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Ailing Inmates Driving Up Costs

June 30th, 2009
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Sick Alachua County FL jail inmates who need hospitalization or expensive treatment are driving up costs and carving out a bigger chunk of the county’s budget when finances are already tight.  Story from the Gainesville Sun.

Pre-existing conditions such as cancer and heart disease that require expensive treatment are now more common and have prompted the county commission and Sheriff Sadie Darnell to begin reviewing medical care contracts to determine if costs can be lowered.

“In the last couple of years, we’ve had a number of inmates coming in that have highly acute illnesses and in some cases terminal illnesses. You have people coming in with cancer, HIV. You have people needing blood transfusions and dialysis,” said Ron Akins, county administrative support manager. “There are times I will receive a $700,000 or $800,000 bill for a quarter, and 14 or 15 inmates will make up 80 percent of that.”

Under state law, medical expenses for jail inmates first must be paid by insurance, the patient or a settlement.   The county is required to pay if those options are exhausted.  Also party to the agreement for inmates’ medical care is Prison Health Services, which oversees the jail’s acute-care infirmary, outside treatment, billing and other financial aspects, the Shands and University of Florida Health Care Network and North Florida Regional Medical Center. The total cost is about $6.5 million a year, said Philip Hoelscher, president of Alliance Medical Management, a consulting firm working with the county on inmate care …

“In most cases, the profile of folks in the jail is that they are not real healthy people. I can’t quantify this in exact numbers, but we all are noticing … that a large number of people are coming in now who are very conscious to their goal of receiving medical care,” Hoelscher said. “A very small percentage of (sick inmates) have insurance. The insurance companies have all gotten smarter to put that fine print in that if you are incarcerated, the policy no longer applies” …

Akins and Hoelscher said costs for inmates with existing conditions are now more apparent to county officials in part because they were hit with large unpaid bills from hospitals several years ago that the county was legally obligated to pay.   More money now is being budgeted for inmate health care.  And the additional money being set aside for inmates’ medical care is being cited by county budget officials as putting the county in a hole for its upcoming 2009-10 budget.

jakking FL Alachua County, Inmate Health Care, PHS

Wyoming DOC Cuts Inmate Programs

June 2nd, 2009
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wy-doc-logo1The Wyoming Department of Corrections is cutting inmate sex offender and mental health treatment programs to save money.  Reported by the AP.

Steve Lindly, deputy director of the Wyoming Department of Corrections, said Monday that the department has decided it won’t renew a sex offender treatment contract worth roughly $850,000 with Forensic Health Services, a Massachusetts company. The contract expires at the end of this month. Lindly said the company has provided treatment of sex offenders at various Wyoming prisons over the past year. He said the company was treating about 220 inmates at any given time and had provided services to more than 500 over the course of the contract.

Forensic Health Services used psychologists as well as trained social workers to provide therapeutic treatment of sex offenders, Lindly said. He said that prison staff will take over the treatment efforts, as they did in the years before the company started. Because the corrections department workers generally don’t have the same level of training as the company workers, Lindly said they will focus on offering inmates a program that’s more educational in scope, rather than therapeutic.

The department is also dropping its Pride Program, which provided three mental health staffers to work with mentally ill inmates at the state penitentiary in Rawlins, he said. Lindly said Prison Health Services, a private company that provides medical care at the prison, had operated the Pride Program. Lindly said the program was dropped as part of negotiations between the department and the company over how to whittle down the company’s proposed $750,000 increase in its annual contract.

There is much more detail in the complete article.

jakking Economic Issues, Inmate Health Care, Inmate Programs, Mental Health Issues, PHS, Sex Offenders, Wyoming

Prison Mental Health Care For Sale

May 28th, 2009
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rod-holliman-webThe Santa Barbara County CA jail mental health system officially is for sale. The prospective buyer — a private Tennessee-based prison health company — is already lined up with a July 1 move-in date, as reported by the Santa Barbara Independent.

This is the way the Sheriff’s Department broke the news at a special meeting of the Santa Barbara County Mental Health Commission on Tuesday, informing the council of the proposed transition of mental health services from county Mental Health to the private company Prison Health Services (PHS). The pitch, helmed by Sheriff Bill Brown, touched on the department’s various budget problems and the need to improve mental health services in County Jail, which oversees the largest number of the mentally ill in the county. “Over the years — with the closure of mental health facilities across the state — County Jail has become the de facto mental health facility,” Brown explained. “The jail is not the best place for people with mental health problems; however, there will always be people in the county’s jail with mental illness because of the nature of the crimes committed.”

According to the proposed plan, PHS would sign a two-year contract to operate its jail mental health services, with an option to extend the contract for an additional two years. A contract with PHS would allow the jail to obtain what officials call crucial mental health objectives currently unmet by county Mental Health: Institute for Medical Quality accreditation, two on-site licensed social workers, 24/7 coverage for mental health assessments, and others. With one out of five incarcerated Americans suffering from mental illness, Sheriff’s officials say the ailing, 38-year-old jail is not only grossly overcrowded — around 50 inmates above capacity each day — but unable to meet its mental health needs …

Brown said the PHS contract would save more than $500,000 in a so-called apple-to-apple comparison. In layman’s terms, PHS could provide the services conducted by Mental Health, plus more, $500,000 cheaper. Both Brown and Mental Health officials assured council and community members repeatedly that the plan to privatize jail mental health services is not a reflection of the performance of current county Mental Health staff. However, George Green — a member of SEIU Local 620, representing jail mental health workers — argued that the plan would wrest jobs away from Santa Barbarans. “I respect Sheriff Brown a great deal, [however] I am shocked by this group’s decision,” Green said. “The county must first engage in bargaining with the union before such a plan in finalized.”

jakking CA Santa Barbara County, California, Inmate Health Care, Mental Health Issues, PHS

Michigan Chooses New Prison Health Vendor

February 10th, 2009
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The AP reports:

Michigan has awarded a three-year, $326 million contract to a Tennessee company to treat prisoners with medical problems.   A state board approved the contract Tuesday, which means the company currently overseeing prison health care will be replaced starting in April.   Brentwood, Tenn.-based Prison Health Services will take over for St. Louis-based Correctional Medical Services.

CMS has hired doctors and others to see Michigan prisoners for about a decade. But a year ago, an independent review found that most doctors, nurse practitioners and physician assistants were seeing too few prisoners a day.   The review was ordered by Gov. Jennifer Granholm in 2006 after reports of inmates dying because of inadequate care.

jakking CMS, Inmate Health Care, Michigan, PHS

Volusia To Improve Mental Health Services

September 7th, 2008
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Volusia County FL corrections could have a local agency providing mental-health services in the jail by Jan. 1.

The Volusia County Council and County Manager Jim Dinneen made a surprise move Thursday to take steps to open the mental-health portion of the jail health care contract to Act Corp. The arrangement could be a subcontract with Prison Health Services or a separate contract with the county.

The move brought praise from local community leaders who for months have called for a change. County administration and the corrections division were originally recommending extending Prison Health Services’ overall contract for 18 months until further review can be made. Its contract ends Sept. 30.

Prison Health Services, which along with the county has faced criticism and lawsuits over the care of inmates, will negotiate over the next 45 days with officials at Act and Stewart-Marchman Center, the area’s main mental-health and substance-abuse providers, which are merging services in October. Prison Health Services will continue providing mental-health care until the county approves a new arrangement…

Since Act many times treats the clients that end up in the jail and when they leave, County Chairman Frank Bruno said, “If we can put this together, it will be a win-win for the whole community.”  Councilman Jack Hayman said he’s had serious concerns with Prison Health Services. He agreed working with Act is a “first step in the right direction.”

More details at the News-Journal.

jakking FL Volusia County, Inmate Health Care, Mental Health Issues, PHS

Daily Sweep 080218

February 18th, 2008
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jakking Aramark, California, FL Volusia County, Florida, Food Services, IN Monroe County, Inmate Health Care, Maine, Mental Health Issues, PHS, Sentencing

Health Care On Rikers

February 13th, 2008
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New York’s massive jail system has a bad rep when it comes to inmate health.

Clinics on Rikers Island now are run by [Prison Health Services] whose contract was just renewed for another three years. Though the quality of care has improved since the days when a private hospital ran the clinics, many advocates argue the system still has an attitude of us versus them, of prisoner versus guard and of control versus the powerless — certainly not conducive to quality care.

It is a massive job.

At any one time on Rikers, there are approximately 14,000 inmates, adding up to about 100,000 admissions in a given year. They are not mass murderers, but alleged drunk drivers or drug addicts, among others convicted of misdemeanors, and about 80 percent are being detained prior to trial. About a quarter are mentally ill, according to the health department, and a third are seen as extremely frail, plagued by severe drug addictions or chronic illnesses. An average inmate stays 40 days, but the most frequent discharge from Rikers Island is on day one. The population is constantly changing, moving from facility to facility or from imprisonment to freedom … All nine jails on the island have their own clinic, and the whole population is served by one infirmary. Inmates in more serious condition are sent [to city hospitals].

Future plans are in hand:

Mayor Michael Bloomberg has made public health a hallmark of his administration, and that focus has had an effect on Rikers Island … “If we can improve the health of those that are incarcerated than we can improve the health of the communities that they come from,” said Louise Cohen, deputy commissioner for health care access and improvement.

There is a great deal more information at the Gotham Gazette.

jakking Inmate Health Care, New York, PHS

Pennsylvania Extends PHS Contract

February 7th, 2008
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A statement issued last night notes:

America Service Group Inc. (ASGR) on Wednesday said the company’s operating subsidiary, Prison Health Services, Inc. and the Commonwealth of Pennsylvania, Department of Corrections have agreed to extend by five years the term of the current contract under which PHS provides general healthcare and specialized medical services to the nearly 44,000 inmates in the custody of the Department. Annual revenues for 2006 under the contract were $68.5 million. The contract will now expire on August 31, 2013.

jakking Inmate Health Care, PHS, Pennsylvania