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Polk County Jail
Des Moines
Correctional Medical Services
Jun 5, 2016 desmoinesregister.com
Daughter: Murder suspect's trial — and health — on hold at Polk County
Jail
Theresa Maher knows that when this story hits the internet, trolls will
have a field day with their opinion of her mother and her condition. She doesn’t
care. They don’t know Pamela Jean Bullington or
what she has lived through. Maher has got a question she feels needs to be
answered: If her mother were any other woman, would she have to endure the
extreme discomfort she’s going through at the Polk County Jail? Bullington's situation
raises larger questions about whether the jail and its for-profit medical
contractor are making decisions to cut costs at the expense of inmates'
suffering. The
57-year-old made headlines a year and a half ago after she allegedly shot her
longtime boyfriend, Jack Duane Dennis, in the head with a pistol and then
called police. She reportedly told a dispatcher she would be sitting on the
back porch, waiting for officers at a house the two shared near the Iowa
State Fairgrounds on Des Moines’ east side. Bullington has pleaded
not guilty to first-degree murder. She told police she was the victim of
domestic violence at the hands of the 69-year-old Dennis. The record
will show Dennis was no saint: He had a long history of arrests for
consumption and intoxication, drunken driving, trespassing, disorderly
conduct, assault, attempted murder and felony terrorism — and just before he
died in 2014, domestic abuse causing injury. He pleaded to the lesser charge
of assault on that last one and got two days in jail. Bullington's trial has
since been delayed so she can recover from a hysterectomy that has not been
performed. A recommendation was made, and preoperative appointments were
scheduled. But in April, a medical expert sought by Corizon
Health, the private, for-profit Tennessee company that oversees the Polk
County Jail’s medical care, examined Bullington and
decided surgery wasn’t necessary. Maher says her mother’s medical problems have only
worsened since then. Bullington ultimately learned
that her weakened vaginal wall had prolapsed, sending her bladder, uterus and
rectum into the vaginal cavity. Her bladder now protrudes from her vagina,
signaling an advanced stage III prolapse. Laugh if you
want, but prolapses are pretty common. The result
for Bullington is that if she coughs, she wets her
pants. If she needs to urinate, she has to reach down and tap or massage her
own protruding bladder so she can go. Suffice to say, bowel movements are
difficult. The problem
has been so uncomfortable, and the taunts around the Polk County Jail so bad,
Bullington had to move to a single jail cell, away
from other inmates, her daughter says. Maher contacted the Reader’s Watchdog, and her mother
signed a medical release, so others were free to talk about why she is not
being allowed to have the surgery she has said she needs. Most of the
cost of any inpatient surgery would likely be borne by Medicaid, whether Bullington was in jail or not. But the county is
ultimately responsible for what costs aren’t covered. Maher believes Corizon is not approving the surgery in order to save
money. “Would
anybody else in the world have to live like this?” she asked. “Would they be
as likely to turn surgery down if she were not in jail?” Maher asked
that I attend a court hearing Tuesday in Polk County District Court to help
find answers. At the hearing, Judge Jeffrey Farrell was asked whether Bullington could have a second opinion from an expert not
chosen by Corizon. Bullington’s attorney,
Matt Sheeley, argued that his client may not be
physically able to stand trial in September. He argued that it would be
almost impossible for her to focus on the trial, which could last up to two
weeks and decide whether she spends the rest of her life behind bars. Sheeley said he has
been unable to find to any case law that applies to the issue. “If she had a
broken leg, the court would suspend the proceeding until she received the
necessary medical care,” Sheeley said. He added:
“The sheriff has the obligation as keeper of the jail to provide the
necessary medical care.” Via telephone, Dr. Emily Chang, the Des Moines
gynecologist tapped by Corizon to evaluate Bullington in April, testified that she recommended that
the inmate first undergo physical therapy sessions before trying surgery. But
Chang, who has never worked with a Polk inmate before, acknowledged that only
about 10 percent of her patients with similar conditions choose that option
over surgery. And she said
the likelihood of physical therapy working on a prolapse
as advanced as Bullington’s was “less than 50
percent.” Asked by Sheeley if she considered the upcoming trial as a factor
before making her recommendation, Chang said she did not. Dr. Glenda
Newell-Harris, regional medical director for Corizon
Health in California, reviewed Chang’s notes and ultimately declined to
authorize the surgery. But here’s the thing: As of Tuesday's hearing, no one
at Corizon or the jail has initiated the physical
therapy sessions Chang recommended in April. Those
sessions promise to come with their own costs to the county for transportation
and escorts by deputies. In the end, physical therapy could prove more costly
to the county than surgery, said Frank Marasco, a
top jail official.
Her face drawn, Bullington testified briefly
about her condition Tuesday, telling Farrell in a soft monotone that she
already has tried Kegel exercises to try to fix the
problem. “People don’t
know what I’m going through,” she said. Marasco, who manages
the jail’s medical contract as head of the sheriff’s planning and development
department, said repeatedly during the hearing that cost “doesn’t play a role
in making medical decisions” at the jail. Asked by Sheeley if he was trying to keep costs down, Marasco said: “I think we have a fiduciary responsibility
to taxpayers. However, we would never avoid an expense if it’s necessary.” An online
search for more information about stage III prolapses
of the bladder suggests that it wouldn't be hard to find someone with a
differing opinion about what’s necessary. An article
about the condition, written by Dr. Matthew Barber of the the
Cleveland Clinic, one of the top-ranked hospitals in the country, said some
patients with severe prolapse do fine without
treatment for years. But once they have difficulty emptying the bladder or
other discomfort, he recommends surgery. “Typically,
we recommend surgery to women who have stage 3 or 4 prolapse
(i.e., prolapse that protrudes more than 1 cm
beyond the vaginal opening with straining) or women with stage 2 prolapse who have bothersome symptoms,” wrote Barber, a
former president of the American Urogynecologic
Society. Bullington's condition is
not life-threatening, but it will worsen over time, such articles suggest. At the heart
of the debate is whether the surgery is a choice or an emergency. Judge
Farrell said he will likely decide within a week what to do next. In Florida,
Idaho, Indiana, Minnesota and Pennsylvania, Corizon
has been investigated, sued or criticized for failing to provide adequate
treatment or authorize more costly health care. The Florida
Court of Appeals ruled that it was reasonable for jurors to conclude that the
company, previously known as PHS before a merger, delayed medical treatment
to save money. Last year, Corizon also refused to provide Polk County Sheriff Bill
McCarthy with a copy of a report on inmate Jeff Cornick's
suicide. And in August
2013, a Corizon nurse was supposed to be monitoring
inmate Ieasha Lenise
Meyers, who complained of being in labor. Meyers, 25, gave birth on the floor
of her cell. Her cellmates assisted with the delivery while the nurse did
rounds in other parts of the jail. Marasco said he's
not aware of any situation in which Corizon failed
to obtain medical help for an inmate because of cost. The company,
the jail's health services provider since 2008, is being replaced by another
Tennessee company July 1. But Marasco said the
switch wasn’t performance-based. Correct Care Solutions, the low bidder, won
the new contract.
Marasco said Correct Care Solutions was
chosen by consensus, in large part because it promised better training in
mental health and suicide prevention for jail staff. The new
contract calls for the company to be paid about $3.2 million in the first
year — less than the $3.5 million paid Corizon this
year, Marasco said. The new
company plans to reduce staffing at the facility by about six hours a week,
and shift more staff to nighttime hours when the jail can be flooded with new
prisoners, Marasco said. The jail will have nurses
on staff around the clock with psychiatrists, dental assistants, dentists and
other medical professionals less frequently. The county
pays for pharmacy costs and off-site medical services. Maher says
her mother, a lifelong alcoholic and drug abuser, called her three times the
night she allegedly shot Dennis. The first time, Maher didn’t pick up. The second time, Bullington said, she awakened to Dennis trying to
suffocate her with a pillow. She also wanted her daughter to know she had a
knife hidden under her pillow. Less than 10 minutes later, Bullington
called her a final time that night. “She said, ‘I did it. I killed him,'” Maher said. “I
told her to hang up right now and call police. And then I called police to
make sure she did.”
Bullington's case has all
the signs of battered women’s syndrome. Abused as a child, she married at age 14 or 15, Maher
said. “I can’t remember a time when my mom wasn’t addicted to
something."
One of Bullington’s boyfriends broke all her
teeth and the bones in her face, then left her by
the side of a road, Maher said. Maher said her mother tried to leave Dennis because of
the frequent beatings, but she returned because he supplied her with drugs
and alcohol. Bullington called police in April 2014 and said
she "feared for her life" because Dennis held a loaded gun to her
head. He also threatened to burn down homes of her family members, police
reports show. A jury, of
course, will ultimately decide what Bullington
deserves as punishment. Maher says she wants her mother to have the surgery so
she can finally go to trial. If the verdict sends her mother to Mitchellville
women’s prison, she’s fine with that. That’s where she believes the healing will finally
begin.
November
24, 2006 Des Moines Register
Polk County supervisors, concerned that a privately run jail medical
clinic hasn't pinched pennies enough, have launched a search for someone to
keep an eye on how it is operated. Supervisors voted unanimously this week to
hire a new "health services administrator" to oversee the county's
contract with Correctional Medical Services Inc., a St. Louis company. The
job, intended to be filled by a registered nurse with managerial experience,
will pay between $62,012 and $81,744 a year. County Administrator Michael Freilinger said the new employee will be expected to
wrestle with the ever-expanding cost of medical care for more than 500
prisoners and help plan for the 2008 opening of a new 1,549-bed jail. Polk
County authorities have watched inmate medical costs increase from $1.4
million in the budget year that ended in June 2003 to roughly $2.4 million
projected for 2006-07. County officials say Correctional Medical has blamed
much of the increase on drug costs. Correctional Medical, one of only a
handful of private companies that run jail clinics, has managed medicine in
the Polk County Jail since 1998. The company has faced several inmate
lawsuits in recent years, mostly based on allegations of delayed care or the
use of substitution drugs in a bid to contain costs.
June 9, 2005 Des Moines
Register
The Polk County Board of Supervisors will pay $35,000 to settle a lawsuit
filed by relatives of a man who died in the county jail after his arrest for
reckless driving. Mark Girres, a 58-year-old
diabetic, died in 2003. His daughters sued, alleging that sheriff's deputies
and medical staffers from Correctional Medical Services of St. Louis ignored
warnings about Girres' health and put off care.
During the past decade, more than a dozen inmates or their families have alleged
that officials delayed or denied treatment. Among them were two cases that
the county also settled out of court: an HIV-positive man charged with
driving drunk who spent 11 days in a coma after he said jail medical workers
delayed treating his low blood pressure, and another inmate who said she
suffered permanent tendon damage after she had to wait days for treatment of
a knife wound to her hand. Girres, a retired
tree-trimmer for the city of Des Moines, was arrested Sept. 19, 2003, after
his car collided with a light pole, a parked vehicle and a fence at an
Ingersoll Avenue gas station. Girres' daughters
said the collisions were a sign he needed medical attention. Girres was booked Sept. 20. A guard noticed Girres seemed ill and recommended he be closely watched.
The lawsuit alleged that Girres was moved but not
treated. He died Sept. 22 at a hospital.
May 5, 2005 Des Moines
Register
Polk County taxpayers will pay 20 percent more to provide medical
services for the nearly 17,000 people that law enforcement officials expect
to lock up next year. The county, which on average has reported a more than 5
percent annual inmate increase over the past decade, will pay $1.8 million
for doctor visits, hospital stays, prescription drugs, dental care and mental
health in the budget year that starts in July. That's $300,000 more than this
year. For the seventh consecutive year, the county Board of Supervisors will
hire Correctional Medical Services, a St. Louis company, to administer the
jail health program. Supervisors have praised the company for consistent and
quality care during the years. But both the company and the jail have been
criticized by inmates and their families. After the 2003 death of Mark Girres, 58, an imprisoned Des Moines diabetic, his
survivors alleged that jail officials knew about his illness but did not
fully evaluate his health or give him needed care. Jail officials denied
wrongdoing, and Iowa's ombudsman's office investigated that and other
complaints but ruled that jail officials have made substantial improvements
that will prevent future problems. Tracie Botts of
Des Moines, who spent six months in jail last year on drug charges, offers a
mixed assessment. She claims a fellow inmate endured constant pain from a
stomach ulcer and was denied medication for months. At the same time,
however, Botts said she was able to kick her
addiction to crack cocaine thanks to treatment provided by the jail.
"That other girl, she had this bleeding ulcer and was more or less
ignored," Botts said. "I got the
treatment I needed, and it worked for me. I'm a year clean and
counting."
October 7, 2004
Des Moines Register
A
Des Moines woman contends that Polk County Jail officials haven't kept a
promise to make "substantial and meaningful" changes to medical
policies she blames for her incarcerated son's suicide attempt last year.
Audrey Rivas said a letter from the state ombudsman's office confirmed that
jail officials acknowledged at least some mistakes prior to Robert Rivas'
attempted Tylenol overdose. The admission came three months after the 2003
death of an imprisoned Des Moines diabetic, Mark Girres,
58, who allegedly was denied medical attention following his September 2003
arrest for reckless driving. A Polk County lawsuit claims jail officials did
not evaluate Girres' health despite repeated
warnings about his illness and erratic behavior before his death. Rivas said
the two cases demonstrated a pattern of poor medical care at the jail. The
ombudsman also faulted Correctional Medical Services, the jail's privately
run medical clinic, for failing to adequately assess Rivas' need for a
prescribed antidepressant, which the clinic had refused to provide. The lawsuit, filed by Girres' two daughters, accuses deputies and Correctional
Medical of negligence.
September 29,
2004 Des Moines Register
Relatives
of a 58-year-old diabetic arrested for reckless driving last year have sued
Polk County Jail officials, alleging that deputies and a private medical company
were negligent for allowing the man's illness to go untreated until he died.
A spokeswoman for St. Louis-based Correctional Medical Services said patient
confidentiality rules forbid any comment on Girres'
case. She stressed that medical staffers "work
very hard every day to meet the medical needs of inmate patients in Polk
County." Court papers state Girres, who
originally was booked into the Des Moines City Jail, was transferred to Polk
County's custody about 1 p.m. last Sept. 20. A questionnaire filled out then
shows Girres told jailers that he suffered from
both diabetes and liver cancer but that no medications were required. Jailhouse reports state Girres was refusing food by the evening of Sept. 20 and
"does not appear to be in good health." That
night, according to the lawsuit, Girres was
transferred into administrative segregation because he was "seemingly
disoriented" and "acting and talking too crazy" to remain in a
regular cell. "The family has reviewed all records pertaining to his
incarceration," Girres' daughters said.
"We are deeply saddened by the withholding of medical attention in spite
of 12 separate documented instances in which medical attention was clearly
warranted." By Sept. 21, Girres was talking to
himself, defecating on himself, "bleeding from open wounds" to his
arms and "incoherent," according to the lawsuit. A 2002 Des Moines
Register article described more than a dozen allegations that Correctional
Medical officials delayed or denied treatment to Polk County inmates during
the company's first four years controlling a jailhouse medical clinic.
Pottawattamie County Jail
Pottawattamie, Iowa
Correctional Medical Services
December
20, 2005 The Daily Nonpareil
Pottawattamie County spends more than $650,000 a year on health care for
inmates at the county jail, but a new way to save money might become a
reality early next year. "It's one of the most substantial costs for the
jail," said Supervisor Loren Knauss. "We
are forced by federal and state laws to spend more on medical care for
inmates than what we do for our veterans." The county has been paying a
private firm, CMS, $55,000 a month or $660,000 a year to oversee health care
needs for the county's prisoners. The firm, however, announced Monday it
plans to cease its operations in February to concentrate on larger state and
federal prisons. The Board of Supervisors gave permission to Sheriff Jeff
Danker and others at the jail who oversee the inmates' health needs to look into the possibility of the county taking
over the operation to save money. "It could be a bunch of savings,"
Supervisor Delbert King said. Under one possible alternative, the county
would hire the three nurses and the administrator currently there as county
employees and contract with a local doctor when needed. Inquiries will also
be made to see if it's cheaper for the county to purchase prescription drugs
locally. CMS, a national company, has its own drug buying policy. The staff
provides 16 hours of health care daily for the more than 250 inmates
currently housed in the jail. Knauss said this new
procedure might save as much as $100,000 a year. "It's a big help to the
taxpayers," King added.
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