By Kate Giammarise
Pittsburgh Post-Gazette
PITTSBURGH, Pa. — One year after the Allegheny County Jail transitioned to a new health care system, officials say medical care at the lockup has improved, though hiring enough staff remains an issue.
“The first year has been a great experience and a job well done by our health service department and [Allegheny Health Network],” said Warden Orlando Harper.
Sept. 1 marked the one-year anniversary of a joint county-AHN partnership, with AHN providing physicians, psychiatrists, nurse practitioners and physician assistants, and the county providing other staff.
Last year, in the wake of a high number of inmate deaths at the jail, County Executive Rich Fitzgerald said he would not renew a contract with Tennessee-based firm Corizon, Inc. In 2014, seven inmates died, a rate double the national norm for jails.
An audit in 2014 by county Controller Chelsa Wagner slammed Corizon for not maintaining required staffing levels, not keeping complete and accurate inmate medical records and not providing inmates with required clinical care, among other issues.
Two inmates have died since last September, both suicides.
Marion Damick, an official visitor for the Pennsylvania Prison Society who visits the jail several times a month and receives letters from inmates, said she receives fewer health care-related complaints than she used to, though she said she remains concerned about mental health care for inmates.
But county officials say that is improving.
“We have definitely seen a big change in terms of mental health. We have two full-time psychiatrists, three part-time psychiatrists, three mid-level practitioners, we have tele-psychiatry … that sees about 30 patients a week. These are all significant changes,” said Aloysius Joseph, health services administrator for the jail.
About 57 percent of the lockup’s 2,400 inmates have a mental health diagnosis, though less than 1 percent have a diagnosis severe enough to require 24-hour observation, according to county statistics.
Still, even under the new partnership, staffing remains an issue, in particular hiring enough licensed practical nurses, who are responsible for passing medication to jail inmates. That means jail officials turn to staffing agencies for temporary workers.
Hiring enough licensed practical nurses is “a challenge in many other places, too,” Mr. Joseph said.
County officials say they are aggressive about advertising and recruiting for jail medical positions through job fairs and other means.
Brad Korinski, chief legal counsel for the controller’s office, who often attends monthly Jail Oversight Board meetings as Ms. Wagner’s representative, said he has seen definite improvements in the past year but does remain concerned about staffing.
“Things seem to be improved, particularly in terms of medication being provided to people who need it in a timely fashion,” Mr. Korinski said. “That being said, Corizon set the bar very low, so that our metric of improved care is not as many people have died, which … I don’t think should be our metric.
“What is concerning is that a year in, we are still struggling with staffing levels, especially … positions such as the mental health nurses and LPNs. Without sufficient staffing, can we be sure that we are providing adequate care at all times?”
Officials had said last year that the new system could cost $2 million to $3 million more than the Corizon agreement. The cost of the new system is budgeted at about $12.5 million for the year, about $2 million more than last year.
“We’re on target to meet that,” county Manager William D. McKain said.
The county has to do its best to provide care to inmates, Mr. Korinski emphasized.
“The folks who come into the jail are going to be back out in our community,” he said. “In most circumstances, we are going to deal with them in the county jail, or we are going to deal with them out in the community.”