Grantee on Panel Discussing Negligence in Tribal Jail Deaths

On Thursday, November 18, 2021, grantee Nate Hegyi was joined by Chris Yazzie, Brandy Tomhave, and Thea Wilshire for a conversation on the future and state of tribal jails.

Hegyi’s Pulitzer Center-supported project, Promised Justice, tells the stories of neglect and insufficient medical care and resources in tribal jails. Yazzie is a Navajo grandfather of four multi-tribal granddaughters and a registered nurse with the State of Arizona. Tomhave, a lawyer, is an enrolled member of the Choctaw Nation and has dedicated her legal career to untangling federal policies that undermine tribal sovereignty and violate the rights of Native people. Wilshire works as a psychologist, author, and educator.

Leading the conversation, Yazzie spoke personally about having lost his brother Carlos to medical neglect in a tribal detention center in New Mexico, Hegyi reported. The sons of a Vietnam veteran, Yazzie and his brother grew up in a challenging home. Yazzie’s brother battled alcoholism for years, and he was often in and out of tribal jails.

“My brother often told me about times he was mistreated by the Navajo police; it got to a point where the police officers were desensitized to my brother’s alcoholism. The night he died, it was documented that he was asking for medical attention, he was laughed at, ridiculed, and put in the cell. He died the next day,” said Yazzie, describing the scene leading up to his brother’s death at the detention center.

Hegyi said, “Carlos' (Yazzie’s brother) story is not unique, unfortunately, 19 people have died in custody in jails overseen by the Bureau of Indian Affairs (BIA) and the government.” In reflecting on Yazzie’s brother’s case, Hegyi noted that Carlos’ blood alcohol level was one that should have been treated at a hospital, not a detention center.

Tomhave focused her remarks on the role and responsibility of government agencies. She has been working on the issue of tribal jails for nearly a decade.

“Bureau of Indian Affairs actually doesn’t have a budget for corrections health care. Neither of the primary federal agencies (BIA or Indian Health Services) that handle incarceration have a budget for taking care of incarcerated American Indians and Alaska Natives,” Tomhave said.

Wilshire raised a pressing question for Hegyi and Tomhave about the responsibility of care in tribal jails. “What resources are available and what training or support should tribal officers be getting? And why is this not handled by the Department of Justice?”

Tomhave said in response,“To be fair, the BIA is in a difficult situation, they do not have expertise or health care personnel,” she continued.

Wilshire noted, “Most state jails and county jails use property tax to fund health care, but Native Americans can’t do that because it’s public trust land. It isn't an easy solution.”

Hegyi elaborated further on the existing and deepening gap between tribal jails and health care access.

“There is no on-site medical personnel at these jails, that’s very different from a lot of other places where people are incarcerated.” He further went on to say, “It becomes the correctional guard’s responsibility to go through this checklist, and they sometimes make life-and-death decisions. They have been wrong a handful of times.”

Beyond health care needs, Hegyi reiterated some of it is just plain negligence.

“People are not checking on inmates who are sick for hours on end, when they are supposed to check every 30 minutes, and that has caused people to die. One woman had a seizure, it was caught on camera, the guards didn’t respond, her cellmate was pleading for help. She died of an alcohol withdrawal seizure. At the end of the day, this is a deadly gap, and a big reason why is because there is no on-site medical personnel.”

Wilshire then took a question from an audience member about a psychotherapy program for helping people who are in jail reintegrate into society. Wilshire, who has a background in psychology, said, “There are no medical, no counseling, no substance abuse treatment in the jails, and if it is, the tribe is absorbing all the costs. There is no way to reimburse, we couldn’t bill for the service, meaning we couldn’t bring in staff. So there aren’t services, and if they are, they're being given by the tribes because they want to care for their members.”

Wilshire followed with a question: “Why are health care needs more acute, in a correctional or detention setting?”

Yazzie responded, noting, “In the case of my brother, in reading the reports, he made it known that he was in distress. The corrections officer correctly requested a medical clearance before they would admit him to jail. That officer, despite being underqualified and undertrained, was overruled by a police officer. That was the biggest break in the train. He was unaware of when to reach out for medical resources. It was appalling as a registered nurse to read about how they treated him.”

“It became obvious that at some point he was dehumanized. It takes training. As a registered nurse, I have been through training to learn how to put my personal feelings aside, and that training doesn’t exist (in tribal jails),” Yazzie said.

Hegyi followed with, “One in five correctional officers haven’t received training for things like first aid, CPR, etc.”

Tomhave, who began her career as a public defender in California, wanted to provide a broader context for inmate health nationally: “In the majority of cases, there is at a minimum substance use disorder, coupled with mental health disorders, they typically go hand in hand and in addition to that there are primary health care needs. Oftentimes an individual is diagnosed for the first time when they get into jail. Their lifestyle is chaotic at best, and they are not getting the health care they need. Their activities exasperate underlying conditions.”

Wilshire’s final question for the panel was, “What is the biggest issue, and what do you think is the biggest solution?”

“From my reporting, the biggest issue that popped up time and time again was the lack of on-site medical personnel,” Hegyi said. “I think the solution in a sense is monetary and it's the public health service commission getting federal nurses and physician assistants into these jails.”

Hegyi also touched on the legislation challenges faced by Native Americans and grassroots organizations to bring these issues to Congress, citing the Missing and Murdered Indigenous Women’s movement.

Yazzie responded, “More training for police and correctional officers, basic things like blood pressure, you can teach these things. Just to give them an idea of how much distress a person is, and then giving them the justification to turn that person over to medical personnel.”

According to Tomhave, “leadership and human decency is the biggest problem, and both are lacking in Washington, D.C.”

Wilshire suggested, “Just a couple word changes with Medicare that could be small congressional changes, that would be a great help in tribes getting reimbursed for the money they are putting into substance abuse and other treatments.”

In final remarks, Wilshire, Hegyi, Yazzie, and Tomhave expressed gratitude for increased awareness around the issue of health care and neglect in tribal jails, but they reminded the audience that this is an ongoing battle.

Tomhave ended with the comment, “(Nelson) Mandela is famously quoted as ‘No one truly knows a nation until one has been inside its jails.’ You know what he had on Robben Island in South Africa, under apartheid? Free medical treatment.”

“BIA never told us the 19 names and locations of people who died in these jails,” Hegyi said. “If there is someone out there watching or listening, and have a story to share, please reach out to me.”

Yazzie encouraged audience members to continue to advocate for Native American issues, and added, “I do miss my brother, rest in peace, Carlos Yazzie, and I’m praying his death won’t be in vain, but will possibly be a platform that can be used (to) help people survive another day, and to possibly overcome the alcoholism, drug abuse, and mental health problems that seem to afflict a percentage of our population on a daily basis.”