Case 4:05-cv-01415-JFM-JVW Document 1396 Filed 1025/212/20056 Page 1 of 15

IN THE UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF PENNSYLVANIA

BENEDICTUS YARZUE,

:

:

Plaintiff

:

v.

:

:

DIVISION OF IMMIGRATION HEALTH :

SERVICES; DEPARTMENT OF

:

HOMELAND SECURITY;

:

YORK COUNTY, PENNSYLVANIA;

:

BERKS COUNTY, PENNSYLVANIA;

:

DR. TIMOTHY SHACK, MEDICAL

:

DIRECTOR, DIVISION OF IMMIGRATION :

HEALTH SERVICES, sued in his individual :

capacity;

:

JOHN/JANE DOE, DIVISION OF

:

IMMIGRATION HEALTH SERVICES sued :

in his/her individual capacity;

:

THOMAS HOGAN, WARDEN, YORK

:

COUNTY PRISON, sued in his individual

:

capacity;

:

DR. CHARLES NORRIS, MEDICAL

:

DIRECTOR, YORK COUNTY PRISON, sued :

in his individual capacity;

:

DR. JOHN/JANE ROE, PHYSICIAN, BERKS :

COUNTY PRISON, sued in his/her individual :

and official capacity;

:

PRISON HEALTH SERVICES, INC.

:

PRIMECARE MEDICAL, INC.

:

:

Defendants.

:

CIVIL ACTION NO. 05-cv-1415
Judge McCLURE
Electronically Filed Document

PLAINTIFF’S SECOND AMENDED COMPLAINT
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Case 4:05-cv-01415-JFM-JVW Document 1396 Filed 1025/212/20056 Page 2 of 15
INTRODUCTION Plaintiff Benedictus Yarzue is a Federal immigration detainee who is currently housed in Berks County Prison.
Mr. Yarzue has repeatedly sought medical treatment for a painful condition in his penis, testicles, and anus. The Division of Immigration Health Services (DIHS) has refused to pay for testing recommended by an urologist. Absent DIHS authorization for reimbursement, the York County Defendants, Berks County Defendants, Prison Health Services, and PrimeCare Medical have failed to provide the recommended care to Mr. Yarzue.
Almost a year has passed and Mr. Yarzue has still not received the testing the urologist recommended. He continues to suffer from extreme pain in his penis, testicles, and anus.
Mr. Yarzue alleges that Defendants violated his rights under the Eighth Amendment to the U. S. Constitution through their deliberate indifference to his serious medical needs. He seeks money damages and equitable relief.
JURISDICTION 1. This action is brought pursuant to 42 U.S.C. §1983, the Eight and/or
Fourteenth Amendments to the United States Constitution, 28 U.S.C. §§2201,
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2202, 2283, and 2284, Rule 65 of the Federal Rules of Civil Procedure, and 5 U.S.C. §702. 2. Jurisdiction is based upon 28 U.S.C. §§1331 and 1343. 3. Venue is proper in the United States District Court for the Middle District of Pennsylvania under 28 U.S.C. § 1391.
PARTIES 3. Benedictus Yarzue is a current immigration detainee at Berks County Prison. 4. The Division of Immigration Health Services (DIHS) is a sub-division of the
Department of Health and Human Services. DIHS provides health care services for individuals detained by Immigration and Customs Enforcement (ICE) through an interagency agreement with the Department of Homeland Security (DHS). 5. The Department of Homeland Security (DHS) is an administrative agency of the United States. 6. Berks County is a political subdivision in Pennsylvania. 7. York County is a political subdivision in Pennsylvania 8. Dr. Timothy Shack is the Medical Director of DIHS. Dr. Shack is sued in his individual capacity.
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9. John/Jane Doe is an employee of DIHS who ordered the transfer of Plaintiff Yarzue from York County Prison to Berks County Prison. His or her true name is currently unknown. He/She is sued in his/her individual capacity.
10. Thomas Hogan is the Warden of York County Prison. He is sued in his individual capacity.
11. Charles Norris is the Medical Director at York County Prison. He is sued in his individual capacity.
12. Dr. Jane/John Roe is a doctor at Berks County Prison. His or her true name is currently unknown. He/She is sued in his/her individual and official capacity.
13. Prison Health Services, Inc. provides medical care at York County Prison. 14. PrimeCare Medical, Inc. provides medical care at Berks County Prison.
FACTS 15. Immigration and Customs Enforcement (ICE) is a bureau of the Department
of Homeland Security (DHS) that performs the detention function of the former Immigration and Nationalization Services (INS). 16. The Division of Immigration Health Services (DIHS) is a bureau of the Department of Health and Human Services (HHS).
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17. DIHS provides and oversees health care services to immigration detainees pursuant to an inter-service agreement between the Department of Health and Human Services and the Department of Homeland Security.
18. DIHS provides health services for undocumented migrants detained in federal, state, and local jails through a managed care/utilization management system.
19. York County and Berks County contract with DHS to house immigration detainees at the York County Prison and the Berks County Prison, respectively.
20. If York or Berks County wishes to be reimbursed for the cost of health care services provided to immigration detainees in their facilities, they must seek authorization from DIHS.
21. In order to receive authorization from DIHS for the provision of health services, the jail or custodial facility must submit a Treatment Authorization Request (TAR) to the appropriate DIHS Utilization Manager.
22. Absent authorization, DIHS will not reimburse the counties for medical costs.
23. Nothing in the agreement between York County and DHS prohibits York County from providing medical care to immigration detainees at its own cost. Upon information and belief, the same is true for Berks County.
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24. Prison Health Services has the ability to set policies related to the provision of medical care at York County Prison.
25. On June 24, 2004, Plaintiff Benedictus Yarzue was detained by Immigration and Customs Enforcement and was held at Clinton County Prison.
26. While he was detained at Clinton County Prison, Plaintiff Yarzue began to suffer from pain in his penis, testicles, and anus. He also found that he was urinating constantly at night.
27. On or about July 21, 2004, he was transferred to the York County Prison. 28. Upon arrival at York County Prison, Plaintiff Yarzue sought medical
treatment complaining of severe pain in his penis, testicles, and anus and also of constant urination. 29. On or about August 17, 2004, Plaintiff Yarzue saw a doctor in York County Prison. 30. The doctor checked Plaintiff’s prostate and took a urine sample. The urine sample tested negative for a urinary tract infection. The doctor prescribed Tetracyline. 31. On or about September 17, 2004, Plaintiff saw the doctor again. He told the doctor that the medication was not helping him at all and that he was still suffering from severe pain in his penis, testicles, and anus also was still urinating constantly.
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32. The doctor checked Plaintiff’s prostate again and prescribed a medication called Hydren. He also filled out a treatment authorization request to DIHS seeking a urology consult for the Plaintiff.
33. In December, 2004, DIHS approved the treatment authorization request and Plaintiff was taken to see Dr. Edgar Baselli.
34. Dr. Baselli checked Plaintiff’ prostate and prescribed a medication called Flomax. He also stated that Plaintiff should return in three months for a Cystocopic evaluation.
35. In January, 2005, Plaintiff’s condition worsened and he was seen by Defendant Dr. Norris at York County Prison.
36. Dr. Norris wrote to DIHS seeking approval for the Cystocopic evaluation that Dr. Baselli had recommended.
37. In February, 2005, Defendant Dr. Norris ordered that Plaintiff be placed on 24 hour urine evaluation. The test showed that Plaintiff was producing 500 milliliters more urine than normal.
38. In February, 2005, Defendant Dr. Norris informed Plaintiff that DIHS had denied authorization for him to receive the Cystocopic evaluation that Dr. Baselli had recommended.
39. Defendant Dr. Norris stated to Plaintiff that there was nothing he could do. He suggested that Plaintiff submit a grievance to Defendant Warden Hogan.
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40. Sometime before March 18, 2005, Plaintiff submitted a grievance in which he complained of the lack of medical care he had received.
41. In response, on March 18, 2005, the complaint supervisor wrote: Immigration has denied the medical department’s request for you to be seen by a urologist. Without immigration approval, the medical department cannot schedule an appointment with a specialist for you.
42. On April 4, 2004, Plaintiff appealed the complaint supervisor’s ruling. 43. The appeal was denied by Deputy Warden Roger Thomas who stated, in
part: Your case was reviewed by Dr. Shack from the Division of Immigration Health Services. These are the medical people responsible for overseeing INS inmates. The request for a cystoscopic evaluation was denied due to lack of medical necessity.
44. Plaintiff appealed Deputy Warden Thomas’ ruling to Deputy Warden Bowen who affirmed Deputy Warden Thomas’ ruling on April 8, 2005.
45. Plaintiff appealed Deputy Warden Bowen’s ruling to the County Solicitor. 46. On April 26, 2005, the Assistant Solicitor, Donald Reihart, ruled that
Plaintiff did have a valid Eighth Amendment claim because he had produced evidence of a serious medical need that was not being addressed. 47. Assistant Solicitor Reihart further ruled that “Under the circumstances, we believe that this case raises serious questions concerning INS responsibility to
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Case 4:05-cv-01415-JFM-JVW Document 1396 Filed 1025/212/20056 Page 9 of 15
approve appropriate health care and the prison’s responsibility to assure that an inmate’s constitutional rights are protected.” 48. Accordingly, Assistant Solicitor Reihart referred the case to the Complaint Review Board. 49. The Complaint Review Board met on May 5, 2005.The hearing was recorded by a stenographer, Plaintiff gave sworn testimony, and the members of the Complaint Review Board spoke on the record. 50. Defendant Dr. Norris was present and he stated “I feel that the need to have a further evaluation as far as a urology consultation is necessary.” 51. One of the members of the board, a Mr. Chronister, asked “What would be wrong if he needs medical treatment, we went ahead and did it and bill INS?” 52. Warden Hogan replied “The worst they could do is they wouldn’t pay, and that would be a mistake.” 53. As a result of the hearing, Plaintiff’s appeal was granted. In so ruling, the Complaint Review Board stated:
Prisoner shall be provided necessary treatment. INS shall be billed for reimbursement. Efforts be made to devise a procedure for alleviating, in the future, the delay in acquiring approval or better define INS obligation to reimburse the county. 54. However, in mid-May of 2005, Plaintiff was transferred to Berks County Prison.
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55. Since he has been detained at Berks County Prison, Plaintiff has continued to experience severe pain in his penis, testicles, and anus as well as constant urination.
56. Plaintiff has requested medical care while at Berks County Prison. 57. Plaintiff was seen by Dr. John/Jane Roe who told him that he/she needed to
talk to Dr. Baselli before he/she could prescribe medication. 58. Dr. Roe also put in a treatment authorization request to DIHS. The request
was denied. 59. He was told by doctors there that there was nothing they could do for him
unless DIHS approved their request for him to see an urologist.
COUNT I 60. Plaintiff incorporates by reference Paragraphs 1 through 59 as if fully set
forth herein. 61. Plaintiff currently suffers from a serious medical need that requires
immediate treatment. 62. The failure of the Division of Immigration Health Services and the
Department of Homeland Security to authorize reimbursement for Plaintiff’s medical care constitutes deliberate indifference to a serious medical need and
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Case 4:05-cv-01415-JFM-JVW Document 1396 Filed 1025/212/20056 Page 11 of 15
therefore deprives Plaintiff of his rights under the Eighth and/or Fourteenth Amendments to the U. S. Constitution. 63. The failure of Dr. Roe to provide Plaintiff with medical care despite the refusal of DIHS and/or DHS to authorize reimbursement constitutes deliberate indifference to a serious medical need and therefore deprives Plaintiff of his rights under the Eighth and/or Fourteenth Amendments to the U. S. Constitution. 64. The policy and/or practice of Berks County and PrimeCare Medical of not providing treatment for serious medical needs absent DIHS and/or DHS authorization of reimbursement constitutes deliberate indifference to a serious medical need and has caused Plaintiff to be deprived of his rights under the Eighth and/or Fourteenth Amendments to the U. S. Constitution.
COUNT II 65. Plaintiff incorporates by reference Paragraphs 1 through 59 as if fully set
forth herein. 66. The failure of Dr. Shack to provide authorization for Plaintiff to receive the
test recommended by Dr. Baselli while he was detained at York County Prison constituted deliberate indifference to a serious medical need and therefore
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Case 4:05-cv-01415-JFM-JVW Document 1396 Filed 1025/212/20056 Page 12 of 15
deprived Plaintiff of his rights under the Eighth and/or Fourteenth Amendments to the U. S. Constitution.
COUNT III 67. Plaintiff incorporates by reference Paragraphs 1 through 59 as if fully set
forth herein. 68. The failure of Dr. Charles Norris and Thomas Hogan to provide Plaintiff
medical care after DIHS and/or DHS denied authorization for reimbursement constituted deliberate indifference to a serious medical need and therefore deprived Plaintiff of his rights under the Eighth and/or Fourteenth Amendments to the U. S. Constitution.
COUNT IV 69. Plaintiff incorporates by reference Paragraphs 1 through 59 as if fully set
forth herein. 70. The policy and/or practice of York County and Prison Health Services of not
providing treatment for serious medical needs absent DIHS and/or DHS authorization of reimbursement constitutes deliberate indifference to a serious medical need and caused Plaintiff to be deprived of his rights under the Eighth and/or Fourteenth Amendments to the U. S. Constitution.
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COUNT V 71. Plaintiff incorporates by reference Paragraphs 1 through 59 as if fully set
forth herein. 72. The decision of John/Jane Doe of the Department of Homeland Security to
transfer Plaintiff after York County had decided to provide him medical care constituted deliberate indifference to a serious medical need and caused Plaintiff to be deprived of his rights under the Eighth and/or Fourteenth Amendments to the U. S. Constitution.
RELIEF REQUESTED Wherefore, Plaintiff requests that this Court:
1. Declare that the failure of the Division of Immigration Health Services and the Department of Homeland Security to authorize reimbursement for Plaintiff’s medical care constitutes deliberate indifference to a serious medical need and therefore deprives Plaintiff of his rights under the Eighth and/or Fourteenth Amendments to the U. S. Constitution.
2. Declare that the policy and/or practice of Berks County and PrimeCare Medical of not providing treatment for serious medical needs absent DIHS and/or DHS authorization of reimbursement constitutes deliberate indifference to a serious medical need and has caused Plaintiff to be
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Case 4:05-cv-01415-JFM-JVW Document 1396 Filed 1025/212/20056 Page 14 of 15
deprived of his rights under the Eighth and/or Fourteenth Amendments to the U. S. Constitution. 3. Order an injunction directing the Division of Immigration Health Services, the Department of Homeland Security, Berks County, and/or PrimeCare Medical to provide treatment for Plaintiff’s serious medical need; 4. Award compensatory damages to Plaintiff against the Defendants, except the Division of Immigration Health Services and the Department of Homeland Security, jointly and severally; 5. Award the costs of this action to Plaintiff; 6. Award punitive damages to the Plaintiff; 7. Award nominal damages to the Plaintiff; 8. Award reasonable attorney’s fess and costs to Plaintiff; and 9. Award any other relief the court may deem appropriate.
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Case 4:05-cv-01415-JFM-JVW Document 1396 Filed 1025/212/20056 Page 15 of 15
Respectfully submitted, __s/Michael Cooke, mjc91247_ Angus Love, Atty# PA22932 Michael Cooke, Atty#PA91247 Pennsylvania Institutional Law Project 924 Cherry Street, Suite 523 Philadelphia, PA 19107 (215) 925-2966 Attorneys for Plaintiff Date: __December 21, 2005_____
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 Case 4:05-cv-01415-JFM-JVW Document 14-1 Filed 11/08/2005 Page 1 of 8

IN THE UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF PENNSYLVANIA (Williamsport)

BENEDICTUS YARZUE

:

Plaintiff,

:

:

v.

:

:

THOMAS HOGAN, Warden, York

:

County Prison, JOHN DOE, Supervisor, :

Department of Homeland Security,

:

BEATA, Deputy Warden ROGER

:

THOMAS, and DENNIS BOWEN,

:

York County Prison,

:

Defendants,

:

:

v.

:

:

THOMAS HOGAN, Warden, York

:

County Prison,

:

BEATA, Deputy Warden ROGER

:

THOMAS, and DENNIS BOWEN,

:

York County Prison,

:

Third Party Plaintiffs,

:

:

v.

:

:

UNITED STATES OF AMERICA

:

DEPARTMENT OF HOMELAND

:

SECURITY, UNITED STATES

:

IMMIGRATION AND CUSTOMS

:

ENFORCEMENT, Office of Detention :

And Removal of Operations,

:

Division of Immigration Health Services, :

Third Party Defendant. :

NO. 4:05-CV-01415-JFM-JVW CIVIL ACTION - LAW
(JUDGE JAMES F. McCLURE, Jr.)

THIRD PARTY COMPLAINT

Case 4:05-cv-01415-JFM-JVW Document 14-1 Filed 11/08/2005 Page 2 of 8
1. Plaintiff, Benedictus Yarzue, has filed against the Defendants, Thomas Hogan, Warden of the York County Prison, Beata, Deputy Warden Roger Thomas and Deputy Warden Dennis Bowen of the York County Prison, a Complaint, a copy of which is attached as Exhibit “A”.
2. The Defendants in this case are all employees of the York County Prison who endeavored to obtain medical care for the Plaintiff, Benedictus Yarzue, as part of an administrative system established in the York County Prison under the Laws of the Commonwealth of Pennsylvania.
3. The additional Defendants are the United States of America and its officials and agents working in the Department of Homeland Security, United States Customs Enforcement Office of Detention and Removal Operations, Division of Immigration Health Services who are responsible for the healthcare of non U.S. citizens who are in the custody of the said Defendants and pending sentencing or deportation.
4. On March 10, 2005, Plaintiff, Benedictus Yarzue, filed an inmate complaint claiming: “I have a prostate problem which I am in pain. I went to see the doctor and she said I need to see urologist. INS denied my request to see the urologist and my condition is getting worst and the doctor is supposed to put in a request to the INS if that happened. It did.”
2

Case 4:05-cv-01415-JFM-JVW Document 14-1 Filed 11/08/2005 Page 3 of 8
5.
Beata Erni, the Complaint Supervisor of the York County Prison investigated the
inmate’s complaint and provided an 802 response, which is a required step of the York
County Prison administrative system which stated the following:
“Immigration has denied the medical department’s request for you to be seen by urologist. Without Immigrations approval, the medical department cannot schedule an appointment with a specialist for you. If you believe your symptoms are getting worse, then you are to notify the medical department via sick call slip. The grievance system isn’t the appropriate form to complete regarding such a notification.”
6.
The inmate appealed this decision to Deputy Warden Roger Thomas who in
reviewing the appeal provided an 805 A response as follows:
“Your appeal was received on 4/4/05. Inmates have five days to appeal grievances. This appeal is late you had received your answer from the Complaint Supervisor on 3/18/05. Your case was reviewed by Dr. Shack from the Division of Immigration Health Services. These are the medical people responsible for overseeing INS inmates. The request for a cystoscopic evaluation was denied due to lack of medical necessity.”
7.
The Plaintiff, Benedictus Yarzue, filed a second appeal to Deputy Warden Dennis
Bowen who responded as follows in his 805 A response:
“Immigration Health Services has refused approval for a cystoscopic evaluation. There is nothing I can do make them (Immigration) grant approval for the procedure. I suggest that you write to Mr. Joe Sallemi of BICE requesting assistance. I will provide you with an 806 appeal form.”
8.
The inmate filed a timely appeal designated as an 806 Request for Solicitor’s
Review.
3

Case 4:05-cv-01415-JFM-JVW Document 14-1 Filed 11/08/2005 Page 4 of 8
9. On April 26, 2005, the Solicitor in reviewing the appeal of the inmate determined that the inmate’s rights may have been violated by the refusal to provide him with appropriate medical care. A copy of the Solicitor’s opinion is marked Exhibit “B” and is appended hereto. The Solicitor recommended that the matter be determined by the Complaint Review Board.
10. The Complaint Review Board met on May 5, 2005. This Board heard evidence from Plaintiff, Benedictus Yarzue, and the medical staff at the prison who recommended that inmate Yarzue be given a cystoscopic evaluation and other healthcare. The Board determined that the requested healthcare was constitutionally required and granted the appeal and made the following recommendation: “Prisoner shall be provided needed treatment. INS shall be billed for reimbursement. Efforts be made to assure a procedure for alleviating in the future the delay in requiring INS approval or better define INS obligation to reimburse the county.”
11. The local INS representative was notified that the Complaint Review Board had determined that Plaintiff, Benedictus Yarzue, should be given medical treatment that was being requested by the inmate and also being recommended by the York County contract provider, Prison Health Services.
12. The response of the INS was to move Plaintiff, Benedictus Yarzue, from the York County Prison to another location so that the healthcare that had been approved by the
4

Case 4:05-cv-01415-JFM-JVW Document 14-1 Filed 11/08/2005 Page 5 of 8
Complaint Review Board could not be delivered and to avoid providing the inmate with necessary and constitutionally required healthcare.
13. The Defendant, the United States by and through its agencies and agents have established an unconstitutional plan, custom and practice of denying INS inmates constitutionally mandated healthcare. The plan, custom and practice consists of denying legitimate requests through an alleged pretextual need for “more information” or through arbitrary denial, which is coupled with repeated acts of moving the inmate from confinement facility to confinement facility thereby provided the Defendants with additional time needed to deport the inmate without providing needed healthcare.
14. The Third Party Defendant in this case is solely responsible for the medical care requested by Plaintiff in this action and under the law should be required to provide adequate medical care to all illegal immigrants that are in their custody. WHEREFORE, Third Party Plaintiffs, Thomas Hogan, Warden of the York County Prison, Beata, Deputy Warden Roger Thomas and Deputy Warden Dennis Bowen of the York County Prison, demand judgment against the Third Party Defendants and specifically request the Court to enter an Order to enter a mandatory injunction requiring that the Defendants provide the inmate in the instant case and all inmates in their custody with healthcare that is mandated by the Constitution of the United States and to cease and desist from its present unlawful practices.
5

Case 4:05-cv-01415-JFM-JVW Document 14-1 Filed 11/08/2005 Page 6 of 8

Date: November 8, 2005

Respectfully submitted,
By: /s/ Donald L. Reihart, Esquire Donald L. Reihart, Esq. Sup. Ct. I.D. #07421 3015 Eastern Boulevard York, PA 17402 Telephone (717) 755-2799 Assistant Solicitor for York County

6

Case 4:05-cv-01415-JFM-JVW Document 14-1 Filed 11/08/2005 Page 7 of 8

IN THE UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF PENNSYLVANIA (Williamsport)

BENEDICTUS YARZUE

:

Plaintiff,

:

:

v.

:

:

THOMAS HOGAN, Warden, York

:

County Prison, JOHN DOE, Supervisor, :

Department of Homeland Security,

:

BEATA, Deputy Warden ROGER

:

THOMAS, and DENNIS BOWEN,

:

York County Prison,

:

Defendants,

:

:

v.

:

:

THOMAS HOGAN, Warden, York

:

County Prison,

:

BEATA, Deputy Warden ROGER

:

THOMAS, and DENNIS BOWEN,

:

York County Prison,

:

Third Party Plaintiffs,

:

:

v.

:

:

UNITED STATES OF AMERICA

:

DEPARTMENT OF HOMELAND

:

SECURITY, UNITED STATES

:

IMMIGRATION AND CUSTOMS

:

ENFORCEMENT, Office of Detention :

And Removal of Operations,

:

Division of Immigration Health Services, :

Third Party Defendant. :

NO. 4:05-CV-01415-JFM-JVW CIVIL ACTION - LAW
(JUDGE JAMES F. McCLURE, Jr.)

CERTIFICATE OF SERVICE

I, Donald L. Reihart, Esquire, certify that a true and correct copy of the foregoing Third Party Complaint was caused to be served on the date shown below by depositing same in the United States mail, first-class, postage prepaid thereon, addressed as follows:

Case 4:05-cv-01415-JFM-JVW Document 14-1 Filed 11/08/2005 Page 8 of 8

Benedictus Yarzue Inmate No. 84579 BERKS COUNTY PRISON 1287 County Welfare Road Leesport, PA 19533

Respectfully submitted,

Date: November 8, 2005

By: /s/ Donald L. Reihart, Esquire Donald L. Reihart, Esq. Sup. Ct. I.D. #07421 3015 Eastern Boulevard York, PA 17402 Telephone (717) 755-2799 Assistant Solicitor for York County

 
 Case 4:05-cv-01415-JFM-JVW Document 33-2 Filed 04/07/2006 Page 32 of 42·
YORK COUNTY PRISON

THOMAS H. HOGAN WARDEN

TELEPHONE 840-7580 AREA CODE 717 FAX 840-7204

3400 CONCORD ROAD YORK, PENNSYLVANIA 17402-9007

TO: FROM:

Joe Sallemi D.A.D.D.

Roger Thomas /.7

1

Deputy Warden f 7~--CJ.

DATE:

11128/05

RE:

Division ofImmigration,Health Services (DillS)

As you know, we have had quite a few problems with DillS of late. While it may appear that they are simply trying to save the government money by looking at detainee medical expenses, in my opinion they have set up an elaborate system that is primarily interested in delaying and/or denying medical care to detainees. You are my contact person with the Philadelphia District so I feel it is my responsibility to keep you informed of the problems DIHS has caused.

Let me explain:

1. In order to receive authorization for detainee medical care, you must fill out a Treatment Authorization Request (TAR). Although the space to request treatment is only % of an inch, DillS demands that we provide: a. Physicians Diagnoses b. What are we requesting c. Duration of the complaint d. Date of complaint e. Precipitating factors f. What are the symptoms g. What treatments/meds have been provided h. Provide progress notes/substantiating information

Demanding that all that information be jammed into a % inch space is not
something an agency would do ifthe agency were interested in things n:u:ming
smoothly.

"EQUAL OPPORTUNITY EMPLOYER"

Case 4:05-cv-01415-JFM-JVW Document 33-2 Filed 04/07/2006 Page 33 of 42
2. Regardless ofhow serious the request is, DillS has a habit of "sitting" on TAR's. The latest example (Mei Ying Xiao) was a 13-day delay. IfDillS were truly interested in providing a service (instead of delaying service) they wouldn't sit on a request for nearly 2 weeks.
3. Many times when we do receive a response it is not given an approval or denial. Instead DillS requests further information. This further delays treatment.
4. Many times when DillS requests further information it is for things they Imow we would not have (e.g. X-rays from 1997, or mammogram from a recently incarcerated detainee). When we receive detainees from BleE we never receive medical records and DmS knows that. I am sure that DillS would state that they are only tryinKto obtain information to make a decision. To request information, however, that they know or should Imow we do not have serves only to delay authorization for necessary health care.
S. IfDmS requests additional information and they don't receive it inwhat they consider "a timely manner", then the case is closed and a new TAR is required. Our policy is to send the entire medical record to DmS but that doesn't count. I have no idea how long a "timely manner" is but it is certainly shorter than the 13 days Dms takes while they sit on TAR's. Ifthey close the case, that delays treatment.
6. While our medical department must prepare elaborate TAR's to request authorization, all DIHS has to do to stop the process is to demand ridiculous information (e.g. X-rays from 1997 for a detainee received in 2005). DJ;HS is in the position of "placing the ball back in our court" with one 10 word sentence. In the guise of seeking information they have deliberately delayed treatment.
7. Ifa TAR is returned unapPFovable or denied, then the case is locked and in order to open the case our medical department must start the process allover again. An example of a case that is ''unapprovable'' occurred recently. One of the Doctors at DillS wanted to ,"watch" the case of the detainee with lumps in her breasts. He can't possibly watch the case because he is located in Washington D.C. Our medical staffwill watch the case and we don't work for DillS. According to DillS we are to keep DIHS infonned of any changes. In the meantime, however, they have completely closed the case. They will never even ask how the detainee is doing. DillS seeks to deny necessary treatment while maldng it appear as if they are truly interested in the detainees well being.
8. While DillS has informed you verbally that they are responsible for their medical decisions they have never put that in writing. I don't believe they will without pages oflegal caveats. If something went wrong and a detainee died after following one ofthe recommendations from DillS, I believe that an army ofBlCE attorneys would suddenly appear claiming that our medical department did not give them enough information for DIHS to malce a decision. Therefore, it would be our medical department's fault that the detainee died.

Case 4:05-cv-01415-JFM-JVW Document 33-2 Filed 04/07/2006 Page 34 of 42
9. There is nothing easy about working with DmS. Ifsomething can be delayed, it is delayed. If it can be denied, it is denied. Ifsomething can be made difficult, it is made difficult. Most importantly, ifthere is some bureaucratic procedure that will 'delay/deny treatment to a detainee, place the ''ball back in our medical department's court" and "cover the backsides" of DmS, you can be assurer;l that DmS will do it.
10. I am attacbing copies of-TAR's to support what I have stated. You may do what you want with this information. You are my contact for the Philadelphia District. I have not and will not tell a massive Wasbington D.C. Bureaucracy like oms what to do. I can only state that I will not participate in the denial or delay ofwhat our medical department feels is necessary health care. If DmS refuses to authorize medical care then I will ask you to move the detainee to a location that concurs with DmS. Ifyou refuse to move the detainee then BleB will assume the cost ofthat necessary care.

.BJD CLAIr"l5 TO:

Immigration Health Services

1220 L Street, NW

Pr/lB 468

Washington, DC 20005-4018

Phone: 1.800.479.0523

Fax: 1.866.475.9349

_.

.'

A separate treatm~nt aut~orizati0ii 'r~quest wfll.be'~~quired for services beyond and outside the scope of the original
authorization. ServicES rendere~'may not be paId wIthout an approved authorization. All payment for services is subject

to detainees' eligibility and cus"tody. All claims are subject to retrospective review. For further guidance and informatlon,

please refer to the DIHS website: www.inshealth.ora or contact the Immigration Health Services' fvlanaged Care

Branch at 1.888.718.8947, IVJ-F BAlVl - 8P~4 EST.

Please ensure all claims include the Patient Identification Information and the Authorization number.

IMPRINT OF DETAINEE ID PLATE, COMPUTER LABEL OR COMPlET~ BELOW:

Name: 1<VIfANE AnBA JIIIC AULEY

Alias:

DOB: 09/27/1980

A #: 074953075

Nationality: TRINIDAD AND TOBAGO

FacUlty: YORK COU~fTY JAIL PA

AUTHORIZED ACT!ON:
Status! Pended ~ More Info Service Type: Emergency
Referral Type;

Auth #: 200507156606 00

To! (Name and Phone ,to'whom ref'erral is being made)

Authorizer: Blean Falzini,RN .

Dialogue of Request:

Cannot approve due to requested clinical information not received.

1. Physician's Dx: (If a mass or lump! indicate size) .

2. What you are requesting:

3, Duration of complaint:

4. Date of complaint: ,

5. Precipitating factor(s):

6. What are the symptoms:

7. What treatment(s) / meds /lave been used:

,

8. Fax any progress notes/substantiating information that wnf assist

LCDR Falzini/CAPT Ganaway! 202.732.0119.

Updated by Eileen Falzini! RN on ~/londaYI July 18, 2005

-;;:iiiJ--/:$i:JJ/JcT;;;-;O-7fJ1e?l7J-IFC--Rxffl@

ORIF right femur 6/2004 C/O pain ambulates with crutches needs x,

,-
Provisional Diagnosis: 88.3 OTH X-RAY

/Vo TE ~YlM7UCe{j ) }.JFO!<yYlA!loN
~

Consultation Report:
http://inshealth.org/TARWeb/ViewAuthForrn,aspx?id={7A672319-E6D8-4... 7/18/2005

/
C9-s'e 4:05-cv-01415-JFM-JVW Document 33-2 Filed 04/07/2006

';'~~-$-

ul'·HTED STATES PUBLiC HEALTH SERVICE

~ DIVISION OF IMMIGI?..ATlON HEALTH SEIWICES (DiBS)

< ~ 6.
t5"

-.rP...EATMENT AUTHOR~ZA.TION REQUEST (TAR)
imnliEraiian H~3hh SJ;r"l1CCS U:!0 t. 1u',,~'.. ['{W -PMB .:i6g . Wasbington, D.C" 2U005

?h'Ji1'; ! ··lWH t15-8947 f:;x !-is65-475 -9J49

Page 36 of 42

Is Ihis request a TAR APPEAL (Plca;;c cirde one"')

".r-';

Yf.S

NO

".

IfYES~ it L" r~ql1iTl;!d fhal you provide the TAR NUlYlBER you are appealing:_ _ _ _ _ _ _ _ _ _ _ __

-

J

Detention

Facility"":

_

.' .: _ -:::=---:;;;;;;=-:;;-_

.'
_ -r~r'·-----------.!.-P.!.!.ho~nJ>eO!.!#-*-------~----

~C;7M;"~'lD7·7:::J-=::d-l~/2:.....::r-_·_-----~Fax!!!>.!ftL..=-.....:...... Address"': ___

_ _ _ _ __

-. -n "ICY CilY~; _____-'--lU,-.+---{-J---------------State"": ___ Zip"": ______

DETAINEE INFORMATION

.rntCau "J\t Last Name":
AlienlD-:
J/Ii/m Camp Amv;!l Dale"':

}~_ i ~W t1n1-~ Fjrs(~:r-K~wpO'~Ln~e~--__,__--

~? 07$

DalcoSSi~h": ~-di) Sex*:Mal~VFemalilD

Country ofOrigin*: .!:.4Y+-HIf-h*1Qb'\1:lQ:!Sff-:"'-r---~~:-------

R.I~ASON FOR.REFIl:R.R.AL RE UIE5T

Dingnosis/Symptoms>!.: .bOLj!::::.Ll.=-.Ji..::.d:lj2.;L-.:t4=:c-;L£.~¢=:lr.::::.--.1'::.f....e:!;~\.,¥·..-!,-.-:c/::L.'a::L---=~:r.!....:u~.L.L.-__4I~'::L..~'i!;J

7+1 e 1'- COUl:Se
JJt1:1J

O_fTreCautn(en~r":~{.- .'(.i~

.

I.

~. (ru

~-- CPT/CDT:-._ _ _ _

__J_ .- •

.

.

. A€STA-f10N OF O/nAINE£ CUS-rDUY

as of____ ~- .

(I'RIN1-NAMI!·)

(TODAY-S DAl

TAR form is correct to the best of my knowledge lind that the detninee is not !l U.S.

,0 US Border Pacrol (BP) - Plem;.: I.:irclt: onr! oflhc following aDd provide: PlN 0
o US Immigration and Customs f.!1forceri1elltlD'::l~rtliOn and Removal (ICr..JDI\C
o US Office ofRefuj!ee Re.'iertlement (ORR)

from

(CUSTODY BF.GrNNING nATF.~)

to ___~~~~~~~~__
(("US'IUD'r' el'lO OAT.e·)

(TITLE"')
PROVIDER OF MEDICAL CARE AND OT!
Provider',; ~ame"'-t; _ _ _ _ _ _ _ _ _ _ _ _ _ _-:-_ _ _ _ __

Provider's Phone Number"'±:._ _ _ _ _ _ _ _ _ _ Provider's City*"':_ _

DIHS.i\UTHORIZI\.TION ACT) (To be r:ampl,,~d by OIHS ONl.y)
DlHS M:magcd Care Coordinator (MCC): _________...,.-----
(Sigl1C1'rwd

MCC TAR Action:

Approved 0

Dcni~d 0

Perldbd 0

_ MCCCOOlmen~:. _____________________________ .___________________________________

Plco.c pruvld~ a copy orlhe "/lpproved- TAR 10 the 1lealth Service ProvidM. Non-elllergeill health servic~s will nOI be paid withtJu!lIn ilpprO\'~u TAR is,tJ~d prior til heullh services being rcndl!rd. F..m~rgency h~;U1f15crviccs n:qLJir~ TAR !'uhmilluf wilhin (1m; bu~in"5S day ~ncr being SO\lghl. A scpamt~ TAR will be required for henll(l services b<:},Olld and IJulSide Ihe scope orlhe of~ginaf ~l1lh()nzed TAR.. FOr heilllll i!i\(c claim Slalus illquiril!S_ t;',J1l 1-800-479-0523_ To "ilppcai a TAR dcd~i{ln IlfDn-lS 10 not "u!horiz~ n 5~rvic,,- <l t!~It:nlion facility musl ~ubmil a TAR A.ppeal through Ih~ TAR: proc!:..," alld inc1ud~ lh~ followil1g infom13lion: al-·rAll. AppC3(~. h) TA\{ number and (11her inlorm:lliOIl t'rOJ11 TAR. being ;lPt)eal~d. £0) r~q!l~Sl~tl {lClion. and cjjusfil1cmion ror the rcquo;"s!cd 3<:lion. For further gllid:mce ~l1d inlomlntion. pl~sc vi";t our w~bsile ;11: \B lI.il\~ll~:\lJh.ol·g or conroel thf DUlS- M,utaged Care CoOrdiliitlOrS ill I-BB2-71 B-8g47_ M f. BAM 6 PM EST. .
"* .Failure 10 complete requiredjields will result in an inabflity ofDIHS to process TAR.
""":Required when reason for TAR submittal isfol' emergenc.y health servfces.
R.1"!3ed woso~z I

Case 4:05-cv.:01415-JFM-JVW Document 33-2 Filed 04/07/2006 Page 37 of 42

. . FRlSON HEAL1H SERVICES, INC.

~~--l~ /l}4}bS
~~~-----,---,-ID~

To:

fVOrE Fk'f.. TO

Dl 1+ '$ ofJ

Re:

{ II/'f/()S

rtorr

com~
Eill ct -

)
Number oftransmitting pL.:;,"" \"~"""""''''~ L";'" fI....~-.JJ~ ............
Telecopy Number. (717) 840 -7604
If you are having any problems with this transmission, please call us as soon as possible at (717) 840 - 7637.

Thank You.

Bridget Smith . - - - - - - - - - R PHc-hSHl-EEM£A-CGI:r.eGtiEmal-CaF8i-----
York County Prison Medical Department

Case 4:05-cv-01415-JFM-JVW Document 33-2 Filed 04/07/2006 Page 38 of 42

Division of Immigration Health Services

Treatment;'Authorization & Consultation Form

SEND CLAIMS TO:

Immigration Health Services

1220 L Street, NW

PMB 468

Washington, DC 2.0005-4018

Phone: 1.800.479.0523

. '~. ,.'

Fax: 1.866.475.9349

"":,.

A separate treatment authorization request will be required for services beyond and outside the scope of the.o'tiginal

authorization. Services rendered may not be paid without an approved authorization. All payment for services is subject to

detainees' eligibility and custody. All claims are subject to retrospective review. 'For furtber guidance andJnformatlon, please

refer to the DIHS website: www.inshealth.org or contact the Immigration Health Services' Managed Care Branch at

1.888.718.8947, M-F BAM - 8PM EST.

'

~ -";. 0.

Please ensure all claims include the Patient Identification Information and the Authorization number.

IMPRINT OF Df
Name: Mel Ylng DOB; 08/08/1962' Nationality: CHINA, PEOPLE'S RE
AUTHORIZED ACTION:
Status: Pended - More Info Service Type: Nan-Emergency Referral Type: 33

AIZrrrz oeLft-C(
ftfJO/(J6 /lflaflf:..
/IlJFtJ
<

)R COMPLETE BELOW:
:hang Park, MD

To: (Name and Phone to whO!

Smith Rad

Dialogue of ReQuesJ.::

2.. Dr. Park wanted to know:
1',10 When was her last mamogram? Are results available? - N C)
Does the lump change during her cycle? .... N c> <'. h &1 r'\~e d

1: Left breast mass R/O malignancy Left breast mass about 1cm x 2cm slightly tender first noticed about 9 months ago numerous smaller cystic masses in both breast positive family history of breast cancer - mother. Patient needs approval for mammograms I did fax this tar on 11/3/05 because it would not go through system I dj, so i entered
This event's case was created by TARweb and should be verified for data

tJ6TE. Ff1c-)( F(26rA

bl K-S TD ()U~

f'A.e.. (j

! (

iLl 11. '-"

7lJ\Cofr)q-

The following patient information was entered manually:
Patient Alien # :073572851
https://www.inshealth.org/tarweb/ViewAuthForm.aspx?id~{DAF517D4-735D-...11/16/2005

4~-CV-014j5-.JFM-.J~W - 3~. --1

.. -

Case

)iT

rmmigration

"Healtii

Document
Services

33-2I reatmFiele.td1t;0A4u1H07io/2fl0za0t6lOn

&P. Caatiensufi:aotlfO4n?t=orm

I".

i,ID CLAIiulS 10: ,rfnmlgration Health Services
'1220 L Street, NW PJVIB 468 Washington, DC 20005-4018
Pho'ne: 1.800.479.0523 ; Fax: 1.866.475.9349
,
A separate treatment authorization
authorization. Services ren{;lered m.
to detainees' eligibility and' custody. please refer to the DIHS website: 11 Branch at 1.888.718.8947, fvJ-F 8AI"

J,. ~ .,.."

rvorf. 'DeiJ( Itt... ~(1kJ SE
VI HS lullP7£/J
X MtjS ffZdYK Iy17

Itside tile scope of the original ,II payment for services Is subject 'urther guidance and information, th Services' Managed Care

Please ensure all claims include the
IMPRINT OF DETAIl Name: Houng Thach
DOB: 04/12/1952 Natlonallty: COMBODIA

1/ /05 // 1J{!.lffi/.Je~· £IYTF-tee() fllf:./.S!J;...} 26 \

ltlon number. )MPlETE BELOW: PA

AUTHORIZED ACTION:

Status: Denied

'Auth #: 200

Service Type: Outpatient

Referral Type: Medical Test/Lab

W. CJl~

1)IQl05

To: (Name and Phone to whom referral is being made)

..._. -.,.-...'" .-.-.-...-'--.---·--.-.·.----·-·-·-··-. .
1 Dla!ogue

o'f Re.que.s~:

,

. . ? q. 2Ifp ..~ ~xrOj~ )~A~ q~ ---·--·----1-·--.;--;~·-

/~ \ N S
-ry J

l-L')QY1,1"S (Q(iJ -1L-,u.-..

r. t....)~J ri \~.

~lJ

I

. I..

I.

I 1

1y,/..l P~~I,

.:.LNS r ue::Jk.o[ I! Cannot approve due to requested clinical in{Jm~:tTo not received. If request is still viable, please resubmit a TAR(rO)~J

with the requested information.

J.J

t~

'iYt~'(G \\'\\~

Cannot approve ,due to requested clinical information not received. Please fax by COB 7/22/05.

1. Physician's Dx: (If a mass or lump, indicate size)

2. What you are requesting:

3. Duration of complaint:

4. Date of complaint:

5. Precipitating fador(s):

6. What are the symptoms:

7. What treatment{s) / meds have been used:

8. Fax any progress notes/substantiating information tilat will assist in making the best medical decision. FI\X to

LCDR Falzini, 202.732.0119.

.

.'

Updated by Eileen Falzini, RN on Friday, July 15, 2005

a Patient needs Scan left lung masses
3 upper lobe densities - RIO granulomata positive ppd on admission chest x-ray found above nodules Radio!ogy
a recommends scan for fUlther eva! Patient is asymptomatic
http://inshealth.0I~g/TARWebIViewAuthform.aspx?id={35F9E015-7016-41... 7/26/2005

TARweb Authorization Form

page lOT j

Case 4:05-cv-01415-JFM-JVW Document 33-2 Filed 04/07/2006 Page 40 of 42

Divjsion of Immigration Health Services

Treatment, Authorization & Consultation Form

SEND CLAIfvlS TO: Immigration Health Services 1220 L Str~et, NW PMB 468 Washington, DC 2.0005-4018 Phone: 1.800.479.052.3 Fax: 1.866.475.9349

• ; .• 0·
......

A separate treatment authorization request will be required for services beyond and outside the scope of the original

authorization. Services rendered may not be paid without an approved authorization. All payment for services is subject to

detainees' eligibility and custody. All claims are subject to retrospective review. For further guidance and information, please

refer to the DIHS website: www.inshealth.ora or contact tbe Immigration Health Services' Managed Care Branch at

1.888.718.8947, M-F 8AM - SPIV) EST.

. :.'.

Please ensure all claims Include the Patient Identification Information and the Authorization number. }J

IMPRINT Of DB;TAINEE ID PLATE,. COMPUTER I

Name: Af-.!lADOU DIALLO DOB: 11/20/1968

Alias:

jUOTE 7)?tJJ/fL

A #: 07360

Nationality: MAU

tJF Facility: Yorl 13eCItU5£

AUTHORIZED ACTION~

IjJft>~76)f-J ;Va T

Status: Denied

Auth #: 200510065101 00

Servlce'Type: Non-Emergency

/?ecel u . Authorizer: Marylc

e6

Referral Type: 11
-
To: (Name and Phone to whom referral is being made)

Ljer lIfO( /flfde.
~prr;2£ /J'le.f)I ('/IG

Ortho Clinic 717.851.2427

/~(LJ!lIJ /

Dialogue of Requsst:
No information received. Please resubmit TAR wi the requested info.
2. Please fac 202.732.0119 consult notes and other relative progress notes for medical review by COB OCT 14. I do have medical record (AUG 05)Thankyou. Updated by Marylouise Ganaway! RN on Tuesday! October 11, 2005
1. These are not duplicate there are 4 appointments that need approved
patient seen by artho on with the diagnosis below. Patient dx with Torn ACL/meniscus tear left knee Ortho doctor recommend that he have artha follow up to give consent for surgeyr This occured July 2 2005 complain of pain left knee instability leg immobilized, non weight bearing. Therapy NSAID / crutches
Provisional Diagnosis: 717.83 OLD DISRUPTION OF ACL
https://www.inshealth.org/tarweb/ViewAuthForm.aspx?id={DClF6AE7-C326-... 10/19/2005

/
Ca,~ 4:05-cv-01415-JFM-JVW
,..,rl of Immigration HeaJth Services o

Document 33-2 Filed 04/07/2006 Page 41 of 42
Treatment, Autnorlzati9tl & Consultation Form

"

SEND CLAIr-IS TO:

Immigration Health Services

1220 L Street, NW

PMB 458:

Washington, DC 20005-4018

Phone: 1.800.479,0523

"

Fax: 1.866.475,9349

"

A separate treatment authorizatIon request will be required for services beyond and outside the scope of th~ original

authorization, Services rendered may not be paid without an approved authorization, All payment for services is subject to

detainees:odig!~Hit',· and custody. Alh:laims are subject to retros~ctive review. For further gL.:kJancc and information, r:leas€.

refer to the DIHS website: www.inshealth.orq or contact the Immigration Health Services' Managed Care Branch at

1.888.718.8947, M-F 8AM - 8PM EST,

, 0,0

Please ensure all claims Include the Patient Identification Information a!'ld the Authorization number.

IMPRINT OF DETAINEE 10 PLATE, COMPUTER LABEL OR COMPLETE BELOW:

Name: Mel Ying DOB: 08/08/1962

l6,lias: ~ #: 073572851

Nationality: CHINA, PEOPLE'S REPUBliC OF

Facility: York Co Jail PA

AUTHORIZED ACTION:
Status: Unapprovable
Servlce Type: Non-Emergency Referral Type; 33

Auth #: 00003094200511186593 00

To: (Name and Phone to whom referral is being made)

Authorizer: Marylouise Ganaway, RN

Dialogue of Request:

lu 6 rr. TItR..

L Rec'd faxed information today. Previous TAR was closed so I opened this fl-N 2) ()((<:.~[) It'-

r /2!J..c Faxed info indicates that lump does not change during her cycle and thaI/IV Fo )Jtf

e/ 1./([) /A-J

studies have been done.

r ' /rTlmI ec

t' /Yl~e,-.

"

r

rt::.. e i.
ii.

Dr. Park
~f there

would is any

like to watcll this change in size or

for 3-months. its condition before

°
the

3

months,

plet;U6

.r:-
TlTte Lo ::;£ /;-

_ iii. If you know there has been a change in size from your intake physica

0;(..

changes now.

UIU/tfljJ/Zc}v/ff3 CE

£/J I j)eN Thank you, Updated by Marylouise Ganaway, RN on Friday, November 11

1. REASON FOR REFERRAL:

"

~

Information below copied from previous TAR which was closed since information had not been received in a timely manner. PLEASE NOTE: WhenOa"TAR is marked APPD, Unaaprovalbe or has been denied, it is locked and requires that a new TAR been submitted RE that request.

3. When you have the requested info, please resubmit for consideration.
https:/ /www.inshealth.org/tarwebIViewAuthForm.Qspx?id={OlFCC2FB-CA9A-...11/21/2005

/'
Case"4:05-cv-01415-JFM-JVW
/0 of Immigration HeaJth Services
SEND CLAIr'iS TO: Immigration Health Services 1220 L Street, ~jW Pf"lB 468 ' Washington, DC 20005-4018 Phone: 1.800.479.0523 Fax: 1.866.475.9349

- Document 33-2 Filed 04/07/2006 Page 42 of 42 Treatment,AuthorizatiPtl & Consultation Form
"

A separate treatment authorization request will be required for services beyond and outside the scope of the original

authorization. Services rendered may not be paid without an approved authqrization. All payment for services is subject to

detainees',c.!ig!~i1jt': anr! custody. AII-claims are subject to retrospective review. For furthe:r gl!id;:;ncc and information, pleasE

refer to the DIHS website: www.inshealth.org or contact the Immigration Health Services' Managed Care Branch at

1.888.718.B947, M-F BAfVJ - BPM EST.

' .

Please ensure all claims include the Patient Identification Information and the Authorization number.

IMPRINT OF DETAINEE 1D PLATE, COMPUTER LABEL OR COMPLETE BELOW:

Name: Me! Yinq DOB: 08/08/1962

iAllas:
IA #:. 073572851

Nationality: CHINA, PEOPLE'S REPUBllC OF

Facility: York Co Jail. PA

AUTHOP..lZED ACTION:

Status: Unappro\lable

Auth #: 00003094200511186593 00

Service Type: Non-Emergency

Referral Type: 33

To: (Name and phone to whom referral i5 being made)

VI (+~ D6 c.1bfZ
bJrtAJi'5 TO IttJ A-rC/-f "
e jJe.(ffl/Ve ifer
(!f75~ /5 (!'-.o SEIJ (

Dialogue of Request:

Rec'd faxed information today. Previous TAR was closed 50 I opened

Faxed info indicates that lump does not change during her cycle and studies have been done.

i. Dr. Park would like to watch this for 3-months.

,

ii. If there Is any change in size or its condition before the 3 months, please su bmit a TAR with the new information.

_ iii. If you know there has been a change in size from your intake physical to now, please submit a TAR with those

changes now.

-

Thank you. Updated by Marylouise Ganaway, RN on Friday, November 18, 2005

1. REASON FOR REFERRAL:

.'

Information below copied from previous TAR which was closed since information had not been received in a timely manner. PLEASE NOTE: Whena'TAR is marked APPD, Unaaprova!be or has been denied! it is locked and requires that a new TAR been submitted RE that request.

3. When i'oU have the requested info! please resubmit for consideration.
https:/ /www.inshealth.org/tarweb/ViewAuthForm.ospx?id=(01FCC2FB-CA9A-...11/21/2005

 
 Pennsylvania Middle District Version 3.0.5 - Docket Report

Page 1 of 11

CLOSED, PROSE, PRSLC
U.S. District Court United States District Court for the Middle District of Pennsylvania (Williamsport)
CIVIL DOCKET FOR CASE #: 4:05-cv-01415-JFM-JVW

Yarzue v. Hogan et al Assigned to: Honorable James F. McClure, Jr Referred to: Pro Se Law Clerk JV Cause: 42:1983 Prisoner Civil Rights

Date Filed: 07/14/2005 Date Terminated: 09/01/2006 Jury Demand: Defendant Nature of Suit: 550 Prisoner: Civil Rights Jurisdiction: Federal Question

Plaintiff Benedictus Yarzue

represented by Angus R. Love PA Institutional Law Project 924 Cherry Street Suite 523 Philadelphia, PA 19107 215-925-2966 Email: alove@pailp.org LEAD ATTORNEY ATTORNEY TO BE NOTICED

Michael J. Cooke Burke O'Neil LLC 4112 Station Street Philadelphia, PA 19127 215-487-6593 Email: mcooke@burkepyle.com LEAD ATTORNEY ATTORNEY TO BE NOTICED

V. Defendant Thomas Hogan Warden, York County Prison
Defendant John Doe

represented by Donald L. Reihart Law Offices of Donald L. Reihart 3015 Eastern Boulevard York, PA 17402 717-755-2799 Fax: 17177552530 Email: email@reihartlaw.com LEAD ATTORNEY ATTORNEY TO BE NOTICED

https://ecf.pamd.uscourts.gov/cgi-bin/DktRpt.pl?755851962141691-L_353_0-1

5/29/2007

Pennsylvania Middle District Version 3.0.5 - Docket Report

Page 2 of 11

Supervisor, Department of Homeland Security, York County Prison TERMINATED: 11/09/2005 Defendant Beata Complaint Supervisor, York County Prison TERMINATED: 05/22/2006 Defendant Roger Thomas Deputy Warden, York County Prison TERMINATED: 05/22/2006 Defendant Dennis Bowen Deputy Warden, York County Prison TERMINATED: 05/22/2006 Defendant Secretary Michael Chertoff TERMINATED: 01/10/2006 Defendant Division of Immigration Health Services Defendant Department of Homeland Security
Defendant York County Pennsylvania
Defendant Berks County Pennsylvania

represented by Michael J. Butler United States Attorney's Office-MDPA 228 Walnut Street, Ste 220 Harrisburg, PA 17108 717-221-4482 Fax: 17172212246 Email: Michael.J.Butler@usdoj.gov LEAD ATTORNEY ATTORNEY TO BE NOTICED
represented by Donald L. Reihart (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
represented by Thomas Edward Brenner Goldberg Katzman, PC 320E Market St., Strawberry Square

https://ecf.pamd.uscourts.gov/cgi-bin/DktRpt.pl?755851962141691-L_353_0-1

5/29/2007

Pennsylvania Middle District Version 3.0.5 - Docket Report

Page 3 of 11

Defendant
Dr. Timothy Shack Medical Director, Division of Immigration Health Services, sued in his individual capacity
Defendant
John Doe Division of Immigration Health Services, sued in his/her individual capacity
Defendant
Jane Doe Division of Immigration Health Services, sued in her individual capacity
Defendant
Dr. Charles Norris Medical Director, York County Prison, sued in his individual capacity

P.O. Box 1268 Harrisburg, PA 17108-1268 (717) 234-4161 Fax: 717-234-6810 Email: teb@goldbergkatzman.com LEAD ATTORNEY ATTORNEY TO BE NOTICED
represented by Charles T. Roessing White and Williams LLP One Westlakes 1235 Westlakes Drive Suite 310 Berwyn, PA 19312-2416 610-251-0466 Email: roessingc@whiteandwilliams.com LEAD ATTORNEY ATTORNEY TO BE NOTICED
David R. Zaslow White and Williams LLP One Westlakes 1235 Westlakes Drive Suite 310 Berwyn, PA 19312-2416 610-240-4716 Email: zaslowd@whiteandwilliams.com LEAD ATTORNEY ATTORNEY TO BE NOTICED

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Defendant Dr. John Roe Physician, Berks County Prison, sued in his/her individual and official capacity Defendant Dr. Jane Roe Physician, Berks County Prison, sued in his/her individual and official capacity Defendant Prison Health Services, Inc.
Defendant PrimeCare Medical Inc.
Cross Claimant Thomas Hogan Warden, York County Prison
Cross Claimant Beata Complaint Supervisor, York County Prison Cross Claimant Roger Thomas Deputy Warden, York County Prison
Cross Claimant Dennis Bowen Deputy Warden, York County Prison
V.

represented by Charles T. Roessing (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
David R. Zaslow (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
represented by Thomas Edward Brenner (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
represented by Donald L. Reihart (See above for address) ATTORNEY TO BE NOTICED
represented by Donald L. Reihart (See above for address) ATTORNEY TO BE NOTICED
represented by Donald L. Reihart (See above for address) ATTORNEY TO BE NOTICED
represented by Donald L. Reihart (See above for address) ATTORNEY TO BE NOTICED

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Cross Defendant United States of America Department of Homeland Security
Cross Defendant John Doe Supervisor, Department of Homeland Security, York County Prison
Third Party Plaintiff Thomas Hogan Warden, York County Prison
Third Party Plaintiff Beata Complaint Supervisor, York County Prison
Third Party Plaintiff Roger Thomas Deputy Warden, York County Prison
Third Party Plaintiff Dennis Bowen Deputy Warden, York County Prison
Third Party Defendant United States of America Department of Homeland Security, United States Immigration and Customs Enforcement, Office of Detention and Removal of Operations, Division of Immigration Health Services
Cross Claimant York County Pennsylvania
Cross Claimant Thomas Hogan Warden, York County Prison

represented by Michael J. Butler (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
represented by Donald L. Reihart (See above for address) ATTORNEY TO BE NOTICED
represented by Donald L. Reihart (See above for address) ATTORNEY TO BE NOTICED
represented by Donald L. Reihart (See above for address) ATTORNEY TO BE NOTICED
represented by Donald L. Reihart (See above for address) ATTORNEY TO BE NOTICED
represented by Michael J. Butler (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
represented by Donald L. Reihart (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

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V.
Cross Defendant
Division of Immigration Health Services
Cross Defendant
Department of Homeland Security
Cross Defendant
United States of America Department of Homeland Security, United States Immigration and Customs Enforcement, Office of Detention and Removal of Operations, Division of Immigration Health Services

represented by Michael J. Butler (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Date Filed 07/14/2005 07/14/2005 07/15/2005 07/15/2005 07/19/2005
07/27/2005
08/01/2005 08/29/2005 09/27/2005

#

Docket Text

1 COMPLAINT against all defendants filed by Plaintiff Benedictus Yarzue, w/request for counsel on his behalf at paragraph 8, Section V. (Entered: 07/15/2005)

2 MOTION and affidavit for Leave to Proceed in forma pauperis by Benedictus Yarzue.(bp) (Entered: 07/15/2005)

3 STANDING PRACTICE ORDER signed by M.D.PA judges issued on 7/15/05.(bp) (Entered: 07/15/2005)

PRISONER LETTER ISSUED w/ Notice & Consent Form and U.S. Marshal Forms to Plf Yarzue from Wmpt. (bp) (Entered: 07/15/2005)

4 ORDER granting 2 Motion for Leave to Proceed in forma pauperis, which is construed as a motion to proceed without full prepayment of fees and costs. U.S.Marshal directed to serve Plf complaint on Dfts named therein. Signed by Judge James F. McClure Jr. on 7/19/05 (bp) (Entered: 07/19/2005)

5 Mail Returned as Undeliverable. Mail sent to Benedictus Yarzue at Berks County Prison. Telephoned Records Department, Berks County Prison, and was told inmate Yarzue left there 7/15/05 in the custody of Immigration, and Berks County did not know where he was taken. (bp) (Entered: 07/27/2005)

6 NOTICE of Change of Address by Benedictus Yarzue (ga, ) (Entered: 08/01/2005)

7 MOTION for Leave to File AMENDED COMPLAINT by Benedictus Yarzue.(kw) (Entered: 08/29/2005)

8 NOTICE of Change of Address by Benedictus Yarzue (lg, ) (Entered:

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10/07/2005 10/17/2005 10/21/2005 10/21/2005 11/08/2005 11/08/2005
11/09/2005 11/09/2005 11/09/2005
11/16/2005 11/18/2005

09/27/2005)
9 WAIVER OF SERVICE Returned by Benedictus Yarzue. Dennis Bowen waiver sent on 9/15/2005, answer due 11/14/2005. (ep, ) (Entered: 10/07/2005)
10 NOTICE of Change of Address by Benedictus Yarzue. Docket Sheet has been updated to reflect current address per filing. (kw, ) (Entered: 10/17/2005)
11 EXHIBITS by Benedictus Yarzue re 1 Complaint. (Attachments: # 1 Exhibit(s) A# 2 B# 3 C# 4 D# 5 E# 6 F# 7 G# 8 H)(kw, ) (Entered: 10/21/2005)
12 NOTICE by Benedictus Yarzue of change of address and asking to be let out of quarantine (lg, ) (Entered: 10/21/2005)
13 Defendants' ANSWER to Complaint with Affirmative Defenses, CROSSCLAIM against United States of America Department of Homeland Security, John Doe by Thomas Hogan, Beata, Roger Thomas, Dennis Bowen.(Reihart, Donald) (Entered: 11/08/2005)
14 THIRD PARTY COMPLAINT against United States of America Department of Homeland Security, United States Immigration and Customs Enforcement, Office of Detention and Removal of Operations, Division of Immigration Health Services, THIRD PARTY COMPLAINT against United States of America Department of Homeland Security, United States Immigration and Customs Enforcement, Office of Detention and Removal of Operations, Division of Immigration Health Services, filed by Thomas Hogan, Beata, Roger Thomas, Dennis Bowen. (Attachments: # 1 Exhibit(s) # 2 Criminal Cover Sheet # 3 Summons) (Reihart, Donald) (Entered: 11/08/2005)
15 ORDER granting 7 Motion for Leave to File amended complaint; secretary Chertoff substituted for Jone Doe; US Marshal shall serve, Signed by Judge James F. McClure Jr. on 11/9/05 (lg, ) (Entered: 11/09/2005)
Summons Issued as to Michael Chertoff and USA and provided to USM for service. (lg, ) (Entered: 11/09/2005)
16 ORDER: Appointing Angus R. Love, Esquire, and Michael J. Cooke, Esquire, counsel for plaintiff through final disposition of the case in the district court; the appointment is pro bono except to the extent that attorneys fees may be awarded pursuant to statute if plaintiff is the prevailing party. Signed by Judge James F. McClure Jr. on 11/9/05. (km, ) (Entered: 11/09/2005)
THIRD Party Summons Issued as to United States of America Department of Homeland Security, United States Immigration and Customs Enforcement, Office of Detention and Removal of Operations, Division of Immigration Health Services. (lg, ) (Entered: 11/16/2005)
17 SUMMONS Returned Executed by Thomas Hogan, Beata, Roger

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11/30/2005
12/21/2005 01/06/2006
01/06/2006 01/10/2006 01/17/2006 01/23/2006
01/24/2006 01/31/2006

Thomas, Dennis Bowen. United States of America Department of Homeland Security, United States Immigration and Customs Enforcement, Office of Detention and Removal of Operations, Division of Immigration Health Services served on 11/15/2005, answer due 1/17/2006. (Reihart, Donald) (Entered: 11/18/2005)
18 SUMMONS Returned Executed by Thomas Hogan, Beata, Roger Thomas, Dennis Bowen. United States of America Department of Homeland Security, United States Immigration and Customs Enforcement, Office of Detention and Removal of Operations, Division of Immigration Health Services served on 11/28/2005, answer due 1/17/2006. (Reihart, Donald) (Entered: 11/30/2005)
19 Unopposed MOTION for Leave to File Amended Complaint by Benedictus Yarzue. (Attachments: # 1 Proposed Amended Complaint) (Cooke, Michael) (Entered: 12/21/2005)
20 ORDER Signed by Judge James F. McClure Jr. on 1/6/05: within 10 days of the date of this order, plaintiff shall serve additional defendant Chertoff with a copy of his motion to file a second amended complaint; within 10 days of the date of this order, plaintiff shall file a brief in support of his pending motion to amend; failure of the plaintiff to timely comply with this Order will result in his motion being deemed withdrawn. (lg, ) (Entered: 01/06/2006)
21 CERTIFICATE OF SERVICE by Benedictus Yarzue re 19 Unopposed MOTION for Leave to File Amended Complaint, 20 Order, (Cooke, Michael) (Entered: 01/06/2006)
22 NOTICE of Voluntary Dismissal by Benedictus Yarzue of Michael Chertoff (Attachments: # 1 Certificate of Service)(Cooke, Michael) (Entered: 01/10/2006)
23 BRIEF IN SUPPORT re 19 Unopposed MOTION for Leave to File Amended Complaint filed by Benedictus Yarzue. (Attachments: # 1 Appendix)(Cooke, Michael) (Entered: 01/17/2006)
24 MOTION for Extension of Time to File Answer re 14 Third Party Complaint,,,,, by United States of America Department of Homeland Security, United States of America Department of Homeland Security, United States Immigration and Customs Enforcement, Office of Detention and Removal of Operations, Division of Immigration Health Services. (Attachments: # 1 Exhibit(s) A# 2 Certificate of Concurrence# 3 Proposed Order)(Butler, Michael) (Entered: 01/23/2006)
25 ORDER: GRANTING the federal defendants' unopposed 24 motion requesting an enlargement of time; the federal defendants may file a response to the third party complaint on or before 3/24/2006. Signed by Judge James F. McClure Jr. on 1/24/2006. (km, ) (Entered: 01/24/2006)
26 Unopposed MOTION for Extension of Time to Respond to Motion for Leave to File Amended Complaint by United States of America Department of Homeland Security, United States of America Department

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02/06/2006 02/14/2006
02/23/2006 03/21/2006 03/24/2006
03/24/2006
04/07/2006 04/21/2006

of Homeland Security, United States Immigration and Customs Enforcement, Office of Detention and Removal of Operations, Division of Immigration Health Services. (Attachments: # 1 Certificate of Concurrence# 2 Proposed Order)(Butler, Michael) (Entered: 01/31/2006)
27 ORDER: GRANTING the federal defendants' unopposed 26 Motion requesting an enlargement of time; federal defendants' response to the plaintiff's motion to file a 2nd amended complaint due by 2/14/2006. Signed by Judge James F. McClure Jr. on 2/6/06. (km, ) (Entered: 02/06/2006)
28 RESPONSE by United States of America Department of Homeland Security, United States of America Department of Homeland Security, United States Immigration and Customs Enforcement, Office of Detention and Removal of Operations, Division of Immigration Health Services to 19 Unopposed MOTION for Leave to File Amended Complaint. (Butler, Michael) (Entered: 02/14/2006)
29 Letter from Plf to the Court, w/attachment. (bp) (Entered: 02/23/2006)
30 Letter from Pro Se Writ Clerk to Benedictus Yarzue advising that the Court cannot give legal advice and he must file a motion rather than a letter. (prose, ) (Entered: 03/21/2006)
31 MOTION to Dismiss Third-Party Complaint by United States of America Department of Homeland Security, United States of America Department of Homeland Security, United States Immigration and Customs Enforcement, Office of Detention and Removal of Operations, Division of Immigration Health Services. (Attachments: # 1 Certificate of Non Concurrence# 2 Proposed Order)(Butler, Michael) (Entered: 03/24/2006)
32 BRIEF IN SUPPORT re 31 MOTION to Dismiss Third-Party Complaint filed by United States of America Department of Homeland Security, United States of America Department of Homeland Security, United States Immigration and Customs Enforcement, Office of Detention and Removal of Operations, Division of Immigration Health Services. (Attachments: # 1 Exhibit(s) A - C)(Butler, Michael) (Entered: 03/24/2006)
33 BRIEF IN OPPOSITION re 31 MOTION to Dismiss Third-Party Complaint filed by Thomas Hogan, Beata, Roger Thomas, Dennis Bowen. (Attachments: # 1 Exhibit(s) 1# 2 Exhibit(s) 2# 3 Cert of Service of Exhibits# 4 Proposed Order)(Reihart, Donald) (Entered: 04/07/2006)
34 REPLY BRIEF re 31 MOTION to Dismiss Third-Party Complaint filed by United States of America Department of Homeland Security, United States of America Department of Homeland Security, United States Immigration and Customs Enforcement, Office of Detention and Removal of Operations, Division of Immigration Health Services. (Attachments: # 1 Exhibit(s) A - D)(Butler, Michael) (Entered: 04/21/2006)

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05/22/2006
05/22/2006 05/22/2006
05/23/2006 05/23/2006 05/23/2006 06/05/2006
06/26/2006 07/19/2006 07/24/2006 08/11/2006 08/11/2006 08/11/2006

35 ORDER: Granting plaintiff's unopposed 19 motion to file a second amended complaint; accepting plaintiff's proposed amended complaint; defendants shall file a response to the second amended complaint within the time frame authorized by the Federal Rules of Civil Procedure. Signed by Judge James F. McClure Jr. on 5/22/2006. (km, ) (Entered: 05/22/2006)
DOCKET ANNOTATION: document 36 deleted; to be re-docketed correctly as second amended complaint against all named parties. (lg, ) (Entered: 05/22/2006)
36 AMENDED COMPLAINT against Division of Immigration Health Services, Department of Homeland Security, York County, Berks County, Timothy Shack, John Doe, Jane Doe, Charles Norris, John Roe, Jane Roe, Prison Health Services, Inc., PrimeCare Medical Inc., Thomas Hogan, filed by Benedictus Yarzue.(lg, ) (Entered: 05/23/2006)
DOCKET ANNOTATION: summons entry deleted; to be re-entered properly as to federal defendants and state defendants. (lg, ) (Entered: 05/23/2006)
Summons Issued as to Division of Immigration Health Services, Department of Homeland Security, Timothy Shack, John Doe, Jane Doe and mailed to attorney Cooke for service. (lg, ) (Entered: 05/23/2006)
Summons Issued as to York County, Berks County, Charles Norris, John Roe, Jane Roe, Prison Health Services, Inc., PrimeCare Medical Inc. and mailed to Attorney Cooke for service on Defendant(s). (lg, ) (Entered: 05/23/2006)
37 ANSWER to Amended Complaint by Defs Thomas Hogan and York County, CROSSCLAIM against Division of Immigration Health Services, Department of Homeland Security, United States of America Department of Homeland Security, United States Immigration and Customs Enforcement, Office of Detention and Removal of Operations, Division of Immigration Health Services by York County, Thomas Hogan.(Reihart, Donald) (Entered: 06/05/2006)
38 NOTICE of Appearance by Thomas Edward Brenner on behalf of PrimeCare Medical Inc. (Brenner, Thomas) (Entered: 06/26/2006)
39 Letter from Yarzue (lg, ) (Entered: 07/19/2006)
40 Letter from Pro Se Writ Clerk to Benedictus Yarzue informing him that no action will be taken on the basis of a letter and any requests for relief must be in the form of a motion. (prose, ) (Entered: 07/24/2006)
41 NOTICE of Appearance by David R. Zaslow on behalf of Charles Norris, Prison Health Services, Inc. (Zaslow, David) (Entered: 08/11/2006)
42 NOTICE of Appearance by Thomas Edward Brenner on behalf of Berks County (Brenner, Thomas) (Entered: 08/11/2006)
43 MOTION for Extension of Time to TO FILE RESPONSIVE

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08/11/2006
08/15/2006 09/01/2006 09/07/2006

PLEADING by Berks County, PrimeCare Medical Inc..(Brenner, Thomas) (Entered: 08/11/2006)
44 Eighth MOTION for Extension of Time to Respond to Plaintiff's Second Amended Complaint by Department of Homeland Security, United States of America Department of Homeland Security, United States Immigration and Customs Enforcement, Office of Detention and Removal of Operations, Division of Immigration Health Services, United States of America Department of Homeland Security, United States of America Department of Homeland Security, United States Immigration and Customs Enforcement, Office of Detention and Removal of Operations, Division of Immigration Health Services. (Attachments: # 1 Certificate of Service# 2 Certificate of Concurrence# 3 Proposed Order) (Butler, Michael) (Entered: 08/11/2006)
45 ORDER: GRANTING defendants PrimeCare Medical, Inc. and Berks' County unopposed 43 Motion requesting an enlargement of time; the moving defendants may file a response to plaintiff's 2nd amd complaint on or before 9/29/2006. Signed by Judge James F. McClure Jr. on 8/15/2006. (km, ) (Entered: 08/15/2006)
46 STIPULATION of Dismissal by Benedictus Yarzue. (Attachments: # 1 Certificate of Service)(Cooke, Michael) (Entered: 09/01/2006)
47 NOTICE of Voluntary Dismissal by Thomas Hogan, Beata, Roger Thomas, Dennis Bowen of Third-Party Complaint (Attachments: # 1 Cert of Service)(Reihart, Donald) (Entered: 09/07/2006)

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 IN THE UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF PENNSYLVANIA (Williamsport)

BENEDICTUS YARZUE Plaintiff,

: NO.4:05-CV-01415-JFM-JVW

v.
THOMAS HOGAN, Warden, York County Prison, SECRETARY MICHAEL CHERTOFF, Department of Homeland Security, BEATA, Deputy Warden ROGER THOMAS, and DENNIS BOWEN, York County Prison,
Defendants,

: CIVIL ACTION - LAW : (JUDGE JAMES F. McCLURE, Jr.)

v.

THOMAS HOGAN, Warden, York County Prison, BEATA, Deputy Warden ROGER THOMAS, and DENNIS BOWEN, York County Prison,
Third Party Plaintiffs,

v.

UNITED STATES OF AMERICA DEPARTMENT OF HOMELAND SECURITY, UNITED STATES IMMIGRATION AND CUSTOMS ENFORCEMENT, Office of Detention and Removal of Operations, Division of Immigration Health Services,
Third Party Defendant.

EXHIBITl:! TO THIRD PARTY PLAINTIFFS' BRIEF IN OPPOSITION TO THE . THIRD PARTY DEFENDANTS' MOTION TO DISMISS THE THIRD PARTY COMPLAINT

Date: APRIL 7. 2006

By: /s/ Donald L. Reihart. Esguire Donald L. Reihart, Esq. Sup. Ct. I.D. #07421 3015 Eastern Boulevard York, PA 17402 Telephone (717) 755-2799 Assistant Solicitor for York County

INDEX
EXHIBIT
AFFIDAVIT OF DEPUTY WARDEN ROGER THOMAS .................................................... 1 Copy of Transcript of Grievance Hearing......................................................A Letter Dated August 23, 2005 ....................................................................... B Letter Addressed to Assistant County Solicitor............................................. C Letter Dated November 28, 2005..................................................................D
AFFIDAVIT OF WARDEN THOMAS HOGAN .................................................................... 2 DIHS Contract ...............................................................................................A 515105 Decision of the Complaint Review Board........................................... B

EXHIBIT "1"

IN THE UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF PENNSYLVANIA (Williamsport)

BENEDICTUS YARZUE Plaintiff,

: NO. 4:05-CV-01415-JFM-JVW

v.
THOMAS HOGAN, Warden, York County Prison, SECRETARY MICHAEL CHERTOFF, Department of Homeland Security, BEATA, Deputy Warden ROGER THOMAS, and DENNIS BOWEN, York County Prison,
Defendants,

: CIVIL ACTION - LAW : (JUDGE JAMES F. McCLURE, Jr.)

v.

THOMAS HOGAN, Warden, York County Prison, BEATA, Deputy Warden ROGER THOMAS, and DENNIS BOWEN, York County Prison,
Third Party Plaintiffs,

v.

UNITED STATES OF AMERICA DEPARTMENT OF HOMELAND SECURITY, UNITED STATES IMMIGRATION AND CUSTOMS ENFORCEMENT, Office of Detention and Removal of Operations, Division of Immigration Health Services,
Third Party Defendant.

AFFIDAVIT OF DEPUTY WARDEN ROGER THOMAS My name is Roger Thomas. I am a Deputy Warden at the York County Prison. have served as a Deputy Warden for the York County Prison since March of 1990. This Affidavit is based upon my personal knowledge and information. I am competent to testify and would state as follows if called as a witness at trial:
1.
I am the Deputy Warden of Treatment at the York County Prison and have been acting in that capacity since March of 1990. I was serving in that capacity during the entire time that inmate Benedictus Yarzue was confined in the York County Prison. continue to be a Deputy Warden through the present time.
2. On and before July 2004 and up to the present time the York County Prison had a grievance system in effect. I am custodian of all grievances filed by inmates at the York County Prison.
3. In March of 2005, inmate Benedictus Yarzue filed an inmate complaint (801) that was processed through the complaint review system.
4. The nature of inmate Yarzue's complaint involved his request for medical assistance, specifically a request that he be seen by a Urologist concerning what he described as a "prostate problem".
-2-

5. The staff at the York County Prison in passing upon inmate Yarzue's request determined that he needed to receive the urology consult and that he should also receive a cystoscopic examination.
6. A request was made to the Immigration Health Services Division for approval of the requested evaluation of inmate Yarzue. This was denied.
7. The contract that exists between the Immigration Department and the York County Prison requires approval of non-emergency medical care by the federal government. If approval is not obtained, any charges that are incurred in delivery of healthcare will not be paid by the government.
8.
The complaint of Benedictus Yarzue was appealed to the York County Assistant Solicitor who directed that the matter be heard by the Complaint Review Board. The Board is independent of the staff at the York County Prison. Warden Hogan sits on the Board together with the President of the York County Prison Board and a lay member from York County.
-3-

9. The Solicitor determined that: 'The inmate does have a valid Eighth Amendment claim when he produces evidence of a serious medical need that is not addressed. If there is a reckless indifference to the inmate's serious medical need, a constitutional violation occurs."
10. When the matter was presented to the Complaint Review Board a transcript of the proceedings was taken, as occurs in every case heard by the Board. A Copy of the transcript is appended hereto as EXHIBIT "A".
11. At the hearing, the Medical Director who is licensed by the Commonwealth as a physician expressed the opinion that the care requested by inmate Yarzue was needed and should be given.
12.
The Complaint Review Board granted the request of the inmate and directed that the care be provided.
13.
The local BICE agent was notified of the decision, but before the inmate could be scheduled for the necessary medical evaluation, he was transferred by the INS from York County Prison to Berks County Prison.
-4-

14. As the Deputy Warden in charge of Treatment I am familiar with the efforts of the medical section to obtain medical care for INS inmates that are located in the York County Prison.
15.
During the past year and a half, there has been a pattem by the Department of Immigration Health Service (DIHS) of routinely either denying legitimate requests for serious medical needs of INS inmates that is requested by the medical staff at the York County Prison or a protracted delay by DIHS by requests of "more information" so that with the expiration of time the Department can deport aliens without having to incur the expense of giving them treatment determined by the medical section at the York County Prison as necessary.
16.
Some examples of the pattem are set forth as follows: Amadou Diallo, #90832, Left knee injury (fall) request for orthopedic consult by prison Medical Director (Denied by DIHS, September 2005) Manuel Genaro Gavilanes-Quijije, #89666, Urology consult for PSA of 5.6 and prostate complaint requested by medical staff (Denied by DIHS, August 2005) Kwame McAuley, #87243, Request by medical staff for x-ray following operation on a broken leg (Denied by DIHS, August 2005) Mohammed Seyed Ghaziaskar, #79459, Request by medical staff for colonoscopy to rule out cancer (Denied by DIHS, August 2005)
-5-

Houng Thach, #89056, Request by Dr. Norris, Medical Director for CT scan to evaluate three nodular densities found on x-ray in inmates lung (Denied by DIHS, August 2005) Mannan Pepari, #88989, Dr. Gustin ordered an echocardiogram on follow up for coronary angioplasty (Denied by DIHS, August 2005)
17. In addition, in another case involving inmate Kailash Kailash the DIHS refused without valid excuse to approve the evaluation and removal of a baseball sized cyst on the back of an INS inmate's neck.
18. This matter identified as case number 120105B-0603 (Inmate Kailash Kailash) was also submitted to the Complaint Review Board with the result that the requested surgery was determined to be both serious and necessary.
19. The surgery was performed despite the refusal of DIHS. The cost, however, of this surgery was placed upon the County.
20. The County Prison staff is faced with a dilemma. DIHS must be requested to approve non-emergency off site evaluation and treatment. DIHS does not approve nonemergency treatment and it is delivered, the County must pay for this.
21. The decisions made by DIHS are not in compliance with the constitutional requirements required by the federal courts.
-6-

22. In a letter that I wrote to the local BICE agent concerning the DIHS pattern is set forth on a letter dated August 23, 2005 which is appended hereto and rnarked as EXHIBIT "B".
23. A letter addressed to the Assistant County Solicitor with which I arn farniliar is appended hereto as EXHIBIT "C". This letter reflects the ongoing pattern of the DIHS whose procedures appear to delay and stretch out the requests for legitirnate inrnate healthcare so that it is either not given or that the cost of the care is born by the local municipalities.
24. On Novernber 28, 2005, I spelled out again the problerns in a letter sent to the local BICE agent which is appended as Exhibit "0".
25. With reference inmate Yarzue, DIHS used the "failure to provide chronic masturbation counseling" as one of the reasons for denying the request of inrnate Yarzue that had been previously approved by the Cornplaint Review Board and apparently which prompted his removal from the York County Prison to the Berks County Prison.
26. I have been sued by INS inrnates because they did not receive healthcare which they requested.
-7-

27. For example, I was named as a defendant in Ferreiras v. York County, et aI., 4:CV04-1799, and as I understand it, will have to stand trial because I was not granted either quasi judicial immunity or qualified immunity. I am facing trial because I endeavored to follow the directions of the INS conceming dental treatment.
28. In that case, inmate Ferreiras, an INS inmate who suffered from HIV, had his 801 appeal approved for a hearing by the Complaint Review Board. Had the matter been presented to the Complaint Review Board, it is likely that he, like Mr. Yarzue and other inmates, would have been given the treatment that he requested.
29. Because Ferreiras was transferred before the hearing, the administrative system could not function, and the result was he was denied treatment that he requested, and I now am facing federal trial.

WI ness 0'
Sworn or affirmed to and subscri~~d to before me,
this -;.;n--- day of QI&--1,j::A:', ,2006.
~~~/
Notary Rublic '
My Commission Expires:

COMMON"WEALTH OF PENNSYLVANIA

Notarial Seal

.

Karon L. SIIltIoIl, Notnry PublIc

SpIinge\t>Jbury Twp., York County

My Commi"ion Expires June 2, 2007

Member, PennsylvanIa Associatlon of Notaries

-8-

EXHIBIT "A"

3

1

MR. REIHART: May it please the Board, this

2

is the appointed hour to consider complaint

3

grievance appeals. And our first case this

4

morning is Benedictus Yarsue, 031805H-0539. As

5

the Board knows, this is a matter that deals

6

with a medical request by the inmate concerning

7

some urologic concerns.

8

You have the right to make a sworn or an

9

unsworn statement. What would you like to do

10

this morning?

11

MR. YARSUE: I'd like to make a statement.

12

MR. REIHART: Would you like to be sworn or

13

unsworn?

14

MR. YARSUE: Sworn.

15

MR. REIHART: Please stand and raise your

16

right hand.

17

BENEDICTUS YARSUE, called as a witness,

18

having been duly sworn, testified as follows:

19

EXAMINATION

20 BY MR. REIHART:

21 Q. 22 A. 23 Q. 24 25 A.

Would you state your name. Benedictus Yarsue. Why are you in the York County Prison? You're an INS prisoner? Yes, sir.

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

What's your country of origin?

Liberia.

Have you been convicted of any crimes?

Yeah, I've been convicted of reentry and

manslaughter in '91 manslaughter and '95

traffic. Are you presently under any charges of any kind

other than as an INS prisoner?

No, sir. Now, you have filed an 801, a grievance,

indicating that you have some concerns about

your care here at the York County Prison. Is

that right?

Yes, sir.

Would you tell the Board what it is that you

would like to have them do?

Ever since I got here like about nine months -It's been about nine months now. I came through

Clinton County before I came to York County

I

was complaining about urinating and in pain a

lot at night. And I filled out a request form in Clinton

County to the doctor, and he refused to see me.

I had togo to like the warden before I could

see the doctor after complaining every night,

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1

getting up at like four or five times a night

2

urinating, constantly in pain.

3

And about two weeks -- two or three weeks

4

later on they shipped me from there to York

5

County, York County Prison. When I got here, I

6

filled out a request, a medical request form. I

7

went to see the doctor, and he put me on this

B

medication. It's for urinary tract infection.

9

And about two weeks later on my problem

10

wasn't improved, so I went back to him and

11

started complaining that I was in pain and I'm

12

waking up at night like four or five times a

13

night and constantly urinating. And because of

14

that, on my private area I'm in pain all my

15

private area.

16

And I can't sleep at night because of the

17

pain. I can't sleep. I get up at night.

18

Sometimes I have to wake up my bunkie to explain

19

my problem to him and tell him the condition

20

that I'm going through in here.

21

So he filled out a form-- The doctor

22

filled out a form for me to see the urologist.

23

I went to see the urologist about four or five

24

months ago, and he told me the problem that I

25

was having. He checked my prostate, and he told

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me that my prostate was enlarged a little bit

2

but he was going to put me on some medication

3

and if my condition has not improved to go back

4

to the doctor and let the doctor know so I can

5

corne back for a reevaluation so he can check me

6

to make sure that everything is all right with

7

me.

8

And I fill out a request form about two

9

months ago after being on the medication that he

10

put me on complaining to the doctor that my

11

problem have not improved and I'm constantly in

12

pain and for him to fill out a form for me to

13

see the urologist. He filled out the form for

14

me to see the urologist, and INS denied my

15

request for me "to see the urologist.

16

Every week I fill out a request form

17

complaining about my problem that I'm still in

18

pain and because of this I'm uncomfortable and

19

the pain give me headaches at night. I feel

20

like-- I don't know how the feeling is. It's

21

just unbearable. You know, like I get--

22

Because of my pain in my private area, I get

23

headaches. You know, I just feel real, real

24

bad.

25

I went back to the doctor and complained to

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1

him my problem. He checked my prostate and told

2

me that my prostate is still enlarged, that he

3

was going to fill out a request form for me to

4

see the urologist.

5

I filled out an INS request form -- I mean

6

talk to the INS why they have denied me for me

7

to see the urologist, that it was wrong for them

8

to deny me upon the urologist request for me to

9

go back to see him to make sure I was all right.

10

And they told me to fill out a medical request

11

form again to go back to the doctor.

12

I took this form back to the doctor, and I

13

show him, and he filled out another second

14

request form for me to see the urologist and

15

sent to INS. And when I went back two weeks

16

ago, he told me that INS denied me again so

17

there was nothing he could do.

18

So I fill out a 801. And from the 801, I

19

got a response, a 802 and a 804 respond back. I

20

give it to my lawyer. My lawyer have it. And I

21

put a request for her to send me back the form,

22.

but she have not send it yet. On the request

23

form I got 801-- I got a 805 and respond from

24

the 805 saying that the warden was going to turn

25

my case to the solicitor. That's the problem

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1

I'm having, sir.

2

MR. REIHART: As you know from looking at

3

the opinion that was written in this case,

4

apparently this is a situation where the medical

5

department in a timely way sent this inmate to

6

Dr. Baselli who is a local urologist who made a

7

determination that if he did not -- if this

8

inmate did not respond to conservative drug

9

therapy that he needed a cystoscopic evaluation

10

to rule out urethral stricture disease and

11

perhaps a voiding dysfunction.

12

NOw, without this test, I don't think a

13

diagnosis of inmate's condition can be made, and

14

I concluded that the prison here, York County

15

Prison, did everything right but the inmate

16

didn't get the treatment and the reason is that

17

INS refuses.

18

Deputy Warden Thomas has advised me they

19

have their own layer of bureaucracy that

20

apparently is designed to make it very difficult

21

to get a timely decision and to get a positive

22

decision on even meritorious requests.

23

Since we have this grievance system in

24

effect, the proper procedure for the inmate is

25

to proceed and for a recommendation to be made.

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Now, your recommendation would be to the York

2

county Prison Board who in turn would invoke the

3

services of the solicitor and take whatever

4

action is necessary to see the inmate gets the

5

treatment necessary.

6

Now, there's a problem here, and it deals

7

with delay. The obligation to pay for this lies

8

with the INS, not with York County. But if the

9

service is not paid for, the inmate can't get

10

it. So we have a problem here of we recognize

11

now there's a need and probably a need for a

12

more timely response, not only this man's

13

request, but this is not I think the first time

14

that we've had problems with INS turning down

15

what the staff here thought were legitimate

16

requests.

17

So in addition to solving the problem with

18

this inmate, we probably should find a procedure

19

to be able to address this kind of an issue in a

20

more expeditious way.

21

MR. HOGAN: Don, if I may, Doctor, as we

22

speak today, is that the circumstance?

23

MR. REIHART: Let me ask you a question.

24

Would you state your name, please.

25

DR. NORRIS: Yes, I'm Dr. Charles Norris.

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1

MR. REIHART: Are you an official here at

2

the York County Prison?

3

DR. NORRIS: Yes.

4

MR. REIHART: You're the medical director?

5

DR. NORRIS: Yes.

6

MR. REIHART: Do you have a comment about

7

this inmate's need?

8

DR. NORRIS: I would say they are qualified

9

and everything that has been presented thus far

10

is correct. I feel that the need to have

11

further evaluation as far as a urology

12

consultation is necessary. Urology-- According

13

to the urologist's notes from his prior

14

encounter with urology, it was recommended that

15

he have a cystogram or cystoscope to rule out

16

bladder neck obstruction or some kind of voiding

17

irregularity.

18

The other alternate diagnosis that we were

19

trying to evaluate was if Mr. Yarsue has

20

diabetes insipidus from a prior head injury,

21

blow to the head. We do know that sometimes

22

with such injuries that can result in diabetes

23

insipidus.

24

He has been treated conservatively with

25

medicine to reduce the size of his prostate and

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11

1

also F10max which helps as far as with voiding.

2

Neither of these have had much impact as far as

3

the overall condition at this point, so we need

4

to progress forward.

5

MR. REIHART: So diabetes insipidus has not

6

been ruled out at this point?

7

DR. NORRIS: No, it has not. And I have

8

submitted a request to INS.

9

MR. HOGAN: I think in the interest of--

10

You recommend it. We recommend it. I think we

11

just do this, and then I'll battle it out with

12

INS.

13

MR. ANDERSON: Do we have any choice but

14

that?

15

MR. HOGAN: I believe we can have enough

16

leverage with INS. I know we have a second

17

problem here where this has happened in other

18

issues where we recommend it, but we don't have

19

the authority to do it unless we're going to pay

20

for it. But I think in this case we need to do

21

that ASAP and follow the recommended medical

22

guidelines, and I'll deal with it.

23

MR. REIHART: Probably what you should

24

consider in your opinion would be to not only

25

solve this problem but to make some

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recommendations of an investigation into

2

improving the procedures to when there are

3

legitimate requests. I mean, when the medical

4

section is saying and the staff is saying that

5

there is a need for an evaluation and you have

6

to wait five months to get it, that's just--

7

MR. ANDERSON: Does the contract with INS

8

address these kinds of issues at all? Does it

9

go into that kind of detail?

10

MR. HOGAN: Not in that detail.

11

MR. ANDERSON: Could it? I mean, is this

12

something that could be negotiated as part of

13

the contract?

14

MR. REIHART: Well, they don't honor

15

everything about the contract right now.

16

MR. HOGAN: This is one of those we need to

17

do it, and I'll put the heat on them.

18

MR. CHRONISTER: What would be wrong if he

19

needs medical treatment, we went ahead and did

20

it and bill INS?

21

MR. HOGAN: The worst thing they could do

22

is they wouldn't pay, and that would be a

23

mistake.

24

MR. THOMAS: They have indicated that if

25

you provide treatment without authorization they

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I
4 5 6 7 8 9 10
11
12 13 14 15 16 17 18 19 20 21 22 23 24 25

13

will refuse to pay.

MR. HOGAN: that.

That's okay.

I'll deal with

MR. THOMAS: I understand.

MR. HOGAN: I think in this case we need to

resolve it now.

MR. THOMAS: Approximately four or five

months ago they carne up with a new level of

bureaucracy in Washington, D.C. Very quickly

what they were trying to do is cut down the costs of medical care for their detainees

throughout the country. And so they've got

doctors in Washington reviewing requests. Well,

the end result is they're in Washington. We're

here. We've got the inmate, and they've got the

purse strings.

MR. CHRONISTER: If this continues, is

there ~ny more damage or any more problems that

could occur if he doesn't have the treatment?

DR. NORRIS: I would say not that I know of

other than just being in the discomfort level

that he's at. However--

MR. CHRONISTER: But, I mean, there's no

chance that it could be cancerous?

DR. NORRIS: There's always a remote chance

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1

of that.

2

MR. HOGAN: I think he's done everything he

3

can do. I think we just need to resolve it, and

4

then I'll fight the battle with them.

5

MR. ANDERSON: I agree. This has to be

6

resolved. If we wait for INS, that's not fair

7

to him because he's caught in the bureaucracy.

8

MR. REIHART: I think we do need to address

9

this issue of what happens now when the next

10

request is made by the medical section for a

11

legitimate need and they say no. There ought to

12

be a more-- And in that case that person does

13

have something where early recognition would

14

make a difference, can't--

15

MR. ANDERSON: Don, with a bureaucracy like

16

INS and the attitude they have, we can make up a

17

major wish list, but they have the last say.

18

MR. REIHART: I think on this particular

19

thing I think there needs to be a clarification

20

as you suggested on the contract. I don't think

21

we can live with a situation where they can

22

stonewall and delay the entire time and put us

23

in a position where we pay for it and then can't

24

get the money back because we haven't complied

25

with their--

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1

MR. CHRONISTER: I mean, how often has this

2

come up over the years? Is it once a year? Is

3

this something that regularly happens?

4

MR. THOMAS: We've had-- We've had four

5

this year.

6

MR. CHRONISTER: Where the medical--

7

MR. THOMAS: This is just starting.

8

MS. SABOL: I would just like to add we

9

requested a change to the contract as far as

10

remuneration last year in March, and we still

11

haven't heard anything, so it's not something

12

they proceed with quickly. So if you're looking

13

for a modification to the contract to solve this

14

problem quickly, I don't see that happening.

15

MR. HOGAN: There is an alternative which

16

we'll talk about later.

17

MR. REIHART: Do you have any other

18

comments that you would like to make other

19

than-- You've heard that we're going to do

20

whatever is necessary to get you this

21

cystoscopic evaluation you need and to get you

22

proper treatment, okay?

23

MR. YARSUE: Yes, sir.

24

MR. REIHART: Thank you for coming.

25

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EXHIBIT"B"

THOMAS H. HOGAN WARDEN

YORK COUNTY PRISON
3400 CONCORD ROAD YORK, PENNSYLVANIA 17402-9007

TELEPHONE 840-7580 AREA CODE 717 FAX 84D-7204

TO:

Joe Sallemi, DADD

BICE

FROM:

Roger S. Thomas Deputy Warden

RE:

Medical Problems

DATE:

August 23, 2005

I am in receipt of your letter of 8/18/05. In your letter you indicated that you were seeking something in writing stating that DillS would be legally liable in any lawsuit filed by a detainee in cases where DillS denied specific treatment. As oftoday's date no such correspondence has been received.

York Couoty Prison is required to provide medical treatment to all inmates incarcerated at the prison. We carmot and will not be deliberately indifferent to serious medical needs. When a BICE detainee requires medical attention, our medical department will cooperate with DillS procedures and complete and submit a Treatment Authomation Request (TAR). IfDillS requests furtber information (they frequently do), our medical department will then send the entire medical recard. DillS will then have in their possession all the information that our medical department has obtained. If DillS denies or delays the request, our medical department will then determine if the medical request is serious enough that it carmot be iguored. If our medical department determines that the detainee has a serious medical need that requires medical attention that has been denied or delayed by DillS, then BICE will be asked to remove the detainee to a facility that accepts the treatment that DillS is willing to provide. IfBICE does not act on our request within 10 days, then our medical department will malce arrangements to provide the detainee with the medical treatment they feel is necessary.

As I have stated in the past, we will not beg DillS to provide necessary medical treatment to detainees. I am sure that DillS has access to numerous attorneys who will defend their decisions and instead seek to blame Yark Couoty Prison for any failure to provide medical care. I am not going to attempt to tell DillS what to do or not do. If DillS's decisions are appropriate, then there are numerous institutions that would be

"EQUAL OPPORTUNITY EMPLOYER"

willing to accept the detainee and not provide the medical treatment. All we ask is that you send the detainee to one ofthose institutions.
In your letter you stated, "IfYCP proceeds with unauthorized medical treatment after the 10 day period, you are doing so on your own volition."
Regardless ofwhat you say, BICE's actions will speak louder than their words. If after 10 days the detainee is not removed, York County Prison will have no choice but to provide the health care that the prison's medical department feels is necessary. BICE will be charged for that medical care. IfBICE does not wish to assume financial responsibility for the detainee's health care, then please remove the detainee. BICE cannot refuse to move the detainee, refuse to authorize necessary medical treatment and then leave YCP to assume all the legal ramifications ofBICE's decisions.

EXHIBIT"C"

RECEIVED
SEP 0 6 ZOOS
YORK CULJI~ J r L ~U"'t:KS
I
RECEIVED SEP 0 7 2005 September 1, 2005
Mr. Donald L. Reihard The County Commissioner of York County County Administrative Office One West Marketway, 4th Floor York, Pennsylvania 17401

{fiee ofDetention and Removal Operations J.S. Department of Homeland Security 425 I Street, NW Washington, DC 20536
u.s. Immigration
and Customs Enforcement
RECEIVED
SEP a6 ZOOS
YORK GuuNTY COMMISSIONERS

Dear Mr. Reihart:

Thank you for your recent letter dated June 23, 2005, to the Department of Homeland Security (DHS). DHS has forwarded your letter to U.S. Immigration and Customs Enforcement (ICE), Office of Detention and Removal Operations (DRO), to address your concerns. First we wish to state that the health issues of Mr. Benedictus Yarzue are very important to us, we wish our detainees to be in good health while in detention.

We understand that York medical is requesting a urologic procedure called a cystoscopy, an outpatient procedure done by an urologist, who inserts a thin flexible fiber optic camera lens through the penile urethra and into the urinary bladder. This test is indicated primarily to look for bladder abnormalities such as cancer, structural problems or deformities of the bladder, urethra, or urethral opening.

However, an urologist saw Mr. Yarzue on November 18, 2004, for complaints of dysuria (difficulty or pain in urination). The urologist stated that the problem was most likely due to either a urethral stricture, an infectious cause, to voiding dysfunction, or to irritation due to chronic masturbation. The urologist doubted that the symptoms were due to an enlargement of the prostrate gland. He prescribed Flomax for possible voiding dysfunction. He also recommended addressing the issue of chronic masturbation with the detainee at the next office visit. If the detainee's symptoms were no better while taking Flomax, then the urologist recommended catheterization to check for residual urine and to calibrate the urethra to· check for urethral stricture. Only after the above evaluations were completed would the urologist proceed to cystoscopy. To date, York medical has not completed the evaluation and counseling requested by the urologist.

Based on that review, Department of Immigration Health Services (DIHS) believes that the medical staff at York has not provided proper evaluation and counseling of the detainee on-site and that further off-site evaluation is not yet warranted. Chronic masturbation counseling and the check for post-void residual can and should be done on-site by the York medical staff. Regarding the determination of the York County Prison Complaint Review Board, which met on May 5, 2005, ICE medical personnel were not involved in the discussion and were not given an chance to present an opposing medical opinion.

Mr. Donald L. Reihart Page 2
In previous discussions with the Warden of York County Prison, DRO Detention Management has consistently taken the position that ICE will not reimburse the prison for any unauthorized off-site medical testing or treatment provided to Mr. Yarzue that their medical department independently chooses to pursue. Detention Management still maintains this position. Mr. Yarzue has since been transferred to Berks County Jail, Leesport, PA, on August 3,2005. DillS will continue to follow this case and if medical indications change, will reco=end whatever testing deemed warranted. Thank you for your patience in awaiting our response, and thank you for writing.
~1L$w ~ ~eSley J. Lee Acting Assistant Director

EXHIBIT "0"

THOMAS H. HOGAN WARDEN

YORK COUNTY PRISON
3400 CONCORD ROAD YORK, PENNSYLVANIA 17402-9007

TELEPHONE 840-7580 AREA CODE 717 FAX 840-7204

TO: FROM:

Joe Sallemi D.A.D.D.

Roger Thomas /.7

J

DeputyWarden f7~Aj.

DATE:

11128/05

RE:

Division ofImmigrationHealth Services (DillS)

As you know, we have had quite a few problems with DillS of late. While it may appear that they are simply trying to save the government money by looking at detainee medical expenses, in my opiuion they have set up an elaborate system that is primarily interested in delaying and/or denying medical care to detainees. You are my contact person with the Philadelphia District so I feel it is my responsibility to keep you informed of the problems DillS has caused.

Let me explain:

1. In order to receive authorization for detainee medical care, you must fill out a

Treatment Authorization Request (TAR). Although the space to request

treatment is only % of an inch, DillS demands that we provide:

a. Physicians Diagnoses

b. What are we requesting

c. Duration of the complaint

d. Date of complaint

e. Precipitating factors

f.

What are the symptoms

g. What treatments/meds have been provided

h. Provide progress notes/substantiating information

Demanding that all that information be jammed into a % inch space is not
something an agency would do ifthe agency were interested in things running
smoothly.

"EQUAL OPPORTUNITY EMPLOYER"

2. Regardless ofhow serious the request is, DIHS has a habit of "sitting" on TAR's. The latest example (Mei Ying Xiao) was a 13-day delay. IfDIHS were truly interested in providing a service (instead of delaying service) they wouldn't sit on a request for nearly 2 weeks.
3. Many times when we do receive a response it is not given an approval or denial. Instead DIHS requests further info=ation. This further delays trea1IDent.
4. Many times when DIHS requests further info=ation it is for things they lmow we would not have (e.g. X-rays from 1997, or mammogram from a recently incarcerated detainee). When we receive detainees from BICE we never receive medical records and DIHS lmows that. I am sure that DillS would state that they are only trying to obtain info=ation to make a decision. To request info=ation, however, that they know or should lmow we do not have serves only to delay authorization for necessary health care.
5. If DillS requests additional info=ation and they don't receive it inwhat they consider "a timely manner", then the case is closed and a new TAR is required. Our policy is to send the entire medical record to DIHS but that doesn't count. I have no idea how long a "timely manner" is but it is certainly shorter than the 13 days DIHS takes while they sit on TAR's. If they close the case, that delays trea1IDent.
6. While our medical department must prepare elaborate TAR's to request authorization, all DIHS has to do to stop the process is to demand ridiculous info=ation (e.g. X-rays from 1997 for a detainee received in 2005). DIHS is in the position of "placing the ball back in our court" with one 10 word sentence. In the guise of seeking info=ation they have deliberately delayed trea1IDent.
7. If a TAR is returned unapprovable or denied, then the case is locked and in order to open the case our medical department must start the process allover again. An example of a case that is "unapprovable" occurred recently. One of the Doctors at DillS wanted to ."watch" the case of the detainee with lumps in her breasts. He can't possibly watch the case because he is located in Washington D.C. Our medical staff will watch the case and we don't work for DillS. According to DIHS we are to keep DillS info=ed of any changes. In the meantime, however, they have completely closed the case. They will never even ask how the detainee is doing. DIHS seeks to deny necessary trea1IDent while malcing it appear as if they are truly interested in the detainees well being.
8. While DillS has info=ed you verbally that they are responsible for their medical decisions they have never put that in writing. I don't believe they will without pages of legal caveats. If something went wrong and a detainee died after following one of the recommendations from DIHS, I believe that an army of BICE attorneys would suddenly appear claiming that our medical department did not give them enough info=ation for DIHS to malce a decision. Therefore, it would be our medical department's fault that the detainee died.

9. There is nothing easy about working with DillS. If something can be delayed, it is delayed. If it can be denied, it is denied. Ifsomething can be made difficult, it is made difficult. Most importantly, ifthere is some bureaucratic procedure that will 'delay/deny treatment to a detainee, place the "ball back in our medical department's court" and "cover the backsides" of DillS, you can be assured that DillS will do it.
10. I am attachlng copies ofTAR's to support what I have stated. You may do what you want with this info=ation. You are my contact for the Philadelphia District. I have not and will not tell a massive Washlngton D.C. Bureaucracy like DillS what to do. I can only state that I will not participate in the denial or delay ofwhat our medical department feels is necessary health care. If DillS refuses to authorize medical care then I will ask you to move the detainee to a location that concurs with DillS. If you refuse to move the detainee then BlCE will assume the cost of that necessary care.

T~'~'iMiatjon HeaJth Services

Treattnentr ~uthorizatjoi1 & Consultation Form

>ENO CLAI~lS TO:

Immigration Healtll Services

1220 L 5tr"e~ NW

prl8468

Washington, DC 20005-4018

Phone: Ui00.479.0523

Fax: 1.866.475.9349

.'

.,:

.... -.
"

A separate treatment authortz,atign request will.be' required for services beyond and outside the scope of the original authorization. Services rendere<l'may not be paid without an approved authorizatIon. All payment for services is subject to detainees' eligibility and cu;;'iody. All claims are subject to retrospective review, For further guidance and inFormation, please reFer to the DIHS website: www.inshealth.ara or contact the Iminigration Health Services' ~Ianaged Care Branch at 1.S88.718.8947, ~I-F SAlVI - SPM EST.

Please ensure all claims include the Patient IdentiFication InFormation and the Authorization number.

IMPRINT OF DETAINEE ID PLATE, COMPUTER LABEL OR COMPLETE BELOW:

Name: KWAME Al1SA ~IC AU LEY

Alias:

DaB: 09/27/1980

A#: 074953075

Nationality: TRINIDAD AND TOBAGO

Fac1l1ty: YORK COUJIfTY JAIL PA

AUTHORIZED ACTION:
Status: Pended - More Info Service Type: Emergency Referral Type:

Auth #: 200507156606 00

To! (Name and Phone to'whom referral is being made)

Authorizer: Bleen Falzini, RN .

Dialogue of Request:
Cannot approve due to requested clinical infomnatian not received. 1. Physician's Ox: (If a mass ar lump, indicate size) . 2. What you are requesting: 3. Duration of complaint: 4. Date of complaint: , 5, Precipitating factor(s): 6. What are the symptoms: 7. What treatment(s) / meds Ilave been used: 8. Fax any progress nates/substantiating information that wITI assist LCDR FaizinijCAPT Ganaway, 202.732.0119.
Updated by Eileen Falzini, RN on ~/landay, July 18, 2005
-;i:iiJ--J;5jjjiJcTrtj/O--7J7tfil'ArlFC--RX ffldY
ORIF right femur 6/2004 CIO pain ambulates with crutches needs x
.'
Provisional Diagnosis: 88.3 OTH X-RAY

No T£ De'i'\.1A7tJ£JE'll
) )JFOf«(IYI/I17W
k:

ConSUltation Report:
http://inshealth,org/TARWeb/ViewAuthFarrn.aspx?id={7A6 72319-E6D8-4,.. 7/18/2005

UNITED STATES FUBLle llliALTH SERVICE

DIVISION OF IMMIGl?..ATlON HEALTH SERVICES (DABS)

TREATMENT AUTI-IORIZATION REQUEST (TARj

immigralion H~Jlih SJ;!"IkC5

l..!]f.: f. '~Il';;~'_ p.:VJ PM846g· 1H;sbinglOn.D.C., 2UOD5

?h')I!'; !··58.;s-ll§·894? f~;; 1-8'65475-9349

..... ,;

Is lhis request a TAR APPEAL (Plea.:;!:: circle one=-)

Yf_S

NO

If YES; it i., requiT"cilhal you _~rovidc the TAR NUIVIBE~you art appealing:_ _ _ _ _ _ _ _ _ _ _ __

-Detention Faci lity"'~ _ _-:::::::-:-:;"-,,,-" _ _,,..,..:--...-_ _ _ _ _ _ _ _ _ _ _.!PJ]h!!<o!J'nt~#t.:*_______________

-.-n -n=________________ Md,",s·: ___---:::-=--7\:,,---""-:0"-._.---r;y· od-'(,+[=----=dt-·_ _ _ _ _ _ _.J:F"'ox!!::H='------_ _ _ _ _ __

Ciry', -----~+C7:-;.-I--_ _

tJ

Slal"~: _ _ _ Zip~: _ _ _ _ _ __

DETAINEE INFORMATION

rq1Ca1w~J-e~ ~f:?-fjyvt~ LasIName*:
Alien1D*: "J:+
Jjt1!, Camp Arrival Date':

)

.

?

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0

7

"

,

>
Country

of

OrigDiant':c-0"i4)J'Bt-i-~t-ht-'1:AHt-1Ftior~s>t-'\: 1<~/rf\Itirg:Q-J.J.)ie,/'-S-e-x-':-M--al-e~)i-";F-em--a-lc-0--

RlcASON FOR REFI;;RRAL RE UtlST

Di.gnO'iSISymPtoms.:.c02&l1:J~lj?~LJ~&;b~y"f!:::~~:e-g\..¥·-!..,_~c/1Jb~-.JSl~:!-~~,;:;,-:~~~~t2-,~,!~f"

CtlrL e Cou",e OfTreauncnr':

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~.

TJ&=3f'> -p. (j;/fBiL{..(.i 7±1

, .

s ,--,-". (ru C£-L< 1U'-(c-

CPTICDT:_ _ _ _ _ _- - . __"_.__

-

- A £STA'nON OF iJ£-fAINE£ cus-roOY

asof____ ~_.

(PRINT NAME-)

ITDDA Y-S DAl

TAR form is correct to the best of my knowledge and tha.t the detainee is not a U.S.
o US Sorder Pa",,\ (BP) - Pleas. circle one of the rollowing aDd provide: FIN 0 o US Immigration and Customs f.nfOJ'cernenuDelcr'L1iOn and Removal (IC[.JDR..C
o US Office ofRefuBee Re.,ertlement (ORR)

from

(CUSTODY BEOrNNlNO DATF."")

~ ____~~~~~~~~.--
(("US'IUDY I:rW OATE·)

'SPf¥-E fO

frITLE:t:)
PROVIOER OF MEDICAL CARE AND OTI
P(ovider's'Name,*"T: _ _ _ _ _ _ _ _ _ _ _ _ _ _~------

Provider's Phone Null1ber*±:_ _ _ _ _ _ _ _ _ _ Pr'ovidcf'S City**!_ _

oms J\UTHORIZI\.nON ACTI (To be rompl.m:d by OIHSONf.y)
DlHS Managed Care Coordinator (MCC): _ _ _ _ _ _ _ _-,-_ _ __
(Siglfoflwd

MCC TAR Action:

Approvcd 0

Denied 0

Pedded 0

MCC COO1menlS:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Plctlst' provIde" copy anile "i\pproved- TAR to the lleilltI\ Se(vjce rravidM. NOIl-~rnergeJll health services will no! be pilid wiLhuuL un llpprO\'t!u TAR i~sUl::d rrinr La hCllllh services being rcndcfeu. F..mergcncy hcalln serviccs rcquirt: TAR ;:ubmillui within onJ: bu.;;inc5S dRY oiler being sO\lghl. A scparalr: TAR will be- required for heal\J! services b~yOlld ilnd oUI5ide Ute scope ot"the O(~gjl1itl \lllihofized TAR. For henllh L'i'lre claim stalus iilQuirii:5. ti..Lll 1-800-479-0513. Tu appeal a TAR lil!d!lion orDTHS L~ nol iluthorizt:: a ~t:rvic:t!. il ut::h:nlitln laciliLy must !iubmit:; TAR Appeal lhrou~h Ihe TAR prQcc.~!i alJd include till: following infQm1:1lion: aJ -'rAJ~ Appcal'-. b) TAR numher and (lthcr inJorrn:llion frOlll TAR. being <lp[~ei1led. I:) requcSTcd {tCLion. "Ild c)juslillc3Iion lar the rcqll~~5,cd :lCIion. For r'lither gnid:mce <lnd infoml(llilJn. pJ~5C" visit our w~bsil~ ill: \~ II .in~11l,.\lIh.ol'g or Con[llCl 'h~ DllIS' Millluged Cart CoordillulClrs ill I-BI3.2-7 J 8-8947_ M F.8li.M 6 PM EST. '
* Failure /0 complete requiredjields will result in an inability ofDIHS to process TAR_
""Required Hillen reason for TAR submittal isfor emergency health services_
R~1'!5ed 20050"111

PRlSON HEALw
SERVICES, INC.
•

..J.-I-4.!+..:l~--Il /I} q}b5
--.0ZJ;:3=it!:f±t::::LJ.!:!.1D ~

To:
fUOrE Fk1--. TO
7)1 H- '$ ojJ

Re:

( II/-I/()S

ID com~
)1\ 81l ct .

)
Number oftransmitting Pi...I;1~ \" :~'~~"'I;I ....~ r'~>:I~/~ ~
Telecopy Number: (717) 840 -7604
If you are having any problems with this transmission, please call us as
soon as possible at (717) 840 - 7637.

Thank You.

Bridget Smith ---------PRH=!tS>+liE-MSA-CGIT-€lGtiGfl3I-CaIBFe----
York Cou nty Prison Medical Department

Division of Immigration Health Services

Treatment; 'Authorization & Consultation Form

SEND CLAIMS TO:

Immigration Health Services

1220 L Street, NW

PMB 468

Washington, DC 20005-4018

Phone: 1.800.479.0523

...~' '

Fax: 1.866.475.9349

. , ~

A separate treatment authorization request will be requirec for services beyond and outside the scope of the.o'figinal authorization. Services rendered may not be paid without an approved authorization. All payment for services is subject to detainees' eligibility and custody. All claims are subject to retrospective review. 'For further guidance and.lnformatlon, please refer to the DIHS webSite: www.inshealth.orq or contact the Immigration Health Services' Managed Care Branch at 1.888.718.8947, M-F 8AM - 8PM EST.

Please ensure all claims include the Patient Identification Information and the Authorization number.

IMPRINT OF DI
Name: Mel Ylno DaB: 08/08/1962 Nationality: CHINA, PEOPLE'S RE
AUTHORIZED ACTION:
Status: Pended - More Info
Servlce Type: Non-Emergency
Referral Type: 33

fVZrTr 'beLft-c(
fkjJ C)I(J G DVlatlf:.. /IUFo
-<

IR COMPLETE BelOW: 'A
:hang Park, MD

To: (Name and Phone to whO!

Smith Rad

Dialogue of Requesj::

2. Dr. Park wanted to know: When was her last mamogram? Are results available? Does the lump change during her cycle? ~ N '"

1: Left breast mass R/O malignancy Left breast mass about 1cm x 2cm slightly tender
first noticed about 9 months ago
numerous smaller cystic masses in both breast positive family history of breast cancer - mother. Patient needs approval for mammograms I did fax this tar on 11/3/05 because it would not go through system I di, so i entered
This event's case was created by TARweb and should be verified ror data
The following patient information was entered manually:
Patient Alien # :073572851

N6TE Ff1cX Ft26r'A
ull+S TD ()Ut( {VleJj !CA:L ()? f rr
t

https:/1www.inshealth.org/tarweblViewAuthForm.aspx?ido:{DAF517D4-735D-...11/16/2005

~

Jrrnrnigration Health Services

Treatme.nt, Authorization & Consultation Form

,~/ 'f¥¥#!!!&t't'&~iW**~~ii. i«f!liiii4i#i.i1i

;j~D CLAIi"IS rO:
frnmigration Health Services '1220 L StreEt, ~IW
P~18 468 Washington, DC 20005-4018 Pho'ne: 1.800.479.0523 ; Fax: 1.866.475.9349
.'
A separate treatment authorization authorization. Services reni;!ered m' to detainees' eligibility and' custody. please refer to the D1HS website: 11 Branch at 1.888.718.8947, r~-F 8A~

fli0T.f'. '[)e1J1 ftL, ~(f'r<J!£
VI HS !LJ/fJ-i!£IJ
X !2Io/S' f1ZtJh< /7 f 7

Itside the scope of the original ,II payment for services Is subject 'urther guidance and information, th Services' Managed Care

Please ensure all claims include the
IMPRINT OF DETAIl Name: Houng Thach DOB: 04/12/1952 Nationality: COMBODIA

1/ jc;5 // uemiiUe~ .EJ.,Jff-tee() /l£/.S!J;...) 20 \

ltlon number. )MPLETE BElOW:
PA

AUTHORIZED ACTION:

Status: Denied

'Auth #: 200

Service Type: Outpatient

Referral Type: Medical TestjLab

c,h.~ ~ '7jIQ[05

To: (Name and Phone to whom referral is being made)

'.' _.. - ''- ._- .- f \. . ,-., ? Dla!ogue of Reques,:

-~i.--CN-S-l~)QVlA-~- ~;'roj~-;-l'-)~'A~-[~-q I -,

I~-ryJZflt; 1(;Jg;.

-1 U

r U

J~r, \~.

.:;lJ

,-,,' L

1y,/J. er~I,

Cannot approve due to requested clinical infJmqffo not received. If request is sti!1 viable, please resubmit a TAR(.mJA

with the requested information.

.M lNS rt~ue::JkD! \'Y\.~'(G ,~~

IJI

Cannot approve .clue to requested clinical information not received. Please fax by COB 7/22/05.

1. Physician's Ox: (If a mass or lump, indicate size)

2. Wilat you are requesting:

3. Duration of complaint:

4. Date of complaint:

5. Precipitating factor(s):

6. What are the symptoms:

7. What treatment(s) / meds have been used:

8. Fax any progress notes/substantiating information that will assist in making the best medical decision. FAX to

LCDR Falzini, 202.732.0119.

.

.-

Updated by Eileen Falzini, RN on Friday, July 15, 2005

Patient needs CT Scan left lung masses 3 upper lobe denSities - RIO granulomata positive ppd on admission chest x-ray found above nodules Radiology recommends CT scan for fUither e'lal Patient is asymptomatic
http://inshealth.org/TARWeblViewAuthForm.aspx?id::{35F9E015-7016-41... 7/26/2005

TARweb Authorization Form
Division of Immigration Health Services

t'oge lor j
Treatment, Authorization & Consultation Form

SEND CLAI~iS TO:

Immigration Health Services

1220 L Str.'jet, NW

PMB 468

Washington, DC 20005-4018

.,.'

Phone: 1.800.479.0523

Fax: 1.866.475.9349

A separate treatment authorization request will be required for services beyond and outside the scope of the original

authorization. Services rendered may not be paid without an approved authorization. All payment for services is subject to

detainees' eligibility and custody. All claims are subject to retrospective review. For further guidance and information, please

refer to the DIHS website: www.inshealth.ora or contact tbe Immigration Health Services' Managed Care Branch at

1.888.718.8947, M-F 8AM - 8PiVi EST.

. ...

Please ensure all claims Include the Patient Identification Information and the Authorization number.
u

IMPRINT Of DETAINEE lD PLATE, COMPUTER I

Name: AiVlAOOU OlALLa

~lias:

DaB: 11/20/1968

l": #: 07360

Nationality: MAU

Facility: Yorl

;U0TE '[):?tJ/ It ( lJeCft;USE CJF

AUTHORIZED ACTION:

/ jJFtJ72IY'I111'6YJ iJa T

Status: Denied

Auth #: 200510065101 00

Servlce'Type: Non-Emergency

f?ecel u . Authorizer: Maryic

e6

Referral Type: 11 -
To: (Name and Phone to whom reterra/ is being made)

Ljer TIfC-j l/?fde
!3"pT!;2£ /J'le./JI c/tG

Ortho Clinic 717.851.2427

/7t. (tJ;d) I

Dialogue of Request:
No information received. Please resubmit TAR wi the requested info.
2. Please fac 202.732.0119 consult notes and other relative progress notes for medical review by COB OCT 14. I do have medical record (AUG 05)Thank you. Updated by Marylouise Ganaway, RN on Tuesday, October 11, 2005
1. These are not duplicate there are 4 appointments that need approved
patient seen by ortho on with the diagnosis below. Patient dx with Torn ACL/meniscus tear left knee Ortho dodor recommend that he have ortho follow up to give consent for surgeyr This occured July 2 2005 complain of pain left knee instability leg imrnobilized , non weight bearing. Therapy
NSAID I crutches
Provisional Diagnosis: 717.83 OLD DISRUPTION OF ACL
https:llwww.inshealth.org/tarweblViewA uthForm.aspx?i d={DC1 F6 AE7-C3 26-". 10/19/2005

of Immigration HeaJth Services

Treatment, Authorizati9!l & Consultation Form
~

SEND CLAI~iS TO: Immigration Health Services 1220 L Street, NW PMB 468: Washington, DC 20005-4018 Phone: 1.800.479.0523 Fax: 1.866.475.9349

..' ,.'

A separate treatment authorization request will be required for services beyond and outside the scope of the original

authorization. Services rendered may not be paid without an approved autllorization. All payment for services is subject to

detainees'.::Iig!'JlIiv; and custody. All-claims are subject to retrosJf.3ctive review. For further gulc!ancc and information, please

refer to the DIHS website: www.inshealth.org or contact the Immigration Health Services' Managed Care Branch at

1.888.718.8947, M-F 8AM - 8PM EST.

. '..

Please ensure all claims indude the Patient Identification Information and the Authorization number.

IMPRINT OF DETAINEE ID PLATE, COMPUTER LABEL OR CQMPLETE BELOW:

Name: Mel Yinq

~lias:

DOB: 08/08/1962

f',#: 073572851

Nationality: CHINA, PEOPLE'S REPUBUC OF

Facility: York Co Jail PA

AUTHORIZED ACTION:

Status: Unapprovable

Auth #: 00003094200511186593 00

Service Type: Non-Emergency

Referral Type: 33

To: (Name and Phone to whom referral is being made)

Authorizer: Marylouise Ganaway, RN

Dialogue of Request:

/U6'{E TftR

Il-N L Rec'd faxed infonmation today. Previous TAR was closed so I opened this

f) ()((<C(J[) /r

I ;u r Faxed info indicates that lump does not change during her cycle and thai jJ Fo

&1 ~Ce/ l/C() //0

studies have been done.

I' ' TlmI t::. ('f

t' ;7/llt~.nJ(? <....

,"

i. Dr. Park would like to watch this for 3-months.

'

~

IF- TITIC ii. If there is any change in size or its condition before the 3 months, ple';J6

t!. [0 ~£ / r

_ Iii. If you know there h~s been a change in size from your intake physica

0;:'

changes now.

U;U/tf'j!!ZcJv/f1'3 (..£

ZJeN / IJ Thank you. Updated by Marylouise Ganaway, RN on Friday, November 11

£.

1. REASON FOR REFERRAL:

~

Information below copied from previous TAR which was closed since information had not been received in a timely manner. PLEASE NOTE: whenii'TAR is marked APPD, Unaaprovalbe or has been denied, it is locked and requires that a new TAR been submitted RE that request.

3. When you have the requested info, please resubmit for consideration.
https:1 Iwww.inshealth.org/tarweblViewAuthForm.aspx?id={01FCC2FB-CA9A-...11/21/2005

Treatment,·Authorizati9tl & Consultation Form

SEND CLAH'IS TO: Immigration Health Services 1220 L Street, NW pr'~8 468, ' Washington, DC 20005-4018 Phone: 1.800.479.0523
."
Fax: 1.866.475.9349

A separate treatment authorization request will be required for services beyond and outside the scope of the original

authorization, Services rendered may not be paid without an approved authorization. All payment for services is subject to

detainees'.::lig!~ilit'; ann custody. AII-<:laims are subject to retrosv-:ctlve review. For furtllcr guidance and information, please

refer to the DIHS website: www.inshealth.org or contact the Immigration Health Services' Managed Care Branch at

1.888.718.8947, M-F SAlVI - 8PM EST.

. .

Please ensure all claims include the Patient Identification Information and the Authorization number.

IMPRINT OF DETAINEE 1D PLATE, COMPUTER LABEL OR COMPLETE BELOW:

Name: Mel Yinq DOB: 08/08/1962

IAllas:
IA #:. 073572851

Nationality: CHINA, PEOPLE'S REPUBUC OF

Facility: York Co Jail, PA

AUTHORIZED ACTION:

Status: Unapprovable

Auth #: 00003094200511186593 00

Service Type: Non-Emergency

Referral Type: 33

. To:' (Name and phone to whom referral is being made)

Dialogue of Request:

,5 Wft-/U

1,-
Tb I { {,tJ A-TC/f

De. (fT/lve e ieT
Q;q-Jj5: IS (!L() S'EIJ (

Rec'd faxed information today, Previous TAR was closed so I opened

Faxed info indicates that lump does not change during her cycle and studies have been done.

i. Dr. Park would like to watcll this for 3-months.

.

ii. If there is any change in size or its condition before the 3 months, please submit a TAR with the new information,

_ iii. If you know there has been a change in size from your intake physical to now, please submit a TAR with those

changes now.

-

Thank you, Updated by Marylouise Ganaway, RN on Friday, November 18, 2005

1. REASON FOR REFERRAL:

"

Information below copied from previous TAR which was closed since information had not been received in a timely manner, PLEASE NOTE: Whena'TAR is marked APPD, Unaaprovalbe or has been denied, it is locked and requires that a new TAR been submitted RE that request,

3, When you have the requested inro, please resubmit for consideration,
https:/ /www.inshealth.org/tarweblViewAuthForm.aspx?id=(01FCC2FB-CA9A-...11/21/2005