$1 billion in prison health care contracts may be thrown out

Florida's prisons chief said Wednesday that she plans to renegotiate — or ultimately toss out — health care contracts worth $1.3 billion

By Pat Beall and John Kennedy
The Palm Beach Post, Fla.

TALLAHASSEE — In the wake of reports of widespread maltreatment and rising inmate deaths by The Palm Beach Post, Florida's prisons chief said Wednesday that she plans to renegotiate — or ultimately toss out — health care contracts worth $1.3 billion.

"All options are on the table," Department of Corrections Secretary Julie Jones told the House Judiciary Committee.

"We are going to make recommendations to the governor and the Legislature about what our best option is for the future," she said. "And it's going to be based solely on the needs of our inmates and their health care."

Jones' unexpected decision comes amid recent revelations by The Post that links the two companies handling prison health services, Corizon Inc. and Wexford Health Sources, to deficient care. State monitors found required reports on inmate deaths in 2014 weren't regularly turned over to the state. Proof that doctors or nurses saw inmates was sometimes faked or nonexistent, some medicines were expired or mislabeled and psychiatric drugs were handed out like candy.

In January, Tammie White became at least the second inmate in 10 months to die after her end-stage cancer was treated with over-the-counter painkillers. A third inmate whose spinal cancer was treated with Tylenol and ibuprofen, featured in Post stories last year, remains in serious condition.

Attorney Randall Berg, director of the Florida Justice Institute, has represented inmates for 30 years. "I thought the medical care provided by the Department of Corrections was bad," said Berg, "but it was certainly better than what I have seen of late."

Senate Criminal Justice Committee Chairman Greg Evers, R-Baker, who visited a Panhandle prison and was shocked to find more than 1,400 inmates monitored by one health care staffer, last week urged Jones to either put teeth in the health care contracts or throw them out entirely.

Jones Wednesday said that DOC already has opened talks with Corizon and Wexford on reworking the contracts, with an eye to enhancing prescription drug delivery, mental health services and nursing care. That includes requiring more registered nurses to be on hand rather than less-skilled staffers.

Changing the contracts could take more than a year to finalize, but Jones said the private companies have endorsed demands for short-term improvements.

If the talks collapse, Jones said the state could return to providing health care.

It shouldn't be a complicated equation, said Randall Berg, an attorney and director of the Florida Justice Institute. "If taxpayers are not getting the medical services they are paying for, then the state ought to get rid of the companies."

Corizon and Wexford each hold five-year contracts to provide medical, psychiatric and dental care. Corizon, which provides care to the vast majority of Florida's roughly 100,000 prisoners and is linked to the majority of reported shortcomings, holds a contract worth $1.2 billion. It did not disclose certain legal settlements and two investigations critical of its care prior to winning the bid, The Post reported last year, despite a requirement to do so.

Wexford's contract is valued at $240 million.

Roughly 100 days after health care was handed off to the two companies beginning in 2013, the state's monthly inmate death count shot to a 10-year high and the number of seriously ill prisoners sent for outside hospital care plummeted, The Post found. The annual death rate for 2014 was the highest in a decade, according to DOC mortality figures.

Following weeks of questions from The Post about inmate deaths, DOC last year announced Corizon failed to provide adequate care and that its contract was at risk. The company and DOC crafted a plan to address substandard care. Additional Corizon staff was brought in. Modest fines were assessed -- $2,500 for every time a company didn't live up to a contractual requirement.

"I don't believe privatization was the wrong thing to do," Jones told the committee. "I think we didn't do it in the right way."

In January, Corizon was penalized $22,500. Wexford was penalized $2,500.

Controversy stemming from private health care is just one problem plaguing Florida's $2 billion prison system, the nation's third largest.

In November, a university panel studying Florida's prisons concluded that it was so deeply flawed that it should basically be rebuilt from the ground up.

The panel also called for creating an independent oversight board for the state's prisons, one that could prove a resource for whistleblowers, work to improve safety for inmates and guards and blunt the cronyism that critics say dominates many lockups.

Gov. Rick Scott last month released a budget proposal that called for increasing DOC's budget by $51.2 million, while adding $17.5 million to fill 300 vacancies within the department, about half what the agency sought.

Jones earlier acknowledged that losing some 1,200 positions, relocating 11,000 inmates and closing almost two-dozen institutions since 2010 have combined to increase tension behind bars for both inmates and correctional officers.

But she has indicated that Scott's spending proposal would move DOC in the right direction after a year marked by reports of inmate deaths, abusive guards and cover-ups.

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