REPORT OF AUDIT: CIA-CONTROLLED DETENTION FACILITIES OPERATED UNDER THE 17 SEPTEMBER 2001 MEMORANDUM OF NOTIFICATION (2005-0017-AS)

• Document Type: FOIA
• Collection: Documents Related to the Former Detention and Interrogation Program
• Document Number (FOIA) /ESDN (CREST): 6541721
• Release Decision: RIPPUB
• Document Page Count: 58
• Document Release Date: June 13, 2016
• Case Number: F-2015-02400
• Publication Date: June 14, 2006

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CENTRAL INTELLIGENCE AGENCY
Office of Inspector General
REPORT OF AUDIT
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Operated Under the 17 September 2001
Memorandum of Notification
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Report No. 2005-0017-AS
006
14 June 2006
ISSUE DATE
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14 June 2006
MEMORANDUM FOR: Acting Executive Director
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FROM: John L. Helgerson
SUBJECT:
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Inspector General
(TS/ NF) Report of Audit:
CIA-controlled Detention Facilities
Operated Under the 17 September 2001
Memorandum of Notification (2005-0017-AS)
1. (eS/ Wir) 'Attached is our final report on
CIA-controlled detention facilities operated under the
17 September 2001 Memorandum of Notification. Recommendation 1
is directed to you. It is my understanding that you are in
agreement with the recommendation. Please provide me a written
response within 60 days setting forth the actions that have been
taken to implement the recommendation and/or a timetable for
eventual implementation.
2. (u) All of the recommendations in the report are
considered significant. The status of the recommendations, as
well as corrective actions taken to address them, will be
included-in an appropriately sanitized way-in the Inspector
General's next semiannual report to the Director, Central
Intelligence Agency.
3. (4) This audit responds to a recommendation in the
Classified Annex to the Joint Explanatory Statement of the
Committee of Conference accompanying the Intelligence
Authorization Act for Fiscal Year 2002 that the Central
Intelligence Agency Inspector General audit each covert action
program at least every three years. Our report will be provided
to the Congressional oversight committees 30 days from the date
of this memorandum.
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14 June 2006
MEMORANDUM FOR: Acting Executive Director
FROM: John L. Helgerson (b)(1)
Inspector General (b)(3) NatSecAct
SUBJECT: (41'S/ HP) Report of Audit:
CIA-controlled Detention Facilities
Operated Under the 17 September 2001
(b)(1) Memorandum of Notification (2005-0017-AS)
(b)(3) NatSecAct
I. er15, Inn 'Attached is our final report on
CIA-controlled detention facilities operated under the
17 September 2001 Memorandum of Notification. Recommendation 1
is directed to you. It is my understanding that you are in
agreement with the recommendation. Please provide me a written
response within 60 days setting forth the actions that have been
taken to implement the recommendation and/or a timetable for
eventual implementation.
2. (U) All of the recommendations in the report are
considered significant. The status of the recommendations, as
well as corrective actions taken to address them, will be
included-in an appropriately sanitized way-in the Inspector
General's next semiannual report to the Director, Central
Intelligence Agency.
3. (-SY This audit responds to a recommendation in the
Classified Annex to the Joint Explanatory Statement of the
Committee of Conference accompanying the Intelligence
Authorization Act for Fiscal Year 2002 that the Central
Intelligence Agency Inspector General audit each covert action
program at least every three years. Our report will be provided
to the Congressional oversight committees 30 days from the date
of this memorandur
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(U) Table of Contents
(U) EXECUTIVE SUMMARY 1
(U) BACKGROUND 3
(W/FelziO) CIA Counterterrorism Authorities 3
(U) AUDIT RESULTS AND REC07:?.1\ IONS
4
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(791/
Operating Detention Fact Has Be ffective 4
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Detention Facilities Were
ents and Standards 4
(UHR9440) Standar
Generally Sufficient
(T-6I
N9
Facilities' Operations
inpatient Treatment for
Recordkeeping Are
6
eakness in Detention
ed 7
$ Are Needed for Providing
7
(TS 4) Timely Access to Critical Medical
Information on Detainees Is Needed in the Field 11
(11//FOLie) Facilities' Staffs Lack Training in Safe Food
Handling and Preparation 12
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(T-6
Detainee Is Needed 16
NF) Policy on Response to the Death of a
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(TS 0) A Shortage of Debriefers at Detention
Facilities May Have Negatively Impacted Intelligence Collection .... 18
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(b)(1) (U) Objectives, Scope, and Methodology EXHIBIT A
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(IS IV) CIA-controlled Detention Facilities That
Were in Use at the Time of the Audit EXHIBIT B
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(b)(3) NatSecActrS Alf) DetentidntFac
a:That Were Not
?
in Use or Were Under Const ? atih'i, e of the Audit....EXHIBIT C
(b)(1)
(b)(3) NatSecAdiF61 Nf) Guid es for Ma ing CIA-controlled
Detention Facilities EXHIBIT D
(b)(1) rrgi
49 De
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,..TC-managed Detention F
Being Held in
EXHIBIT E
(U) Recommendations *4, EXHIBIT F
EXHIBIT G
(U/fFGUO) Audit Team M
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Report of Audit
NF) CIA-controlled Detention Facilities Operated
Under the 17 September 2001 Memorandum of Notification
(b)(1) (U) EXECUTIVE SUMMARY
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(T-Si Icir) The objectives of this audit were to determine
whether the Central Intelligence Agency (CIA):
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? Developed and adhere
guidelines for opera
and maintaining d
? Maintained adeq
and the detainee
National Clandestine Service
Detainees Group (RDG) were c
contain detainees and promote
facilities operated by CTC/RDG
nourishment, and hygiene; medi
limited dental and vision care; op
iate standards and
lied detention facilities
-Co
Q. unter
? cted, equippe
gence exploi
rovided ess
d psycholo
ities for k
tention facilities
detention facilities operated by the
m Center (CTC), Renditions and
and staffed to securely and safely
of detainees. Detainees at
s of shelter, clothing,
examinations and treatment;
cal exercise and intellectual,
religious, and recreational pursuits;an
et with facility staff. Detainees are
(b)(1) held in solitary confinement in clima , lighted, aboveground, windowless
(b)(3) NatSecAct:iis_ that are equipped with a
mattress, a sink, and a toilet. At the time we visited the CIA-controlled detention
(b)(1) facilities in use, no detainees were being interrogated; all detainees were in the
(b)(3) NatSecActcbricfing phase of their confinement. None of the detainees showed any apparent
(b)(1) physical signs of mistreatment.
(b)(3) NatSecAct (Ts./ CTC/RDG is responsible for ensuring that each
detention facility is properly staffed and has developed a staffing plan for each facility
in response to a recommendation contained in a prior Office of Inspector General
(OIG) report?Special Review ? Counterterrorism Detention and Interrogation
Activities (September 2001 ? October 2003) (2003-7123-IG, May 2004). At the time
(b)(1)
(b)(3) NatSecActat we visited the detention facilities in use, except for a shortage of debriefers,
the facilities were staffed with sufficient numbers and types of personnel, including
chiefs of base (COBs), support officers, communications officers, security officers,
interrogators, and linguists, as detailed in the staffing plans. Personnel from CTC; the
CIA Office of General Counsel (OGC); and the CIA Directorate of Support, Office of
Medical Services (OMS) (b)(1) developed generally sufficient
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provide medical treatment to detaineme,
disorders, and operable plans are n911
Facilities' staffs do not have imm
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standards and guidelines for operating CIA-controlled detention facilities, maintaining
the health of detainees, and safely handling detainees. Facilities' staffs generally
followed the standards and guidelines in the conduct of their duties and responsibilities.
With minor exceptions, responsible officials maintained adequate records of the
detainees confined at CIA-controlled detention facilities operated by CTC/RDG.
However, additional or more detailed standards, guidelines, plans, and training are
needed to address certain areas of weakness in detention facilities' operations that could
jeopardize the health and safety of both detainees and detention facility staff.
(b)(1)
(b)(3) NatSecAct Rs N-F) Ted detention facilities have
experienced a shortage of qualified debriefer , which may have negatively impacted
intelligence exploitation of detainees. Some CIA personnel who successfully
completed a special training program to be debriefers of high value detainees (HVDs)
laCg
? access to:
may be needed to safely and effedively respond tifiVinedical emergency. CIA officers
and other personnel at CTC/RD ention facilities have not been trained in safe food
handling and preparation, and siiiid?sandproc?rcs designed to avoid the
introduction and transmission offoo4bome*tqc,,alcs have not been instituted at the
detention facilities are not equipped to
veo develop serious physical or mental
ide inpatient care for detainees.
.
cal information on detainees that
facilities.
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have been unavailable for temporary assignment to detention facilities.
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(b)(6)
.Astnnt Inspector General for Audit
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(U) BACKGROUND
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(b)(1) (U1 AUDIT RESULTS AND RECOMMENDATIONS
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(TS, 11P) The CounterTerrorism Center Program
(b)(1) for Operating Detention Facilities Has Been Effective
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(TV 141f) CTC/RDG's program for operating detention
facilities has been effective in providing secure and safe custody of persons detained by
the CIA under authority of the 17 September 2001 MoN. The CIA-controlled detention
facilities that were in operation during the time of our audit were constructed, equipped,
and staffed to provide detainees essentia ,t!lter, clothing, nourishment, and
hygiene; medical and psychological F., 1 'bib nd outpatient treatment; limited
dental and vision care; opportunitie ysrcise and intellectual, religious,
and recreational pursuits. CIA offii develop.il erally sufficient standards and
guidelines for operating CIA-con
detainees, and safely handling d
controlled detention facilities, f
guidelines in carrying out their
detention facilities, no detainee
debriefing phase of their confin
(b)(1) theF7detention facilities op
(b)(3) NatSecActrnistrcatment.
d detention lities, maintaining the health of
ees. We found that personnel assigned to CIA-
omplied with the standards and
lities. At the time we visited the
ted; all detaineeS were in the
tainees at the time that we visited
owed any apparent physical signs
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("TS istri
Facilities Were Designe
Requirements and Stan ar s
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(fS NF) CIA-controlled detention facilities operated by
CTC/RDG were designed, constructed, and equipped to securely and safely contain
(b)(1) detainees and to promote intelligence exploitation of detainees. We visited the
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tention facilities that were in use at the time of our audit
CTC/RDG manages the detention facilities
twenty-four hours a day with CIA staff and cleared contractor personnel. Detainees are
held in solitary confinement; they generally are not physically restrained while in their
cells. Detainees are held in climate-controlled, lighted, aboveground, windowless
cells-H -that are equipped with a
mattress, a sink, and a toilet. Detainees are provided three balanced meals per day,
adequate clothing, and access to showers and personal hygiene products. Detention
facilities' staff personnel consult with an OMS dietician regarding detainees' meal
plans and nutritional requirements. Each detention facility has an exercise room, which
detainees are encouraged to use.
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(irsH
NE) Detainees are given medical examinations every
six to eight weeks, or more often if required by the detainee's medical condition. OMS
physicians and physician assistants?both Headquarters-based personnel and regional
medical officers?travel to the detention facilities to conduct medical examinations.
(b)(1) fAr detainees.
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CTC/RDG has also arranged for limited dental and vision care
ff-S 14F), ffs are sensitive to the detainees'
?
religious and cultural requirements inees access to the Koran and the Bible,
a prayer rug, a prayer schedule, ock, and i, are provided uninterrupted time
for daily prayer. Detainees are s? meals that t n orm with their religious and
cultural requirements, and speci visions are made to accommodate detainees'
customs associated with religio se o help alleviate the impact of
prolonged solitary confinement, ovided access to selected books,
movies, and games. Facilities' o have daily contact with each
detainee during debriefings, rap informal cell visits, and when
delivering meals. The Director, Center (Director, CTC) has
advised us that, beginning in Fe Te ainees individually have been
afforded "social visits" with anot oximately one hour in a
4,*
controlled and monitored setting. 41 .,? amenity that must be earned, and
the Director, CTC believes that the ,ha tive impact on detainees' behavior
(b)(1) and coping skills.
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(T-S/ NF) CTC/RDG is responsible for ensuring that each
detention facility is properly staffed and has developed a staffing plan for each facility
in response to a recommendation contained in a prior OIG report?Special Review ?
(b)(1) Counterterrorism Detention and Interrogation Activities (September 2001 ? October
(b)(3) NatSecAct03) (2003-7123-IG, May 2004). At the time we visited theF7detention facilities
in use, except for a shortage of debriefers, the facilities were staffed with sufficient
numbers and types of personnel, including C013s, support officers, communications
(b)(1) officers, security officers, interrogators, and linguists, as detailed in the staffing plans.
(b)(3) CIAAct officers were providing physical
(b)(3) NatSecAct
ecurity at the facilities and had responsibility for the safety of both facility staff and
detainees at the time of our site visits.
ake an e
fuilding sess
CounterTerr
y 2006, sele
etainee for
1 visits
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frs7
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NP)
are
(b)(1) discussed in Exhibit B of this report. During the audit, we visited another facility
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signed and built to be a CIA-controlled detention facility?
is unique among the facilities in the CTC/RDG program in that it was
was completed in
million, but has not been used. Senior
approvals have been received for its use
(b)(1) designed for
(b)(3) NatSecAct at a cost of approximately
CTC officials told us that not all
(b)(1) by the CIA: We also obtained information on but did not visit other CIA-
(b)(3) NatSecAct)ntrolled detention facilities that either were not in use or were under construction at
the time of our audit. other detention facilities that were
not in use are discusse in x
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on the care and treatment of detain
(TT
developed generally sufficient s
detention facilities, maintaining
Facilities' staffs generally folio
duties and responsibilities. Wit
adequate records of the detainee
(U/iFeEt&) Standards,
Recordkeeping Are Ge
b)(1)
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Ines, an
ly Sufficie
Pers
(b)(1)
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from CTC, OGC, OMS, and
ines for operating CIA-controlled
s, and safely handling detainees.
guidelines in the conduct of their
onsible officials maintained
(b)(1)
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(b)(1)
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(q-S/
e standard
;ftor exception
onfined at
personnel promulgated guidance
idelines on Interrogations and the
DCI Guidelines on Confinement Con IA Detainees govern the conduct of
interrogations and the conditions of confinement for detainees) The OMS guidelines
provide general guidance on medical and psychological issues during: (1) rendition
and initial interrogation, (2) sustained debriefing, and (3) long-term care. Although the
DCI and OMS guidelines contain appropriate provisions, they speak in very general
terms concerning how the guidelines and standards contained therein should be
implemented. The DCI and OMS guidelines are discussed in Exhibit D of this report.
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ilf-) To supplement the DCI and OMS guidelines,
RDG has developed and issued a number of standard operating procedures (SOPs) that
address the day-to-day operation of its detention facilities. The SOPs address: staffing
of the facilities, biweekly reporting of detainees' confinement conditions, managing
books and other print media provided to detainees, development of meal plans, cutting
I (T-S/ WF) The guidelines are currently under revision in response to a recommendation contained
in a prior OIG report?Special Review? Counterterrorism Detention and Interrogation Activities (September 2001
? October 2003) (2003-7123-1G, May 2004).
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and trimming detainees' hair and beards, and handling of detainees in a variety of
(b)(1) situations. Officials at each of the detention facilities established additional SOPs,
(b)(3) NatSecActed on each facility's operational environment,
and the provision of additional amenities to
(b)(1)
(b)(3) NatSecAct (Ts,
read-in files at each facility and require all permanently assigned and temporary duty
personnel to read and acknowledge the procedures in writing upon arrival. SOPs have
been updated as needed to reflect the ch o erational environment. Other records
related to detention facilities and detaine detainees' medical records, are
available electronically and in hard es rf ined at Headquarters.
detainees.
NW) COBs at detention facilities maintain SOPs in
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Cr& /NE) Ce
Facilities' Operations Nee
1-T-S
standards and guidelines for op
the health of detainees, and safe
detailed standards, guidelines, p
weakness in detention facilities'
of both detainees and detention
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(b)(1)
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t"T'S
Needed for Providing lnp
for Detainees
Areas of We kness in Detention
Be Addressed
at.
eveloped generally sufficient
detention facilities, maintaining
However, additional or more
eeded to address certain areas of
eopardize the health and safety
IA-co
dling detai
land training
ations that co
ties' staffs.
(b)(1)
CTC/RDG detention facilities are not equipped to
provide medical treatment to detainees who have or develop serious physical or mental
disorders, and operable plans are not in place to provide inpatient care for detainees.
As a result, there have been delays in providing necessary medical treatment for
detainees, and CIA funds have been wasted in constructing and equipping a medical
facility that was later determined not to be a viable option for providing inpatient care
(b)(3) NatSecAc'er detainees.
(TS/ Lix4f) At least detainees in CTC/RDG detention
facilities have physical illnesses or conditions that require the detainees to be
(b)(1) hoqnitalized for treatment.
(b)61-9(3) NatSecAct
(b)(3) NatSecActiagnosed with hepatitis C in September 2003 and should have a liver biopsy
was
(b)(6)
(b)(7)(c)
performed.
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(b)(6)
(b)(7)(c)
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(b)(1)
medical examination that
In Au ust 2005, an OMS officer discovered durin
a routine
1
(b)(3) NatSecAct Although most detainees are in
(b)(6) good physical health, the possibility exists of an unforeseen acute medical condition
(b)(7)(c) that would require a detainee to be immediately hospitalized. In December 2005,
symptoms exhibited by that, at first suggested appendicitis, were
determined to be attributable to kidney stones, and was successfully
(b)(1) treated at
(b)(3) NatSecAct
(T-S/ Th
(b)(1) situations where a detainee's medical
-
(b)(3) NatSecActtention facility, detention facility
to the host country's health care s
(b)(1) CTC/RDG detention facilities ha
(b)(3) NatSecAc Et-Le cooperation of the host-coun
'
nospitalization for a detainee.
non-emergency inpatient requir
(b)(1) nnerational. CTC and OMS off
(b)(3) NatSecAct,
Department of Defense (Do
for CIA detainees at a DoD mih
(b)(1) requiring additional medical trea
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has not become
nes issued by OMS recommend that, in
not be adequately treated at the
IA station personnel arrange access
erienced42 medical emergency that required
'n arranging immediate
us that treatment of detainees with
rred until became
ticipate
acility would
ospital.
nt and was tr
tional, and
the CIA is currently denied acces .
CIA detainees. CIA station and ba -1 ii
(b)(1) treatment for detainees from host-coill''''
(b)(3) NatSecAct
mited success.
proximity to a
it convenient to obtain treatment
came into CIA custody
a I military hospital. But
and OMS officials told us that
facilities to obtain treatment for
ght support in obtaining medical
, but they have had
have reneged on
previous assurances that they would arrange inpatient treatment or have declined to
become involved in providing medical treatment for CIA detainees. The medical
facilities and personnel of certain foreign countries that have agreed to provide medical
treatment for CIA detainees have been determined by OMS personnel to be of
unacceptable quality. In March 2006, CTC, OMS, and CIA station personnel obtained
(b)(1) medical treatment for at a third-country medical facility
(b)(3) NatSecAct
medical treatment for
treatment for additional CIA detainees.
The same country's facilitated
but has indicated its unwillingness to provide
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(b)(1)
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(b)(1)
(b)(3) NatSecAC quipped in late December 2005 at a co ? million.
t'
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lAtaRaRt4a4R
(T-S1 Ivrf) As an alternative means of providing inpatient
treatment for detainees, CTC/RDG began in May 2005 to construct and equip a medical
treatment facility near
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
(b)(1)
(b)(3) NatSecAct
The Imedical facility was completed and fully
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
(b)(1) facility has never been used.
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controlled detention facility for
treatment for detainees The CIA41*I
(b)(1) country will be will'''. 0.4
(b)(3) NatSecAct
medical treatment
Operable pla ed to be in place at each CIA-
ing emerg and non-emergency, inpatient
t assum tha in exigent circumstances the host-
ea f providing support, and it appears
tiurr tly an option. The DCI Guidelines on
at access to DoD medical facilities
Confinement Conditions for CIA Detainees require that provisions be made to protect
the welfare of detainees, including the provision of adequate medical care. However,
the guidelines do not assign responsibility for ensuring that detainees are provided
necessary medical treatment. Although the security aspects of providing inpatient
treatment for detainees will need to be coordinated closely with each detention facility
staff and local CIA station personnel, the substantive knowledge of OMS personnel
makes them better suited to make critical decisions concerning the viability of plans for
providing inpatient care for detainees.
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
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(b)(3) NatSecAct
(b)(3) CIAAct
(b)(5)
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
(b)(5)
(b)(1)
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NC:WORN/MAR
(b)(1)
(b)(3) CIAAct
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(b)(1)
(b)(3) NatSecAct
(WS Nf)ritical medical information on detainees is not
immediately available to the staff o detention facilities. Program
(b)(1) officials told us that medical files on eletitiiiee aie not maintained at each detention
-? '
(b)(3) NatSecActt Y
According to program officials, a medical officer at a detention facility who needs
medical information on a detainee can either contact Headquarters, where medical files
on all detainees are maintained, or search through the facility's cable database for
medical information. Both of these options are dependent on the detention facility's
ETS/ Timely Access t
- ,
Critical Medical lnforthfkn on Detainees
4
Needed in the Field
(b)(1)
(b)(3) NatSecAct cess to
A search of the detention facility's cable database for medical information, in
addition to being time consuming, would yield information on a particular detainee
only for the period that the detainee was held at that facility. Neither option appears to
be a viable solution when immediate medical information on a detainee is needed to
respond to a medical emergency.
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(b)(1)
(b)(3) NatSecAct
11
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(b)(3) NatSecAct
(TS/ 'N?g) Detention facility managers and OMS officers told
us that, because of the number of detainees with chronic medical conditions and the
(b)(1) lack of on-site medical personnel at they believe it
(b)(3) NatSecAct necessary to have hardcopy records containing critical medical information on
detainees available at detention facilities. The on-site medical records need not contain
a complete medical history of a detainee and the results of every medical and
psychological examination, but should contain critical information needed to safely and
effectively respond to a medical emergency involving the detainee, such as information
on chronic illnesses, medical conditions, and behavioral problems; allergies to
particular medications; or contagious dseasjuiring special handling of the detainee
(b)(1) during treatment.
(b)(3) NatSecAct
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(b)(3) NatSecAct
'NerFORNTAVIR
rf-Sh 717),41tecommendifkin, 3 (significant): For the Chief
.Z4
of Medical Services in coordintie with the Chief, Counter Terrorism Center,
Renditions and Detainees Group: Maintain hardcopy records at CIA-controlled
detention facilities that contailif'Cir*.iii information that may be needed by
' ?
facility staff and medical personnettn safely and effectively respond to a medical
(b)(1)
(b)(3) NatSecActemergency in a detainee.
(b)(1)
(b)(3) NatSecAct Iitf) CIA officers and other personnel at
have not been trained in safe food handling and
preparation. officers at prepare, portion, and serve all meals to the
(b)(1) detainees. The guards at prepare and portion detainees'
(b)(3) NatSecActieals in the guards' kitchenE?Pfficers then serve the meals. officers at
prepare and serve most of the detainees' meals. None of these persons
have been trained in safe food handling. We observed certain practices and conditions
that were inconsistent with avoiding contamination of food and transmission of food-
borne illnesses. For example, we observed an officer using the back of his bare
hand to check the temperature of a meal he was heating for a detainee. At a detention
(b)(1) (b)(1) (b)(1)
(b)(3) CIAAct (b)(3) CIAAct (b)(3) CIAAct
(b)(3) NatSecAct (b)(3) NatSecAct (b)(3) NatSecAct
12
/1?) In comments on a draft of this report, the Chief
of Medical Services stated that 14.4dcopy medicat?utn7.' maries that include information
on detainees' medical conditionS',*qications,,Oprgies, and blood-borne pathogens
have been provided to each detenliqkflIttOpetention and reference in the event
of a medical emergency. The Chieriit.geWitt Services provided us copies of the
medical summaries. Recommendation -3 Is 'closed.
(U//Pert10) Facilities' Staffs Lack Training in
Safe Food Handling and Preparation
(b)(1)
(b)(3) NatSecAct
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Nier-GRN/1114/3
(b)(1) facility that has experienced rodent infestation, we noted that the kitchen ar(b)(i )3 left
(b)(3) NatSecAct an unsanitary condition following meal clean up.2 Staff bathrooms at all(b)(3) NatSecAct
I facilities, including a bathroom immediately adjacent to the kitchen at
were e uipped with communal, cloth towels. Ir 2005, five staff personnel at
(b)(1) reported acute gastrointestinal illness, which a visiting physician assistant
(b)(3) NatSecAc
lagnosed as giardiasis.3 Within days, the facility reported similar symptoms in a
detainee. The physician assistant believed that the giardia were likely introduced by
food or water contamination.
(U) The US Department of Health
Control and Prevention (CDC) and F
the US Department of Agriculture'
produce the latest edition of the F 69
manageable, enforceable provisi ejjior
borne illness. The code is a refe
food safety in restaurants, retail
child care centers. According to
? related to employee behavior an
borne illness: (1) Improper hol
(3) contaminated equipment, (4
? hygiene. The code recommends
for example, the provision of dis
(b)(1) supplies each user a clean towel;
(b)(3) NatSecActashing sink.
uman Services' Centers for Disease
Administration collaborated with
a Inspection Service in 2005 to
ode. Th e provides practical guidance and
mitigatin factors known to cause food-
document for regulatory agencies that ensures
tutions, such as nursing homes and
ere are five major risk factors
ctices that contribute to food-
nadequate cooking,
ces, and (5) poor personal
ces to address these risk factors,
tinuous towel system that
drying device at each hand-
from
dards
le to
eate
unsafe'
and pr. c
wets; afi
d-air
ftlf) Incid s of food-borne illnesses at CIA-
(b)(1) controlled detention facilities have been rare; th 2005 illnesses at were
(b)(3) NatSecAs.tz only reported cases. However, because of the shortage of appropriate personnel to
staff CIA detention facilities, and the difficulty involved in providing inpatient
(b)(1) treatment to detainees, the CIA can ill afford outbreaks of food-borne illnesses at its
(b)(3) NatSecActtention facilities that could be prevented by proper food handling and good hygiene
practices. Personnel who are involved in the handling and preparation of food at CIA
(b)(1)
(b)(3) NatSecAct
(b)(3) NatSecAct
2 6s, Illf) Certain staff living areas at including the kitchen,
dining area, and bathrooms, are communal in nature; personnel residing at the facilities are responsible for
cleaning these areas on a rotating, daily schedule.
3 (U) The giardia parasite, according to the CDC, resides in the intestine of infected humans or animals. The
parasite is found in soil, food, water, or surfaces that have been contaminated with the feces from infected humans
or animals, and individuals can become infected after accidentally swallowing something that has come in contact
with the feces of a person or animal infected with the parasite. The CDC notes that giardia may be spread via
contaminated bathroom fixtures and recommends the washing of hands with soap and water after using the toilet
and before eating or preparing food.
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(b)(3) NatSecAct
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istetFORNMAR
detention facilities should receive basic training in safe food handling. In addition,
standards and procedures designed to avoid the introduction and transmission of food-
(b)(1) borne illnesses should be developed and instituted at detention facilities.
(b)(3) NatSecAct
(b)(1)
(b)(3) NatSecAct
TTS/ In comments.mithe draft audit report, the
Director, CTC concurred with th 4Commendation and provided details of actions
(b)(1)
fiken to implement it. SinceQQ5;,CTC/RDG has been working to identify and
(b)(3) NatSecAct
,ngage under contract at least cleared cooks. To date,nzooks have
been engaged. The cooks are as'stimpdto the se facility, and they have instituted
(b)(3) CIAAct cleanliness and sanitation standiTds4nd procedur4eonsistent with food service
guidelines at that facility. The qs* of Medical *vices also advised us in his
comments that trained, professiollilooks have beiiii'etained by CTC and that training
and instruction on correct food preparation have bee,ry provided to staff and contract
personnel assigned to CTC detentiOkfacilities.
ra Recommendation 4 (significant): For the Chief
CounterTerrorism Center, Renditions and Detainees Group in coordination with
the Chief of Medical Services: (I) Provide training in safe food handling for
personnel involved in the preparation of meals and handling of food at CIA-
controlled detention facilities. (2) Develop and institute standards and
procedures designed to avoid the intdiilonand transmission of food-borne
illnesses at CIA-controlled detentionfic
(b)(1)
(b)(3) NatSecAct
(b)(3) CIAAct
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(b)(1)
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(b)(1)
(b)(3) NatSecAct
(b)(1)
(b)(3) NatSecAct
RS $F) Policy on Response
to the Death of a Detainee Is Needed
(TS NF) CIA employees and contractor personnel assigned
to CIA-controlled detention facilities have not been provided standard procedures for
responding to the death of a detainee. In 2003, the Office of Inspector General
(b)(1) Investigations Staff initiated an investigation into the circumstances surrounding the
(b)(3) NatSecAp,t
ovember 2002 death of a detainee at a CIA detention facility that
operated from August 2002 to May
(b)(3) CIAAct
(b)(5)
(b)(1)
(b)(3) NatSecAct
However, the lack of
formal procedures to be followed i event eath of a detainee in CIA custody
could cause personnel at these facili onally compromise the medical
examiner's autopsy or an OIG invest' a ii ri s isturbing the detainee's body and/or
the death scene. Adherence to prescribed procedures in the event of a detainee death
could protect facility staff from being wrongly accused of detainee mistreatment or
responsibility in the detainee's death. I
(b)(3) CIAAct
(b)(5)
(b)(1)
(b)(3) NatSecAct
(b)(1)
(b)(3) NatSecAct
4 (T.& 44f) CTC/RDG officials told us that the facility was not part of the
CTC/RDG detention program and was not managed by CTC/RDG at the time of the detainee's death. CTC,
(b)(1) Renditions Group, which was renamed CTC/RDG, assumed Headquarters management of (b)(1) on
(b)(3) NatSecActDecember 2002. Prior to that time, other CTC components (b)(3) NatSecAct
-oversaw operations af Thc death of the detainee at was
reported on by OIG/INV in Death of a Detain(b)(1) 2003-7402-IG, 27 April 2005.
(b)(3) NatSecAct 16
(b)(1)
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(b)(1)
(b)(3) CIAAct
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(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
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(b)(1)
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17
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NOFeRttMVIR
(b)(1)
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(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
(b)(1) NF) A Shortage of Debriefers at Detention
(b)(3) NatSecAct Facilities May Have Negatively Impacted Intelligence Collection
(T-Si NIf) CIA detention facilities have experienced a
shortage of qualified debriefers, which may have negatively impacted intelligence
exploitation of detainees.
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
(b)(1)
(b)(3) NatSecAct
18
NGFORNIIIVIR
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(1S, W.) To help ensure that enough qualified debriefers
would be available to CIA detention facilities, CTC began a formal program in 2004 to
develop a cadre of persons with the necessary skills and requisite knowledge to elicit
intelligence from the high value detainees being held in CIA detention facilities.
Participants are recommended to the program by their components' management and
are required to successfully complete specialized, HVD debriefer training.
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
(b)(1)
(b)(3) NatSecAct
(PS Islf) Staffing CIA detention facilities with a sufficient
number of qualified debriefers is a continuing challenge for CTC/RDG.
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
19
(b)(1)
+Ctla-SEeRETh (b)(3) NatSecAct
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fterPerRiclinWR-
(b)(1)
(b)(3) CIAAct
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(b)(5)
(b)(1)
(b)(3) NatSecAct
(T-R4
facilities is an on-going problem,
shortage a hfied debriefers at detention
(b)(1)
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(b)(3) NatSecAct
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(b)(1)
(b)(3) NatSecAct
(b)(1)
(b)(3) NatSecAct i517151/TIWR
(U) Objectives, Scope, and Methodology
(TS/1 NF) The objectives of this audit were to determine
whether the Central Intelligence Agency (CIA):
? Developed and adhered to appropriate standards and
guidelines for operating CIA-controlled detention facilities
and maintaining detainees.
Exhibit A
(b)(1)
(b)(3) NatSecAct
? Maintained adequate,00#4,
and the detainees.
(+SI /44f6
to appropriate standards and gui4
holding detainees, we:
(b)(1)
(b)(3) NatSecAct
(b)(1)
(b)(3) NatSecAct
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
$1he detention facilities
determin ether the CIA developed and adhered
rANu
bs for operating CIA-controlled detention facilities and
? Reviewed the sCO
Memorandum at
atiiti?horized under the
17 September 2001
'ficationIn'
and procedu
er which th
? Examined guidel.
detention faciliti
or the operation of
onal Clandestine
Service (NCS), rTerroris ter (CTC) had control
between August Mind .IW2006.
? Interviewed current and officials responsible for CIA-
controlled detention facilities from CTC; the Directorate of
Support (DS), Office of Medical Services (OMS); the
and
(b)(3) NatSecAct
? Reviewed cable traffic contained in
databases, reports, and other documents related to CTC covert
action (CA) activities maintained by the NCS
the NCS, Operations and Resource Management Staff;
the DS, OMS; and the Office of the Chief Financial Officer.
?TOP-SECRE-Ti
(b)(1)
(b)(3) NatSecAct
(b)(3) CIAAct
istOPORWMft
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(b)(1)
(b)(3) NatSecAct
NGFORNINIR
? Reviewed the National Security Act of 1947, Title 5,
Accountability for Intelligence Activities; the Central
Intelligence Agency Act of 1949, as amended, Section 8;
and Executive Orders 12333 and 13354.
? Reviewed CTC/RDG detention program-specific policies,
standard operating procedures, and guidelines pertaining
to the conduct of CA activities promulgated by the Director
of Central Intelligence, CTC, and OMS.
? Assessed the facilities- aiiifO-4iatipns at
(b)(1)
(b)(3) NatSecAct
(b)(1)
(b)(3) NatSecAct
/4F) To determine whether the CIA maintained adequate
records of the detention facilities and the detainees, we:
? Reviewed files maintained on each detainee by OMS.
? Reviewed operational files maintained on each detainee by
CTC. (b)(3) CIAAct
? Received a demonstration of CTC's
database.
Reviewed cable traffic contained in
record-keeping
atabases.
(b)(3) NatSecAct
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(b)(1) ?Ter CEC?RE-17 (b)(3) NatSecAct
(b)(3) NatSecAct
f-T-5// tif) During the audit, we received assurances from
senior CTC officials that we had access to all relevant rilatabases and other
operational records and that there were no other CIA-controlled detention
facilities.
(b)(1)
(b)(3) NatSecAct
(b)(3) CIAAct
(b)(3) NatSecAct
Because no interrogatOpkwere being conducted at the time that we
deny interrogation activities.
o of this audit, and we did not
ilines ogations, or examine the
&employed at: current CIA-controlled detention
e did not examine activities associated with the
renditions of Ofoineptiordid we examine on a case-by-case basis
t e justi ications or holding park. aV e did not assess the value of
intelligence obtained from the d "pd?s': We "if
pd the costs associated with
constructing detention facilities TC official tit we did not examine contract
and expense documentation,
visited the detention facilities, we dig*
Moreover, interrogation techniquesc,
review US Department of Justice
(b)(1) evolution of interrogation techni
(b)(3) NatSecActilities ? ? - ? " ssor facilities
I
(U) The audit was perform m July 200 ebruary 2006 and in accordance
with generally accepted governm diting sta . Comments on the draft report
were received from the Acting ExP* D e Director of the National
Clandestine Service; the Director foi the Acting General Counsel; the
,.
Director, CIA CounterTerrorism Center; aria the Chief of Medical Services and were
considered in the preparation of this report.
(b)(1)
(b)(3) NatSecAct
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NOPORNitiVtR
(b)(3) NatSecAct
(TS1
Exhibit B
'.1F) CIA-controlled Detention Facilities That
Were in Use at the Time of the Audit
(b)(1)
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(b)(3) NatSecAct
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2
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(b)(3) NatSecAct
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ECRET (b)(3) NatSecAct NeFeRt4WR
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lICYPORNHMR?
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(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
(b)(1)
(b)(3) NatSecAct
-TOP-SEGRET/ NGFEIRitftrair
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TOP-SECRET/
(b)(1)
(b)(3) NatSecAct
NOKIRt4ffPAR
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
12
(b)(1)
RET/ (b)(3) NatSecAct istCWORt4ttIVIR-
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-fietP-SEGIZET.
(b)(1)
(b)(3) NatSecAct
41tepperRitomit
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
TI
(b)(1)-t/
(b)(3) NatSecAct
NeFrORN/IMIT
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TOP SECRET/
(b)(1)
(b)(3) NatSecAct
NOFORNftriltR-
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
(b)(6)
TCYP-SECREI7
(b)(1)
14
(b)(3) NatSecAct
NeFORNftiVIR-
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TOP SECRET
(b)(1)
(b)(3) NatSecAct
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(b)(1)
(b)(3) NatSecAct
NOf4ERNttNtR-
Exhibit C
-N.F) Detention Facilities That Were Not in Use
or Were Under Construction at the Time of the Audit
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
-TOP-SECRET
(b)(1)
(b)(3) NatSecAct
TfeFORNI/MR
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(b)(1)
(b)(3) NatSecAct
-ToP-SEGI7JT
FIORYR-NAIR
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
TOP SECRET/I
(b)(1)
(b)(3) NatSecAct
NerPORNT/IVIR
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TOP SECRET!)
(b)(1)
(b)(3) NatSecAct
ueFeRtittipAR
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
(b)(1)
(b)(3) NatSecAct
OP SECRET/ NeFeRttineR-
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TOP SECRET!
(b)(1)
(b)(3) NatSecAct
NGFORNffMR
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
TOP-SECRET/
(b)(1)
(b)(3) NatSecAct
NOFURNIIMR
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TOP SECRET/
(b)(1)
(b)(3) NatSecAct
titeFORNttraR-
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
1-OP SECRET
(b)(1)
(b)(3) NatSecAct
$40FORt4ftMR
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Approved for Release: 2016/06/10 C06541721
T-010-SfeftET/
(b)(1)
(b)(3) NatSecAct
?Frette
J// r) DCI GUIDELINES
(b)(1)
(b)(3) NatSecAct
(b)(1)
(b)(3) NatSecAct
'NeFORNtfMR
(TV/ NF) Guidelines for Managing
CIA-controlled Detention Facilities
Exhibit D
-(-T-S//
(b)(1) lif) On 28 January 2003, the Director of Central
(b)(3) CIAAct Intelligence (DCI) signed the DC7 Guidelines on Interrogations and the DC7
(b)(3) NatSecAct
ruidelines on Confinement Conditions forXI4 Detainees. The first set of guidelines
applies to CIA employees Df the CIA engaged in
interrogations.
(b)(1) (TSh
(b)(3) NatSecAct?uidelines on Confinement Con
neld in detention facilities opera
guidelines mandate that adequat
(b)(1) detainees to include the provisi
(b)(3) CIAAct medical care, and periods of ph
(b)(3) NatSecActinditions of confinement at de
prison or other established stand
qualified medical professionals t
and psychological evaluations of
records. The guidelines further re
he second ie f guidelines?The DCI
s for CIA Detainees?is applicable to individuals
nde
ontrol of the CIA. The
e to protect the welfare of
-clothing, basic sanitary facilities,
idelines note that although
fc4
4
ion facilities areAlot required to conform to US
xercise.
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
detainees sh
sure their we
nees shoul
irt that
Officers involved with tlig46iifrtion or operation of detention
facilities will be appropriatAY'Vetted and trained prior to their
assignments.
receive periodic evaluations by
ng, and the results of medical
:documented in appropriate
The D/CTC will ensure that the designated responsible CIA
officerl who operates a detention facility, and other officers, both
those assigned permanently and those on temporary duty, who
participate in any aspect of the CTC/Renditions and Detainees
Group (RDG) detention program are provided both sets of DCI
guidelines to read, understand, and formally acknowledge by
cable.
(b)(1)
(b)(3) NatSecAct
facility.
4E4 The responsible CIA officer is generally the chief of base (COB) at the detention
1
(b)(1)
?TeP-S-EeRETL?(b)(3) NlatSeciTheFeRt4ttr9tR
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TOP SECRET/
(b)(1)
(b)(3) NatSecAct
NOM,littifttlitR
The guidelines require that a quarterly review be conducted by Headquarters of the
conditions at each detention facility and that the review include a written report to the
D/CTC, Associate Deputy Director for Operations (ADDO), DDO, General Counsel,
Deputy Director of Central Intelligence (DDCI), and DCI.2
(b)(1) (ll/Ft}tiO) CIA OFFICE OF MEDICAL SERVICES GUIDELINES
(b)(3) NatSecAct
(b)(1)
(b)(3) NatSecAcPtember 2005.5
(TS/
4F) The Chief of Medical Services disseminated
guidelines concerning medical support to CIA interrogation and detention activities in
April 2003 to Office of Medical Service Spersonnel assigned to detention
facilities .3 According to OMS, the gtit et: a compilation of previously issued
guidance.
(b)(5)
guidelines and disseminated the
program. In response to a reco
General special assessment (Spe
Interrogation Activities (Septem
guidelines were issued in final
riodically rOped and updated the draft
all OMS personnel involved in the detention
dati. rk,the May 2004 Office of Inspector
nterterrorism Detention and
2003), 2003-7123-IG), the
he guidelines were revised in
detention process: (1) rendition
(3) long-term care. The majority 8
interrogation phase, as this is the ris
aspects of medical/psychological care t
guidance on how to handle detainees during renditions and the use of interrogation
techniques is very specific. Post-interrogation guidelines, which were the focus of this
audit, address generally applicable and more familiar aspects of health care. OMS
guidelines for the care of detainees in the post-interrogation phase require that periodic
medical and psychological evaluations be performed and the results documented.
nes address three phases of the
on, (2) sustained debriefing, and
e devoted to the rendition and
the detention process and involves
familiar to most OMS officers. The
2 (U/Iff$71.0) In April 2005, the President established the positions of Director and Deputy Director of National
Intelligence, effectively eliminating the positions of DCI and DDCI, respectively. The Director, CIA and his
(b)(1)
,1Tuty were thereafter known as DCIA and DDCIA, respectively. In October 2005, the DCIA announced that
(b)(3) NatSecAct, Directorate of Operations became part of the National Clandestine Service (NCS). The positions of ADDO
and DDO thereafter became known as Deputy Director, NCS and Director, NCS, respectively.
(b)(1) 4F) Draft OMS Guidelines on Medical and Psychological Support to Detainee
(b)(3) NatSecAc11t
interrogations.
OMS Guidelines on Medical and Psychological Support to Detainee Rendition,
Interrogation, and Detention.
5 g.gi
(b)(1) Itlf--) Additional OMS guidance entitled Part 2: Psychological and Psychiatric Support to
n-'-inee Interrogations, dated December 2003, remains in draft.
(b)(3) NatSecAct
2
TiEW-SEC-R-ET/
(b)(1)
(b)(3) NatSecAct ffieFORPVIPAR
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(b)(1)
T-GP-SECRET/ (b)(3) NatSecAct
4GFOR-NOMR
Absent any specific medical problems, bimonthly medical evaluations of detainees
held at facilities under the direct control of the US Government are to be conducted and
documented. Acute problems are to be addressed in a "clinically appropriate"
(b)(1)
t"--ieframe.
(b)(3) NatSecAct
'CM tif) In addition to detecting and treating health
problems, the OMS guidelines require medical officers to assess detainees for
indications of inadequate nutrition. Detainees' weights are to be obtained and recorded
at least monthly. In the event of a hunger strike by a detainee, medical officers are to
evaluate the detainee for evidence of deitlyis in and starvation. The OMS guidelines
authorize intervention on a hunger stOltEiS without the detainee's consent, when
necessary to preserve the life of th o fluid replacement may be
undertaken when the medical offi as reason lieve that the refusal to take fluids
poses a significant threat to the 11 'for health of th detainee. The detainee must first be
made aware of the risk associate th his behavior and refuse to resume oral hydration
voluntarily. If the detainee is ta fl t nutrients, intervention must be
undertaken when the detainee eight4141 b 0 percent of normal or the medical
It4, ?
officer finds other evidence of p slat detcrioratinsuggesting risk to the detainee's
life or health. Treatment is to be tinued until etainee is seen resuming
(b)(1)
voluntary eating and drinking.
(b)(3) NatSecAct
(b)(1)
(b)(3) NatSecAct
(TS/ 4111t) To promote the long-term health of the detainee
population, the OMS guidelines make recommendations on the use of vitamins and
vaccines. If a detainee will not be exposed to sunlight for a sustained period, OMS
recommends supplementing the detainee's diet with calcium and Vitamin D.
OMS also offers and recommends the tetanus/diphtheria, MMR (mumps, measles and
rubella), hepatitis B (combined with hepatitis A if possible), and influenza vaccines.
The guidelines note that all detainees with hepatitis B or C should receive appropriate
(b)(1) hepatitis immunizations to reduce the risk of additional liver damage.
(b)(3) NatSecAct
Z14.) The OMS guidelines provide some information on
handling violent detainees. OMS advocates a stepped approach that ranges from
discussions with the detainee to the use of physical restraints and medication. The
OMS guidelines stress that a decision to involuntarily administer medication to control
a detainee's behavior should be a last resort. The guidelines prescribe that medical
officers alone are authorized to make this determination and to administer medications
detainee cells be kept clean and th,
hygiene. All detainees are to be m6iiit?redto
care. OMS arranges vision testing
for detainees. CTC/RDG arranges for a
The guidelines ote that it is important that
'there be pro ons for regular bathing and oral
they are actively involved in self-
on of appropriate corrective lenses
-fist to provide urgent dental care.
?T-GP-SE-CRETh
2
3
(b)(1)
(b)(3) NatSecAct
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+EW-SECRET/
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(b)(1)
(b)(3) NatSecAct
NOFGRNHIVIR
to control a detainee's behavior. The guidelines provide that if medication is
administered involuntarily, the medical officer is to remain at the facility until the
detainee has recovered and a long-term treatment plan is developed. Specific
guidelines on the use of medications intended to control detainee behavior, including
information on specific substances and recommended dosages, are included in the
(b)(1) OMS guidelines.
(b)(3) NatSecAct
eT-S/ Nil) In situations where a detainee's medical condition
cannot be adequately treated at the detention facility, OMS guidelines recommend that
(b)(1) detention facility staff and local CIA station, e sonnel obtain through the host-country
(b)(3) NatSecAct a point of access to thpli? 's health care system.
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
(b)(1)
(b)(3) NatSecAct
(-T-Sw'defines reference a document
(b)(3) CIAActprepared by OMS' yt
eh' logical and Psychiatric Support
to Detainee Interrogation?for I guidance pw to deal with detainees'
psychological problems. All de s rendered t IA-controlled detention facility
are to be given psychological evrhilitions on a "re ir basis." If a CIA psychologist
determines that a detainee has a e i osable psychoPgical disorder, a treatment plan
will be developed in coordination OMS and,. /RDG.
(b)(1)
(b)(3) NatSecAct emergencies are specifically
addressed in an appendix to the OMS g e s. Contingency plans for handling
mental health emergencies are to be developed for each CIA detention facility. A
mental health emergency is defined as behavior that is a marked change from the
detainee's usual behavior and may be agitated, impulsive, potentially harmful to self or
others or psychotic. In the event of a mental health emergency, the Senior Site Officer
is directed to consult with the CIA
psychologist at the facility or, it none is present, a psychologist assigned to CTC/RDG
or OMS(b)(3) CIAAct Division.(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
(b)(3) CIAAct
A medical and
psychological examination should be administered to the detainee at the earliest time
possible. If a medical officer is present, he may use medication to sedate the detainee
(b)(1)
(b)(3) NatSecAct
6 cfs
'Mt') The COB at the detention facility is generally the "Senior Site Officer'
(b)(3) CIAAct
TOP SECRET
(b)(1)
(b)(3) NatSecAct
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Approved for Release: 2016/06/10 C06541721
TOP oteRETh
(b)(1)
(b)(3) NatSecAct
4G1OR-NIIMR
until the behavior abates and further evaluation can take place. The psychologist or
medical officer will then manage the emergency until it has resolved and the detainee
(b)(1) has been judged to be stable from a mental health/medical perspective.
(b)(3) NatSecAct
rr-S/ N. OMS also encourages medical officers in its guidelines
to refer to outside sources on prison medical care. The guidelines specifically cite the
US Department of Justice, Bureau of Prisons website, which outlines its clinical
practice guidelines. Other references cited in the OMS guidelines include Standards
for Health Services in Prisons, a regular publication of the National Commission on
Correctional Health Care, and Clinical Practice in Correctional Medicine by
Michael Puisis published in 1998.
TOP SECRET
(b)(1)
(b)(3) NatSecAct
NOPORNMOR
1
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TOP SECRET,
(b)(1)
(b)(3) NatSecAct
140FOR-INH4MR
Exhibit E
(b)(1)
(b)(3) NatSecAct
TOP SECRETI)
(b)(1)
(b)(3) NatSecAct
KentlettIttNtR
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Approved for Release: 2016/06/10 C06541721
TOP-SECRET/
(b)(1)
(b)(3) NatSecAct
NCYPORNitivtit
Exhibit F
(U) Recommendations
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
(b)(5)
(b)(1)
(b)(3) CIAAct
(b)(1) (b)(3) NatSecAct
(b)(3) NatSecAct
(b)(1)
(b)(3)
(T-SI 44F)
Medical Services in coordinati
Renditions and Detainees Gro
detention facilities that contai
staff and medical personnel t
emergency involving a detain
NatSecAct
(P8/ 14-F)
CounterTerrorism Center, Ren
Chief of Medical Services: (1) Pro
involved in the preparation of me
detention facilities. (2) Develop and in vritt
ecommendation 3 (significant): For the Chief of
the.Chie , CounterTerrorism Center,
-AilAgilttIntsopy records at CIA-controlled
.info a that may be needed by facility
respond to a medical
(significant): For the Chief
Group in coordination with the
safe food handling for personnel
mg of food at CIA-controlled
standards and procedures designed
to avoid the introduction and transmission of food-borne illnesses at CIA-
controlled detention facilities.
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
TOP SECRET/
1
(b)(1)
(b)(3) NatSecAct
VtFORNttiVtR
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Approved for Release: 2016/06/10 C06541721
TOP-S"Ee-RETI
(b)(1)
(b)(3) NatSecAct
ritetFORNffNIR
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
(b)(5)
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
(b)(5)
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
(b)(5)
(b)(1)
(b)(3) CIAAct
(b)(3) NatSecAct
2
4-0P-SEeRETI
(b)(1)
(b)(3) NatSecAct
NiefeRt4ttrtfrrt
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Approved for Release: 2016/06/10 C06541721
TOP SECRET
(b)(1)
(b)(3) NatSecAct
Exhibit G
(U) Audit Team Members
(U//F43.14E)) This audit report was prepared by the Operations Division, Audit
Staff, Office of Inspector General.
Exhibit is Unclassified/Medd()
When Separated From Report
(b)(1)
(b)(3) NatSecAct
-Tar SECRET//
Approved for Release: 2016/06/10 C06541721