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Arizona
Department of Corrections
Mar
5, 2021 stateofreform.com
Deprivatization — not continual
fines — is the solution to health care incompetency in Arizona prisons
Eli
Kirshbaum | Mar 2, 2021
In
2018, Arizona’s private prison health care contractor Centurion received
$1.4 million in additional funding from the state to improve inmate health
care. By 2020, that number had risen to $30 million. Yet just last week,
the Arizona Department of Corrections (ADC) was fined — for the second time
in three years — for refusing to comply with agreed-upon standards of
health care for its inmates. In last week’s decision, U.S. District Court
Judge Roslyn Silver fined ADC $1.1 million, finding the state guilty of
noncompliance with performance measures including neglecting to promptly
notify inmates of their medical results, providing them with needed
medications and other violations. Arizona faced a similar charge in 2018,
when it was fined $1.4 million after hearings showed a failure to improve
prison health care. In this instance, prisoners reported nurses withholding
medicine from inmates, prison guards sleeping on the job and inmates with
cancer being left untreated. These charges stem from a 2012 class action
lawsuit brought against ADC by the American Civil Liberties Union, filing
suit on behalf of a group of Arizona prison inmates. In Parsons v. Ryan,
the plaintiffs alleged that state prisons failed to deliver adequate
medical care, dental care, mental health care and more to its inmate
population. The two parties eventually reached a deal in 2015 in which ADC
— while nonetheless claiming its innocence of the plaintiffs’ claims —
agreed to increase its funding for prison health initiatives and comply
with multiple standards of care for inmates. Reports have shown the
devastating impact COVID-19 has had on prisoners, who live in a confined
space and often lack adequate preventive care. However, according to
Rebecca Fealk, policy program coordinator for the
American Friends Service Committee of Arizona (AFSC-AZ), the issue of low quality health care in Arizona prisons started long
before the arrival of COVID-19. The foundation of this issue is Arizona’s
shift from a public to a private prison system, she said. Per their 2013
report on Arizona’s correctional health care system, AFSC-AZ says the
ongoing transfer of power over Arizona prisons between contracted prison
health care companies has perpetuated this issue. Following the removal of
a statute provision that restricted over-priced privatization of state
services like the prison system in 2011, correctional health care company
Wexford assumed control of the state’s prison systems. Wexford was replaced
with Corizon in 2013, and Centurion replaced Corizon in 2018. According to Fealk,
Wexford’s departure offered an opportunity for the state to address the
ineffectiveness of its privatized system. Instead, Arizona chose to replace
one private contractor with another. “As opposed to Wexford being held
accountable, they just shifted to a different provider, completely ignoring
that Corizon had the same history.” Fealk said the decision to privatize Arizona’s prison
system was detrimental to the health of inmates because, through a
privatized system, health care costs are an additional expense for private
contractors. These companies have the ability to
increasingly augment their budget while refusing to act in the best interest
of prisoners by spending money on additional health services. “They’re fine
with paying fines and fees because that doesn’t mess with their profit
margin. But if they actually provide health care,
it costs more. So it’s this extremely damaging
choice the state made to privatize these health care companies. It’s not like [these are] people who have health care
and can choose a different provider — they have no choice. People are dying
because of it.” Fealk also explained that the
harmful effects of prison privatization are not unique to Arizona;
Mississippi, Idaho, Alabama and other states have
also had this “pattern of privatization.” She explained how the pandemic
has only exacerbated the issue, saying COVID-19 outbreaks in prisons affect
their surrounding communities as well as their inmates. “It does not just
stop in the prison walls. The communities that house the prisons, often
more rural and low income communities, have been
affected due to the staff who work in the prisons going in and out on a
daily basis. Outbreaks in Yuma and Florence have been reported, where 5 of
the 16 state prisons are located.” When asked if she thought making the
prisons fully public was the solution, Fealk said
that while the issue is perhaps not that black and white, deprivatizing Arizona’s prisons and restoring
accountability is a key start to solving the problem. “We would definitely
say that there is less harm done when the state is running it, and there’s
evidence for that. That is one step. The solution is to actually ensure
that people are being provided adequate health care inside, and the only
way we’re going to allow that is that there has to be a certain
transparency around that.” Fealk said that
Arizona must increase the transparency in its prison health care, but must do so without violating the Health
Insurance Portability and Accountability Act (HIPAA) by publicizing the
medical information of prisoners. Inmates in need of mental health care
have reportedly only been able to meet with a mental health professional
for appointments lasting several minutes. After asking to see a provider
for severe body pains, one inmate killed herself while her request remained
unanswered ten days later. State prisons have also refused to provide
needed cancer treatments to inmates. “People in prison are some of the most
vulnerable because of the ostracization we’ve done as a society, but also
because it’s often people who are low income, people of color, who are most
warehoused in our prisons due to all these other systemic issues.”
Florida Department of Corrections
Jun
9, 2018 .mypalmbeachpost.com
Florida: Health care provider too big to get rid of?
TALLAHASSEE — Deep cuts to drug treatment, mental health and community
re-entry programs across Florida are heightening scrutiny of a lucrative,
prison health care contract poised to be finalized this month. The $375
million deal now on the table with Centurion of Florida allows it to take
an 11.5 percent “administrative fee” that can not only cover a variety of
costs, but also be pocketed by the company as profit. Centurion, whose
parent company, Centene, is a sizable campaign contributor to Gov. Rick
Scott and the Florida Republican Party, began treating the 97,000 inmates
in Florida’s prison system two years ago. Centurion is the only company
that agreed to negotiate with the state on a health care contract, set to
take effect by July 1. “When you’re only negotiating with one contractor,
he can drive up the prices. It’s not like the Corrections Department is in
a good bargaining position — it’s kind of held hostage to whatever
Centurion wants,” said P.J. Brooks, vice-president of outpatient services
at First Step of Sarasota. First Step is one of 33 community programs cut
by the Corrections Department to make money available to finance the
Centurion health care contract. First Step is losing almost $500,000, and
will reduce its two Sarasota residential treatment centers — a women’s
facility losing four of its 10 beds and a 52-bed men’s center eliminating
22 beds. While Centurion is looking at an 11.5 percent, “costs-plus” contract,
earlier prison health care companies were denied this extra incentive, and
claimed to be losing millions while working with the Department of
Corrections. These firms, Corizon Correctional
Healthcare and Wexford Health Services, along with others in the industry
showed no interest in bidding on the latest contract to care for inmates in
the nation’s third largest prison system. Centurion and DOC, though, seem
happy together. And Florida Corrections Chief Julie Jones fought hard to
make sure the company stayed on board. Jones last month ordered $50 million
in department cuts and reductions to key community services in a scramble
to find cash for the health care contract after state lawmakers low-balled
funding for the prison system. But those cuts are roiling most community
services and ending needed treatment and re-entry programs for offenders
nearing the end of their sentences. As many as 500 inmates may be sent back
behind bars, while programs are shuttered and centers lay-off hundreds of
counselors, treatment specialists and even kitchen workers. “It’s
devastating,” said Michelle Bateman, facility director of the Jacksonville
Bridge Transition Center, where a 165-bed substance abuse program is
closing at the end of this month. Bateman’s center is part of Bridges of
America, which is losing $4 million in state contracts and eliminating 300
beds from substance abuse centers in Jacksonville, Bradenton, Orlando,
Pompano Beach and Auburndale. Bateman has let 50 staffers go this month and
saw about 100 offenders return to prison since the DOC cuts were announced
in May. “We’d seen such progress,” she said. “The people we work with won’t
have a chance if they’re just let out on the street without any help.
They’ll be right back in prison.” The slashing of drug treatment programs
for those about to leave prison comes even as the state is pouring millions
of dollars into fighting a raging opioid crisis that prompted Florida
Attorney General Pam Bondi to join other states in suing big pharmaceutical
companies accused of contributing to the problem. DOC spokeswoman Michelle
Glady said the agency regretted imposing almost $30 million in cuts to 33
community providers, along with another $20 million reduction in prison
operating costs. But Glady said the department is obligated to fund inmate
health care. She added that there were few places to find money when the
Legislature shorted the prison system in the state’s $88.7 billion budget
for the year beginning July 1. Meanwhile, she said the department considers
it a success that the new contract reduces to 11.5 percent the current,
13.5 percent administrative fee Centurion collects in a $321 million
contract that is set to expire. The $55 million contrast boost for next
year reflects, “the rising cost of health care, naturally,” Glady said. For
his part, Scott said that he asked the Legislature for enough money to
properly fund prisons, inmate health care, and maintain community services.
But when lawmakers didn’t pour enough in, Scott declined to take any action
when program-slashing began across the state — although the state is
sitting on $3.3 billion in budget reserves. By contrast, when the Zika
virus was coursing through Florida two years ago, Scott used his emergency
authority to put more than $60 million toward prevention and treatment.
Centurion’s parent company, Centene, also is a major health care provider
in the state’s Medicaid managed care program through its subsidiary,
Sunshine Health. The company’s Florida interests have helped prompt more
than $750,000 in contributions to the Florida Republican Party since Scott
took office in 2011, and another $205,000 to the Florida Republican
Senatorial Campaign Committee in the past three years, state campaign
finance records show. Scott’s Let’s Get to Work political committee took in
$125,000 from Centene last year, along with $35,000 during his 2014
re-election campaign. That year, the company also contributed $175,000 to
the Republican Governors Association Florida PAC, which mostly went to
helping re-elect Scott, records show. Term-limited as governor, Scott is
now challenging Democratic U.S. Sen. Bill Nelson. Sen. Jeff Brandes, a St. Petersburg Republican who chairs the
Appropriations Subcommittee on Criminal and Civil Justice, tried to use
some budget maneuvers on the Centurion contract to keep the community
program cuts from happening. But neither the House nor Centurion would go
along, he said. A problem, he added, is Centurion’s position as the only
company providing prison health care — to the entire state. “If you squeeze
them too hard, do they walk away?” Brandes said.
“That’s the situation we’re in. And we’ve got to come up with something
better.” Brandes said he’d like to avoid having
one contractor for all Florida prisons, recommending, instead, that a portion
of prison health care could be provided by the state. Florida has only used
outside firms for inmate care on a large scale since 2012, when Scott
pushed to privatize the system. Corizon and
Wexford, the contractors before Centurion, left the state under bad terms
following wholesale complaints about patient care, Brandes
pointed out. “I believe you never want to deal with just one vendor,” Brandes said. “But we’re looking at a situation now
where next year, we’re going to have to revisit the health care contract
and also rebuild these community programs we’ve cut, somehow. “It’s the
worst of both worlds,” he added.
Nov 5, 2016 politico.com
Audit raises 'grave concerns’ about mental health treatment for inmates
at central Fla. prison
TALLAHASSEE — State auditors, reviewing prisoner medical records at a
central Florida prison, found widespread compliance problems in providing
mental health treatment to prisoners and “confirmed grave concerns about
the administration of medications.” "This review indicates serious and
multiple deficiencies in the delivery of mental health care in both the
inpatient and outpatient settings at Union Correctional Institution,” the
report states. Auditors looked through 19 medical records of Union
prisoners and found only one who received his medication as prescribed over
a several months in 2015. The state's prison medical oversight agency, the
Correctional Medical Authority, found prisoners had not received one or
more doses of their medication or, in some case, received the wrong dose.
The CMA also found that in two separate instances, involving the use of
psychiatric restraints, vital requirements were either not followed or not
documented as required. That included failing to check whether the patient
was still breathing and had a pulse. In another instance, two prisoners
described to auditors a case where a prisoner tried to alert guards that he
was having a “mental health emergency,” but was ignored for several hours
until he attempted to hang himself. Auditors found the prisoner had
recently been placed on suicide watch and referred to a crisis
stabilization unit after trying to hang himself, and their review of his
health records revealed “several concerning issues.” They further found
that the prisoner didn't receive any of his medications in the first two
days after he was discharged from a medical transitional care unit. In the
case of the same prisoner, auditors found no documentation that the
discharge was properly authorized and that, despite plans two weeks later for
a follow up evaluation with a psychiatrist, he never saw one — even though
his anti-psychotic medication dosage had been increased. In addition to not
seeing a psychiatrist, the auditor found he was discharged a month later
without any documentation that his case manager had seen him. The audit
also noted "significant compliance issues in the areas of laboratory
tests, medication consents, and Emergency Treatment Orders." Overall,
the auditors wrote that their review “indicates serious and multiple deficiencies
in the delivery of mental health care in both the inpatient and outpatient
settings at Union Correctional Institution." Five months later after
their initial review, auditors checked in on the prison again to see if the
department had followed the “corrective action plans” to fix the problems.
Their findings: Almost two-thirds of the issues “remained deficient,”
including making sure inmates receive their medication as prescribed.
"[The Florida Department of Corrections] is committed to making certain
all inmates incarcerated in Florida are given comprehensive health care
services,” Michelle Glady, a department spokeswoman, said in an email.
"While health care within the Department’s institutions is privatized,
FDC closely monitors these services to ensure any deficiencies or necessary
improvements are being adequately addressed.” She noted that when auditors
conducted their follow-up, the department was about to transition private
healthcare providers from Corizon, which decided
to walk away from its $1.2 billion contract with the department more than
two years early, to Centurion, which got the contract to complete the term
for Corizon’s contract. DOC staff did their own
follow up review in August. Of the 49 deficient “corrective action plans”
during the CMA review in April, 28 were still deficient, the department
found. Though inmates are now receiving medication as prescribed, the
department’s review found there are still several deficiencies when it
comes to placing prisoners in psychiatric restraints and checking the pulse
and breathing of these prisoners while they’re restrained. Such
requirements are in place to prevent prisoner deaths, which are associated
with the use of restraint devices in prisons.
Florida Legislature
Feb 13, 2016 tallahassee.com
Lawmakers criticizing prison health contract
Lawmakers are expressing reservations over the Department of
Corrections deal with a Florida company to provide health care in its
prisons, saying it wasn’t fully vetted or formally bid and includes provisions
that could drive up costs. Sen. Greg Evers, chairman of the Senate
Committee on Criminal Justice, said Thursday he was surprised to learn of
the contract with Centurion of Florida, which the agency entered into two
weeks ago after its current vendor, Corizon
Healthcare, walked out early on its five-year contract. Centurion will be
paid a maximum of $267.9 million a year to provide health care to 82
percent of the state’s inmates in prisons throughout Central and North
Florida, including the Big Bend, where Corizon
operates for now. The “cost-plus” contract pays the company for its actual
costs, like salaries and benefits, and gives it an additional payment of
13.5 percent of its costs, for overhead and profit. Though the agency says
it’s unlikely to happen, Centurion could get more than $30 million a year
in fees and profits. “Anytime you get caught in a situation where you’re
paying cost-plus, I don’t think that’s a good deal,” said Evers, a
Republican from Baker. “Because the more you spend, the more you make.” In
other developments, DOC on Thursday rejected a move by another of its
prison health vendors, Wexford Health Services, challenging the agency’s
selection of Centurion. Wexford last week notified the department it would
file a bid protest. But DOC dismissed the filing, saying the agency didn’t
have to follow a competitive process under state procurement laws because
the contract involved health services, which are exempt under statutes. The
agency, however, gave Wexford until Wednesday to file an amended petition.
DOC defended its handling of the Centurion contract in an email, saying the
company’s price was tens of millions of dollars lower than those offered by
Wexford and Armor Correctional Health Services, a third company involved in
the negotiations. The agency said that while it didn’t follow a formal
competitive process, it fostered competition in its negotiations with the
companies. “When Corizon chose to terminate their
contract early, the department was forced to find a temporary health care
solution that was both fiscally responsible and focused on ensuring
continuity of quality care for our inmate population,” said DOC spokesman
McKinley Lewis. “Looking forward, the department remains focused on
negotiating and securing permanent contracts which prioritize quality care
for our inmates at a reasonable and affordable rate for the state of
Florida.” Evers, however, said the 13.5 percent payment for fees and profit
is too high. And he said he has other problems with contract, including a provision
allowing Centurion to terminate with only two months notice. Corizon’s contract requires six months notification
before it can terminate, which it exercised in November. He said that in a
recent meeting with DOC Secretary Julie Jones, he voiced support for an
idea to bring medical care to rural Florida prisons through small,
community hospitals, which he said are hurting financially. He suggested
the agency conduct a pilot program, possibly including telemedicine, to
improve care and keep down costs. “Here I find out that we have entered
into a contract but yet we haven’t fully vetted what I had discussed with
her,” Evers said. “I feel like there should have been alternatives looked
at before you would have entered into a contract such as this.” Lewis said
DOC is examining the concept of pairing rural prisons with community
hospitals. If it’s a viable option, the department will consider it as it
continues looking for long-term prison health vendors. The agency last year
began a lengthy, formal process to secure vendors and is expected to award
contracts next year. He also said the agency fully vetted Centurion, a St.
Louis-based company that operates in five other states. "We contacted
other states that they are currently operating in as well as other
references that they provided," Lewis said. "We found that they
had an outstanding track record.” Evers last year ordered Jones to
renegotiate its contract with Corizon following
media reports on problems including suspicious inmate deaths, questionable
care and staffing shortages. Last year, 354 inmates — a record number —
died in Florida prisons. House Democratic Leader Mark Pafford
of West Palm Beach said the push for privatization, which began several
years ago under Gov. Rick Scott, hasn’t improved conditions. “I think they
went so far in this habit they have of privatization and loosening
regulations, and they did that I think to attract the private sector into
their prisons,” he said. “And now look what they’ve got — a mess on their
hands.” Corizon, which had a five-year, $1.1
billion contract, will end its work for the state May 31, two years sooner
than expected. Centurion is under a two-year “gap” contract, though there
are options to renew it for three more years. Florida TaxWatch
on Thursday issued a statement calling for greater scrutiny of the
Centurion contract, noting that DOC is facing “terrible funding issues that
have put hard-working officers in dangerous situations.” “Our elected
officials must demand a full and transparent explanation on how this
decision will best serve and protect Floridians,” said Dominic Calabro,
president and CEO of the watchdog group. “It is very difficult for
Floridians to believe their interests are being protected by the decision
to spend hundreds of millions of dollars without any competing bids or
public debate.”
Feb 3, 2016 miamiherald.typepad.com
Corrections agrees to temporary new contract with prison healthcare
company, Centurion
A company that provides prison healthcare services in five other
states, announced Monday that it has signed a contract with the Florida
Department of Corrections to fill in the gap in coverage after Corizon Healthcare terminated its agreement with the
state last fall. Centurion of Florida, LLC, a joint venture between Centene
Corporation and MHM Services, Inc., announced it has signed a formal
agreement to begin in April to replace Corizon
Healthcare as the medical provider in Florida's prisons beginning in the
second quarter. The company's lead lobbyist is former House Speaker Dean
Cannon, and its parent company, Centene Health, is a primary provider of
managed medicaid services in Florida -- doing
business as Sunshine Health -- and one of the largest contributors to
legislative political committees in the state. Centene gave $298,000 to
legislative campaigns and political committees in 2015 alone. Centurion
currently currently has five has statewide
contracts to provide correctional healthcare services, though none in a
state as large as Florida. They are in Massachusetts, Minnesota,
Mississippi, Tennessee and Vermont. Corizon
Health decided not to renew its $1.1 billion contract with the state in
November after months of complaints about inadequate inmate healthcare and
dozens of lawsuits. A year ago, state Sen. Greg Evers, R-Baker, chairman of
the Senate Criminal Justice Committee, ordered the Department of
Corrections Secretary Julie Jones to renegotiate the Corizon
contract after a series of reports in the Miami Herald and other news
organizations showed suspicious inmate deaths were covered up or never
reviewed, staffing was inadequate, and inmate grievances and complaints of
harmful medical care were dismissed or ignored. Centurion's press release
said the company will serve 70,000 inmates in the new prison Regions 1, 2
and 3, for a contract that runs through January 2018, when the agency
expects to complete negotiations for a longer-term health care provider.
Wexford Health Sources will continue to operate in Region 4, which includes
Miami-Dade and Broward, during that time. Details of the contract, and what
kinds of performance measures will be included, have not yet been released.
Jones said in a statement that the agency “looks forward to working
collaboratively with Centurion of Florida and Corizon
Health to ensure a seamless transition of health care services for our
facilities.” She said the department is committed to providing “quality
health care to those in our custody and improving health outcomes for
Florida’s inmates.” "This agreement with Centurion is a result of the
state undertaking negotiation of a gap contract due to early termination by
its prior vendor,'' Centene Corp. wrote in a press release. He said “the
agreement also includes optional renewal periods if the formal procurement
is not finalized in the anticipated timeframe.” Steven H. Wheeler, CEO of
Centurion, said the company is “pleased to be able to work with the
Department to improve the quality of services and care levels provided to
this population. We also recognize the importance of maintaining sound financial
discipline on behalf of the State and its residents.”
July
16, 2013 correctionsone.com
NASHVILLE — A legislative watchdog
group agreed Monday to delve deeper into the state Department of
Correction's awarding of a $200 million-plus contract to handle inmate
health care to a relative newcomer despite its $6.4 million higher bid.
Fiscal Review Committee members want the winner of the contract, Centurion
LLC, to come before the panel in September. Correction Department officials
went before Fiscal Review for approval of their request to extend the
current contract of Brentwood, Tenn.-based Corizon
until Sept. 30 to provide Centurion additional time to prepare taking over
the service. While the business at hand was the 90-day extension of Corizon's existing contract, committee members devoted
most of their time questioning Centurion's winning of the new three-year
contract. Corizon, which had the existing
contract, lost the competition to Centurion on the new three-year contract.
Corizon protested but two state panels upheld the
award to Centurion, the most recent coming in a June 6 ruling. Recently,
Correction Department officials said, Corizon
indicated it would not push the protest further by going to court.
Lawmakers criticized the request-for-proposal process and raised concerns
about the higher cost and what they see as the recently created Centurion's
relative lack of experience. Rep. Tim Wirgau,
R-Buchanan, said it raises "red flags" for him. "Give me
some reasons why you decided to spend $6.4 million more," he told Wes
Landers, chief financial officer for the Correction Department. Rep. Jeremy
Faison, R-Cosby, was highly critical of Centurion's experience. "That
seems a little shady there," Faison said, adding that the state either
had standards or not in awarding points in the request-for-proposal process
for experience. In remarks both during the committee and afterward, Wes
Landers, the Correction Department's chief financial officer, defended the
decision to go with Centurion. Centurion is a relatively new joint venture
between MHM Services Inc., which has a track record in inmate mental health
care, and Centene Corp., which specializes in managed care. The RFP allowed
for "unique" ventures as the state seeks to cut its costs on inmate
health care, Landers said. Between MHM and Centene, the experience
requirement was met, Landers said, noting MHM has a history of work in
Tennessee. Centene, he said, has cost-containing agreements with a number
of hospitals in the state. The remarks about the RFP allowing room for
"unique" ventures prompted Faison's remark about
"shady" requirements. Landers later said in an interview that
through Centene, Centurion will be able to pay the hospitals at Medicaid
rates, which are cheaper, for inmate care. He said the company also has
provided for a risk-sharing model that financially rewards the state for
holding down unnecessary hospital visits. "I've got really high hopes
for what we might be able to do," he said. Landers said under the RFP
process, the decision is based on three factors: cost, the proposal itself
and experience. Cost accounts for 35 percent of the decision while the
technical proposal accounts for 45 percent and 20 percent is based on a
firm's experience. Following the initial RFP, General Services' Central
Procurement Office took over and continued negotiations with both firms to
reduce costs. Landers said after all was said and done, Centurion had a
six-point advantage despite Corizon's lower
costs. Corizon's initial offer was around $229
million while Centurion's was $247.3 million, Landers said. After several
rounds of negotiation, Corizon ended up at $225.6
million while Centurion was $232 million. Last month, eyebrows were raised
after The Tennessean reported that Correction Commissioner Derrick
Schofield's wife works in a midlevel capacity for Centurion in Georgia.
Officials said there is no conflict and that Schofield recused himself from
involvement in the awarding of the contract. Corizon,
meanwhile, has had problems in other states with allegations the company's
inmate care was inadequate. Kentucky television station WHAS reported it
found "multiple wrongful death lawsuits" filed against the
company, including one involving an inmate's death in the Lexington-Fayette
County jail in 2012. Landers said Tennessee has assessed the company
$37,000 for several problems, including failure to maintain adequate
staffing and failure to perform tuberculosis skin tests on inmates. The
Fiscal Review Committee granted the department's 90-day contract extension
for Corizon. Landers said it was necessary
because of delays caused by the bid protest with Centurion unable to come
in to begin planning until the issue was settled.
New Mexico Corrections Department
Sep 8, 2018
kunm.org
State Fines Prison Health Care Companies Millions
The state fired the private company in charge of prisoner health care
and gave the contract to another company after a 2016 investigation into
dangerously bad medical care in prisons by the Santa Fe New Mexican. But in
the two years since the change, millions of dollars in fines have been
leveled against the new private health care provider. The state’s
Department of Corrections has fined Centurion—the new private corporation
it hired—$2.1 million for staffing shortages since 2016. Attorneys who
represent inmates told lawmakers last month of an incarcerated man who
slipped in the hallway, broke his arm, and spent more than a week with it
bent like a question mark. Local civil rights lawyer Matthew Coyte said there's a human
cost and a financial cost to taxpayers. "They are in prison. They have
no control over if they can go to an emergency room, for example," he
said. "And if the system is understaffed or underfunded—or
dysfunctional in some way, then the inmates suffer." Another new for-profit
company, MHM, that was contracted to provide behavioral health care, was
also fined almost half a million dollars for not adequately staffing state
prisons. New Mexico’s prisons held more than 7,000 people last month.
Jun 5, 2016 santafenewmexican.com
Centurion lands
contract after supplier’s wife helped craft specs
A consultant who
helped write the New Mexico Corrections Department’s request for proposal
on a $41 million health care contract also has ties to a business that
sells medical supplies to Centurion, the company that received the
contract. The consultant, Ann Perham, is married to Jonathan Perham, owner
of Axess Medical LLC, a Middleton, Mass., company
that sells medical supplies to prison health care providers, including to
Centurion for its contract in Massachusetts. She said there was no
impropriety in her helping to craft the proposal soliciting companies to
provide health care for 7,200 prisoners in New Mexico. But one of the phone
numbers Axess lists on its website leads to a
voicemail recording by Ann Perham, who is also the signatory of the
company’s records. Perham billed the state 44.75 hours of work at $200 an
hour and requested a payment of $8,950 to be sent to her Massachusetts
home. The phone and fax numbers on Perham’s invoice are the same as her
husband’s medical supply company. Axess
incorporated in Massachusetts in 2009 to “provide procurement services to
private companies and institutions for medical supplies, medical equipment
and healthcare products,” according to its website. Ann Perham said she
disclosed to the New Mexico Corrections Department the relationship between
her and her husband’s business. Perham said in a brief telephone interview
that she works with different companies as a consultant. She would not
disclose the names of the companies. “There’s no conflict of interest. It
was a basic RFP,” Ann Perham said, using the acronym for request for
proposal. Ann Perham and Alex Tomlin, a deputy secretary of the Corrections
Department, said in separate interviews that Axess
will not supply Centurion with medical equipment for its New Mexico
contract. Neither could say where Centurion would purchase equipment. Mike
Brewer, senior vice president of corporate development for Centurion, did
not respond to questions emailed to him last week. Tomlin also told The New
Mexican she thought Axess Medical also had a
business relationship with one of the other bidders on the New Mexico
medical services contract that Centurion won. But spokeswomen for the other
two bidders on the contract, Wexford Health Sources and Corizon
Correctional Healthcare, said in emails Friday they have no record of ever
doing business with Axess Medical. This would
indicate that Jonathan Perham’s company had a relationship only with the
successful bidder of the contract for which his wife wrote the
specifications. Tomlin said the state’s hiring of Ann Perham was a wise move
because Perham is in the prison health care industry and understands how to
write the specifications of how a private company would care for inmates.
“It’s a very small world, medical contract vending for prisons, and we were
trying our damnedest to make the best deal for taxpayers and not leave
anything out,” Tomlin said. “We said, ‘We are not the expert. Let’s go find
the expert to help us write the medical contract. Tomlin said the
department found that expertise in Ann Perham, a former vice president of
Corrections Medical Services Inc., but not before it had already hired and
then rejected a separate consultant. The Corrections Department gave the
job to Perham after it had first hired Jacqueline Moore & Associates,a Colorado-based
firm. The state on Jan. 4 paid Ann Perham $8,950 for helping to write the
190-page request for proposal, according to a copy of the check turned over
by the Corrections Department. Jacqueline Moore said she was never paid for
the time she spent preparing the RFP. Rather, Moore said, Angela Martinez,
the Corrections Department’s health services administrator, told Moore her
“services were no longer needed.” Martinez told Moore she was in
discussions with potential bidders on the contract, Moore said. State rules
on contract bidding outlaw certain communications between the state and
bidders. Such laws are meant to prevent one company from having an edge
over competitors. “I told her she really shouldn’t be doing that,” Moore
said. “There should be a cone of silence once the RFP process has started,
and you should not have RFP conversations with anyone else. And it was from
one of the vendors that she got the name of the consultant she used. The
vendor was Centurion.” Tomlin says otherwise. “There was not communications
with vendors,” she said, adding that the department did not know what
companies would bid on the contract when the state was writing the request
for proposal. Tomlin said the state entered into a
contract with Moore, then rejected her. Tomlin would not explain why. As
for Moore’s allegation that the process was improper, Tomlin said only one
official in the department was authorized to speak to the three companies
that bid on the health care contract that Centurion won. Tomlin said there
was a directive that prohibited state employees other than Lori Vigil from
communicating with the bidders. Vigil is General Services bureau chief of
the Corrections Department. Moore insists that Martinez had communications
with Centurion. Moore said that she called Centurion herself when she was
working on the proposal for bids. She said she requested data from the
company. “The RFP was not released at that time, but she was talking to
vendors,” Moore said of Martinez. “She was talking to Centurion. We were
working on the RFP and when I start to work on a project at that point I
don’t talk to vendors, you know, and neither does anyone else from the …
state. It’s just not ethical. I mean you just don’t give someone else an
unfair advantage.” Moore said the department never paid her for about
$8,000 in work. She said she would like to resolve the issue “amicably”
rather than through a lawsuit. The Corrections Department signed a contract
with Ann Perham in November. It called on Perham to “perform technical RFP
writing and due diligence services” for the department for 40 hours at a
rate of $200 an hour. She eventually billed the state for nearly five
additional hours. It specified that Perham would assist the department in
preparing performance on contract-issues that included penalties,
sanctions, cost proposal sheets, Medicaid and staffing requirements. Tomlin
said the Corrections Department was satisfied that Perham had identified
her husband as being in the business of supplying goods to prison health
care providers. “As far as NMCD is concerned, our position was, ‘Yes, she
made the disclosure,’ ” Tomlin said in reference to Perham. “And we were
aware.” The request for proposal served as the basis for bids submitted to
the state by three companies in the prison health care industry. After a
six-month competition for the contract, the Corrections Department this
month awarded Centurion both contracts to provide both medical care and
pharmaceutical services that are worth a combined $52 million. Corizon, the state’s former inmate medical care
provider whose contract expired last week, was not selected, despite
earning a higher technical score and offering a lower bid, according to the
company’s spokeswoman. Corizon lost the bid a
month after a six-month investigation by The New Mexican that raised
questions about the quality of care the company provided to inmates
Tennessee Department of Corrections.
Oct 30, 2016 tennessean.com
After jail cell birth, Nashville inmate files suit
An inmate who gave birth inside a cell at the Tennessee Prison for
Women has filed suit, alleging nurses and a doctor “alternately ignored and
only occasionally checked on” the pregnant woman during four hours of
labor. The inmate gave birth inside a cell in the prison’s medical wing
without a qualified OB-GYN, in non-sterile conditions and without pain
medication, according to the lawsuit filed against Centurion, a private
company that contracts with the state to provide prisoner health care. The
lawsuit also names Dr. Donald Bruce, a doctor employed by the company. The
newborn was wrapped in a “dirty towel or cloth and his umbilical cord was
cut with a non-sterile object,” the lawsuit said. The infant boy eventually
spent five days in the intensive care unit of Nashville General Hospital at
Meharry with a severe infection after his birth on July 17, 2015. The
lawsuit accuses Centurion nurses of telling the inmate she was “faking it”
during her labor. The woman was nine months pregnant at the time and prison
officials were aware she was near her due date, the lawsuit said. “It’s
shocking,” said attorney Michael Smith, who is representing inmate Amanda Lemka. “It boils down to an indifference and lack of
care for patients there. Instead of treating her like a human being, they
instead acted like we live in a Third World country.” Lemka
remains in prison over a parole violation for a nonviolent crime, said
Smith, who declined to specify her crime or her sentence. A spokesman for
the prison did not respond to a request for information about the prisoner
by the newspaper's deadline. The prison is not named in the lawsuit.
Neither lawyers for Bruce or Centurion responded to a request for comment.
The lawsuit, filed in September in Davidson County Circuit Court, comes
after scrutiny of the medical services provided at the Nashville prison —
and a series of controversies at the Tennessee Department of Correction. In
October, Centurion’s health services administrator and the regional health
administrator were removed from their positions at the women's prison after
an audit revealed that medications were not being given out in a timely
manner. In addition, the top three wardens at the facility were demoted or
retired over “concerns” about the effectiveness of their leadership,
including their failure to manage the medical contractors. Additionally,
two inmates filed a federal lawsuit seeking class-action status against the
state and Centurion earlier this year alleging inadequate treatment of
inmates with hepatitis C. The lawsuit follows a Tennessean investigation
into the treatment of hepatitis C in prison, which revealed thousands of
inmates have the potentially life-threatening liver disease but only a rare
few receive the costly but effective treatment. The department argued that
regularly testing an inmate’s blood amounts to treatment, but experts say
that will do nothing to actually cure inmates of the disease. The
Department of Correction is in the process of seeking bids for the prison
health services contract that is currently with Centurion, a contract
likely valued at more than $200 million. It’s unclear if Centurion will
submit a bid to keep the contract, or how an additional lawsuit could
affect the company’s chances of again earning the contract. The lawsuit
alleges that after the birth, nurses refused to allow the mother to hold or
have contact with the newborn infant, instead passing the baby around to
other staff in the cell. Lemka was diagnosed with
post-traumatic stress disorder and depression after the events surrounding
the baby's birth, according to the lawsuit. The 1-year-old baby lives with
his father and is in good health, Smith said.
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