Alabama Hall of Shame

Alabama Department of Corrections
Correctional Medical Services, Louisiana Correctional Services, Naphcare, Prison Health Services, Wexford
September 9, 2007 Huntsville Times
The Alabama Medicaid Agency will get a $3.8 million contract with a company with a checkered past, but a political cloud may linger over the transaction. And the state Department of Corrections will get a $233.73 million contract with a St. Louis company that bid $6 million more than the losing bidder for inmate health care services. Democrats insinuate that politics may have played a role in ACS Heritage Inc.'s winning the Medicaid contract even though its bid was $500,000 higher than the next company. And the firm that won the prison contract, Correctional Medical Services, Inc., was represented by former Republican Lt. Gov. Steve Windom, a lobbyist with close ties to Gov. Bob Riley.

September 7, 3007 Birmingham News
The Legislative Contract Review Committee on Thursday delayed implementation of a $223 million prison health-care contract after an official with a company that bid $9 million less questioned the process. The panel also delayed a $3.7 million Medicaid contract to computerize medical records after lawmakers questioned the company's performance in other states. The Contract Review Committee reviews state agency contracts. Committee members can delay the contracts for 45 days but do not have the power to cancel them. The Department of Corrections, after taking proposals, selected Correctional Medical Services Inc. of St. Louis to provide medical care to Alabama's more than 20,000 inmates. Another company, Wexford Health Sources, had submitted the low bid that was about $9 million cheaper than Correctional Medical Services'. Rep. Alvin Holmes, D-Montgomery, and other legislators asked Corrections Commissioner Richard Allen why the department had not selected the low bidder. Allen said Correctional Medical Services scored slightly higher on bid reviews, which take quality of care into account. "I don't know that Mr. Holmes would go to the cheapest doctor in town," Allen said after the meeting. Lawmakers also questioned that the prison staff who reviewed the bids included several former employees of CMS. Allen said none had worked for the company in at least six years. "I have full confidence in these people. There was no politics involved in this selection," Allen said. But Michael Davis, a lawyer representing Wexford, said company officials wanted to meet with the commissioner before the contract was finalized. Davis said company officials had questions about how bidders' scores were determined.

September 6, 3007 Huntsville Times
The state corrections commissioner was questioned by legislators Wednesday over a $233.73 million contract for health care for Alabama's nearly 26,000 inmates. Commissioner Richard Allen is seeking approval of a three-year contract with St. Louis-based Correctional Medical Services Inc. CMS would take over a contract now held by Prison Health Services Inc., of Brentwood, Tenn. Sen. Parker Griffith, D-Huntsville, a retired physician, endorsed the CMS contract, which would have two potential one-year renewals. "I have a keen interest in (prisons), particularly the health care," Griffith told the committee. "We're rapidly moving into the baby boomers going through the prison system just like we're going through it outside the prison system." Griffith said health care for convicts is a "major, major cost factor" for the state, but he added that "we're capping it with this contract and I think it's well thought out." The committee has the power to delay the contract for 45 days but cannot stop it from being enacted. Some members of the Joint Legislative Contract Review Committee questioned Allen about members of his staff who formerly worked for the two private companies and were involved in the selection process for CMS. A third company that submitted a proposal, Pittsburgh-based Wexford Health Sources, was represented by an attorney who said he will ask for an explanation of the grading process when the committee meets again today. Allen acknowledged that Wexford's bid was about $6 million lower than CMS. "We evaluated the contracts very carefully," said Allen. "All the bidders were told that price would be 40 percent of the score and other things - innovations, cost savings, those types of things - would be scored 60 percent." Allen said Wexford scored third. Rep. Blaine Galliher, R-Gadsden, said he was concerned that Department of Corrections employees who formerly worked for CMS and PHS were on the team that graded proposals submitted by the three companies. But Allen defended the process, calling prison health care "a very narrow specialty." "If you look at the resumes of these (DOC) people, they have worked for several companies, not just this company (CMS)," he said. "Nobody in our department has worked for this company in the last six or seven years. They've also worked for PHS. They've also worked for about a dozen other companies. They go back and forth between the companies and state service."

August 29, 2007 The Huntsville Times
The Alabama Department of Corrections said Tuesday that it will transfer 134 male inmates from a private Louisiana prison to the Limestone Correctional Facility as part of a cost-cutting measure. Prisons Commissioner Richard Allen said the transfer is the first of several required to return more than 1,100 Alabama convicts who are housed out of state. "In an attempt to save taxpayer dollars and eliminate our budget shortfall, we plan to return all out-of-state inmates to Alabama by year's end," Allen said in a prepared statement. "This move will allow us to save an estimated $10 million annually on rented bed space." Prior to Tuesday's transfer, 294 male inmates were housed at the West Carroll Detention Center in Epps, La., at a cost of $26.75 per inmate, per day. Alabama inmates are also kept at the J.B. Evans Correctional Facility, South Louisiana Correctional Center and Perry County Detention Center, all owned and operated by Lafayette, La.-based LCS Corrections Services.

August 17, 2007 Tennessean
America Service Group Inc. said Thursday that its Prison Health Services subsidiary would lose its contract with the Alabama Department of Corrections. The contract expires on Oct. 31. PHS provides medical services to inmates. Brentwood-based America Service Group said it would update its fourth-quarter earnings estimate later. It had projected revenues from a renewed contract of $12.3 million in the three months ending Dec. 31.

July 12, 2007 All American Patriots
The Alabama Department of Corrections will put 5,763 acres of unproductive and money-losing properties up for sale, bring state inmates back from Louisiana prisons and put more inmates to work. Governor Bob Riley and Corrections Commission Richard Allen said Wednesday that proceeds generated from the land sales during the coming year will go toward prison infrastructure improvements and not operating expenses. All property to be sold will be appraised, advertised and sold through a public process to the highest bidder. Such a process was used earlier this year when 540 acres of the Farquhar State Cattle Ranch near Greensboro was sold for more than $1.6 million, which is higher than its appraised value of $1.4 million. The properties being put up for sale are: 1,851 acres of the 2,215 acres at Red Eagle Honor Farm in Montgomery The remaining 3,869 acres of the Farquhar State Cattle Ranch An empty and unused 16,000-square foot building on South Union Street in Montgomery 32 acres in Wetumpka on Highway 231 North 10 acres at the old Kilby prison in Montgomery All the properties are either unneeded or losing money. The Farquhar State Cattle Ranch, for example, has lost approximately $377,000 during the past two fiscal years and has lost almost $60,000 in the first six months of the current fiscal year. "These properties are a financial drain on the taxpayers and aren't needed," said Governor Riley. "It makes no sense to hold on to them. We will sell them, relieve this burden on the taxpayers and use the money for some long-needed improvements to correctional facilities." The Department of Corrections expects the sale of the properties will bring in up to $22 million. This is not the first time land owned by the Department of Corrections has been sold. In addition to the sale earlier this year of 540 acres at the cattle ranch, more than 630 acres of Corrections property was sold through the bid process in 2003 and 2004 for $3.8 million. Governor Riley said the sale of idle land would not be limited to the Department of Corrections, noting that several agencies, including the Department of Mental Health and Mental Retardation, own properties that may be sold. The Governor's office is working with state agencies to determine what property they own is unneeded and could be sold. In addition to selling unneeded property, the Department of Corrections will terminate its contracts with two Louisiana-based companies and return approximately 1,300 male and female inmates from private prisons in Louisiana. All inmates in Louisiana will be back in Alabama by the end of November. That move is expected to save the Corrections Department almost $10 million.

April 16, 2007 The Press-Register
Some members of a legislative oversight committee contend that Gov. Bob Riley's administration broke the law on three no-bid contracts by failing to submit them to the panel months ago. "If you have got a law, all departments in the Riley administration have to follow the law," said state Rep. Alvin Holmes, D-Montgomery, a committee member. "The same law applied to Don Siegelman that applies to the Riley administration." During Riley's 2002 campaign for a first term, the Republican blasted then-Gov. Don Siegelman, a Democrat, for his administration's handling of no-bid contracts. Ken Wallis, legal advisor to Riley, said recently that the administration is "absolutely" following state law regarding all contracts, including the three questioned by some lawmakers. One of the three was an emergency contract -- for prison health services -- that was used for four months before the administration submitted the permanent deal to the committee. Panel members said they learned about the other two contracts through reporters. The prison contract totaled more than $56 million, while each of the others was for $60,000 or less.

July 27, 2006 AP
About 320 female Alabama prisoners being housed in Louisiana are being moved to another prison in that state but one closer to Alabama. The women inmates had been housed at a private prison at Basile in southwest Louisiana. They are being moved to J.B. Evans Correctional Center in Newellton, La., which is on the Louisiana-Mississippi line about 60 miles west of Jackson. The move brings the inmates about two and a-half hours closer to the Julia Tutwiler Prison for Women in Wetumpka, prisons commissioner Richard Allen said Thursday. It also reduces travel time for corrections officers. The Alabama Department of Corrections has a contract with LCS Correctional Services to house the inmates to help reduce overcrowded conditions at Tutwiler. The J.B. Evans Correctional Center opened in 1994 and is a medium security facility with the capacity of holding 440 inmates. Allen said it will be used exclusively for the Alabama women prisoners. More than 600 male inmates are also housed in private facilities in Louisiana because of overcrowded conditions in Alabama prisons.

March 2, 2006 Birmingham News
In the recent letter "Partnerships can ease overcrowding," the executive director of the Association of Private Correctional and Treatment Organizations resorts to smoke and mirrors in promoting privatization as the answer to Alabama's overcrowded prisons. He relies on dubious studies, some of which were paid for by his boss - the for-profit private prison industry. The Association of Private Correctional and Treatment Organizations advocates nothing more than a throwback to the convict lease system of the late 1800s, which was ended in the early 1900s. Privatization has resulted in a "race to the bottom." You get what you pay for, folks. For more information about this industry, visit our Web site: www.PrivateCI.org. We don't make this stuff up. Ken Kopczynski, Executive director, Private Corrections Institute

February 22, 2006 Pickens Herald
The Pickens County Commission in a press briefing last Tuesday after their regular meeting questioned the state’s motives in housing several hundred prisoners in Louisiana when they could easily house them at the Pickens County Jail at a cheaper rate. County Attorney Buddy Kirk addressed the Herald with four of the five commissioners present (Commissioners Earnest Summer-ville, William Latham, Willie Colvin and Ted Ezelle were present; Tony Junkin was absent) about the matter after the Commission became aware that the state had moved 140 male prisoners from the Bibb Correctional Facility in Brent, Ala. to a private prison over 300 miles away in Pine Prairie, La. The Commission has contacted the Alabama County Commission Association about the matter, said Kirk, to ask for their help in approaching state officials about this curious action. Brian Corbett, a spokesman for the Alabama state prison system, told the Associated Press last Monday that the state plans to move 500 inmates from the Bibb County facility to the Pine Prairie Correctional Center in central Louisiana, a private prison operated by LCS Corrections Services Inc. The sticking point for the Pickens County Commission is that not only is the state having to carry the expense of transporting the prisoners to another state but are willing to pay $29.50 a day per inmate to house them there. The state only pays counties $1.75 per day to house state prisoners in county jails. “It doesn’t seem right to the Commission,” said Kirk, who noted that the state will virtually drive right by Pickens County from Bibb County to travel 300 miles to Louisiana. Furthermore, Kirk said if a prisoner has to meet with his attorney, it is a general rule that the state will have to pay that attorney’s expenses if the prisoner is housed far away.

February 23, 2006 Montgomery Advertiser
The fact that incoming prison commissioner Richard Allen, who takes over next week, has no previous experience in corrections has been widely noted. Given Allen's demonstrated abilities throughout a distinguished career, there is no reason Alabamians should be concerned about that. In fact, the fresh perspective he will bring to the Department of Corrections is likely to be an asset. Allen surely will be attuned to apparent conflicts of interest such as the one involving a prison health care monitor. In that case, the Birmingham News reported this week, a nurse hired by the department to monitor health care delivered under a contract with an outside provider came directly from that provider. One day he was working for the provider, and the next day he was being paid to monitor the work of that provider. That was a dubious arrangement in itself, but the situation was made even more questionable when the nurse resigned his monitor's job with DOC after working only a few weeks to return to his former employer. He has since rescinded the resignation and remains with DOC. This is an unacceptable situation that cannot engender any confidence in the proper delivery of health care to inmates or the proper oversight of health care delivery by the prison system. In order to have any credibility, a monitor cannot have such ties to the operator being monitored. Allen will have a stack of problems on his desk when he walks in for his first day as commissioner on Wednesday, foremost among them the chronic overcrowding of the prison system. As he wrestles with that daunting challenge, however, he also must take a newcomer's clear-eyed look at issues such as too-close connections between the department and outside contractors.

February 18, 2006 Birmingham News
A nurse hired by the state prison system last month to monitor its medical contract had until then worked for the company he was hired to keep tabs on. After a few weeks on the job, nurse Brandon Kinard resigned from the state to return to Prison Health Services, then rescinded his resignation Friday. Despite earlier plans to go back to the company, Kinard will remain a regional clinical manager with the Department of Corrections assigned to make sure PHS does an adequate job, prisons spokesman Brian Corbett said. The state pays Kinard a $59,000 annual salary. He is one of several regional managers who oversee quality control, protocols and contract compliance, specifically DOC's $143 million contract with PHS, a Tennessee-based company that has come under scrutiny in several states on allegations of placing economic interests above patient care. Kinard's boss at DOC, Associate Commissioner Ruth Naglich, ultimately is in charge of making sure the company lives up to its contract. She also has ties to PHS, where she was vice president for sales and marketing before taking the state job. Kinard's employment falls within a gray area of state ethics law, officials say. Attorneys who represent prisoners treated by PHS say it's a conflict of interest even though it may be legal. "I don't know if it violates any state laws. But effective monitoring of a private company by the state Department of Corrections needs to be done by people who are independent of the medical company and independent of the DOC, and this is ..... something that would seem to prevent effective monitoring," said Joshua Lipman, an attorney with the Southern Center for Human Rights. Previous state monitoring efforts have resulted in DOC's withholding payments to PHS because the company failed to fulfill minimal contract staffing levels. The state withheld $1.2 million last year when monitors found the provider did not have enough doctors, nurses, administrators and support staff in the prisons, and later withheld $580,000 as a performance penalty. Kinard first worked for PHS at Hamilton Aged and Infirm. He worked both as a director of nursing and in an administrative position, making decisions about patient health care. He'd been with the company since November 2003, when PHS received the Alabama contract. He also had worked in prison medicine with companies that previously contracted with the state. Kinard began his job at DOC the first week in January. In early February, he submitted his resignation, effective Feb. 24, to return to PHS. A day after The News contacted PHS about the situation, Kinard rescinded his resignation, staying with the DOC job. Alabama ethics law prevents state employees from immediately accepting jobs at companies they audited, investigated or regulated for the state, said Hugh Evans, general counsel at the Alabama Ethics Commission. There has not been a ruling on whether that includes returning to jobs they came from. "Under the ethics law, if you are involved in auditing, investigating or regulating a private entity, that would include monitoring or awarding a contract to a private entity, you can't go to work for them for two years," Evans said. However, he said, "The issue is somewhat muddied, if that person is returning to the status quo. It could be a cause for concern."

February 16, 2006 Montgomery Advertiser
How willing would you be to do business with a company with a record of legal problems, even if it was the low bidder? Most Alabamians, we'd wager, would have some reservations about that -- and Alabamians certainly should have reservations about their state sending prison inmates to a private prison. For years, the Advertiser has expressed serious concerns about the use of private prisons. Nothing reported from the ones involved in state contracts has eased those concerns. The Birmingham News reported this week that the Department of Corrections has begun transferring male inmates to a private prison in Pine Prairie, La. The prison is operated by Louisiana Corrections Service, which also operates a facility in Basile, La., where Alabama has housed about 300 female inmates since 2003. The reason for using these facilities is the chronic overcrowding of Alabama's prison system, which is the subject of constant litigation. The transfer of male inmates -- eventually about 500 of them -- is an effort to ease the backlog in county jails of state inmates who haven't been sent to state prisons because there is no space for them. The overcrowding problem is at present intractable, given Alabama's sentencing structure and its decades of failing to address the shortcomings of a system now bulging with almost twice as many inmates as its facilities were designed to handle. LCS will house the male inmates for $29.50 per day per inmate, but how much of a bargain is that? There are important issues inherent in any private prison operation. This is not someone's hobby; this is a for-profit enterprise. That's fine in most pursuits; in fact, it is the core of the American economy. But incarceration is a solemn obligation of the state. Depriving individuals of liberty is serious business and the state, even though justified in doing so, has an undeniable responsibility to those individuals. A for-profit prison has financial considerations that a state facility does not. It has profit expectations from its investors, and these could all too easily lead to dangerous corner-cutting that compromises the safety of inmates and potentially the public as well. Unlike the state, a private prison operator has no stake in the rehabilitation of inmates vs. the mere warehousing of them. Add to those concerns -- inherent in any private prison operation -- the legal troubles at LSC facilities and it is easy to see why Alabamians should be uncomfortable with this arrangement. Last week, the News reported, a former supervisor at Pine Prairie was convicted of rights violations and witness tampering in the beating of an inmate. Earlier, four guards at the Basile facility were indicted on sexual abuse charges. Problems can occur at state prisons, of course, but there the state has direct authority to act, to set employment standards and to otherwise control the addressing of problems. That is largely lost when private prisons are used. The private prison issue is not going to fade away. LCS is working with officials in Perry County to open a private prison there. The facility, located outside Uniontown, will be ready in a few months. The Department of Corrections says there is no agreement for it to place prisoners there, but clearly there will be great political pressure to do so. This is a poor approach to prison issues. A far better one is broad reform of Alabama's sentencing structure, which now sends to prison far too many people who could serve their sentences in community-based corrections facilities with drug treatment programs and work opportunities -- without presenting a significant threat to the safety of the populace. Funneling non-violent offenders into prisons is always costly and seldom productive. Absent this kind of reform of the current system, inherently unsound practices such as the use of private prisons will continue -- not because they are better, but because they are cheaper.

February 16, 2006 Ledger-Enquirer
Tough on crime, or on taxpayers. Last week, Alabama's prison commissioner went over the wall. And who could blame Commissioner Donal Campbell for resigning? He had been given the literally impossible task of operating an Alabama prison system with too many inmates and not nearly enough money. Not only is he set up for failure, but he is also set up to go to jail himself for not obeying court orders to relieve crowding. Of course, he can't build prisons out of his own pocket, and the Alabama legislature isn't about to spend precious tax dollars on inmates, so what could the commissioner do but throw up his hands and walk away? "I wouldn't want that job," said Lynda Flynt, executive director of the Alabama Sentencing Commission. She knows what she's talking about, having worked closely with Campbell to alleviate crowding. Knowing they're going to have a problem filling a position that includes perks such as being party to a lawsuit, state officials are finally scrambling to do something. On Monday, the state announced that it is going to send 500 state inmates to a private prison in Louisiana. The private prison company there already houses more than 300 Alabama inmates. At $29.50 a day per inmate, that's going to cost Alabama taxpayers about $24,000 a day. That's Alabama tax money that's flowing into the Louisiana economy. If Alabama would build the prisons it needs (or consider sentencing reforms that might ease the stress on the system) some of that cash might stay home. Or some of it might be sent to Alabama counties that are picking up a huge tab for housing state prisoners. As of last December, there were about 100 state inmates being housed in Russell, Lee and Chambers County jails. It costs counties about $30 a day to house a state prisoner, but the state pays the counties about $1.75 a day. So housing those prisoners costs East Alabama taxpayers more than a million dollars a year, while the state is sending more than $8 million a year to Louisiana private prisons. If the Alabama legislature is going to insist that this many people be in prison, then the lawmakers have the moral responsibility to see that there is space to house the inmates. If you're going to be tough on crime, then you're going to have to be tough enough to pay the piper. -- Michael Owen, for the editorial board

February 13, 2006 AP
A total of 140 medium-security male prisoners were transferred Sunday night from Alabama to a private correctional facility in Louisiana, the first of 500 to be moved in the latest attempt to ease overcrowded cellblocks. The prisoners were transferred from Bibb Correctional Facility in Brent to Pine Prairie Correctional Center in Pine Prairie, La., in an effort to make room for state inmates who are in county jails in violation of an Alabama court order. State prisons spokesman Brian Corbett said Monday the state entered into an emergency contract with LCS Corrections Services Inc. to send up to 500 inmates to the central Louisiana facility. The Department of Corrections currently houses 311 female prisoners at an LCS facility in Basile, La. Prisons Commissioner Donal Campbell announced Friday that he had resigned, effective Feb. 28. He had pushed for increased state funding for prisons and recently said there was no money in Gov. Bob Riley's budget proposal to pay for the use of private prisons, an alternative he supported.

July 16, 2005 AP
A court-appointed monitor warns that erratic treatment of HIV-positive inmates in an Alabama prison could develop into treatment-resistant AIDS. A new report by Dr. Joseph Bick issued that warning. It came a year after the state Department of Corrections agreed to improve medical treatment for the HIV-positive prisoners. Bick documented four types of "sub-optimal" HIV treatment at Limestone Correctional Facility, where more than 200 HIV-positive inmates are housed. A California expert in prison medicine, Bick was appointed by U.S. Magistrate Judge John Ott to visit Limestone four times a year and evaluate whether the state and its medical contractor provided dozens of improvements required in a lawsuit settlement. Although state officials promised in the settlement last year to hire an HIV specialist for the men, there has not been one during much of the year, leading to erratic treatment. Tennessee-based Prison Health Services, the private company that oversees care in Alabama prisons, says many of the problems Bick found were related to that position's being vacant. "It's difficult to recruit a highly qualified HIV specialist, especially to a rural area," the company said in a statement Friday. Two specialists PHS previously hired left the job within weeks or months. Bick warned that the mistakes in previous care could have irreversibly harmed patients. During his week-long visit in late May, Bick found: substitute doctors who mixed drugs that were not supposed to be used together; patients with rising viral loads who had not been seen for treatment changes or whose failing regimens were changed only one drug at a time; and doctors who made treatment changes without telling the patient. Bick's reports have noted some improvements but he has continued to focus on the inability of keeping doctors and of keeping critical positions filled. "Due to the fragile nature of this medical program, I recommend that every effort be made to retain physicians once they are hired," Bick wrote in the new report. Besides the HIV population, Limestone houses 1,800 other prisoners and has one physician and one nurse practitioner to provide their care as well as care for 135 work-release prisoners in Decatur. Bick called this "by all measures ... inadequate" and recommended three full-time physicians. PHS has hired several doctors over the last year, including HIV specialists, who have not stayed long. The company also said that negative press coverage has frustrated its efforts to hire a specialist.

June 3, 2005 Decatur Daily
With its magnifying glass focused on inmate health expenses, a legislative committee came up with as many questions as answers Thursday for the spiraling medical costs for state prisoners. High hospital costs for ill inmates, concerns about the company that provides on-site medical services at state prisons and a prison population that is close to double capacity all complicate the challenge for the Department of Corrections. The committee questioned, but approved, two contracts for medically related inmate care. In a $60,000 part-time contract, Cullman internist Dr. George Lyrene will review all deaths at state prisons and give court testimony related to the deaths for $1,100 to $1,250 per day. In a second contract, the state will pay Rebecca Jones, a registered nurse from Wetumpka, up to $40,000 for inmate-specific diabetes education and meal monitoring at state prisons. Committee members also questioned the performance and expenses of Prison Health Services, the Tennessee company that currently has the contract to provide medical care for inmates. "The provider has major, major problems, and there are deep concerns among members of the committee about them," Morrison said after the meeting. Morrison said Corrections Commissioner Donal Campbell and Naglich are working to solve the problems. Morrison said some of the health costs are the result of actions before the time the Tennessee company took over inmate care in Alabama. "We are still in lawsuits related to the previous provider," Morrison said. "With some things, we can only go as fast as the courts allow."

May 26, 2005 AP
Seeking to save money, the Department of Corrections has signed a contract to send inmates with chronic illnesses to a South Carolina hospital specializing in treating prisoners. Alabama prison system officials announced Thursday the inmates would be sent to Columbia Care Center , rather than to regular community hospitals in the state. The hospital in Columbia, S.C. , currently has space to treat up to 50 Alabama inmates who need long-term care, such as chemotherapy, radiation therapy or kidney dialysis, but the number to be sent initially has not been determined. There is no set cost for the contract - DOC pays Just Care as the hospital's services are needed. Department officials said the prisons are not equipped to treat inmates who need certain specialized treatments for highly advanced cancers, diabetes and other chronic diseases. Those limitations force the DOC's health care provider, Prison Health Services, to refer the inmates to outside hospitals for repeated treatments, said DOC spokesman Brian Corbett. In fiscal year 2004, the prison system had to pay $9.4 million for treatments that fell outside PHS's responsibility, officials said. The DOC has refused to pay $1.2 million to PHS, saying the company has not provided enough doctors and nurses at the prisons. That issue is under mediation, but is unrelated to the decision to team up with Just Care, Corbett said.

May 5, 2005 Birmingham News
Alabama's prison medical provider is losing $1.2 million from the state because it has not provided enough doctors and nurses to state prisons. Prison Health Services has not fulfilled minimal contract requirements that call for a certain number of doctors, nurses, administrators and support staff. The company is not being fined, Department of Corrections spokesman Brian Corbett said, but DOC will not have to pay $1.2 million of its contract. The department hired PHS in November 2003. The company's three-year, $143 million contract could see more reductions if the medical staff does not increase. Tennessee-based Prison Health Services also has come under fire in recent months by physicians who are monitoring two prisons under federal court settlements. A lawsuit alleging inadequate medical care is pending at a third prison, the Hamilton Aged and Infirm facility, where the oldest, sickest men are housed. Dr. Michael Puisis, court monitor at Tutwiler Prison for Women, said in a March report that prison medical staff provided poor or incomplete care to three inmates who died last year. He suggested that negligence might have led to two of those deaths. The third, a suicide, was likely the result of inadequate care by mental health workers, who are employed by a different company. Two deaths since then are still under investigation. Still, attorneys for the Limestone inmates have asked the federal courts to hold the state in contempt for failing to abide by the conditions of the settlement. Last year, the state agreed to dozens of improvements, centering on added medical staff and more humane housing conditions. Doctors keep leaving, some after claiming PHS did not allow them the flexibility and resources to practice medicine as they want to do. "There are just as many complaints raised after the settlement as before," said Gretchen Rohr, an attorney with the Atlanta-based Southern Center for Human Rights, who represents Alabama prisons in both cases.

April 25, 2005 Anniston Star
Historically, Alabama has never placed a high priority on the care of its inmates. Like many states, Alabama is often in a locking-up mood when it comes to wrongdoers. We don’t mind building prisons and then filling them up. Once these men and women are behind bars, though, it’s out of sight, out of mind. Like a lot of states, Alabama also outsources the medical care of inmates in an effort to cut costs. The problems associated with the hiring out of health care for prisoners are becoming more obvious by the day. It’s beyond debate — or at least it should be — that prisoners should not be denied proper medical treatment. To do otherwise would be cruelly inhumane and a violation of the human rights of inmates. In 2003 following reports of deaths and various abuses, Alabama dropped its contract with Naphcare, a company specializing in treating prisoners. The state replaced the firm with Prison Health Services, a Nashville-based company. That decision is looking like a mistake. Last month, The New York Times reported that New York officials are blaming the deaths of more than 20 inmates on PHS’ lax policies. Closer to home, the Birmingham News recently reported on the deaths of two Alabama inmates under the care of Prison Health Services. Independent observers as well as the families of Tutwiler Prison for Women inmates Teresa Morris, who died March 6, and Edna Britt, who died March 23, point to Prison Health Services shortcomings. Morris, who was a diabetic, was allegedly taken off her insulin. And advocates are questioning the circumstances surrounding the death Britt, who had recently been treated for cancer. At Donaldson, Tutwiler and Limestone prisons, the complaints center on denial of medicines and a gross shortage of medical personnel. Previous challenges on behalf of prisoners have put these three facilities under heightened scrutiny. Dr. Joseph Bick is a physician assigned to observe conditions at Limestone, where inmates with HIV are housed. He has written, “Interviews with patients, chart reviews and feedback from physicians support the concern that patients are not consistently given the medications that have been ordered for them for serious life-threatening conditions.” The Department of Corrections can outsource all it wants, but in the end, state inmates are the responsibility of the state. It’s time to start asking hard questions.

April 17, 2005 Birmingham News
By the time Teresa Morris died, her legs were so badly swollen that the prison shackles dug into them. A 53-year-old diabetic serving time for domestic violence at Tutwiler Prison for Women, Morris spent the hours before her March 6 death shackled in a hospital bed in Montgomery. Prison officials say she died of natural causes. Morris's family believes the prison medical staff, employees of private contractor Prison Health Services, provided inadequate care for her diabetes. They say she was taken off her insulin shots, for reasons the family does not understand. Her death is the latest in a series of red flags suggesting that Prison Health Services is not providing sufficient quality medical care to many Alabama prisoners, according to interviews with prisoners' attorneys, former PHS employees and reports from independent physicians who monitor care at some of Alabama's prisons. "I can't say whether or not she was given insulin," said Ben Purser, the company's vice president for ethics and chief compliance officer. "It was an expected death; that is about the best thing I can say to you." Morris's death certificate says she died from diabetes, cirrhosis of the liver and Hepatitis C. But she was not being treated for the last two, Freeman said. Last November, Dr. Michael Puisis, court monitor for the Tutwiler medical settlement, visited the prison and reviewed treatment records for several prisoners. Of Morris's care, he wrote: "She was seen every three months, but not by a doctor. ... Liver function tests were abnormal but not investigated. An incomplete physical examination was done." Even after the legal settlements mandating better care at Tutwiler and Limestone, there have been severe shortages of doctors and nurses at the prisons. Nearly a year later, critical reports by court monitors continue to come out of both places. "These records reflect thousands of doses of medications ordered by physicians that have either not been given, or have been given without being documented," Dr. Joseph Bick, monitor in the Limestone case, wrote after visiting the HIV Unit in February. "Interviews with patients, chart reviews and feedback from physicians support the concern that patients are not consistently given the medications that have been ordered for them for serious life-threatening conditions." What was even more disturbing, the doctor wrote, was that Prison Health Services provided documents showing that nurses had recently been trained on this issue. It was Bick's third visit to the prison. Each was followed by a report showing the state was out of compliance with several key medical provisions of the 2004 settlement. A constant failing at Limestone is doctor and nurse shortages. The prison, with 2,200 people, has become a revolving door for physicians. One physician left in late 2004. Another, Dr. Valda Chijide, an infectious disease specialist, was placed on administrative leave after writing her superiors about constrictions placed on her that made it impossible to do her job. She resigned in February. Prison Health Services then brought in a doctor from a temporary agency, but by early April she, too, decided not to return, PHS' Purser said. During vacancies, Dr. Will Mosier, Prison Health Services' Montgomery-based medical director, fills in at Limestone and other prisons when needed. There are provisions in the company's contract for the state to deduct payment to the company if its staff numbers are down, and the Corrections Department monitors staffing levels on a regular basis, Corbett said. How much money the state is owed for empty positions is under debate, he said.

February 9, 2004
A $500,000 tab for unused slots in a private out-of-state prison is a bitter pill for taxpayers of Alabama to swallow. Particularly with prisons here crammed with nearly twice as many inmates as they were built to house and with state government in a severe financial bind. Prison officials must not only review how the state came to agree to pay for beds that are going unused as state inmates are returned from the Mississippi prison, but to make sure any future prison contracts don't come with hidden surprises. (Al.com)

February 5, 2004
The Alabama Department of Corrections will pay a private prison company at least $500,000 for empty prison space in Mississippi. That's because the state's contract with the Tennessee-based Corrections Corporation of America requires Alabama to pay rent for 1,345 beds through March 11. The state has opted to bring most of the prisoners home early, but still must pay the $27.50 per diem cost. Alabama prison officials say the unused beds are a necessity, and the result of the state's chronic underfunding and overcrowding of prisons. Now that bed space has been freed up at state prisons, the department is sending inmates home a few at a time, but the contract requires the state to continue paying for 95 percent of the full occupancy rate. Corrections employees began returning inmates Jan. 19. By the end of this week, they expect to return 379. Unused beds for that group alone will cost $340,000 for 35 days. More men will be returning every week until March 12, leaving empty beds that will push the total to at least $500,000. "There's no way you could keep them over there until the last day of the contract and bring them back all at once," said Brian Corbett, spokesman for the Alabama Department of Corrections. "It's physically impossible to move 1,416 inmates in one day." State officials signed the emergency contract with CCA last June. Alabama's prison population had hit an all-time high of 28,440, and the Department of Corrections was facing pressure from lawsuits related to prison conditions and the backlog of state inmates in county jails. "We did what we had to do out of an emergency situation. And yes, unfortunately, it cost money," Corbett said. "It would be wiser in the long run and cheaper in the long run if you would properly fund corrections up front, as opposed to trying to correct your emergency situations on the back end," Corbett said. State got bargain: A spokesman for CCA said Alabama got a bargain in its per diem rate. Elsewhere, private prison companies have charged states more than $50 per inmate per day. CCA's Tallahatchie County Correctional Facility in Tutwiler, Miss., sat empty last summer. The company quickly staffed it for the Alabama contract, and federal law requires CCA to give those employees a 60-day notice before termination, said CCA spokesman Steve Owen. "There had to be some guarantees for us to hire, ramp up and staff that institution for the duration of that contract," Owen said. Increased parole and community corrections programs have freed up space in Alabama prisons. The prison population was down to 27,344 in December 2003. The Department of Corrections is also shifting work release and minimum security inmates, primarily from Montgomery and from the Elmore Correctional Facility, to make room for the men returning from Mississippi. Many minimum security inmates will transfer to vacant work release beds. 980 backlogged: Prior to sending the prisoners to Mississippi, 980 state inmates were backlogged in county jails for more than 30 days - the crux of a lawsuit against the Department of Corrections. A year later, in part because of the Mississippi contract, no state prisoners have been housed in counties more than 30 days, Corbett said. The contract possibly saved money by halting additional costly litigation or federal intervention, he said. "We averted a crisis situation last summer, but by no means are we out of the woods," Corbett said. State prisons continue to operate at 185 percent of capacity. (AL.com)

January 10, 2004
The state prison system plans to continue with its new health service contracts for inmates even though a legislative committee wouldn't approve the deals. On Thursday, members of the Legislature's Contract Revenue Committee said the deals were too expensive and were reached without open bidding. Prison system spokesman Brian Corbett said the contracts have already been implemented and will continue in effect. "Nothing is going to change," he said. "We still have 100 percent coverage." Committee members objected to a $143 million contract with Prison Health Services of Brentwood, Tenn., to provide medical care for Alabama's inmates for three years; a $29 million contract for MHM Correctional Services Inc. of Vienna, Va., to provide mental health care for three years; and a $90,000 contract with Correctional Medical Management of Nashville, Tenn., to monitor the work for three months. Normally, state agencies submit contracts to the Legislature's Contract Review Committee before they take effect. If the committee objects to them, the committee can delay them for 45 days, but the state agency can implement them after that time pass. (AP)

January 9, 2004
A legislative committee blocked three contracts with companies for medical care in Alabama prisons, saying the deals were too expensive and were reached without open bidding. The move could leave more than 27,000 inmates temporarily without health care. Prison system officials have defended the contracts, valued at a combined $172.3 million. Corrections Commissioner Donal Campbell warned that delaying them could land the state in trouble with federal courts, which are already reviewing prison conditions. (AP)

January 6, 2004
The 1,424 male Alabama inmates being housed in a private prison in Mississippi should be returned to Alabama within 90 days, state Corrections Commissioner Donal Campbell said Tuesday. Alabama transferred the inmates last summer to a prison run by Corrections Corporation of America, the Tallahatchie County Correctional Facility in Tutwiler, Miss., to ease the overcrowding in Alabama's prisons and county jails. (AP)

October 14, 2003
With his $1.2 billion tax plan rejected, Gov. Bob Riley plans to release 5000-6000 non-violent, Alabama inmates this fiscal year due to budget cuts. After 54 of 67 Alabama counties rejected the governor’s tax plan on September 9, the state government was left on its own to find a way to alleviate the state’s over-crowded prisons without the additional funds and a state budget deficit of $675 million. In his state of the state address on March 4, 2003, Gov. Riley predicted a state deficit of at least $500 million in 2004. His solution was to cut the General Fund Budget by 20 percent. He also predicted a need of $125 million more in 2004 for the Alabama State Corrections budget. An estimated 27,000 inmates inhabit prisons that were designed to hold only 12,000. The release of non-violent inmates has not been the first step to alleviate the problem of over-crowded prisons in Alabama. In July of this year the Corrections Corporation of America, for the first time in its history, agreed to aid the Alabama Department of Corrections by relocating 1,400 male, medium-security prisoners to the Tallahatchie County Correctional Facility in Tutwiler, Miss. However, the relocation was always intended as a temporary solution to the problem. Now, Gov. Riley has introduced the Pardons and Paroles Bill. This bill expands the Pardons and Parole Board from three members to seven members and will divide it into two separate boards. This will hopefully give the parole boards a chance to hear more cases and release 200 inmates per week as opposed to the 75 to 80 which are released a week now. The intention is that the release of non-violent inmates will leave room for more dangerous criminals that would be more of a danger to society. The inmates released will be those convicted of possession and distribution of drugs, felony DUI and theft of property. Alabama is not the first state to enact of releasing non-violent inmates. In December of 2002, Gov. Paul Patton of Kentucky’s plan to avoid his state’s own $6 million budget deficit released hundreds of Kentucky inmates. They were non-violent prisoners as well. University of Alabama criminal justice professor Dr. Robert Sigler who is an expert on prison systems agrees with the idea to release non-violent inmates. “Right now we’re at a point where we’re putting a lot of people in prison who we really don’t need to; its not a good use of our money. It doesn’t increase our safety,” he said. Dr. Sigler also gave his opinion on the experience of released inmates in general, not just the proposed to be released inmates. “Almost all people, if they get a little bit of help at home, will make that adjustment back. Prison is a pretty bad place,” Dr. Sigler said. (Dateline Alabama)

September 13, 2003
State prison officials, already contemplating the early release of 20 per cent of the inmate population to shave costs, now face a new problem: The price for providing adequate health care to the remaining prisoners may rise by tens of millions of dollars next year. The increased costs became apparent as the state received bids on a new health care contract, a contract that prison officials say is better designed to comply with court orders and recent lawsuits. The state, along with the current health care provider -- Birmingham-based NaphCare Inc. -- has been named in lawsuits for allegedly neglecting to provide adequate care for Alabama inmates during the last three years. An Atlanta-based human rights group recently sued the state, alleging that the deaths of 38 HIV-infected inmates during a four-year period at Limestone Correctional Facility could have been prevented with proper care. Gov. Bob Riley has proposed adding about $16 million to the Department of Corrections' $234 million annual budget. "When you underfund something for decades, and this agency sees a population explosion of more than 1,000 inmates per year, you can't put a $16 million Band-Aid on it and think it's going to solve all of our problems," said Brian Corbett, spokesman for the Department of Corrections. Prison officials say some of that money could help pay for the new health care contract. But much of the increase is expected to be eaten by the additional costs of housing prisoners out-of-state, a move made this year to comply with a court order to relieve severe overcrowding in state prisons. State prison officials say they have no choice but to revise the requirements in the health care contract. Corbett said Friday that even if the Department can pay nearly double what it did during the last three-year term, that amount won't be nearly enough to provide all the health care services the department would like. Bids for the next three-year contract were submitted last week, the lowest nearly double that of the previous three-year term. The contract is scheduled to be awarded Oct. 6, Corbett said, after the Legislature approves the new state budget. Seven different companies, including NaphCare, offered bids ranging from $150 million to more than $200 million for medical anor mental health services for the three-year period. The previous three-year contract with NaphCare cost the state nearly $90 million. NaphCare's current bid is among the lowest, at nearly $155 million -- though NaphCare leaders said they could negotiate a less demanding contract for less money. While NaphCare and the state do not openly criticize or blame the other for any negligence, each has a different perspective on how a new contract and an increase in funds would affect inmate care. Corbett said the revised contract would give the state more control over care -- something lacking during the previous three years. "The problem is not so much with NaphCare but with the contract itself," Corbett said. "The contract was not in the best interest of the state, because it was not specific enough. Staffing levels, administrative policy, standards of care, pool overages ... were not specific enough to give the department as much control as we desired." In the old contract, Corbett said, NaphCare "determined all administrative policies regarding delivery of the health care. Therefore, they did not have to respond to requests as far as developing treatment protocols and procedures." NaphCare spokesman David Davis said that an increase in spending on inmate care was not the answer to improving inmate health. "It's not that more money means better health," Davis said. "It has to do with facilities, operations, health care, everything coming together. "Any health care provider is limited by the facilities, the environment and the stipulations of the contract," Davis said. He would not elaborate on what specifically could be improved at Alabama prisons. NaphCare maintains that it did not fail to do its duty as laid out in the contract during its three-year term. (Al.com)

August 14, 2003
The quality and quantity of medical care for prison inmates is among state services hanging in the balance in the Sept. 9 referendum on Gov. Bob Riley's tax proposals. Prison Commissioner Donal Campbell has notified more than 300 medical services vendors that they have until Sept. 10 - the day after the vote - to file written proposals for providing medical services for inmates during the next three years. If the tax plan fails, "We're all going to have to go back and revisit our budgets and see where we cut and where we don't cut," said Deputy Commissioner Terrence Jones. Jones, whose duties include overseeing inmate medical care, said the detailed 73-page request for proposals being sent to medical service vendors across the nation proposes more services and controls in some areas than the present contract with Birmingham-based NaphCare Inc. Unlike the present contract, the proposed new contract would allow the state to withhold money due to be paid to the company if required services are not provided, or to deduct the costs of bringing services up to standards, Jones said. The proposed contract also would require more dental services for inmates and more inmate health education and training, and it would provide for termination of the contract for failure to secure or maintain personnel described in the contract, Jones said. Campbell notified NaphCare on May 2 that its $29.5 million-per-year contract with the state would be canceled in 90 days, or about the first of August, but he has extended the contract on a month-by-month basis until a new contract is signed. Campbell told members of the state Legislature's prison oversight committee several weeks ago that he can't sign a new medical services contract until he gets a budget for the fiscal year starting Oct. 1, and that won't happen until after the referendum. Jones wouldn't say Tuesday how many of the more than 300 vendors invited to submit proposals have done so or have expressed interest in doing so. NaphCare, whose services have been criticized by Chicago consultants Jacqueline Moore and Associates and which has been named as a defendant in inmate lawsuits, is among those vying for the new contract. "Our hope is to continue to provide Alabama inmates health care as we do across the country," said NaphCar spokesman David Davis. "NaphCare is committed in providing quality and affordable health care to the Alabama inmate population in accordance with the stipulations in the contract with the Alabama Department of Corrections." NaphCare filed suit against Moore and Associates last month, contending that their audit reports contained "numerous inaccurate and unsubstantiated statements and conclusions" that have damaged the company's reputation. (Al.com)

July 16, 2003
Alabama prison Commissioner Donal Campbell is quick to say that sending inmates to private, out-of-state prisons to ease overcrowding is only a temporary fix. Until, he says, more space is available in Alabama's prison system. Campbell is correct in taking that stance. Indeed, paying to house up to 300 female and 1,400 male inmates in private lock-ups makes sense only in the short term. Long term, it's a loser, even at the bargain-basement rate of $27.50 per day per inmate (about $10,000 a year). That's because the state can't afford to watch its prison population grow at the current rate. The inmates kept in Mississippi and Louisiana are farther from their families (some of them mothers separated from their children) making visitations more of a hardship. Plus, for the $27.50 per day, the inmates don't have access to the programs they need to help them reintegrate into society, such as drug treatment, job training and education. And don't think for a moment that the price the state pays now when the private prisons are new with ample space will be the same years from now when space even in private lockups might be scarce. Private prisons are no bargain for Alabama.

June 23, 2003
Alabama might have to pay more to house 309 women inmates at a Louisiana private prison because of higher-than-expected medical costs, owners of the prison said. "The medical issue is more than we anticipated," Patrick LeBlanc, owner of LCS Corrections Services, told The Birmingham News for a Saturday story. Alabama pays LCS $22.85 per inmate per day to house women transferred from the crowded Tutwiler Prison in Wetumpka to the private prison in Basile, La. That rate was approved earlier this month by the Legislature's Contract Review Committee and is less than the initial $24 daily rate agreed upon in April when Alabama began sending women to the LCS lockup. Since then, LCS officials have realized Alabama's inmates require more medical attention than Louisiana prisoners housed at Basile, LeBlanc said. About 20 to 25 of every 150 Louisiana inmates require prescription medication, he said. The Alabama prisoners' prescription needs are more than double that. Alabama prisons spokesman Brian Corbett said the state and LCS have not yet agreed upon a rate adjustment or any other compromise. He said the Corrections Department chose which prisoners were sent out of state based on low security risk, not medical problems. Corrections Commissioner Donal Campbell this week asked LCS for proposals on the cost of enhanced medical care. "He did ask them to put together something from a cost-analysis standpoint to determine, if things weren't being met or handled correctly, what would it take to make sure they were," Corbett said. Inmate Linda Faye Knight was sent to Basile on June 12. She's still waiting for blood-pressure medicine she's taken for the last 15 years, said her sister, Victoria White of Birmingham. "She saw a nurse, but the nurse told her the medicine was not there," White said. Her 46-year-old sister is up for parole July 8 on a manslaughter conviction. (AP)

June 11, 2003
The Legislature's Contract Review Committee gave formal approval Thursday to a plan to send women prisoners to a private prison in Louisiana. The Alabama Department of Corrections transferred 140 women prisoners in April to the South Louisiana Correctional Center in Basile, La., to relieve overcrowding at Tutwiler Prison for women in Wetumpka. The state is under a federal court order to reduce the population at the women's prison. Prison Commissioner Donal Campbell has promised U.S. District Judge Myron Thompson that the number of inmates at Tutwiler would be reduced from 1,000 to 750 by June 30. Campbell originally made the transfers under an emergency contract, which did not have to be approved by the Legislative committee. The committee approved a one-year contract Thursday without comment, allowing the prison system to house up to 300 inmates at the Louisiana prison for up to a year. The contract with LCS Correctional Services Inc. calls for the state to pay $24 a day per inmate to house the prisoners in Louisiana. (AP)

April 2, 2003
A Senate appropriation bill that will pay for efforts to reduce crowding in Alabama prisons won final passage in the House on Tuesday. The bill will give the Department of Corrections $2.7 million in emergency funding to reduce overcrowding at Julia Tutwiler Prison for Women to comply with a federal court order to reduce the prison population. That money would be used to move female inmates to out-of-state prisons, probably in Louisiana. Rep. John Knight, D-Montgomery, sponsored similar legislation in the House. He wants women to be moved out of Alabama only as a last resort. Lucia Penland, director of the Alabama Prison Project, a prison advocacy organization, said prisoners who maintain close relationships with their families return to prison less often than those who do not. "If they are two states away, that will not be possible," she said. (Montgomery Advertiser)

March 15, 2003
The Birmingham company that holds the $30-million-a-year contract for providing medical treatment in Alabama prisons faces tough questions about cost overruns and the quality of its care. The pressure on NaphCare Inc. comes from Donal Campbell, Gov. Bob Riley's appointee as commissioner of the Department of Corrections. Campbell has had to ask the Legislature for $6.9 million to cover extra prison health care costs, even as his legal staff scrambles to defend lawsuits alleging that medical treatment of Alabama inmates is so bad as to amount to cruel and unusual punishment, forbidden by the U.S. Constitution. Campbell recently met with NaphCare officials, wanting explanations for both the overruns and an outside monitor's reports that tend to substantiate inmates' complaints about lax care. In 2000, prison health care in Alabama was provided by Correctional Medical Services of St. Louis, for roughly $26 million a year. But CMS had been working on a series of contract extensions, and because of rising costs and a growing inmate population wanted a new contract for more money. The Department of Corrections invited CMS and other companies to bid on the work, and offers ranged from $38 million to $46 million. At that point, finance officials in the administration of Gov. Don Siegelman bypassed the DOC legal staff and hired the Mobile law firm Miller, Hamilton, Snider & Odom. But critics immediately questioned whether any company could make a profit and provide adequate medical care to 27,000 inmates for such a sum. Indeed, while the $30 million contract may seem large, it solidified Alabama's position as the state that spends the least per inmate on health care. Florida -- whose prisons, unlike Alabama's, are accredited by a national correctional health care board -- spends three times as much per inmate. "The average state spends about $2,500 to $3,000 per inmate, and Alabama's spending a little over $1,000," said Ron Shanksy of Chicago, co-founder of the Society of Correctional Physicians. "You're off the charts." Even before the state contract was signed in early 2001, Jefferson County officials were complaining publicly about NaphCare's performance in county jails in Birmingham and Bessemer. Last year, Jefferson, Morgan and Madison counties all parted ways with NaphCare, finding new jail health care providers amid complaints by inmates, family members and jail officials. Last year also saw a rush of litigation against NaphCare and the state Department of Corrections, alleging inadequate medical care for Alabama prisoners. The Southern Center for Human Rights, an Atlanta based nonprofit legal group, sued on behalf of inmates at Tutwiler Prison for Women. A wrongful death suit was recently filed against NaphCare and DOC in Montgomery County Circuit Court. The charge there is negligence in the sudden death of a 29-year-old Tutwiler inmate, Pamela Brown, in 2001. In all these suits, NaphCare and DOC are co-defendants. One of the lawyers representing NaphCare is Giles Perkins. That has raised eyebrows in the legal community because Perkins, a former state Democratic Party official, is employed by the firm Miller, Hamilton, Snider & Odom and helped run the state prison health care contract negotiations won by NaphCare. But reports by Jacqueline Moore & Associates, a Chicago consulting firm hired by the DOC to monitor NaphCare's performance, tend to back up some complaints voiced by Alabama inmates. Perhaps most alarming was her assertion that the death rate among HIV inmates at Limestone was twice that of the national rate for such inmates. At several institutions, she found high turnover and staff vacancies among medical personnel. In her August 2000 review of Staton Correctional Facility, which provides medical care for nearly 4,000 inmates at four central Alabama prisons, she found that the sole physician had recently quit and six nursing slots were unfilled. In an interview, Harrison described Moore's reports as "inaccurate," and went on to suggest she tried to steer Jefferson County's jail medical care contract from NaphCare to Prison Health Services, a Brentwood, Tenn.-based company she co-founded and for which her ex-husband still works. She dismissed Harrison's charge that she was trying to help PHS. "I left that company in 1990," Moore said. "My ex-husband and I don't speak." A former NaphCare dentist, Elcid Burkett, said medicine was hard to come by for health care professionals working in Alabama prisons. "I was buying my own peroxide," he said. NaphCare is no worse or better than its predecessor CMS, according to Sam Eichold, a Mobile physician who serves on a prison medical oversight committee. He thinks the companies have done about as well as anyone can expect, given what Alabama pays per inmate. "They cut corners," said Eichold, whose committee has expressed its own concerns to DOC. "That's how they make their profit." (Mobile Register)

February 7, 2003
MONTGOMERY Medical consultants hired to review health-care services in Alabama prisons have reported what a lawyer for inmates calls "serious deficiencies." The audit reports released Thursday were ordered last year by the Siegelman administration to monitor health care services provided to prison inmates by NaphCare, a Birmingham-based health management contractor. Former Prison Commissioner Mike Haley and former Gov. Don Siegelman refused repeated requests last year to release the reports, conducted at eight Alabama prisons between May and August. "This is totally consistent with what the prisoners have been telling us, that they have to wait for weeks for dental services, for things such as abscesses which are so painful that some of the women are pulling their own teeth," said Tamara Serwer of the Southern Center for Human Rights, which is representing inmates in a pending federal lawsuit. "These are serious deficiencies in health care services for Alabama prison inmates." (Al.com)

January 27, 2003
Gov. Bob Riley on Wednesday selected the former head of the Tennessee prison system to lead Alabama's troubled Department of Corrections. Donal Campbell, 51, takes over a prison system under court orders to reduce overcrowding in its women's prison and to find more space for its male inmates. Campbell said Alabama's problems are nothing new to him because Tennessee's prisons dealt with the same issues in the late 1980s and early 1990s. Tennessee uses private prisons to house about 4,500 of its 18,000 inmates - something Campbell and Riley said they plan to consider in Alabama, which has never used private prisons. Campbell said he's not in favor of privatizing existing prisons but would consider privately run prisons to provide new space for inmates. (Huntsville Times)

Alabama Legislature
September 9, 2007 Huntsville Times
The Alabama Medicaid Agency will get a $3.8 million contract with a company with a checkered past, but a political cloud may linger over the transaction. And the state Department of Corrections will get a $233.73 million contract with a St. Louis company that bid $6 million more than the losing bidder for inmate health care services. Democrats insinuate that politics may have played a role in ACS Heritage Inc.'s winning the Medicaid contract even though its bid was $500,000 higher than the next company. And the firm that won the prison contract, Correctional Medical Services, Inc., was represented by former Republican Lt. Gov. Steve Windom, a lobbyist with close ties to Gov. Bob Riley.

September 7, 2007 Birmingham News
The Legislative Contract Review Committee on Thursday delayed implementation of a $223 million prison health-care contract after an official with a company that bid $9 million less questioned the process. The panel also delayed a $3.7 million Medicaid contract to computerize medical records after lawmakers questioned the company's performance in other states. The Contract Review Committee reviews state agency contracts. Committee members can delay the contracts for 45 days but do not have the power to cancel them. The Department of Corrections, after taking proposals, selected Correctional Medical Services Inc. of St. Louis to provide medical care to Alabama's more than 20,000 inmates. Another company, Wexford Health Sources, had submitted the low bid that was about $9 million cheaper than Correctional Medical Services'. Rep. Alvin Holmes, D-Montgomery, and other legislators asked Corrections Commissioner Richard Allen why the department had not selected the low bidder. Allen said Correctional Medical Services scored slightly higher on bid reviews, which take quality of care into account. "I don't know that Mr. Holmes would go to the cheapest doctor in town," Allen said after the meeting. Lawmakers also questioned that the prison staff who reviewed the bids included several former employees of CMS. Allen said none had worked for the company in at least six years. "I have full confidence in these people. There was no politics involved in this selection," Allen said. But Michael Davis, a lawyer representing Wexford, said company officials wanted to meet with the commissioner before the contract was finalized. Davis said company officials had questions about how bidders' scores were determined.

September 5, 2007 Huntsville Times
The state corrections commissioner was questioned by legislators Wednesday over a $233.73 million contract for health care for Alabama's nearly 26,000 inmates. Commissioner Richard Allen is seeking approval of a three-year contract with St. Louis-based Correctional Medical Services Inc. CMS would take over a contract now held by Prison Health Services Inc., of Brentwood, Tenn. Sen. Parker Griffith, D-Huntsville, a retired physician, endorsed the CMS contract, which would have two potential one-year renewals. "I have a keen interest in (prisons), particularly the health care," Griffith told the committee. "We're rapidly moving into the baby boomers going through the prison system just like we're going through it outside the prison system." Griffith said health care for convicts is a "major, major cost factor" for the state, but he added that "we're capping it with this contract and I think it's well thought out." The committee has the power to delay the contract for 45 days but cannot stop it from being enacted. Some members of the Joint Legislative Contract Review Committee questioned Allen about members of his staff who formerly worked for the two private companies and were involved in the selection process for CMS. A third company that submitted a proposal, Pittsburgh-based Wexford Health Sources, was represented by an attorney who said he will ask for an explanation of the grading process when the committee meets again today. Allen acknowledged that Wexford's bid was about $6 million lower than CMS. "We evaluated the contracts very carefully," said Allen. "All the bidders were told that price would be 40 percent of the score and other things - innovations, cost savings, those types of things - would be scored 60 percent." Allen said Wexford scored third. Rep. Blaine Galliher, R-Gadsden, said he was concerned that Department of Corrections employees who formerly worked for CMS and PHS were on the team that graded proposals submitted by the three companies. But Allen defended the process, calling prison health care "a very narrow specialty." "If you look at the resumes of these (DOC) people, they have worked for several companies, not just this company (CMS)," he said. "Nobody in our department has worked for this company in the last six or seven years. They've also worked for PHS. They've also worked for about a dozen other companies. They go back and forth between the companies and state service."

December 8, 2006 Ledger-Enquirer
Gov. Bob Riley's chief of staff, Toby Roth, is leaving to become a lobbyist and will be replaced by Riley's senior adviser, Dave Stewart. Roth directed Riley's campaign for governor in 2002 and then became his chief of staff. His last day will be Dec. 15, Riley said Friday. Roth will open a Montgomery office for Capitol Resources, a Jackson, Miss.-based lobbying company whose principals include two nephews of Mississippi Gov. Haley Barbour. The firm lists many clients, including Beau Rivage Resorts, eBay, Corrections Corporation of America, Northrop Grumman Ship Systems, Rolls-Royce North America, and the Mississippi Band of Choctaw Indians.

January 23, 2006 AP
Proponents of legislation to extend state contracts up to five years say it could save the state money, but critics, including Lt. Gov. Lucy Baxley, say it would allow an outgoing governor to lock in the next administration. The bill's sponsor, Rep. Marcel Black, D-Tuscumbia, said Monday he hopes to get the House to pass it Tuesday. The bill would still have to be passed by the Senate and signed by the governor to become law. Black and Means proposed the legislation at the request of the Fine Geddie lobbying firm, which represents many corporations at the Legislature. Ben Patterson, a member of the firm, said it has several clients interested in doing business with the state, including Northrop Grumman. The firm's long list of clients also includes BellSouth, Corrections Corp. of America, General Electric and Motorola, according to the company's reports to the State Ethics Commission. They were major fundraisers for Riley in the 2002 race for governor, with their political action committees contributing more than $660,000.

March 12, 2003
With Alabama facing court orders to reduce prison overcrowding and a $500 million funding crunch, Gov. Bob Riley is turning to the private sector for relief. As part of the plan to decrease the population at Tutwiler Prison for women, the Department of Corrections has proposed transferring prisoners out-of-state. Privatization -- or contracting state government services to private businesses is not new -- as state and local officials nationwide struggle to find ways to make government more efficient and cost effective in tough financial times. The governor and prison commissioner Donal Campbell proposed in February to move approximately 300 state inmates to private out-of-state facilities as part of a plan to ease overcrowding at Tulwiler. E.J. "Mac" McArthur, executive director of the Alabama State Employees Association, doesn't want private industry involved in government functions. Rep. John Knight, D-Montgomery, chairman of the House Government Finance and Appropriations Committee, said he doesn't sense tremendous interest among legislators in moving in the direction of privatization of prisons. "I think the coin flips both ways. Some can point to cost-savings, but there are horror stories in other states on prison privatization," Knight said. "Alabama prisoners should be Alabama's responsibility, and we should live up to that responsibility. McArthur says state employees worked hard to pass a 1999 law that provides for direct and effective control over corrections institutions in the state in an attempt to head off privatization. The law also forbids control of corrections institutions by a "nongovernmental entity" without approval of both the Alabama House and Senate. McArthur thinks that law would bar private prison construction or operation in Alabama. It might, but that law did not stop the transfer to out-of-state facilities after Campbell got an attorney general's opinion that said it did not apply to such a move. James Barber, deputy director of the Mississippi Legislative Peer Committee, said privatization may have peaked and plateaued, based on what colleagues in other states have said. (Montgomery Advertiser)

March 11, 2003
Legislation to ease the overcrowding crisis at Alabama's prison for women appears to be on the fast track as lawmakers return today, the first day of the 2003 regular session in which either house of the Legislature can pass bills. Finance Director Drayton Nabers last week told the Senate's General Fund budget writing committee that the $3.6 million would partly be used to transfer the women prisoners to the private facility. (Montgomery Advertiser)

Baldwin County Jail
Baldwin County, Alabama
Correctional Medical Services
April 26, 2005 Mobile Register
Scott Allen Winingear spent less than two months in the Baldwin County jail last year before administrators concluded they were not equipped to control the diabetic inmate's blood sugar, according to federal court testimony. So concerned was the nursing staff about Winingear's condition, that officials had him transferred to Mobile County Metro Jail, which has 24-hour medical services on staff, Baldwin jail personnel testified. But in about three months at Metro Jail, the 31-year-old Indiana man's blood sugar readings actually got worse, according to the federal court testimony earlier this year. The case marks another criticism of the Metro Jail system that has come under attack in recent years and echoes findings of a nutritional consultant who reported last week that the jail does not appear to be preparing different meals for diabetics and other inmates with special needs. According to testimony at the sentencing hearing, Winingear's problems at Mobile County Metro Jail stemmed from a switch to a cheaper form of insulin and a diet that was not conducive to controlling his diabetes. Testimony at the hearing indicated that the jails in Baldwin and Mobile treated Winingear differently. At Metro Jail, Winingear testified, he received the same meals everyone else did. He said the diet consisted of high-carbohydrate foods like spaghetti and white bread, along with sugar-laden items like fruit cocktail and Kool-Aid. Unsweetened alternatives were not available, he said. Winingear testified that his parents put money in his jail account but that administrators deducted those funds to pay for his medical care. As a result, he testified, he was unable to supplement his meals by purchasing snacks from the jail store. Winingear contended in his testimony that the jail gave him Novolin 70/30, a cheaper mix of Humulin-R and Humulin-L that he said was not as effective. A former nurse at Metro Jail, who asked not to be identified out of fear she might face professional reprisals, said the jail switched insulins in the fall. She also said nurses often did not test diabetic inmates' blood sugar levels frequently enough. "The nurses were pushed so hard that there hardly was a time in the day when we were not so far behind," she said. The nurse said administrators also showed little flexibility in making sure diabetics were regularly monitored. "If they were at a religious service or something else when blood sugars were tested, the unwritten policy was they would do without," she said. Correctional Medical Services, a St. Louis company that has provided health services to Metro Jail inmates since July could not immediately offer a response. In testimony at Winingear's sentencing hearing, an administrator with the firm acknowledged that a nurse at one time was late making rounds to check blood sugar levels and administer insulin. Carla Wasden, the jail's health services administrator, testified that it was possible the nurse was late more than once.

Correctional Medical Services
December 17, 2004 Corrections Professional
Private prison employees' terror claim survived dismissal. Case name: Bullin et al.,v. Correctional Medical Services Inc., No. 2030573 (Ala. Civ. App. 11/19/04). Ruling: Because private prison employees claimed they suffered mental anguish as a result of their employer's failure to properly implement policies to protect them from the prison population, their claim was not covered under the Alabama Workers' Compensation Act. Accordingly, their claim survived dismissal and will proceed. Summary: In August 2002, Jamie Bullin, Lisa Johnson and Tabitha Manuel brought a civil action against Correctional Medical Services Inc., three individuals employed by the Alabama Department of Corrections, and several fictitiously named defendants in the Baldwin Circuit Court. The employees collectively alleged that CMS had negligently failed to formulate policies for the protection of the employees from the wrongful conduct of the prison population. The employees said they had been terrorized and caused to suffer severe and continuing mental anguish and emotional distress as a proximate result of CMS' omissions. The Baldwin Circuit Court transferred the cause to the Montgomery Circuit Court, and CMS filed a motion for summary judgment. CMS alleged that the employees' exclusive remedy was a claim under the Alabama Workers' Compensation Act. The employees contended that their claim alleged purely psychological injuries, therefore the claim was outside the scope of the act's exclusivity provisions. The trial court granted CMS' summary-judgment motion, and the employees appealed. The Alabama Court of Civil Appeals held that the employees' claim against CMS was not barred by exclusivity provisions of Workers' Compensation Act because the employees' injuries were purely psychological in nature. The "injury" the employees complained of expressly included mental injuries that had neither been produced nor proximately caused by physical injury to body. The decision of the lower court was reversed and remanded.

Donaldson Prison
Jefferson County
Prison Health Services
March 18, 2005 Birmingham News
The administrator over health care at Donaldson Correctional Facility was fired for failing to improve medical care at the beleaguered lockup, but not before issuing repeated warnings about inadequate staff. Stephanie Lawson, a registered nurse employed by the private contractor Prison Health Services, said she was especially frustrated that no full-time physician was assigned to the western Jefferson County prison, which houses about 1,625 men. "I was terminated for lack of progress at the site, and it's an impossible site to manage with the staff that PHS has allocated for health care," Lawson said. "It's just wrong." "It really did kind of all tie in," she said. "How can I be expected in 10 months to turn this place around when there is not even adequate security?" She spoke highly of the officers but said they often were tired. A few men sought care in the health unit for chest pains or headaches. "A body can only take so much," Lawson said. Lawson's staffing complaints are similar to those raised by Dr. Valda Chijide, the former HIV doctor at Limestone Prison. Chijide resigned earlier this year after sending PHS several memos detailing inadequate support and staffing at the north Alabama prison. Lawson's firing leaves Donaldson minus experienced staff in the two top posts, overseeing the prison and the health care unit.

March 18, 2005 WHNT19
A fired medical administrator said Donaldson Prison in Jefferson County needs a full-time doctor before medical care improves at the overcrowded facility. Stephanie Lawson was fired in early March, the same week Warden Stephen Bullard was placed on administrative leave after writing a memo about inadequate staffing and poor conditions. Corrections officials said Bullard was placed on leave because of health problems associated with his job. Lawson was employed by the private contractor Prison Health Services. She said she was fired for lack of improvements in medical care at the prison. Lawson made the comments in an interview with the Birmingham News. P-H-S has declined to comment on Lawson's termination or replacement. Her staffing complaints are similar to those raised by another physician at Limestone Prison. Doctor Valda Chijide resigned earlier this year after sending P-H-S several memos detailing inadequate support and staffing at the prison.

Limestone Correctional Facility
Limestone County, Alabama
Prison Health Services (formerly run by NaphCare)
August 1, 2005 New York Times
If there was ever a prison that needed help, it was Limestone Correctional Facility. Even within the troubled Alabama penal system, this state compound near Huntsville was notorious for cruel punishment and medical neglect. In one drafty, rat-infested warehouse once reserved for chain gangs, the state quarantined its male prisoners with H.I.V. and AIDS, until the extraordinary death toll - 36 inmates from 1999 to 2002 - moved inmates to sue and the government to promise change. Alabama's solution was to fire the local company in charge of medical care and hire Prison Health Services, the nation's largest commercial provider of health care behind bars. Prison Health's solution was to recruit Dr. Valda M. Chijide, an infectious-disease specialist who arrived last November with a lofty title: statewide coordinator of inmate H.I.V. care. She was an unlikely candidate for the job in one sense, having never stepped inside a prison. But it did not take her long to conclude that the chaos was continuing, and that much of the problem was Prison Health itself. Though the company had promised the help of other doctors, she said, she was left alone to care for not only the 230 men in the H.I.V. unit, but the 1,800 other prisoners, too. Nurses were so poorly trained, Dr. Chijide said, that they neglected to hand out life-sustaining drugs or gave the wrong ones. Medical charts were a mess, she said, and often it was impossible to find such basic items as a thermometer, or even soap. Dr. Chijide lasted barely three months. After she complained in writing, Prison Health suspended her for reasons it would not disclose, and she quit. Her short, frantic stint - battling for drugs, hospitalizations and extra food for skeletal inmates, she said - was not unusual in the world of Prison Health Services, which has had a turbulent record in many of the 33 states where it has provided jail or prison medicine. But her story, a rare firsthand account of a doctor in charge of a prison's health care, offers an intimate glimpse of the company's work at a moment when the need for change could not have been more pressing, and the spotlight on Prison Health could hardly have been more intense. Limestone is not the only hitch in Prison Health's effort to transform a penal backwater. Two hundred miles south, at the state's Julia Tutwiler Prison for Women, another federal monitor reported that Prison Health lacked any "organized and structured medical program," and deplored the care given two inmates who died last year. There is, of course, a higher authority that Prison Health must answer to: the state official charged with making sure it lives up to its contract. That person is Ruth Naglich, who as associate commissioner of the Alabama Corrections Department is supposed to review the company's work. Three years ago, Ms. Naglich was a Prison Health executive, vice president for sales and marketing, at the company's headquarters outside Nashville.

May 6, 2005 Birmingham News
Prison Health Services has been under the gun, and rightly so, for the way it's provided medical care to Alabama inmates. The Tennessee-based company was hired to improve health care in Alabama prisons, which had been sued over services provided by a previous contractor. But the care in prisons remains unacceptable. A recurring theme is a shortage of doctors, nurses and other staff to tend to the inmates, with predictable consequences. At best, the care has been inadequate. At worst, it may have been downright deadly. The state of Alabama, which has the ultimate responsibility (and liability) for what happens to prisoners in its custody, has every reason to demand better from Prison Health Services. And withholding part of the company's payment is an appropriate place to start. The state is reducing the company's $143 million contract by $1.2 million for staffing shortages, and may cut more if staffing levels aren't increased. Why not? The state is paying Prison Health Services to provide a certain number of professionals and support staff to administer inmates' health care. If the company is not meeting the requirements of the contract, it should not expect to be paid as if it were. Besides, what's really at stake here is bigger than money. Too many inmates are not receiving proper care for chronic conditions, and some are dying unnecessarily as a result, according to doctors who monitor prison health care for the courts. At the Tutwiler women's prison, the monitor found that three inmates who died last year received poor or incomplete care, and two of them may have died as a result. At Limestone Correctional Facility, which houses HIV-positive inmates, the monitor found prisoners weren't getting crucial medication and that a required HIV specialist was not on staff. It's true that turnover has been a big problem. Prison Health Services has had problems retaining doctors and other health care workers; some have left complaining they didn't have the resources to do their jobs. But the bottom line is that the company agreed to provide a certain level of services, and it has been failing to do so. At the very least, the state should adjust the payments to Prison Health Services accordingly. So the company is losing dollars. Inmates are losing their lives.

April 29, 2005 Tuscaloosa News
Recent complaints by HIV inmates over medical attention at Limestone prison are "misleading and inaccurate," attorneys for the prison system and its health provider said in asking a federal judge to dismiss a contempt motion. The attorneys' filing says the state Department of Corrections and Prison Healthcare Services have taken adequate steps to comply with a settlement over housing and medical care for some 240 HIV inmates at the state prison in Limestone County. The document was in response to a complaint filed last week by inmate attorneys at the Atlanta-based Southern Center for Human Rights. The complaint said the prison system and health provider have yet to show they are carrying out any plan to correct "extensive noncompliant acts." Southern Center attorney Gretchen Rohr said the plaintiffs have asked U.S. District Court Judge Karon Bowdre in Birmingham to hold the state in contempt of court for failing to follow the April 2004 settlement. Though DOC and PHS concede that they don't have a permanent HIV specialist as required by the settlement, they "have worked tirelessly to retain" one, according to the court filing. They said several candidates have lost interest in the position after learning about the highly publicized complaints of the plaintiffs. The post opened after Dr. Valda Chijidi resigned earlier this year. He had sent PHS several memos detailing inadequate support and staffing at the north Alabama prison. The plaintiffs allege that inmates still have to provide emergency care to other inmates because an adequate nursing staff is not available - a claim denied by the prison and PHS. Rohr said she appreciates the efforts to improve conditions at Limestone, but remains skeptical about the plan actually being implemented. "For a long time we've been hearing that they have a plan and voluntarily are taking action. Not to rain on your parade, but we've heard it before," she said.

February 19, 2005 WPMI
Attorneys for 240 HIV-positive prisoners at Limestone Correctional Facility have accused prison officials of violating an agreement to improve their medical care. The north Alabama prison has no specialist for them and has constant gaps in medication, the attorneys claim in a contempt motion filed Thursday in U.S. District Court. The attorneys have asked U.S. District Court Judge Karon Bowdre in Birmingham to hold the state in contempt of court for failing to follow the April 2004 settlement in a lawsuit over inmate housing and medical care. Department of Corrections attorney Kim Thomas said Friday she couldn't comment on the motion until she has read it. According to the motion, two physicians, hired in the last eight months as part of the settlement, recently resigned. One of the doctor's memos detailed dozens of medical shortcomings, including a rat in the exam room and chaotic record-keeping. Dr. Valda Chijide wrote of being unable to care for patients because of disorganization in the medical unit and because prison staff has overruled her medical decisions. Once she walked in on a heart patient with chest pains who was trying to give himself nitroglycerin because no nurse was in sight, she wrote. "The law of diminishing returns sets in after riding on a skeletal staff and scanty resources for so long," Chijide wrote in a Jan. 25 letter to supervisors at Prison Health Services, the private prison medical company that Alabama contracts with to provide medical care at all state prisons. Now, one physician handles care for more than 2,200 prisoners, including the HIV Unit. A PHS supervisor in Montgomery also has been filling in, Keldie said. "The state is ultimately the one who is responsible for the medical care and the state should be forcing PHS to implement the settlement agreement that we've reached," said Joshua Lipman, a Southern Center for Human Rights attorney. "What they've done so far is pretty appalling."

May 25, 2004
A settlement has been reached in a lawsuit against the state Department of Corrections and its former medical provider, claiming HIV-positive inmates at Limestone Correctional Facility were not given adequate health care. The settlement, reached after several months of negotiations mediated by Magistrate Judge John Ott, was filed in the federal district court in Birmingham on Friday. The terms of the settlement, set to be signed at a hearing Wednesday, were not disclosed. David Lipman, attorney for the four HIV-positive inmates named as plaintiffs in the suit, has argued that prison medical provider NaphCare Inc. did not adequately treat the inmates and ultimately hastened some inmate deaths in 2002. The Department of Corrections has since changed medical providers. (Gainesville Sun)

March 19, 2004
Some of the sickest men in Alabama prisons live in drafty cells in a building with broken windows. They must stand in line in the middle of the night for their pills. And several have died prematurely because of gaps in medical care, according to a report released Thursday as part of a lawsuit against the prison system. Dr. Stephen Tabet, an infectious disease specialist from Seattle, first documented the harsh conditions at Limestone prison's HIV unit last year. When he returned for a follow-up visit, he found few improvements. "More strongly than ever, I feel the Limestone Correctional Facility is in dire need of outside intervention and oversight," Tabet wrote after his Feb. 23 visit to the prison, where all of Alabama's male HIV-positive inmates, about 250 men, are housed. "Patients continue to die because of the failure of the medical system," he wrote. The Department of Corrections strongly disagrees with the report's conclusions, a spokesman said. "It is important to note that this report is written by a trial witness, hired by plaintiff lawyers," said DOC spokesman Brian Corbett. Tabet has been reviewing HIV Unit medical care for the Southern Center for Human Rights, an Atlanta-based law firm representing HIV-infected prisoners in a class-action lawsuit against the state. His August 2003 report documented conditions leading to 39 deaths since 1999. Thursday's follow-up looks at five new deaths in five months. One patient dropped a third of his weight in five months, to 110 pounds, before dying in February. A doctor prescribed a high protein supplement for 35-year-old Gerald Lewis, but the kitchen wouldn't provide it. Another man arrived at Limestone with active tuberculosis, but his medical records from another prison did not follow. Alfred Thomas, 42, was placed with all the other HIV patients, potentially exposing them to the disease. No one at Limestone knew about his TB until an autopsy following his October death. Prisoner Nathan Sullivan began suffering with low oxygen levels a week before he died. "I am so sick, I can't even walk," he told a nurse who made notes in his files. "Inmate crying, praying to God to deliver him from his illness. Achy head to toe, nausea, headache, diarrhea after taking meds," she wrote. Sullivan was suffocating, and died at a Huntsville hospital. Ambulance personnel initially refused to take him from the prison because of his oxygen level, according to the specialist's report. One of Tabet's gravest concerns is lack of critical medication and middle-of-the-night pill call. "The pill line is a disaster," he wrote. Many medications were not on hand, and patients were sent away without them, Tabet wrote. Not all bad news: There have been some improvements since Tabet's first report. Before, the HIV inmates lived in a crowded, converted warehouse. Currently, they live in cells in another building. But some of the windows are broken and covered with plastic or blankets. The doctor called the situation "unbearable for these immune-compromised patients." The prison added a part-time physician to its previous staffing of one physician, but staffing remains below the National Commission on Correctional Health Care guideline of 110-physician hours per week for a prison with 2,200 inmates. Since Tabet's first visit, DOC has switched medical contractors and spends more money on prisoners' care systemwide. The department hired Tennessee-based Prison Health Services for medical care and Mental Health Management Services for mental health care in November. The 3-year contracts are worth $172 million. Previously, Birmingham-based Naphcare held the contract which costs the state $135 million over three years. Prison Health Services officials issued a written response to the report, but declined to answer questions. Company Vice President Larry Pomeroy described the medical care as appropriate and high quality. "All clinical and operation policies implemented by PHS within the ADOC system, including the Limestone facility, are in compliance with national standards of health care delivery as established by the National Commission of Correctional Health Care," Pomeroy wrote. Corbett at DOC said, "... we are in the process of addressing the complaints and resolving the issues in compliance with national health care standards as established by the National Commission of Correctional Health Care." Alabama's prisoner health care costs remain the lowest in the country. The state spends about $5.50 per prisoner per day. The national average is $7.38. Despite the new contract, much of the Limestone medical staff has not changed since before the lawsuit was filed, said Gretchen Rohr, an attorney with the Southern Center for Human Rights. "It's key they somehow show us that the new contract has been properly implemented," Rohr said. "We have not seen any evidence of this implementation." The trial in the Limestone case has been scheduled to begin May 17 before U.S. District Judge Karon Bowdre. (Al.com)

August 29, 2003
A health care contractor blasted for allegedly inadequate care of HIV-infected patients at Limestone Correctional Facility plans to bid for another statewide contract with the Department of Corrections on Sept. 10. A 125-page report released Wednesday by Dr. Stephen Tabet, hired by plaintiffs in a lawsuit, said poor medical care and inadequate facilities caused or accelerated many HIV-related deaths at the Capshaw prison. A spokesman for the contractor providing the Capshaw prison's health care, Birmingham-based NaphCare Inc., said his company is complying with all department requirements, but NaphCare's $29.5 million contract with the state, covering all state prisons, dictates staffing levels. The Limestone prison houses 2,260 prisoners, about 200 with HIV. NaphCare spokesman David Davis said his company has handled the DOC's health care only since March 2001. He said there have been only 14 HIV-related deaths at Capshaw since . Tabet discussed 38 deaths in his report, but many occurred before 2001. "Dr. Tabet's engaged by, employed by, and I suspect wants to be employed again by, the plaintiff," Davis said. "Obviously the plaintiff does not understand the contract that NaphCare operates under with the DOC, Davis said. DOC Commissioner Donal Campbell notified NaphCare of his intent to terminate its contract shortly after Gov. Bob Riley appointed him to the post. Davis said NaphCare will submit a bid higher than its current charges because of more stringent DOC requirements. (Decatur Daily)

Mobile County Metro Jail
Mobile, Alabama
Correctional Medical Services
January 28, 2006 Mobile Register
A woman who was jailed in Mobile last year went into a diabetic shock and nearly died because officers and medical staff denied her proper medication and ignored her problems, a federal lawsuit claims. The suit, filed last month in U.S. District Court, seeks unspecified damages from Mobile County Sheriff Jack Tillman, Warden Mike Haley, the private company that provides medical services and several employees of the firm and the jail. Lawyers for the Mobile County Sheriff's Office and Correctional Medical Services denied the allegations in written responses filed in court this month. Lofton, 33, was booked into the jail Feb. 23 on a charge of driving on a revoked license. The insulin-dependent diabetic was not evaluated until 10 hours later, according to the complaint. The lawsuit states that Lofton told medical personnel that she takes two shots of insulin every day, but staffers did not provide her with any insulin until 4 p.m. the following day. At that time, according to the suit, medical staffers at the jail gave her insulin from a bottle given to all diabetic detainees.

March 5, 2005 Mobile Register
A federal prisoner who was being held at Mobile County Metro Jail tried to commit suicide shortly after officials took away his anti-depression medication, according to documents filed in U.S. District Court. Sean Gaston Atwood's lawyer asked a federal judge in December to transfer the man to a federal medical facility. The motion, which Chief U.S. District Judge Ginny Granade granted Dec. 9, states that Atwood tried to hang himself less than a month after his arrest Oct. 27 for escaping from the custody of U.S. marshals. Atwood had been prescribed a drug called seroquel by the Federal Bureau of Prisons, but Metro Jail staff took it away amid concerns that other inmates had abused the medication, according to the motion. Assistant Federal Defender Lyn Hillman said jail staff indicated that they had banned the medicine because some inmates had been using it to get high. She said a doctor should have examined her client and replaced the drug with another medication. Jail Warden Mike Haley declined to discuss Atwood's case in detail, citing federal privacy laws regarding medical treatment. He said medical personnel working for Correctional Medical Services, a St. Louis firm hired by the jail to provide health care, determine which drugs inmates receive. Haley referred other inquiries to Dr. Charles Smith, a Mobile psychiatrist who works for Correctional Medical Services. "Within that one question that you have asked, there are a half-dozen thorny questions, difficult questions," said Smith, who declined to comment further.

Perry County Correctional and Rehabilitation Center
Uniontown, Alabama
Louisiana Correctional Services
May 3, 2006 Selma Times Journal
The city of Uniontown welcomed a new business Wednesday, one which is likely to employee more than 100 Perry County residents, but it wasn't the sort of commercial site where officials and dignitaries usually hold ribbon-cutting ceremonies. This ribbon-cutting took place in the shadow of walls, watchtowers and razor-wire, as Black Belt officials celebrated the completion of the Perry County Correctional and Rehabilitation Center. Louisiana-based LCS Corrections, a private prison operator that houses a number of female Alabama inmates at the South Louisiana Correctional Center in Basil, La., will administer the facility. State Sen. Bobby Singleton, who helped attract LCS to Perry County three years ago as a state representative, said the city, county and surrounding area should be proud of the facility. "We're never proud to be incarcerating someone, " Singleton said, "however, I feel we've partnered with good corporate citizen, on that's looking toward rehabilitation and other positive programs in their facility."

Pine Prairie Correctional Center
Pine Prairie, Louisiana
Louisiana Correctional Services
February 22, 2006 Pickens Herald
The Pickens County Commission in a press briefing last Tuesday after their regular meeting questioned the state’s motives in housing several hundred prisoners in Louisiana when they could easily house them at the Pickens County Jail at a cheaper rate. County Attorney Buddy Kirk addressed the Herald with four of the five commissioners present (Commissioners Earnest Summer-ville, William Latham, Willie Colvin and Ted Ezelle were present; Tony Junkin was absent) about the matter after the Commission became aware that the state had moved 140 male prisoners from the Bibb Correctional Facility in Brent, Ala. to a private prison over 300 miles away in Pine Prairie, La. The Commission has contacted the Ala-bama County Commission Association about the matter, said Kirk, to ask for their help in approaching state officials about this curious action. Brian Corbett, a spokesman for the Ala-bama state prison system, told the Associated Press last Monday that the state plans to move 500 inmates from the Bibb County facility to the Pine Prairie Correctional Center in central Louisiana, a private prison operated by LCS Corrections Services Inc. The sticking point for the Pickens County Commission is that not only is the state having to carry the expense of transporting the prisoners to another state but are willing to pay $29.50 a day per inmate to house them there. The state only pays counties $1.75 per day to house state prisoners in county jails. “It doesn’t seem right to the Commission,” said Kirk, who noted that the state will virtually drive right by Pickens County from Bibb County to travel 300 miles to Louisiana. Furthermore, Kirk said if a prisoner has to meet with his attorney, it is a general rule that the state will have to pay that attorney’s expenses if the prisoner is housed far away.