on Jan. 31, 2013
On Wednesday, January 30th, the Department of Corrections abruptly announced that it had severed its contract with Wexford Health Sources Inc. and had already reached an agreement with Corizon, Inc. of Brentwood, Tenn., to become the health care provider for all state-run prisons as of March 4.
Reportedly, the divorce was initiated by Wexford, which claims it’s “performance was hindered by state monitors and a lack of cooperation by corrections.” The company was also testy about the fact that ADC had threatened it with a $10,000 fine for failure to fix staffing problems, properly distribute medication, and communicate problems to the state. Not to mention the fact that one of their “nurses” managed to expose 103 inmates to Hepatitis C because she apparently didn’t know that you can’t stick a dirty needle back into a bottle of insulin you plan to give to other people.
Is Wexford at all apologetic for all this? Not in the slightest. And they don’t have to be. They know that there’s another state legislature somewhere that, like ours, is naïve enough to believe that privatization of prisons and prison medical care will save them money. Why put up with Arizona’s pesky monitors and pay fines when you screw up when you can go somewhere where everybody’s willing to look the other way for the promise of saving a few bucks?
After all, it’s not like ADC didn’t know Wexford’s dismal track record when they hired them. Bob Ortega reported in the Arizona Republic that:
- Wexford opted not to renew a contract with Clark County, Wash., that expired at the beginning of 2010 after an independent audit concluded that “Wexford has systematically failed to comply” with its contract and had failed to provide adequate staffing, properly licensed staff, and adequate and timely medical service.
- In Mississippi, a 2007 audit was harshly critical of both the company and state corrections officials for failing to provide timely, adequate medical care. It also found that Mississippi’s Department of Corrections failed to collect $931,310 in fines its chief medical officer recommended against Wexford after the company charged the state for more staff members than it actually provided.
- Wexford has also faced fines for similar problems in numerous other states, including a $12,500 fine by New Mexico’s Department of Corrections in 2006; a $106,000 fine by Ohio’s Correction Department in 2009; $50,000 by Chesapeake, Va., in 2006 for staffing shortages; three fines totaling $273,000 by Florida’s Department of Corrections in 2005 for what it described as “service-delivery issues that were resolved” before the contract’s end; and a $68,000 fine by the Broward Sheriff’s Office in Florida in 2003 for delays in providing medical services.
A little background: Corizon was created after the merger of two other huge for-profit prison health care corporations—PHS Corrections and Correctional Medical Services (CMS). Prior to the merger, PHS had 57 contracts in 150 jails across 19 states, serving about 165,000 prisoners. CMS served 250,000 in 19 states. When the two merged, Corizon became the largest prison health care provider in the country, operating in 400 correctional facilities in 31 states. Now, about 400,000 prisoners are subject to Corizon’s “care.”
A quick internet search of just the last three years of articles on the corporation’s misdeeds yielded enough evidence of medical neglect, wrongful death lawsuits, financial shenanigans, and outright abuse to give any rational person pause. Here’s a brief rundown:
A wrongful death and malpractice lawsuit was filed in St. Louis last year over the death of a jail inmate from complications of a heart problem. The suit alleges that the prisoner collapsed and died an hour after a doctor instructed jail staff to send him to a hospital immediately. Records show that a Corizon nurse believed that the prisoner’s episodes were ‘staged,’ and point to numerous instances of doctor’s orders not being consistently followed. (“Suit blames St. Louis medical care in inmate’s death,” St. Louis Post Dispatch, 5/24/12).
In 2012, Corizon paid the city of Philadelphia a $1.8 million fine after an investigation found the company was using a sham female-owned subcontractor to falsely claim it was meeting city requirements for participation by firms owned by women or people of color. A rival company owned by a woman claimed that it submitted a bid that was $3.5 million per year less than Corizon’s. Despite the fine, Corizon retained its right to bid on contracts and is up for renewal. Meanwhile, the city has paid out at least $1 million since 1995 to settle lawsuits over negligent medical care.. (“With contract out to bid, prison health care questioned,” Philadelphia Daily News, 8/28/12 and “City questioned over prison health care firm,” Philadelphia Daily News, 1/10/13).
A federal lawsuit against the Minnesota Department of Corrections was filed last year after an inmate with a history of seizures was denied emergency care by a Corizon nurse who overrode doctors’ orders for an ambulance. Within an hour, the man suffered irreversible brain damage that led to his death. Records indicate that Corizon’s “rationed care philosophy” is at the root of many such problems. For example, no Corizon doctors work after 4pm or on weekends. Nurses employed by the state department of corrections end their shifts at 10:30pm, leaving the prisons without medical staff overnight. Under Corizon’s contract, there is just one on-call doctor to serve the entire state prison system, and this doctor cannot access the medical files because the health services units are shut down overnight. (“Prisoner dies after denial of care,” Minneapolis Star Tribune, 7/9/12).
Washington County, OR ordered an audit of Corizon’s jail health services after the county went $171,000 over its almost $4.6 million budget in FY 2011-12. Cost overruns were reportedly common over the past six years. However, the county ran into “legal roadblocks” in obtaining the needed documents from Corizon. The company’s lack of transparency prompted the county to amend its contract with Corizon in 2012 in order to ensure that the county will have access to financial records and other documents, as well as the ability to perform site reviews. (“Long-delayed Washington County audit of jail health services points to contract problems, new auditing approach,” The Oregonian, 8/20/12).
In 2011, Corizon was fined nearly $400,000 by the state of Idaho for failing to meet some of the most basic health care requirements outlined by the state. Among the problems listed were the fact that one women’s prison had gone without an OB/GYN for two years and another maximum security prison had no staff psychologies for at least 8 months. These lapses were in violation of Idaho’s contract, which requires that vacant positions be filled within 60 days. The Director of the Department of Corrections indicated that the steep fines were the only way to ensure that the corporation comply with its contract requirements. “They’re bottom-line driven,” he remarked. (“Idaho fines prison health care company $382K,” Associated Press, 6/5/11).
Then, in 2012, A Federal report on the Idaho State Correctional Institution charged that prison care under Corizon “amounts to cruel and unusual punishment.” The court-ordered report, part of decades of litigation by Idaho inmates, was released publicly even though the state had argued to keep the report sealed. The report states that Idaho Department authorities are “deliberately indifferent to the serious health care needs of their charges,” says corrections medical expert Dr. Marc Stern, who was appointed by the court to review Idaho prison care. According to the report, Corizon failed 23 of 33 audit categories in 2010 – and despite feedback and follow-up – failed 26 of 33 categories in 2011. (“Federal court unseals report on prison health care,” KIVI News, 3/19/12). You can read the full report here.
Here’s the take-home message to taxpayers: Privatization of anything in a corrections context will always result in fraud, waste, abuse, and neglect.
That’s because the profit motive is directly at odds with the purpose of correctional institutions. There will always be a perverse incentive not to rehabilitate, not to treat, and to prioritize the bottom line over public safety. Because it is in the corporation’s financial interest to keep prisoners coming back. And, if they get sick or even die, the worst your company will face will be a series of fines. Even if the state cancels the contract, there are always some schmucks in some other state or some other town, who want to believe the myth that you can have mass incarceration on the cheap and who really don’t give a damn what happens to incarcerated people.
Noted privatization expert Alex Friedmann, Associate Editor of Prison Legal News, said it best:
“If you take all the bad parts of the HMO [Health Maintenance Organization] and put it in a monopoly situation, then you have the private prison medical care industry…But prisoners can’t go to another clinic, can’t pick a plan.”