The CNMI Advisory Committee to the U.S. Commission on Civil Rights released a report, Examining Access to Adequate Healthcare within the Northern Mariana Islands’ Justice System, following an in-person briefing, series of web briefings, and tour of the CNMI prison. During this study, the Committee received testimony and written statements from various stakeholders including academics, healthcare providers, legal and community advocates, prior inmates, judicial representatives and various government officials.
Through the testimony they received, the Committee identified several key concerns including:
(i) Despite the termination of the 1999 Consent Decree between the United States and the CNMI, CNMI currently falls short of the assurances made under said Consent Decree;
(ii) CNMI has a shortage of healthcare providers and extreme shortage of mental health care providers, which contributes to the CNMI’s inability to provide access to adequate healthcare for individuals within the criminal justice system;
(iii) Despite having an on-site medical unit and psychological unit, DOC inmates face several barriers in accessing adequate healthcare within DOC, including DOC guards and/or medical unit ignoring sick calls and grievances or not addressing either in a timely manner, DOC lacking adequately trained medical staff and mental health professionals, and DOC lacking dental care;
(iv) Because of the challenges in providing inmates with adequate on-site healthcare, DOC often sends inmates off-site to CHCC—even for routine healthcare services, but inmates still face barriers in accessing adequate healthcare through CHCC;
(v) The Department of Youth Services, responsible for the probation and detention of CNMI juvenile offenders, faces several barriers in providing juvenile offenders with medical and mental healthcare services;
(vi) Participants of, and individuals seeking participation in, the Mental Health Court and Drug Court face barriers in accessing adequate mental health care through these programs; and
(vii) The CNMI fails to ensure that pretrial detainees have access to adequate health and mental health care, including freedom from unnecessary involuntary medication.
The recommendations in the report are directed to the Commission, requesting specific actions from stakeholders, including the U.S. Congress and President, the CNMI Legislature and Governor, the CNMI Department of Corrections, the CNMI Judiciary,
and the Commonwealth Healthcare Corporation, to remedy the above barriers. Key recommendations include:
(i) publish the DOC updated practices and procedures, specifically related to the grievance procedure available to inmates;
(ii) conduct routine needs assessments, including evaluating staffing level needs, and implement policies and practices recommended from the needs assessments;
(iii) improve transparency, especially related to the delivery of health and mental health care to inmates;
(iv) identify, and fund the position of, a DOC ombudsman within a separate agency, such as the Public Defender’s Office or NMPASI, to provide adequate oversight over inmates’ sick calls and grievances;
(v) allow inmates to access DOC tablets to electronically submit sick calls or grievances; the sick calls and grievances would be sent directly to the appropriate unit/person and would allow for easier oversight for DOC or ombudsman;
(vi) invest in an electronic medical record system to streamline the delivery of care and coordination with CHCC;
(vii) obtain privilege at CHCC so that the DOC medical unit can access CHCC’s electronic health records for the inmates;
(viii) Mental Health Court and Drug Court programs should expand their eligibility requirements to include less severe criminal charges, including petty or misdemeanor offenses;
(ix) fund and/or build more long-term residential treatment facilities on Saipan;
The CNMI Advisory Committee Chair, Catherine Cachero said: “Safeguarding the rights of individuals within CNMI’s justice system to access adequate healthcare has been a serious ongoing problem and concern in the Commonwealth of the Northern Mariana Islands for decades. The Committee is grateful for the testimony and statements from the various stakeholders and impacted individuals regarding their experiences and expertise related to access to adequate medical care for those within the Northern Mariana Islands’ Justice System. The Committee hopes that the various federal and local policymakers and authorities carefully consider the findings in our report and adopt the recommendations made in the report to ensure equal and adequate healthcare to all members of our community.”
kfajota@usccr.gov