other cases the inmate reported that s he had re uested
to be seenin sic call for other reasons despite notin symptoms of CO ID-19 on the sic call
re uest form.'° The revie of the sampled cases also sho various dia noses reached
follo in the sic call visit, such as asthma, constipation, aller ies sinusitis, and acid
reflu astrointestinal reflu disease. In none of these cases, as there documentation in the

EHR that CO ID-19 as suspected but testin —_as not done.

101 The director cited ase amples inmates dia nosed ith Crohn s disease reportin _astrointestinal symptoms and

inmates dia nosed ithasthmareportin acou h. Incases such as these, a provider mi ht conclude the symptoms
ere related to the dia nosed chronic condition rather than CO ID-19.

102 These other reasons included re uests for foot cream, medicine for heartburn or treatment for constipation.

4
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 49 of 51

F Timeliness of Testin Res Its
Durin the November 9, 2020 hearin , the Plaintiffsin uired hether a ere
a are of any delays inreceivin testin results from laboratories. have revie_ ed the
available data re ardin elapsed days from test administration to receipt of testin results.
Amon the 2, 1 tests administered bet een une 18 and October 1, 2020, data ere
available for 9 percent of the test results. Be innin in Au ust 2020, the date test results
ere received as recorded much less fre uently than durin une and uly 2020. ere
not able to determine hether the tests ith data sufficient to calculate the number of elapsed
days bet een test administration and receipt of testin results(.e., the 9 percent) ere
representative of test processin timesin eneral. With that caveat, in the months of October
and November 2020, 9 percent of the tests for hich a calculation could be made resulted in
test results that ere returned thin four days of the test administration. !°
Concl sion, Re irement Six
Since the issuance of the preliminary in unction, the DOC has administered over 2, 00
CO ID-19 tests to inmates at the CD and CT , over1 tests perday. Thea ency s testin
protocols pay particular emphasis to identifyin and containin anyinmates ithCO ID-19
before they interact ith the eneral population and have an opportunity to communicate the
virus to other inmates or staff. Since the issuance of the preliminary in unction, 10 of the 11
inmates ho tested positive forCO ID-19 ere discovered durin routine inta etestin and

the 11th case, caused by ane ly admitted inmate s placement on the mental health unit, as

10 orreference, there as sufficient data for 149 of the 1,002 tests administered in those t o months. Thirty-three
of the tests ere administeredt o days before the data as provided to a and the results of those tests ere still
pendin .
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 50 of 51

uic ly contained because of the inta etestin . Inthe one casein hich aninmate ho tested
positive for CO ID-19 had a cellmate, the cellmate as also tested.

The evidence indicates that the DOC does not as a matter of eneral practice test
inmates ho are transferred to Saint Eli abeths Hospital. Medical staff indicate they often are
not informed that aninmate ill be transferred to Saint Eli abeths in advance. The data also
indicate that the DOC does not routinely test inmates ho are transferred to federal
correctional facilities. Medical staffe plained that they follo the procedure established by
the Marshals Service.

inally,arevie ofasample of sic call re uests that included symptoms consistent
ith CO ID-19 revealed that most inmates ere not tested forCO ID-19 in response to the
sic callre uest. Unity medical staffe plained that there is clinical ud ement involved in
decidin hether to administera CO ID-19 test to an inmate. did not assess those
decisions.
CONCLUSION
are available to ans er any uestions the Court or the Parties have about the
matters addressed in this report.

Respectfully submitted,

s_raceM. opes

rae
race M. opes
BarNo. 8 0O

E ecutive Director
Risin for ustice
901 4" Street, N.W., Suite 000
Washin ton, D.C. 20001
202- QO -2224
mlopes @risin for ustice.or
Case 1:20-cv-00849-CKK Document 138 Filed 12/12/20 Page 51 of 51

December 11, 2020
Washin ton, D.C.

48

Mar ordan
mar mar ordan.consultin
1220 19" Street, N.W.

Suite 00
Washin ton, D.C. 200
202-2- 2
Case 1:20-cv-00849-CKK Document 138-1 Filed 12/12/20 Page 1 of 63

APPENDI A

Exhibit 1A

Exhibit 1B

Exhibit 1C

Exhibit 1D

Exhibit 2A

Exhibit 2B

Exhibit 2C

Exhibit 3A

Exhibit 3B

Exhibit 3C

Exhibit 4A

Exhibit 4B

Exhibit 4C

Exhibit 4D

Exhibit 4E

REPORT SUBMITTED BY AMICUS CURIAE PURSUANT
TO SEPTEMBER 16, 2020 ORDER

Index to Exhibits

Chart, Combined Population of CDF and CTF, by Day and Legal Status, June 18,
2020 — October 31, 2020

Table, Combined Population of CDF and CTF, by Status and Day, June 18, 2020
— October 31, 2020

Table, Admissions to CDF and CTF, by Status and Month, June 18, 2020 —
October 31, 2020

Table, Average Length of Stay of Inmates Housed at CDF and CTF, by Status and
Month, June 18, 2020 — October 31, 2020

May 18, 2020 Modification of Contract CW68868

Sick Call Request Form

Inmate Request Slip

Quick Guide to COVID-19

Response to COVID Survival Guide

Wearing Personal Protective Equipment

August 18, 2020 Modification of Contract CW82753
SARS-CoV-2 (COVID-19) Disinfection and Cleaning Protocols

Onsite Audit Inspection Report, Environmental Conditions Inspection for SARS-
CoV-2 (COVID-19) Disinfection and Cleaning Protocols, dated July 2020

Follow-Up Onsite Audit Inspection Report, Environmental Conditions Inspection
for SARS-CoV-2 (COVID-19) Disinfection and Cleaning Protocols, dated July
23, 2020

Follow-Up Onsite Audit Inspection Report No. 2, Environmental Conditions
Inspection for SARS-CoV-2 (COVID-19) Disinfection and Cleaning Protocols,
dated September 2020
Case 1:20-cv-00849-CKK Document 138-1 Filed 12/12/20 Page 2 of 63

Exhibit 4F

Exhibit 4G

Exhibit 4H

Exhibit 41

Exhibit 4J

Exhibit 4K

Exhibit 4L

Exhibit 4M

Exhibit 4N

Exhibit 5A

Exhibit 5B

Exhibit 5C

Exhibit 5D

Exhibit 6

APPENDI B

App. B, Ex. 1

Follow-Up Onsite Audit Inspection Report No. 3, Environmental Conditions
Inspection for SARS-CoV-2 (COVID-19) Disinfection and Cleaning Protocols,
dated October 30, 2020

Modification of Contract DCAM-20-NC-EM-0079C

Modification of Contract DCAM-20-NC-EM-0079B

November 23, 2020 e-mail from George Lewis to Gitana Stewart-Ponder

Sanitarian Inspection Specialist, job description and vacancy announcement

NEHA Registered Environmental Health Specialist/Registered Sanitarian
(REHS/RS) Candidate Information Brochure

Sanitarian Job Description and Vacancy Announcement
Training Plan for DOC Sanitarian
Draft Position Description, Environmental Sanitarian CS-1801-12

Chart, Legal Calls, Emergency Calls to Private and Public Attorneys, April 20 - October
15, 2020

Chart, Legal Calls Cont., Number of Emergency Legal Calls Requested by Public and
Private Attorneys, April 20 - October 15, 2020

Order Confirmation, First Net, Order No. 587640299 (cell phones)
Proof of Delivery, Technomic, RTS No. 100561 (wireless handsets)

Prisoner in Transit Form, Redacted

Center for Disease Control, Interim Guidance on Management of Coronavirus
Disease 2019 (COVID-19) in Correctional and Detention Facilities, Updated
December 3, 2020
Case 1:20-cv-00849-CKK Document 138-1 Filed 12/12/20 Page 3 of 63

APPENDI A
Case 1:20-cv-00849-CKK Document 138-1 Filed 12/12/20 Page 4 of 63

Ex 1A
Case 1:20-cv-00849-CKK Document 138-1 Filed 12/12/20 Page 5 of 63

Combined Population of the CDF and the CTF, by Day and Legal Status
June 18 - October 31, 2020

700
600
500 ,
Pretrial lel eV]
400
300
200 Fugitive
@ Sentenced Misdemeanant
100
@ Other
0 Writ or Hold
oa
NaS @ Sentenced Felon
(a)
ARS
> . .
ONS uty @ Pretrial Misdemeanor
oS Nao
nil Ao Ro @ Parole Violator
SAS Ao
oaNSoaeo
Note ono
Teta sage Sie @ Hold for Transfer
o> oO :
ody Se NON
Sle ol tS AI O | | O .
mn ™N ON GO
Jul ae ata pec |e Vy LS | Sa) |) Ve | LT @ Pretrial Felony
ONAN AO mo
Om rHoOn~A OO A oO
om Se # > N GO Ao
Aug Bs Bi Lsi8 Ais
adtaeas 8
an 2 8 sia 8)\s
oO tS BR ~~ A DA oo
2020 PISS S| Alls
Sep Yoknw Sawsyg
ABS SB 8 So
So #2 8 8 &
AS 8 § 8
4 BS A ~
S|) 8 8
Oct S
Case 1:20-cv-00849-CKK Document 138-1 Filed 12/12/20 Page 6 of 63

Ex 1B
Distinct Count of DCDC
Row Labels

2020

Jun
6/18/2020
6/19/2020
6/20/2020
6/21/2020
6/22/2020
6/23/2020
6/24/2020
6/25/2020
6/26/2020
6/27/2020
6/28/2020
6/29/2020
6/30/2020

Jul
7/1/2020
7/2/2020
7/3/2020
7/4/2020
7/5/2020
7/6/2020
7/7/2020
7/8/2020
7/9/2020
7/10/2020
7/11/2020
7/12/2020
7/13/2020
7/14/2020
7/15/2020
7/16/2020
7/17/2020
7/18/2020
7/19/2020
7/20/2020
7/21/2020
7/22/2020
7/23/2020
7/24/2020
7/25/2020
7/26/2020
7/27/2020
7/28/2020
7/29/2020
7/30/2020
7/31/2020

Aug
8/1/2020
8/2/2020
8/3/2020
8/4/2020
8/5/2020
8/6/2020
8/7/2020
8/8/2020
8/9/2020
8/10/2020
8/11/2020
8/12/2020
8/13/2020
8/14/2020
8/15/2020
8/16/2020
8/17/2020
8/18/2020
8/19/2020
8/20/2020
8/21/2020
8/22/2020
8/23/2020
8/24/2020
8/25/2020

Fugitive

Case 1:20-cv-00849-CKK Document 138-1 Filed 12/12/20 Page 7 of 63

Combined Population of CDF and CTF, by Status and Month

Sentenced
Misdemeanor

BRRPAPWWWWWWWWH

OMOODRARARAORARAUUTMDMBDOORARA AR AR A

ee ee ee ee ee ee a ee a ee ee
DODO BA BAH DDO ON NNN WNWNODDDHD HD OD

Other

- - MONNNMNN PY

MN - +--+ NNH HH H KH WWWARWANNNNNM “ND

-+-NND A

Nh PDP P

PO Pp pO — A A A

June 18, 2020 - October 31, 2020

Writ or
Hold

94
94
94
94
94
94
94
94
93
93
93
93
93

93
93
93
93
93
93
93
93
93
93
92
92
92
92
91
90
90
90
90
90
91
92
90
90
89
89
89
89
87
86
86

86
86
86
86
86
86
86
84
84
84
84
88
87
87
87
87
87
87
87
87
87
87
87
87
87

Sentenced
Felon

72
72
13
13
13
13
13
74
74
75
75
75
74

75
75
75
75
75
75
75
74
75
72
72
72
72
13
72
72
72
71
71
71
71
71
71
13
74
74
74
74
75
75
13

72
72
72
67
68
68
68
69
70
70
70
70
70
72
72
72
72
72
72
13
13
71
71
71
67

Pretrial

Parole Hold for Pretrial

Grand

Misdemeanor Violator Transfer Felony Total

68
67
66
66
66
67
67
66
66
65
67
67
67

67
67
62
63
63
63
64
62
63
61
62
63
63
65
64
64
62
62
65
65
69
68
67
68
70
74
74
13
72
15
76

76
80
80
81
79
79
78
77
78
78
81
81
84
83
85
86
86
84
82
82
78
80
82
82
85

88
88
89
90
90
91
92
91
90
91
91
91
93

92
92
90
90
91
91
92
94
91
91
92
92
92
90
96
96
98
105
106
106
100
105
106
103
104
105
105
100
103
103
108

106
108
108
109
105
110
101
105
105
105
103
103
102
101
101
102
102
108
113
112
114
114
115
115
119

440
440
440
440
440
439
439
439
437
436
437
437
435

434
434
433
434
434
434
434
434
435
435
433
433
433
432
431
431
430
431
431
431
432
430
431
430
429
429
429
429
428
426
428

427
426
426
427
425
426
426
431
432
432
431
432
434
444
438
440
440
436
434
432
431
432
432
432
431

482
487
488
488
488
490
492
491
492
493
497
497
495

494
495
497
500
501
501
501
505
502
504
504
506
506
5114
5114
514
520
517
519
519
518
520
518
519
524
528
528
532
532
535
533

532
534
534
538
534
535
536
537
539
539
542
542
539
543
544
547
547
547
546
550
557
558
558
558
564

1249
1253
1255
1256
1256
1259
1262
1259
1256
1257
1264
1264
1262

1259
1260
1254
1259
1261
1261
1265
1267
1264
1263
1263
1266
1266
1271
1274
1275
1281
1283
1289
1289
1286
1292
1288
1288
1295
1305
1305
1302
1304
1307
1312

1309
1314
1314
1315
1303
1310
1301
1311
1316
1316
1318
1323
1324
1337
1339
1346
1346
1345
1346
1349
1352
1353
1357
1357
1365
Row Labels

8/26/2020
8/27/2020
8/28/2020
8/29/2020
8/30/2020
8/31/2020

Sep

9/1/2020

9/2/2020

9/3/2020

9/4/2020

9/5/2020

9/6/2020

9/7/2020

9/8/2020

9/9/2020

9/10/2020
9/11/2020
9/12/2020
9/13/2020
9/14/2020
9/15/2020
9/16/2020
9/17/2020
9/18/2020
9/19/2020
9/20/2020
9/21/2020
9/22/2020
9/23/2020
9/24/2020
9/25/2020
9/26/2020
9/27/2020
9/28/2020
9/29/2020
9/30/2020

Oct

10/1/2020

10/2/2020

10/3/2020

10/4/2020

10/5/2020

10/6/2020

10/7/2020

10/8/2020

10/9/2020

10/10/2020
10/11/2020
10/12/2020
10/13/2020
10/14/2020
10/15/2020
10/16/2020
10/17/2020
10/18/2020
10/19/2020
10/20/2020
10/21/2020
10/22/2020
10/23/2020
10/24/2020
10/25/2020
10/26/2020
10/27/2020
10/28/2020
10/29/2020
10/30/2020
10/31/2020

Fugitive

Sentenced
Misdemeanor

10
10
10
9
9

oO

THOWMDDMDANDDAWAADDMADMDA®A ©

Other

oa oo OP et

— qw pon - —

a

MNWAWH NMNAHNMNNMNNAWABRRANANA WWD

June 18, 2020 - October 31, 2020

Writ or
Hold

85
85
85
84
84
84

81
80
80
80
80
80
80
80
80
78
78
78
78
78
78
78
78
78
78
78
78
77
77
78
78
15
15
15
15
15

75
74
74
74
74
75
13
13
13
72
72
72
72
71
71
71
71
71
71
71
71
71
71
71
71
71
71
71
72
71
71

Sentenced
Felon

66
67
67
68
68
68

67
69
70
65
66
66
66
66
63
65
63
63
63
63
64
65
61
64
65
65
65
65
66
67
63
65
65
65
67
68

63
61
62
62
62
62
64
64
61
64
64
64
64
59
61
61
62
62
62
63
63
60
62
62
63
63
62
63
62
63
65

Pretrial

Parole Hold for Pretrial

Case 1:20-cv-00849-CKK Document 138-1 Filed 12/12/20 Page 8 of 63
Combined Population of CDF and CTF, by Status and Month

Grand

Misdemeanor Violator Transfer Felony Total

88
88
90
90
91
91

97
97
100
103
104
108
108
110
110
112
110
110
114
114
115
112
112
110
109
110
110
112
106
109
114
114
114
114
115
112

113
112
113
116
116
117
113
115
117
117
117
117
119
116
118
115
113
115
115
117
110
110
110
109
110
110
114
114
106
105
106

117
119
123
122
122
122

114
125
133
128
126
131
131
135
130
133
129
130
133
133
135
137
140
138
134
134
134
134
129
127
131
131
130
130
129
137

143
133
134
136
136
128
133
134
136
133
134
134
135
137
137
135
136
136
136
141
142
142
144
146
145
145
149
147
145
150
151

434
431
432
432
432
432

432
432
434
438
439
442
442
445
448
446
447
444
444
444
445
448
450
452
447
445
445
445
448
447
448
449
452
452
451
447

451
452
452
452
452
444
433
435
435
434
434
434
434
433
434
431
434
434
434
436
437
436
437
437
440
440
440
434
434
434
433

563
567
564
567
571
571

576
576
574
582
576
578
578
579
579
573
579
582
586
586
584
584
591
583
588
596
596
591
591
592
595
593
595
595
596
601

600
594
595
600
600
614
607
607
617
615
618
618
623
633
626
633
624
627
627
626
625
630
628
633
635
635
638
645
650
647
644

1364
1367
1371
1373
1378
1378

1375
1389
1399
1402
1398
1412
1413
1422
1419
1416
1415
1415
1426
1426
1429
1432
1441
1433
1432
1439
1440
1438
1431
1432
1436
1437
1441
1440
1444
1450

1456
1437
1440
1450
1450
1447
1435
1439
1449
1448
1452
1452
1461
1463
1464
1461
1456
1461
1461
1470
1465
1467
1468
1472
1478
1478
1487
1484
1486
1487
1487
Case 1:20-cv-00849-CKK Document 138-1 Filed 12/12/20 Page 9 of 63

Ex 1C
Distinct Count of DCDC
Row Labels

2020
Jun 18 - 30
Jul
Aug
Sep
Oct
Grand Total

Case 1:20-cv-00849-CKK Document 138-1 Filed 12/12/20 Page 10 of 63

Admissions to CDF and CTF, by Status and Month
June 18, 2020 - October 31, 2020

Column Labels

Pretrial Felony Parole Pretrial Hold for Other Sentenced Sentenced Writ or Fugitive Grand Total
Violator Misdemeanor Transfer Felon Misdemeanant_ Hold

20 22 9 3 1 2 51

74 80 41 14 13 4 6 1 199
109 63 52 31 10 13 7 5 1 246
94 118 56 55 15 9 4 1 314
113 83 46 39 15 4 6 287
409 337 198 139 54 30 25 7 1 1044
Case 1:20-cv-00849-CKK Document 138-1 Filed 12/12/20 Page 11 of 63

Ex 1D
Case 1:20-cv-00849-CKK Document 138-1 Filed 12/12/20 Page 12 of 63

Average Length of Stay of Inmates Housed at CDF and CTF, by Status and Month
June 18, 2020 - October 31, 2020

Average of LOS Column Labels

Row Labels Pretrial Felony Parole Pretrial Hold for Other Sentenced Sentenced Writor Fugitive Grand
Violator Misdemeanor Transfer Felon Misdemeanant_ Hold Total
2020
Jun 18 - 20 273 158 47 333 132 407 128 446 294
Jul 281 151 52 354 146 409 130 472 304
Aug 286 133 50 371 36 433 102 505 1 307
Sep 291 112 51 375 38 459 123 533 302
Oct 296 119 62 379 25 438 103 556 303

Grand Total 288 129 54 366 68 431 112 506 1 303
Case 1:20-cv-00849-CKK Document 138-1 Filed 12/12/20 Page 13 of 63

Ex 2A
Case 1:20-cv-00849-CKK Document 138-1 Filed 12/12/20 Page 14 of 63

1. Contract Number Page of Pages

AMENDMENT OF SOLICITATION / MODIFICATION OF CONTRACT CW68868 1 2
2. Amendment/Modification Number | 3. Effective Date 4. Requisition/Purchase Request No.
M0006 May 18, 2020 onererensive Medical Services
6. Issued by: Peter Kern Code | 7. Administered by (If other than line 6)
Office of Contracting and Procurement Department of Corrections
441 4" Street, NW Suite 330 South 2000 14° St. NW 7" Floor
Washington, DC 20001 Washington, DC 20009
8. Name and Address of Contractor (No. street, city, county, state and zip code) 9A. Amendment of Solicitation No.
Unity Health Care, Inc.
1100 New Jersey Ave SE, Suite 500 9B. Dated (See Item 11)
Washington DC 20003 ——

10A. Modif f No.
Office: 202-715-7900 x Cwesses of Contract/Order No

Attn.: Vincent A. Keane
vkeane@unityhealthcare.org

10B. Dated (See Item 13)
Code Facility 04/05/2019

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

|_| the above numbered solicitation is amended as set forth in item 14. The hour and date specified for receipt of Offers oO is extended. Ol is not extended.
Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

(a) By completing Items 8 and 15, and returning copies of the amendment: (b) By acknowledging receipt of this amendment on each copy of the offer
submitted; or (c) BY separate letter or fax which includes a reference to the solicitation and amendment number. FAILURE OF YOUR ACKNOWLEDGMENT TO
BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION
OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such may be made by letter or fax, provided each letter or
telegram makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. Accounting and Appropriation Data (If Required)

13. THIS ITEM APPLIES ONLY TO M

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/4654795. Public record. Not legal advice.