We haven't talked a lot about the privatization of prison health care services yet because of so much other stuff going on - and because the state has done such a poor job itself of delivering health and mental health care. But this is an issue we need to watch, especially with so many suicides despite the Prison Law Office and ACLU National Prison Project's lawsuit ready to go.
A good source of information about privatization of prisons and correctional services is the Private Corrections Working Group. Here are their "rap sheets" (from news articles) for the private correctional heath providers named below:
Corizon, Inc
As I recall from previous research, under Wexford Health Serivces' contract with the state of Mississippi, the prisoner mortality rate skyrocketed. Mississippi apparently contracted with them despite New Mexico cancelling contracts because of poor service and unnecessary deaths.
-------thank you, Arizona Republic and Bob Ortega-----
Arizona prisons in health-care quandary
The Arizona Department of Corrections, under orders to privatize its
troubled prison health-care system, faces a questionable choice.
The department is expected shortly to award a three-year contract to
provide medical and mental-health care for the nearly 34,000 inmates in
Arizona's 10 state-run prisons.
Lawmakers adopted legislation two years ago and revised it last year,
requiring Corrections to privatize the health-care system regardless of
whether it saves money. But the choices are between two companies with
checkered records and a third company that has no track record in
correctional health care.
Corizon Inc. of Brentwood, Tenn., a privately held company, is the
country's largest provider of correctional medical care, operating at
400 prisons and jails in 31 states, with a total prison population of
about 400,000. Corizon formed last June out of the merger of the parent
companies of Correctional Medical Services and PHS Correctional Health
Care, previously fierce rivals. Both Corizon's CMS and PHS sides have
repeatedly run into problems providing adequate health care in other
states.
Last November, the Maine Legislature's Office of Program Evaluation
and Government Accountability issued a study blasting Corizon's CMS
unit, saying that more than 50 percent of inmates' medical records
checked by auditors had errors and that there were no records for more
than 10 percent of inmates treated.
The Maine study also reported CMS failed to respond to sick calls,
provide dental services and physicals in a timely manner, had persistent
problems issuing prescribed medicines properly and hadn't trained staff
properly, among other problems.
Over 12 months ending in June, Idaho fined Corizon's CMS unit more
than $270,000 for a wide range of medical- and mental-health-care
shortfalls, including staffing shortages. Public documents released to
the Associated Press said CMS, though it was supposed to fill vacancies
within 60 days, left the South Boise Women's Correctional Center without
an Ob/Gyn for more than two years and left another maximum-security
prison without a staff psychologist for more than eight months.
Since 2005, Corizon's CMS or PHS have lost contracts or failed to win
renewals with prison systems in four states, each with seven to 24
prisons: Vermont (2005), Alabama (2007), Delaware (2010) and Maryland
(2010). Additionally, Corizon's units also lost contracts at individual
county jails in Galveston County, Texas (2007), Pima County, Ariz.
(2008), and Monroe County, N.Y. (2010).
In almost every case, the contract losses followed allegations by
correctional or county officials that the company failed to provide
adequate health care. Pima County officials withheld $1.3 million in
payments over staffing and health-care problems.
"I have huge issues with the quality of the staff, the quality of the
care. ... Their whole goal is how not to do any work," Pima County
Superior Court Judge Nanette Warner said of the company during a court
hearing in 2008, according to the Arizona Daily Star.
Corizon officials declined to respond to specific questions about
these issues or allegations. Spokeswoman Courtney Eller said that
"Corizon has a strong track record of quality care, and we are committed
to continuously working to improve and get better at what we do."
Wexford Health Sources Inc. of Pittsburgh, also privately held,
contracts with 100 prisons and jails, holding about 91,000 inmates in 10
states. That includes a contract with Yavapai County in Arizona to
provide medical services at the county jail. Yavapai County also has
contracted with Wexford since 2010 to run a small program to restore
mental competency for defendants awaiting trial.
Assistant Yavapai County Administrator Dave Hunt said officials have been satisfied with both programs.
Wexford doesn't have as long a record as Corizon of losing contracts,
but there are issues. Wexford was implicated in a 2008 payoff scandal
in which the former corrections director for Illinois, Donald Snyder,
was sentenced to two years in federal prison after he admitted taking a
$30,000 bribe from Wexford's lobbyist, Larry Sims, to steer business to
Wexford.
No Wexford official was charged in the case. The company declined to
comment on the scandal. However, in 2008, a spokeswoman denied to the Chicago Tribune, any company involvement in the bribe.
Wexford also lost a contract in New Mexico in 2007, after an audit by
that state's Legislative Finance Committee reported shortages of
physicians, dentists and optometrists on staff and noted that the
company had failed to issue timely reports on 14 inmates who died at
correctional facilities in 2006. That same year, a Mississippi
legislative committee reported that Wexford wasn't complying with its
contract and had not filled 13 percent of the positions it was required
to by contract at three prisons. Wexford officials also declined to
comment on the staffing and care issues in those reports, or to respond
to questions from The Republic in any manner.
The third bidder, Centurion LLC, was incorporated in Arizona in
December, shortly before its bid was submitted. Centurion is a unit of
Centene Corp. of Clayton, Mo., a publicly traded Fortune 500 company and
the country's fourth-largest Medicaid-claims manager. Centene reported
$111 million in profits on $5.2 billion in revenue last year. Centene
also filed incorporation papers for Centurion in recent months in
Georgia and North Carolina. Centene officials declined to comment on
their bids or on their entry into correctional health care.
It isn't clear whether Centene's Centurion unit can meet Arizona's
contract requirement that the successful bidder must have five years or
more of experience in the past 10 years providing medical- or
mental-health services to at least 10,000 daily patients in a
correctional or custodial setting.
Arizona Department of Corrections officials declined to comment on
when the department may award a contract. But there are just as many
questions about the caliber of care the department currently offers. As
soon as next week, a legal coalition representing Arizona inmates is
expected to file suit in federal court alleging that the department has
systematically and unconstitutionally denied medical care to inmates for
weeks or months even for severe, life-threatening conditions.
The Prison Law Office, a California legal-advocacy group, outlined
allegations in a letter to the department last October, demanding
changes in medical care. In November, Corrections officials signed an
agreement with the group that delayed legal action and gave the state
until Friday to investigate and respond to scores of medical claims.
With that deadline approaching, Corrections spokesman Bill Lamoreaux
would comment only that "we are still looking at this matter." Director
Charles Ryan said in early December that he didn't see any evidence of
systemic problems in the state's medical- or mental-health care for
prisoners.
However, as The Republic previously reported, scores of
inmates from prisons both public and private around the state have
provided letters alleging weeks and months of waiting for even basic
health-care services, difficulties getting prescribed medications and
other problems.
Also, last fiscal year Arizona's per capita prison suicide rate was
more than double the national average, a problem that advocates say
reflects inadequate mental-health-care services; and in recent months,
suicides appear to be continuing at a similar pace, with three reported
in the past month. Since June 1, the department has reported six
suicides and nine other deaths that remain under investigation.
Corrections officials have not complied with public-information requests by The Republic for results of the preliminary investigations into any of these deaths.
Nationally, there have been few studies of the impact of privatizing
prison medical care. "Part of the problem is that good data is really
hard to come by," said Kelly Bedard, an economist at the University of
California-Santa Barbara who co-authored a 2007 study analyzing
privatization outcomes in 32 states.
She concluded that inmate deaths rose 2 percent for every 20 percent
increase in medical-care privatization. "Our results were very clear,"
she said. But Bedard cautioned that, "theoretically, it could go either
way ... just like insurance companies, private providers always have an
incentive to say 'no' because they're trying to save money." But she
said, at least theoretically, a well-written contract with tough
oversight and enforcement could improve care.
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