Alabama Department of Corrections
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 6, 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."

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."

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.

Allegheny County Jail, Allegheny, Pennsylvania
On Oct. 21, 1996, 33-year-old Charles Fine, a heroin addict From Monongahela, became the first inmate to kill himself in what was then the new Allegheny County Jail. He rigged a makeshift noose out of his shoelaces and hung himself from a bunk in his cell. Now, seven years later, the medical company that used to screen inmates for suicide risk at the jail is on trial in U.S. District Court, defending itself against a negligence claim. Fine's stepmother, Barbara Mayfield, represented by local attorney Vincent Coppola, says employees of Correctional Medical Services Inc. of Missouri should have known Fine was going to kill himself. (Pittsburgh Post-Gazette January 24, 2003)

Arkansas Legislature
November 18, 2007Arkansas News
Several companies with ties to state legislators have contracts with the state. The deals involve more than $ 700, 000, most of the contracts were awarded after competitive bidding, the arrangements are legal, and they were publicly disclosed in recent reports to lawmakers because of a law the Legislature enacted this year. Sen. Percy Malone, an Arkadelphia Democrat and a legislator since 1995, is president and the majority stock owner of W. P. Malone Inc., which owns Pharmacy Care of Arkansas. That company does business as Allcare Pharmacy, which has a $ 25, 000-a-year pharmacy services contract with the Department of Human Services’ Alexander, Arkadelphia and Jonesboro Human Development Centers, said the state’s procurement director, Joe Giddis. It was awarded Jan. 20, 2005. Allcare also has had a contract with the department for the Arkansas Health Center at Benton since July 2004, said Julie Munsell, a spokesman for the department. That’s for $ 200, 000 a year, Giddis said. Allcare was paid $ 437, 890 from July 2004 to Nov. 8 this year for drugs under the contract, Munsell said...Malone’s firm also is a subcontractor to the Department of Correction for inmate medical care, Giddis said. That arrangement, too, began before he was a legislator, Malone said. The firm provides prescription drugs and other services through Correctional Medical Services of St. Louis. He and Correctional Medical Services declined to say how much business Allcare does each year with Correctional Medical Services. “It’s proprietary [information ],” Malone said.

Arlington County Detention Center, Arlington, Virginia
March 1, 2006 DC Examiner
The cost of medical services for inmates in the Arlington County Detention Facility has gone up, staff turnover is high and service is lacking, according to an audit released this week by the Criminal Justice Institute. A 43 percent rise in operating costs was due to skyrocketing health care expenses, a higher influx of inmates with acute medical conditions and the rising prices of drugs prescribed for mental illness, said Susie Doyel, the facility's administrative director. Doyel said the report, which outlines a number of problems in the service provided by contractor Correctional Medical Services, is a positive thing for the facility. A number of criteria that were not specified in the contract with CMS led to inefficiencies and costly procedures. CMS's contract ends Oct. 31. In April, the detention facility plans to send out a request for new contracts that includes the majority of the auditor's recommended changes in operations, including allowing inmates to take drugs like Tylenol or antibiotics without the assistance of a nurse - freeing nurses for more pressing duties. But high turnover also contributed. Nurses were leaving, said the report, because of "high costs for parking, transportation issues and higher-paying positions in the vicinity with free parking."

Baldwin County Jail, Baldwin County, Alabama
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 prob lems 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.

Bayside State Prison, Leesburg, New Jersey
A New Jersey inmate infected with potentially deadly hepatitis C has filed a federal lawsuit against the state Corrections Department and its medical contractor, contending that his disease was left untreated for a decade after it was detected. The suit by Jose Lopez, 49, an inmate at Bayside State Prison in Leesburg, Cumberland County, is the latest to allege that New Jersey neither treated inmates for the liver disease nor told them that tests had found they were infected. "The conduct of prison officials and medical providers was outrageous. Not to inform Mr. Lopez of a life-threatening disease is tantamount to watching a person having a heart attack and sit idly by," said Lopez's Philadelphia lawyer, Mark B. Frost, who filed the suit Friday in Camden. The Department of Corrections declined to comment on the lawsuit. A spokesman for the department's medical contractor, the St. Louis-based Correctional Medical Services Inc., said he had not reviewed the lawsuit and could not immediately comment. Lopez, a career criminal who has been in prison since 1983, tested positive for the hepatitis virus in 1992, the suit said. By the time he was notified 10 years later, it said, his health had seriously deteriorated. He has since developed bleeding ulcers, a sign of liver cirrhosis caused by hepatitis C, medical records show. In addition to Lopez, several other current and former New Jersey prisoners have sued the Department of Corrections and Correctional Medical Services - the largest prison health company in the nation. (Philadelphia Inquirer, May 13, 2004)    

Broome County Jail, Broome, New York
A state report issued this month on two inmate suicides at the Broome County Jail last year found fault with medical procedures but said staff security and supervision were performed properly. The state Commission of Correction, the agency that oversees all of New York's jails, issued its report nearly a year after a 20-year-old asphyxiated himself Oct. 18, 2002, with a shoelace by wrapping it around a window frame in his cell and tying it around his neck. A murder suspect died in a similar manner on Christmas Eve by asphyxiating himself using a sheet. The two were the first suicides at the jail since it opened in 1996. Both men had medical issues when they were booked in, the report indicated. Scott Sickles suffered symptoms of heroin withdrawal, but did not receive standard treatment for drug withdrawal from medical staff, the report states.  Both families have put the county on notice that they plan to sue the county and its officials. In the past, inmates waited 24 hours while CMS obtained medication from a facility in Minnesota. (Press & Bulletin Sun, October 27, 2003)

Calhoun County Jail, Battle Creek, Michigan
March 25, 2005 WZZN13
A sneeze changed Linda Peterson's life forever.  Peterson, 53, of Battle Creek, was a licensed practical nurse working in the Calhoun County jail when a female inmate sneezed during an examination on May 15, 2002. What Peterson didn't know at the time was that the woman was infected with Methicillin-resistant Staphylococcus aureus, or MRSA, a bacteria resistant to many antibiotics. Peterson believes it was that sneeze which infected her. For Peterson, the infection forced amputation of her middle toe and a portion of her left foot, forced her to stop working, plunged her into depression and placed her nearly $100,000 in debt because of medical bills and her inability to work.  She can't rid her body of the infection and can only hope to control it. Peterson was working for Correctional Medical Services, a St. Louis, Mo., company which contracts with Calhoun County to provide medical care in the jail. The company provides correctional health care in 27 states. Peterson and another former registered nurse working for CMS, Sally Lett of Kalamazoo, and two former inmates, contend CMS and jail personnel did not do all they could to disinfect jail living areas and equipment to help prevent the spread of the bacteria. "It wasn't as clean as it should be," Peterson said. "We didn't always have the supplies." "The health and safety of the inmates and the employees was not a consideration," Lett alleged.

Callaway County Jail, Fulton, Missouri
November 17, 2005 Fulton Sun
With half a month left before inmates at the Callaway County Jail lose their healthcare provider, county officials believe they have found a new provider, one that will offer more benefits at a cheaper rate. The Callaway County Commission decided Wednesday morning to pursue using Advanced Correctional Healthcare to provide medical services to the county's inmates. After Correctional Medical Services - which will provide the county's healthcare until Nov. 30 - notified the county that it was pulling out of the contract at the end of October, Callaway officials have been hurriedly looking for another provider. "I was really concerned when the sheriff said (CMS) would no longer be providing services," said county auditor Rosemary Gannaway. "That was the scary part." CMS generally provides medical services to institutions larger than county jails, but because of Callaway's proximity to the Department of Corrections in Jefferson City - which CMS services - CMS agreed to cover the Callaway jail, Gannaway said. CMS provided a nurse practitioner to work 18 hours a week at the jail, as well as an on-call doctor. Because the nurse practitioner recently accepted another job, Gannaway said CMS decided to end the contract rather than trying to find another nurse practitioner to fill the position.

Central Mississippi Correctional Facility, Mississippi
July 16, 2005 Clarion Ledger
A state prisoner suffering from life-threatening illnesses has been denied medical treatment for more than a month, a lawsuit claims.  The lawsuit, filed this week in U.S. District Court in Jackson, seeks immediate medical treatment for Raymond Winne of Gulfport, an inmate at Central Mississippi Correctional Facility in Rankin County. The Eighth Amendment of the U.S. Constitution guarantees an inmate the right to receive necessary medical attention, the suit says.   Named as defendants are the correctional facility Superintendent Margaret Bingham and Correctional Medical Services, Inc., which provides medical treatment for state inmates.  The lawsuit comes after an American Civil Liberties Union class- action lawsuit was filed in June on behalf of roughly 1,000 inmates in Unit 32 at the state Penitentiary in Parchman.  The lawsuit's allegations include that inmates in the super maximum security unit are subjected to inadequate medical, mental health and dental care.  In 2003, the ACLU filed a lawsuit and won improvements in Unit 32 for death row inmates.

Correctional Industrial Facility, Pendleton, Indiana
December 4, 2007 The Herald Bulletin
A contractual employee at a Pendleton prison has resigned after she admitted to trafficking with an inmate. Tim Horan, public information officer for the Correctional Industrial Facility, said Margie Rickner resigned Friday after admitting to Indiana State Police investigators she brought in tobacco for an inmate. Rickner, a behavioral clinician employed by Correctional Medical Services, had been working at the prison since Dec. 3, 2006. Her job duties included counseling inmates. Rickner has not been charged with any crime, but Horan said ISP is pursuing charges against her. Trafficking in tobacco with an inmate is a Class A misdemeanor punishable by up to a year in prison and up to a $5,000 fine. The $5,000 fine is mandatory if the person who committed the crime is a Indiana Department of Correction employee or is an employee of a penal facility, according to state law. CMS provides medical services for about 250,000 inmates in 24 states, according to the company’s Web site. The inmate’s name and the amount of tobacco brought into the prison weren’t released, Horan said, because the case remains under investigation. He could also not release when Rickner allegedly began bringing the contraband inside. Her age and city or residence were also unavailable from prison officials. “CIF staff are due all the credit,” Superintendent Tom Hanlon said in a news release. “Through their observations and communication, this trafficking incident was detected.”

Correctional Medical Services, St. Louis, Missouri
November 7, 2007 Financial Times
Madison Dearborn is preparing a sale of Valitas, a company that provides medical care to prison populations, three sources told mergermarket. An auction for the company will probably kick off early next year, and the company is working on putting together a staple financing package at the moment, according to one of the sources. UBS has been mandated to run the process, the second source said. Valitas’ EBITDA is around USD 50m, according to an industry banker. The company’s main subsidiary, Correctional Medical Services, reached USD 750m in revenues in 2007, according to its website. The company is likely to draw interest from private equity buyers only, as there are no natural strategic buyers for the asset, the banker added. Valitas could draw interest from Maximus, a listed provider of healthcare services to the US government, a second industry banker said. Madison Dearborn backed a management buyout of the Missouri-based company in 1997 from Aramark, the company that provides food service and uniforms to institutions, according to news reports. Under Aramark the division was called Spectrum Healthcare, and included a business that provided contract healthcare services to the US military. That business, however, was sold to Team Health, another Madison Dearborn portfolio holding, in 2002. Team Health itself was sold to the Blackstone Group, in 2005. The company is one of the oldest healthcare investments in Madison Dearborn’s portfolio, the industry banker said. A company spokesperson declined comment, and a Madison Dearborn official did not return calls.

November 8, 2001
Gregory Jennings, Jacqueline Reich, Lorenzo Ingram, Sr., Henry Simmons, Calvin Moore, Billy Roberts and Kathy S. Kearns didn't know each other in life, but they shared a common bond in death: All died in U.S. prisons, the victims not of the death penalty, or at the hands of fellow inmates or guards, but in the allegedly negligent care of a single provider of privatized health services.  Correctional Medical Services (CMS) is a St. Louis, Missouri-based for-profit corporation that contracts to provide health care services to over 270,000 inmates at more than 330 prison sites in 29 states.  A 1998 in-depth investigative report done by the St. Louis Post-Dispatch, its hometown newspaper, shed light on the downside of prison care privatization. The Post-Dispatch's investigative team spent five months "visiting prisons and jails; gathering hundreds of police, court and medical records and other documents; and interviewing doctors, nurses, inmates, lawyers, scholars, prison and health experts and families of inmates who died behind bars."  Published in September 1998, "Death, Neglect and the Bottom Line: Push to Cut Costs Poses Risks," found that while CMS successfully reduced the cost of health care to several states, there were "more than 20 cases in which inmates allegedly died as a result of negligence, indifference, understaffing, inadequate training or overzealous cost-cutting."  At the ACLU web site, the civil liberties organization posts a late-January 2001 letter it sent to the Connecticut Department of Correction (CDOC) that claims CMS's health care services -- medical, mental health and dental care -- at the Wallens Ridge State Prison in Big Stone Gap, Virginia is woefully "inadequate."  The ACLU writes: "The health care provided by Correctional Medical Services, the contract provider at [Wallens Ridge], was considered so grossly inadequate that [Virginia Department of Corrections] recently fined CMS nearly one million dollars. The Virginia State Auditor specifically found that CMS did not provide a dentist at [Wallens Ridge] for over three months, and never provided an optometrist. Medical privacy and confidentiality is non-existent at [Wallens Ridge]; as a matter of policy, prisoners are required to discuss their most private medical and mental health issues in the presence of security staff and other prisoners."  In 1998, the Minnesota Department of Corrections contracted with CMS for health care services in its state's prisons.  According to the Twin Cities Independent Media Center, the NAACP called a press conference in mid-October to publicize a lawsuit "over the death of Gregory Jennings, who died in Stillwater prison on April 6, 2001 because the medical staff were indifferent to his complaints of symptoms of diabetes."  Should Calvin Moore, in custody for less than a month at the Kilby Correction Facility in Alabama, have died from being ignored while he lost fifty pounds and exhibited severe symptoms of mental illness, dehydration and starvation? Should Diane Nelson, a 46-year-old mother of three, have died because her request to receive her heart medicine prescribed by her doctor was refused? And what of Charles Guffey, who died of a perforated ulcer because nurses at the Tulsa County Adult Detention Center in Oklahoma refused to pay attention to his complaints of severe abdominal pain? If these folks were around today they'd have a lot to say about the human cost of the growing privatization of prison health care services. Hopefully, privatization will begin to receive the close scrutiny it deserves. That is the least we can do. The deaths of these men and women, while tragic, should not have been in vain.  (AlterNet.org)

Cumberland County Jail, Cumberland County, Maine
February 26, 2008 Portland Press Herald
Cumberland County Sheriff Mark Dion said today that the county has begun its own internal investigation to determine whether a man who is HIV-positive was denied medication when he arrived at the jail on a misdemeanor charge of failing to pay a fine. Dion said he is assessing how much time elapsed between when Charles Wynott arrived at the end of January and when he was provided medication prior to his release about a week later. The jail typically does not store a wide range of expensive HIV medicines but Dion said he will assess whether there was an unacceptably long delay in determining the medical care Wynott needed and then obtaining medicine and providing it to Wynott. Inmates are not allowed to bring their own medication into the jail. Wynott, who is representing himself, filed a federal lawsuit Friday in U.S. District Court in Portland against Correctional Medical Services, which manages medical care in the jail, saying delays in getting him his medicine may have allowed the virus in his system to mutate, making it more resistant to medicine. Dion said CMS would not have had a financial motive to deny the medicine. CMS does not pay for the medicines it prescribes, but is instead paid a management fee by the county and then passes the cost of medicine and hospitalizations on to the county. Medicine costs alone were almost $400,000 last year.

February 26, 2008 WMTW
A Westbrook man is suing the company that provides health care services at the Cumberland County Jail, saying it took the jail five days to give him his HIV medication. Charlie Wynott spent about a week at the jail last month after being arrested for driving with a suspended license. Wynott, 44, filed a lawsuit in federal court last week against Correctional Medical Services. He said he wants to see policies changed. He told News 8, "It's not about the money to me. It's about taking care of the inmates in the jail. It shouldn't take five days for them to get the meds to you." Cumberland County Sheriff Mark Dion said the jail tries to provide the best care possible. "I've looked at the timeline. There was a lag,” he admitted. “The reason for the delays is it wasn't available in the pharmacy. It's pretty costly, and we don't normally keep it on the shelf. Once we did get it, he received it." While Dion said he would like to see the lawsuit open up a conversation on the issue, Wynott said he just wants to make a difference. Another man filed a similar suit against the jail’s former medical provider about 10 years ago. David McNally settled out of court.

Cummins Unit, Lincoln County, Arkansas
September 8, 2005 Northwest Arkansas News
An inmate died last year after a prison doctor neglected to effectively treat an ailment that caused his lungs to fill with infected pus, according to a lawsuit filed Wednesday in Jefferson County Circuit Court. Willliam Jobes died at Jefferson Regional Medical Center after being transferred from the Cummins Unit in Lincoln County on Feb. 9, 2004. About two months later, he received a posthumous pardon by Gov. Mike Huckabee. Five days before he died, Jobes, 50, had been admitted to the Cummins infirmary after complaining of pain in his left side and back for three weeks. Dr. Olabode Olumofin ordered a chest X-ray, which showed a buildup of fluids in Jobes’ chest. Olumofin tried to drain the fluid, but it would not flow through a catheter. The lawsuit contends that the lab reports "were blatantly and willfully disregarded" by Olumofin, who "wholly failed to take any action in response to save Bill Jobes’ life." Olumofin works for Correctional Medical Services Inc., a St. Louis-based company that provides medical care for Arkansas’ 13,000 inmates under a $38 million contract. The company has contracts for prison and jail health in 26 other states and is responsible for 212,000 prisoners nationwide. According to federal court records, Correctional Medical Services has been named as a party in about 200 suits in the Eastern District of Arkansas. A suit filed Aug. 16 in Little Rock against the company contends that incompetent medical care provided by Dr. Craig Bardell at the McPherson Unit in Newport led to the Oct. 23, 2004, death of 47-year-old Virginia Morris. Morris, the mother of two grown sons, was seven months into a 10-year sentence on drug charges when she died after months of neglect by Bardell, who resigned in late July 2005, according to the suit. The Morris suit alleges that the company "has a history and reputation of customarily cutting corners in prisoner health care to maintain high profits" and trains its personnel "to be deliberately indifferent" to prisoners’ health needs.

Davidson County Criminal Justice Center, Davidson, Tennessee
A state prison inmate who contends that he had to wait months for surgery to repair his fractured wrist has filed suit against the private firm that provides health care for Tennessee's penitentiaries.  Michael W. Mallory, 45, slipped and fell in the Davidson County Criminal Justice Center immediately before his transfer to the state prison system in 2003. The fall fractured his hand and wrist, according to his federal lawsuit against St. Louis-based Correctional Medical Services Inc.  Although initially treated with a fiberglass splint at Meharry Medical Center, the Aug. 31 injury failed to heal properly. It was not until March 26, 2004, that he received the surgical repairs he claims he needed all along.  CMS officials said yesterday that medical privacy laws prevent them from discussing the particulars of Mallory's medical case. But Mallory ''was seen and treated by health-care professionals and specialists on numerous occasions,'' according to company spokesman Ken Fields. ''We will defend against these allegations,'' Fields said.  The suit echoes the complaints of other inmates who have filed suit in recent months contending that painful and sometimes life-threatening conditions have been ignored — including that of Terry Crouch, whose headaches and precipitous weight loss were treated with antacids administered by prison doctors.  In fact, Crouch had a brain tumor and was transferred, partially blind and unable to walk, to a local nursing home after long-delayed surgery.  (The Tennessean, September 4, 2004)

DeKalb County Jail, Georgia
December 8, 2004 Atlanta Journal-Constitution
If Adams v. Dorsey were an old movie instead of a lawsuit, calendar pages might blow past the camera, stopping briefly at the turn of the years from 1999 to 2004. Now it appears the story will continue past one more New Year's Day, because some disputes remain in the long and costly battle over medical care at the DeKalb jail. By mid-December, Superior Court Judge Hilton Fuller will receive written arguments on one aspect of what may be the final steps in the lawsuit. Lawyers for the Southern Center for Human Rights, representing jail inmates, want to send in their own expert to review the care provided by the jail's private medical contractor. Lawyers for the county government and Sheriff Thomas Brown oppose that request. Also this month, the inmates' lawyers are to meet with the jail's medical staff in the first of what a court-appointed monitor recommends should be monthly meetings to review any complaints. The case began in 1998, finally yielding a settlement in March 2001. At the time, Fuller said that inmates with life-threatening diseases weren't being treated and that the jail's failure to adequately protect against contagious diseases posed a hazard to guards and the public. Later, Fuller ruled the agreement wasn't being followed. He found the county government in contempt and said he would continue to oversee the jail medical program until the agreement's conditions were met. Since the settlement, the jail's annual medical bill has increased from about $7 million to about $11.5 million. The county's legal bills for the lifetime of the case total more than $700,000.

February 16, 2004
A new court-appointed inspector says medical care at the DeKalb County jail has improved enough that a costly six-year legal battle could end soon.   The county has spent more than $700,000 in legal expenses on the case that began when inmates sued over poor medical care. Meanwhile, county jail medical costs have jumped to about $11 million this year from $7 million in 2001.  (The Atlanta Journal-Constitution)

March 17, 2003
Georgia Philpot knows her complaints about her son's medical treatment by the DeKalb County sheriff's Department won't get the attention of many county residents.  Her youngest child, 21-year old Alan D. Philpot, has been held in the DeKalb jail since September for violating probation on a drug conviction.  He has a history of ear infections that required surgery, and began telling jail officials in October that he had a new infection, his mother said.  She said it took more than three months and at least 10 phone calls to various jail officials to find someone who made sure Philpot got the antibiotics he needed.  "The public is generally unconcerned about the medical care rendered to inmates," Superior Court Judge Hilton Fuller wrote in a 2001 ruling in which he nonetheless tried to spell out reasons the public should care.  He cited society's moral duty to treat humanely and health risks to guards, jail visitors and the outside world.  Such charges and countercharges are part of an ongoing 3 1/2-year old battle over health care for the 2,700 men and women housed in Georgia's largest jail.  Tamara Serwer, lawyer representing inmates, insists inmates are still at risk and the public sector could be too, from inmates released with communicable diseases.  Failure to control communicable diseases, including tuberculosis, has been a frequent criticism in reports by Dr. Robert Greifinger, a former chief medical officer for the New York Department of Corrections.  He was appointed by Fuller to monitor the jail's compliance with its 2001 agreement to improve medical care at the jail.  Even as Greinger praised a new management team installed at the jail by private contractor Correctional Medical Services in his latest report in February, he said he found cases in  which there was not "timely and appropriate follow-up" for inmates whose chest X-rays showed a risk of TB.  (The Atlanta Journal Constitution)

February 25, 2003
Sheriff Thomas Brown on Monday said the DeKalb County Jail's much-criticized medical care system is close to earning national accreditation.  Brown called a recent positive review by the National Commission on Correctional Health Care a welcome counterpoint to a series of critical reports by a court-appointed inspector.  Brown described medical care at the jail as in a crisis when he took office two years ago. The jail has operated under a court-approved settlement of an inmate lawsuit over inadequate care since March 2001.  As recently as last week, the inspector appointed to monitor the settlement reported that minimum standards were not being met, though there were signs the jail's private medical contractor was trying to improve.  Brown said the reports by the inspector, Dr. Robert Greifinger, have focused on problems with individual inmates, while the accrediting commission review shows that the jail's overall approach to health care is sound. In a jail with 2,700 inmates, "you can miss one and not do something just right," the sheriff said. But, he said, "We think we're well on the way to solving this particular litigation."  That assessment was disputed by Tamara Serwer, a lawyer for the inmates who brought the medical care lawsuit. She said Greifinger reviews random cases and that the examples he has cited show "the system is not functioning."  She said the commission focuses on written policies. "It's a great thing to be accredited by the NCCHC, but it doesn't tell you anything about the way patients are actually treated." She said it was "amazing" that it took two years to get adequate policies in place. Actual improvement will take months more, she said.  (The Atlanta Journal)

January 24, 2003
A court-appointed inspector says some diabetics inmates haven't been getting proper doses of insulin at the DeKalb County Jail and the jail medical staff has been slow to react to potential tuberculosis and HIV cases.  Dr. Robert Greifinger, a former medical director of the New York State Department of Corrections, made the criticisms in a report after visiting the jail last week.  Greifinger visits the jail to monitor compliance with a 2001 settlement in a lawsuit over inmate medical care.  Greifinger said one diabetic inmate received no insulin for three days and "developed a life-threatening condition" that required emergency hospitalization.  He said he reviewed the records of four other inmates with diabetes that was "seriously out of control."  Two had foot ulcers and "none have had insulin adjustments to get them in control," according to the report.  Ken Fields, a spokesman for CMS, the company contracted to provide jail medical care, said it was not clear if some of the diabetic inmates Greifinger cited were recent arrivals.  Fields said CMS officials do not agree with Greifinger's assertion that no HIV tests had been ordered at the jail since Dec. 25.  He said he could not comment specifically on five cases in which Greifinger said CMS did not appropriately follow up on chest X-rays "suspicious for tuberculosis."  Tamara Serwer, staff attorney for the Southern Center for Human Rights, which filed the original lawsuit, said Greifinger's report signaled a need for further action to improve conditions at the jail.  (The Atlanta Journal Constitution)

August 9, 2001
Earlier this month, the court-appointed monitor released a scathing report about medical care at the jail and said that Healing Touch was doing little to improve it. The lawyers for the plaintiffs in the lawsuit have filed a motion to put the jail's medical care under control of the courts.  DeKalb County hopes its newest contractor finally will improve medical care at the jail and get the court system off its back.  The County Commission Tuesday hired Correctional Medical Services Inc. of St. Louis to provide medical care to inmates at the state's largest jail. The contract, which is for up to five years, is worth at least $8.16 million a year, an increase of $1 million over the last contract.  In 1998, a group of inmates sued the county over poor medical care. Under a settlement agreement signed in March, the county agreed to improve the care and the court appointed a monitor to oversee the progress.   In April, the county's medical care provider ---Correctional Healthcare Solutions --- walked away from its $7 million contract. A local company, Healing Touch Inc., was given an interim contract.   Earlier this month, the court-appointed monitor released a scathing report about medical care at the jail and said that Healing Touch was doing little to improve it. The lawyers for the plaintiffs in the lawsuit have filed a motion to put the jail's medical care under control of the courts.  (The Atlanta Journal and Constitution)

Delaware Department of Corrections
April 5, 2008 News Journal
Fifteen current and former inmates at Young Correctional Institution filed a federal lawsuit Friday alleging their medical care while behind bars was not only negligent but amounted to cruel and unusual punishment. In at least one incident in 2006, a prison health care contractor allegedly used the same needle on multiple inmates, perhaps all 15, to draw blood and inject medicine -- exposing all to blood-borne diseases including hepatitis C and possibly HIV/AIDS. At least three allege they have contracted hepatitis and possibly other illnesses since that incident. Attorney Joseph M. Bernstein, who along with attorney Bruce Hudson is representing the 15, said he didn't know whether the woman identified in the lawsuit as "Nurse Beth" used the same needle to save money, because the prison hospital was short on supplies that day, because she made a mistake, or for some other reason. "Legally, it doesn't matter," said Bernstein. "They were still entitled to a minimum level of care." And just because a person is in prison, there is no lower level of acceptable care, he said. Although inmate Duane J. Williams was not named in the lawsuit, his family says the exposure led to the 32-year-old's death last month. Ken Fields, a spokesman for the prison's medical contractor, St. Louis-based Correctional Medical Services, said Friday the company was aware of the allegations in 2006 but said there was no evidence the nurse did what the lawsuit charges. He added that even if such a thing happened, it was unlikely -- and there is no evidence -- that any infection actually resulted. He acknowledged that the company did contact patients and offer follow-up blood testing, but said it only did so as a precaution because of the serious nature of the allegations against the nurse. Department of Correction officials did not return calls for comment Friday. The Rev. Christopher Bullock, senior pastor of New Canaan Baptist Church and co-founder of the Delaware Coalition for Prison Reform and Justice, said Friday the acts of the nurse and her employer CMS were potentially criminal. "We must decry this kind of behavior. It is not acceptable," he said. Bullock said the situation described in the lawsuit reminded him of the Tuskegee experiments in which hundreds of poor black men in Alabama were allowed, without knowing it, to suffer and die from syphilis by government doctors who were studying the disease's progression. He said inmates deserve to be treated humanely and their families should not have to put up with this kind of pain and anguish. The 15 inmates who filed the lawsuit were at various stages in the criminal justice system when they were exposed, Bernstein said. Some were being held for probation violations, some were serving sentences for drug violations or crimes such as theft, and some were being held pending a trial. Some have since gotten out of jail, but most remain incarcerated, Bernstein said. Normally, he said, a lancet is used to test a diabetic's blood, then a separate syringe is used to administer the insulin. Neither is supposed to be re-used. In this case, the inmates allege, the nurse used the syringe to test their blood, then used the same syringe to administer the insulin -- potentially contaminating the multi-use vial. She then re-used the syringe in the same way with other inmates, potentially compounding the spread of blood-borne disease. The 15 inmates say their rights were violated and are seeking compensatory and punitive damages and changes in prison medical care to prevent a repeat of the incident. Attorneys for the plaintiffs provided a copy of a memo given to the inmate patients sometime in the summer of 2006, which appears to acknowledge some kind of contamination incident. The "Patient Information Sheet" states a nurse "may have" used the same hypodermic needle to draw blood and to administer insulin, in violation of policy. "A few other inmate patients are now making the same claim," it states, with a handwritten notation adding that some have tested positive for hepatitis. The memo offers the inmates a blood screening to check for infection and says the unnamed nurse denied the charges and had left her job at Young Correctional. Bernstein said some of his clients who agreed to the blood screening were never told the results. Harry Williams, the brother of the inmate who died last month at a Philadelphia hospital, said Friday that his brother Duane, who was a diabetic and serving a three-year sentence on a drug and a weapons charge, had received the same Patient Information Sheet and that "Nurse Beth" was involved in his treatment in 2006 at Young Correctional Institution, formerly known as Gander Hill. Some 46 other diabetic inmates were treated from the same multi-use vial. Six subsequently tested positive for hepatitis, although prison officials said they could not definitively state that the illness was linked to the allegedly contaminated insulin. One month before the earliest date of alleged contamination, in March 2006, the Justice Department's Civil Rights Division launched an investigation of inmate health care in Delaware. That federal involvement followed a series of stories published in The News Journal detailing abuses and problems with inmate health care. The state later signed a settlement agreement with federal authorities promising to revamp and reform the prison health care system. In February of this year, a report on the progress of that reform by former Superior Court Judge Joshua W. Martin III gave the state and CMS poor grades. Bullock said Friday that CMS and its "incompetent and unethical" practices have to go. "The coalition will again be calling for the removal of CMS and we will be doing whatever is necessary -- demonstrations, protest marches -- to bring justice to an unjust system. Someone must be held accountable. We are talking about the lives of human beings," he said.

March 13, 2008 News Journal
An inmate mistakenly exposed to blood-borne diseases died Wednesday, months after his initial complaints of abdominal pain were ignored, his family says. "If I die, it's because of the prison," Duane J. Williams said just before he died, according to his brother. In 2006, a prison nurse administered a contaminated insulin shot to Williams. Because he wasn't tested for a variety of diseases and viruses prior to his incarceration for drug and weapons' offenses, it may never be known whether exposure to hepatitis, HIV and other infections contributed to his liver problems. But the prison medical staff's failure to act quickly when pain first developed, his family says, was a deadly mistake. "When I came into his room for the last time, I actually saw his breath leave his body," said Harry Williams Jr., Duane's brother. "I told him it was OK to let go. I saw the life go out of him. He's at peace. He is free now. He is definitely free." Four days before he died, Duane Williams, 32, told The News Journal that he first felt a pain in his gut over four months ago but the pain wasn't taken seriously until this month when a prison guard noticed Williams' eyes were turning yellow. The officer demanded that a nurse or doctor provide treatment or transfer the inmate to a hospital. Williams was taken to Wilmington Hospital and then Philadelphia's Albert Einstein Medical Center, where he died at approximately 1:30 a.m. His family requested an autopsy, but the exact cause of death remains unknown. "One of the doctors said he had acute hepatitis," his brother said. "But no one is telling us anything official." "He didn't deserve this," wife Megan Williams said through tears. "I will miss him very, very much."

March 9, 2008 News Journal
Gander Hill inmate Duane J. Williams is clinging to life in a Pennsylvania hospital, his eyes bright yellow from near-total liver failure. Severe abdominal pain, which he first reported over four months ago, wasn't taken seriously by the prison's medical contractor, Correctional Medical Services, until last week, he says. When a corrections sergeant noticed Williams' eyes, the officer demanded that CMS staff provide treatment or transfer the inmate to a hospital. Ten days ago, the inmate was taken to Wilmington Hospital, where he waited for a week before being transferred to Philadelphia's Albert Einstein Medical Center on Thursday night for specialized treatment. A diabetic, Williams was exposed to blood-borne diseases such as hepatitis in July 2006, when a former prison nurse drew insulin from a multidose vial with a syringe she had earlier used to obtain a blood sample from another inmate. The nurse, who resigned after the mistake was discovered, delivered insulin from that vial to Williams and 46 other diabetic inmates. Six have since tested positive for hepatitis, although prison officials can't definitively link their illnesses to the contaminated insulin. Most of the inmates, including Williams, were not tested for hepatitis before the exposure. To Williams, none of this matters. "My liver's failing me," he said. He doesn't know how long he will live if he doesn't get a transplant. "They won't tell me straight out," he said. Like the other exposed inmates, Williams has lived with the possibility he contracted hepatitis or HIV from the insulin shot. Because viral infections can take months to appear, nurses conducted a series of blood tests in 2006 to monitor the inmates' health. Williams, 32, was retested last week at Wilmington Hospital, but he says doctors tell him they don't know what caused his liver to fail. While hepatitis C can cause liver failure, it typically takes longer between exposure and failure than what Williams has experienced, according to Dr. Robert Fontana, an associate professor of internal medicine and medical director for liver transplant at the University of Michigan in Ann Arbor. The rarer former of hepatitis B, also can lead to liver failure, and progresses much quicker. Other medical circumstances can shorten or lengthen the progression of either strain. Sentenced to three years for drug and weapons offenses, Williams is dying six months before his scheduled September release. "He wasn't sentenced to death," said his mother, Teri Williams.

February 1, 2008 News Journal
Continued poor performance by the Department of Correction's medical vendor could hamper the department's efforts to get out from under supervision by the U.S. Justice Department, according to a new report by an independent monitor overseeing the state prison system. Correctional Medical Services, a private company Delaware pays millions of dollars a year to provide medical care to inmates, suffers from a "lack of stable and effective leadership," independent monitor Joshua W. Martin III wrote in a 229-page report released Thursday. "Moreover, there has been consistent turnover at staff-level positions, and, at [Young Correctional Institution] in particular, there is a problem with staff insubordination that needs to be addressed because it affects inmate medical and mental health services negatively," Martin wrote in his report. "The Monitoring Team has also faced difficulty in receiving consistent and accurate information from CMS." While Martin found that the DOC has made some improvements, he concluded that many CMS staff lacked proper credentials or were working outside their areas of expertise: At the Delaware Correctional Center near Smyrna, a pathologist is practicing general medicine. The monitoring team also found that for three months last year, no inmate at the Smyrna prison received a referral to an outside specialist because "the person who was assigned to schedule appointments for inmates was on sick leave, and CMS had failed to find a temporary replacement." Inmate medical files were found stashed in boxes, while others were out of date, doctored or missing. At the Baylor Women's Correctional Institution, a book used to keep track of inmates suffering from highly contagious flesh-eating bacteria was lost, the data irretrievable. Lisa Williams got out of the women's prison two weeks ago after spending six days there awaiting extradition to Maryland on a theft charge. Williams was burned over 60 percent of her body when she was a child, after a lighter she was playing with set her dress on fire. Now 31, she dehydrates easily because of the burns. When she overheated in a holding cell with 13 other women, just getting to the prison infirmary was difficult. "I put in a sick call slip, but it was four days before it was addressed," she said. The CMS nurse gave her an ice pack. "She said I was just a crackhead withdrawing," Williams said. "I'm not on drugs. I was very sick. They assume everyone's a crackhead. I saw a girl have a seizure in the cell. They made her walk to the infirmary, once she stopped." 'Lack of supervision' -- According to Martin's report, on several occasions the monitors were told about a practice or procedure staff believed was being adhered to, but "it often turns out that such practice or procedure is not, in fact, being followed in spite of the belief of the individual providing information. This is symptomatic of a lack of supervision of staff, and poor or nonexistent self-monitoring. The Monitoring Team recommends that CMS begin to self-monitor for compliance with DOC policies as soon as possible so as to be able to assess its own compliance, and provide the Monitoring Team with reliable information." CMS corporate spokesman Ken Fields refused to be interviewed for this story. "I am not going to respond to any specifics," he said. Fields also refused to allow CMS employees working in Delaware to be interviewed. "Our healthcare staff are focused on patient care rather than dealing with news media," he said in an e-mail. The "report shows clearly that, working together, the Delaware Department of Correction and CMS have made a great deal of progress enhancing the inmate healthcare system. The report also notes there is more to be done." Department of Correction Commissioner Carl Danberg said the monitor's report was "fair and balanced." "I've made it clear to CMS that I am not satisfied with the pace of progress, but CMS has been working cooperatively with us, and I will continue to hold them to the terms of the contract, and push for total compliance," Danberg said. Danberg's fiscal year 2009 budget proposal includes $40 million for inmate medical care -- $38 million for CMS. A call for change -- Inmate advocates have urged Minner and other state leaders to sever the state's contract with CMS. Danberg would not say if that is an option. "I will consider any change that I believe will lead to improvement of medical care, but at the moment, I'm not prepared to discuss the potential for changing vendors," Danberg said. Martin, a Wilmington attorney and former judge, was selected in May by the Department of Correction and the Justice Department to serve as the state's first independent prison monitor. Martin oversees efforts by the Department of Correction to satisfy a settlement agreement with the federal government over "substantial civil rights violations" in four state prisons. Martin declined to be interviewed for this story, as did Delaware Gov. Ruth Ann Minner. In preparing his report, Martin, together with a team of medical and mental health professionals, reviewed Department of Correction policies and procedures, record-keeping, medication and laboratory orders, staffing and training, screening and treatment, access to care, chronic disease care, medication management, emergency care, mental health care, suicide prevention and quality assurance. According to the mandates of the settlement agreement, the monitors must gauge compliance with 217 provisions. The settlement agreement, signed by Danberg, who at the time was Delaware's attorney general, and former Correction Commissioner Stan Taylor, called on the state to revamp its prison health care system and to report its progress regularly to the Justice Department. The agreement remains in effect for three years, although the state can get off earlier if it achieves "substantial compliance" with each portion of the agreement. Martin found the state failed to comply with 17 of 217 total provisions, and was in substantial compliance with 31 of the 217. The state was said to be in partial compliance with the remainder of the requirements. "The assessment of partial compliance that the Monitoring Team has used is a very broad designation and in some instances reflects minimal progress that the State has made in eliminating the constitutional deficiencies that motivated the parties to enter into [the settlement]," Martin wrote. Advocates, families dismayed -- Prison reform advocates, former inmates and their families didn't need Martin's report to reinforce their belief that inmate medical care in Delaware is poor. Francine Wright, whose son died while an inmate, said she continues to hear complaints from families who have imprisoned family members. "The medical care is not up to par," Wright said. "People are still not getting their medical treatment." Wright's son, Darnell Anderson, was serving a four-year sentence when he was taken to Wilmington's St. Francis Hospital in 2004. During his hospitalization, doctors learned Anderson had pneumocystis carinii pneumonia, an AIDS-related infection that is usually preventable and treatable when caught early. He died at St. Francis. "They need to fire the people over there who are not doing their job," Wright said. Dover attorney Steve Hampton, who has represented inmates and their families in lawsuits against the Department of Correction, said the problems outlined in Martin's report should come as no surprise to DOC officials. "Even with the monitor in place, very little real improvement is taking place," Hampton said. "Our state government officials have turned a blind eye to widespread human rights violations in a program for which they have oversight. It seems that they are not going to seriously address the problems at DOC unless forced to by the Justice Department." Hampton represented the family of Anthony Pierce, who became known as "the brother with two heads" as an inmate at Sussex Correctional Institution because of a large tumor growing on his head. Pierce, who was being treated by CMS staff, died from the brain tumor in 2002. The state settled a wrongful-death lawsuit in a confidential agreement last year. Public health at risk -- "This report tells me that the state is continuing to pay tens of millions of dollars for a health care program that routinely breaches the applicable standards of medicine, violates the human rights of inmates and puts us all at risk of serious infectious diseases," Hampton said. "The prisons have become incubators for all sorts of diseases such as MRSA, TB and hepatitis. These diseases are not stopped by prison walls. Allowing them to flourish in prison means they will eventually flourish on the outside." Problems with prison health care and high inmate death rates, especially from AIDS, were examined by The News Journal in a series published in 2005. In March 2006, the Justice Department's Civil Rights Division launched its probe. Minner tried unsuccessfully to derail the federal investigation. Her legal counsel at the time, Joseph C. Schoell, sent a letter to U.S. Attorney General Alberto Gonzales calling The News Journal's series "misleading." The Rev. Christopher Bullock, a founder of the Delaware Coalition for Prison Reform and Justice, said it was time for the state to terminate its contract with CMS. "Until CMS is replaced with a Delaware group -- for Delaware from Delaware -- there will be no significant or sustainable change," he said. "It's now time for the state to act in the best interest of Delaware and our reputation in this country."

January 4, 2008 News Journal
A former inmate who successfully sued the medical contractor for the state's prison system, without an attorney, has resolved his case out of court. Richard Mark Turner, 52, charged that Correctional Medical Services failed to provide him with adequate care in 2001 and 2002 to treat his hepatitis C. Attorney Jeffrey K. Martin, who is now representing Turner, said the resolution with CMS was "amicable" but confidential. He said Turner was pleased with the result. CMS spokesman Ken Fields said the case was settled to "to avoid further litigation." Neither side would say if Turner received money as part of the resolution. In March, District Judge Sue L. Robinson ruled in Turner's favor before his civil case went to trial, stating the undisputed evidence showed Turner's care was "obviously inadequate" and violated his rights. The result stunned legal observers because Turner won the case without formal legal assistance. At the time he filed the case, in 2003, Turner demanded $14.9 million. Martin joined the case several weeks after Robinson's ruling. The two sides agreed to settle the case following mediation sessions with Magistrate Judge Leonard Stark in late November and Tuesday entered a stipulation with the court to drop the case. In her March ruling, Robinson said CMS employees did not adequately instruct Turner on how to give himself injections of Interferon -- a form of chemotherapy -- and then "turned a blind eye" when they saw him improperly injecting himself three times a week for seven months. According to court papers, Turner injected himself in the same spot rather than in different locations -- as medically recommended -- resulting in serious infections. Martin said his client continues to suffer significant health problems as a result. Turner had been in prison on assault and reckless endangerment charges. He was released in 2006 but several months later ended up in a Pennsylvania prison on assault charges. Martin said Turner was released on the Pennsylvania charges in September and now lives in Sussex County. Turner has a second civil case pending in federal courts -- filed in 2006 -- alleging subsequent medical negligence by the state and CMS related to the infections. Turner also filed that case on his own, but Martin has agreed to now represent him in that matter as well.

July 6, 2007 News Journal
The state’s new prison monitor released his first semi-annual report today, which is highly critical of Correctional Medical Services, the Department of Correction’s medical contractor. In May, Joshua W. Martin III, a Wilmington attorney and former judge, was selected by the Department of Correction and the U. S. Department of Justice to serve as the state’s first independent prison monitor. As such, Martin will oversee the efforts made by the DOC in satisfying a settlement agreement with the federal government following an investigation that revealed “substantial civil rights violations” in four state prisons. Martin, together with a team of medical and mental health professionals, is monitoring Department of Correction policies and procedures, record keeping, medication and laboratory orders, staffing and training, screening and treatment, access to care, chronic disease care, medication management, emergency care, mental health care, suicide prevention, and quality assurance. In addition, the team is providing technical assistance to assist the department with reaching or sustaining compliance with certain of the requirements under the memorandum of understanding. Martin spells out that his team’s compliance checks are in their initial stages, with more detail to come in subsequent reports. “This report primarily summarizes the obligations of the state under the MOA, the preliminary observations and recommendations the Monitoring Team has regarding the state's compliance with the MOA, and the monitoring team's plan of action for the coming months,” Martin stated in his report. However, the team did identify several problem areas, such as poor sanitation and chronic understaffing by Correctional Medical Services. “Staffing by the state's medical vendor, Correctional Medical Services, of its leadership positions is a serious concern,” the report states. “Without adequate and consistent leadership, it is very difficult for the state to implement and maintain the changes necessary to comply with the MOA.” The reason for the understaffing, Martin’s team discovered, was an unwillingness by Correctional Medical Services to spend money. “It is the monitoring team's understanding that CMS has had difficulty finding appropriate individuals to fill leadership positions. The monitoring team also has received information that tends to indicate that CMS' regional or national management has not been willing to take such measures as offering relatively small increases in pay in order to attract and retain individuals that would be qualified to fill the vacant positions, nor has CMS' regional or national management been particularly supportive of facility-level CMS management regarding staffing concerns.” Dover lawyer Steve Hampton represents several inmates and their families, including the young daughter of Anthony Pierce, who became known as "the brother with two heads" as an inmate at Sussex Correctional Institution. Pierce, who was profiled in a series of articles by The News Journal, was serving a 14-month sentence from an attempted burglary. “They’ve identified some problems such as horrible sanitation and understaffing, which are well known to anyone in the system,” Hampton said. “The question is, what’s being done about it. I don’t see any details. It’s just another report that describes deficiencies.” For six months in 2005, The News Journal examined conditions of care within the state’s prisons. In late September that year, the newspaper published a series of stories highlighting the findings in a special report.

March 31, 2007 News Journal
The contractor handling medical services for state prisons violated an inmate's constitutional rights in 2001 and 2002 through "obviously inadequate" care, according to a federal judge. Chief Judge Sue L. Robinson further found the evidence was so overwhelming that she granted inmate Richard Mark Turner's motion for summary judgment, meaning he has won his case without a trial. What makes the ruling even more remarkable, according to legal experts, is that Turner, 51, got the ruling in a lawsuit that he filed and argued without an attorney. "This is a very rare event," said Elizabeth Alexander, director of the American Civil Liberties Union's National Prison Project. Turner, who is now incarcerated in Bellefonte, Pa., could not be reached for comment. Prison officials and officials with Correctional Medical Services said Friday they had not read the ruling, handed down late Wednesday, and therefore could not respond directly to it. "We intend to review the judge's ruling in detail before taking any additional action," CMS spokesman Ken Fields wrote in an e-mail Friday. He also noted the case involves events that are more than five years old, a time when less was known about the treatment of hepatitis C, which Turner had. The U.S. Department of Justice found "substantial civil rights violations" in Delaware prisons last year, following a 2005 News Journal series on prison medical care documenting abuses in the prison. In December, the state signed a settlement agreement with federal investigators, promising to correct the problems. On Friday, Corrections spokeswoman Gail Stallings Minor said the department is continuing to address every issue identified in the report. According to Robinson's ruling, Correctional Medical Services violated Turner's rights when its employees failed to adequately train him in how to use a syringe to inject himself with Interferon -- a form of chemotherapy -- to treat his hepatitis C and "turned a blind eye" when they observed him improperly injecting himself three times a week for seven months. Turner injected himself in the same spot rather than in several different locations as recommended by the information sheet included with the medicine. As a result of the improper injections, Turner developed a serious infection, according to court papers.

January 16, 2007 News Journal
Legislation that would guarantee public access to any state agency report that was paid for with public money was released from a House committee today, on track for possible action by the full house this month. House Bill 5, sponsored by Rep. Nancy Wagner, R-Dover North, is virtually identical to legislation that passed the House unanimously last year but died in the Senate for lack of action. It was prompted by the Department of Correction’s refusal to release a performance audit of Correctional Medical Services, the contractor that provided medical services to the state’s prisons. State officials refused to release the audit saying to do so would reveal private medical information that federal privacy laws preclude from disclosure. The state also refused to release a redacted version of the audit that would have removed patient identities while retaining the audit's conclusions regarding CMS' performance. John Flaherty, lobbyist for Delaware Common Cause, told the House Sunset/Policy Analysis & Government Accountability Committee that House Bill 5 “essentially makes public what is already public.”

January 13, 2007 The News Journal
Demetrius Caldwell, a 24-year-old drug dealer, had been undergoing unspecified treatment for a month in the state's newest prison infirmary before he was found dead this week, laying on a mattress on the floor of his infirmary cell. A medical staffer had checked on him 25 minutes before he died. Prison officials ruled out meningococcal meningitis as the cause of death Friday, after naming it as a possibility Thursday evening. A less virulent strain of meningitis remains a slight possibility. "Everything's negative," said James Welch, the Department of Correction's health services administrator. "There's no trauma, no heart problems, no brain tumor. We're still waiting on toxicology. We can't find anything. We're as concerned as anyone else is." The length of time Caldwell spent in the state's prison infirmary and the lack of an explanation for his death point to the same medical deficiencies that prompted the U.S. Justice Department last month to find "substantial civil rights violations" in four Delaware prisons, said Senate Minority Leader Charles L. Copeland, R-West Farms. The federal investigation was prompted by a series of articles in The News Journal that revealed inadequate health care and questionable treatment within the prisons. In their report, federal prison regulators found "consistent backlogs with the respect to the treatment of chronic care inmates." Any inmate who has been in the infirmary for a month meets the "chronic care" definition and should have been taken to a private hospital, said Copeland, one of the co-founders of the Delaware Coalition for Prison Reform and Justice. "Someone should have recognized that the prison infirmary was not the place for him to be," he said. "The fact they failed to identify that re-emphasizes the legitimacy of the constitutional violations of prison health care performance." Federal investigators, who negotiated an 87-point settlement with the state to improve prison medical care, declined to comment about Caldwell's death. Correction commissioner nominee Carl Danberg said Friday that doctors from Correctional Medical Service, or CMS, the prison's contract medical provider, along with the Department of Correction's medical team, the Chief Medical Examiner's Office and Public Health are reviewing the case. "Additional outside expertise might be sought, depending upon what we find in the tests that are still pending," Danberg said. "We are following Department of Correction procedures and following Delaware law for a death in custody. All information is being turned over to the Medical Examiner."

December 31, 2006 The News Journal
Delaware Correctional Center near Smyrna is among the Delaware prisons looking at major changes in inmate health care after an investigation by the U.S. Department of Justice found the prison system guilty of civil rights violations. It's been more than a year since a coalition of concerned citizens, lawmakers and clergy marched on the governor's mansion and knelt in prayer asking for better health care for inmates in Delaware's prisons. They were galvanized by horrific conditions outlined in a series of stories in The News Journal, the first of which appeared in late September 2005 -- a series Correction Commissioner Stan Taylor charged was "sloppy reporting" in a five-page response the newspaper published. What's happened since will bring groundbreaking changes to Delaware's prison system: • On Friday, following a nine-month investigation, the U.S. Department of Justice announced that federal investigators found "substantial civil rights violations" inside four Delaware prisons. For example, the report noted, flesh-eating bacteria inside Gander Hill prison went undiagnosed and untreated, placing "inmates and staff at risk of acquiring the infection and passing it to others in the community." • Taylor and Attorney General Carl Danberg signed an 87-point agreement with the federal government that calls for sweeping changes in Delaware's penal institutions. The state promised to correct the deficiencies and "meet generally accepted professional standards." However, the state did not admit to violating any inmate's civil rights or breaking any other federal law. • The 55-year-old Taylor, who's served the past 11 years as commissioner, announced this month that he will retire on Feb. 1. On Saturday a prison spokeswoman announced that Paul Howard, Taylor's longtime bureau chief of prisons, is retiring the same day. Prison spokeswoman Gail Minor Stallings said Howard's departure had nothing to do with the federal report that orders the state to completely renovate its prison health care system. • Trial lawyers say the damning federal findings will serve as a road map for inmate lawsuits against the state. • Senate Minority Leader Charles Copeland, R-West Farms, said Saturday the federal government might have taken a "wait and see" approach, if the state had reacted once concerns about inmate care were first raised by the newspaper, and by the citizen coalition he co-founded. "If there had been a positive response from the state, the feds might have not felt the need to be the hammer," said Copeland, who estimates that changes ordered by the Justice Department will cost $20 million to $30 million more than the state already spends annually on prisons. • House Majority Leader Wayne Smith, R-Clair Manor, said he was disturbed about the agreement being signed in secret. "I am troubled that we (lawmakers) were not consulted about something this important. By signing this, the governor and the attorney general have obligated the state to spending money without the General Assembly's consent -- and I think we should have learned about this from them, rather than from a reporter." Copeland wasn't alone in suggesting that had state officials acknowledged serious problems existed, rather than denying their existence, the pain and suffering among inmates and their families -- as well as the final cost of taxpayer dollars -- would not have been as high. Sen. Karen Peterson, D-Stanton, an early backer of the federal probe who wrote a letter in support of the investigation to U.S. Attorney General Alberto Gonzales, said it's not as though the state pleaded no-contest to the federal charges of poor inmate health care. "It's worse than that," Peterson said. "They don't think they did anything wrong."

October 20, 2006 Wilmington News-Journal
Seven months ago, the U.S. Department of Justice opened an investigation of the prison health care system in Delaware -- where the rates of inmates dying of AIDS and suicide have been among the highest in the nation, and where hepatitis and skin infections are constant problems. Eleven months ago, a former inmate's breast cancer went undetected while she was forced to wait five months for a mammogram inside Baylor Women's Correctional Institution, near New Castle. Twelve months ago, an outbreak of Legionnaires' disease hit Sussex Correctional Institution, in Georgetown. And yet little has changed for the inmates, a coalition of prison advocates said Thursday. On the anniversary of the coalition's founding, leaders of the group gathered in Wilmington's Rodney Square to lament a year's worth of what they called inaction by the leaders of Delaware. There has been only "silence" from Gov. Ruth Ann Minner and "stonewalling" from the General Assembly, said co-founders of the Delaware Coalition for Prison Reform and Justice. "We are here today to continue to raise the issue in the consciousness of prison crisis in our state," said the Rev. Christopher Bullock, pastor of Canaan Baptist Church. "We are going to continue to fight on behalf of the voiceless, those incarcerated and their families." For six months in 2005, The News Journal examined conditions of care within the state's prisons. In late September 2005, the newspaper published a series of articles highlighting AIDS-related inmate deaths and suicides during the past four years; allegations by inmates of poor medical treatment for cancer, meningitis and hepatitis; and a no-bid $25.9 million contract awarded to St. Louis-based Correctional Medical Services to manage health care in the state's prisons. The series revealed: •Dr. Janet Kramer, of Wilmington, an expert in prison health care, said inmates should be screened for hepatitis C and HIV. But pretrial and convicted inmates in Delaware are not routinely screened when they are sent to prison or when they leave. Delaware prisons have become incubators for new strains of the AIDS virus, creating a public health crisis, experts say. •Former prison doctor Ramesh Vemulapalli said a private medical company ordered him to treat inmates for HIV or hepatitis C, but not both. •The state does not routinely conduct autopsies on inmates who die in prison or those hospitalized at the time of their death, a policy the president of the National Association of Medical Examiners believes prevents evaluation of the quality of prison medical treatment. And if it does conduct autopsies, the results are sent to the medical vendor, not the prison. •Dr. Robert Cohen, an expert in prison health care whom state and federal courts have appointed to monitor prisons in five states, said Delaware should investigate medical malpractice claims. Instead, the state's medical board occasionally takes complaints from inmates and their families about prison health care professionals, but it is only an advisory panel.

August 8, 2006 News Journal
The American Civil Liberties Union of Delaware filed a civil lawsuit today charging the state Department of Correction with refusing to provide information about how it treats prisoners for with illnesses such as HIV, hepatitis and high blood pressure. The ACLU, represented by Public Citizen, filed the suit in New Castle County Superior Court when the prison department denied its records request. According to the suit, prison officials claimed some information about treatment is “a trade secret” and “privileged or confidential” property of the prison’s medical contractor, St. Louis-based Correctional Medical Services, Inc. The lawsuit maintains that the withholding of documents relating to the correctional facility’s treatment protocols for certain illnesses and operating procedures for wellness visits is in direct violation of the Delaware Freedom of Information Act. The ACLU also said that corrections departments in other states have provided similar prison health care policy information to the public. The U.S. Justice Department’s Civil Rights Division started investigating prison health care in Delaware on March 8 -- a probe Correction Commissioner Stanley W. Taylor Jr. and Gov. Ruth Ann Minner opposed and lobbied to stop. Last year, The News Journal published a series of articles documenting inadequate medical care in Delaware prisons.

July 21, 2006 News Journal
As many as four dozen current and former inmates at the Young Correctional Institution may have been exposed to blood-borne diseases, including AIDS and hepatitis, by a former nurse accused of improper needle use. "This is a potential crisis in our community," said the Rev. Christopher Bullock, a founder of the Delaware Coalition for Prison Reform and Justice. "It goes to our original point, that when there is incompetent medical services provided to those who are incarcerated, it opens up Pandora's Box for things to happen of this nature." According to the Department of Correction, a licensed practical nurse who was hired April 10 used a diabetic needle and syringe instead of an individual lancet to obtain a blood sample from an inmate earlier this month. The nurse later used the same needle to draw insulin from a multiple-dose vial -- potentially contaminating the vial -- then used the vial to provide insulin to other inmates. Department of Correction Commissioner Stan Taylor said the procedure was completely inappropriate and something any health practitioner would be taught early not to do. "It is alarming because it is very basic medical protocol," he said. Taylor would not name the nurse but said she had resigned. The nurse was hired by St. Louis-based Correctional Medical Services, or CMS, the state prison's health care provider. A News Journal investigation of the state prison health care last year pointed out high rates of AIDS-related inmate deaths. The series, which looked at the quality of medical and mental health services, is central to an ongoing investigation of the Delaware prison system by a special civil rights team from the U.S. Justice Department. United States Attorney Colm F. Connolly refrained from commenting about the new allegations because of the ongoing Justice Department investigation. 'More of the ongoing tragedy' Dover Attorney Stephen A. Hampton, who has successfully sued the Department of Correction on behalf of inmates or their survivors who alleged improper care, said "this is more of the ongoing tragedy that is CMS and the DOC." Bullock said the investigation should be comprehensive and that all 48 people involved, as well as those with whom they have had contact, should be tested. "There needs to be a health alert within the prison and also in the community due to this unprofessional behavior by this particular nurse," he said.

June 11, 2006 News Journal
A 56-year-old Hockessin man hanged himself last month hours after he was taken off a suicide watch by the Department of Correction -- and despite warnings from family and mental health advocates of a recent suicide attempt. At 4:52 a.m. on May 30, prison guards found Thomas J. Burns hanging from a bedsheet in his cell. Burns had arrived at Young Correctional Institution on a forgery warrant. Only days before the prison suicide, Burns was released from Christiana Hospital, where he nearly died after trying to kill himself by mixing medication and liquor. Mental health advocates flooded the prison with phone calls, trying to alert the jailers that Burns would try to kill himself in the prison. Prison officials initially placed Burns on suicide watch -- a restrictive status involving constant surveillance during which Burns was allowed only a paper gown in his cell. But on Memorial Day, a counselor employed by the prison's private medical contractor, Correctional Medical Services, conducted a mental health evaluation and ordered Burns placed on the less-restrictive psychiatric observation. Burns was given several personal items -- including bedsheets -- and guards were supposed to check on him every 15 minutes. Hours later, he was dead. Suicide is the third-leading cause of death in prisons nationally -- behind natural causes and AIDS-related deaths, which are recorded separately from natural causes by the U.S. Bureau of Justice Statistics. According to the bureau's latest report, issued last month, Delaware's prisoner suicide rate for 2001 and 2002 was double the national average of 14 per 100,000 inmates. The quality of medical and mental health services inside Delaware prisons is central to an ongoing investigation of the Delaware Department of Correction by a special civil rights team from the U.S. Justice Department. High rates of inmate deaths from HIV/AIDS, mistreatment of cancerous tumors and the spread of flesh-eating bacteria are just some of the factors attracting federal scrutiny. Burns' death will be reviewed internally, said Correction Commissioner Stan Taylor, and the findings will be closed to the public. Burns' suicide is similar to previous deaths in Delaware prisons. As he was booked into Howard Young (then called Gander Hill prison) in 2004, Christopher Barkes told a mental health screener that he had attempted suicide before -- when he had earlier served time in Gander Hill. Barkes provided a list of drugs he was taking for depression, post-traumatic stress disorder and other forms of mental illness. Instead of placing Barkes on suicide watch, prison officials put him in a cell, alone and unsupervised. Hours later, Barkes hanged himself with a bedsheet. His widow, Karen, has sued the state over the death. "It is very disturbing that after Chris's suicide, they still aren't going to change anything," she said. "Chris died and nothing changes." According to the Department of Correction, 11 inmates have killed themselves since January 2000 -- most by hanging. Experts say effective mental health care can reduce the number of suicides in the state's nine prison facilities. In Delaware, Correctional Medical Services provides medical and mental health treatment. When an inmate arrives in prison, these CMS counselors use a form that has a series of yes/no questions to determine suicide risk. If the risk of suicide is high, they may require the inmate to sign a "suicide contract" promising not to kill themselves. Mental health experts have described these practices as antiquated and ineffective. Level of expertise. Neither prison nor Correctional Medical Services officials would name the counselor who evaluated Burns. They described the counselor as a "master's-level clinician." "You do not evaluate a person for suicide without a psychiatrist," said Rita Marocco, executive director of the National Alliance for the Mentally Ill in Delaware. "If a person has made a suicide attempt, it certainly must be a psychiatrist who makes the decisions. I believe they do not have qualified people doing these evaluations." Dr. Carol A. Tavani, a board-certified neuropsychiatrist and executive director of Christiana Psychiatric Services, agrees that a psychiatrist -- not a counselor -- should have conducted the evaluation. "When you have something of this seriousness, with this kind of history, especially when there's a prior attempt, that ratchets up the seriousness of the risk," Tavani said. "Evaluation of suicidality has to be done very carefully, and it's always the better part of valor to err on the safe side, particularly if there's previous history. Those calls are always safest when made by a psychiatrist, and I know they do have them." Patricia McDowell, Delaware's director of support and outreach services for the National Alliance for the Mentally Ill, told prison officials about Burns' recent suicide attempt and warned them he would try it again. After Burns' death, these officials stopped taking her calls. "We worked very carefully to get to the right people, to help someone at a very critical point in his life, and the very people we turned to let us down," McDowell said. "The system failed. His life ended."

May 19, 2006 Delaware State News
The General Assembly's budget committee approved creating three positions Thursday to provide additional oversight of the Department of Correction's inmate medical care system. The agency's handling of prisoner health care has come into question in the past year amid newspaper accounts and lawsuits questioning the quality. The positions, which will pay a combined $238,900 in salary, were created by the Joint Finance Committee as it approved the DOC's operating budget for fiscal 2007, which begins July 1. "We just want more oversight and supervision," said Sen. Nancy W. Cook, D-Kenton, a JFC co-chair.

May 19, 2006 News Journal
A bill that would require wholesale improvements in Delaware's prison medical system is dead for this year, crushed by a $30 million annual price tag attached to it by the General Assembly's staff. The demise of Sen. Margaret Rose Henry's reform bill, Senate Bill 291, came Thursday when the Joint Finance Committee included no money in the Department of Correction's budget for next year to pay for the improvements. The bill has been mired in the Senate Judiciary Committee, chaired by Sen. James Vaughn, D-Clayton, for months. Henry and Vaughn said the bill would not be considered this year, in large part because of the fiscal-impact report from the Controller General's Office. The committee, which is amending Gov. Ruth Ann Minner's proposed $3 billion budget for the year that begins July 1, did add some extra money for prison health care. The panel agreed to pay the state's private health care provider more for existing services, and for several positions to better oversee Correctional Medical Services. The panel added $2.9 million as an "inflation adjustment" for the CMS contract, raising the annual cost by 11 percent to more than $28.8 million. The multiyear contract was transferred to CMS without bidding last July on an emergency basis. The committee shifted $238,900 to Corrections for prison health care oversight by the Division of Public Health, and prison care reviewers. That extends changes begun last fall by Minner and Correction Commissioner Stan Taylor to address substandard prison care. Those steps followed the reports in The News Journal. This spring, articles detailed how a female inmate gave birth to twins in a toilet stall at Baylor Women's Correctional Institution in March. She said a prison nurse employed by CMS ignored her complaints of powerful contractions, which began 24 hours prior to the births. The reform bill also would require CMS to deliver records of inmate deaths within three days to the Medical Society of Delaware's Prison Health Committee for review, and make other records available to the state for audit. Inmate medical grievances would have to be sent to the Department of Correction, not to the medical service provider. But all of that would be costly, according to the fiscal analysis. Legislation that would make publicly funded reports open to public scrutiny -- including an audit of prison health care -- passed the state House this month without a vote against it. House Bill 320, sponsored by North Dover Republican state Rep. Nancy H. Wagner, would require the state to release the audit and other such reports, provided that personal information such as medical records is withheld. The bill faces an uncertain future in the Senate.

April 9, 2006 News-Journal
Kimwayna "Kim" Allen gave birth to twins in a toilet stall at Baylor Women's Correctional Institution last month, after she says a prison nurse employed by Correctional Medical Services ignored her complaints of powerful contractions, which began 24 hours prior to the births. Each of the babies -- son Ny-Aire and daughter Ny-Bree -- weighed barely a pound. They are clinging to life in intensive care at Christiana Hospital, swaddled in tiny blankets inside incubators monitored around-the-clock by nurses. Even if Kim's daughter survives, her prognosis is poor. The likelihood of brain damage and mental retardation is high. Ny-Bree had no pulse and was barely breathing after delivery. Her tiny brain was starved of oxygen for about eight minutes, until two paramedic units and three ambulances raced into the prison grounds after the nurse called 911. The paramedics began CPR in the prison and continued all the way to Christiana, but Ny-Bree was still in very rough shape by the time they got her to the hospital. Kim, a 19-year-old who lives with her mother, has had to make monstrous decisions about her children's future. "They told me I should pull the plug on my daughter because she wasn't doing too well," Kim said. "I couldn't do it." The U.S. Justice Department's Civil Rights Division launched a federal investigation into prison health care in Delaware on March 8 -- a probe Correction Commissioner Stanley W. Taylor Jr. and Gov. Ruth Ann Minner opposed and lobbied to stop. Although Minner agreed to cooperate with the Justice Department, the governor told U.S. Attorney General Alberto Gonzales that the federal probe was not necessary. The bathroom prison deliveries occurred four days before the investigation was launched. Last year, The News Journal published a series of articles documenting inadequate medical care -- including prenatal -- in Delaware prisons. Neither Taylor nor Minner returned e-mail or telephone requests to talk about Kim or her twins, or the care she received before giving birth in the women's prison bathroom. On March 30, The News Journal made a request under the Delaware Freedom of Information Act for a copy of the policy and the lists required as part of the department's health care accreditation. Welch, in an e-mail response, wrote, "The DOC does not have a specific policy regarding the care of pregnant inmates." She couldn't explain why. Correctional Medical Services spokesman Ken Fields couldn't say how CMS staff should respond if a pregnant inmate complains of contractions. And he declined to provide a copy of the CMS policy regarding pregnant inmates. Fields said CMS employees make their own decisions. "Correction health care professionals are trained to address these types of issues using their own training and judgment, in their own assessment of each patient's condition to make decisions about the next step for treatment," he said.

March 9, 2006 News Journal
After years of high inmate death rates due to HIV/AIDS, suicide and poor medical care, federal civil rights regulators have launched an investigation of Delaware's prison medical system -- a process that could take years to complete and forever change the way the state treats its 6,800 inmates. The investigation comes on the heels of a five-month preliminary inquiry by the Justice Department during which federal regulators interviewed many of the same medical experts, inmates and families of dead inmates who spoke to The News Journal late last year during the newspaper's six-month investigation of prison health care. As with the newspaper's investigation, the Justice Department uncovered significant problems at the Delaware Department of Correction. The federal investigation now may involve FBI agents and grand juries with subpoena power."Thank you, Jesus. I've been praying for this so hard," said Susie Wilson, whose son, Jermaine Lamar Wilson, was found hanging in his cell with blood-stained clothes and a gash on his head. It was Feb. 18, 2005 -- the day his family says he was scheduled to be released after serving time for robbery. Wilson's death is now the focus of a federal wrongful death lawsuit, which claims Jermaine Lamar Wilson was murdered while being held at the Delaware Correctional Center near Smyrna. The federal investigation will be conducted by the Special Litigation Section of the Justice Department's Civil Rights Division. A News Journal special report on inmate health care published in September revealed sometimes gruesome details of neglect, such as an inmate's massive brain tumor -- largely ignored by staff -- which led to his death, and an outbreak of flesh-eating bacteria. Other findings of the newspaper's six-month investigation were inmate death rates -- specifically AIDS-related and suicide -- far above the national norm. During the newspaper's investigation, reporters discovered that Minner and Taylor awarded a $25.9 million no-bid contract for inmate health care to Correctional Medical Services -- a private medical contractor with a history of litigation over how the company provides medical care. Minner and Taylor also refused to release -- publicly or to lawmakers -- an audit of prison health care they say prompted the emergency hiring of CMS. Former prison doctor Ramesh Vemulapalli, an AIDS specialist practicing in Dover, said the investigation is long overdue. Vemulapalli said he quit working in Delaware prisons because he was not allowed to provide adequate care. "I think the investigation will help make reforms in the prison system," Vemulapalli said. "It's a good thing. It will benefit the people of Delaware."

February 18, 2006 News Journal
Correction Commissioner Stanley W. Taylor Jr.'s failure to properly train his staff to recognize suicidal inmates and properly care for them allowed Christopher Barkes to hang himself in his prison cell in November 2004, a federal lawsuit contends. The lawsuit, filed in U.S. District Court in Wilmington by his family members, said the prison's former medical provider also failed to properly train staff to recognize and properly care for inmates who had made previous attempts on their lives. That medical provider, Arizona-based First Correctional Medical, or FCM, pulled out of its contract last year. During his time at the Young Correctional Institution in Wilmington, the suit said, Barkes told prison officials he had attempted suicide before. Prison staff placed him in a cell alone, though, with no suicide watch, the suit said. Barkes, 37, was found unconscious the following morning and taken to Christiana Hospital, where he died. Prison officials determined Barkes used his bedsheet to hang himself. Taylor often defends his department by noting it is accredited by the national commission, a process that cost taxpayers $12,400. Taylor, though, has declined to make public an audit by the commission on prison health care, saying it contains inmate medical information and peer reviews of doctors. Lawmakers, who have repeatedly asked for the report, even if elements are blacked out, are considering legislation to make it public. Barkes' case came to light during an investigation by The News Journal last year. The six-month investigation highlighted allegations by inmates of poor medical treatment for cancer, meningitis and hepatitis; a no-bid $25.9 million contract awarded to the current health care provider, Correctional Medical Services, based in St. Louis; and a comparatively high rate of AIDS-related inmate deaths and suicides over a four-year period. Another lawsuit filed by a prisoner highlighted in the newspaper articles was settled out of court in October. Anthony Pierce, also known to inmates as "the brother with two heads," was serving a 14-month sentence for a parole violation when a small lump appeared on the back of his head. At the time, a prison doctor employed by Correctional Medical Services said the marble-size lump was a cyst or an ingrown hair. The tumor kept growing, and on March 22, 2002, Pierce died from a "brain tumor, due to osteosarcoma of the skull," according to an autopsy report. The conditions revealed in the articles are the subject of an inquiry by the U.S. Department of Justice's Civil Rights Division. "Stan Taylor said that they follow the guidelines, and it is clear that they didn't," said Barkes' wife, Karen. She also said "it is discouraging that the lawmakers aren't doing anything to change the problems in the prisons." The lawsuit targets Taylor and FCM, along with prison warden Raphael Williams, the Department of Correction and unknown Correction Department and FCM employees. The suit, which alleges wrongful death and cruel and unusual punishment, seeks compensatory and punitive damages to be set by the court. Contact Esteban Parra at 324-2299 or eparra@delawareonline.com. Contact investigative reporter Lee Williams at 324-2362 or lwilliams@delawareonline.com.

January 26, 2006 Wilmington News Journal
Lee McMillan, whose husband nearly died in prison after flesh-eating bacteria attacked his body, wants to know why the state won't release an audit of Delaware's prison health care system. So do some legislators, who are backing a bill that would require the state to release the audit and similar reports -- as long as confidential information such as personal medical records is withheld. House Bill 320, sponsored by Rep. Nancy Wagner, R-Dover North, would make reports that are paid for with public funds open to the public under the Freedom of Information Act. The News Journal requested the audit, which cost taxpayers $12,400, while investigating AIDS-related inmate deaths and suicides of Delaware prisoners as well as reports of poor medical treatment for cancer, meningitis and hepatitis. Prompted in part by a series of News Journal stories, the U.S. Department of Justice is conducting an inquiry into the Department of Correction's management and inmate health care. In defending his record, Correction Commissioner Stan Taylor pointed to the audit, prepared by the National Commission on Correctional Health Care, but denied a Freedom of Information request for the report by the newspaper. Taylor and former Attorney General M. Jane Brady ruled the accreditation report was not a public document. Taylor, though, said the audit was critical of the work of First Correctional Medical, a Tucson, Ariz., company. In July, Gov. Ruth Ann Minner and Taylor awarded a $25.9 million no-bid contract to Correctional Medical Services of St. Louis to pick up the provision of medical care in Delaware's prisons. Rep. Pamela S. Maier, R-Drummond Hill, is a House co-sponsor who said she believes that "sunshine helps" in governmental affairs. "I think the public needs to know, and if they're not satisfied, we need to keep the pressure on the Department of Correction and [prison health care provider Correctional Medical Services] to improve the health of our prisoners."

November 16, 2005 Wilmington News Journal
The Delaware Department of Correction has hired longtime HIV/AIDS educator and advocate James Welch from the Department of Public Health, to serve as the health services administrator for the state's prison system. Welch, a registered nurse, currently serves as the Department of Public Health's HIV/ AIDS/STD director in a program he created 20 years ago to coordinate prevention and treatment of HIV/AIDS and other diseases. "Jim will oversee the DOC's day-to-day medical operation," said Ed Synoski, the Department of Correction's deputy chief of the Bureau of Management Services, which oversees the department's medical services contracts. Taylor announced the creation of Welch's position during a public hearing last week called by lawmakers to examine a series of articles in The News Journal highlighting AIDS-related inmate deaths and suicides during the past four years, and allegations by inmates of poor medical treatment for cancer, meningitis and hepatitis. Prompted in part by the series, the U.S. Department of Justice has launched a preliminary inquiry into the Department of Correction's management and inmate health care. Welch previously has played a behind-the-scenes role in the inmate health care debate -- lobbying in 2002 against allowing Dr. Keith Ivens to remain as the prison system's medical director when Correctional Medical Services (CMS) of St. Louis, Ivens' employer, was replaced by another medical contractor. In July, Taylor brought CMS back to Delaware with a $25.9 million no-bid contract to manage inmate health care. In a sworn deposition, Kathy English, the former deputy bureau chief of management services for the Department of Correction, said Ivens was a frequent source of inmate complaints. English testified that Welch expressed "informal concerns" about the physician and told the incoming contractor to not allow Ivens to continue as medical director. The Rev. Christopher Bullock, pastor of Canaan Baptist Church in Wilmington, is one of the founding members of the Delaware Coalition for Prison Reform and Justice. "The DOC doesn't need to be hiring new people," Bullock said. "They need to be firing people. This appears to be another effort to cover up and conceal the real issue."

November 8, 2005 Wilmington News Journal
Family members of dead, dying or grievously ill inmates lashed out at Correction Commissioner Stan Taylor on Monday night, accusing Taylor and the prison's medical vendor of causing illnesses and deaths by providing inadequate medical care to the state's 6,800 inmates. Some of those who testified said the state treats its inmates worse than animals. The public scolding occurred at an "informational" hearing called by Speaker of the House Terry Spence, R-Stratford, and Rep. Pamela S. Maier, R-Drummond Hill, who sought to educate lawmakers about prison conditions before the upcoming legislative session. "It's your facility -- clean it up," Matilda Carello, whose son is an inmate with Grave's disease, yelled at Taylor, who was sitting by her side. Also in the audience were representatives from Correctional Medical Services, the company Taylor recently awarded a controversial $25.9 million no-bid contract to run inmate health care. "CMS -- you're a liar," Carello said. "Stan Taylor -- you are a liar!" After about 50 witnesses from the public testified at the hearing, Spence said "it's time for a gut check." "We've lost confidence in the department," he said. "We've lost confidence in CMS." Spence called for an independent oversight panel for the department and CMS. Ann Mac, a nurse practitioner and CMS vice president of operations, told lawmakers and inmate family members that "delivering health care in prisons is a uniquely challenging but very rewarding field." Her message was not well received. "I am sorry, but the things being said from this lady -- this is not what's really going on inside," said Lee McMillan, who says her husband, an inmate, nearly died when flesh-eating bacteria ravaged his body. Monday night's hearing was scheduled after a six-month investigation by The News Journal found a high rate of AIDS-related inmate deaths and suicides over the past four years, and uncovered allegations of poor medical treatment for cancer, meningitis, hepatitis and other communicable diseases and bacterial infections. Prompted in part by the newspaper's series, the U.S. Department of Justice has launched a preliminary inquiry into the Department of Correction's management and inmate health care. Maryanne McGonegal, secretary of Common Cause, criticized Gov. Ruth Ann Minner for failing to address evidence of negligent inmate care. On Oct. 3, Common Cause of Delaware asked U.S. Attorney General Alberto Gonzales to open a federal investigation. "The lack of response by our governor is the strongest indication of the need for outside oversight of prison conditions," McGonegal said Monday night. Several of those who testified said after the hearing that Taylor should release a recent audit of inmate health care under the state's former prison medical vendor, First Correctional Medical. Performance audited: Taylor asked a medical accreditation firm to audit FCM's performance from December 2004 to January 2005. According to documents Taylor provided to lawmakers, the audit showed "several problems with medical administration and clinical practices including record keeping, utilization management, medical history and sick call follow-up." The News Journal submitted a request under Delaware's Freedom of Information Act for the audit, which cost Delaware taxpayers $12,400, but Attorney General M. Jane Brady denied the newspaper's request. Former CMS substance abuse counselor Denise Rodriguez said she supports punishment for those who break the law. "But that punishment should not be neglect, humiliation or death," Rodriguez said. Rodriguez, who worked for CMS at Gander Hill from 1999 to 2002, told The News Journal in a previously published story that a CMS official ordered her to falsify documents so state inspectors would not pull the company's license to run a prison treatment program. "Stan Taylor, I always told my clients that in order to make changes in your life, you have to hold yourself accountable," she told Taylor at Monday's hearing. "Someone needs to hold you accountable."

November 7, 2005 Delaware State News
The state's correction chief and the medical company hired by the agency defended the level of medical care inmates receive Monday during a hearing at Legislative Hall. Commissioner of Correction Stanley W. Taylor and Ann Mack, vice president of operations for Correctional Medical Services, made their presentation to a hearing called by the House of Representatives' Health and Human Development Committee. Mr. Taylor and CMS have come under heavy criticism recently af