AZ Hospital Signs Contract to Treat State Prisoners
A new contract to treat state prisoners at Kino hospital includes a plan to separate inmates from the public. But hospital officials said they won’t know whether they’ll make money from treating prisoners until the contract has been in place for at least six months. They expect that, at best, they’ll break even. Rep0rted by the Arizona Daily Star.
Had the hospital declined to enter into a contract, the state would have continued sending inmates to its emergency room, hospital CEO Diane Rafferty said. With the contract in place, the Department of Corrections will pay for necessary security upgrades.
The contract signed this month calls for segregating inmates from other patients via a security upgrade and renovation of one floor of the hospital, formally known as University Physicians Healthcare Hospital at Kino.
The one-year contract covers emergency care; inpatient care, including surgery; and outpatient care, including pharmacy, radiology and laboratory services.
UPH Hospital leases the medical buildings and land on East Ajo Way near Tucson Electric Park from Pima County. The county has subsidized the hospital’s deficit for several years, but says it won’t cover any shortfalls for inmate health care.
Treatment of prisoners became an issue five months ago, after the Department of Corrections lost its contracts with Carondelet St. Mary’s Hospital in Tucson and Maricopa Medical Center in Phoenix. The hospitals terminated their contracts after the state decided to pay less for inmate care, matching reimbursement rates for the Arizona Health Care Cost Containment System, the state’s indigent health plan.
Officials at St. Mary’s and Maricopa Medical Center said accepting the low rates meant operating at a loss.
While searching for new hospital partners, the Corrections Department sent hundreds of inmates to emergency rooms. UPH Hospital saw the majority of ER admissions in Southern Arizona due to its proximity to the state prison on Wilmot Road south of Interstate 10, where most inmates with chronic and serious health conditions are housed.
Six to eight inmates are at UPH Hospital on any given day, and the length of their stays varies from hours to days, said Charles Flanagan, deputy director of the state Corrections Department. County documents list a larger number of inmates being treated each month, but Flanagan says officials are incorrectly counting each day as a new visit.
Elsewhere in the state, the Corrections Department signed a contract earlier this year with Abrazo Health Care, which has five hospitals in Central and Northern Arizona.
It also entered into three contracts to replace services formerly provided by the hospitals: DaVita will provide dialysis treatment in Tucson and 21st Century Oncology will provide cancer treatment in Queen Creek. And it has ongoing contracts with four hospitals in relatively rural areas and sometimes sends inmates to non-contracted specialists.
Securing UPH Hospital
Formerly a psychiatric inpatient facility and office space, the fifth floor of UPH Hospital is being converted into a 12-bed unit for inmates.The Corrections Department has agreed to pay for the work and estimates it will cost a few hundred dollars to add new doors with security glass and bar the windows, using inmate labor to do the work, Flanagan said.
But UPH Hospital officials suggested it could be hundreds of thousands. In addition, the hospital may have to make the ceiling more secure, Rafferty said.
The inmates going to UPH Hospital for emergency care use a separate parking lot and entrance from other emergency patients, Rafferty said. Inside, they are treated in individual rooms within the shared emergency unit. Corrections officials call ahead to let the hospital know an inmate is coming.
To get inmates beyond the emergency room, hospital staff uses an internal elevator that other patients and visitors can’t access, Rafferty said. At least one corrections officer is with each inmate during admission, and all inmates in the hospital are supervised by officers.
Until renovations are complete, corrections officers are stationed in a makeshift inmate unit 24 hours a day, and medical staffers never enter an inmate’s room without a corrections officer, Flanagan said.
Those security measures will be transferred to the locked fifth-floor inmate unit after the renovations.
Concerns remain
The hospital has struggled for three decades as the main purveyor of health care to the county’s indigent population – and county officials worry that financial woes will continue with the new contract.While Pima County has tentatively agreed to give the hospital a $25 million subsidy this year – $15 million more than planned – county taxpayers shouldn’t have to foot the bill if the prisoners become too expensive, Pima County Administrator Chuck Huckelberry said.
Despite the contract, the question remains as to how many prisoners have gone without critically needed health care in the last six months.
One inmate, 29-year-old David Wiser, was diagnosed with malignant melanoma in September 2009 after he found a tumor in his leg in March 2008.
Wiser, who is serving a life sentence for first-degree murder, was moved to the Wilmot facility in October after a doctor at St. Mary’s recommended “a rapid and aggressive workup for this tumor” and indicated that his “continuing weight loss is an ominous symptom and may very well show symptomatic spread,” medical records indicate.
Wiser said he didn’t receive treatment until earlier this month. He still doesn’t know the stage of his cancer and hasn’t received some of the care recommended more than six months ago, he said.
“I have just been wondering, ‘Am I going to die?’ ” he said. “The worst part is not knowing how severe this is, and I still don’t know.”
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