Alabama Department of Corrections
December 1, 2009 Huntsville Times
State prison officials today released a 795-page report showing Farron Barksdale, who killed two police officers, died from hypothermia after being heavily medicated with anti-psychotic drugs. Barksdale, 32, of Athens, sentenced to life without parole after pleading guilty to capital murder in the shooting deaths of two Athens police officers, died Aug. 20, 2007, after he was found unconscious in his prison cell. After he was rushed to a Montgomery hospital, it was discovered he had several large, fresh-looking, bruises around his waist, arms, legs, elbows and knees. But Sarah Geraghty, senior attorney for the Southern Center for Human Rights in Atlanta, said questions still remain about how Barksdale received such extensive bruising. The report said Barksdale was given several different drugs that could cause bruising. And they noted the special seat belts used to transport Barksdale from the Limestone County Jail to the Kilby Correctional Facility could also have been responsible for some of the bruises. When a private ambulance company was summoned to take Barkdale to the hospital after he collapsed, according to the report, paramedic Angela Anderson said she "found patient lying on treatment table by himself with distressed respirations, unresponsive; no medical personnel in room; saw bruises on his body on abdominal and pelvic area; noted they were unusual for size and location . . . "Patient had no oxygen therapy being (administered and) there was no medical personnel in the room (with) the patient the entire time while on scene only DOC personnel. Patient had several bruises throughout body major-sized bruises noted anterior on lower abdomen/pelvic area measuring in comparison to a salad plate covering most of the area from hip joint area to umbilicus. "Color of bruises indicate newly sustained. Patient also had bruising to both forearms posterior area in same color as ones noted to abdomen/pelvic area." In addition, Heath Bruner, an EMT, was quoted in the report as noting "massive" bruising on both sides of pelvis. He also noted there were no nurses present in the room with Barksdale at Kilby. Barksdale's mother, Mary, earlier this year won $750,000 in a wrongful death lawsuit against former Kilby Warden Arnold Holt, Dr. Joseph McGinn of MHM Correctional Services in Vienna, Va., and Dr. Arnold Holt of Prison Health Services of Brentwood, Tenn. Ken Williams, general counsel for the Corrections Department, said Tuesday that McGinn was responsible for prescribing the drugs to Barksdale and leaving him in an unairconditioned cell rather than transferring him to an air-conditioned mental health unit.

September 24, 2009 Huntsville Times
The mother of an inmate who died a few days after entering a state prison was awarded $750,000 in a wrongful death lawsuit against prison officials and a mental health provider. The money was awarded to Mary Barksdale, the mother of Farron Barksdale, 32, of Athens who died Aug. 20, 2007, after he was found unconscious in his Kilby Prison cell. "We reached what we believed to be a fair settlement in light of what we knew of the troubling circumstances surrounding Mr. Barksdale's demise while in state custody," Sarah Geraghty, senior attorney for the Atlanta-based Southern Center for Human Rights, said Wednesday. "Some facts surrounding the death, however, remain a mystery to this day due to the department's policy against releasing records on deaths in custody." Jake Watson, a Huntsville attorney who also represented Mary Barksdale, said Wednesday, "In light of all the circumstances, I think that was the best settlement." The state Department of Corrections was not a defendant in the case. According to the settlement agreement filed in U.S. District Court in Montgomery, former Kilby Warden Arnold Holt was ordered to pay $300,000 to the settlement, Dr. Joseph McGinn of MHM Correctional Services in Vienna, Va., was to contribute $370,000, and Dr. Arnold Holt of Prison Health Services of Brentwood, Tenn., was to pay $80,000. MHM provides mental health services for the Department of Corrections. The suit alleged that Barksdale, who suffered from schizophrenia, died because of "the deliberate indifference, medical neglect and negligence" of the prison staff.

September 23, 2009 Huntsville Times
A wrongful death lawsuit filed by the mother of an inmate who died just 12 days after entering prison has been settled with the state Department of Corrections, her lawyers said Tuesday. Though the terms were not disclosed, the settlement was also confirmed by state prison Commissioner Richard Allen. The suit was filed in U.S. District Court in Montgomery on behalf of Mary Barksdale, the mother of Farron Barksdale, 32, of Athens, who died Aug. 20, 2007, after he was found unconscious in his Kilby Prison cell. Barksdale, who pleaded guilty to capital murder in the shooting death of two Athens police officers, had been transferred to the prison just three days earlier to begin serving a sentence of life without parole. Mary Barksdale, who could not be reached for comment Tuesday, was represented by Sarah Geraghty, an attorney for the Atlanta-based Southern Center for Human Rights, and Huntsville attorney Jake Watson. Geraghty and Watson confirmed that Mary Barksdale was awarded a cash settlement, but they would not disclose the amount. The defendants in the suit were former Kilby Warden Arnold Hold, Drs. Michael Robbins and Joseph McGinn, two unnamed correctional officers, an unnamed medical worker and Vienna, Va., based MHM Correctional Services. MHM provides mental health services for the Department of Corrections. The suit alleged that Barksdale, who suffered from schizophrenia, died because of "the deliberate indifference, medical neglect and negligence" of the prison staff. "Mr. Barksdale was medicated with an unusually large dose of psychotropic medications that made his body unable to withstand high temperatures, confined to an isolation cell with a medically dangerous degree of heat and left there without adequate monitoring," the complaint said. "He fell into a coma and died." The complaint said Barksdale was not placed in Kilby's mental health unit, which is air-conditioned. On the day he was found unresponsive in his cell, the temperature in Montgomery was 106 degrees. Kilby is located just east of Montgomery. On that day, the complaint said, correctional officers found Barksdale in a coma, "snoring and moaning," with a temperature of 103.1 degrees. He was taken to the hospital but never regained consciousness after eight days. An autopsy said he died of pneumonia and complications from hypothermia and a blood-clotting problem, and that bruises on his upper body and hip did not contribute to his death. A state prison inmate later wrote in an Oct. 24, 2008, letter to Montgomery County Circuit Judge Eugene Reese that Barksdale was severely beaten by four prison guards. Allen asked the Alabama Bureau of Investigation and the Department of Corrections' Department of Investigations and Intelligence to reopen the investigation into Barksdale's death, but the results of that probe have never been released. The Alabama Supreme Court ruled Friday that the Department of Corrections must comply with the state's Open Records law and make records available on crimes committed within prisons. The Southern Center for Human Rights had sued over that issue. Despite the high court's 5-0 ruling, Allen said Friday state attorneys may ask for a rehearing.

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."

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

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

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

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

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

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

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

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

Some of the sickest men in Alabama prisons live in drafty cells in a building with broken windows. They must stand in line in the middle of the night for their pills. And several have died prematurely because of gaps in medical care, according to a report released Thursday as part of a lawsuit against the prison system. Dr. Stephen Tabet, an infectious disease specialist from Seattle, first documented the harsh conditions at Limestone prison's HIV unit last year. When he returned for a follow-up visit, he found few improvements. His August 2003 report documented conditions leading to 39 deaths since 1999. Thursday's follow-up looks at five new deaths in five months. One patient dropped a third of his weight in five months, to 110 pounds, before dying in February. A doctor prescribed a high protein supplement for 35-year-old Gerald Lewis, but the kitchen wouldn't provide it. Another man arrived at Limestone with active tuberculosis, but his medical records from another prison did not follow. Alfred Thomas, 42, was placed with all the other HIV patients, potentially exposing them to the disease. No one at Limestone knew about his TB until an autopsy following his October death. (Birmingham News, March 12, 2004)

Albany County Jail, Albany, New York
A Bronx woman who delivered a live baby in a jail toilet in 2001 after her premature labor allegedly was ignored for days has filed a federal civil rights claim blaming Albany County officials and a former jail nurse for her son's death.  Ajadyan Venny was at least 5 months pregnant when she was jailed on a drug charge on Aug. 30, 2001, according to the suit filed in U.S. District Court Thursday.  The 30-page lawsuit alleges the following chain of events:  The 22-year-old was given a cursory exam and pregnancy test and then left on her own as pain in her abdomen and back spiked over the next 10 days.  A female jail nurse who is employed by Prison Health Services, Inc., told Venny repeatedly that the pain was a normal result of being pregnant in jail, which is a stressful environment.  Venny was supposed to see an obstetrics consultant on Sept. 4, 2001, but her appointment was canceled. Five days later, on Sept. 9, her screams woke the dorm at 5 a.m.  At 6:30 a.m., correction officers told Venny she couldn't get help until the 7 a.m. shift change. By then, she could no longer walk on her own. The nurse told guards she couldn't leave her post.  A concerned correction officer finally radioed his sergeant, who ordered the nurse to see to Venny, who now was sitting on the toilet in her cell and bleeding profusely. But the nurse was ineffective, court papers said: "At approximately 7:15 a.m. nurse Hunt responded to the dorm, bringing with her only a blood pressure cuff to attend the plaintiff, who was in the end stage of labor."  The nurse attempted to console Venny rather than render medical assistance. She told officers at 7:18 a.m. that Venny had miscarried in-utero and ordered an ambulance. It was only after a Colonie EMS workers asked if there was a baby that a guard went back to check the toilet "and found a sac containing a child who had been unattended for a substantial period of time."  Correction officers freed the baby and cut his umbilical cord.  After two days in Albany Medical Center Hospital's neonatal unit, the struggling newborn, Scott Mayo Jr., died at 3 a.m. on Sept. 11.  "This was a full-grown, viable baby," attorney Kevin Luibrand said. "It was not a fetus. She was probably much further along than she thought."  State correction officials later faulted Prison Health Services Inc. for their handling of the situation.  The county did not renew its contract with the company in Feb. 2002, saying it would go with a less expensive provider.  Officials at the jail declined to comment on the lawsuit. Richard Wright, president and CEO of Prison Health Services, also declined to comment.  The Brentwood, Tenn.-based company recently was dismissed from an eight-year contract with the Schenectady County Jail after the death of an inmate.  (Times Union, September 4, 2004)

American Service Group, Brentwood, Tennessee
March 2, 2010 Tennessean
America Service Group reported a fourth-quarter net loss of $236,000 compared with net income of $1.2 million a year earlier The recent quarter’s net income would have been $4.3 million excluding after-tax costs related to a shareholder litigation settlement during the quarter. Healthcare revenues from continuing contracts rose 36.7 percent to $160.8 million. For all of 2010, the Brentwood-based prison health care company expects net income of $10.1 million, or $1.08 a share, on revenues of $635 to $645 million.

October 29, 2009 AP
Shares of Psychiatric Solutions Inc. plunged nearly 23 percent on Wednesday, a day after the behavioral hospital operator reported disappointing results for the third quarter and cut its expectations for the rest of 2009. The Franklin-based firm's stock dropped $5.47 to close at $18.67 per share in Nasdaq trading. Psychiatric Solutions said profits haven't lived up to the company's own goals and revenue per patient per day hasn't grown as much as expected. Profits at its management-contract segment did not meet its forecasts either. In a note to clients, Raymond James analyst John Ransom downgraded the stock to "market perform" from "strong buy." He said tight state budgets and uncertainty about future profits probably will pressure Psychiatric Solutions' stock over the next few months. Psychiatric Solution reported third-quarter net income attributable to its stockholders of $28.2 million, or 50 cents per share, on revenue of $455.3 million. Analysts surveyed by Thomson Reuters had expected profits of 56 cents per share on revenue of $462.2 million. The company this year expects to earn $2.11 to $2.14 per share, down from a previous forecast of $2.16 to $2.24 per share. In other health-care related earnings Wednesday: • Community Health Systems Inc. reported third-quarter net income of $59.7 million, up 18.5 percent from $50.4 million a year earlier. Per share results of 65 cents for the recent quarter beat the average forecast of analysts surveyed by Thomson Reuters by 3 cents. Revenues rose 12 percent to $3.09 billion, better than the $3.02 billion that analysts had forecast. For all of next year, the Franklin-based hospital chain expects profits of $2.80 to $3 per share. • America Service Group in Brentwood lowered its full-year earnings forecast to 65 cents a share from 88 cents, citing the effects of large inmate medical claims in Michigan in the third quarter and unrelated litigation costs. But the prison health-care provider still more than doubled its net income in the third quarter. Net income rose to $716,000 from $348,000 a year ago.

July 15, 2009 PR Inside
A lawsuit on behalf of purchasers of America Service Group, Inc. (NASDAQ:ASGR) stock between September 24, 2003 to March 16, 2006, alleging America Service violated Federal Securities Laws is pending at the US District Court for the Middle District of Tennessee. On March 31, 2009, Federal Judge William J. Haynes, Jr. granted in part and denied in part the defendants’ motion to dismiss. If you purchased America Service Group, Inc. (NASDAQ:ASGR) before March 2006 and currently still hold your ASGR shares, you have certain options and you should contact the Shareholders Foundation, Inc at email: mail(at)shareholdersfoundation.com or call us at: +1 (858) 779 - 1554. According to the complaint the plaintiff alleges that that America Service Group and its top executive officers engaged in accounting fraud and violated the federal securities laws by misleading investors and failing to disclose between September 24, 2003 to March 16, 2006 that “ (1) America Service was not charging its customers in accordance with their contracts; (2) America Service failed to properly credit customers with discounts, rebates, and price concessions; (3) America Service failed to provide customers with appropriate credits for returned pharmaceutical products; and (4) America Service inappropriately established and utilized reserves to help it more closely meet budgeted results”. The complaint further alleges that after the markets closed, on March 15, 2006, America Service Group announced that as a result of the findings of an internal investigation, it would restate earnings for the years ended December 31, 2001 through December 31, 2004 and for the first six months of 2005 and issue refunds of $3.6 million, plus interest, to customers for instances in which it failed to credit them with discounts, rebates or price savings to which they were entitled. On this news, so the lawsuit, the price of America Service Group, Inc. (NASDAQ:ASGR) fell $5.65, or almost 29%, to close at $13.95 per share. America Service Group Inc., a Delaware corporation headquartered in Brentwood, Tennessee with a $141 market cap, through its subsidiaries Prison Health Services, Inc. , EMSA Limited Partnership, and Correctional Health Services, LLC, contracts to provide and/or administer managed healthcare services to over 120 correctional facilities throughout the United States. America Service Group reported in 2007 Total Revenue of $464million with a Net Income of $2.81million and in 2008 Total Revenue of $497.74million with a Net Income of $3.83million. Shares of America Service Group Inc. (NASDAQ:ASGR) traded recently at $15.84 per share, down from a 52weekhigh of $17.22 per share and almost $30 per share in 2005.

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

April 12, 2007 Business Wire
America Service Group Inc. (NASDAQ:ASGR) announced today that it has executed an asset purchase agreement for the sale of certain assets of its indirect subsidiary, Secure Pharmacy Plus, LLC (SPP), to Maxor National Pharmacy Services Corporation (Maxor). Additionally, as a part of the transaction, Maxor and Prison Health Services, Inc. (PHS), the Company's primary operating subsidiary, have entered into a long-term pharmacy services agreement pursuant to which Maxor will become the provider of pharmaceuticals and medical supplies to PHS. The asset purchase agreement is to be effective April 30, 2007, subject to standard closing conditions. The pharmacy services agreement will commence May 1, 2007, subject to the closing of the asset purchase agreement. America Service Group Inc., based in Brentwood, Tennessee, is a leading provider of correctional healthcare services in the United States. America Service Group Inc., through its subsidiaries, provides a wide range of healthcare and pharmacy programs to government agencies for the medical care of inmates. More information about America Service Group Inc. can be found on the Company's website at www.asgr.com or www.prisonhealthmedia.com.

December 11, 2006 AP
Prison health care and pharmacy service provider America Service Group Inc. lowered its 2006 guidance again on Monday, but said it expects "stronger, more consistent performance from its contract portfolio in 2007." The company now sees adjusted 2006 earnings of $5.3 million, or 50 cents per share, on sales between $640 million and 650 million. In October, the company forecast adjusted earnings in a range of 58 cents to 61 cents per share, on sales between $650 million to $655 million. In August, America Service said it saw profit of 72 cents to 75 cents per share on revenue between $650 million and $660 million for the year. The company said its lower 2006 outlook is due mainly to the Florida Department of Corrections' decision to "reject all bids to provide comprehensive health care services in its Region IV," and to expected cost increases, including professional liability expenses. Looking toward 2007, the company sees adjusted earnings of $8.2 million, or 86 cents per share, on sales in the range of $570 million to $580 million. Shares fell 91 cents, or 5.8 percent, to $14.69 in after-hours trading. The stock had closed unchanged at $15.60 on the Nasdaq.

October 24, 2006 Tallahassee Democrat
With a stern warning and a promise to levy stiff fines for past failures, Florida's top prison boss said Monday he would allow a controversial Tennessee company to continue providing health care to 17,000 South Florida inmates. The Department of Corrections announced that Prison Health Services is the only one of three competing companies that submitted a qualifying bid for the nearly $800 million, 10-year health-care-services contract. However, in a letter to PHS executives, DOC Secretary Jim McDonough noted the company's abrupt pullout from an original contract it signed last year. Company officials said they were losing money on their $645 million bid because they dramatically underestimated the cost of hospitalizing sick inmates. ''Having been disappointed by you in the past, I will be doubly vigilant in regard to both your performance and your attitude providing proper health services to the men and women under my care,'' McDonough wrote. ''You can expect that the next time, it will be me, not you, who moves abruptly to exercise the withdrawal option.'' McDonough also warned that the company faces ''significant fines'' for ''shortcomings of services provided by you under the original contract." McDonough has been under pressure from Democratic legislators who sit on committees that oversee prison spending. Sen. Dave Aronberg of Greenacres and Walter ''Skip'' Campbell of Tamarac recently sent letters to McDonough demanding to know why the department has been slow to fine PHS for poor performance. In a letter McDonough issued Monday to the lawmakers, he said he did not want to reveal the amount of fines PHS faces to prevent companies from changing their bids. ''To have issued such a letter earlier could have impacted the current (bidding) process, resulting in adjusted bids that might have raised the bottom line to the taxpayer,'' McDonough said. Aronberg said Monday that he did not object to allowing PHS to compete again for the contract. But he didn't expect PHS to win the latest competition. ''I'm surprised because of the way the last contract was handled and terminated and because they were not the lowest bidder. My concern has always been making sure that the state fulfilled its end of the contract by imposing the fines,'' Aronberg said.

August 23, 2006 Gainesville Sun
One of the state's largest privatization efforts is ending abruptly with Prison Health Services' decision to end work with the Florida Department of Corrections nearly eight years before the contract was to expire. PHS, a Tennessee-based company that handles health care needs for local- and state-run jails and prisons around the country, announced on Monday that it would end its contract providing services to nearly 14,000 prisoners in more than a dozen South Florida prisons. "The contract has underperformed financially," a news release states, "primarily due to a higher than anticipated volume of off-site hospitalization services. The company's decision to terminate the contract was made only after diligent efforts on the part of both PHS and Florida Department of Corrections representatives to reach agreement on provisions that would allow the contract to continue on mutually beneficial terms." PHS will cease providing services for DOC on Nov. 20. DOC spokesman JoEllyn Rackleff said that was enough time for the agency to maintain prisoner well-being in the transition. DOC Secretary James McDonough has previously said he is willing to end privatization efforts and return oversight of certain programs to the agency. PHS won the South Florida contract last year, despite protests from some lawmakers that the bid was too low to provide quality service. PHS was set to receive more than $790 million over 10 years for the work.

August 21, 2006 Yahoo News
America Service Group Inc. (NASDAQ:ASGR - News) announced today that its primary operating subsidiary, Prison Health Services, Inc. (PHS), has formally delivered written notice to terminate its contract with the Florida Department of Corrections, effective November 20, 2006. As previously announced, the contract has underperformed financially, primarily due to a higher than anticipated volume of off-site hospitalization services required for this patient population. The Company had been in discussions with the Florida Department of Corrections as to potential alternatives that could improve the future financial performance of the contract. The Company's decision to terminate the contract was made only after diligent efforts on the part of both PHS and Florida Department of Corrections representatives to reach agreement on provisions that would allow the contract to continue on mutually beneficial terms.

August 2, 2006 Nashville Business Journal
America Service Group Inc. saw its earnings for the second quarter plummet 81 percent compared to results for the same period last year. The provider of prison health care and pharmacy services showed a profit of $514,000, or 5 cents per diluted share, in the quarter ended June 30 compared to $2.8 million, or 26 cents per diluted share last year. Though earnings were down, the second quarter saw the company return to an operating profit - something that hasn't occurred since the second quarter last year. Nevertheless, the company's stock dropped nearly 19 percent, trading at $11.66 at 10:20 a.m. The 52-week range of the stock is $11.32 to $23.20. Brentwood-based America Service (NASDAQ: ASGR) lowered its guidance and now expects revenues to fall between $650 million and $660 million and earnings to range between $7.7 million to 8 million. The company cited an underperforming Florida Department of Corrections contract as the cause of the reduction. The company's previous guidance called for revenues between $660 million and $680 million and earnings between $9.4 million and $10 million. Second-quarter revenues were on the upswing, coming in at $160 million compared to $139 million in the second quarter a year ago. Expenses increased to $150 million in the quarter compared to $128 million in the second quarter last year. The company also recorded $1.0 million in charges associated with an audit committee investigation of its Secure Pharmacy Plus subsidiary. On March 15, the company said an investigation into financial improprieties at its Secure Pharmacy Plus unit found that the company failed to properly credit customers with discounts, rebates and savings and failed to give customers proper credit for returned pharmaceuticals. Expenses related to the audit amounted to $4.6 million through the first half of this year and the company expects it will spend another $400,000 to $900,000. The company continued its stock repurchase program approved in July of last year to repurchase and retire 217,000 shares at a value of $3.0 million. The repurchase was suspended during part of the second quarter when the company received a third-party proposal to acquire pharmacy services subsidiary Secure Pharmacy Plus. Ultimately, a deal wasn't reached.

June 22, 2006 Tennessean
America Service Group Inc. says it has received notice that its stock won't be dropped from the Nasdaq National Market. Last month, after two directors quit, the Brentwood-based prison health company said it had received notice that it was no longer in compliance with Nasdaq rules requiring a majority of independent directors. On June 14, ASG added four independent directors. On Wednesday, it said Nasdaq had determined the company is now in compliance with rules governing board membership and corporate oversight.

June 14, 2006 Tennessean
Brentwood’s America Service Group Inc., the prison health company whose stock was in danger of being dropped by the Nasdaq National Market, named four new independent members to its board today. The move should bring the company back into compliance with Nasdaq’s rules requiring a certain number of outside directors and allow the stock to continue to be listed, company officials said this afternoon. Two outside directors bolted from America Service Group’s board earlier this year after they unsuccessfully tried to oust CEO Michael Catalano. New board members are: • John C. McCauley, assistant vice chancellor of risk and insurance management at Vanderbilt University. • William E. Hale, formerly president and chief executive of Beech Street Corp., a preferred provider organization. • John W. Gildea, managing director of Gildea Management Co., and a former board member of America Service Group from 1986-1999. • William M. Fenimore, managing partner of BridgeLink LLC, Swiss-based capital advisors.

May 30, 2006 Tennessean
America Service Group Inc., the beleaguered prison health-care company, expects to beat a June 14 deadline to fill at least one vacancy on its board of directors so its stock won't be dropped from the Nasdaq National Market. Under Nasdaq rules, the departure this month of two board members who quit after trying to oust CEO Michael Catalano meant the company no longer complied with a requirement that a majority of its directors be independent. A third independent director left in December. Only two of its four remaining directors have no other ties to the company. ASG has until its next annual meeting, scheduled for June 14, to address the vacancies on its board. Catalano said the company would fill at least two of the three vacant seats by that deadline. "We're confident we'll come back into compliance," he said. But this month's departure of two board members and Nasdaq's threat to drop or delist the Brentwood-based company's stock as a result aren't its only problems. It has come under fire in several states over the quality of medical care it provides to inmates. The Washington Post in an editorial recently called on officials to keep a closer eye on the company's Prison Health Services subsidiary after the Associated Press reported that some inmates in Virginia had said medical care there was so shoddy that they feared for their lives. Last spring, a report by the Metro Health Department blamed the death of a diabetic inmate at Metro Jail on myriad failures by the jail's nurses, who were employed by PHS. Catalano wouldn't comment on the specific allegations against the company but said competitors get similar complaints about the quality of care they provide.

May 19, 2006 Nashville Business Journal
America Service Group Inc. announced today it received an expected notice on May 17 from NASDAQ Listing Qualifications indicating it no longer complies stock exchange's independent director and audit committee requirements. The company received the notification due to the resignation of Michael E. Gallagher and Carol R. Goldberg on May 6 and May 8 from the company's board of directors. NASDAQ rules requires that a majority of board members be comprised of independent directors and that the company's audit committee be comprised of at least three members, each of whom are independent. Gallagher and Goldberg were members of the company's audit committee. The addition of one qualified independent director to serve on the audit committee will allow the company to regain compliance. The company is actively conducting a search for at least two independent directors to serve on its board of directors and audit committee, according to a release announcing the NASDAQ notice. Gallagher is the director of Edgar Group LLC, a health care consulting firm and was a partner in Shamrock Investments LLC, a health care advisory firm. Goldberg is president of AVCAR Group Ltd., a management consulting firm. Brentwood-based America Service (NASDAQ: ASGR - News) provides prison health services through its subsidiaries Prison Health Services and Secure Pharmacy Plus.

May 11, 2006 Tennessean
America Service Group Inc. says two members of its board quit after saying they'd lost confidence in the company's chief executive officer. Michael Gallagher, who led the board's audit committee, which recently looked into mismanagement at the company's prison pharmacy unit, submitted his resignation on Friday. Carol Goldberg, who led the board's compensation com- mittee, resigned on Monday. Brentwood-based ASG, which is being sued by shareholders in federal court over the problems at its Secure Pharmacy Plus subsidiary, disclosed the resignations in a regulatory filing after the markets closed Tuesday. According to the filing, the company's remaining board members met Tuesday and "confirmed their view that the company's chief executive officer should continue to serve in that capacity." CEO Michael Catalano, who chairs the board, "abstained from consideration of this matter," the company said in its filing. On Wednesday, Catalano said in a statement that the company wouldn't allow itself to become distracted by the developments. "While the public filings from America Service Group Inc. speak to the issues of two directors' resignations, I think it is important to know that our focus remains unchanged," Catalano said. "The dedicated health-care professionals representing our company are committed to the mission of providing quality medical care to the patients we serve in jails and prisons nationwide." Gallagher and Goldberg, who couldn't be reached yesterday, told a meeting of the board's governance committee they believed "the company would be better served by replacing its chief executive." Gallagher apparently resigned soon after the meeting. Goldberg e-mailed her resignation letter to the company on Monday. She said simply, "I hereby tender my resignation as a director of America Service Group Inc., effective today. I wish the company the best in its future endeavors." In his letter, Gallagher wrote that because "my fellow independent board members are unwilling to make a change … I have no other alternative but to hold true to the courage of my convictions and resign. "It is my business judgment that while there are many good people in the executive ranks of the company there nonetheless needs to be a change at the top," Gallagher said. "Such change is urgently needed in order to maximize the probability of successfully meeting the company's challenges and to ensure the full implementation of the recommendations resulting from the recent investigation (into Secure Pharmacy Plus)," he said. In March, the company said the audit committee recommended strengthening the company's internal controls and compliance functions after finding that problems at Secure Pharmacy Plus caused the company as a whole to post inflated earnings over a four-and-a-half-year period. ASG, which provides health services at jails and prisons nationwide, said that problems with the subsidiary had caused the company as a whole to overstate profits by $2.1 million for 2001 through the second quarter of 2005. It also agreed to refund $3.6 million to clients who were overcharged for prescription drugs. It found that some clients weren't properly credited with discounts or rebates on drug purchases and others weren't properly credited for prescription drugs that were returned. The resignation of two board members was "just one of those unfortunate things following a hard year," said Anton Hie, an analyst with Jefferies & Co. in Nashville. In a research note to clients, he maintained his "hold" rating on the stock. ASG said in its quarterly earnings filing on Wednesday that it had 104 health-care and pharmacy contracts as of April 1, five fewer than it had a year earlier. It posted a net loss of about $1.1 million in the first quarter, compared with a profit of $3.9 million in the first quarter of 2005. Still, shares of the company were up Wednesday, climbing 44 cents, or 3.4 percent, in moderate trading on the Nasdaq Stock Market to close at $13.42 a share, well below its 52-week high of $23.81.

May 3, 2006 Nashville Business Journal
Prison health services provider America Service Group Inc.'s troubles with its Secure Pharmacy Plus business helped push the company into a first-quarter loss. The company posted a loss of $1.4 million in the quarter ended March 31 compared to a profit of $3.9 million in the first quarter a year ago. Revenue from health care services were up nearly 26 percent to $167 million, but expenses to provide those services rose nearly 30 percent. Further denting the first-quarter numbers was a $3.6 million charge associated with an audit committee investigation into financial improprieties at Secure Pharmacy Plus. Brentwood-based America Service (NASDAQ: ASGR) expects to record another $200,000 to $700,000 in expenses related to the audit this year. That audit found that the company failed to properly credit customers with discounts, rebates and savings and failed to give customers proper credit for returned pharmaceuticals. The investigation also found that SPP inappropriately created reserves over the past five years to ensure the company's reported earnings matched budgeted results. The company restated its earnings going back to 2001. Excluding that charge, income from operations prior to income tax, interest and discontinued operations, would have been $2.4 million. Income from operations in the first quarter a year ago amounted to $6.2 million. The company also saw a $1.6 million increase in selling, general and administrative expenses, with $1 million of that coming from share-based compensation expense. The company has affirmed its guidance for 2006 and expects total revenue to be in the range of $660 million to $680 million. Earnings per diluted share are expected to be in the range of 90 cents to 96 cents. The revised 2005 number was 39 cents.

April 11, 2006 Nashville City Paper
A Brentwood prison health company’s announcement that it will restate earnings because of internal problems in its pharmacy subsidiary has spawned a shareholders’ lawsuit by a union pension fund. The Plumbers and Pipefitters Local 51 Pension Fund filed the suit last week in U.S. District Court in Nashville against America Service Group, which provides health care services to prisons. The complaint stems from the company’s March 15 disclosure of an internal investigation that uncovered several problems with its Secure Pharmacy Plus (SPP) subsidiary, which contracts with governments to distribute medications to inmates. The announcement “shocked the market,” the suit states. The company’s stock price fell nearly 29 percent, or $5.65 per share, to close at $13.95. The pension fund claims that America Service Group, through its public statements and filings, knowingly misled shareholders about the company’s financial health, which artificially inflated ASG’s common stock. The pension fund’s law firms — Barrett, Johnston & Parsley of Nashville and Lerach, Coughlin, Stoia, Geller, Rudman & Robbins of New York — are seeking class-action status on behalf of shareholders of common stock between Sept. 24, 2003, and March 16, 2006. The suit asks for unspecified damages.

April 7, 2006 Tennessean
The law firm of Lerach Coughlin Stoia Geller Rudman & Robbins LLP said yesterday that a potential class-action lawsuit has been filed in federal court here on behalf of investors who bought stock in America Service Group Inc. between Sept. 24, 2003, and March 16, 2006. Attorneys said the suit stems from the Brentwood-based prison health services company's internal investigation into the business practices of its Secure Pharmacy Plus subsidiary. Last month, ASG said an investigation into the unit had caused the company as a whole to overstate profits by $2.1 million for 2001 through the second quarter of 2005. ASG also said it would refund $3.6 million to clients who were overcharged for prescription drugs. It found that some clients weren't properly credited with discounts or rebates on drug purchases and others weren't properly credited for prescription drugs that were returned.

March 29, 2006 Tennessean
Brentwood-based America Service Group Inc. has named Richard Hallworth as chief operating officer. He will also serve as president and chief executive officer of the company's wholly owned subsidiary, Prison Health Services Inc. Hallworth previously held several executive positions with Tufts Health Plan, a managed care company. He began his career as a certified public accountant, first with Coopers & Lybrand and then as a partner with Ernst & Young LLP. He will replace former executive vice president Trey Hartman as president of Prison Health Services, which provides medical care to jail and prison inmates. In a filing with the Securities and Exchange Commission, America Service Group said Hartman was fired for cause in December in connection with an internal probe into whether the company’s Secure Pharmacy Plus subsidiary had overcharged for drugs and failed to follow proper accounting procedures. Hartman was a former head of the pharmacy unit.

March 16, 2006 Nashville Business Journal
Prison health care services company America Service Group Inc. has released the findings of an internal investigation into financial improprieties at its Secure Pharmacy Plus subsidiary. The results: restated earnings going back to 2001, a stock price plunge and a $3.7 million bill for the investigation. Last October, the company announced that the audit committee of its board of directors would conduct an investigation of SPP over pharmaceutical pricing and accounting practices. Independent forensic accountants conducted the investigation and found that SPP failed to properly credit customers with discounts, rebates and savings and failed to give customers proper credit for returned pharmaceuticals. Brentwood-based America Service (NASDAQ: ASGRE) plans to refund $3.6 million, plus interest, to customers as a result. Management of SPP also inappropriately created reserves over the past five years to ensure the company's reported earnings matched budgeted results. Auditors determined the company's pre-tax income was $355,000 higher than previously reported. Auditors also found that SPP charged some of its customers less than it should have to the tune of $5.9 million. The company will try to collect that money, but is uncertain of how much success it will have doing so. The news slammed America Service shares. At 12:40 p.m., they were trading at $13.90, down more than 29 percent their closing price Wednesday. The 52-week range of the stock is $12 to $26.10. On Dec. 7, the company fired Grant Bryson, president and CEO of SPP, in connection with the investigation. Two days later, it sent packing Trey Hartman, president and chief operating officer of Prison Health Services Inc., a move also connected with the investigation. Hartman was with SPP when America Service bought the company in 2000. Kendall Lynch is now CEO of SPP. In a statement announcing the results of the investigation, America Service said both the Securities and Exchange Commission and the U.S. Attorney for the Middle District of Tennessee are conducting informal inquiries. The company says it will continue to cooperate with both. As it wrapped up its own investigation, the company had delayed reporting its third-quarter results. Those financials were released after the market closed March 15 along with fourth-quarter and full-year numbers and restated earnings going back to 2001. Fourth-quarter results show America Service with a loss of $1.2 million compared to restated earnings of $4.9 million in the fourth quarter of 2004. Revenue for the quarter ended Dec. 31 came to $149 million compared to $130 million the year before. The fourth-quarter loss includes $3.3 million in expenses related to the investigation. During the third quarter ended Sept. 30, the company also posted a loss of $1.2 million compared to restated earnings of $81,000 last year. Revenue for the quarter came to $140 million compared to $135 million last year. Third-quarter results include $370,000 in expenses related to the investigation. Other restated earnings: The company's earnings for the first two quarters of 2005 were $6.7 million instead of the $7.1 million that was reported. Revenues for the two-quarter period were $273 million instead of $315 million. In 2004, the company had a profit of $9.9 million instead of the $9 million that was reported. Revenues for the year were $517 million instead of $665 million. Earnings in 2003 were $11.3 million instead of the previously reported $11.9 million. Revenues for the year were $380 million instead of $517 million. In 2002, the company's profit was $11.3 million instead of $11.9 million. Revenue for the year was $293 million instead of $410 million. The company's loss in 2001 was $46.5 million rather than the reported $45 million. Revenue for the year was $299 million instead of $397 million.

January 16, 2006 Tennessean
Prison health care services provider America Service Group Inc. will continue to be listed on NASDAQ. The company had received notice from the stock exchange in November that it was subject to delisting because it had failed to make timely financial filings with the Securities and Exchange Commission. The company delayed its third quarter financial reports pending the conclusion of an internal investigation by its audit committee of a subsidiary, Secure Pharmacy Plus. On Jan. 10, the company received a letter from NASDAQ that it would continue to be listed on the exchange provided it files its quarterly report for the third quarter ended Sept. 30 by March 15, according to a statement released by the company. The company also must provide the final report of the internal investigation by Feb. 28. The investigation was to "determine whether SPP provided pricing of pharmaceuticals in accordance with" client contracts and whether accruals and reserves maintained by the company were in line with accounting principles, according to a Oct. 24 statement by the company. America Service Group fired Grant Bryson, president and CEO of Secure Pharmacy, on Dec. 7 in connection with the internal investigation. On Dec. 9, the company also fired Trey Hartman, president and chief operating officer of Prison Health Services Inc. His termination also was based on the ongoing internal investigation. Hartman formerly served as the head of Secure Pharmacy. The trading symbol for the company currently is "ASGRE." The "E" will be removed from the trading symbol when the company has fully complied with NASDAQ filing requirements.

December 13, 2005 Tennessean
Brentwood-based America Service Group Inc. said today that it has fired two people in connection with an ongoing investigation into the billing practices of its prison pharmacy subsidiary. The company fired Trey Hartman, its executive vice president, on Dec. 9 and Grant Bryson, head of Secure Pharmacy Plus, on Dec. 7. Hartman also was president and chief operating officer of Prison Health Services, which provides medical services to jail and prison inmates. He previously ran America Service Group's pharmacy unit. The company said Hartman and Bryson were terminated for cause. Bryson had been on paid leave. He wasn't an executive officer of the company. America Service Group also said that Richard M. Mastaler would resign from the company's board of directors on Dec. 30 to pursue other interests. The company said his resignation is unrelated to its internal investigation of the pharmacy unit. The company announced in October that it was looking into whether its pharmacy operation overcharged for drugs and failed to follow proper accounting procedures. It said its audit committee had hired outside counsel who, in turn, had brought in a team of independent auditors to review the books of Secure Pharmacy Plus. Secure Pharmacy's former controller, who recently resigned, had identified the issues that are under investigation, the company said.

November 17, 2005 Tennessean
NASDAQ notified the company on Nov. 11 that its stock may be delisted because of a delay in filing its third-quarter report. ASG announced late Monday that it had received the notice. It informed the Securities and Exchange Commission on Tuesday. The Brentwood-based jail and prison health-care company said on Nov. 9 that it would be late in filing its quarterly financial report because of a previously announced internal investigation into a pharmacy subsidiary. On Tuesday, the company's stock symbol changed from "ASGR" to "ASGRE." Shares in the company were at $16.27, down 83 cents, or 4.85%, in early trading today. If the company is dropped from the stock exchange, its shares would be traded over the counter. Some institutional investors have policies against owning shares in companies that aren't traded on one of the major exchanges, analyst Anton Hie said. If these investors are forced to sell a large amount of stock, the price would probably fall sharply, said Hie, an analyst with Jefferies & Co. in Nashville.

October 25, 2005 Tennessean
Shares in America Service Group Inc. plunged 28% yesterday on news that the company is looking into whether its pharmacy unit overcharged for drugs and failed to follow proper accounting procedures. The Brentwood-based prison health-care company said its audit committee had hired outside counsel who, in turn, had brought in a team of independent auditors to review the books of Secure Pharmacy Plus. Secure Pharmacy's former controller, who recently resigned, had identified the issues that are under investigation, the company said. The unit's president, Grant Bryson, has been placed on paid leave. America Service Group didn't name the former controller, and there was no controller listed on the unit's Web site yesterday, but an earlier version of the site, saved on www.google.com, identified him as Randy Beaman. Beaman would not comment on issues under investigation. Because of the probe, America Service Group has withdrawn its earlier financial guidance and warned that it will delay filing its quarterly earnings report.

October 24, 2005 Tennessean
America Service Group Inc.'s stock tumbled in early trading today on the disclosure that its audit committee is investigating the company's pharmacy subsidiary. The Brentwood-based prison health company said in a news release this morning that the inquiry is being conducted to determine whether Secure Pharmacy Plus is providing pricing of prescription drugs in accordance with the terms of its contracts. America Service Group also is looking into whether some of the unit's financial accounts were established and utilized in accordance with generally accepted accounting principles. By mid-morning, the company's stock was trading at $13.31 a share, down $4.85, or nearly 27%, from Friday's closing price of $18.16 on the NASDAQ Stock Market. Jeffries & Company analysts Anton Hie downgraded the stock to "hold" from "buy" and lowered his target price to $20 from $22.50. The internal investigation is only the latest setback for America Service Group. Since its stock closed at $30 a share in February, the price has dropped on a string of bad news beginning with a series in The New York Times that month that claimed the company's care was "flawed and sometimes lethal." It also has lost several large contracts since the first of the year, including one to treat inmates at Nashville's Metro Jail. The company's nurses were blamed in the death of a diabetic inmate there last winter.

October 24, 2005 Yahoo
America Service Group Inc. (NASDAQ:ASGR - News) announced today that the Audit Committee of its Board of Directors is conducting an internal investigation into certain matters related to its subsidiary, Secure Pharmacy Plus ("SPP"). The Company said the investigation primarily is being conducted to determine whether SPP provided pricing of pharmaceuticals in accordance with applicable client contract terms and whether some of the accruals and reserves maintained by SPP were established and utilized in accordance with generally accepted accounting principles. "We take allegations of impropriety very seriously, and we are conducting a thorough investigative process to determine if the issues described in this press release, as well as any other issues which may be identified as a result of the investigation, will impact the Company's previously reported financial results," said Michael Gallagher, a member of the Company's Board of Directors and Chairman of its Audit Committee. "We will report on our findings as soon as the investigation is complete." Secure Pharmacy Plus provides pharmacy services to the Company, in facilities where the Company provides correctional medical services, as well as to third party clients who provide their own correctional medical services. The Audit Committee's inquiry into whether SPP charged its clients in accordance with applicable contract terms includes reviewing whether discounts received from wholesalers, rebates received from manufacturers or wholesalers, certain temporary price reductions from alternate vendors and distributions received from a group purchasing organization of which SPP is a member should have been credited, under the terms of the contracts, to such clients. The Audit Committee also is examining whether returns of unused pharmaceuticals were appropriately credited to clients.

September 25, 2005 Tennessean
America Service Group Inc., whose business is built around providing care for sick or injured inmates, is having a rough year. Or, it's doing OK. It depends on your point of view. Since its stock closed at $30 a share in February, the price has fallen about 45% on a run of bad news — beginning with a series in The New York Times that month that claimed the company's care was "flawed and sometimes lethal." Based in Brentwood, the company has lost at least six contracts since the first of the year, including one to treat inmates at Nashville's Metro Jail. The company's nurses were blamed in the death of a diabetic inmate there last winter. Recently, it warned Wall Street of lower profits. Originally, the company expected to earn $1.45 to $1.52 a share on the year, but last month, on a Friday night, it disclosed the loss of yet another contract and lowered its earnings estimate by 2 cents. Its stock fell an additional 8% the following Monday. Only about a third of the country's correctional health services are provided by for-profit companies, said Michael Catalano, America Service Group's chairman, president and chief executive. But every year, more agencies privatize their medical services in hopes of reducing costs and improving the quality of care. It's not clear whether privatization improves the quality of correctional care; but since the 1970s, a growing number of public officials have decided that "it's much easier to turn it over to a health consortium, and they can handle the whole nine yards," said Ken Kerle, managing editor of American Jail, the magazine of the American Jail Association. America Service Group has 21% of the outsourced correctional health market, behind Correctional Medical Services, which has an estimated 22%, Catalano said. CMS, a privately held company based in St. Louis, underbid America Service Group by about 10% in Maryland, about 14% in Idaho and about 21% in Indiana. Catalano said he doesn't understand why CMS believes it can provide adequate care for less money. "We're there providing services," he said. "We know what it costs." Catalano said, "The most significant rebids we haven't won this year have been based upon price." But this month in South Carolina, the Richland County Council voted unanimously to fire Prison Health Services after the deaths of three mentally ill inmates. One council member told The State newspaper of Columbia the treatment of the prisoners was "unacceptable and inhumane." Richland County officials didn't return calls to The Tennessean. And locally, the company's contract with Metro Jail will be allowed to expire Sept. 30. In March, a city government report blamed the Jan. 19 death of a diabetic inmate on a "failure to adhere to established practices on the part of individual employees of Prison Health Services." Claims of poor medical care are common throughout the correctional health industry. Correct Care Solutions, the Nashville company replacing Prison Health Servicesat Metro Jail, was criticized by the family of a Virginia woman who died in July in a Norfolk jail. Relatives said she complained that her pneumonia wasn't being treated. Officials said the company wasn't to blame. A month earlier, the American Civil Liberties Union sued CMS, alleging that inmates of a Mississippi prison were misdiagnosed and received poor care.

July 3, 2005 The Tennessean
America Service Group couldn't seem to catch a break in the second quarter. Its stock fell 28.4% in the three months ended June 30, shoved lower by troubles that unnerved many investors and left the health-services company lying near the bottom of the Bloomberg Tennessee Index.  Of 73 businesses on the list, onlyonefell harder in the period.  "ASGR has had a tough 2005 so far," analyst Anton Hie said, referring to the Brentwood-based company by its stock symbol.  Its stock took a hit in the first quarter after The New York Times ran several stories questioningthe quality of care provided by its Prison Health Services subsidiary, which cares for inmates.  But investors really started to worry in the most recent three months, as the company announced the loss of lucrative contracts with the Maryland, Idaho and Indiana prison systems.  He said ASGR's greatest challenge, at least in the short term, could be aggressive bidding by one of its competitors, Correctional Medical Services.  CMS, based in St. Louis, is privately held, meaning it doesn't have the legal and auditing costs associated with filing quarterly earnings reports, Hie said.  Patrick Swindle, an analyst with Avondale Partners in Nashville, said CMS also doesn't have to please investors by posting ever-increasing quarterly earnings.  "What a private company can do," Swindle said, "is take lower margins in the short term, hoping to improve those margins in time."  CMS underbid ASGR in Maryland and Idaho and is likely to replace the company in Indiana, as well, Swindle said.  One issue that has affected the company's stock but shouldn't affect its ability to win business in the future is negative news about the company.   In a front-page story in February, The Times reported that a yearlong investigation into the company's operations had found numerous examples "of medical care that has been flawed and sometimes lethal."  "The company's performance around the nation has provoked criticism from judges and sheriffs, lawsuits from inmates' families and whistle-blowers and condemnations by federal, state and local authorities," the newspaper said.  Locally, the Metro Health Department concluded recently that the death of a diabetic inmate at the Metro Jail in January could have been prevented if nurses working for Prison Health Services had followed procedures. The report said nurses failed to properly document the patient's medical problems when he was booked, lost track of his medical history and ignored repeated requests for help.

Baltimore City Detention Center, Baltimore, Maryland
May 19, 2008 Daily Record
The Court of Special Appeals once again ruled Baltimore County was a day late in an attempt three years ago to renew its contract with a medical services provider for inmates. A three-judge panel last week unanimously reversed a Baltimore County Circuit Court decision and remanded the case back with instructions to grant summary judgment in favor of Prison Health Services Inc. “It was the county’s burden to establish that it timely manifested its option to renew the contract, not PHS’s burden to establish the opposite,” Judge Mary Ellen Barbera wrote. “We have concluded that, on this record, the county is unable as a matter of law to carry that burden.” Andrew D. Levy of Brown, Goldstein & Levy LLP in Baltimore, who represented Prison Health, was pleased with the decision. “We were not bound by their exercise option,” he said Wednesday. “I’m glad the Court of Special Appeals agreed.” Jeffrey G. Cook, an assistant county attorney involved with the case, did not return calls for comment. Clear intent -- The case stemmed from a contract the county and Tennessee-based Prison Health entered into on July 1, 2000, covering two jails. The five-year agreement was to “continue through” June 30, 2005, with options for up to three two-year extensions. The county sent notice of its intention to extend the contract July 1, 2005; earlier that same day, Prison Health sent a letter to the county declaring the contract completed because the county did not extend it by June 30. The county filed a declaratory and injunctive relief action against Prison Health in Baltimore County Circuit Court in July 2005. Four months later, Judge Dana M. Levitz found in favor of the county, saying “through June 30” meant a reasonable time thereafter, a standard met by the July 1 notice of extension. Prison Health appealed the decision, and the Court of Special Appeals reversed Levitz in December 2006, sending the case back to the lower court. Levitz again ruled in favor of the county last May, a decision appealed by Prison Health a month later. The county argued the two sides had conversations prior to June 30 about extending the contract, so its intent to renew was apparent even if not in writing. It cited a May 2005 e-mail from a county official indicating it would grant an increase in Prison Health’s compensation based on a rise in the Consumer Price Index once the company returned paperwork with the necessary corrections. But the court agreed with Prison Health that the county’s e-mail was “not an objectively reasonable expression of its intent” because it did not “explicitly refer” to the contract extension. “We have made clear…that acknowledgement of an existing relationship that is anticipated to continue does not constitute an exercise of an option,” Barbera wrote, citing past court decisions. Levy said the decision means Prison Health does not have to pay the county the difference between the 2000 contract and the county’s subsequent contract with another medical services provider. He did not know the exact amount, but believed it was several million dollars. A county spokeswoman did not know the dollar figure either and said Cook was the only lawyer who did. Prison Health has not performed work for the county since September 2006, Levy said.

April 7, 2008 Daily Record
Baltimore County and Prison Health Services Inc. once again asked the Maryland Court of Special Appeals on Monday to determine what difference a day makes when it comes to a contract’s expiration. The two sides repeated many of the same arguments they have used the past three years in a dispute concerning the county’s attempt to renew a contract providing medical services to inmates one day after Prison Health claims the deal expired. The case returned from Baltimore County Circuit Court after the appeals court remanded it there in a 2006 opinion. Lawyers for Tennessee-based Prison Health again argued the county could not seek to extend a contract providing medical services to inmates at two county jails the day after the deal expired. “They are not allowed to create a contract and then hold us to perform what is really connect-the-dots,” said Andrew D. Levy of Brown, Goldstein & Levy LLP in Baltimore, representing Prison Health. Jeffrey G. Cook, an assistant county attorney, acknowledged under judges’ questioning the county could have handled the renewal process differently but said it was still done lawfully. “It might not be the best way, but it is a permissible way,” he said. The case stems from a contract the two sides entered July 1, 2000, covering two jails. The five-year agreement was to “continue through” June 30, 2005, with options for up to three additional two-year terms. The county did not send notice of its intention to continue the contract until July 1, 2005. Earlier that same day, Prison Health sent a letter to the county declaring the contract completed because the county had not exercised its option for renewal by June 30, 2005. The county filed a declaratory and injunctive relief action against Prison Health in July 2005 in Baltimore County Circuit Court. Four months later, Judge Dana M. Levitz sided with the county, saying “through June 30” meant a reasonable time thereafter, a standard the county met by exercising its renewal option July 1. Prison Health appealed the decision, and the Court of Special Appeals ruled in the company’s favor in December 2006. The three-judge panel sent the case back to Baltimore County. Levitz again ruled in the county’s favor last May, and Prison Health filed an appeal in June. On Monday, Judge Mary Ellen Barbera questioned the county’s reasoning and wondered if Prison Health was simply protecting itself by sending the letter to the county July 1, 2005. Barbera was joined on the bench by Judge James P. Salmon, who also heard the first case, and Judge Sean D. Wallace, who was specially assigned from Prince George’s County Circuit Court. Cook repeated one of the county’s arguments that both sides were discussing terms of a contract extension before July 1, 2005, so the county’s intent was clear even if not in writing. “Everybody knew what was going on,” Cook said. Levy countered that intent to renew is not enough. “They are still required to exercise the option in a clear, unconditional and unequivocal way,” he said. The court is expected to issue its opinion later this year.

June 6, 2007 Daily Record
The mother of a mentally troubled man who died in state custody has filed a $2 million lawsuit following his overdose on prescription medication given to him at the Baltimore City Detention Center. Verbena Harris is suing the state, the Department of Public Safety and Correctional Services and Prison Health Services Inc. for malpractice and the wrongful death of her son, Ronald E. Faulk. She claims he was denied treatment for more than a week, then given a month’s supply of drugs instead of the daily dose he required. “Not only is this another piece of evidence of the way Prison Health Services has failed to live up to the standard of care necessary, it’s another example of what happens to men like Mr. Faulk,” said Alison Kohler of Dugan, Babij and Tolley LLC, Harris’ attorney. Faulk, 51, was a Vietnam War veteran whose ailments included high blood pressure, post-traumatic stress syndrome, bipolar disorder and alcohol abuse. The Baltimore resident had been in and out of the detention center for various minor charges since at least 1990. “He had his mood swings, but he was a good person,” Harris said of her son in a telephone interview on Wednesday. “There was nothing he wouldn’t do for me. He loved his mother.” According to the complaint pending in U.S. District Court in Baltimore, Faulk was arrested on Feb. 22, 2004, for disorderly conduct and street fighting. After his arrest, he allegedly went more than a week without receiving medication of any kind, despite being evaluated and prescribed medication by physicians at the detention center. Faulk was twice referred for a psychiatric evaluation he never received, and physicians’ orders to monitor his heart and blood pressure daily were not followed, the complaint alleges. Harris said she learned of Faulk’s arrest the day it happened and contacted the facility herself to explain her son’s medication needs, but said she did not receive a convincing response that they would be met. “There seems to be at best a deliberative indifference to the care while he was in jail,” said Kohler. “As I read through the record, the message that I get is ‘We’ll get to you when we get to you.’” By the morning of March 3, 2004, Kohler said, Faulk was “agitated and manic,” pacing the room and asking repeatedly for his medication. Later that day, staff nurses gave Faulk an entire month’s supply of blood pressure medication, rather than administering it dose-by-dose as ordered by the facility physicians, the complaint says. The next morning, Faulk was found pale and heavily perspiring and taken to the Johns Hopkins Hospital, where a doctor called Harris to tell her that her son had overdosed. “I’m thinking it was illegal drugs, I’m not thinking prescription drugs,” Harris said of her first reaction. Faulk died at Hopkins early the next day. An autopsy confirmed that the cause of death was an overdose of the blood pressure medication given to him at the detention center. Harris, on behalf of herself and Faulk’s estate, as well as Faulk’s father and his son, is seeking $1 million each in compensatory and punitive damages. The attorneys for the state and Prison Health Services were unavailable for comment. This is not the first time a death in custody has provoked debate about Baltimore City Detention Center’s health services. The American Civil Liberties Union’s National Prisons Project and the Public Justice Center in Baltimore sued the state in 2003 to improve conditions at the detention center and central booking facility in Baltimore. The suit is in negotiations, according to Elizabeth Alexander, director of the ACLU’s prisons project. Alexander said the ACLU suit highlights multiple cases of serious medical neglect at the jail that have aggravated chronic conditions and in some cases caused death. Prison Health Services Inc., a defendant in both Harris’ suit and the ACLU’s, has traditionally had “a very bad reputation, particularly in administering medication,” Alexander said. The company’s contract with the state expired nearly two years ago, and since then multiple vendors have been selected to provide services in a completely restructured health care system. Alexander called the new standard of care “not quite as dreadful” as in years past. A February report on inmate health care by the Department of Legislative Services in Annapolis also exposed understaffed facilities and found inconsistent monitoring of patients. Although originally filed in Baltimore City Circuit Court earlier this year, Harris’ case was removed to federal court this month.

September 20, 2005 Baltimore Sun
The state did a poor job of providing medical care to prisoners at Baltimore's downtown prison over much of the past five years because of a flawed and underfunded contract with a private company that took effect in 2000, according to a grand jury report released yesterday. The grand jury report came out of a review of prison conditions that are part of the routine of grand juries in Maryland. Circuit Court Judge Stuart R. Berger ordered the Baltimore grand jury in May to examine health care services at the state-run detention center in Baltimore. The grand jury identified what it said were serious problems with the flat-fee contract the state held with Tennessee-based Prison Health Services Inc. Under the contract, which expired June 30, Prison Health was responsible for all health care needs for most Maryland inmates. Putting one organization in charge of all aspects of offender health care was a serious mistake at the outset," the report states. In addition, it said, the documents the state sent out inviting companies to bid on health care services for inmates in 2000 were poorly written. And the state's monitoring for compliance in the initial years after the contracts were signed was inadequate, jurors found. More importantly, jurors said, the long-term, fixed-price contract locked Prison Health into what turned out to be a money-losing deal that affected services provided to inmates. "This resulted in enormous pressure from PHS management to economize on operations," the report says. "Instead of looking for efficiencies, PHS made it more and more difficult for offenders to receive prescription medications, hospital procedures or laboratory tests." The report said that detainees often did not receive prescribed medication for weeks after they were booked into the city's jail, and it listed a series of other problems that The Sun had also discovered in its investigation. PHS officials have consistently denied that economic factors influenced decisions on medical care. They say the company lost $15 million on the Maryland contract, which generated $260 million in revenues over five years. "We hope the report will be helpful, but their tone is a little more hopeful than we think the current situation calls for," said Sally Dworak-Fisher, a lawyer with the Public Justice Center in Baltimore. Her group and the American Civil Liberties Union's National Prisons Project have a long-standing lawsuit against the state to improve conditions at the detention center and central booking facility in Baltimore. Dworak-Fisher said that detainees, in interviews, are currently reporting many of the same kinds of problems as in the past, with few signs of improvement since the new contracts took effect July 1. She noted that the company that holds the $125.6 million, two-year contract for primary care services, by far the largest segment of the work, has fallen short of supplying the number of staff it agreed to provide. The grand jury report also said that St. Louis-based Correctional Medical Services "has a history of troubled performance in other states, as well as in Maryland."

June 1, 2005 The Daily Record
The company that provides medical services to Baltimore County inmates is arguing that it should not have to continue delivering those services at the county's expanded prison. Tennessee-based Prison Health Services filed suit against the county in Baltimore County Circuit Court last week, alleging that logistical aspects of the expansion will force the company to spend more to provide the same services. The $74 million expansion on Kenilworth Drive in Towson is set to be completed in the fall. The County did not bargain for, and the PHS did not agree to provide services, personnel and costs at this new facility; rather PHS contracted to provide services to the 'facilities' as they existed at the time the contract was formed, based on the RFP and Bid documents, the complaint states. The County has given notice to PHS that it expects PHS to provide the same services at the new facility as at the old facilities, despite the increased manpower required, at no increase in price.

May 10, 2005 Baltimore Sun
As they were sworn in yesterday, members of Baltimore's newest grand jury were charged with investigating the city jail's health care system over the next four months. City grand jurors, in addition to deciding which felony cases to indict, typically prepare a report on a specific criminal justice issue, such as prison conditions, drug treatment and witness intimidation. A major reason to explore the status of health care is because of "the extent the health issues associated with the ever increasing population in our prisons," he wrote. He also noted that prisoners are 17 times more likely than the general population to have tuberculosis and five times more likely to have AIDS. Since 2000, health care at the jail has been provided by Tennessee-based Prison Health Services. That company has a contract with the state, which expires in July, for health services at more than 20 state prison facilities.

October 20, 2004 AP
The firm providing medical care to Maryland's prison inmates has disciplined four employees in connection with the treatment they gave to a 34-year-old woman who died last month after she became ill at the women's detention center in Baltimore. A statement from Prison Health Services says the three nurses and a physician's assistant have been reprimanded and reassigned. The statement says the workers didn't perform a function usually done during the sick-call intake process. Hospital records indicate she had been experiencing fainting spells before she was sent to the hospital. Her family wonders if better care might have saved her life.

Broward County Detention Center, Ft. Lauderdale, Florida
December 4, 2004 Miami Herald
Three days after Correctional Health Services was formed, the Broward Sheriff's Office sought bids to provide medical care to 5,000 inmates at the county Jail. Only companies with longstanding experience at large jails or prisons need apply, officials wrote in a request for proposals. But a week later, on July 28, BSO did an about-face on its requirements. The agency announced it was tossing out its request for bids. And when a new request for proposals was issued Aug. 10, one requirement had been dropped: bidders no longer needed to have experience providing healthcare to inmates. The new solicitation left the door open for Correctional Health to bid, and the newly formed company was awarded a $127 million, five-year contract to manage healthcare at the Broward County Jail. Correctional Health Services (CHS) was not the lowest of the four bidders for the lucrative contract. Wexford Health Source, the company that had provided care at the jail for the last three years, submitted a bid that was $300,000 less, records show. The company's first few days at the jail already have been rocky. State pharmacy officials said they had not issued pharmacy licenses when CHS took over management of the jail on Wednesday, and company employees could not dispense medications until Friday, when they obtained a temporary license. Attempts to reach Doyle H. Moore, CHS's chief executive officer, or Jose Armas, CHS president and chairman, were unsuccessful Friday. Acccording to county Supervisor of Elections records, businesses owned by Armas, a doctor, contributed $4,250 to Broward Sheriff Ken Jenne's most recent campaign for reelection. In addition, Armas contributed another $500 as an individual to Jenne's campaign. The company's chief executive officer, Doyle Moore, had run into trouble in Broward before, however. At the 1993 federal tax fraud trial of former Port Everglades Commissioner Walter Browne, Moore -- the founder of a company called Prison Health Services -- testified he funneled money to a Republican power broker and hired lobbyists to sway then-Sheriff Nick Navarro when he became concerned Prison Health was going to lose its contract to provide medical care at the Broward jail. Moore testified with the guarantee his testimony would not be used against him. His attorney at the time said neither Moore nor the company did anything wrong. In 1985, Palm Beach County jail inmate Mario Abraham died after languishing in his cell for five days with a broken neck before Prison Health Services employees treated him. A grand jury at the time called the company's care of the man ``grossly inadequate and incompetent.''

Camden County Jail, Camden New Jersey
The family of a Cherry Hill man killed in Camden County Jail filed a federal lawsuit Wednesday, charging county correctional officials with "reckless and deliberate indifference" in his death.  The suit charges that Joel Seidel's constitutional rights to medical care, due process and to be free from cruel and unusual punishment were violated while the former stockbroker was in custody.  The lawsuit was filed in U.S. District Court on behalf of Seidel's daughters, Sharon Clark and Devra Seidel, co-administrators of his estate.  "This tragedy was preventable and we intend to prove that the reckless and deliberate indifference of the prison guards and officials led to the death of Mr. Seidel," said Tom Kline, of Kline & Specter of Cherry Hill, attorney for the Seidel daughters.  County officials had not been served with the lawsuit late Wednesday and because of that were unable to comment, according to a spokesman.  The suit alleges "negligent, reckless, intentional, wrongful, deliberately indifferent and unlawful conduct" on the part of prison officials.  The suit cites overcrowding at the prison in general and the failure to move Seidel to a hospital, psychiatric facility or his own cell and failure to provide adequate observation.  The suit names as defendants the Camden County Jail, Camden County Department of Corrections and Camden County; and Prison Health Services Inc. and Steininger Behavioral Care Services, both of which had contracts to provide services to inmates.  (Courier-Post, April 29, 2004)

Charlotte County Jail, Punta Gorda, Florida
April 11, 2006 NBC2
A former Charlotte County inmate is demanding answers after two nurses at the Charlotte County Jail took drugs out of a bio-hazard trash bin and injected him with the drugs. William Parbus, a diabetic, was given a shot of insulin that could have cost him his life. The nurses have since been fired. Parbus is now out of jail. He was serving 15 days for driving with a suspended license. He may be out of jail, but he's a prisoner to fear. "I don't want to be with my wife. I kind of miss it already. Five months to go," said Parbus. Doctors told him HIV or hepatitis may be lurking in his system, but won't know for certain for six months. The concerns come after Parbus, a diabetic, was injected with outdated insulin from a bio-hazard trash bin while he was an inmate at the Charlotte County Jail. "I was outraged. For what reason could this person do this to me? What reason in the world? She's out of insulin, fine. I'm out of insulin," said Parbus. The two nurses worked for Prison Health Systems, an outside contractor hired by the jail. They said the nurses responsible were immediately fired. PHS officials and jail commanders alerted Parbus that his health could be at risk. "It's not anything we want to tell anybody. We had to be up front with it. Told him what happened and told him what we would do to rectify the situation," said Lieutenant Daniel Kacynski, Jail Support Commander. PHS told Parbus to send them his medical bills and they might pay them. But Parbus says that's not enough. "I think there should be an investigation. They just fired these ladies. Are they licensed nurses? Are they going to get a job at a hospital down the road? Is this going to happen again if they don't feel like going down the road for insulin?" said Parbus. Parbus claims he won't give up until he gets some answers. Until then, his thought will be on his health. Parbus says he is looking for an attorney. He says he wants to make sure this doesn't happen to anyone else. PHS commented about potentially paying Parbus' medical bills through a statement they released through jail supervisors. We tried to reach the two nurses who were fired. Sheryl Staples declined to comment. Karen Helmick has not returned our call.

April 5, 2006 Herald Tribune
Two nurses charged with the care of inmates in the county jail were fired for giving an inmate expired medication taken from a biohazard disposal box. Karen Helmick and Sheryl Staples were both registered nurses with Prison Health Services Inc., the agency contracted to care for inmates' medical needs. They were fired March 14. "Unfortunately, it happened," said Linda Antuono, PHS health service administrator. "It was rectified immediately." A PHS doctor checked on the inmate the day after the incident, explained the risk factors to him and ordered testing for HIV and hepatitis, according to the incident report Antuono filed with the Sheriff's Office. According to the report, another nurse saw Helmick break open a sharps container -- a box used to dispose of glass medicine vials and used needles -- and remove a vial of expired drugs. Helmick gave Staples the medicine to administer to the inmate. Staples told authorities that the nurses had run out of the medication the inmate needed. The nurses should have called an outside pharmacy to order backup medication, the report states. "Sheryl stated to me that she did not want to cross Karen," Antuono wrote in the report. Karen Helmick said that she knew she was in a supervisory position, which made her responsible for retrieving backup drugs from the pharmacy, the report states. She told Antuono that "she just did not feel like driving and getting it," according to the report.

November 22, 2004 AP
A Charlotte County Jail inmate and his nurse girlfriend on Monday denied charges she smuggled drugs into the facility for him. Ruth E. Brodis, a nurse at the jail, was arrested Thursday and charged with introducing contraband into a correctional facility, a felony punishable by up to five years in prison if convicted. Brodis was working for Prison Health Services, a contractor which provides medical services to the county. But Brodis said she suffers from fibromyalgia and the pills found by detectives were hers and not intended for her fiancee, Tyler Schwartzkopf, who is currently in jail on a second-degree felony charge of grand theft.

November 20, 2004 Herald Tribune
A private health care nurse at the county jail smuggled prescription drugs to an inmate she planned to marry, according to the Charlotte County Sheriff's Office. The nurse, Ruth Ellen Brodis, was arrested Thursday at the jail when she arrived for her shift, sheriff's Detective Martha Faul said. The Deep Creek resident is charged with introduction of contraband, a felony. Brodis works for Prison Health Services, a Tennessee-based company that provides health care to inmates in hundreds of jails, prisons and juvenile facilities across the country.

Chittenden Regional Correctional Facility, Burlington, Vermont
September 2, 2010 Burlington Free Press
A prison rights group's efforts to force disclosure of information from a government contractor is a critical effort to keep public records open as state government increasingly looks to privatize services to save money. Prison Legal News -- a magazine and organization promoting prisoners rights -- is arguing that a company formerly known as Prison Health Services that provides health care services in Vermont prisons is subject to the state's public records law. Prison Legal News editor Paul Wright got it right when he told The Associated Press that the state "cannot contract out the public's fundamental right to know how their tax dollars are being spent and the quality of services the pubic is getting for its money." If there is any ambiguity about the reach of open government laws when government functions are contracted out to private firms, then the Legislature must make erasing that ambiguity a priority in the next session. Vermont's open government laws are so full of exemptions and so lacking in consequences for the offender as to render them largely meaningless. The least the Legislature can do is to make sure the public's already limited ability to keep government accountable isn't shut down by privatization. Around the country, private contractors are being hired by state and local governments in search of savings. There is no reason the reach of open government laws should stop simply because government functions paid for with tax dollars are in the hands of private companies. If private companies want to profit by performing government functions, then they should expect to held accountable by taxpayers who will be paying the bills. The principle must be that any government meeting or information that would be open to the public must remain so even if the function has been transferred outside of government. Otherwise, government officials could erect a wall of secrecy simply by outsourcing anything they might be hard pressed to explain to the public. People have a right to know what their government is up to, and access is the first step in keeping government accountable. The responsibility to deliver information to the public rests with the elected officials and civil servants. That responsibility is undiminished even if government functions are privatized. Advocating for open government will require a shift in culture for a Legislature more prone to seeking exclusions and exceptions to the open government laws to every interest that comes along. This is a change that must happen at the polls in November by extracting a pledge of open access and accountability from every candidate.

August 26, 2010 Serious News
Here's a fascinating lawsuit that will test the legal boundaries of Vermont's public-records statute. Prison Legal News (PLN), a Brattleboro-based nonprofit that publishes the nation's largest jailhouse newspaper, filed suit today against PHS Correctional Healthcare — formerly known as Prison Health Services — seeking documents related to the August 2009 death of a female inmate at Northwest State Correctional Facility in St. Albans. Until last year, PHS, a Brentwood, Tenn.-based private corporation, was contracted by the state to provide medical services to inmates in all of Vermont prisons. On August 16, 2009, Ashley Ellis, a 23-year-old Rutland woman who suffered from anorexia and was serving a 30-day sentence, was found unresponsive in her cell and later pronounced dead. The state's chief medical examiner determined that a contributing factor in her death was the "denial of access to medication" by the prison's medical staff. Ellis' family eventually settled its lawsuit with PHS for an undisclosed sum. Late last year, the Vermont Department of Corrections decided not to renew the company's five-year contract when it expired in January. According to a PLN press release issued today, the Brattleboro nonprofit submitted a formal document request to PHS Correctional Healthcare under Vermont's open-records law, seeking "copies of the company’s contracts with government agencies in Vermont; records related to settlements and judgments that PHS had paid as a result of lawsuits and civil claims; and documents concerning costs incurred by PHS to defend against claims or suits." PHS Correctional Services subsequently denied that request, claiming that, as a private company, it wasn't subject to Vermont's public-records law. However, in a complaint filed in Vermont Superior Court, PLN contends that the prison health provider served as the "functional equivalent" of a state agency, as it provided a service that would otherwise be delivered by the state. According to PLN Editor Paul Wright, this "functional equivalency" standard has been successfully applied to private corporations providing similar services in other states. “The state can outsource public functions and services such as health care for prisoners,” Wright said, in a statement, “but it cannot contract out the public’s fundamental right to know how their tax dollars are being spent and the quality of services the public is getting for its money.” Wright also questioned “why PHS refuses to release records that state agencies would have to produce if the state were providing prison medical care.”

May 28, 2010 Rutland Herald
A watchdog group charged with safeguarding the rights of the disabled released a report Thursday that cites a number of systematic failures that led to the death of a Vermont inmate last year. Disability Rights Vermont's 23-page report about the death of Ashley Ellis found that miscommunications between the Department of Corrections and Prison Health Services — the private company contracted to provide health care in the state's prisons at the time of Ellis' death — along with other breakdowns in the system of care led to the 23-year-old's death from a combination of hypokalemic-induced cardiac arrhythmia due to anorexia/bulimia nervosa and denial of medications to boost her potassium levels. The report also includes a number of recommendations to prevent similar deaths, including improving the identification of inmates in need of medical treatment for substance withdrawal, assuring that important medical information is received and verified promptly by prison health staff and assuring that qualified nursing staff are available at all shifts, including weekends.

December 29, 2007 Rutland Herald
The proposed settlement in a wrongful death suit against the state has been sealed. Earlier this month, attorneys for the estate of the late Robert Nichols of Brandon filed a motion to seal an order for the distribution of settlement proceeds and related documents. The papers will remain sealed at least until Rutland Superior Court holds a hearing on the motion, according to a court clerk. Robert "Bones" Nichols, a meat cutter who worked at his family's slaughterhouse, died in 2005 at age 44 while at the Chittenden Regional Correctional Facility in South Burlington. He was undergoing a severe case of heroin withdrawal and a later report by a statewide advocacy group said his death could have been prevented. His widow, Eva Nichols, filed a lawsuit in 2006 against the state and against Prison Health Services, Inc., a company contracted to provide medical services in the Vermont prison system shortly before Nichols died. Eva Nichols was acting as administrator of her husband's estate. The lawsuit sought unspecified damages. The documents were sealed because of a confidentiality agreement between the plaintiff and Prison Health Services that is part of the proposed settlement. Attorney Devin McLaughlin, who represents the plaintiff, could not be reached for comment Friday. Samuel Hoar, the attorney for Prison Health Services, said that the motion was necessary because wrongful death suits require a court order on the distribution of settlement money and the parties cannot just mutually dismiss the case like in other types of lawsuits.

September 13, 2007 Rutland Herald
A settlement has been reached in a civil lawsuit against the state filed by the family of a Brandon man who died in a South Burlington jail while suffering from severe heroin withdrawal, according to court records. Paperwork indicating that the lawsuit brought on behalf of the estate of the late Robert Nichols has been resolved was filed last week in Rutland Superior Court. The documents do not state a dollar amount of the settlement, only that a resolution of the case was reached following a mediation session involving the parties. Attorneys in the case said since formal paperwork regarding the settlement hasn't yet been filed in court as of Wednesday, they could not disclose details of the resolution. "Unfortunately I can't really comment at this point in time because it hasn't been finalized," Assistant State Attorney David Groff, said. "When that happens there will be a stipulation of the parties and I'll be able to comment at that time." Peter Langrock, a Middlebury attorney representing the Nichols' family, said he could not yet talk about the settlement amount either. "I can tell you that we settled and at this point it's for an undisclosed sum," Langrock said. The lawsuit was filed in October 2006 on the behalf of Nichols' estate, which is administered by his wife, Eva Nichols. Nichols died in February 2005 while in the Chittenden Regional Correctional Facility in South Burlington. The lawsuit named the state of Vermont as a defendant as well as Prison Health Services, a company that had been contracted to provide medical services in Vermont's prisons shortly before Nichols' death. The lawsuit sought unspecified damages. According to court records, Nichols, 44, was arrested Feb. 3, 2005, on federal firearms charges and the next morning he was taken to the South Burlington jail before being taken to federal court. However, he was deemed too ill to go before a judge and later that night, he saw a nurse from Prison Health Services, the lawsuit said. "This was approximately 16 hours after first arriving at the facility with obvious withdrawal symptoms. Mr. Nichols was not seen by a doctor or referred to an outside facility," according to the lawsuit. "Rather, he was returned to his cell after apparent administration of some medication. He was not sent to a medical bed or facility." Nichols told the nurse that he had vomited three times and had a fever and tremors. Fifteen-minute checks were ordered. In the response to the lawsuit, the state acknowledged that not all the checks were done properly. "The state admits that Mr. Nichols was placed on 15-minute checks, but was not observed on a continuous, uninterrupted basis," the response stated. "The state further admits that some checks did not comply with the standards and practices demanded by the state." Nichols was found dead just before 6 a.m. the next morning. In June 2005, Vermont Protection & Advocacy issued a report stating that Nichols' death at the jail could have been prevented if the staff had provided better medical care. The advocacy group stated corrections officials knew Nichols was sick when he arrived at the jail, but did not properly monitor his condition. "Had they taken a more active role in assuring he was receiving adequate medical care and follow up, this tragedy may have been avoided," the advocacy group's report stated.

October 9, 2006 Rutland Herald
The family of a Brandon man, who died in a jail more than a year ago, is suing the state, claiming that while he was suffering from severe heroin withdrawal, he failed to get necessary medical care while behind bars. The lawsuit was filed last week in Rutland Superior Court on behalf of the late Robert Nichols' estate, which is administered by his wife, Eva Nichols. Robert Nichols died Feb. 5, 2005, while in the Chittenden Regional Correctional Facility in South Burlington. The lawsuit names as defendants not only the state of Vermont, but Prison Health Services, a company that had been contracted to provide medical services in the Vermont's prisons shortly before Nichols' death. The lawsuit alleges proper procedures were not followed for Nichols, an inmate experiencing withdrawal symptoms from the use of heroin at the time of his incarceration. The lawsuit seeks unspecified damages. According to the lawsuit, Nichols was arrested on Feb. 3, 2005, on federal firearms charges, and on Feb. 4 at about 3:30 a.m., agents from the federal Department of Alcohol, Tobacco & Firearms brought Nichols to the South Burlington jail, where he was lodged as a federal detainee. "Mr. Nichols reported that he was suffering from heroin withdrawal, and that he had ingested eighty (80) bags of heroin within three days of being incarcerated," the lawsuit stated. "He was not given immediate medical attention." At about 9 a.m. on Feb. 4, Nichols was transported to federal court in Burlington, but because of the severity of his withdrawal symptoms, he could not appear before the judge and was taken back to the South Burlington jail around 1:30 p.m., according to the lawsuit. "Again, Mr. Nichols received no immediate medical treatment," the lawsuit stated. "The U.S. Marshals reported the severity of Mr. Nichols' symptoms to (the South Burlington jail)." The first medical treatment Nichols received at the jail was more than five hours later, at about 7:15 p.m. of Feb. 4, when he was seen by a nurse from Prison Health Services, the lawsuit stated. "This was approximately 16 hours after first arriving at the facility with obvious withdrawal symptoms. Mr. Nichols was not seen by a doctor or referred to an outside facility," according to the lawsuit. "Rather, he was returned to his cell after apparent administration of some medication. He was not sent to a medical bed or facility." Nichols had reported to the nurse that he had vomited three times that evening and had a fever and tremors, the lawsuit stated. Fifteen-minute checks were ordered on Nichols, who had been returned to a cell. "However, these checks were either not conducted in whole or in part or were so cursory a fashion as to not constitute meaningful observation," and Nichols continued to vomit in his cell, the lawsuit stated. The next morning, at 5:54 a.m., when a correctional officer opened the cell door to bring in breakfast, Nichols was found dead, and he appeared to have been deceased for about an hour. The lawsuit stated that state Department of Corrections employees, as well as employees of Prison Health Services, violated Nichols' rights "by their deliberate indifference to Mr. Nichols' serious medical needs, as they knew of and disregarded excessive risk to Mr. Nichols though gross incompetence and grossly inadequate treatment and supervision." In June 2005, a statewide advocacy group issued a report looking into Nichols' death. The report stated that Nichols' death could have been avoided if he had received better medical care. Vermont Protection & Advocacy reported that the state Department of Corrections knew Nichols had been sick when he came into the jail, but did not properly monitor him.

August 11, 2006 Burlington Free Press
The parents of an inmate who committed suicide in his cell in 2004 have sued the state Corrections Department, alleging that prison workers knew their son was thinking of killing himself but did not act to prevent his death. Ryan Rodriguez, 24, was found hanging in his cell Oct. 19, 2004 at the Chittenden Regional Correctional Facility in South Burlington. He died at Fletcher Allen Health Care four days later after his parents had him removed from life support. Court documents show he had been in jail for 15 months awaiting trial on charges he mistreated a toddler he was caring for at a Burlington motel. Rodriguez, from New Mexico, was visiting friends in Burlington at the time of his arrest. Rodriguez's death occurred six months after an independent study examined seven inmate deaths in an 18-month stretch, including two by suicide. The study found evidence the Corrections Department had mishandled inmates with mental health issues. "We had no idea Ryan was being treated so badly," Ryan Rodriguez's mother, Carol, said during a telephone interview last week from Tucson, Ariz., where she and her husband, Joe Rodriguez, live. "When Joe got there after Ryan's suicide, one of the guards told him to seek legal help. He said, 'This has happened previously here.'" The Rodriguezes allege in their lawsuit that four times during their son's 15 months in jail awaiting trial, he told Corrections officers he was thinking of hurting or killing himself but was never referred to mental health workers for help. The case, filed in federal court in Burlington, lists as defendants the Corrections Department, three of its employees and Correctional Medical Services, the department's medical care contractor at the time.

June 23, 2005 Rutland Herald
An advocacy group claims the death of a prison inmate suffering from heroin withdrawal could have been prevented if staff had provided better medical care.  Vermont Protection & Advocacy said Friday that the Corrections Department knew Robert Nichols was sick when he arrived at jail but failed to adequately monitor his condition. "Had they taken a more active role in assuring he was receiving adequate medical care and follow- up this tragedy may have been avoided," Vermont Protection & Advocacy said in its report released Friday.  The advocacy group claims procedures were not followed for inmates experiencing drug withdrawal symptoms or undergoing detoxification.     The records show Nichols was seen by a nurse 14 hours after he lodged at the prison when Corrections policy require that inmates who are suffering from drug withdrawal be reported to medical staff for evaluation, the report said.  The report also questioned whether prison guards checked on Nichols throughout the night. The report also raises concerns about Prison Health Services, who was contracted to provide medical services in the state's prisons a week before Nichols' death.  Among the recommendations, the report advises the state to monitor the care provided by Prison Health Services and makes sure staff follow policies and are trained to recognize behaviors that are potentially life threatening. The group also recommends that the Corrections Department provide an apology and financial settlement to Nichols' family.  Nichols death follows a spate of seven inmate deaths, including two suicides, over an 18-month period that ended in late 2003. An outside investigation concluded that state actions and policies were partly to blame for the deaths of some of the seven people who have died in state custody.

Clarke County Jail, Athens, Georgia
December 6, 2004 Athens Banner Herald
The denial of medical care to a Clarke County Jail prisoner who later died from a heart attack was tantamount to the woman being "punished by death on a misdemeanor charge," according to a lawsuit filed by her husband in Clarke County Superior Court. In the lawsuit, Muscogee County resident Stephan Lamar Hubbard Jr. claims his wife, 40-year-old Laverne Rose Hubbard, died two years ago after repeatedly pleading for jail personnel to take her to the hospital because she was suffering with chest pain. In the lawsuit, however, Clarke County Sheriff Ira Edwards, Athens-Clarke County and the jail's contracted health care provider, Tennessee-based Prison Health Systems Inc., are all alleged to have been negligent in the training of jail personnel on proper emergency medical response and treatment procedures. Eight hours after arriving at the jail, the lawsuit states, Mrs. Hubbard was taken to the hospital after being found unconscious on the floor of her cell. "Mrs. Hubbard died of a heart attack, which would have been avoided if (jail personnel) had not denied Mrs. Hubbard medical care," the lawsuit states. "(Their medical) policy violated contemporary standards of decency."

Clark County Detention Center, Clark, Nevada
Just as they were due to present their case, trial attorneys for Prison Health Services and Metro Police settled a civil rights lawsuit filed by the estate of a Las Vegas man who allegedly died from the denial of his AIDS medication while in the Clark County Detention Center. The undisclosed settlement was agreed to Friday before U.S. District Judge Roger Hunt. The ACLU and Robert Langford acted as joint counsel on the case that centered on Karl Robert Kurfis' death...Langford told the jury that Dr. Harvey Hoffman, the jail's medical director, discontinued Kurfis' medication soon after he was booked into the jail, and in a deposition Kurfis testified that Hoffman told him that he didn't deserve his medication because he was a drug addict. (Las Vegas Sun, May 10, 2004)

The death of Karl Robert Kurfis was caused by the denial of his HIV medication while in the Clark County Detention Center, attorney Robert Langford said during opening arguments in a federal trial Monday.  A lawsuit originally filed on Kurfis' behalf and now listing his mother as the plaintiff seeks $10 million in punitive damages from Metro Police and Prison Health Services Inc., the medical contractor for the Clark County Detention Center.  "Karl Kurfis died because of a system that does not care about the detainees who arrive and get sick at the Clark County Detention Center," Langford said. "This trial is about a system that isn't working. A system that does not provide medical care to citizens when they are detained at the detention center."  Bruce Alverson, representing the defendants in the case, who also include former Sheriff Jerry Keller and Dr. Harvey Hoffman, the jail's medical director, countered that Kurfis did not die because of mistreatment at the jail, but because of his own unwillingness to take his medication.  "The plaintiff refused to take his HIV medication," Alverson said. "Why? Because he abused methamphetamine and it has been shown that drug abusers lack the responsibility to take care of themselves."  Kurfis, 34, died on June 3, 2002, of a strain of pneumonia that often attacks AIDS patients. Kurfis had been arrested in February 2000 on a burglary charge, and was held until September of that year. Kurfis only received his HIV medication for 14 days during the incarceration, Langford said.  (Las Vegas Sun, May 4, 2004)

The family of a French citizen who died in a videotaped struggle with Las Vegas jail guards has settled a federal lawsuit against the jail's health care provider, according to a relative and the American Civil Liberties Union. The undisclosed settlement between the family of Philippe LeMenn, 33, and Prison Health Services Inc., was the last of a series of civil lawsuits stemming from LeMenn's death in January 2001. (Reno Gazette-Journal, November 19, 2003)

A former Clark County Detention Center inmate who said the jail's decision to cut off his access to AIDS medications worsened his condition has died. Karl Robert Kurfis, 34, died June 3 at Nathan Adelson Hospice. The lawsuit names a variety of defendants. Dr. Harvey Hoffman, director of the jail's medical clinic; Prison Health Services; and EMSA Correctional Care. According to the lawsuit that was filed with the backing of the American Civil Liberties Union of Nevada, Kurfis was arrested on a burglary charge and housed at the jail in February 2000. At the time of his arrest, he was taking what is referred to as a cocktail of medications aimed at combating the disease. Kurfis' lawsuit alleges that a jail official who blamed Kurfis' drug habit for his condition cut off the medications for as long as seven months. (Las Vegas Review-Journal, July 1, 2002)

Clarke County Jail, Clark, Washington
Donna Power says officers at the Clark County Jail abused her husband, Gale, by failing to provide his medication for several days after he was arrested.  The Powers, who live on a 12-acre horse ranch in Brush Prairie, have threatened to sue. They say Gale Power, 62, suffered elevated blood pressure, headaches, shakes and difficulty walking as a result of not getting his medicine.  In recent years, several people have complained of not being allowed to bring their meds into the jail, Sheriff Garry Lucas said. The Columbian also has heard many such beefs from inmates and their family members.  Donna Power complained to Lucas on March 10.  For at least nine days while Gale Power was in custody in October and last month, she said, he wasn't allowed his doctor-prescribed blood-pressure and antidepressant medication. She said their attorney intervened, and officials provided the drugs. Officials investigated the Powers' complaint and determined that any delays were justified, said jail Chief Joe Dunegan.  Since January 2001, the county's inmate medical program has been operated by Prison Health Services, a Nashville, Tenn., managed-care company. Now serving jails in 26 states, the company is the largest provider of contracted inmate medical services in the United States, a spokesman said.  (Columbian, April 4, 2004)

Collier County Jail, Naples, Florida
February 4, 2010 Naples Daily News
Joan Laurel Graeber still cries when she thinks about the baby she and her fiancé, Elias Guzman, lost while she was an inmate in the Collier County Jail last year. The 23-year-old former Bonita Springs woman visits Elena Laurel Guzman’s grave often and works from home because socializing is still hard for her while she’s grieving. Today, it will have been a year since they lost Elena, and the couple, who have since moved to New Jersey, plan to get married soon. They’re also expecting another child, Julieta Isabella. Because of the problems Graeber had with Elena’s dead fetus remaining inside her for so long in the jail, her doctor is monitoring her closely and their baby may be delivered by C-section early, possibly this week. “Doctors have said she was in there too long and an infection had started to develop,” said Graeber’s attorney, Sharon Hanlon of Naples. Graeber said doctors don’t want to wait the full 40 weeks. “They’re just really worried and don’t want the same thing to happen again,” Graeber said. “But she’s very healthy. Because of Elena, I’ve had to go through so many tests.” Graeber, who was jailed under her married name, Joan Laurel Small, has since divorced Ken Enright Small, whom she blames for landing her in jail when she was 22 and pregnant. She’d never been in trouble with the law. “I wanted that name gone,” Graeber said, adding she filed for divorce and pushed doctors to remove “Small” from her medical records. “It’s his fault I was in this predicament.” In September 2007, Graeber landed in jail when her estranged husband was stopped for a traffic violation as he drove her to the bus station. She was leaving him to return to New Jersey. Small, who has a criminal record involving drugs and domestic violence, asked her to hold $30 of crack in her purse, according to arrest reports and Graeber, who said she told deputies it was his. But it was too late. She was jailed. Because she had no record, she qualified for pretrial release and in July 2008, she was sentenced to probation and an adjudication of guilt was withheld. Because she relied on friends for transportation, she was late returning from a class and her probation was violated when she returned late one night, after curfew, and her probation officer was waiting. On Dec. 22, 2008, eight weeks before her baby was due, she was thrown in jail. About a month later, she was sentenced to six months in jail with credit for 127 days. While behind bars, she experienced pregnancy complications. Graeber told jail medical staff she had RH negative blood and needed a RhoGAM shot to protect the baby, but she was denied the recommended shot for weeks. Then she experienced a discharge and asked to go to the emergency room. Graeber was told it was normal, to monitor it. It continued for 1½ weeks and she kept medical staff apprised. She also questioned why her baby appeared to be so small, but was told nothing was wrong. On Feb. 3, 2008, she was scheduled to go to the health department, just yards away from the jail, to have the shot and an ultrasound. She planned to schedule delivery for Feb. 19, her release date. But the doctor told her the baby was dead: The skull had collapsed because all Graeber’s amniotic fluid had leaked out. Still, jail officials refused to release her and scheduled removal of the baby for three days later. Knowing a dead fetus could lead to infection or death, Graeber’s public defender, Amy Shirvanipour, fought for her release the next day. Circuit Judge Fred Hardt signed the order at 11:57 a.m. Feb. 4, ending her sentence and granting immediate release due to her “grave condition.” But jail officials didn’t release her until 3:10 p.m. and refused to let Shirvanipour drive her to the hospital, where she’d scheduled a room. A deputy drove her. “I can’t believe they forced me to go with them,” Graeber said. She and Guzman hired Hanlon before they moved to New Jersey. The American Civil Liberties Union, which heard about her plight and others’ detailed by the Daily News, demanded records from the county jail to review its medical policies and others statewide. Other mothers told the Daily News similar stories and one described having to deliver her baby inside the jail as guards watched and joked. Two other pregnant mothers were released by judges after their attorneys detailed complications. “I anticipate filing a lawsuit against both parties in the near future,” Hanlon said of the sheriff’s office and Tennessee-based Prison Health Services, which provides medical care. Jail and sheriff’s officials and PHS have defended their care, but declined comment.

March 1, 2009 Naples News
After an inmate lost her baby and two other pregnant inmates were released due to complications, the American Civil Liberties Union of Florida is asking the Collier County jail to disclose how many inmates reported miscarriages or stillborn babies — and to detail its policies for pregnancies in jail. The request, filed under the state public records law, followed several reports in the Daily News about pregnant women’s complaints about the jail’s medical provider, Prison Health Services, including an inmate whose dead fetus was left inside her, inmates shackled to hospital beds, and one who said her cries that she was in labor were ignored so long that her baby was delivered inside the jail. Defense attorneys quoted in the Daily News articles were contacted by Maria Kayanan, ACLU of Florida’s legal director. “The ACLU of Florida is committed to ensuring pregnant women who are incarcerated get the health care they need and that their constitutional rights are not violated,” Brandon Hensler, spokesman for the ACLU of Florida, said of its check on jails and prisons in Florida. The ACLU request, sent to Collier County Sheriff Kevin Rambosk last week, also asks for the number of inmates who gave birth full-term and prematurely; grievances filed by inmates involving pregnancy and birth-related complaints about treatment or lack of treatment; how grievances were handled; how many inmates sought prenatal care; and its policies and procedures for testing pregnant inmates for gestational diabetes and sexually-transmitted diseases. In addition, the ACLU sought information that included the jail’s policies and procedures involving the care of pregnant inmates; policies involving shackling inmates during delivery; diet and nutritional guidelines, including prenatal vitamins; whether educational information is provided; and information on providers who treat pregnant inmates. Jail officials and a spokeswoman for Tennessee-based Prison Health Services have defended their medical care. Hensler said the ACLU has been gathering information from various sources throughout the state since December 2008 about prenatal care provided to pregnant inmates in jails and prisons, but added that it was too early to determine what the results will show.

February 14, 2009 Naples News
Joan Laurel Small and her boyfriend, Elias Guzman, flip through a remembrance book showing photos of the baby girl they lost a week earlier while Small was an inmate at the Collier County jail. There’s a photo of baby Elena Laurel Guzman tucked in a blanket. Another page shows her small handprints and footprints. And then there are sayings to allay grief: “This child was wanted. This child was real. This child is loved.” “The minute they showed her to me, I couldn’t stop crying,” Small said as she sat in a Naples hotel Tuesday, a day after her release from The Birth Place at North Naples Hospital. “She was so small and fragile. I held her hand. We kept her in the room with us all day.” They’re still in shock. The couple question why Prison Health Services, which provides medical services at the jail, ignored Small’s complaints that she was leaking fluid for nearly two weeks, ending in her baby dying. On Feb. 3, a doctor told her an ultrasound showed there was no amniotic fluid and the baby’s skull had collapsed. The 22-year-old Bonita Springs woman’s miscarriage is bringing to light other medical complaints against the Tennessee-based company contracted by the jail, a firm targeted in lawsuits nationwide that have ended in millions of dollars in settlements. The death of baby Elena also led to the release this past week of a 27-year-old woman who is eight weeks pregnant and developed gestational diabetes in jail. Her term was converted to house arrest on Wednesday. “I want them to make changes,” Small said of hiring lawyers to file a lawsuit. “I don’t want this to happen to other mothers.” This week, Small and Guzman, her 2-year-old son Michael, and her parents, Jennifer and Michael Graeber, will attend memorial services in New Jersey for the baby, who was cremated by Fuller Funeral Home. Meanwhile, Small’s attorneys, Sharon Hanlon and Ted Zelman of Naples, are gathering evidence for a negligence and wrongful death lawsuit. An autopsy conducted by Dr. Marta Coburn, Collier County’s chief medical examiner, showed the baby, delivered at 9 1/2 months, was perfectly formed, but seriously underweight at 1 pound, 11 ounces. Coburn said she believed the baby had been dead “a little while” and sent the baby’s heart to a cardiac specialist for analysis. Coburn told Small it was “possible” the baby could have been saved. Small said the emergency room doctor, and her obstetrician, Dr. Sanford Estes, believed she could have been saved if she’d been taken to an emergency room as soon as she complained of a heavy discharge about two weeks earlier. A forensic medical expert interviewed by the Daily News, Dr. Gary Helmbrecht of Virginia, a member of the The American College of Obstetricians and Gynecologists, called it an “appalling” case of neglect. He also said the baby probably could have been saved if Small was was taken to a hospital immediately after she began leaking amniotic fluid.

February 5, 2009 Naples News
It was a girl. Doctors removed the dead fetus from Joan Laurel Small on Thursday, a day after her release from the Collier County jail. The 22-year-old mother cradled baby “Elena Laurel.” Nurses cut a lock of the baby’s hair for a keepsake. “They cleaned her up and allowed her to hold her,” said Small’s mother, Jennifer Graeber of New Jersey. “The hospital is making her a little remembrance book. They’re putting in a lock of the baby’s hair.” Graeber said when her daughter arrived at The Birth Place at NCH North Naples Hospital, her blood-pressure had risen and she had a fever. “That’s the beginning signs of septic shock,” Graeber said of leaving a dead fetus inside a mother. Because the baby had been left in her womb more than a day, she said, Small could not deliver the baby, but had to undergo a C-section. Small, a Bonita Springs woman who is recovering at the hospital, could not be reached for comment. Her boyfriend and the baby’s father, Elias Guzman, 24, also could not be reached Thursday. Graeber said her daughter is very depressed and probably will cremate the baby after an autopsy is conducted. Small, who was housed in the jail’s medical unit, learned her baby was dead Tuesday morning as she underwent an ultrasound to determine the baby’s sex and to schedule delivery after her Feb. 19 release from jail. Small, whose 40-week due date was Feb. 21, has said she’d complained about a heavy discharge, which continued for 1 1/2 weeks, but was told it was normal and to monitor it. She told the Daily News the doctor who conducted the ultrasound Tuesday morning told her all her amniotic fluid had leaked out, the baby’s skull collapsed and it had no heartbeat. A day later, after she remained in jail with the dead fetus inside her, Small’s public defender, Amy Shirvanipour, spoke to Assistant State Attorney Rob Denny, who agreed to a stipulation to modify her sentence to time-served and immediate release. They went to Circuit Judge Fred Hardt, who immediately signed the stipulation. Three hours later, Shirvanipour was still waiting to take her to a hospital and then learned a deputy would take her. She was released at 3:10 p.m. and Shirvanipour met her at the hospital. When told of Small’s account, a nationally known medical expert said the death could have been avoided if Small had been taken to a hospital immediately after complaining of the discharge. Dr. Gary Helmbrecht, a member of the The American College of Obstetricians and Gynecologists, called it a case of medical neglect and said the symptoms indicated a pre-term rupture of membranes that required immediate hospitalization. Small said she’d also requested a RhoGAM shot, which protects her baby from her RH negative blood, but wasn’t given one until Tuesday. The shot is recommended between 28 and 30 weeks and she was jailed on her 30th week. She’d been held since Dec. 22 after she violated probation by returning home after her nightly 10 p.m. curfew. Small said she’d been attending a parenting class in Naples and couldn’t get a ride home; she has no car. Records show the probation violation involved a 2007 drug charge; an adjudication of guilt was withheld. It’s her only criminal conviction and records show it occurred when she was caught with drugs in the car of her former husband, Ken Enright Small, during a traffic stop; his record includes drug convictions. Graeber, who said her daughter plans to sue, has contacted local attorneys about the case. “I feel they were negligent in not taking her to the emergency room when she asked for help and was leaking amniotic fluid,” Graeber said, adding that she hoped a lawsuit would improve care at the jail and help her daughter move on. Chief Scott Salley, who oversees the jail, said Tennessee-based Prison Health Services, which operates the medical unit, was reviewing what occurred, but said initial reviews show medical and administrative policies were followed.

February 4, 2009 Naples Daily News
Joan Laurel Small looked forward to becoming a mother again. The 22-year-old Bonita Springs woman and her boyfriend, Elias Guzman, 24, had even picked out names: Elena Laurel or Jeremiah Nathaniel. But instead of going into labor, she landed in jail on a probation violation eight weeks before her Feb. 21 due date. While in the Collier County jail, Small said she began to experience complications — leaking amniotic fluid for 1 1/2 weeks. And instead of finding out the baby’s sex during an ultrasound Tuesday, a doctor told her the baby had died. One expert, after being told of Small’s account, said the fetal death could have been avoided. “This is neglect,” said Dr. Gary Helmbrecht of Virginia, a member of The American College of Obstetricians and Gynecologists who testifies as a fetal medical expert. “When they had the complaint of fluid leaking, she should have been brought to a hospital.” “I see this over and over again. How jails treat women, everybody,” said Helmbrecht, chairman of the American Society of Addictive Medicine’s Committee on Incarceration. “This is out of line, without regard for an innocent life. I am shocked and appalled. It’s inexcusable.” More than 24 hours later, Still remained in the jail — a dead fetus inside her. Collier County Sheriff’s officials would not explain why they didn’t take her to a hospital to deliver the fetus until 3:10 p.m. Wednesday — after her public defender sought her release. “We are prohibited from answering that question,” said Capt. Mike Hedberg, the Sheriff Office’s legal counsel. “We would run afoul of HIPAA.” Hedberg was referring to the Health Insurance Portability and Accountability Act, which prohibits release of medical information without a signed waiver from a patient. Chief Scott Salley, who oversees the jail, said Tennessee-based Prison Health Services, which operates the medical unit, is reviewing Small’s case. “Medically and administratively, everything was followed by policy,” Salley said, adding that logs show she was provided with “adequate” health care. “There was nothing out of the ordinary about her ailment.” Helmbrecht, calling it a full-term baby, disputed that, saying a dead baby in the third trimester could seriously harm Small. “This baby should have been delivered,” he said. “They’ve got enough liability on their hands. They already have a dead baby. They could have a dead mother.” Small’s public defender, Amy Shirvanipour, worked Wednesday morning to get her released. “I couldn’t sleep last night,” Shirvanipour said. “I told my husband I was heartbroken. I woke up this morning and knew I had to do something.”

September 14, 2006 Naples News
An East Naples woman suffering from what her attorneys describe as a severely painful condition in her hip has filed a lawsuit asking a federal judge to force the Collier County Sheriff’s Office to allow her to leave jail for surgery and rehabilitation. Patricia Ann Farrell, 41, of 4760 Pine St., is serving a five-month jail sentence for second-offense drunken driving. Farrell has osteoarthritis in her hip, a painful, degenerative condition caused by broken-down cartilage that results in the bones of the joint rubbing together. Farrell had scheduled a hip-replacement surgery for Aug. 23 and had received permission from jail officials before she began serving her sentence, her Naples attorney, Michael McDonnell, said. But Deputy Joseph Bastys, one of the officials who’s in charge of jail operations, refused to allow her to have the surgery. “Defendant Bastys, in response to an inquiry by plaintiff’s defense counsel’s office, advised that (Farrell) would not be allowed to attend the surgery after all because the procedure she was scheduled to undergo was elec- tive,” according to the lawsuit, filed Sept. 5 in U.S. District Court in Fort Myers. Sheriff’s Office spokeswoman Kristin Adams said Wednesday she couldn’t comment on the case because it’s pending litigation. McDonnell said the surgery isn’t elective. He pointed to an affidavit from Farrell’s doctor, Howard J. Kapp, that says the surgery is necessary and would relieve her pain. She needs several days for the surgery and recovery and about three weeks in a rehabilitation hospital afterward, McDonnell said. She has been receiving only Tylenol, not her prescription pain medicine, while in the jail, according to the lawsuit, which also names Sheriff Don Hunter and Prison Health Services Inc., a private company that administers health care to inmates.

Curran-Fromhold Prison, Pennsylvania
May 10, 2006 Philadelphia Weekly
A new federal civil rights lawsuit alleges mistreatment of a Curran-Fromhold prison inmate that culminated in a brutal rape. Attorney Rich Ostriak of the law firm Ostriak Birley filed the suit last week in U.S. District Court, demanding unspecified damages on behalf of inmate Thomas Moore, who entered the Philadelphia prison system in January 2005, awaiting trial on robbery charges, and fought with a pair of inmates over use of the phone on his first day there. Moore was transferred to restrictive confinement, otherwise known as "the hole," where his complaints about severe pain and difficulty breathing were ignored for almost three days before he was taken to the infirmary. On June 20 he was transferred to Frankford Hospital to receive coronary angioplasty and an arterial stent. The suit alleges Prison Health Services failed to deliver his required heart medications for five days after he returned to jail.

Three suicides in a month, mentally ill patients being drugged senseless, filthy treatment rooms, staffing shortages, management systems unable to cope. Those are just some of the medical problems two consultants have found within the city's prison health-care system, according to secret reports obtained by the Daily News. It is a system operated by a Tennessee conglomerate that the city pays $25 million a year. The city's contractor, Prison Health Services, a subsidiary of American Service Group Inc., freely admits it's losing money in Philadelphia, but insists the quality of care has not dipped. (Daily News, August 16, 2001)

When Kyle York, 20, showed up at the Philadelphia prisons, his life was in utter shambles. After ingesting PCP on New Year's Eve last year, he'd gone into a hallucinatory rage, shooting his mother, shooting at his father and inflicting a grazing wound to himself. Less than three months later he was dead. And Blake Berenbaum, the attorney hired by York's parents, is trying to learn what happened to the troubled young man. Was he beaten to death by prison guards? Given too many injections of sedatives by prison physicians? Was it a combination of the two? Or did he meet his fate by some unknown means? Prison spokesman Bob Eskind said York had been under "four-point restraint," meaning that four guards each took a limb. Both Eskind and Berenbaum said a PHS doctor had given York a dose of Ativan, a sedative. Berenbaum identified the physician as Benjamin Caoile. Put into an infirmary bed, York was still combative, Berenbaum said. At that point Caoile left York and the guards in the room. Berenbaum said records show that the doctor ordered the nurse to give York "another" injection of Haldol and Benadryl, both sedatives. To Berenbaum, that suggests there were earlier and unrecorded doses of those drugs. When Caoile returned about 15 minutes later, York was in an unresponsive state and emergency measures were started. York never regained consciousness and died on March 14. (Daily News, August 16, 2001)

Dane County Jail, Dane, Wisconsin
December 6, 2007 Wisconsin State Journal
Dane County 's new contract for jail health services will cost the county about $600,000 more a year than its current agreement, but county officials say mental health services should improve. The proposed $4.4 million-a-year contract with Nashville-based Correct Care Solutions must win approval from the Dane County Board tonight before it is sent to Dane County Executive Kathleen Falk for her signature. Falk 's office said the expiring contract with Prison Health Services cost about $3.8 million a year. Dane County Sup. Paul Rusk of Madison, who chairs the County Public Protection and Judiciary Committee, said the new contract includes staff for mental health services to inmates around the clock. "That was among my highest priorities -- to have more mental health care available in the jail, " Rusk said. If approved, CCS will take over Jan. 1 from Prison Health Services, which has had the contract for the last five years. According to documents provided by Falk 's office, PHS was paying about 30 full-time equivalent employees to work in the jail. The new contract calls for almost 39 staff workers, including a full-time mental health director, a part-time psychiatrist and the equivalent of almost seven social workers. Contract documents show an average hourly rate of $90 for a medical director, $92 an hour for a psychiatrist, $69 an hour for a dentist and $40 an hour for a health services administrator. Dane County Sheriff Dave Mahoney on Tuesday said CCS did not have the cheapest proposal. "But the company will deliver a level of service that is better than the current contract provider, " said Mahoney.

December 7, 2006 The Capital Times
Some Dane County Board supervisors are up in arms over a huge, unexpected cost increase in the health services contract for inmates at the Dane County Jail. At the same time, county officials are also grappling with costs that have risen by more than $2 million over the last five years to house inmates in other counties. Both issues are up for votes tonight. Prison Health Services Inc., the company contracted to provide health care, is requesting more than $500,000 above what the county has approved for next year's budget. It's a replay of what's happened in each of the four previous years during which Prison Health Services has had the jail contract, said County Board Supervisor Paul Rusk, chair of the Public Protection and Judiciary Committee. The problem is, the company doesn't come up with its estimated costs for the next year until most of the current year is over, he said. The contract has averaged between $3.2 million and $3.3 million a year since the company was awarded the contract in fall 2002. For 2007, however, PHS said it needs $3,886,155 to serve the more than 1,000 inmates housed in the three county jail facilities. That's the price the board will vote on tonight in authorizing the 2007 contract with PHS, even though Rusk's committee has not approved the contract. "I am very upset by this contract," said Supervisor Bob Salov. "We should put this contract on hold, extend the status quo for a couple of months and investigate it." Supervisor Mike Hanson said the board can argue for hours about minor line items in the budget but will be okaying this half-million dollar expense not budgeted for. "It's amazing how the board can quibble over $500 for Rhythm and Booms, and then we're expected to just rubber-stamp a $500,000 item that's clearly needed, but so late in the game," Hanson said. Sheriff Gary Hamblin said PHS's contractual cycle always comes after the county budget is approved. "Their increase is tied to the consumer price index, so they wait until the last quarter before they make their estimate on how much money they need for the next year," Hamblin said. "This year is no exception." Regardless of the overage, both Hamblin and Rusk say they are happy with the work done by PHS. "It's ten times better than what we had before," Rusk said.

August 9, 2006 Milwaukee Journal Sentinel
Attorney General Peg Lautenschlager's campaign took her opponent, Dane County Executive Kathleen Falk, to task for taking donations from those pursuing Dane County business. Lautenschlager's aides said that was inconsistent with Falk's statements that as attorney general she would not take money from people subject to enforcement actions by the state Department of Justice. Lautenschlager's campaign blasted Falk for accepting a $10,000 donation June 27 from the political action committee of Unite Here, a laundry workers union. The donation came six days after Dane County started an audit of non-union laundry contractor Superior Health Linens - a company that Unite Here has long criticized for its labor practices. Lautenschlager's campaign also criticized Falk for: • Accepting $1,500 from America Service Group Inc.'s political action committee in 2004 because its subsidiary Prison Health Services has a contract with the county. • Taking $2,500 from Government Payment Service CEO Dale Conrad last year because his firm has a county contract allowing people to pay bail with credit cards. • Receiving money from developers and others who sat on a committee that Falk convened to advise her on a land-use plan.

February 4, 2005 Capital Times
Dane County Sheriff Gary Hamblin and jailer Mike Plumer won't give a detailed report on Meng-Ju "Mark" Wu's suicide to the County Board's Public Protection and Judiciary Committee because a notice of intent to file a claim in the last jail suicide hasn't been settled. Following the suicide by inmate Tierra Hill, who hanged herself May 20 in high-security Cell F of Cell Block 727 in the City-County Building jail, Hamblin and Plumer gave a detailed report to the committee, trying to give a clearer picture of the situation before and following Hill's death.  On Sept. 20, the last day of the 120-day window for claims following an incident, a "notice of circumstances of a claim" with no specific damages attached was filed with the county by attorney Todd Winstrom of the Wisconsin Coalition for Advocacy on behalf of Hill's estate, administered by Minnie Marie Hill, Tierra's mother. According to the notice, Hill was not given the proper mental health and psychiatric care by jail staff; the Mental Health Center of Dane County; and Prison Health Services, medical services contractor for the jail.

There are no guarantees that Terrance Griffith, who died in the Dane County Jail Nov. 17, 2002, would have lived if he had gotten better treatment from jailers and the private firm that provides medical service in the jail. But there is a good deal of evidence to suggest that, had Griffith received better care, he might have lived. And there is a good deal more evidence to suggest that Griffith was neglected by the people who had a legal and moral responsibility to ensure that he received basic care.  Unable to sleep, vomiting relentlessly, the 27-year-old man complained of numbness in his legs and blurred vision. A paraplegic who was suffering from drug withdrawal, he was in deep distress.  Finally, with the last bit of strength he could muster, Griffith pounded on the steel door of his cell in the segregation unit, begging for medical care.  He was told to shut up.  He shook uncontrollably. He vomited so much that at least one guard admitted the stench from Griffith's cell was alarming.  But after a cursory check, he was left alone in a cell that stunk of vomit and decay.  Then he died. One of the most respected physicians in Dane County, Dr. Linda Farley, said after reviewing the records of Griffth's last hours, "He really was neglected."   According to Farley, health care workers at the jail ignored obvious signs that Griffith was suffering a medical emergency. "The big point is that his physical condition should have placed him in a hospital situation," said the doctor.  Yet Sheriff Gary Hamblin says "it's simply not true" that Griffith was neglected. The sheriff claims that an undiagnosed heart condition could have killed Griffith whether he was in the jail or in a hospital. On that final point, the sheriff may be right. Then again, he may be wrong. What is beyond debate, however, is that the failure to move Griffith from the jail to the hospital has left open the question of whether better treatment would have saved his life.  For Sheriff Hamblin to try to dismiss the evidence that points to failures on the part of his own staff and the out-of-state health care firm that provides care in the jail is deeply disappointing. We still think that the sheriff, who has had the endorsement of this newspaper in every election campaign that he has run, is a decent and honorable man. But he has fallen into a bad pattern here.  Sheriff Hamblin needs to rethink the unyielding stance he has taken. Instead of defending actions that seem to be indefensible, the sheriff should take steps to address the legitimate concerns that have arisen as a result of Griffith's death. These include:  Inviting independent specialists on health care in jails to review the record and propose reforms.  Examining the contract with Tennessee-based Prison Health Services with an eye to determining whether private health care services are appropriate in a public jail.  Ensuring that the upcoming county budget process focuses on the need to develop an infirmary inside, or closely associated with, the jail, which was built 10 years ago without such a facility.  The bottom line should be clear to all: Sheriff Hamblin can, and must, respond more thoughtfully and appropriately to the revelations regarding the death of Terrance Griffith.  (Madison.com, April 15, 2004)

Dauphin County Prison, Dauphin, Pennsylvania
September 20, 2005 AP
Dauphin County Prison's food service vendor agreed to reimburse the county $65,000 for overbilling during 2002 and 2003, authorities said. Officials said there was no criminal intent behind the overbilling, and Philadelphia-based Aramark Corp. did provide adequate food as called for in its contract with the prison. "I'm very pleased with the amount of money we received," District Attorney Edward M. Marsico said. "I believe it more than covers any loss the county may have had." Masrisco said much of the overbilling occurred because the company had charged a flat amount for meals instead of tracking the actual ups and downs of the jail population, and he said both prison officials and the company would keeping a more careful eye on how many meals actually are provided. Aramark officials declined to discuss what went wrong what steps they were taking to prevent a recurrence. "We fully cooperated with the inquiry and consider the situation to be resolved," company spokeswoman Sarah Jarvis said.

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

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

Dutchess County Jail, New York, New York
July 19, 2004
New York state investigators have accused Prison Health Services, the company seeking to renew its contact at the Palm Beach County Jail, of causing the death of a Schenectady, N.Y., inmate suffering from Parkinson's disease.  A scathing report issued last month by the New York Commission on Correction echoed criticism in Palm Beach County that Prison Health Services has withheld care to inmates for added profit. The company is one of five bidding on the county contract.  The New York report details what led to inmate Brian Tetrault's brain basically shutting down after he was denied his prescribed medication for advanced Parkinson's disease by a Prison Health Services medical director at the Schenectady County Jail.  In October 2002, the commission -- a three-member body that evaluates, investigates and oversees correctional facilities in New York -- issued a report on the death of Victoria Smith, who died of cardiac arrest at the Dutchess County Jail in southeast New York after complaining multiple times of chest pains.  In the cases of both Tetrault and Smith, Prison Health Services' main reaction to the commission's inquiries was to get its lawyers involved, Lamy wrote to the company: "You and your colleagues are exclusively focused on protecting the business interests of PHS."  The New York deaths evoke similar issues in Palm Beach County. Both inmates were denied medication. Prison Health Services staff concluded Tetrault was faking illness and labeled Smith a drug abuser. Company officials and doctors have cited malingering inmates and drug abuse as reasons for denying medication.  (Palm Beach Post)

El Paso County Jail, El Paso, Texas
May 24, 2006 KTSM
Sheriff deputies tell us 47-year old Mario Lopez was arrested today, charged with violating the civil rights of a inmate and having improper sexual activity with a person in custody. The Sheriff's Office say the investigation started after an inmate complained about Lopez. He is now in the County Jail under a $50,000 bond. The Sheriff's Office says Lopez is an employee of Prison Health Services, which is under a contract with El Paso County to provide medical services to prisoners at the jail.

Erie County Jail, PA
July 19, 2005 Red Nova
Erie County must soon come up with another $311,877 to pay 2004 medical expenses at the Erie County Prison.  Warden James Veshecco said medical costs have been rising partly because the number of inmates has been increasing. The average population was 705 in 2004, compared with 676 in 2003.  The $311,877 will be on top of the regular premium of $1.3 million already paid in 2004, he said.  Veshecco said the prison is receiving more inmates who need mental health treatment and related prescriptions. There are also more women, some of whom are pregnant.  The county has contracted with Prison Health Services of Brentwood, Tenn., since 1999 to provide all medical care and pharmaceutical costs at the prison.  Because of the rising costs, the county in recent years agreed to a contract that set limits on the amount that the insurance company would pay for inmates who go to hospitals and other facilities and for pharmaceutical products. The prison must pay any amount above that.  In 2003, the premium was $1.2 million and the county had to pay an additional $60,000 for exceeding the cap.  In 2004, the prison once again exceeded the caps and had to pay $207,365 more for off-site visits and $104,512 more for pharmaceutical products, totaling $311,877.  The premium to PHS has been increased to nearly $1.5 million for 2005, exclusive of the money owed if the caps are exceeded.

Escambia County Jail, Pensacola, Florida
January 14, 2008 Pensacola News-Journal
The family of a man who died strapped to a jailhouse restraint chair reached a settlement with six jail employees. Estelle Smith, the wife of Robert Boggon, reached an agreement last week during a private mediation proceeding, according to court papers. U.S. Judge Casey Rodgers signed an order Friday giving all parties named in the lawsuit 60 days to agree on the settlement terms, which were not made public. Boggon, 65, a long-distance truck driver from Lincoln Park, was placed in Escambia County Jail in August 2005 after a disturbance at a Dollar Tree store in Ensley. Family members said he suffered a "mental episode" and began acting strangely, knocking over boxes in the store. Boggon was found dead the night of Aug. 29, 2005, strapped to a restraint chair in the jail's infirmary. The lawsuit, filed in October 2005 by Smith, originally claimed that the Escambia County Sheriff's Office, Sheriff Ron McNesby, and other Sheriff's Office and jail employees violated Boggon's civil rights alleging that he died from "malicious" and "sadistic" use of a Taser stun gun. Testimony at an two-day inquest in April 2006 revealed that Boggon was shot with a Taser on Aug. 25 and again on Aug. 26 , testimony that was at odds with an allegation contained in the civil lawsuit. The final settlement names detention deputy Scott Driver, Lt. Sherrie Day, Sgt. Brett Whitlock, Cpl. Roger Lastinger, and Prison Health Services employees Trudy Burden, Dana Helms and Lisa Whitlock as defendants. McNesby and others were later dismissed from the lawsuit. Escambia County Judge David Ackerman cleared all officers of any criminal wrongdoing after the inquest. All but Helms continue to work at the jail. Prison Health Services no longer is the medical provider for the jail, but Burden and Whitlock continue work for Armor Correctional Health Services, sheriff's attorney Darlene Dickey said. The department�s liability insurance through the Florida Sheriffs Association would pay for any monetary award to Smith, Dickey said. Dr. Andi Minyard, the local medical examiner, said Boggon died from heart disease and paranoid schizophrenia. But Minyard listed confinement to a restraint chair and injections of Haloperidol, a tranquilizer, as contributory causes. Because Boggon's experience in the jail "exacerbated" the natural diseases that ultimately led to his death, Minyard ruled the death a homicide. But she stopped short of saying that it involved any criminal intent or activity.

Falkenburg Road Jail, Florida
August 15, 2007 Tampa Tribune
A former Hillsborough County jail inmate who had cervical cancer filed a federal lawsuit Monday saying the sheriff's former medical provider allowed her to bleed and suffer for weeks before sending her to a hospital. Karen Sue Ramsey says her civil rights were violated by Prison Health Services, the Brentwood, Tenn.-based company that provided health care at the jail at the time, and Sheriff David Gee in the capacity of his office. Ramsey, now 48, was transferred to Hillsborough from Orange County on Nov. 1, 2004, on a prostitution charge, records show. Her petition gives the following account: When booked into jail, Ramsey gave a history of cervical cancer and vaginal bleeding. A PHS nurse examined her Nov. 5, 2004, and noted the bleeding. About three weeks later, a PHS obstetrician found a large mass extending from Ramsey's cervix. His plan was to send her to a clinic for a biopsy, but she was returned to her cell for five more days. The bleeding increased dramatically, and when she complained to a detention deputy, he refused to summon medical help, the lawsuit said. On Nov. 29, 2004, PHS sent her to a clinic, and she was transferred to Tampa General Hospital. Doctors there found a 2-inch mass of dying tissue. She required multiple blood transfusions and underwent a hysterectomy. When Ramsey was returned to jail, a doctor's post-operative plan for cervical cancer treatment was not carried out, her lawsuit said. She was transferred to prison a few weeks later, having had no followup appointments. Ramsey's one-year prison sentence stemmed from a third prostitution conviction, state records show. She was released Aug. 10, 2005. Hillsborough County Sheriff's Office spokeswoman Debbie Carter referred calls to the sheriff's legal counsel, Ellen Leonard, who did not immediately return a phone call Tuesday afternoon. Messages for Ramsey's attorney, Mike Trentalange, and PHS also were not immediately returned Tuesday afternoon. This year, Trentalange represented another former Hillsborough County inmate, Kimberly Grey, who received a $1.25 million settlement from PHS and a $350,000 settlement from the sheriff's office. Grey gave birth in an infirmary cell March 4, 2004. Records show she complained for 12 hours of labor pains, but that PHS staff did not send her to a hospital. Nearly three months premature, the baby died from an infection in his lungs, according to an autopsy. PHS served as Hillsborough's inmate medical provider until October 2005.

April 19, 2007 AP
An inmate whose baby died after being born over a jail cell toilet has received a $1.25 million settlement from the Tennessee company that provided health care at the facility. Kimberly Grey sued over the death, saying she had complained of labor pains for nearly 12 hours. But Prison Health Services, based in Brentwood, Tenn., settled with her Wednesday, after jurors heard two weeks of testimony and began deliberations. "We had discussions of a settlement throughout the trial," Grey's attorney, Mike Trentalange, said. "We were finally able to do that with the imminent return of the jury." Prison Health Services had no comment on why it chose to settle the case, company spokeswoman Susan Morgenstern said. The company no longer serves as Hillsborough County's inmate medical provider. The Hillsborough sheriff's office settled its portion of the case in November for $350,000. In March 2004, nurses were giving Grey a pelvic exam when the boy was born over the toilet. He died in an ambulance on the way to Tampa General Hospital. Grey's lawsuit claimed officials displayed a deadly indifference to the newborn's medical distress.

March 10, 2007 Tampa Tribune
A former Hillsborough County jail inmate whose baby died after being born over a jail cell toilet in 2004 received a $350,000 settlement last fall, according to records released Friday. Kimberly Grey kept $104,000 of the money she received Nov. 27 in a check signed by Sheriff David Gee. The remainder was paid to her attorney, Mike Trentalange, and covered the expenses of expert witnesses, case consultants and documents, Trentalange said. The settlement removed the Hillsborough County Sheriff's Office as a defendant in an ongoing federal civil rights lawsuit Grey filed in December 2004. She received the check shortly after being released from state prison in November, having served nearly two years on a prostitution conviction. On Friday, Chief Deputy Jose Docobo said the sheriff's office decided to pay what it considered a reasonable settlement to Grey rather than face continued litigation costs. Attorney fees, payments to expert witnesses and document costs already had exceeded $100,000, he said. The original court complaint named the defendants as Prison Health Services, the Brentwood, Tenn.-based company that provided health care at the jail at the time; the sheriff's office and the jail's administrator; and a PHS-employed doctor and two nurses. As of Friday, only PHS and one nurse remained as defendants, and the case is set for trial April 2. Armor Correctional Medical Services became the jail's health care provider in October 2005. Docobo said the settlement does not mean the sheriff's office is admitting any negligence.

March 18, 2006 Tampa Tribune
Clint Joshua Grey barely whimpered when he was born two years ago over a jail cell toilet, but his death sounded an alarm about the care of pregnant inmates in Hillsborough County. His mother, in jail on a drug charge, was nearly seven months pregnant when she gave birth on March 5, 2004. Kimberly Grey says her son died because a medical group was more concerned with saving money than lives. She has pending lawsuits against the jail's former care provider, Prison Health Services, its staff and members of the Hillsborough County Sheriff's Office. Her attorney, Tampa lawyer Mike Trentalange, said the death was more than a tragic set of circumstances - it was a crime. That's why he is asking Hillsborough State Attorney Mark Ober to consider filing felony charges against PHS, which is based in Tennessee, and a member of the staff at Falkenburg Road Jail. Last week, Trentalange mailed Ober a letter outlining why the lack of care shown by PHS constituted felony child neglect, he said. "States' attorneys are typically reluctant to charge corporate entities with a crime," Trentalange said. "I think that's just so terribly wrong. Grey filed her first lawsuit in December 2004 in federal court, claiming a violation of her civil rights. That case is pending. She filed another last month in state court claiming malpractice. Not long after the baby's death, the sheriff's office announced PHS had fired a nurse practitioner for not sending Grey to a hospital sooner. That nurse practitioner, Debbie Devine, of Tampa, said she wasn't on duty during Grey's labor and delivery, however. She filed her own lawsuit against PHS in May. "I was terminated because I was [PHS'] scapegoat," Devine wrote in an affidavit. The company "blamed me for the death of an inmate's baby who died on a night that I was not working or on-call and published information to the press and/or third parties that wrongfully implicated me as the cause of the baby's death." Devine's affidavits give this account of the events leading up to the baby's death: Over 11 hours, Devine responded to several phone pages from the jail's on-duty nurses who were treating Grey. The first nurse told Devine it was her first time there and that she was alone with 35 female patients, most of whom were pregnant. Devine advised the day nurse to perform a litany of tests on Grey for her complaints, but she later learned some were never performed. When a night nurse called her shortly before 2 a.m., Grey had complained of bleeding. Devine told the nurse that if the patient was bleeding, she should be hospitalized immediately. Two hours later, Grey was still in the infirmary cell when she gave birth. Devine said she was not officially on call, that she told the nurses that, and that she was never paid for taking any off-duty calls. She previously told her supervisors about the off-duty problem and offered to take calls if paid, but Devine said she was told that would not be necessary. Devine said PHS suspended her but never questioned her before firing her in May. The two other nurses kept their jobs, but the sheriff's office denied them access to the jail.

October 28, 2005 St. Petersburg Times
Another former inmate at the Hillsborough County jail has sued Prison Health Services, the company once in charge of inmate medical care, accusing the firm of taunting him instead of treating his injured hand. Sean Norbury, now 21, had a severe hand fracture when he was jailed Oct. 3, 2003, according to the lawsuit filed Wednesday in Hillsborough County Circuit Court. When he arrived at the jail, he pleaded for treatment, the suit says. But nurses taunted him, saying he shouldn't have hit anyone if his hand hurt, the suit says. The next day, the jail's nurses and staff saw his hand was bruised and swollen and that he could not make a fist, the suit says. Norbury complained of pain and asked again for treatment but was ignored, the suit says. On Oct. 8, 2003, an X-ray was ordered but never provided, the suit says. Norbury never saw a doctor at the jail. Two days later he was released on bail; his mother took him to St. Joseph's Hospital, which noted his fracture, Norbury said. The negligence of the jail's medical staff caused him undue pain and suffering and ongoing medical problems, the suit says.

October 26, 2005 St. Petersburg Times
A former inmate at the Hillsborough County jail has sued the company once responsible for inmate medical care, alleging that the company's staff blocked her from treatment and as a result she went blind. Aretha Jackson accused Prison Health Services Inc. of cruel and unusual punishment and failing to provide necessary medical care, according to the suit filed Tuesday in Hillsborough Circuit Court. Jackson was an inmate at the county jail from Aug. 16, 2004, until June 1, the suit says. Court records show she had been charged with possession of cocaine and drug paraphernalia. She was an HIV patient with vision deterioration linked to the virus, the suit says. She was evaluated by Dr. Todd Berger, a retinal specialist, on Oct. 13, 2004, who noted, among other complaints, one week with no vision in the right eye, the suit says. He ordered lab work and scheduled another appointment for two days later, the suit says. Instead, the jail "and/or the employees or agents of PHS" ignored the follow-up plan, the suit alleges. The jail's nurses and medical staff were untrained and unfamiliar "or indifferent" to the proper care and management of HIV patients with serious vision problems, the suit says, and did not have proper HIV treatment policies and procedures. PHS refused or failed to allow Jackson follow-up services by Berger or another qualified doctor or otherwise failed to follow Berger's medical orders, the suit alleges, and as a result, Jackson lost her eyesight. Late last year, Kimberly Grey filed a lawsuit that is still pending saying she pleaded for medical help for 12 hours before giving birth to a baby boy in March 2004, over an infirmary toilet. Grey had complications for five days, she said. Jail officials did not call 911 until the baby arrived. The baby later died. A yearlong examination of Prison Health Services by the New York Times published this year revealed repeated instances of flawed and sometimes fatal medical care in other parts of the country. But PHS is no longer doing business at the jail infirmaries. The sheriff's office awarded the contract last month to Armor Correctional Health Services Inc.

October 14, 2005 Tampa Tribune
A new company took over medical care this month for Hillsborough County's jail inmates after Sheriff David Gee solicited new bids rather than renew a contract with the previous provider. Armor Correctional Health Services Inc. assumed control of the jail's two 50-bed infirmaries on Oct. 1, replacing Prison Health Services. The contract will cost taxpayers $19,888,000 in its first 12 months and total more than $60 million over the course of the three-year agreement, Col. David Parrish said. PHS served Hillsborough jails for for the last three years and for seven years during the 1980s. The company came under fire and was the target of a federal lawsuit by former Hillsborough inmate Kimberly Grey earlier this year after she gave birth in a jail toilet after complaining for hours she felt ill. Her infant son died en route to the hospital. Parrish said one of the motivating factors that prompted the sheriff to open up the contract to bidding rather than to renew with PHS was the bad publicity that the jail received because of the Grey case. Armor is based in Broward County, where it holds a five- year contract with that county's five-jail system. Armor's chief executive officer, Doyle Moore, founded PHS in 1978 and stayed with the firm in various leadership positions until 2004. Four other key officers also worked for PHS.

September 3, 2005 Tampa Tribune
Describing her attorney's request for documents as a ``fishing expedition,'' a federal judge on Friday denied a former Hillsborough County jail inmate's motion to compel the jail's medical provider to compile and submit a voluminous set of documents. Kimberly Grey gave birth over a Falkenburg Road Jail toilet March 4, 2004, after complaining for 12 hours to medical and jail staff that she was in pain, records show. An ambulance took them to a hospital, but the infant died en route. Grey's medical care in the jail was provided by Prison Health Services Inc., based in Brentwood, Tenn. Tampa lawyer Michael Trentalange filed a lawsuit in December on behalf of Grey and her child, Clint Joshua Grey. The defendants include Prison Health Services, the sheriff and the jail's medical director. The lawsuit contends Grey's complaints were ignored and the care she received was grossly inadequate. Trentalange asked the court to order Prison Health Services to submit staff training records, documents on the company's standard of patient care for 380 facilities in 38 states, and inmate complaints and court judgments against the company. Trentalange accused Prison Health Services of a widespread indifference to patients' needs and said the records might prove it. ``This is not a one-time deal or a two- time deal,'' he said. ``This is a pattern.''

December 10, 2004 Tampa Tribune
A former inmate whose baby died after being born over a toilet in Falkenburg Road Jail filed a federal lawsuit Thursday against her caregivers and sheriff's officials. Mike Trentalange, a Tampa lawyer representing 35-year- old Kimberly Grey, filed the lawsuit in U.S. District Court in Tampa on behalf of Grey and her deceased newborn, Clint Joshua Grey. The complaint names Prison Health Services, the Brentwood, Tenn.-based company that provides health care at the jail; Sheriff Cal Henderson; sheriff's Col. David Parrish, who oversees the jail system; and a PHS-employed doctor and two nurses as defendants. The lawsuit alleges all parties ``demonstrated deliberate indifference to [Grey's] serious medical needs and to the serious medical needs of her son.'' It seeks compensatory and punitive damages. Medical records obtained by The Tampa Tribune and WFLA, News Channel 8, showed that beginning March 4, Grey complained for nearly 12 hours about labor pains and repeatedly asked to be taken to a hospital. She was leaking fluid and running a fever, but jail nurses gave her Tylenol and refused to call an ambulance. Nurses were performing the first pelvic exam on Grey early in the morning March 5 when the baby was born over a toilet. An ambulance was called, and the baby was taken to Tampa General Hospital. He died before arriving. A medical examiner determined the baby died of a lung infection. In October, a former Lee County jail inmate sued county officials and jail health care providers there, alleging her fetus died because her medical needs were ignored. Prison Health Services Inc. was named as a defendant in that lawsuit also. Company officials could not be reached for comment Thursday.

A sheriff's deputy assigned to guard the infirmary at the Falkenburg Road Jail was scolded for calling 911 after an inmate gave birth while squatting over a jail toilet, records released Wednesday show.   An investigation into the birth of inmate Kimberly Grey's baby shows nearly two dozen witnesses in the jail's infirmary backed her claim that she complained she was in labor and needed to get to a hospital for 12 hours before she gave birth. The baby died later on the way to Tampa General Hospital.  Sheriff's Col. David Parrish, who oversees the county's jail system, declined to comment on the documents in the report or the department's investigation. He said the sheriff's office will release a synopsis of its three-pronged investigation Friday and will comment then. He wouldn't say whether any disciplinary action will be taken against medical officials on duty the night Grey, 34, gave birth.  Mark Cox, executive assistant to Hillsborough County State Attorney Mark Ober, said Ober's office decided not to file criminal charges after reviewing evidence from the county medical examiner's office and the sheriff's office report.  "Our position is that there wasn't enough evidence to support criminal charges,'' Cox said.  Documents released Wednesday as part of a joint investigation by The Tampa Tribune and WFLA, News Channel 8, show that sheriff's Deputy Holly Deluca called the jail's command center and asked staff there to call an ambulance after Grey gave birth to a premature baby boy at 2:45 a.m. March 5.  Officials at the command center told Deluca that an infirmary nurse would have to call 911, and when the nurses on duty didn't, Deluca made the call herself, records show. Witnesses reported hearing Deluca's supervisor tell her ``Don't ever do that again'' after she called 911, documents show.  (Tampa Tribune, April 8, 2004)

Florida Civil Commitment Center, Arcadia, Florida
June 2, 2006 Sun-Herald
When its contract expires June 30, the contractor operating a state treatment center for sexually violent predators near Arcadia will be shown the door. The Florida Department of Children and Families, which manages the Florida Civil Commitment Center, will not retain Liberty Behavioral Health to run the facility until a new contractor can be hired, said Tim Bottcher, spokesman for the Florida Department of Children and Families. The process to award a new contract and build a new facility could take six months or more. To run the facility in the interim, the state will assign perhaps dozens of Department of Corrections officers from prisons in surrounding counties to provide security. And a temporary employee service will provide other workers, Bottcher indicated. Technically, Liberty is still in the running for the new contract. But the DCF's inspector general in a past investigation cited numerous incidents of violent assaults, drug abuse, alcohol bootlegging and inappropriate behavior involving both residents and staffers. "I don't think it's any secret we haven't been happy with Liberty's performance as far as the current contract is concerned," Bottcher said. The change in center management has Liberty's local employees worried about both their jobs and the treatment of the residents, said John Brosnihan, a security supervisor for Liberty. Liberty was the only bidder at the time the center was started. A competing firm had declined to bid because of the facility proposed for the center -- in a defunct state prison, an officer of the firm, Geo Group, said in a past interview. In 2005, the Legislature passed a bill that authorized the DCF to hire a contractor to both build and operate a new 600-bed center. The DCF's bidding process was derailed, however, after Liberty challenged the bid specifications for alleged bid-rigging. That litigation was recently resolved and now the bidding selection process will get under way, Bottcher said. Liberty and the Geo Group have submitted bids. Bottcher said a site for the new facility has not been identified, but it will likely be located within the Arcadia area. Prison Health Services will be hired to provide health care and clinical treatment until the contract is awarded. The DCF is still "in talks" with a temporary employment service to fill other roles in the interim, Bottcher said.

Florida Department of Corrections, Tallahassee, Florida
November 21, 2006 Tallahassee Democrat
After making a dramatic decision not to award a $707 million contract for prison health care, the Florida Department of Corrections spent its first day Monday managing the job itself. ''We are very confident that we can do this,'' said DOC Secretary Jim McDonough. ''I have been tracking it hour by hour and it appears that the transition is going very well.'' McDonough stunned the private prison-health-care industry late last week when he announced that the department was rejecting Tennessee-based Prison Health Services' latest bid to continue the work. The company's existing contract expired at just after midnight on Sunday. PHS has a troubled history with the department, one that began earlier this year when it announced it was pulling out of a 10-year contract it originally signed in 2005 because its $645 million bid did not anticipate the cost of hospitalizing sick inmates. The department recently announced that it was fining PHS $696,000 for failing to meet a series of benchmarks, including keeping legible medical records and missing deadlines to assign caseworkers and perform medical evaluations. Regardless, PHS was the department's choice again last month, after it was allowed to compete in a new round of bidding. That changed again after Pennsylvania-based rival Wexford Health Sources Inc. challenged the PHS award, saying that its lowest bid of $689 million should have made it the winner. McDonough said Monday that a new evaluation by outside experts showed that none of the contractors had the financial qualifications to complete the contract. ''Therefore, there were no responsive and responsible bidders,'' McDonough said. PHS spokesman John Van Mol said the company would have no comment. Wexford executives could not be reached for comment. As recently as this month, McDonough praised the effort to hand over the job of treating 16,000 inmates in South Florida to private industry, describing it as a $20 million cost saver for taxpayers. But at the same time, McDonough ordered his contract managers to begin an intensive review process to see if the department could perform the work itself. McDonough said the solution they came up with is a ''hybrid'' form of privatization that involves issuing 145 smaller contracts and purchasing orders. The department does not have to hire additional workers to get the job done, McDonough said. McDonough estimates that there will be a $12 million additional cost to the department in the first year, but that the department will save money in the long run. ''I have, in effect, cut out the middle man,'' McDonough said. ''I think we have come up with a very cost-effective way of doing it.'' Sen. Dave Aronberg, D-Greenacres, has been a critic of the privatization effort since it began under McDonough's predecessor. Aronberg pressured McDonough to impose the fines on PHS, and says he will be watching the department's performance under the new scheme. ''This is too important an issue to have a new policy in place every two weeks,'' Aronberg said.''We are very confident that we can do this. ..... it appears that the transition is going very well.''

November 17, 2006 AP
The Department of Corrections announced Friday that it will divide health services for nearly 18,000 inmates in South Florida prisons among many providers instead of bidding one comprehensive, multimillion-dollar contract. The agency has issued about 115 purchase orders and more than 30 non-bid contracts for its new health plan that goes into effect midnight Monday. A little-used state law provides an exception to bidding requirements for medical services, but two price quotes still were obtained for each contract, said department spokeswoman Gretl Plessinger. The decision was made after a review by independent auditors caught an error in the state's financial analysis after a second round of bidding for a comprehensive contract last month. The revised analysis indicated all bidders failed to met financial responsibility requirements. In October the agency declared its intent to award a $703 million, 10-year contract to Prison Health Services of Brentwood, Tenn., as the only "responsible and responsive bidder" based on the erroneous financial calculations. The contract award had been subject to negotiating final terms and resolving another bidder's protest. The rebidding had been ordered in response to Prison Health Services' decision to pull out of its current $645 million contract, signed earlier this year, claiming it was losing money on the deal. "DOC has a legal and moral obligation to provide appropriate health care, while ensuring the most efficient use of taxpayer money," Corrections Secretary James McDonough said in a statement. "The department has taken all necessary steps to ensure those obligations are met." A spokeswoman for Prison Health Services' parent, American Service Group Inc., declined comment beyond a news release that simply announced the state's decision and that the company will not provide service past Monday. McDonough last month also announced he intended to levy fines against the company for shortcomings under the original contract. Wexford Health Resources of Pittsburgh, Pa., had challenged the department's intent to award the rebid contract to Prison Health Services. Wexford submitted the low bid of $689 million but the department deemed the company was not financially qualified. Wexford did not immediately respond to a telephone message seeking comment. McDonough said he is confident inmates and taxpayers will benefit from the new plan. "This private-public hybrid is a groundbreaking approach to privatization efforts that have brought great savings to Florida taxpayers," he said.

November 7, 2006 Tallahassee Democrat
A Pennsylvania-based prison health-care firm filed a formal protest Monday, disputing the Department of Corrections decision to award a $707 million, 10-year contract to a rival company with a troubled history. Wexford Health Sources Inc. filed a 10-page protest late in the day, saying that its lowest bid of $689 million should have given it the advantage and that the department made mistakes in calculating its financial strength. A Wexford executive questioned why the department awarded the bid to Tennessee-based Prison Health Services Inc., even though the department said Monday that it is fining PHS $696,000 for problems with its past work. ''The question has to come to mind, how can PHS be determined to be a responsible bidder?'' Wexford President and CEO Mark Hale said. Department spokeswoman Gretl Plessinger said the department received the protest at the end of the business day and would not be able to comment until after it had time to study the document. PHS initially won the job in 2005 with a $645 million bid, tens of millions of dollars lower than Wexford. But PHS abruptly announced it was pulling out last year. PHS said it dramatically underestimated the cost of hospitalizing sick inmates and was losing too much money. However, PHS was invited to compete again when the department put out a new bid. ''Yes, $696,000 is a lot of money, but this is a $78 million-a-year contract and in terms of the overall contract, it is less than 1 percent,'' Plessinger said.

October 31, 2006 Palm Beach Post
Floridians who thought Gov. Bush was on to something when he touted privatization as the cure-all for government's ills know better now after seven years of disappointing results. When it comes to disappointment, no private contractor has been worse than Prison Health Services. The Department of Corrections awarded the company a contract to provide health care in 13 South Florida facilities late last year. Then-DOC Secretary James Crosby ignored warnings about the contractor's track record. PHS faces dozens of lawsuits across the nation over allegations of shoddy care. The Palm Beach County Sheriff's Office dropped PHS in 2004 after a series of suits and complaints from inmates; the county health department also blamed the company for allowing staph infections to spread through the jail. Crosby discounted the complaints and insisted that PHS was the right choice. "As a result of this contract," he said, "it is estimated that Florida's taxpayers will save nearly $3 million between now and June 2007." When a company with a record of poor performance makes a deal that sounds too good to be true, the odds are overwhelming that it is. Within months, PHS was complaining that it was losing money and threatening to pull out of the contract. This month, the state accepted a revised bid and added another $58 million to the company's 10-year, $645 million deal. Crosby didn't have to answer for the mess because he was forced out of office in July after admitting taking thousands of dollars in kickbacks from another prison contractor. Jim McDonough, Crosby's successor, wrote a tough-sounding letter to PHS: "Having been disappointed by you in the past, I will be doubly vigilant to both your performance and your attitude. You can expect that the next time, it will be me, not you, who moves abruptly to exercise the withdrawal option." Sens. Dave Aronberg, D-Greenacres, and Walter "Skip" Campbell, D-Tamarac, have asked Mr. McDonough to explain why the state shouldn't fine PHS for its dishonest behavior. Clearly, the company low-balled its bid to get the contract and, once the state was hooked, shook it down for more money. Either of two other bidders last year - one higher, and one lower than PHS - would have been preferable to the unfaithful partner DOC chose. Mr. McDonough should back up his tough talk with tough sanctions against PHS. Florida taxpayers know what to think the next time they hear about bargains from the private sector.

October 24, 2006 Tallahassee Democrat
With a stern warning and a promise to levy stiff fines for past failures, Florida's top prison boss said Monday he would allow a controversial Tennessee company to continue providing health care to 17,000 South Florida inmates. The Department of Corrections announced that Prison Health Services is the only one of three competing companies that submitted a qualifying bid for the nearly $800 million, 10-year health-care-services contract. However, in a letter to PHS executives, DOC Secretary Jim McDonough noted the company's abrupt pullout from an original contract it signed last year. Company officials said they were losing money on their $645 million bid because they dramatically underestimated the cost of hospitalizing sick inmates. ''Having been disappointed by you in the past, I will be doubly vigilant in regard to both your performance and your attitude providing proper health services to the men and women under my care,'' McDonough wrote. ''You can expect that the next time, it will be me, not you, who moves abruptly to exercise the withdrawal option.'' McDonough also warned that the company faces ''significant fines'' for ''shortcomings of services provided by you under the original contract." McDonough has been under pressure from Democratic legislators who sit on committees that oversee prison spending. Sen. Dave Aronberg of Greenacres and Walter ''Skip'' Campbell of Tamarac recently sent letters to McDonough demanding to know why the department has been slow to fine PHS for poor performance. In a letter McDonough issued Monday to the lawmakers, he said he did not want to reveal the amount of fines PHS faces to prevent companies from changing their bids. ''To have issued such a letter earlier could have impacted the current (bidding) process, resulting in adjusted bids that might have raised the bottom line to the taxpayer,'' McDonough said. Aronberg said Monday that he did not object to allowing PHS to compete again for the contract. But he didn't expect PHS to win the latest competition. ''I'm surprised because of the way the last contract was handled and terminated and because they were not the lowest bidder. My concern has always been making sure that the state fulfilled its end of the contract by imposing the fines,'' Aronberg said.

September 29, 2006 Tallahassee Democrat
Two South Florida Democratic lawmakers turned up the heat this afternoon on the Florida Department of Corrections, demanding to know why it hasn't imposed fines on a controversial prison health contractor. Sen. Dave Aronberg of Greenacres and Sen. Walter ''Skip'' Campbell of Tamarac, who is running for attorney general, released a letter they sent Wednesday to DOC Secretary Jim McDonough demanding to know why Prison Health Services has not faced fines. ''This information is critical to better understanding whether this privatization of prison health services is truly serving the best interest of taxpayers,'' the letter states. Tennessee-based PHS underbid its closest competitor eight months ago by tens of millions of dollars for a 10-year, nearly $800 million contract to treat 17,000 prisoners in 13 institutions in South Florida. PHS withdrew from the contract earlier this month after company officials said they dramatically underestimated the cost of treating prisoners who needed to be hospitalized. The company was invited to compete for a new contract that will be awarded this fall. McDonough issued a statement this afternoon defending the privatization effort. He said privatizing prison health care has saved the state $23 million since 2001 in South Florida alone. A review of PHS performance before it withdrew is still under way, McDonough said. ''No liquidated damages have been assessed of PHS at this time, but we remain in the review process, which means all matters are still on the table,'' McDonough said. PHS spokeswoman Martha Harbin said the company expects to face at least some fines, although she could not say how much. She described it as the cost of doing business with the state on such a large scale. ''We welcome these reviews as part of quality assurance,'' she said. ''At this point, I would say that the senators are probably just a little premature. There is a process for reviewing performance, and that process is not yet complete.''

September 19, 2006 Gainesville Sun
Back in January, the Department of Corrections thought it had health care for a quarter of all state inmates taken care of for a decade. Prison officials signed a nearly $69 million-a-year contract with Prison Health Services to provide health care for inmates in 13 South Florida prisons for the next 10 years. Instead of 10 years, however, the contract will end up lasting just over 10 months. Officials at Prison Health Services, owned by the publicly traded American Service Group, said they based their winning low bid for the contract on faulty numbers from the state. They also blamed rising health care costs for needing to bail out of a contract that they said "underperformed financially." Before ending the contract, the company tried to negotiate with Department of Corrections Secretary James McDonough, a tact that had been successful for the firm in other places, including: June 2002 - Philadelphia and Maine contracts were renegotiated after Prison Health claimed it was losing money. October 2003 - Kansas contract with Prison Health was transferred to another company after a failed renegotiation attempt. Winter 2006 - Wyoming contract renegotiated after Prison Health claimed it lost $600,000 in a single fiscal quarter. Summer 2006 - Renegotiations get under way in Vermont after Prison Health announced it had lost $800,000 in a previous fiscal quarter. Also during the summer, Prison Health tried to renegotiate the South Florida contract. "They (Prison Health) came to my office and asked if there was something I could do for them," McDonough said. "The answer was a polite no - there was nothing I would be doing for them." Among requests McDonough could recall Prison Health Services making during the meeting was to have medically expensive inmates transferred out of prisons in Region IV (South Florida) and into other regions where Prison Health Services was not contracted to provide medical care. Following the meeting, prison officials received the contract termination letter from Prison Health.

September 12, 2006 Ft Lauderdale Sun-Sentinel
Only eight months after launching one of Florida's largest privatization projects, a Tennessee-based company has backed out of a $792 million deal to provide health care to 14,000 inmates in South Florida's state prisons over 10 years. Prison Health Services announced that, effective Nov. 20, it will end its state contract, which "has underperformed financially" for the firm, according to a company spokesman. The company said higher than anticipated use of hospitals located off prison grounds was the main reason it was ending the agreement. PHS won the contract last year despite protests from legislators and competitors who said the company's bid was too low to provide quality service. Publicly traded PHS was the low bidder among three experienced national firms that sought to do the work. PHS undercut the next-lowest bidder, Pittsburgh-based Wexford Health Sources, by more than $80 million. Despite abandoning its deal with the state, the company intends to rebid to continue the work, possibly at a more lucrative price for the firm, according to Martha Harbin, a spokeswoman in Tallahassee for PHS. State Sen. Dave Aronberg, D-Greenacres, grilled state officials before the contract was under way about whether PHS would be adequately compensated. On Monday, Aronberg said the company's decision to drop the contract shows the need for greater legislative scrutiny. "This is what I was warning about," Aronberg said. Last year, Aronberg noted, Gov. Jeb Bush vetoed legislation that would have created a commission to approve state contracts worth more than $10 million. Bush said the measure would add "layers of process and bureaucracy" and cause substantial delays in the purchasing of necessary goods and services. The measure came in the wake of questions about several state contracts, including the outsourcing of the glitch-filled state payroll system.

August 23, 2006 Gainesville Sun
One of the state's largest privatization efforts is ending abruptly with Prison Health Services' decision to end work with the Florida Department of Corrections nearly eight years before the contract was to expire. PHS, a Tennessee-based company that handles health care needs for local- and state-run jails and prisons around the country, announced on Monday that it would end its contract providing services to nearly 14,000 prisoners in more than a dozen South Florida prisons. "The contract has underperformed financially," a news release states, "primarily due to a higher than anticipated volume of off-site hospitalization services. The company's decision to terminate the contract was made only after diligent efforts on the part of both PHS and Florida Department of Corrections representatives to reach agreement on provisions that would allow the contract to continue on mutually beneficial terms." PHS will cease providing services for DOC on Nov. 20. DOC spokesman JoEllyn Rackleff said that was enough time for the agency to maintain prisoner well-being in the transition. DOC Secretary James McDonough has previously said he is willing to end privatization efforts and return oversight of certain programs to the agency. PHS won the South Florida contract last year, despite protests from some lawmakers that the bid was too low to provide quality service. PHS was set to receive more than $790 million over 10 years for the work.

August 21, 2006 Yahoo News
America Service Group Inc. (NASDAQ:ASGR - News) announced today that its primary operating subsidiary, Prison Health Services, Inc. (PHS), has formally delivered written notice to terminate its contract with the Florida Department of Corrections, effective November 20, 2006. As previously announced, the contract has underperformed financially, primarily due to a higher than anticipated volume of off-site hospitalization services required for this patient population. The Company had been in discussions with the Florida Department of Corrections as to potential alternatives that could improve the future financial performance of the contract. The Company's decision to terminate the contract was made only after diligent efforts on the part of both PHS and Florida Department of Corrections representatives to reach agreement on provisions that would allow the contract to continue on mutually beneficial terms.

August 2, 2006 Nashville Business Journal
America Service Group Inc. saw its earnings for the second quarter plummet 81 percent compared to results for the same period last year. The provider of prison health care and pharmacy services showed a profit of $514,000, or 5 cents per diluted share, in the quarter ended June 30 compared to $2.8 million, or 26 cents per diluted share last year. Though earnings were down, the second quarter saw the company return to an operating profit - something that hasn't occurred since the second quarter last year. Nevertheless, the company's stock dropped nearly 19 percent, trading at $11.66 at 10:20 a.m. The 52-week range of the stock is $11.32 to $23.20. Brentwood-based America Service (NASDAQ: ASGR) lowered its guidance and now expects revenues to fall between $650 million and $660 million and earnings to range between $7.7 million to 8 million. The company cited an underperforming Florida Department of Corrections contract as the cause of the reduction. The company's previous guidance called for revenues between $660 million and $680 million and earnings between $9.4 million and $10 million. Second-quarter revenues were on the upswing, coming in at $160 million compared to $139 million in the second quarter a year ago. Expenses increased to $150 million in the quarter compared to $128 million in the second quarter last year. The company also recorded $1.0 million in charges associated with an audit committee investigation of its Secure Pharmacy Plus subsidiary. On March 15, the company said an investigation into financial improprieties at its Secure Pharmacy Plus unit found that the company failed to properly credit customers with discounts, rebates and savings and failed to give customers proper credit for returned pharmaceuticals. Expenses related to the audit amounted to $4.6 million through the first half of this year and the company expects it will spend another $400,000 to $900,000. The company continued its stock repurchase program approved in July of last year to repurchase and retire 217,000 shares at a value of $3.0 million. The repurchase was suspended during part of the second quarter when the company received a third-party proposal to acquire pharmacy services subsidiary Secure Pharmacy Plus. Ultimately, a deal wasn't reached.

April 1, 2006 Gainesville Sun
The Florida Department of Corrections has taken the unusual step of ending a contract for the splitting of pharmaceutical drugs, bowing to legislative pressure on the matter. In a letter delivered on Friday, the agency told TYA Pharmaceuticals that it was ending the $12 million contract to split pills for inmates effective May 1. The agency will perform the job, intended to save money by splitting high-dosage pills into smaller doses, in its own pharmacies. The agency also notified TYA, a Tallahassee company, that it will invite competing bids for the company's $72 million contract to repackage pills in bubble packages. The packages are used to prevent inmates from hoarding pills or misusing the containers. The corrections department will publish a request for bids in the next 10 days and have a new contract in place by July 1. Robby Cunningham, a DOC spokesman, said interim Secretary James McDonough felt the decisions "were in the best interest of the state."

February 18, 2006 Herald Tribune
A Florida company squeezed out of a lucrative contract to provide prescription drugs to South Florida prisons says its replacement may harm inmates by placing profits over proper prescriptions. And TYA Pharmaceuticals officials say they were used by industry giant Prison Health Services to secure the Florida contract late last year, before PHS replaced them with a PHS sister company after one month of work. Last year, PHS won the contract to supply health-care services to inmates in Department of Corrections Region IV facilities in South Florida. PHS said TYA Pharmaceuticals would handle the distribution of prescription drugs. The PHS contract with the state took effect in January. TYA founder Terry Yon said his employees had to begin working on Christmas Day to start filling more than 30,000 prescriptions for the transition. But earlier this month, PHS informed the agency that it was replacing TYA with a PHS subsidiary, Secure Pharmacy Plus. While there was a letter of intent between PHS and TYA, there was no signed contract. TYA has had a working relationship with the department since the late 1990s, though lawmakers have criticized that relationship, citing Florida Auditor General reports that show the Tallahassee-based company failed to provide basic oversight and accounting. Prison Health Services is based in Tennessee. "One could conclude that PHS intended all along to use TYA to obtain the contract because of our successful history with DOC and to do all the hard work associated with the transition and then to abandon TYA in favor of their own subsidiary," Yon said in a statement. "That certainly is how this story has played out." DOC officials have said PHS was the lowest bidder for the South Florida contract and was chosen on that basis. Yon also said PHS will use older anti-psychotropic drugs like Thorazine and Trilafon that "are less expensive for PHS, but they have the potential of producing more serious side effects." PHS spokeswoman Martha Harbin responded with a prepared statement: "PHS is continuing to provide quality medical care to the inmates in region IV and meeting each and every one of our contractual obligations we have to the Department of Corrections. Every action we take is done in support of that. PHS is now entering into a contract with Secure Pharmacy Plus. The DOC is fully aware and has approved this contract." Yon said PHS owes his company nearly $4 million for the month of work. His company has retained an attorney to study legal options related to their dismissal. TYA is fighting to keep its other business with the state. Lawmakers forced the DOC to rebid the two no-bid pharmaceutical contracts TYA had received for the splitting and repacking of drugs for inmate use in the state's other three regions. But despite the agency's search of more than 100 companies to find a suitable replacement, only TYA made successful bids. DOC officials are studying the financial advantages of the outsourcing and are considering canceling the contracts. Prison Health Services has been implicated in a number of deaths and mishaps in prisons and jails around the country, including injuries allegedly caused by inattentive care of a prisoner at the Sarasota County jail last year. A New York Times report last year found at least 15 inmate deaths at 11 Florida jails due to alleged inadequate care by PHS.

February 15, 2006 Herald Tribune
A controversial pharmaceutical company is losing its job of supplying prescription drugs to Department of Corrections inmates in South Florida. The company, Tallahassee-based TYA Pharmaceuticals, was chosen to dispense prescription drugs to inmates in DOC Region IV, which serves 18 counties including Manatee, Sarasota and Charlotte. Prison Health Services, a Tennessee-based company that has received a DOC contract to supply health-care needs for inmates in that region, selected TYA for the job. The DOC handles health care for inmates in its other three regions. PHS took over the Region IV contract in January and had agreed to subcontract the pharmaceutical program to TYA but never signed a contract. TYA has been performing the work since January. PHS notified the Department of Corrections that it has chosen to replace TYA with its own sister company, Secure Pharmacy Plus. Martha Harbin, a spokeswoman for PHS, did not supply specific reasons for the company's decision. "TYA doesn't have a contract with PHS. They've been trying to reach terms for a contract, and it's become clear that they're not going to be able to," she said.

January 12, 2006 Palm Beach Post
The Florida Department of Corrections is touting this week's deal with a private prison health-care company that sounds too good to be true. It is — since the company is Prison Health Services. The Brentwood, Tenn., firm underbid two rivals by tens of millions of dollars to get the 10-year contract to care for 14,000 inmates in 13 prisons from Vero Beach to Homestead, including those from St. Lucie, Martin and Palm Beach counties. The PHS bid was even $7 million a year below the existing contract. The state will pay PHS about $792 million; Wexford Health Sources, which has held the contract since 2001, wanted $884 million and Correctional Medical Services more than $1 billion. Even if PHS had a sterling record, the bargain price would be suspicious. But PHS doesn't. A New York Times investigation found that the company's substandard care contributed to at least 15 inmate deaths in 11 Florida jails over the past 13 years. PHS provided care at the Palm Beach County Jail until 2004, and health department officials complained that the company's slow response allowed staph infections to spread, endangering workers, visitors and inmates. PHS, which provides care at the St. Lucie County Jail, faced lawsuits from, among others, inmates who said negligence and refusal to provide medication had caused them to go blind, lose limbs and suffer psychotic episodes. PHS has 110 contracts in 37 states; many of those prisons have stories similar to those from the Palm Beach County Jail. The low-ball bid seems particularly disingenuous because of the increase in infectious health conditions such as staph, HIV and hepatitis C. State legislators who supported giving the contract to the lowest bidder and dismissed attempts to consider other factors should prepare to give PHS more money when it comes back to lament its soaring costs. An unrealistic deal will have consequences.

January 9, 2006 Ft Lauderdale Sun-Sentinel
Health care for inmates in all South Florida state prisons is being turned over this month to a national firm that promises to save the state millions of dollars a year.  Gov. Jeb Bush's administration is touting the boon to taxpayers that comes with putting Nashville-based Prison Health Services in charge of caring for more than 14,000 inmates in 13 prisons in southern Florida, including those in Broward, Palm Beach and Miami-Dade counties. Some legislators are wary, in part because Prison Health's bid for the work was tens of millions of dollars lower than its nearest rival bidders. They worry the company will take shortcuts that could bring unnecessary health risks to the prisons, and hidden costs like inmate lawsuits. "It all seems very suspect," said Sen. Frederica Wilson, a Miami Democrat who sits on legislative panels dealing with criminal justice and corrections issues. "We know the health care in the prisons already isn't what it should be. There are deaths and there's almost an epidemic of tuberculosis and hepatitis C and HIV/AIDS. If this company is going to under-bid all the others, then I fear we can only expect greater disappointment. "Under the contract, the state Department of Corrections will pay Prison Health $792 million over 10 years. Wexford Health Sources, which held the southern Florida prison health care contract since 2001, would have charged $884 million. A third bidder, Correctional Medical Services, priced the contract at more than $1 billion. Prison Health, a publicly traded company with 25 years of experience in Florida, is represented in Tallahassee by an influential lobbying firm headed by Brian Ballard, who has ties to Bush and other Republican leaders. But the contract with the state was competitively bid and there are no indications the firm's political connections were key to its getting the contract. Wexford officials say they were shocked that Prison Health bid for the work at that price, and suggested the contract could be financially risky for Prison Health. Inmates in these institutions are considered to be among the sickest in the country, suffering disproportionately from health conditions like HIV/AIDS, hepatitis C, diabetes and hypertension, according to prison health officials. "I'm willing to give them the benefit of the doubt. But past experience doesn't make me overly optimistic," said Sen. Dave Aronberg, D-Greenacres, who sits on criminal justice committees. The company has 110 prison health care contracts in 37 states and previously has been in charge of inmate care in Broward and Palm Beach county jails. Newspaper investigations and other reports have raised some concerns. The New York Times found last year that substandard care by the company contributed to at least 15 inmate deaths in 11 Florida jails since 1992, and it identified numerous administrative and healthcare problems at correctional centers under its care throughout the country.

January 4, 2006 St Petersburg Times
The state Department of Corrections has hired Prison Health Services, one of the nation's largest for-profit inmate health care companies, to care for more than 14,000 inmates in a sprawling southeast Florida region from Homestead to Vero Beach. The contract is for five years with a five-year option to renew at the 13 prisons. PHS' bid of $545-million was nearly $200-million less than its nearest rival, Wexford Health Sources, which held the contract since 2001. The third bidder was Correctional Medical Services. After a yearlong investigation of Prison Health Services, the New York Times reported last February that substandard care by the company contributed to at least 15 inmate deaths in 11 Florida jails since 1992. Pinellas County severed ties with Prison Health in 1995, after the death of a woman inmate from a heart attack. For two days, nurses refused to order the heart medication her doctor had prescribed. In 2004, a woman in the Hillsborough County jail sued Prison Health Services, blaming the company for the death of her newborn son from complications during delivery. The baby was born over an infirmary toilet at the Falkenburg Road jail. PHS' new deal with the state also means more state work for Terry Yon & Associates, a Tallahassee firm specializing in repackaging pharmaceuticals for use by inmates. Under terms of its state contract, PHS partners with other firms to provide pharmacy, mental health and dental services.

Franklin County Jail, Pennsylvania
EMSA was warned that it -- not taxpayers-- must pay any legal damages that might be awarded in connection with the death of an inmate last month. Inmate, Rocky Eickstadt, dies of complications from diabetes. Jail records show he requested medical help not knowing he was diabetic, complaining of problems and did not see a jail nurse for eighteen days. Family is suing. Three lawsuits are pending against EMSA and one against CMS in Franklin County Common Pleas Court on other issues. (Columbus Dispatch, October 5, 2000)

Gaston County Jail, Gastonia North Carolina
August 23, 2007 Charlotte Observer
Prison Health Services, Gaston County and Sheriff Alan Cloninger are being sued in the 2004 death of a jail inmate who suffered a seizure in his cell. The lawsuit filed Wednesday alleges that Prison Health Services, a company contracted by the jail, failed to provide Hugh Locklear Jr., 21, his epileptic-seizure medication and didn't monitor his condition. The suit, which seeks in excess of $75,000, alleges that the defendants violated Locklear's civil rights by showing a "deliberate indifference" to his "serious medical needs." It was filed in U.S. District Court by Pamela Dunbar. The suit does not specify her relationship to Locklear. Cloninger and the county's attorney could not be reached Wednesday. Citing patient confidentiality, Prison Health Services would not comment, spokeswoman Susan Morgenstern said. On Aug. 28, 2004, Locklear collapsed in his cell, police said, and was pronounced dead at Gaston Memorial Hospital. His father, Hugh Locklear, 41, was also an inmate at the time. He has said his son never got epilepsy medication at the jail despite repeated requests. Locklear Jr. had been taking phenytoin and carbamazepine for seizures, but refused to take the medications after he was arrested in June 2004, according to an N.C. State Bureau of Investigation report.

January 6, 2005 Charlotte Observer
No criminal charges will be filed in the death last year of a 21-year-old Gaston County Jail inmate who collapsed in his cell and died of a seizure disorder.  The inmate, Hugh Locklear Jr., repeatedly asked for medication to control his epilepsy and never received any, said his father. Jail officials dispute that. So does Gaston County District Attorney Mike Lands. "There is no indication in here that Locklear (Jr.) asked for medication," said Lands, referring to a report from the N.C. State Bureau of Investigation, which looked into the Aug. 28 death. Jail officials knew Locklear Jr. had epilepsy because he noted it on a form, but they said he refused to take any medication, the report said. Hugh Locklear said he filed several requests asking that his son be given medication, but the jail doesn't have any records showing that, the report stated.

October 23, 2004 AP
A seizure disorder caused the death of a Gaston County jail inmate two months ago, according to the state Medical Examiner's Office. Hugh Locklear Jr., 21, collapsed in his cell Aug. 28, turned blue and made gurgling sounds, police have said. Locklear died later that day at Gaston Memorial Hospital. He was the second Gaston inmate to die at the jail in August -- raising some questions about the Tennessee-based company that oversees the jail's medical care. The medical examiner's report found that "the history of an untreated seizure disorder provides a sufficient cause of death" but that "there is nothing in the history to suggest foul play." The other inmate who died, Yolanda Patterson, 28, of Gastonia, died of a cocaine overdose, an autopsy determined. She went into cardiac arrest at the jail. The State Bureau of Investigation is still looking into the two deaths. The jail's medical care is provided by Prison Health Services of Brentwood, Tenn., which has come under fire in other states. The company has been criticized in two reports by New York state in recent years, and last week, Florida's Palm Beach County terminated a contract with PHS. Gaston officials renewed the county jail's contract in late August. They said they weren't aware of PHS's troubles in other states but have been satisfied with the level of care it has provided.

Gaston County officials say contracting with a private company for inmate health care saves money, but a watchdog group spokesman says such outsourcing is a growing practice that can lead to inadequate medical treatment.  Two recent deaths of people held at the Gaston County Jail have raised questions about the quality of medical care there. Gaston renewed its contract with Prison Health Services three days after the first death. The county expects to pay PHS $750,000 during fiscal year 2004-05.  Large companies that specialize in prison health care are interested in making a profit, so they cut costs where they can, said Ken Kopczynski, executive director of Florida-based Private Corrections Institute, a group that monitors privatization of prison health care. He's a lobbyist for the Police Benevolent Association and believes officers' safety depends on how inmates are treated.  "You get what you pay for," he said. "But the problem is, a lot of the people that are going into prisons and jails don't take care of themselves anyway. They probably already have medical problems."  (The Charlotte Observer, September 4, 2004)

Hugh Locklear Jr. did not have a trial. Yolanda Evett Patterson had not been charged with a crime. Yet each received a death sentence while incarcerated in Gaston County.  Officials at the Gaston County Jail need to find out why, and how to keep it from happening again.  Mr. Locklear, 21, died Sunday in the Gaston jail awaiting trial on drug and larceny charges. Ms. Patterson died at Gaston Memorial Hospital Aug. 20 after she stopped breathing in the jail. She was awaiting charges in connection with shoplifting.  Autopsies are not complete. Local and State Bureau of Investigation probes are under way. But contradictory facts raise specific questions about the care taken in Gaston County when medical emergencies arise behind bars. The circumstances of these deaths also warrant a pointed examination of the record of a private company paid to provide health care to prisoners.  Mr. Locklear's father, also a prisoner in the jail, said his son was epileptic and did not receive his medication. A jail nurse and the Gaston sheriff said the son did not cooperate and refused medical treatment.  Ms. Patterson's cousin, who faces charges of misdemeanor larceny, said she complained of breathing problems after being taken into custody. Yet jail officials did not respond for about 20 minutes, the cousin said, and called Ms. Patterson "a good actor."  Any police officer will tell you: Suspects in custody are quick to cry medical emergency if they think it will buy them preferential treatment in the harsh confines of a jail. It is often difficult to judge the difference between distress and a disruptive ploy.  Yet allegations that two prisoners' needs were either bypassed or ignored -- a response that may have contributed to their deaths -- must be resolved.  The record of Prison Health Systems merits scrutiny as well. Palm Beach County, Fla., officials said the company's performance in nine inmate deaths persuaded jail officials to drop it as a health care provider. In New York, the state Commission of Corrections has issued two reports critical of PHS's performance since 2001 in connection with two prisoner deaths.  Privatizing services is a proven way to reduce the cost of local government for citizens. Yet accountability is often the rub. Medical care in particular is difficult to monitor with quantitative measures because it requires subjective decisions.  Most ordinary citizens have never seen the inside of a jail cell. They do not give much thought to details like medical care for prisoners. Yet they bear the financial and moral responsibility for how suspects are treated when in public custody.  All citizens, then, have a direct interest in finding out what happened when two suspects held in Gaston's jail died. A medical emergency behind bars should not equate to a death sentence.  (The Charlotte Observer, September 1, 2004)

Gaston County Jail officials renewed their contract with Prison Health Services last week, just days after the first of two people held at the jail died after complaining of illness.  Gaston officials said they didn't know about PHS's troubles in other parts of the country where lawsuits have been filed alleging improper medical care.  Last week, the Palm Beach County (Fla.) Sheriff's Office dropped PHS as its medical provider before its contract expired, said Commander Diane Carhart Tuesday, citing concerns about PHS's quality of care.  Nine inmates at that jail have died in the last two years, and a staph outbreak that lasted about a year prompted county health officials to threaten legal action.  Nationwide, PHS serves about 235,000 inmates at more than 400 correctional facilities in 35 states. Fewer than 500 inmates die each year at those jails and prisons, said Dr. Carl Keldie, PHS's national medical director.  The nation's jails had 919 inmate deaths in 1999, according to a Census of Jails study from the Bureau of Justice that year. Those deaths included 324 suicides, 385 due to illness/natural causes, and 104 "others," including overdoses and accidental injuries.  The Gaston County Jail has had three deaths since it opened in November 1999. Two of those deaths happened within eight days of one another.  (The Charlotte Observer, September 1, 2004)

Jail officials said Tuesday that Hugh Locklear Jr., who was found not breathing in his cell Saturday, refused medical treatment during the first two weeks he was incarcerated.  As is customary, a jail nurse tried to fill out a medical questionnaire when Locklear was arrested June 7, said Gaston County Sheriff Alan Cloninger. "He refused to answer any questions," Cloninger said. "He stood mute."  After 14 days, officers took Locklear, 21, to the jail's medical department, which is done when inmates refuse initial treatment, Cloninger said. But he refused a physical exam, he said.  Cloninger said Locklear's requests to see a nurse on June 23 and Aug. 22 were granted. But he declined to say why Locklear made the request and whether any medication was administered.  (The Charlotte Observer, August 31, 2004)

The company that provides medical care at Gaston County Jail, which has dealt with two recent deaths, was recently dropped as the healthcare provider by Palm Beach County, Fla., jail officials.  Palm Beach County officials blamed the performance of Tennessee-based Prison Health Services in nine inmate deaths in the last two years.  "I would think that at the very least, Prison Health Services with regards to their services to Gaston County, should warrant an audit," said Gaston County commissioner Tom Keigher on Sunday.  The most recent death occurred Saturday.  Hugh Locklear Jr., 21, was found not breathing in his cell that afternoon. His father, Hugh Locklear, 41, blames PHS.  Locklear said from jail Sunday that his son was epileptic. Father and son had asked repeatedly for medication since they were jailed about three months ago, but received none, Locklear said.  Autopsy results are pending for Locklear Jr., who was facing drug and larceny charges. A PHS registered nurse at Gaston County Jail said that before he died Locklear Jr. was "being taken care of."  (The Charlotte Observer, August 30, 2004)

Glenn Dyer Jail, Oakland, California
March 10, 2010 AP
Health care workers at both jails in Alameda County were locked out Wednesday, a day after they staged a one-day strike to protest stagnant contract negotiations. "It's just another intimidation tactic," said Maxine Persky, a nurse for 10 years at Santa Rita Jail in Dublin who was told she would not be allowed back to work until next week after showing up at 6:30 a.m. Wednesday. "How is this bargaining in good faith?" Nearly 140 health care workers — members of the Service Employees International Union-United Healthcare Workers West — held a one-day strike Tuesday at both Santa Rita Jail and the North County Jail in Oakland after working more than two months without a contract and making minimal headway on a new one with Tennessee-based Prison Health Services. That company has a contract with Alameda County to provide both jails with health care staff and workers, such as nurses and medical record technicians. On Wednesday, Prison Health Services released another statement, saying it "will continue to fulfill its contract with the county and to maintain patient care through the use of temporary replacement employees through 6 a.m. March 16 or until we reach a settlement with the union, whichever comes first." Persky said the union and management are set to meet again today to try to work out a new contract, but in the meantime are concerned about the inmates. "We're concerned for them," Persky said.

March 9, 2010 Oakland Tribune
Nearly 140 health care workers at both jails in Alameda County took to the picket lines Tuesday to protest six months of stalled contract negotiations and what they call unfair labor practices. The workers, members of the Service Employees International Union-United Healthcare Workers West, approved the one-day strike last month after working more than two months without a contract and making minimal headway on a new one with Tennessee-based Prison Health Services. That company has a contract with Alameda County to provide health care staff, such as nurses and medical record technicians, to Santa Rita Jail in Dublin and the North County Jail in Oakland. "This is to show we mean business and we're not going to give in," said Kim Tovar, a medical records technician at North County Jail. Tovar and about two dozen others protested outside North County Jail while a much larger procession marched in front of the county's largest jail, Santa Rita Jail. Although workers called for a one-day strike, rumors swirled Tuesday that Prison Health Services was expected to lock out the workers for a week starting at 6 a.m. today. Prison Health Services officials would not comment Tuesday but did issue a statement Friday that said, "PHS regrets SEIU's decision to walk out and remains committed to negotiate a fair, reasonable and competitive contract" and said it would "ensure patient care is uninterrupted." Temporary workers did replace union workers at 6 a.m. Tuesday. Sgt. J.D. Nelson, a spokesman for the Sheriff's Office, said no problems at either facility had been reported. A memo from the company to staff was circulated last week saying the union workers would not be allowed back to work until March 16 or until a new contract was signed — whichever happened first. "I think it's dirty," Tovar said of the potential lockout. "I think it's low." Carrie Singleton, a licensed vocational nurse at North County Jail, said that if the company locks out workers, workers still must stand their ground. "If they do it, they do it," Singleton said. "We have to make a commitment to fight." The main sticking point in negotiations, according to the union, is what they see as a huge increase in health care costs employees must pick up. According to Blaire Behrens, a nurse at North County Jail for 19 years and member of the union's negotiating team, any proposed wage increase is more than eaten up by the 30 percent health care cost increase.

February 25, 2010 Oakland Tribune
Health care workers at both jails in the Alameda County have agreed to strike as early as next month if negotiations for a new contract remain stalled. About 140 workers — members of the Service Employees International Union-United Healthcare Workers West — have voted to strike if their representatives cannot come to a settlement with Tennessee-based Prison Health Services. That company has a contract with Alameda County to provide health care staff and workers — such as nurses and medical record technicians — to both Santa Rita Jail in Dublin and the Glenn Dyer Detention Facility in Oakland. The current plan by the health care workers union is to hold a one-day strike March 9, according to Blaire Behrens, a nurse at Glenn Dyer jail for 19 years and member of the union's negotiating team. There are two bargaining sessions scheduled for next week. "It would certainly be better if both sides could come to an agreement," Behrens said. "It would be better for management, the inmates and the workers. "We work in a very difficult environment," Behrens continued. "But it's a job we want to do. We don't want to strike." Behrens said the main sticking point is what the union sees as a huge increase in health care costs employees must pick up. She said even though Prison Health Services is offering 3 percent wage increases, those are more than offset by the 30 percent health care cost increase. Starting nurses at the facilities make approximately $40.50 an hour. Behrens said the union has been negotiating with management for nearly six months with little movement. The current contract expired in December. The union has sought the help of both county supervisors and the Alameda County Sheriff's Office to help break the stalemate. Sgt. J.D. Nelson, a spokesman for the sheriff's office, said if the union members do strike, it will be up to Prison Health Services to provide the county with replacement workers. Prison Health Services did not return multiple requests for comment.

February 6, 2007 The Daily-Californian
The medical center at a county jail that some say has poor medical care will hire additional personnel this year following the jail’s settlement of negotiations with the health care providers’ union. The health contractors said the conditions before the agreement led to potentially unsafe conditions for the 4,000 inmates in Santa Rita Jail, the primary jail facility for Alameda County. The facility’s safety has been questioned by inmates’ relatives in the last several years. In 2006, eight Santa Rita Jail inmates died. Most recent was the death of Berkeley resident and inmate Cedrick Pinkney’s, suspected to be related to longstanding health issues. Jail officials said Pinkney’s death was not due to medical negligence. That mortality rate is lower than both that of the general population and that in jails and prisons nationwide, said Bill Wilson, the jail’s health services administrator Regardless of the circumstances of those deaths, health care workers at Santa Rita Jail said the new agreement will mitigate what they considered to be unsafe levels of staffing. “It’s an excellent agreement for both the jail and the nurses as well,” Wilson said. The agreement, which officials expect to finalize next week, is the product of a settlement reached in December between Prison Health Services, the firm contracted by Alameda County to provide care to the inmates, and the union representing the jail’s 120 health care workers. Union officials said the health workers were ill-equipped to respond to the inmates’ medical needs. “There were many days when the staffing levels were as low as 50 percent of the staffing levels that Prison Health Services had committed to provide in their contract,” said Dana Simon, spokesperson for the Service Employees International Union-United Health Care Workers-West. “Absolutely, it was affecting the basic care.” Understaffing put inmates with chronic conditions in particular danger, Simon said, because they cannot administer their own medicine. “There were many days when they just cancelled pill call in particular houses,” Simon said. But Prison Health Services representatives denied this claim.

January 5, 2007 Inside Bay Area
Alameda County Supervisor Alice Lai-Bitker is probing accusations that severe understaffing of medical personnel at two Alameda County jails is endangering their safety and inmates' health. The inquiry by Lai-Bitker, the board's Health Committee chairwoman, came in response to complaints by Prison Health Services workers that staffing was 30 to 50 percent below contract requirements from August to December. Nurses were forced to work overtime, and inmates' access to medical care was denied because too few nurses were available, according to Service Employees International Union-United Health Care Workers-West, the union that represents about 120 of the employees. "We are constantly plagued with understaffing in the Santa Rita jail," a registered nurse and union member said in a statement provided by the union on condition of anonymity. "We are all tired." Prison Health Services has contracted with the Alameda County Sheriff's Office since 1989. The company's current $51 million three-year contract, which serves about 4,000 inmates at Santa Rita jail in Pleasanton and Glenn E. Dyer jail in Oakland, expires in June.

December 20, 2006 Mercury News
Health care workers at two Alameda County jails late Monday night withdrew notice of a planned two-day strike that would have begun Tuesday, as negotiations continued to address staffing issues, according to a jail administrator. Leaders of the union that represents about 120 nurses, physicians and other health workers at the Santa Rita Jail in Dublin and the Glenn E. Dyer jail in Oakland called the strike early Monday after a bargaining session failed to produce a new contract. But by evening, they called off the plan because of progress in contract talks. The workers are employed by Prison Health Services Inc., a Tennessee-based firm that staffs more than 300 prisons and jails nationwide, including the two in Alameda County. "We're continuing to negotiate with the union this evening, and we're optimistic that we'll come up with a collective bargaining agreement," said Bill Wilson, administrator for the Alameda County jails. The workers claim the agency's failure to recruit and hire enough workers has endangered the health of inmates, said Dana Simon, a spokesman for Service Employees International Union-United Healthcare Workers-West. Workers and their supporters had planned to picket outside the jails in Dublin and Oakland beginning at 6 a.m. and return to work at 6 a.m. Thursday.

December 5, 2006 CBS 5
Healthcare workers negotiating a new contract with a firm that provides health services at two jails in Alameda County were threatening to give formal notice of a strike on Wednesday if talks failed to deliver an agreement tonight. Employees represented by Service Employees International Union-United Healthcare Workers-West are seeking a new contract with Prison Health Services, Inc., a Tennessee-based firm that serves Santa Rita and Glenn Dyer jails in Alameda County, among hundreds of other correctional facilities across the country. Union representatives and healthcare professionals allege the jails have a shortage of healthcare workers causing detrimental conditions for the patients they serve. A nurse working at Santa Rita Jail, Donna Chatman, said a recent example of substandard care she heard of was "that an inmate with a colostomy bag was not seen for days to get his bag changed because the nurse had to many patients to take care of. So he used a Pepsi bottle for a colostomy bag until he could see a nurse. That is what is happening in our jails." David Wolf, a spokesman for Prison Health Services, said he had no information on that allegation, or another alleged by a healthcare worker, in which an inmate with an infected foot saw his condition worsen due to lack of rudimentary care. Wolf said short staffing in the healthcare profession is common, but no more so at the Santa Rita Jail than anywhere else. "We are proud of the hard work that these nurses and the rest of the staff provide for the inmates," said Wolf. Union spokeswoman Dana Simon said that in addition to desiring a greater salary increase, "The main issue here is PHS is staffing the jails with 50 percent of the required number of healthcare workers as is required per the contract they submitted to the Alameda County Sheriff's Office." However, Santa Rita jail administrative Captain Wilkinson denied these allegations. "PHS is not violating their contract and they are providing adequate staffing when they are dealing with a shortage of nurses."

November 10, 2006 PR News Wire
Healthcare workers at Alameda County's Santa Rita jail in Pleasanton and Glenn Dyer jail in Oakland announced today that they will give formal strike notice to their employer, Prison Health Services (PHS), on December 2, if a new contract agreement is not reached. The caregivers are represented by SEIU United Healthcare Workers-West (UHW) and include RN's, LVNs, certified nursing assistants, technicians, and clerical workers. The workers point to wages that are 35% to 40% below area averages, resulting in dramatic understaffing. They consider the low staffing levels to be so serious that the facilities are no longer safe for the caregivers or the inmates/patients they care for. Workers also highlight the fact that under the contract with the Sheriff's Department, PHS is paid a rate based on specific staffing levels, but on most days reaches only about half those levels. "Staffing at half the level that is required by the contract between the Alameda County Sheriff's Department and Prison Health Services is not only unsafe for the caregivers and the patients, but PHS is also breaking its commitments to taxpayers and the Sheriff's Department," said SEIU UHW President Sal Rosselli. PHS, a Tennessee-based for-profit corporation, was the subject of a three- part New York Times expose in February, 2005 for practices harmful to the well-being of patients/inmates, issues similar to those cited by the healthcare workers in Alameda County. Access the entire article at: http://www.nytimes.com/2005/02/27/nyregion/27jail.html?ex=1163307600&en=339 a81 097e61fe2c&ei=5070 SEIU United Healthcare Workers-West, with more than 130,000 members, is the largest and most powerful healthcare union in the Western U.S. We represent every type of healthcare worker, including nursing, professional, technical and service classifications. Our mission is to achieve high quality healthcare for all.

Gloucester County Jail, Woodbury, New Jersey
August 29, 2006 Gloucester County Times
A former Gloucester County Jail inmate and his significant other are suing the county, alleging that he contracted an often drug-resistant staph infection while locked up and then brought it home. Michael DiFelice of Deptford Township was an inmate at the jail for seven months, starting on April 11, 2005. Not long after his release on Nov. 1, DiFelice's "domestic partner" began exhibiting signs of the same infection, according to the lawsuit filed in Superior Court. DiFelice and Kelly Filipponi have both been diagnosed with the boil-like skin infection, according to the lawsuit. The lawsuit alleges that the county failed to properly inform its staff and inmates of other cases of methicillin-resistant Staphylococcus aureus. Also named in the lawsuit were the county department of corrections, the sheriff's department and Prison Health Services Inc. More than a dozen other lawsuits have been filed against the county from both former inmates and corrections officers at the jail.

July 13, 2006 Gloucester County Times
A fifth lawsuit filed against the county claims that a former inmate of the Gloucester County Jail became infected with staph while incarcerated there. Brantley Owens of Glassboro allegedly began "exhibiting signs and symptoms of an infection" caused by staphylococcus aureus bacteria shortly after his incarceration in August 2004, according to the complaint filed in Superior Court. Owens claims that jail officials knew of other cases of the often contagious and drug-resistant skin infection and failed to notify inmates and put policies in place to minimize or prevent exposure, according to the suit. Owens' suit is the fifth lodged against the county concerning staph infection -- one officer and two former inmates previously filed individual suits, and last month five people, corrections officers and their spouses, filed a joint suit. The most recent claim names the county, county freeholders, the county department of corrections, the county Sheriff's Department, Prison Health Services, Inc., former jail warden John Tevoli and former corrections director W. Stanley Nunn. County spokeswoman Debra Sellitto declined comment because the matter is in litigation. Owens' Attorney Scott McKinley, of the firm Hoffman and DiMuzio, has filed three other lawsuits on behalf of two former inmates as well as a corrections officer who claim they contracted staph while at the jail.

March 23, 2006 The Daily Journal
Gloucester County faces a third lawsuit over an outbreak of drug-resistant staph infections at the county jail in 2003 and 2004. The latest lawsuit -- filed by Jeffrey Maxie of Johnson City, Tenn., and his domestic companion, Marlene Byrnes of Westville -- accuses the county of failing to address the staph outbreak properly. The contagious skin infection can be fatal if untreated. Byrnes contracted staph from close contact with Maxie after he left the jail in April 2004, but before he was aware he had contracted it, said the couple's attorney, Scott C. McKinley. In a lawsuit filed last week in Gloucester County Superior Court, Maxie contends he contracted staph while in the jail on an unspecified charge in April 2004. The county "failed to inform the plaintiffs of the risk of exposure, failed to prevent said exposure, (and) failed to put procedures or policies (in) place to eliminate or minimize the risk of exposure," according to the lawsuit. County Counsel Samuel J. Leone could not be immediately reached for comment. The lawsuit also names as defendants the county freeholder board; the county's Department of Correctional Services; the Sheriff's Department; Prison Health Services Inc., which provides medical care at the jail; former warden John Tevoli; and W. Stanley Nunn, the former corrections director.

November 1, 2005 Courier-Post
A former inmate at Gloucester County Jail alleges in a lawsuit that negligent oversight of the jail caused him to contract a staph infection while he was incarcerated in 2003. The lawsuit, filed by Joseph Favacchia of Swedesboro, is the second to accuse the county of failing to properly address an outbreak of drug-resistant staph infections at the jail in 2003. The contagious skin infection can be fatal if untreated. Favacchia contends he contracted staph while in the jail on a violation of probation charge in November 2003. A year later, Favacchia learned that county officials had been aware of other cases of staph infections at the jail but "withheld and fraudulently concealed" that information, Favacchia contends in his complaint. The county "failed to inform the plaintiff of the risk of exposure, failed to prevent said exposure, (and) failed to put procedures or policies (in) place to eliminate or minimize the risk of exposure," according to the lawsuit. The lawsuit also names as defendants the county freeholder board, the county's Department of Correctional Services, the county Sheriff's Department, Prison Health Services Inc., which provides medical care at the jail, former warden John Tevoli and W. Stanley Nunn, the former corrections director. In September 2004, county freeholders suspended Tevoli for two weeks without pay after determining he misled a Citizens Advisory Board about the extent of the staph outbreak. Tevoli resigned in January after two years as warden.

Guilford County Jail, Greensboro, North Carolina
November 30, 2007 News & Record
The family of a 41-year-old woman who died in the Guilford County jail has reached a settlement with the national company that provides health care to inmates. Neither the attorney representing the family of Judy McDaniel Woodle nor a spokeswoman with Prison Health Services would discuss details of the settlement. Susan Morgenstern, spokeswoman for Prison Health Services, said the settlement carries a confidentiality clause. "The issue has been resolved pending approval by the court, and there is no fault involved," Morgenstern said Thursday. Woodle died April 30 inside her cell from what was determined to be a strangulated left femoral hernia. She had spent six days in jail awaiting trial on petty theft charges and was taking anti-diarrheal and pain medication for what was thought to be an ovarian cyst. Steve Bowden, an attorney for Woodle's family, said the matter was resolved this week. "I'm not allowed to reveal the terms. I'm just happy the family was able to get this resolved," Bowden said. No lawsuit was filed in Woodle's death, he said. Prison Health Services, based in Brentwood, Tenn., provides care to inmates in 180 jails and prisons across the country, according to its Web site. It has a contract to provide medical care to the Guilford inmates through June. The sheriff's office pays the company more than $200,000 each month for its services. Guilford County Sheriff BJ Barnes said in May that Woodle began complaining of symptoms a few days after her arrest and that Prison Health Services medical personnel did not take her for a hospital evaluation. Barnes said Thursday that he does not fault Prison Health Services for Woodle's death, calling the care the company provides for the inmates "more than sufficient."

July 10, 2007 News Record
Attorneys for the family of a woman who died in jail said the hernia that killed her should have been detected by a simple physical exam. An autopsy report for Judy McDaniel Woodle , who died in April, showed she had a visible nodule on her groin. That lump was caused by the strangulated femoral hernia that killed her, according to the report. Eddie Darton , an attorney with the firm representing Woodle's family, said a physical exam should have easily revealed the nodule, which the report stated was 3-1/2 inches by 1-3/4 inches by 2 inches. That discovery, in conjunction with the fact that Woodle had been suffering from vomiting and stomach pain, should have led to the realization that she had a serious medical problem, Darton said. Instead, the hernia went undiagnosed, and Woodle died on April 30 in her cell. Attorney Steve Bowden , who is representing Woodle's family, said the outcome would have been different if the problem had been detected. "She'd be alive today," he said. Guilford Sheriff BJ Barnes said that a doctor had looked at Woodle while she was in the jail. Woodle had told correctional officers when she arrived at the jail that she suffered from an ovarian cyst, and she was receiving medication at the jail for that problem. Barnes said the nodule might have looked like a cyst, but Darton, who has a medical degree, said a cyst would not have had that appearance. Bowden said the family is looking for a financial settlement, and a lawsuit is possible. "It depends on what kind of cooperation we get," he said. "She's got five children." If an agreement isn't reached by the end of August, he said, the matter will move to court. Barnes said he has not spoken with Bowden but did not rule out the possibility of a settlement. "You never close any doors on anything," he said. Woodle, who was 41 , had been jailed six days before her death. She had been charged with stealing $5.09 worth of fish from a Food Lion. She also faced charges of resisting a police officer and failing to appear in court on a previous theft charge. According to the autopsy, the hernia led to gangrene, or the death of tissue, in the small intestine, and complications eventually caused Woodle's death. Medical care at the jail is provided by a private company, the Tennessee-based Prison Health Services. Guilford County pays the company more than $200,000 monthly to provide care at the Greensboro and High Point jails and the county prison farm. No changes have been made to the jail's medical procedures, Barnes said, but the sheriff's office is always looking for ways to improve, he said. "This did not end the way anyone wanted it to end," he said.

June 5, 2007 News & Record
The company that provides health care in the Guilford County jails told the sheriff last month it will not share records that explain how its staff makes medical decisions. Sheriff BJ Barnes requested documents from the company after an inmate died in April on her cell floor. The News & Record asked Barnes for some of the records mentioned in a policy manual he has made available to the newspaper. Barnes contracts with Prison Health Services Inc. for medical, dental and psychological care of inmates in three county jails. The Tennessee-based company turned over some information, including the names of jail medical staff. But in a letter dated May 25, a lawyer representing Prison Health told the sheriff's office that no documents would be shared, saying the records are "private, confidential, or otherwise protected material." Barnes on Monday declined to answer whether he believes the county has a right to records and manuals maintained by companies that work for him. "At the present time, I don't have a need for this information," he said. "There may come a time when I feel there is a need. If it does, I'll come to Matt (Mason, the sheriff's attorney) and say 'all right, let's force the issue.'" Because Prison Health is a private company, its records are not something the News & Record can directly receive under public records laws. Prison Health's attorney, Steven Weaver, could not be reached for comment late Monday. His voice mail message indicates he is out of the office until mid-June. Barnes and his top officers have maintained that medical staff acted properly in the days leading to the woman's death. They said they based their conclusion on talks with Prison Health staff without reviewing records themselves. "The medical field is not my area," Barnes said. "That's why we hire them. A doctor or a nurse oftentimes knows things that I don't know." The county is paying $2.7 million this year to Prison Health. Among the records it denied to the sheriff: l A copy of the Utilization Management Resource Manual, a document that, according to Prison Health's policies manual, is something medical staff can reference when making clinical judgments. l A copy of the most recent annual review of Prison Health's "Continuous Quality Improvement Program." l A copy of the clinical incident report stemming from the death of Judy McDaniel Woodle. Woodle, 41, died April 30 on the floor of her jail cell. The state medical examiner's office found she suffered from a strangulated hernia, where her intestines got pinched outside her abdomen and the lack of blood killed off part of the organ. While the autopsy report has not been completed, medical experts say that with most untreated strangulated hernias, the bowel ruptures once it dies, spilling bacteria into the bloodstream. Barnes said last month that Woodle had told staff on her arrival in jail that she suffered from an ovarian cyst. She had been taking antidiarrheal and pain medication at the time of her death. Woodle's family has hired an attorney to review her death. Attorney Steve Bowden was out of the office Monday and not available for comment.

May 12, 2007 News & Record
The attorney for Guilford County Sheriff BJ Barnes has asked a Tennessee-based health care contractor for internal procedural guidelines following an inmate death in the Greensboro jail. The News & Record had asked the sheriff's office for those documents and others after Judy McDaniel Woodle died on April 30. The county pays Prison Health Services more than $200,000 per month to handle inmate health care in its jails. The letter from attorney Matt Mason said the sheriff's office would assess the documents under public records laws and respond to the newspaper. Among the records requested were company documents outlining how its physicians should make clinical judgments. Sheriff's officials have said all proper policies and procedures were followed, even though they had not reviewed all of Prison Health's written policies. Woodle died of a strangulated hernia, health officials have said. The letter was addressed to Steven P. Weaver, a Greensboro lawyer who represents Prison Health.

May 10, 2007 News & Record
Guilford County sheriff's officials have maintained for the past week that jail medical staff followed proper procedures treating an inmate who died last month of a strangulated hernia. They stood by their findings on Wednesday, while acknowledging in an interview with the News & Record that they had not reviewed all the written policies of the company contracted to provide inmate health care. Nor had they examined the medical files of the inmate, Judy McDaniel Woodle. Sheriff's Maj. Deb Montgomery , accompanied by sheriff's attorney Matt Mason , said that officials discussed the death with medical staff from Prison Health Services, a Tennessee-based company. The sheriff's office determined no mistakes were made based on the discussions, they said. But Prison Health has not yet provided the sheriff's office with company documents outlining how its physicians should make clinical judgments. Sheriff's officials would not reveal details of the talks with Prison Health staff, citing federal health privacy laws. It is unclear why Prison Health has not given the sheriff's office the policy documents. The county pays it more than $200,000 a month to provide medical services to inmates at all three county facilities. Mason met with an attorney for Prison Health on Wednesday. He said he will brief Sheriff BJ Barnes today and it will be the sheriff's decision how to proceed on obtaining the records. The meeting of lawyers was called after the News & Record requested documents that show how medical staff determine the need for hospital care. According to Montgomery and records provided by the sheriff's office, Prison Health is responsible for the first $25,000 of any hospital care required for a condition that develops in the jail. If costs exceed that, the county covers the difference. A spokeswoman for Prison Health was unable to find answers to questions posed by the News & Record late Wednesday afternoon, including how jail staff are trained and who had been made aware of the inmate's complaints. As for the medical documents, sheriff's officials said those files were sent to the State Medical Examiner's Office, which conducted the autopsy. Woodle, 41, of Greensboro, died April 30 in her jail cell. Staff had given her pain and antidiarrheal medication for what they believed to be an ovarian cyst. Woodle had not been taken for an ultrasound or other body imaging tests. The mother of five told jailers upon her admission she suffered from a cyst, and they observed that the medication appeared to be relieving pain. Woodle's family hired a lawyer this week and is now examining legal options. The family's attorney, Steve Bowden, could not be reached Wednesday afternoon for comment.

May 5, 2007 News Record
The Tennessee-based company that handles medical treatment in the Guilford County jail declined to comment Friday on why a local inmate died under its care. A spokeswoman for Prison Health Services Inc. said she was unaware that a Greensboro woman died until contacted by the News & Record four days later. Prison Health handles medical care in nearly 300 jails and prisons nationwide. "We will do a thorough review of our own files," spokeswoman Susan Morgenstern said. "We will make sure all our policies were filed. Any time there’s a death, it’s what we do." Judy McDaniel Woodle, 41, died Monday night from complications of a strangulated hernia. Her intestine had been choked by a muscle or tissue in her left upper thigh, cutting off the blood flow. Still, officials have said all policies and procedures were followed. But the sheriff’s office could not provide a copy Friday of the written policies and procedures that govern medical care in the Greensboro and High Point jails, despite the fact that it had launched an investigation into the death early this week. Maj. Deborah Montgomery said a lawyer for the sheriff’s office has requested that documentation from Prison Health after the News & Record asked for it. Sheriff BJ Barnes previously said Woodle, facing charges of petty theft, told jailers when she was arrested that she suffered from an ovarian cyst. The diarrhea and abdominal pains she had matched those symptoms. "A lot of times, certain things have similar symptoms," Montgomery said. "That’s common sense." Prison Health Services last month paid a Florida woman $1.25 million in a settlement over claims of negligence. The former inmate sued when she gave birth over a toilet in her jail cell in 2004. The infant died. The woman claimed medical staff ignored her complaints of labor pains for several hours. Barnes hired Prison Health in 2005 when the county ended its contract with another provider because of performance dissatisfaction.

Gwinnett County Detention Center, Lawrenceville, Georgia
July 24, 2008 Atlanta Journal-Constitution
The widow of a Lawrenceville man who died after struggling with Gwinnett deputies and being stunned with a Taser has dropped a lawsuit against the county. The wife of Frederick Jerome Williams abandoned all claims in the wrongful death lawsuit against Gwinnett County and several deputies involved in the scuffle with Williams, the Sheriff's department announced late Thursday afternoon. The federal lawsuit was dismissed with prejudice, meaning the Williams family cannot refile it at a later date, said Thomas Mitchell, the attorney who represented Gwinnett County. Williams' death drew a firestorm of criticism from civil rights groups such as the Gwinnett NAACP and the Southern Christian Leadership Conference (SCLC), who led three marches outside the Gwinnett County courthouse calling for a moratorium on Taser use by law enforcement. Yanga Williams, Frederick Williams' widow, did not return messages left on her home or cellphone Thursday evening. A receptionist at the office of her attorney, Keenan R.S. Nix, said he was out of the office. Yanga Williams' attorney is going forward with the lawsuit against Taser International and the contracted healthcare provider for the jail, Prison Health Services, Mitchell said. The suit alleges that a nurse working at the jail gave inadequate and lackadaisical medical care to Williams in the critical moments after he lost consciousness. On the night of Williams' arrest in May 2004, police were called to his Lawrenceville home to settle a domestic dispute. Williams fought with officers before his arrest. Later at the jail, Williams started to fight with deputies. A videotape shows deputies shocking Williams five times with the stun gun and then placing him in a restraint chair. He lost consciousness and died in a hospital two days later. Williams, 31, a native of Liberia, died of brain damage from a heart attack, according to the final autopsy report, although officials were unable to say what caused the heart attack.

September 25, 2007 Atlanta Journal Constitution
The death of an inmate who fell ill while being held at the Gwinnett County Jail awaiting transfer to another jurisdiction has spurred a lawsuit against the Gwinnett County Sheriff's Department and its contracted health care provider. It is the fourth wrongful death lawsuit to be filed against the two parties within the past four years. According to the lawsuit filed Monday in U.S. District Court in Atlanta, William Hargrove was suffering from abdominal pains on March 5, 2006, when a doctor ordered that he be sent to a hospital emergency room. However, a supervising deputy told medical staff not to send Hargrove to the hospital and instead attempted to transfer him to Newton County, the lawsuit states. He died two hours later, before the transport had been arranged. An autopsy revealed the cause of death was a perforated ulcer of the small intestine. Police had picked up Hargrove March 4 for failing to appear in court in Newton County on a speeding violation. Representatives from both the Sheriff's Department and Prison Health Services declined comment. The lawsuit follows on the heels of another filed Sept. 7 in federal court on behalf of deceased inmate Harriett Washington. Washington died of leukemia on Oct. 17, 2005. Lawyers for Washington have criticized Prison Health Services staffers for repeatedly rebuffing her requests to be hospitalized during the days leading up to her death. Both PHS and the Sheriff's Department also were named in two Taser-related wrongful death suits. Earlier this year, county officials agreed to pay the family of Ray Charles Austin $100,000 to dismiss a lawsuit arising from Austin's death during a 2003 scuffle with deputies. A lawsuit is still pending in the 2004 death of Frederick Jerome Williams at the jail.

October 6, 2006 Gwinnett Daily Post
The president of the NAACP's Gwinnett branch wants county leaders to reconsider their decision to bestow a multimillion dollar contract for inmate health care services on a provider that faces multiple wrongful death lawsuits. County commissioners voted Tuesday to award a one-year contract to Prison Health Services for $6.15 million. John Stewart, the local chapter president of the National Association for the Advancement of Colored People, on Monday plans to review six bids submitted by other health care providers to determine if there were other viable options. "I understand the reason why PHS won a contract again was because of their financial stability and experience," Stewart said. "I am going to be looking to see if the other vendors have a track record of providing medical services and see if one of those vendors should be given the opportunity to have the contract." Stewart views PHS as "an enormous liability" to county residents and says negligent care is putting the lives of more inmates at risk. The private company has provided inmate medical, dental and mental health care in Gwinnett since 1997. It was recommended by officials from both the sheriff's and corrections departments who looked at cost, experience, references and financial stability before making their decision. Prison Health Services has been targeted in lawsuits filed by two inmates who died after struggling with deputies at the Gwinnett County Detention Center and being stunned with a Taser. Both inmates were black. The lawsuits claimed that medical staff at the jail were lackadaisical in their attempts to resuscitate one inmate, Frederick Williams, and failed to document a fear of needles in the medical file of the other inmate, Ray Austin. A third lawsuit is pending by the family of a black female inmate, 43-year-old Harriett Washington, who died of leukemia on Oct. 17, 2005. An attorney for Washington's family criticized PHS for repeatedly ignoring her requests to be hospitalized. District 3 Commissioner Mike Beaudreau said Tuesday he was concerned PHS had been targeted by the recent lawsuits in Gwinnett, but "we aren't going to let lawsuits dictate how we do the business of the people." Stewart is also scheduling a town hall meeting for people who have been incarcerated in the Gwinnett County Detention Center to give public testimony about their experiences with Prison Health Services. "I am not sure if the county has all the information available as to the inadequate services provided by this provider," Stewart said.

October 4, 2006 Gwinnett Daily Post
Gwinnett County commissioners have signed on with an embattled inmate health care provider for another year. Six other companies submitted proposals to provide health care services for the Gwinnett County Department of Corrections and the Sheriff’s Department. However, the current provider, Prison Health Services, was granted the $6.15 million contract. The commissioners did not discuss the contract during Tuesday’s public meeting, but afterward said they supported the decision of a committee who evaluated the seven bids. PHS, a private company that has provided inmate medical, dental and mental health care in Gwinnett since 1997, had been recommended by officials from both the sheriff’s and corrections departments. A committee composed of officials from both departments looked at cost, experience, references and financial stability in making its recommendation. District 3 Commissioner Mike Beaudreau expressed concern that PHS had been targeted by two lawsuits in Gwinnett within the past 13 months, but said, “We aren’t going to let lawsuits dictate how we do the business of the people.”Joan Crumpler, one of the attorneys representing the Williams family in the lawsuit, warned that in voting for PHS on Monday, county commissioners were overlooking problems at the jail that could lead to more deaths. “If the Gwinnett decision-makers limited their criteria to cost, experience, references and financial stability, then they can easily justify contracting with PHS, since PHS owns 25 percent of the national marketshare for outsourced inmate medical care,” Crumpler said. “However, Gwinnett County must never ignore very real problems at the jail, including PHS’s failure to adequately respond to medical crises. It is this kind of problem that has resulted in unnecessary deaths.”

October 3, 2006 Gwinnett Daily Post
Several pending lawsuits against the company contracted to provide health care for Gwinnett County inmates has apparently done little to influence its chances of renewing a multimillion dollar contract. Six other companies have submitted proposals to provide health care services for the Gwinnett County Department of Corrections and the Sheriff’s Department, but Prison Health Services seems to be the front-runner. Its current contract expires Oct. 31. PHS was recommended by officials from both the Sheriff’s and Corrections departments again this year. Gwinnett County Commissioners will consider that recommendation today while reviewing proposals in a public meeting. If approved, the contract awarded to PHS to provide medical, dental and mental health care for inmates would be worth more than $6.1 million. PHS had the highest-scoring proposal of all those submitted for consideration, according to a county memo. But not all the feedback on PHS has been positive. The company was targeted by two lawsuits in Gwinnett within the past 13 months. It also came under harsh criticism in January following the release of an internal investigation by the Gwinnett County Sheriff’s Department into the death of a terminally ill inmate. Several deputies and inmates blasted PHS for its handling of the woman, who died of leukemia on Oct. 17, 2005. Harriett Washington, 43, repeatedly asked to be taken to a hospital in the days leading up to her death, but her requests were rebuffed by staff members who instead sent her back to her cell. Washington’s two cellmates and several deputies reported that she was sent to the infirmary three times in a two-day period only to be returned to her cell in the same condition — vomiting, experiencing high fevers and having difficulty breathing. Jonathan P. Sexton, an attorney for Washington’s family, said he plans to file a wrongful death lawsuit against PHS and Gwinnett County in the next six weeks. He was dismayed to hear that PHS’ contract may be renewed. “I hope they don’t use them again,” Sexton said Monday.

May 2, 2006 Atlanta Journal-Constitution
Nearly 175 inmates and employees at the Gwinnett County Detention Center were put on antibiotics after the weekend death of an inmate, officials said Monday. Detainee Zachary Harris, 20, died from an infection in his bloodstream at Gwinnett Medical Center on Saturday after being admitted three days earlier, jail officials said. A Detention Center physician said Harris' blood contained a bacterium that commonly causes meningitis. Harris, who had been at the jail a year, complained of a sore throat April 18 and was taken to the hospital Thursday when his blood pressure dropped dangerously low. He had been awaiting trial on multiple charges, including impersonating a police officer and drug possession. Detention Center doctor Lee Grose — who works for the jail's contract medical provider, Prison Health Services — said the bacterium can be spread through sneezing and coughing. Jail officials don't know how he contracted the bacterium but discounted that a visitor could have passed it on. Medical services at the jail have been under scrutiny since the October 2005 death of inmate Harriet Washington, 43, who had myeloid leukemia. Washington, who died in her jail cell, had asked to be hospitalized numerous times in the days before her death but was turned away by the Prison Health Services staff, internal jail reports said. At least four of the health provider's employees were fired, resigned or were transferred as a result of Washington's death.

April 21, 2006 Gwinnett Daily Post
After nine years, the woman tasked with supervising health care for Gwinnett County inmates has been reassigned to another post. The departure of Dwana Gebhardt, health system administrator for Prison Health Services, comes four months after allegations of inadequate health care at the Gwinnett County Detention Center surfaced following the death of a female inmate. Prison Health Services, based in Nashville, Tenn., is the nation’s largest private provider of correctional health care. The company has a contract with Gwinnett to provide medical services for both the detention center and Gwinnett County Comprehensive Correctional Complex. Officials at the Gwinnett County Sheriff’s Department say Gebhardt’s reassignment is not related to the recent hubbub over jail health care. “I don’t think it is,” said Maj. J.J. Hogan, who was appointed last month as the sheriff’s liaison and supervisor to Prison Health Services. Both the Sheriff’s Department and PHS came under scrutiny following the Oct. 17, 2005, death of a 43-year-old female inmate who was awaiting trial on a cocaine possession charge. Harriett Washington had previously been diagnosed with myeloid leukemia. An internal investigation at the Sheriff’s Department revealed Washington asked several times to be hospitalized in the days leading up to her death, but her pleadings were rebuffed by medical staff. Washington’s cellmates and deputies who were in the housing unit said they witnessed Washington vomiting repeatedly, experiencing dizziness, acting delirious and having difficulty breathing. She was taken to the jail’s medical unit at least three times in the two days before her death, but none of her visits were documented as required, according to the internal investigation. Each time Washington was sent back to her cell as her health deteriorated. After Washington died, five other inmates and a former PHS mental health counselor came forward to the Gwinnett Daily Post with other complaints about botched medications, lapses in medical documentation, patient neglect and staff indifference. In the months that followed, at least four PHS employees that were on duty that night or were in supervisory positions have been fired, resigned, retired or transferred. PHS officials have said none of the staffing changes were a result of Washington’s death or the subsequent complaints.

March 21, 2006 Gwinnett Daily Post
In the wake of a highly publicized inmate death and complaints about poor health care at the Gwinnett County Detention Center, a high-ranking deputy has been tasked with overseeing the jail’s contracted medical staff. Maj. Jim Hogan will supervise employees of Prison Health Services, the contracted medical provider for the jail, on a full-time basis beginning Monday. Gwinnett County Sheriff Butch Conway said his department pays Prison Health Services (PHS) about $6 million a year to provide health care for inmates. “I think we should have had a medical monitor before now,” Conway said. “I think with the size of that contract that it’s prudent for us to have someone on staff monitor the quality of the work.” Hogan will serve as the primary point of contact for PHS management, monitoring medical service issues, meeting daily with staffers, making policy recommendations, reviewing grievances and providing regular reports to the sheriff. Hogan is a 26-year veteran of the Sheriff’s Department. He has been second in command over jail administration since 1999. Both the Sheriff’s Department and PHS came under scrutiny following the death of a 43-year-old female inmate who was awaiting trial on a cocaine possession charge on Oct. 17. Harriett Washington had previously been diagnosed with myeloid leukemia. An internal investigation at the Sheriff’s Department revealed Washington asked several times to be hospitalized in the days leading up to her death, but her pleadings were rebuffed by medical staff. Washington’s cellmates and deputies who were in the housing unit said they witnessed Washington vomiting repeatedly, experiencing dizziness, acting delirious and having difficulty breathing. She was taken to the jail’s medical unit at least three times in the two days before her death, but none of her visits were documented as required, according to the internal investigation. Each time Washington was sent back to her cell as her health continued to deteriorate. After Washington died, at least five other inmates and a former PHS mental health counselor came forward with complaints about botched medications, lapses in medical documentation, patient neglect and staff indifference. Hogan said Monday he is up to the challenge of overseeing PHS.

January 22, 2006 Gwinnett Daily Post
A review of the personnel files of more than 60 employees of Prison Health Services, the contracted medical provider for the Gwinnett County Detention Center, reveals several employees have something in common with the inmates they treat — six have been arrested in the past. The six employees, including the jail’s medical director, were arrested as long ago as 1981 and as recently as this year for a range of offenses. In addition, a nurse and a certified medical assistant were accused of criminal behavior while they were still working at the jail less than three months ago. One has since been fired and the other resigned amid an internal investigation. While his resume lists an impressive amount of supervisory experience in the field, his personnel file reveals staff psychiatrist Dr. Jeffrey Howard Flatlow had his medical license put on probation by the Composite Board of Medical Examiners in 1985. The sanctions were lifted in 1993. The reason why Flatlow was on probation is not said, but the file does say Flatlow was in an “impaired physician’s program” or designated as a “recovering physician.” A pattern of supervisors tolerating mistakes also emerges from a study of the PHS files. Employees who were found to be sleeping on the job, providing inmates with the wrong medication, forgetting to document patient treatments or allowing an inmate to administer their own medication were given a verbal or written reprimand. However, some employees, such as Kessie, racked up as many as seven written reprimands in less than two years without losing their jobs. Kessie was finally fired in October upon being arrested and charged with providing an inmate with a cell phone. A high turnover of medical staff at the jail is also evident in the documentation PHS produces. The jail is staffed with 30 full-time health care employees and seven mental health professionals, according to Stacey Kelley, spokeswoman for the Gwinnett County Detention Center. A records request for the personnel files of staff currently employed and any staff members who left after Sept. 1, 2005, because of resignation or termination resulted in 63 employee files, thus 26 people left within that time frame. Stacey Kelley, spokeswoman for the Gwinnett County Sheriff’s Department, issued a statement on behalf of Sheriff Butch Conway this week saying he is weighing his options regarding PHS’ contract with the county, which expires this year on Oct. 31. No serious talks have occurred regarding termination of the contract, Kelley said. “I am in the process of determining what my options are regarding Prison Health Services,” Conway says in the statement. “When I do, I will make a decision that is in the best interest of the Gwinnett County Sheriff’s Department, the inmates and our personnel.”

January 20, 2006 Atlanta Journal-Constitution
Gwinnett Sheriff Butch Conway is trying to decide whether to fire the county jail's medical provider. The sheriff could decide to opt out of the county's $4.8 million annual contract with Prison Health Services. The company's performance was called into question in a scathing internal report on the 2005 death of a detainee. Harriet Washington, 43, who had been in the jail since June on a cocaine possession charge, died early on Oct. 17. She suffered from leukemia. The report states that jail deputies and Washington's cellmates urged that she be taken to a hospital, but that their pleas were ignored by employees of the Tennessee- based health provider. A letter from Washington's cellmates to Conway alleged that multiple requests that Washington be treated were ignored in the two days before her death. Washington had not seen an outside doctor since July, according to jail records. "Either party can opt out of the contract" with at least 10 days' notice, Conway said Thursday. The contract states that any violation of its provisions or stipulations is grounds for termination. Conway said he believes it would be possible to switch providers with a minimum of disruption, if that's what he decides to do. The report particularly questions the actions of Brian Woodard, a licensed practical nurse for Prison Health Services who treated Washington over a two-day span that ended with her death. Woodard could not be reached for comment Thursday. He has been a licensed practical nurse since at least 1994, according to state professional license information. Woodard resigned a week after Washington's death as a result of a separate, unrelated internal investigation into narcotics missing from the medical unit, the report says. The company already is named in at least two federal suits filed after Gwinnett inmates died in custody.

January 20, 2006 AP
Gwinnett County attorneys are blaming Taser International and Prison Health Services in the death of a jail inmate, who died after being repeatedly shocked with a stun gun. The county, which has been sued by the family of Frederick Williams, filed a cross claim this week blaming Scottsdale, Ariz.-based Taser International for providing false training documents and not warning users that their stun guns could be lethal if used repeatedly. Taser International and Brentwood, Tenn.-based Prison Health Services, which provides medical care at the jail, should be held accountable, the county says, especially if a court finds that Williams died from the Taser or because of improper medical care.

January 19, 2006 Atlanta Journal-Constitution
Jail inmate Harriet Washington was the victim of a confused and clumsy medical response when she died in front of her cellmates, concluded a Gwinnett Sheriff's Department investigation released Wednesday. Washington, of Norcross, died on Oct. 17. Jailed at the Gwinnett County Detention Center since June for possession of cocaine, Washington suffered from leukemia. She was 43. The internal affairs investigation clears Sheriff's Department deputies of any culpability, stating they "adhered to existing policy and acted in a manner consistent with the needs of the situation." The report raises questions, however, about the performance of Prison Health Services, the Tennessee-based company contracted to care for Gwinnett inmates. Deputies had urged that Washington be taken to the hospital, to no avail, the report states. "If the medical staff had ordered outside treatment at Gwinnett Medical Center, as sworn staff [deputies] had urged, instead of allowing the inmate to remain in the housing unit, the end result very well may have been the same," the report's conclusion states. "Had the inmate been transferred to the hospital, however, it would have eliminated the doubt surrounding the appropriateness of the treatment provided." Sheriff Butch Conway declined an interview on the report, but issued a prepared statement: "I am in the process of determining what my options are regarding Prison Health Services," it read. "When I do, I'll make a decision that is in the best interest of the Gwinnett County Sheriff's Department, the inmates and our personnel." According to the internal affairs report, Washington was briefly taken to the medical unit at least once the day before she died but was returned to her cell a short time later. The report accuses the company of failing to adequately document her care. Records even conflicted on how many times she was taken to the medical unit. Inmate Cheryl Horstman, who was in the medical unit at the time, told investigators that nurse Brian Woodard and Deputy Benita Smallwood seemed "bothered" by Washington's presence. At one point, Woodard told Washington, "only one problem per visit," according to Horstman. In a subsequent debriefing with his superior in the medical unit, Woodard said, "I know I [messed] up" by failing to document Washington's treatment. Woodard submitted his resignation on Oct. 24 as a result of a separate internal investigation into narcotics missing from the medical unit, the report says without elaboration. Woodard could not be reached for comment Wednesday. On Oct. 16, as Washington was trying to move from her wheelchair to a "boat" — a plastic tub that serves as a bed in the detention center — she passed out, the report said. The nurse and deputy asked her why she had tried to move at all. "I don't feel right. ... I need to go the the hospital, something doesn't feel right," the report quoted Washington as saying. Horstman said Smallwood then told Washington, "There isn't even a doctor here on weekends. The whole jail is in lockdown, and you can't stay in medical. What do you think this is, the Hyatt?" In interviews with investigators, Smallwood denied making the comment. Washington was sent back to her cell but apparently received no assistance from medical personnel until midnight, when she received crackers and Pepto-Bismol during "pill call." At 2:41 a.m. Oct. 17, the "I" pod deputy pressed the panic button to summon help after Washington screamed in pain and collapsed. According to the report, a nurse and a medical assistant from the jail intake area — neither of whom was qualified as a first responder — arrived three minutes later but could not get a response from Washington. The report noted that no "progress notes" were kept of her vital signs or treatment, which violated Prison Health Services internal protocols.

December 11, 2005 Gwinnett Daily Post
The death of a cancer patient at the Gwinnett County Detention Center has touched off an avalanche of complaints by other inmates about substandard health care. The allegations paint a disturbing portrait of botched medications, patient neglect and staff indifference by the county's contracted medical provider at the jail, Prison Health Services. Before she died, 43-year-old Harriett Washington was known affectionately as "Sparkles" among her fellow female inmates. In and out of prison several times for cocaine possession, theft and forgery, friends said Washington was nonetheless an extremely likable woman who had been diagnosed with myeloid leukemia, a rapidly progressing cancer of the blood. The autopsy conducted by the Gwinnett County Medical Examiner's Office shows Washington's cancer was in remission prior to being jailed in June, but she died of leukemia in her jail cell just five months later. While she was incarcerated, the only documented medical complaint in her file was on Oct. 16, when she complained of knee pain, according to the autopsy. Washington died before daybreak on Oct. 17. Her cellmates, Kimberly Holmes and Carla Dotson, say Washington begged repeatedly to be taken to the hospital the week before she died. There are no records of this alluded to in the Medical Examiner's Report. Holmes and Dotson claim their pleadings to hospitalize Washington were repeatedly rebuffed by PHS staff. A spokeswoman for Prison Health Services would not release Washington's medical records, citing right to privacy laws which they believe still remain in effect despite Washington's death. One former PHS worker said she became furious with the company over their lack of concern for inmates' well being. Diane Yociss, a former Prison Health Services mental health counselor, was fired in October. Yociss said her supervisors told her it was because she had been written up for going to physical therapy appointments for an on-the-job injury and for giving blood during work hours. Yociss believes the real reason for her firing was that she was becoming too vocal about lapses in health care at the jail. Her claim couldn't be verified because Prison Health Services did not make her personnel records available by press time. Yociss said she couldn't discuss Washington's case or cite specific examples of inmate health care because it would violate a code of ethics for her profession. However, Yociss said she wasn't surprised to hear about Washington's death. "Turnover there is horrific," Yociss said. "A lot of times people's follow-up care gets dropped. Other times they do the right thing and send them out (to a hospital)." Yociss said she confronted supervisors several times about mistakes - severely neglected patients, medication mix-ups and poor medical documentation, but her complaints were largely ignored. Instead, supervisors made excuses for employee mishaps, Yociss said. "The whole attitude toward inmates when they came in was they are either faking, they're malingering, they want to get out of their cells, or they want medicine," Yociss said. "In a lot of cases, yes they are. But in other cases, no, they're not. They are genuinely sick." In a series of jailhouse and telephone interviews last week, several inmates talked about their encounters with nurses and doctors employed by Prison Health Services. The following inmates' stories couldn't be verified because PHS would not provide their medical records, citing privacy laws as the reason for their exemption from Open Records law. Natalie Horne, 20, in jail on a felony drug possession charge, said she had to be hospitalized after a nurse gave her the wrong medication in August. Horne was supposed to get medicine to treat pain in her ankle when the nurse came into the pod for daily "pill call." Horne, who is hearing impaired, couldn't hear the names being called, but she got in line to receive her usual dose. The nurse was supposed to check the identification on Horne's arm band before dispensing the appropriate medication, but she didn't, Horne said. Instead, the nurse gave her someone else's medication. Horne doesn't even know what it was, but it made her cough and her lungs hurt. "I was dizzy and weak and I didn't feel like eating for three days," Horne scribbled on a piece of paper during her interview. When Horne told the nurse she had been given the wrong medicine, she alleges the woman seemed indifferent and replied "Oh well, just throw up." Tina Thompson told a similar story. Jailed in June for allegedly violating her probation by possessing a small quantity of crack cocaine, the 35-year-old woman said she was supposed to receive 400 mg of a medication to treat epilepsy. Two weeks ago, Thompson said she was accidentally given 500 mg of the drug. Thompson said the nurse also dispensed another unknown medicine to her that she wasn't supposed to receive, but she threw the pill away because she didn't recognize it. "I told her it was too much, but she said 'No, no, no, you take. It's OK," Thompson said Thursday during a jailhouse interview. Thompson said she didn't suffer any ill effects from the overdose of epilepsy medication, but it could have caused her to go into seizures. When she brought the mistake to another nurse's attention, Thompson said she was told "People make mistakes." "That mistake could've killed me," Thompson said, shaking her head. There are also several allegations that the record-keeping at the jail is sometimes spotty, botched or misplaced. Georgia E. MacDonnell, 48, landed in the Gwinnett County Detention Center earlier this year because Hall County didn't have the medical facilities to treat her. Reached by phone Thursday at her Gainesville home, MacDonnell said her only crime was trying to kill herself. McDonnell said she was charged with aggravated assault for attempting to shoot herself after hearing her fiance had been diagnosed with a terminal cancer. MacDonnell needed ongoing treatment while at the jail because she has a colostomy bag attached to her abdomen to collect her body's waste. She said the skin where the bag attaches became infected when PHS staff failed to provide her with supplies to change the bag every three days, as recommended by her doctor. She claimed she only received the supplies to change 17 bags during her entire five-month incarceration. MacDonnell regularly requested them at pill call, but she was usually told to wait because more were being ordered, she said. MacDonnell explained that the sticky bandage that the plastic bag attaches to is useless when it gets wet, so it must be changed after each shower just like a Band-Aid. When she wasn't supplied with the bandages, called flanges, MacDonnell said she couldn't take showers. On one occasion, MacDonnell said she took a mandatory shower. Afterward, she asked a deputy for another colostomy bag, but allegedly didn't receive one until six hours later. During that time, MacDonnell said she was forced to sit in the medical unit with her body's waste dripping out all over her, making her abdomen raw. On the only time she was taken to see a physician in the medical unit, MacDonnell said yet another snafu occurred. "The doctor had my nephew's medical records instead of mine, and they returned me to my dorm without treating me," MacDonnell said. "I think that Gwinnett needs to answer to a lot of things, especially the medical care." Holmes, who has hepatitis, also alleges a poor experience with one of PHS' doctors. She followed protocol by submitting a request to see a doctor for pain in the area of her liver. When Holmes was transported to the medical unit to see a physician, she claimed the doctor didn't even know what she was doing there. Then he dismissed her complaints as imaginary. "He never touched me or examined me," Holmes said. "He said I was imagining it." Yociss said the inmates experiences are not uncharacteristic with what she witnessed as a former PHS employee. "I am not disgruntled. I am furious that people are still being treated like this," Yociss said. "I am furious that people have to die. I am not anybody's guardian angel. I'm just doing this because it is the right thing to do."

December 10, 2005 Gwinnett Daily Post
Information in the medical files of a leukemia patient who died at the Gwinnett County Detention Center in October conflicts with her cellmates' allegations that the woman was repeatedly denied hospitalization, according to autopsy records released Friday. The autopsy conducted by the Gwinnett County Medical Examiner's Office stated 43-year-old Harriett Washington's cancer was in remission prior to her being jailed in June. However, she died of leukemia just five months later. The Gwinnett County Detention Center has no record of Washington receiving any cancer treatments during her stay there, according to the autopsy. The only documented medical complaint in her file was on Oct. 16, when she complained of knee pain. Washington died before dawn on the following day. "(Washington's) roommates found her to be experiencing seizure-like activity before losing consciousness," the autopsy said. "Responding staff members found her lying supine on the floor with her head resting on a pillow that had been placed there by her roommates. Staff members immediately called 911 and transported her to the clinic." Washington was taken to Gwinnett Medical Center in full cardiac arrest, where she was pronounced dead. Kimberly Holmes and Carla Dotson claim Washington was scheduled to see a specialist for cancer treatment two weeks before she died, but she was never taken. The inmates also claim Washington begged repeatedly to be hospitalized because she realized that she was relapsing and getting sicker.

December 9, 2005 Atlanta Journal-Constitution
Whenever a prison inmate dies in custody - especially when the death may have been the result of inadequate medical care delivered by a for-profit company - the public deserves to know what happened and why. Gwinnett County Sheriff Butch Conway has promised to investigate eyewitness claims that jail health workers largely ignored inmate Harriet Washington's symptoms for two days and let her suffer before she died in her county jail cell on Oct. 17. Jail officials knew Washington had leukemia. Washington's death is the third over the last two years to raise questions about the quality of medical services at the Gwinnett jail. The county pays Prison Health Services of Brentwood, Tenn., $4.8 million a year to provide nursing and physician care to inmates. The company has contracts with eight other jail facilities in Georgia and works at 310 facilities around the country. In September, the family of Ray Austin, who died at the Gwinnett jail in 2003, sued Prison Health Services, alleging company employees injected him with psychotropic drugs against his will shortly before being shocked eight times with a Taser during an altercation there. On Wednesday, the family of Frederick Williams filed a lawsuit against Conway, Taser International, Prison Health Services and several other defendants for another Taser-related death at the jail in May 2004. In Alabama, the state settled a class-action suit filed by inmates over inadequate care provided by Prison Health Services at state prisons. And Richland County, S.C., officials recently terminated a contract with the company after three inmate deaths in the county jail over the last three years. Many critics fear that in their quest for higher profits, private companies will cut costs through such arrangements as reducing shift workers, putting doctors on call instead of working on site at the jail, and giving employees unchecked decision-making power about what drugs are given to prisoners. Employees are also answerable to their employer, the private company, and not to those actually running the jail. Conway and Gwinnett officials need to ensure that's not happening at the county jail. The best way to do that is to make public as much of the investigation about Washington's death as possible and re-examine the staffing arrangement it has with Prison Health Services. The county may be able to contract out health care, but it can't contract out its legal and moral obligation to those in its custody.

December 7, 2005 Atlanta Journal-Constitution
Attorneys for a man who died after a Taser-related scuffle at the Gwinnett County jail today filed a wrongful death lawsuit. The Gwinnett State Court suit was filed today by attorneys representing the family of Frederick Williams, who lost consciousness and died after a May 2004 scuffle in the jail. The handcuffed and manacled inmate was shocked multiple times with a Taser. In the Williams lawsuit, attorneys named Sheriff Butch Conway, three of his deputies and two Gwinnett police officers allegedly involved in the altercation, weapon manufacturer Taser International and Prison Health Services, a Nashville-based company that provides medical services for the jail.

December 7, 2005 Atlanta Journal-Constitution
A Tennessee company responsible for providing care to Gwinnett County jail inmates has faced a litany of lawsuits in at least four states in recent years. Already named in one Gwinnett County lawsuit linked to an inmate's death, Prison Health Services has been cited by cellmates of a woman who died in jail seven weeks ago. Harriet Washington, 43, of Norcross, died Oct. 17 in her cell. Her two cellmates said their pleas that Washington receive help went largely unheeded. The Brentwood, Tenn., company's Web site says it provides care to about 214,000 inmates in 310 jails and prisons in 37 states. The company says it serves eight facilities in Georgia. This year, Gary Watts, a coroner in Richland County, S.C., led an inquest after an inmate in the county jail hanged himself. A coroner's jury found that Prison Health Services had not provided the mentally ill man his prescribed medication for several days. "Horrible care," Watts said. "Absolutely horrible care." In Alabama, the state Department of Corrections settled a class-action lawsuit filed by inmates over health care provided by the company. Among other things, the lawsuit charged that inmates were not given their medication at the proper time or in correct dosages and were examined in rat-infested rooms. "There were some significant lapses in the system of medical care being provided at the facility," said Joshua Lipman, a lawyer at the Atlanta-based Southern Center for Human Rights, which represented the inmates. Added Lipman, "Prison Health Services has problems all over the country right now." Prison Health Services was named in a lawsuit filed by the family of a Gwinnett inmate last September. Attorneys for Ray Austin's family allege that Austin was shocked eight times with a Taser after company employees injected him with psychotropic drugs during a September 2003 altercation at the jail. Austin lost consciousness and died after the incident. Austin's attorneys allege that Prison Health Services officials ignored a doctor's warning that Austin not be forcibly medicated. The warning was in his jail medical file, according to the lawsuit. Medical personnel and deputies also ignored Austin's wishes he not be medicated. Austin had signed jail paperwork granting him the right to refuse medical treatment, according to the lawsuit. "But for the decision on the part of ... medical personnel to proceed with forced administration of medication, Austin would not have resisted," the lawsuit said. "He would not have been in the altercation ... and would not have died." The details of Washington's death sounded familiar to David Almeida, executive director of the South Carolina chapter of the National Alliance on Mental Illness. Three mentally ill inmates have died at the Richland jail, including the man who hanged himself, in the past three years. After the third death, the Richland County Council voted to terminate its contract with Prison Health Services. The estates of the first two inmates who died settled lawsuits with Prison Health Services. "It just seems to me that when it comes to Prison Health Services, you have to be very careful," Almeida said. Watts, the coroner, said the inquest revealed a pattern of poor record-keeping, insufficient personnel and a failure to provide inmates with medication. Watts said that Prison Health Services employees subpoenaed in the inquest testified that that level of service was "almost a way of doing business: just go in, and do what you could. If you couldn't do it, don't worry about it."

December 6, 2005 Atlanta Journal-Constitution
Gwinnett's sheriff promised a thorough investigation Monday into an inmate's death, which prompted two cellmates to allege inadequate medical response. Butch Conway also defended the jail's contract medical provider, Prison Health Services, of Brentwood, Tenn. The company declined comment on the Oct. 17 death of Harriet Washington, 43, jailed since June for possession of cocaine. Washington, who suffered from leukemia, died on the jailhouse floor as her two cellmates watched. Morgenstern said the company initiates an in-house review of every patient's death. The two inmates, Kim Holmes and Carla Dotson, said in a jail interview Monday that they can't get the images out of their heads. They described Washington screaming in pain and convulsing before dying. Holmes and Dotson began keeping a list of Washington's numerous symptoms. On Sunday afternoon, they say, a medical unit nurse came to assess her condition. Holmes and Dotson decided to risk retaliation by writing the letter because they think a change is needed. "The only thing I have to say is that I didn't want Harriet to die and nothing change," Holmes said. "I just appreciate knowing that we have a voice even though we're in here."

December 5, 2005 Atlanta Journal-Constitution
Two Gwinnett Detention Center inmates are alleging that shoddy medical treatment contributed to the death of their cellmate. Harriet Washington, 43, died in her cell Oct. 17 while being attended to by staff from Tennessee-based Prison Health Services, a private firm contracted by the county to provide medical care at the jail. In a Nov. 8 letter addressed to the medical unit supervisor and the Sheriff's Department's internal affairs unit, inmates Kim Holmes and Carla Dotson allege that Washington's multiple symptoms were for the most part ignored. Representatives of Prison Health Services did not return phone calls Sunday seeking comment. Holmes and Dotson were moved into Washington's cell about 8:30 a.m. Oct. 15. According to their letter, Washington was "extremely sick" and worsened as the day went on. The medical unit and a nurse who delivers medications at "pill call" were consulted, the letter says, but advised the women to fill out a medical request and turn it in. On Oct. 16, Washington eventually was sent to the medical unit, but was returned after an hour with no medications, according to Holmes. Several hours later medical was called again, the letter says. Washington was briefly taken back to the medical unit, the letter says, but was returned to her cell a short time later. Holmes' letter says she and Dotson continued to try to get medical attention for Washington, but were told that Washington had leukemia and nothing could be done, so she had to stay in the cell. Other times, they say, they were told that Washington "would be fine." Holmes further states that as Washington worsened and began to vomit continuously, she asked a deputy to seek medical help. The deputy returned and told her the medical department said vomiting was good for Washington. Early on Oct. 17, the letter states, Washington began screaming in pain and could not stop. According to the jail's Unusual Occurrence Report, a deputy notified medical at 2:10 a.m. and was told to bring Washington to the unit. Washington could not be moved, so the deputy pressed his "panic button" and announced a medical emergency. As he waited in Washington's cell, the report said, Washington "exhaled one loud breath and her eyes were open and fixated." The Unusual Occurrence Report states that nurses arrived at the cell at 2:44 a.m., but could not get any response from Washington. At 2:53 a.m., an ambulance was summoned. Homes' and Dotson's letter says that the medical staff decided that the hospital was necessary after the nurse announced that Washington had "no pulse." Holmes also alleged in her letter that Washington was supposed to see a cancer doctor every six weeks, but was already overdue. According to the jail's "inmate external movements" report, Washington last went to an outside doctor on July 18.

October 7, 2005 Gwinnett Daily Post
The nation's largest private provider of health care services to prison inmates has faced a recent lawsuit in Gwinnett and criticism from local officials in other states, but county commissioners have voted to extend their contract for another year. Prison Health Systems, a Nashville-based company, will continue providing medical, dental and mental treatment for inmates at the Gwinnett County Detention Center and the Department of Corrections until Oct. 31, 2006. Commissioners voted in September to extend the contract with PHS, said Kristine Tallent, budget division director for Gwinnett County. A lawsuit filed in September in the U.S. District Court's Northern District in Atlanta took aim at the company, claiming that medical personnel employed by PHS at the Gwinnett County Detention Center should not have forced deceased inmate Ray Charles Austin to receive an injection of an anti-psychotic drug. Prison Health Services has been faulted for inmate deaths in other jurisdictions, prompting some local officials to discontinue contracts with the company. A series of articles which ran in The New York Times beginning in late February documented cases of inmate suicide, shoddy care to children in custody and prisoners dying after being denied treatment. Last month, officials in Richland County, S.C., ended a contract with PHS following the deaths of three mentally ill inmates during the past three years, saying they were "terribly dissatisfied" with services. Nashville jail officials also replaced PHS last month with another inmate health care service in the wake of widespread criticism for failing to give inmates enough medical attention. Three diabetic inmates were alleged to have become ill there after receiving substandard care since January. Prison Health Services has a profitable business relationship with Gwinnett County in recent years. Last year, it was paid approximately $6.4 million, and the company has received more than $3 million in compensation this year.

September 22, 2005 Gwinnett Daily Post
An attorney for the children of an inmate who died after struggling with deputies has filed a lawsuit against the Gwinnett County Sheriff’s Department and its contracted health care provider. The lawsuit was filed Monday in the U.S. District Court’s Northern District in Atlanta on behalf of the son and daughter of Ray Charles Austin, who are both under the age of 10. The suit claims that deputies and medical personnel employed by Prison Health Services should not have forced Austin to receive an injection of a drug to calm a psychotic outburst at the Gwinnett County Detention Center. Austin, 25, struggled with deputies who were attempting to restrain him so a nurse could administer the injection on Sept. 24, 2003. Brian Spears, the attorney for Austin’s family, said Austin was a diagnosed schizophrenic and he was afraid of needles. During the struggle deputies shocked Austin about six to eight times with a Taser stun gun, according to the lawsuit. Austin bit off a portion of a deputy’s ear, and several deputies used their fists, choke holds, Taser shocks and deprivation of oxygen to retrieve the piece of flesh from Austin’s mouth. He subsequently lost consciousness and died.

September 21, 2005 Atlanta Journal-Constitution
The family of a man who died at the Gwinnett jail after being repeatedly shocked with a Taser has filed a federal lawsuit against members of the sheriff's department. The wrongful death suit was filed this week in U.S. District Court in Atlanta by attorneys representing the family of Ray Charles Austin. It is the first of two Taser-related lawsuits expected to be filed by the families of inmates who have died after scuffles at the jail. Attorneys for Frederick Williams, an inmate who died in a similar altercation eight months after Austin, say they plan to file a lawsuit soon. The suit names Sheriff Butch Conway, three of his deputies allegedly involved in the altercation, and Prison Health Services, a Nashville-based company that provides medical services for the jail. Austin's attorneys allege in the suit that the 24-year-old man would not have died if deputies and a jail nurse had not forced him to take medication, shocked him eight times, beat and choked him. Gwinnett's medical examiner reported that Austin died of a heart attack but the autopsy did not clearly determine what caused the heart attack. Austin's attorneys allege that jail medical officials ignored a doctor's warning that he should not be forcibly medicated. The warning was in his jail medical file, according to the suit. Medical personnel and deputies also ignored Austin's wishes of not being medicated even though Austin had signed jail paperwork stating that he had the right to refuse medical treatment, according to the suit.

Hampton Roads Regional Jail, Portsmouth, Virginia
June 20, 2004
Three inmates at Hampton Roads Regional Jail in Portsmouth who suffer from mental illnesses say the jail's medical staff failed to prescribe drugs that effectively treat their conditions.  For months they were wracked with feelings of hopelessness, anxiety, sleeplessness and delusional thoughts, they say. Sometimes they even wanted to harm themselves.  The men didn't get the medicine they requested until the end of May, after repeated calls to the press and to an advocacy group for the mentally ill. Since then, they say they're feeling better.  Hampton Roads Regional Jail holds about 1,060 inmates from Hampton, Newport News, Norfolk and Portsmouth. Of those, about 260 inmates are treated for mental illness by Prison Health Services, Inc., a private company that provides health care to inmates in 400 jails and prisons in 35 states.  The quality of medical care for mentally ill inmates treated by private companies has been the subject of investigations and lawsuits throughout the country in recent years. In Virginia, officials are examining the quality of mental health care at jails and prisons to see if mentally ill inmates are receiving the proper medications.  The issue boils down to this: Mental health advocates say these private companies often care more about their bottom lines than about the well-being of inmates. They say these companies are reluctant to prescribe expensive drugs, even if they provide the most effective treatment.  Prison health care companies typically devise their own pre-approved lists of drugs that often don't include more expensive, proven drugs, said Valerie Marsh, director of the Alliance. They can prescribe drugs not on the list, Phelps said, but they may be reluctant to do it.  (Dailypress.com)

Idaho Department of Corrections
May 22, 2005 AP
A prison healthcare company from Saint Louis, Missouri, has beaten out the existing provider of medical care for Idaho Department of Correction prisoners. Correctional Medical Services will take over duties at all Idaho prisons July 11th. It offered to provide inmates with medical and dental care for nine-dollars and 75 cents per day per prisoner. Teresa Jones, a D-O-C spokeswoman, says that was less than the bid of Tennessee-based Prison Health Services. Idaho has roughly 64-hundred prisoners across the state.

Department of Correction Director Tom Beauclair is disappointed in the contractor providing medical care to prison inmates and says his agency has launched three separate investigations into employees of Prison Health Services.  Beauclair declined to elaborate on the investigations or complaints that precipitated them.  An official with Prison Health Services, which has a $12 million contract to provide medical care to the state´s more than 5,820 inmates, denies that Idaho prison inmates are being hampered from getting the medical services to which they´re entitled.  “We are doing a fine job out there,” said Rod Holliman, a vice president for Prison Health Services.  However, Beauclair said that while the company is providing the health care to inmates required by the U.S. Constitution, the work is still not up to par.  “There are concerns,” Beauclair said.  “We have employee management issues, communication issues and accountability issues,” Beauclair said of the company.  (Idaho Statesman, April 6, 2004)

Indiana Department of Corrections
June 24, 2005 Yahoo
America Service Group Inc. (NASDAQ:ASGR - News) announced today that its subsidiary, Prison Health Services, Inc. (PHS), has been informed by the Indiana Department of Correction (IDOC) that, as a result of a rebid process, it has not been selected to enter negotiations for a new inmate healthcare contract scheduled to start September 1, 2005. PHS' current contract with the IDOC expires on August 31, 2005.

March 2, 2005 Fort Wayne Journal Gazette
The Department of Correction’s ombudsman should investigate the performance of a private prison health care provider that receives $35 million annually to provide care in Indiana’s jails. Since the late 1990s, Public Health Services, a Brentwood, Tenn.-based organization, has provided health care for about 24,000 inmates in Indiana. Given that the current prison health care contract lapses at the end of July, investigating the company should be more of an imperative for Indiana Ombudsman Bureau. The bureau, housed in the state’s Department of Administration, has broad powers to investigate and attempt to resolve complaints concerning the Department of Correction. In Indiana, the company faces a lawsuit from one ex-employee, and the Indiana Civil Liberties Union has been critical of prison health care for a number of years. A Department of Correction spokesman would say only that Public Health Services has met its obligation to Indiana’s prisoners. It has not been the best week for Prison Health Services. The company is currently battling a reputation-battering series in the New York Times that focused on inmates who have died in New York state jails serviced by Prison Health Services. The company characterizes the Times investigation as a “blatantly unfair story” that contains many “mischaracterizations, exaggerations and  oversimplifications.” However, the story details plenty of damning evidence, including New York State Commission of Correction reports that faulted Prison Health Service’s “policies, or mistakes and misconduct by its employees” in 23 deaths in New York City and six other counties. Prison Health Services continues to dispute the commission’s analysis. Although nothing like what’s happening in New York has been documented in Indiana, Prison Health Services and the Department of Correction have had their fair share of trouble. In 2003, the ICLU sued on behalf of an inmate who suffered from a hernia since 1997. Although the lawsuit has not been settled, Prison Health Services has changed its policy on hernia operations, the ICLU’s Ken Falk says. The ICLU receives hundreds of letters annually from prisoners complaining about health care, Falk says. Then there’s the case of Barbara Logan, who, in April, filed a lawsuit against the correction department and Prison Health Services for wrongful termination. Logan complained about inmate care.

Kane County Jail, Kane, Illinois
February 15, 2010 The Daily Herald
A convicted robber has filed a federal lawsuit claiming he was given the wrong medication while incarcerated at the Kane County jail. Michael H. Morris, 30, of North Aurora, was "unable to urinate, suffered neuropathy in his feet and had difficulty breathing" after the jail gave him a form of insulin that doctors had concluded was "no longer effective" in treating his diabetes, the lawsuit says. Morris claims he repeatedly was treated incorrectly, despite protests from himself and his mother, during a 90-day jail sentence he served after pleading guilty to aggravated robbery in 2007. The lawsuit filed in U.S. District Court says Morris' "blood sugar levels went dangerously high, to more than double the normal range," and also accuses jailers of acting "willfully and wantonly, maliciously, and with a conscious disregard and deliberate indifference to the plaintiff's rights." Kane County Sheriff's Lt. Pat Gengler said the office does not comment on pending litigation. The lawsuit, which seeks unspecified damages, names as defendants Sheriff Pat Perez, the county and the jail's medical provider, Prison Health Services, as well as four unnamed guards and the jail's health services administrator.

May 7, 2006 Kane County Chronicle
At 12:01 a.m. Saturday, a controversial correctional health-care company took over medical services for Kane County Jail inmates. Tennessee-based Prison Health Services Inc. has seen its share of scandal, with New York state investigations revealing "flagrantly" and "grossly" inadequate service in two cases of inmate death. Lawsuits against the company allege poor care in jails in several states, leading to deaths and, in one allegation, the amputation of a woman's legs below the knees. In December 2005, the Kane County Board, on the advice of the sheriff's office, approved a $1.97 million contract with Prison Health Services, which, as of August 2005, served 310 jails and 214,000 inmates nationwide. As of Saturday, the Kane County Jail housed 401 inmates. Since the jail was built in 1975, it has increased from 102 beds to 399 beds. The infirmary area, however, has not increased since 1975. It has six beds. Kane County Sheriff Kenneth Ramsey said he was aware of some issues in Prison Health Services' past, but that the company was the best of the four that submitted bids last year. "[Prison Health Services] had some problems in the past," Ramsey said. "They straightened them out." However, Prison Health Services spokesman Pat Nolan said the past incidents had not led to any change in company policy. "We've just continued to do the best job that we can, and that's how we've responded to it," Nolan said. David Fathi, a lawyer for the American Civil Liberties Union's National Prison Project, said the problem is not with Prison Health Services, but with the process of subcontracting health services. "Prison Health Services is one company. I'm not saying it's better or worse than any others. The real problem in our view is farming out a constitutional service to the lowest bidder," he said. "If you or I are not getting good care, we can go somewhere else. Prisoners do not have that option."

King Pharmaceuticals, Brentwood, Tennessee
December 9, 2004 Porterville Recorder
King Pharmaceuticals Inc. said Wednesday it was restating its earnings for 2002, 2003 and the first six months of 2004 to recognize expenses related to product returns _ a move that was not a complete surprise but could affect the firm's takeover by Mylan Laboratories Inc. The companies announced last July that Mylan would take over the Bristol, Tenn.-based drug company in a deal valued at $4 billion. However, the deal has a condition that would allow Mylan to back out if King revised its financial statements. As a result of the restatement, net sales in 2003 are expected to be reduced by $16.4 million while net income will be reduced by $13.9 million or 6 cents a share. The company is still determining whether the remaining $37.6 million of net sales and $23.8 million of net income should be reflected in 2002 or whether financial results for 2000 and 2001 should also be restated. Last year, the SEC subpoenaed drug-pricing records and other documents from King involving sales in 1999 and 2000 to VitaRx, a Louisiana-based national mail order pharmacy, and Prison Health Services, a Brentwood, Tenn.-based health care company serving jails and prisons around the country. The SEC ordered King to turn over its "best price" lists, all documents related to the pricing of its drug products to any Medicaid agency during 1999 and records concerning accrual and payment of rebates on the heart drug Altace from 2000 to early.

The top contributor to Attorney General Jerry W. Kilgore’s gubernatorial campaign is a retired Tennessee millionaire whose former pharmaceutical company is under federal investigation over how it set prices on drugs for government health programs.  John M. Gregory, of Bristol, Tenn., has contributed $325,000 to Kilgore through personal donations and gifts from an investment company he owns.  The reason for Gregory’s generosity toward Kilgore is unclear, but the businessman has a history of giving to Republicans, particularly those who have publicly identified themselves as conservative Christians.  Gregory has credited his own religious conversion for his success in starting King Pharmaceuticals Inc. The company thrived until last year, when the Securities and Exchange Commission and the U.S. Department of Health and Human Services notified the firm that officials are looking into whether King followed federal rules requiring it to offer its cheapest prices on drugs for the government-operated Medicaid insurance program.  Gregory also is being sued in federal court by investors who accuse him and other former King executives of artificially inflating sales to enrich themselves, a scheme those stockholders say has cost them millions of dollars. King officials notified their investors that the SEC is looking at rebates on Altace that King gave to Prison Health Services, a Tennessee company that provides health care to prison and jail inmates.  A spokesman for Prison Health Services said he knew nothing about the investigation. He said the company’s Virginia clients include the Virginia Department of Corrections, the Hampton Roads Regional Jail and the Portsmouth city jail. A contract with the Norfolk city jail ended last month.  DOC officials said the agency began doing business with the health company in February 2001, long after Kilgore had left his previous position as the state’s secretary of public safety. The health company provides medical and dental services at prison clinics. Officials estimated the annual contract at $33 million.  (The Virginian-Pilot, August 2, 2004)

King Pharmaceuticals is the subject of a U.S. Securities and Exchange Commission investigation that appears to be focused on the company's sales to two wholesale customers. The SEC has not disclosed the underlying cause of the investigation, but King officials said Tuesday that documents requested by subpoena seem to focus on two years worth of King sales to VitaRx, a national mail order pharmacy, and Prison Health Services, a Tennessee-based company serving jails and prisons around the country. The SEC requested all documents related to sales of Kings products to the two companies during 1999 and 2000. (Johnson City Press, March 12, 2003)

Lee County Jail, Naples, Florida
July 1, 2010 Naples Daily News
The widow of an Ohio man killed by heavy exposure to pepper spray in the Lee County Jail has filed a wrongful death lawsuit against the Lee County Sheriff’s Office, the jail’s medical contractor and a slate of deputies and nurses involved in the 2009 death. Twenty individuals are named in the suit, filed in federal court in Fort Myers, including Lee County Sheriff Mike Scott and the director of Prison Health Services, the jail medical provider. In a 59-page complaint, Joyce Christie, of Girard, Ohio, contends all violated her husband’s civil rights through their “acts, failures to act, and omissions committed, and policies, procedures, and customs in place.” The defendants used excessive force that showed “deliberate indifference” and “callous disregard” for her husband’s welfare, the lawsuit asserts. The lawsuit requests an unnamed amount of compensatory and punitive damages, and it asks the court to curtail jail practices that resulted in the death, as well as force better care of inmates from medical contractor Prison Health Services. Nicholas Christie, 62, a retired boilermaker, died from cardiac arrest on May 31, following his exposure to pepper spray 10 times in 43 hours as an inmate at the jail. Arrested four days earlier on trespassing charges, Christie was placed in an observation wing after becoming loud. As he continued acting up, jailers sprayed him repeatedly, fogged his cell with the chemical and eventually restrained him in a chair. He was rushed to Gulf Coast Medical Center and died two days later. The Medical Examiner’s Office ruled the death a homicide. An investigation conducted by the Sheriff’s Office found that Nicholas Christie had refused to tell nurses about his heart condition during booking. It also noted that nurses checked Christie after each application of the spray. Nurse Maria Canete told investigators that when she warned one of the jailers, Kurtis Calhoun, about the level of pepper spray being used, he called it “good training for everyone,” and laughed. Another nurse, Linda Sundo, said the spray was heavy in the observation ward and that during one check of Christie, she didn’t get very close to him, for fear of the chemical. Canete, Calhoun and Sundo are all named in the complaint. The State Attorney’s Office declined to prosecute any of the individuals involved, concluding that Christie represented a threat and that jailers didn’t show “reckless disregard” for his life. Scott declined to review jail policies following the investigation.

May 26, 2010 Marco Eagle
A former Marco Island man who served a sentence for drunken driving is suing the county jail's medical provider, contending medical staff ignored repeated pleas for medical help for his heart condition, causing him to pass out and break his spine. Vernon Criner, 62, who is now a quadriplegic living in Lansing, Mich., is suing physician's assistant José Hernandez, who works in the Collier County jail, and its contracted medical provider, Tennessee-based Prison Health Services. The lawsuit, filed in U.S. District Court in Fort Myers on Tuesday, seeks damages for failure to provide medical treatment, unconstitutional county or Prison Health Services medical customs or policies, and compensation for medical and hospital expenses and loss of income. "It is our policy at PHS because of patient confidentiality requirements that we cannot comment on pending litigation," said PHS Spokesman Pat Nolan. It's the second lawsuit to be filed in less than a year against Prison Health Services by an inmate who contends its lack of care caused paralysis. In August, Brett Fields, 27, of Bokeelia, sued Prison Health Services and Lee County Sheriff Mike Scott. Prison Health Services has been the target of lawsuits nationwide involving poor medical care. Many plaintiffs obtained confidential settlements, while others — including a Tampa woman whose baby died after she gave birth on a toilet — won multimillion dollar jury awards or settlements. "They just didn't want to pay for a pacemaker," said Criner's attorney, Paul Broschay of Southfield, Mich., adding that Prison Health Services is paid a flat fee and it benefits them to deny care to cut costs. "It was pretty clear to them he had problems. He was flopping around all over the place." Broschay said Prison Health Services did send Criner to a hospital two months before his spine fractured, but they sent him back after checking him. "The guy needed a pacemaker and they finally gave it to him after he fell over," Broschay said.

January 13, 2010 News-Press
The widow of Nicholas Christie, who died shortly after he was released from jail, intends to sue the Lee County Sheriff's Office, as well as the company contracted by the county to provide medical care to inmates. Christie, 62, of Girard, Ohio, was arrested twice last March after traveling to the area while suffering what his wife described as a mental breakdown when he stopped taking his medication. He died three days following his second incarceration, during which he was pepper sprayed eight times; another two times, his cell mate was sprayed. The medical examiner's office ruled his death a homicide. Earlier this week, the state attorney's office cleared the five corrections deputies - Kurtis Calhoun, Frank Hansen, Daniel Falzone, Monshay Gibbs and Dathan Pyle - of criminal wrongdoing in the case, though federal investigations are ongoing. A separate internal review of policy and protocol was not conducted, according to the sheriff's legal director, Barry Hillmyer. In a letter sent to the sheriff's office, attorneys for Joyce Christie allege corrections officers "used excessive force, acted with deliberate indifference to Nicholas Christie's need for medical care and violated his rights under state and federal law." Last week, attorneys also sent a letter to Prison Health Services Inc., saying the jail's medical staff did not properly care for him while Christie was in custody. Ohio attorney Nicholas DiCello, who is working in conjunction with Tallahassee attorneys, said a letter of intent to sue has been sent, which has to be done in civil suits against government agencies. He expects the lawsuits will be formally filed by April.

August 11, 2009 Naples News
A 27-year-old Bokeelia man filed a federal lawsuit Tuesday against Lee County Sheriff Mike Scott and the jail’s medical provider, alleging that he walked into the jail a healthy man and left paralyzed a month later. The lawsuit filed by Brett Allen Fields against Scott and Tennessee-based Prison Health Services comes just days after the U.S. Department of Justice announced it was investigating the death of a Lee County jail inmate who was pepper sprayed in March. Prison Health Services has been the target of lawsuits nationwide involving poor medical care. Many plaintiffs obtained confidential settlements, while others — including a Tampa woman whose baby died after she gave birth on a toilet — won multimillion dollar jury awards or settlements. John Van Mol, a spokesman for Prison Health Services, and Tony Schall, a spokesman for Scott, said they do not comment on pending litigation. The lawsuit gives the following account of what occurred after Fields was booked into the jail on July 6, 2007: He requested medical attention four days later for an infected wound on his left arm. A nurse examined him, determined it was a boil, and prescribed an antibiotic, Bactrim. Two weeks later, on July 24, 2007, after it hadn’t healed, he filled out an “Inmate Medical Request Form,” but it was ignored by the sheriff and medical staff, the lawsuit says. In early August, he began to suffer from severe back pains, difficulty standing up, numbness and weakness in his lower body. He pleaded with medical staff and sheriff’s employees, asking for medical help and saying he hadn’t urinated in days, but his pleas were ignored, according to the suit. The evening of Aug. 7, 2007, a nurse examined him and he told her of neurological problems and physical symptoms, including numbness and weakness in his legs. She scheduled an exam for the next morning. When he was examined by a physician’s assistant that morning, he could no longer walk and was confined to a wheelchair. He told the physician’s assistant how a boil had progressed into numbness and neurological damage and the assistant conducted a cursory examination and prescribed Tylenol. Once back in his cell, Fields, who could no longer use his legs, dragged himself to a mattress, where he remained until the early morning hours of Aug. 9, 2007. When he used the toilet, he realized his insides were coming out and were visible outside his body, a condition known as a rectal prolapse. Cellmates alerted medical and jail staff, who pushed his insides back into his body and removed him from the cell. “Despite the grave and critical nature of these symptoms, PHS waited almost 12 hours to have a doctor examine Fields,” the lawsuit alleges. At 12:30 p.m. that day, he was transferred to Southwest Florida Regional Medical Center with almost complete paralysis in his lower body. Hospital staff diagnosed him with Methicillin-resistant Staphylococcus aureus (MRSA)-related abscess in his spine causing paraplegia, and he underwent surgery. “Despite two years of intense physical therapy, Fields still suffers partial paralysis in both legs,” the lawsuit says. “Fields’ now-permanent spinal injury could have easily been avoided had defendants not been deliberately indifferent to Fields’ obvious serious medical needs during his incarceration and provided him with basic medical care.” Jail records show Fields, who has a minor record that includes petty theft convictions, was booked into the jail on charges he violated a domestic violence restraining order, criminal mischief and a probation violation, all misdemeanors. Court records show he was sentenced to 26 days — credit for time served.

December 13, 2005 Bonita Daily News
A former Lee County Jail inmate who miscarried less than two weeks after first reporting medical problems cannot take her case to trial because she didn't follow internal grievance procedures, a federal judge has ruled. Michelle Goebert, 43, filed a civil lawsuit in U.S. District Court in Fort Myers last year contending that she miscarried 11 days after reporting to jail medical and detention staff that she was leaking amniotic fluid. Almost 14 months after filing suit, U.S. District Judge John E. Steele tossed it out, saying her daily informal requests for medical help didn't meet the jail's requirement to first exhaust the internal grievance procedures. Goebert's eight-count civil suit alleged that her civil rights were violated because she suffered cruel and unusual punishment, and that sheriff's staff and medical workers with Prison Health Services Inc. were negligent in her care. She sued the Sheriff's Office and sheriff, Capt. Thomas P. Weaver, Lee County, Prison Health Services Inc., EMSA Correctional Care Inc., jail doctor David F. Brown, and jail nurse Sandee Malanoski. Steele tossed Lee County from the suit in January. If inmates can't reach informal resolution for complaints, they must file a request with the shift commander, who investigates their claims and forwards the requests to the facility commander. That commander then investigates claims' legitimacy, Steele wrote. If deemed legitimate, requests are forwarded to the Grievance Committee chairman, who schedules them for hearings. After the Hearing Commission's recommendation, the facility commander may approve, deny or modify the recommendation. If an inmate is dissatisfied, he or she may appeal to the detention bureau commander within five days of receiving the decision. After her miscarriage, Goebert didn't appeal Weaver's Nov. 29 reply. Sheriff's spokeswoman Ileana LiMarzi said jail staff could not provide the Daily News on Monday with the number of grievances forwarded this year to the Grievance Committee's chairman. Jail staff also could not provide the number of grievances set for hearings, nor the number of cases appealed to the detention bureau's commander. Buried in Steele's ruling, he said if Goebert's lawsuit wasn't tossed out, her claims against Brown and Prison Health Services would have gone forward. A "reasonable jury ... could find that Dr. Brown acted with an attitude of deliberate indifference to Ms. Goebert's serious medical need," Steele wrote.

September 6, 2005 News-Press
Sheriff Mike Scott plans to ask the Lee County Commission today for nearly $1 million to pay for unexpected inmate medical expenses. Sheriff's budget director Bill Bergquist said the $982,153 is needed because of rising costs for inmate health coverage. The budget year ends Sept. 30, but Bergquist said the fund is nearly depleted. The commission is obligated by law to provide health care to county inmates. Prison Health Services is the provider contracted with the county.

April 14, 2005 Naples Daily News
A federal judge ruled Wednesday to drop the Lee County Sheriff's Office from a lawsuit filed against it by a former inmate who contends she miscarried after leaking amniotic fluid while jailed. Michelle Goebert, 42, filed suit in October in U.S. District Court in Fort Myers against the Sheriff's Office and sheriff, Capt. Thomas P. Weaver, Lee County, Prison Health Services Inc., EMSA Correctional Care Inc., Dr. David F. Brown, and nurse Sandee Malanoski, saying that spanning 11 days in 2001, she leaked amniotic fluid while in the Lee County Jail in Fort Myers. On the 11th day she was hospitalized and, three days later, her baby died, according to the suit.

January 29, 2005 Naples Daily News
Lee County has been dropped from a federal lawsuit filed in fall by a former Lee County Jail inmate who said unnecessary delays in medical help there caused her to miscarry. The civil suit, filed in October in U.S. District Court in Fort Myers, says that during 11 days in 2001, Michelle Goebert leaked amniotic fluid while jailed in Fort Myers. On the 11th day she was hospitalized, and three days later the baby died, according to the suit. U.S. District Judge John E. Steele ruled Thursday that Lee County could be dismissed from the suit, saying the county was not responsible for what Goebert contends happened. "The sheriff, and not the defendant Lee County, has the responsibility to operate the Lee County Jail, and funding by the county does not affect this responsibility," Steele said in the order.

January 17, 2005 Naples Daily News
An HIV-positive prison inmate is suing the Lee County Sheriff's Office and jail's medical care provider, saying it took too long to receive the life-sustaining drug cocktail his doctors prescribed. And to compensate him, he wants $10 million. Jimmy D. Hatten, 41, was remanded into custody after a March 30, 2004. When he was booked into the Lee County Jail, he told medical staff from Prison Health Services he needed the medications and how to reach his doctors, Hatten said in his suit. He said he suffered facial swelling, a fever, bleeding and an infection because he didn't receive his medication, the suit said.

December 12, 2004 News-Press
A Lee County sheriff's deputy arrested Ralph Scheibel on March 7 at Gulf Coast Hospital and took him to jail, where he had a heart attack the same day and died. His death was followed by eight more inmate deaths — three men who committed suicide, two who died of complications from HIV, two more heart attack victims and Byron Black, 39, who died Nov. 27 after being pepper-sprayed and Tasered while struggling with guards. But Sheriff-elect Mike Scott said he is concerned about the jail — and the number of deaths — and plans to make changes when he takes office in January. Black's cause of death may not be determined for weeks. The District 21 Medical Examiner's Office is awaiting toxicology results before releasing a finding. The private company that performs medical care at the jail is Prison Health Services, which is based in Brentwood, Tenn., and is the largest provider of inmate health care in the nation.  Prison Health Services is supposed to screen inmates entering the jail for medical conditions that need monitoring. Scott said he will review Prison Health Services' contract. But neither he nor Ferrante said they could find fault with the company when they're "on the outside looking in."

November 23, 2004 Naples News
Lawyers for the state's jail medical care providers are asking a federal judge to toss out a lawsuit brought by an Estero firefighter's father after the man died one day after being jailed. Roger H. Barnhart Sr., of Bonita Springs, filed suit in May against Prison Health Services, Lee County Sheriff Rod Shoap, his department and jail medical staff after Barnhart's 42-year-old son died the day after being jailed on a drunken driving charge. The elder Barnhart's suit contends that Roger H. Barnhart's death resulted from medical negligence and a violation of his civil rights. Prison Health Services attorney Gregg Toomey said the elder Barnhart's civil rights complaint against the company should be dismissed because his attorneys haven't proven his son's right to medical treatment and diagnoses was violated.

October 16, 2004 Naples News
Just three days after her 39th birthday, Michelle Goebert lost a baby she repeatedly tried to save while imprisoned at the Lee County jail in 2001. In a span of 14 days after her Oct. 19, 2001, arrest, Goebert asked for medical help or to visit an obstetrician because she was leaking amniotic fluid and feared for the life of her unborn child. Medical staff at the jail took her to a local hospital too late, Goebert contends, and the 41-year-old Lee County woman now seeks an unspecified amount in damages in a federal civil rights and negligence lawsuit filed Thursday at the U.S. District Courthouse in Fort Myers. From Nov. 19 until Nov. 30, 2001, Goebert leaked amniotic fluid and asked daily to see a prison doctor or go to an outside hospital, according to the suit against the Lee County Sheriff's Office, Sheriff Rod Shoap, Capt. Thomas P. Weaver, Prison Health Services Inc., EMSA Correctional Care Inc., doctor David F. Brown, nurse Sandee Malanoski and Lee County government. Taken to the hospital on her birthday, Nov. 30, doctors there said the baby's chances of surviving were slim because Goebert lost so much amniotic fluid, the suit says. Her child died Dec. 3.

September 16, 2004 News-Press
The day before Gregory Kokolakis took his own life, he called his mother from the Lee County Stockade in agony. "He called me crying," said his mother, Adrienne Croom. "He said, "I am in so much pain. I can't stand it.' " Kokolakis, 21, wasn't allowed access to his methadone, an opiate used by doctors to help addicts off painkillers. "He said 'Mom, my medication is in my property, and they won't give it to me,' " Croom recalled Wednesday. On Sept. 7, Kokolakis wrapped a sheet around his neck, tied it to an air vent in the stockade barracks and attempted to hang himself. He died five days later. Kokolakis was the third inmate to commit suicide since July. The Lee County Jail has a contract with Tennessee-based Prison Health Services Inc. to provide medical treatment, including treating inmates' withdrawal from narcotics.

June 26, 2004 News-Press
A Bonita Springs man is suing Lee County sheriff's officials and the company that provides jail medical services, claiming officials failed to provide appropriate medical care to his son while he was in jail.  Roger Barnhart Sr.'s son, Roger Barnhart, 42, died about 10 hours after being released from custody on a DUI charge.  The lawsuit claims jail officials failed and refused to provide appropriate medical care. Barnhart was not "unlawfully under the influence of alcohol but rather was suffering from an adverse reaction to prescribed medication and/or psychiatric or medical illness," the lawsuit states.  

Leon County Jail, Tallahassee, Florida
September 25, 2005 Tallahassee Democrat
The family of the late Ruth Hubbs, who died at the Leon County Jail infirmary, is being paid $350,000 by Prison Health Services, a company that oversees inmate care at the facility. Hubbs, 39, was found dead in the infirmary May 16, 2003, about a day after deputies reported seeing her sitting on the floor of her jail cell and yelling incoherently to herself. Some correctional officers later reported the jail's medical workers seemed unconcerned about her condition. An autopsy found she had an intoxicating level of an antidepressant in her system, but an investigation was unable to determine whether the jail's medical workers had given her too much medication. Last year, her parents filed a lawsuit against PHS, three of its employees and Sheriff Larry Campbell. The PHS employees named in the lawsuit were Susan Cole, the health-care administrator at the jail; Dr. William Primas, the staff doctor; and another physician who later was released from the lawsuit. According to the lawsuit, Hubbs died because she was overmedicated. The lawsuit states she was given increasing doses of the antidepressant Doxepin, and that PHS had a policy of rarely using a safer but more expensive medication. "Hubbs objected to taking the medication," the lawsuit states, "and for at least two weeks before her death, Hubbs showed signs of being chronically overmedicated. Her attorney, a social worker and corrections officers made repeated complaints which were ignored by Prison Health Services, their agents and employees." Two other inmates have died at the jail since Hubbs was found dead. Clyde Fuller, 26, was found dead in the infirmary June 12, 2003, after being sprayed with pepper spray, placed in a restraint chair and injected with a sedative. According to a Sheriff's Office report, he had been screaming and spitting at staff members. An autopsy found cocaine in his system. Steven Tomiano, 32, died after hanging himself with a sheet in his cell Oct. 31, 2004. An investigation determined no foul play occurred.

August 31, 2005 Tallahassee Democrat
Leon County commissioners took the following actions during their Tuesday meeting: • Voted 5-1 to accept a report on three inmate deaths at the Leon County Jail that occurred from May 2003 to September 2004. Ruth Hubbs died May 16, 2003, and a subsequent investigation found she had an intoxicating level of a psychotropic drug in her system. Investigators were unable to determine whether she had been storing pills in her mouth or jail medical workers had over-medicated her. Clyde Fuller died June 12, 2003, after he became combative with correctional officers and was sprayed with pepper spray, placed in a restraint chair and injected with a sedative by a jail nurse. An investigation found that cocaine and marijuana in his system might have contributed to his death. Steven Tomiano died Oct. 31, 2004, after hanging himself in a cell with a sheet, and investigators found no foul play occurred. Sheriff Larry Campbell said that at the time of the deaths, he was unhappy with the service of the jail's medical provider, Prison Health Services. But Campbell said PHS since has made improvements and that he now is satisfied with the company's performance. Changes in jail health care include creation of a medical-grievance committee that takes up inmate health complaints and a medical hot line for family members to call with concerns about inmates. Rodney Holliman, PHS vice president of operations, said the company is doing a "phenomenal job" in caring for inmates. Commissioner Bill Proctor also said improvements have been made. But Commissioner Bob Rackleff, who cast the only dissenting vote, worried that not enough is being done to prevent future tragedies.

December 14, 2004 Tallahassee Democrat
Improving the county jail. Making health insurance more affordable. Boosting economic development. Those are the top issues for Leon County commissioners, who met Monday for their annual priority-setting session. Commissioners expressed concern about a variety of jail issues, from staffing and employee pay to overcrowding and inmate health care. Commissioners Bill Proctor and Dan Winchester said they are aware of patients who haven't been able to get medications they needed. And Commissioner Ed DePuy expressed "grave concerns" over the company that provides medical care to inmates. But commissioners, who have the authority to assume control of the jail, said they want to continue delegating that responsibility to Sheriff Larry Campbell. DePuy in particular emphasized a desire to work with Campbell to make improvements. "This is to work in a constructive fashion with the sheriff and his staff," he said. Prison Health Services, which provides medical care to inmates at the jail, and the Sheriff's Office are being sued by the family of a 39-year-old woman who died last year after medical staff gave her fatal levels of antidepressant drugs.

October 29, 2004 Tallahassee Democrat
A year and a half after a mentally-ill inmate died at the Leon County Jail, a local judge Thursday ordered that another inmate diagnosed with schizophrenia receive his medication, lawyers said. Circuit Judge Nikki Clark ruled that the jail psychiatrist should confer with inmate Shayne F. Huber's doctors today, according to Assistant Public Defender Joel Remland, who represents Huber. "We got what we wanted," Remland said. "The jail just needs to be more conscientious and improve their own procedures to avoid lapses in treatment." Remland noted the case of Ruth Hubbs, 39, who was found dead in the jail's infirmary in May 2003. She was awaiting sentencing on a burglary charge. An autopsy revealed fatal levels of the antidepressant jail medical staff had been giving her. Records later revealed that corrections officers and her attorney had complained for nearly two weeks before her death that she appeared to be overmedicated. Medical staff largely ignored those concerns, according to reports. The jail clinic is run by Prison Health Services, which earns $2.6 million a year for the job, records show.

September 14, 2004 Tallahassee Democrat
A lawyer for the family of Ruth Hubbs has filed a lawsuit against Prison Health Services and the Leon County Sheriff's Office over her death in the county jail last year. The suit alleges Hubbs was subjected to "cruel and unusual punishment" and died as a result of negligent health care. It is at least the second pending death-related lawsuit against PHS in Florida. Hubbs, 39, was found dead in her cell in the jail's infirmary in May 2003. She'd recently been acquitted of a fraud charge and was awaiting sentencing on a burglary charge. An autopsy revealed fatal levels of the antidepressant jail medical staff had been giving her.  Records later revealed that corrections officers and her attorney had complained for nearly two weeks before her death that she appeared to be overmedicated. Medical staff largely ignored those concerns, according to the reports. Also, examiners said Hubbs had to take the lethal dosage all at once, even though she'd shown overdose symptoms for weeks, and detectives could find no evidence she'd purposely taken the pills.

Leon County Sheriff Larry Campbell isn't known for his patience. So it's easy to understand his justifiable frustration with the private company that provides medical services to inmates at the county jail. Leon County taxpayers shell out $2.6 million a year to Prison Health Services, a national company with a mixed record of performance and an unenviable trail of lawsuits. Sheriff Campbell's concern comes on the heels of an investigation by his detectives into an inmate's suspicious death last year. The results of the sheriff's probe into the death of Ruth Hubbs were inconclusive. Ms. Hubbs died from a probable overdose of antidepressant medication, according to her autopsy report, which also was inconclusive. But the company's performance in Leon County - correctional officers and inmates' families have reported inferior medical care - as well as the firm's record of complaints, investigations and lawsuits elsewhere lead to inevitable questions about the wisdom of continuing to do business with PHS. (Tallahassee Democrat, February 17, 2004)

Records from Ruth Hubbs' stay in the Leon County Jail last year raise serious questions about the cause of her death - and point to the medical care she received as a possible factor. For at least two weeks before she died, Hubbs showed textbook symptoms that she was suffering from chronic overdoses of her jail-prescribed depression medication. Corrections officers, a social worker, her attorney and Hubbs herself made repeated complaints that she was being overmedicated - concerns that senior administrators of the private company that runs the jail's medical services are accused of ignoring. After she died, an autopsy proved inconclusive but showed the most likely cause was "doxepin intoxication" - in other words, an overdose of the antidepressant. The infirmary recently had been turned over to Prison Health Services, a company paid $2.6 million a year to provide medical services. (Tallahassee Democrat, February 15, 2004)

Autopsy results show it was a massive overdose of prescription drugs that killed a Leon County Jail inmate earlier this year - medication likely administered by the jail's own infirmary. Ruth Hubbs, 39, was found dead in her cell May 16, only hours after medical staff reportedly ignored complaints from deputies that something was wrong with her. Now, detectives with the Leon County Sheriff's Office are trying to figure out how she received a lethal amount of the anti-depressant doxepin. A medical exam found more than 20 times the recommended dosage in her system. It's not clear yet whether doxepin was one of the drugs Hubbs - who was bipolar - was taking in the medical unit. (Tallahassee Democrat, August 6, 2003 )

Inmates at the Leon County Jail get their medical treatment from a company with a mixed health-care record and a splintered public image. Prison Health Services took over the jail's infirmary in October. Since then, three inmates have died, two of them while in the medical unit under the company's care. There is no evidence to date of improper medical practices. However, jail deputies reported that PHS staff did not respond to their concerns about a female inmate just hours before she died. Ruth Hubbs, 39, was found dead May 16 on the floor of her cell in the infirmary, wedged between the bed and the wall. A search of the Lexis-Nexis database and the Internet turned up dozens of reports of deaths and medical problems at jail health facilities the company operates under contract. Many of them detail allegations of understaffing, denial of medication and a general lack of compassion. By contract, PHS has to keep a certain number of nurses, doctors and other staff on duty at any given time. If the company falls short, it pays back money to the Sheriff's Office. That's happened every month since December. For example, at one point the jail had only a part-time psychiatrist who visited from out of town. And, in some months, the infirmary was short on nurses by as many 200 to 400 work hours. (Tallahassee Democrat, June 30, 2003)

Limestone Correctional Facility, Limestone County, Alabama
December 1, 2009 Huntsville Times
State prison officials today released a 795-page report showing Farron Barksdale, who killed two police officers, died from hypothermia after being heavily medicated with anti-psychotic drugs. Barksdale, 32, of Athens, sentenced to life without parole after pleading guilty to capital murder in the shooting deaths of two Athens police officers, died Aug. 20, 2007, after he was found unconscious in his prison cell. After he was rushed to a Montgomery hospital, it was discovered he had several large, fresh-looking, bruises around his waist, arms, legs, elbows and knees. But Sarah Geraghty, senior attorney for the Southern Center for Human Rights in Atlanta, said questions still remain about how Barksdale received such extensive bruising. The report said Barksdale was given several different drugs that could cause bruising. And they noted the special seat belts used to transport Barksdale from the Limestone County Jail to the Kilby Correctional Facility could also have been responsible for some of the bruises. When a private ambulance company was summoned to take Barkdale to the hospital after he collapsed, according to the report, paramedic Angela Anderson said she "found patient lying on treatment table by himself with distressed respirations, unresponsive; no medical personnel in room; saw bruises on his body on abdominal and pelvic area; noted they were unusual for size and location . . . "Patient had no oxygen therapy being (administered and) there was no medical personnel in the room (with) the patient the entire time while on scene only DOC personnel. Patient had several bruises throughout body major-sized bruises noted anterior on lower abdomen/pelvic area measuring in comparison to a salad plate covering most of the area from hip joint area to umbilicus. "Color of bruises indicate newly sustained. Patient also had bruising to both forearms posterior area in same color as ones noted to abdomen/pelvic area." In addition, Heath Bruner, an EMT, was quoted in the report as noting "massive" bruising on both sides of pelvis. He also noted there were no nurses present in the room with Barksdale at Kilby. Barksdale's mother, Mary, earlier this year won $750,000 in a wrongful death lawsuit against former Kilby Warden Arnold Holt, Dr. Joseph McGinn of MHM Correctional Services in Vienna, Va., and Dr. Arnold Holt of Prison Health Services of Brentwood, Tenn. Ken Williams, general counsel for the Corrections Department, said Tuesday that McGinn was responsible for prescribing the drugs to Barksdale and leaving him in an unairconditioned cell rather than transferring him to an air-conditioned mental health unit.

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

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

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

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

Louisville Metro Corrections, Louisville, Kentucky
August 3, 2007 Courier-Journal
The family of a man who committed suicide at Metro Corrections in June 2006 filed a lawsuit today against the director of the jail and its health services provider, claiming they were negligent in preventing the 48-year-old’s death. The lawsuit, filed in Jefferson Circuit Court on behalf of William Whitworth, claims the jail allowed Whitworth to be alone in a cell without any security or observation despite the fact that he was suicidal. The suit names as defendants the jail, as represented by Director Tom Campbell, and Prison Health Services Inc. Pam Windsor, a spokeswoman for the jail, declined to comment because the litigation is ongoing. A spokesperson with Prison Health Services, whose main office is in Brentwood, Tenn., also said the company does not comment on pending litigation. The suit claims Whitworth had attempted to commit suicide in a Metro Corrections holding sell after being arrested for public intoxication in February 2006 by hanging himself with his shirt, but survived. Four months later, on June 7, Whitworth was arrested for allegedly driving drunk and was again admitted to Metro Corrections, according to the suit. Whitworth had a history of attempting suicide and complained of being depressed while in Metro Corrections, yet was evaluated as stable and put in an regular cell alone and not monitored, the suit claims. Whitworth died June 14, 2006, after he was found hanging from a bed sheet in his cell during a routine check. The lawsuit requests unspecified compensatory and punitive damages. Claims made in filing a lawsuit give only one side of the case.

Manatee County Jail, Bradenton, Florida
November 2, 2006 Bradenton Herald
Sheriff's spokesman Dave Bristow said Wednesday that four employees and four inmates were confirmed to have the disease. Sheriff's officials found out about the chicken pox outbreak Tuesday, Bristow said. The four employees are not at work and the four inmates are in the medical unit of the jail, where they are being treated by Prison Health Services, the medical provider under contract with the sheriff's office. Vendors can still make deliveries to the jail and attorneys can enter the jail, but other visitors are not being allowed, Bristow said. The sheriff's office does not know when the restrictions will be lifted.

March 29, 2005 Herald Tribune
Prison Health Services Inc., the private health-care provider whose work in jails and prisons has drawn criticism and lawsuits, is likely to continue to treat inmates at the Manatee County jail for another year. In 2004, PHS fired two nurses and its medical director at the Manatee County jail after the death of an inmate who should have been taken to a hospital. Nurses watched for two days as the unresponsive prisoner, Tony Myrick, had at least four seizures and fell critically ill. Myrick, 41, died in the jail infirmary. Also last year, PHS fired a nurse practitioner and reprimanded two nurses at a Hillsborough County jail over the death of an infant born there. An inmate had complained of abdominal pains for nearly 12 hours before giving birth, but no one called 911 until after the baby was born. The baby boy died before reaching Tampa General Hospital. In Charlotte County, PHS fired a jail nurse who was arrested in November on a charge that she brought prescription drugs to an inmate she planned to marry.

March 10, 2005 Bradenton Herald
A male nurse who works for the company that provides medical services at the Manatee County jail is under investigation by the Manatee County Sheriff's Office. The sheriff's office launched an investigation March 3, agency spokesman Dave Bristow said. Because the case remains under investigation, details were not released Wednesday. The sheriff's office did not release the identity of the man. The agency typically doesn't release the names of suspects until an arrest is made. "At this time, it appears to be misdemeanors we're dealing with," Bristow said. "We don't know if there'll be charges or not."

It's not surprising to learn that the private contractor handling the medical care of inmates at the Manatee County jail has attracted lawsuits around the nation. After all, the company -- Prison Health Services -- serves more than 235,000 people in more than 400 institutions. Someone's bound to sue.  But the volume of suits --more than a thousand nationally -- and other serious signs of trouble are sufficient reason for Manatee Sheriff Charlie Wells to re-examine whether to keep using the company.  PHS recently fired the medical director and two nurses at the jail here in connection with the death of 41-year-old Tony Myrick of Palmetto last May.  Myrick, who had a history of seizures, was incarcerated after a fight with another man over what TV show to watch. While in jail, Myrick suffered a series of epileptic seizures over two days but was never taken to a hospital. An autopsy indicates he died from the effects of the seizures.  Besides firing the medical director and the nurses involved, PHS officials say they will provide more training for staff.  But that may not be enough. As Herald- Tribune reporter Selina Roman noted Saturday, the contractor has been accused repeatedly of neglect. This year, New York corrections officials ruled that the care that PHS provided two inmates before their deaths was "flagrantly inadequate."  Wells and his staff plan to investigate the Myrick case further. Afterward, they need to take whatever steps necessary to ensure that inmates are receiving quality care and that taxpayers aren't vulnerable to lawsuits for substandard treatment.  (Herald Tribune, July 28, 2004)

The doctor formerly in charge of the Manatee County jail's infirmary has been fired, according to the private company that provides medical services at the facility.  Dr. Thomas Adams, a doctor with Prison Health Services Inc. for two years, lost his job Wednesday in connection with the May death of a jail inmate under his care, said Rod Holliman, group vice president for PHS.  Manatee County Sheriff Charlie Wells said Friday evening that he and County Administrator Ernie Padgett plan to meet next week to re-evaluate PHS's three-year contract.  Inquiries by PHS and the Manatee County Sheriff's Office were launched after Tony Myrick, 41, died of seizures in the jail clinic May 7. Two nurses were fired two weeks ago in connection with Myrick's death after PHS said they failed to comply with company policy.  (Bradenton, July 24, 2004)

Among his many duties, Sheriff Charlie Wells is the biggest restaurateur in Manatee County, responsible for preparing and serving some 4,500 meals a day. If the diners aren't always ecstatic over the quality of the food or the service, well, he doesn't really worry about losing a repeat customer. This is, after all, not the Ritz; it's the Manatee County jail.  Indeed, it's hard to imagine any restaurant, from the Ritz to Mom's Diner, serving that many meals without some complaints about the food. So some grousing, especially considering the sheriff's captive market, is to be expected.  But lately Chef Wells has been getting more than the usual inmate whining about mystery meat and watery juice drinks. The U.S. Immigration and Customs Enforcement Department last week confirmed complaints by as many as 200 detainees at the Port Manatee detention facility of being served spoiled and outdated food. Coming on the heels of an investigation into the death of an inmate in the jail's medical ward, the food complaints indicated a possible pattern of lax administration at the jail.  Wells denies any such pattern. Jail medical decisions are out of his hands, he says; medical care is contracted out to the private Prison Health Services by Manatee County government. It was PHS employees, not jail guards, who assessed inmate Tony Myrick's condition and prescribed treatment in the days before his death May 7. Two nurses were fired in the wake of Myrick's death and the jail's physician placed on paid administrative leave pending return of autopsy results. A PHS official said his investigation indicated the employees didn't follow company policy in handling of Myrick's case.  (Bradenton.com, July 20, 2004)

The head doctor and two other jail medical employees have been placed on paid leave after the death of an inmate. Both the Manatee County Sheriff's Office and Prison Health Services, the company contracted to provide medical service at the jail, continue to investigate the death of Tony Myrick, 41. Jail personnel placed Myrick in the jail infirmary May 5 for observation because he suffered from seizures. He died two days later while under PHS care. Amy Myrick, who raised Tony, said her family wants to know how he died and if he received proper medical attention. She said her son had been on anti-seizure medication since he was a young child and needed doses every day. (Bradenton Herald, May 21, 2004)

A bacterial infection highly resistant to treatment has hit Manatee County jail, health officials reported Tuesday. Two inmates tested positive for a staph bacteria called MRSA that is resistant to the usual penicillin-type antibiotics, said Lori Ingles, administrator for Prison Health Services, which provides medical care at the jail. She confirmed two other outbreaks of MRSA have occurred at the jail since Prison Health Services Inc. was awarded the contract for medical services in April 2002. (Bradenton Herald, August 21, 2003)

Marion County Jail, Ocala, Florida
May 14, 2009 Ocala Star-Banner
It’s been more than a year since Lindsay Hayes, a leading expert in jail suicide prevention, visited the Marion County Jail and made more than a dozen recommendations for improving the jail’s medical system and its handling of inmates. Since then, however, the Department of Justice has launched an investigation of the jail that focuses on suicide prevention efforts and possible excessive use of force. Hayes’ updated report, produced last week, shows that the jail has implemented all of his recommendations, even though some of them cost the jail money and required additional staffing. “Back in 2008 they had an adequate program but there were several deficiencies in it, including lack of mental health staff that contributed to the problems,” Hayes said on Wednesday. “When I came back a year later, it was extremely impressive to see the work that had been done, and to see the sheriff’s commitment in making the changes.” Both Hayes, a project director at the National Center on Institutions and Alternatives, and Sheriff Ed Dean believe Hayes’ latest report will help the jail in the Justice Department investigation. “What the DOJ will see is that this is a county jail system that previously had a problem with identification and management of suicidal inmates and it no longer does,” said Hayes, who also works closely with the Justice Department. Hayes’ 2008 visit to the jail came on the heels of three suicides in 2007, before Dean ended the jail’s contract with private provider Prison Health Services, which handled all medical care for the jail’s inmates. Dean then created Ocala Community Care to harness the resources of local health providers, including the hospitals and The Centers.

February 7, 2009 Ocala Star-Banner
On a recent afternoon, Greg sat on a simple metal chair in a bare room at the Marion County Jail. The only colors were the red stripes of his jail outfit and the deep purple color that crawled up his legs. He only wanted his first name used, so his family wouldn't be embarrassed by his incarceration. When Greg was booked into the jail early in January, he was not just an inmate. He was a patient. Greg said he's been suffering for five years from chronic cellulitis, an almost constant infection of the skin and the soft tissues underneath the skin, which in his case is caused by poor circulation. He said that outside the jail, although uninsured, he sometimes had to take expensive antibiotics that he received for free from pharmaceutical companies. He regularly visited a wound care specialist. But he wasn't sure what to expect after he was booked into the jail early in January. "I'm in jail. It's a different kind of world. But I'm extremely thankful for the care I've gotten," he said. He said he had received antibiotics and daily wound care. "And they got me a small whirlpool bath," which helps with circulation in his legs. Greg's experience stands in stark contrast with the interviews the Star-Banner conducted with inmates in 2007, before Sheriff Ed Dean ended the jail's contract with the national private medical provider, Prison Health Services, Inc. Dean replaced PHS with a newly formed local nonprofit organization called Ocala Community Care. "It's easy for people to say it won't work, because it's never been tried here," Dean said in an interview a few weeks before OCC took over the inmates' medical care in January 2008. Now, a year later, he says, "I'm very excited and proud with quality and cost-effectiveness of OCC. I had great confidence in our medical care partners in the community and that we could do what we set out to do. I think the OCC model is now a bona fide model for others."

January 3, 2008 Ocala Star-Banner
At midnight Tuesday, Ocala Community Care Inc. became the official medical care provider at the Marion County Jail, replacing Tennessee-based Prison Health Services. The transition was "uneventful because of preparation," said Capt. Clint Bowen, assistant bureau chief at the Marion County Sheriff's Office. "We're just ready for it." Continuation of inmates' medications was among the primary focuses of the transition, according to Bowen. "We've been working with PHS," Bowen said. "It was a simple transition, and when the time came, they took their final stuff." Monday was the last official day for Prison Health Services. Ocala Community Care, or OCC, an organization created by Sheriff Ed Dean, collaborates with local health care providers to extend inmate health care beyond the jail's steel bars, and eventually will be incorporated into the community's health care system. Many jails use national private providers like PHS, which bring in their own staff and have no community ties. Dean managed to pull together major community leaders and care providers quickly after he decided last July to not renew the PHS contract due to a disagreement over the cost of care for the coming year. In a matter of six months, OCC was incorporated and ready to launch. As one of the largest private providers of correctional health care, PHS has been the subject of frequent complaints and lawsuits over the quality of care here and at facilities around the nation. Critics say private companies like PHS cut corners when it comes to providing medical care to inmates in order to save money and keep their investors happy. In addition, companies like PHS bring their own doctors and psychiatrists to the jail - and most of them have no connection to local health providers and don't have privileges at local hospitals, creating a gap in inmates' medical care after they're released. Dean hopes to address these issues with the new model and keep taxpayers' money in the community. "And if issues arise in the future, we will have enough local professionals to determine what changes need to be made," he said in an earlier interview. The Centers, the mental health provider in the county, is among the main collaborators in OCC. Bowen said providers from The Centers were at the jail on Wednesday. With the departure of PHS, The Centers will send two psychiatrists to the jail. As a result, inmates with mental illness have the opportunity to remain in the care of The Centers, said Russell Rasco, CEO of The Centers, in an earlier interview. Such continuity of care did not exist under PHS, which brought in its own psychiatrist who was not based in Marion County. OCC also brings in a physician who has privileges at Munroe Regional Medical Center, and its dentist has been with the Marion County Jail for several years. Close to 90 percent of the staff working with PHS has been rehired by OCC. The new system makes the Marion County Jail one of the few jails in the nation to implement such a program, which is modeled after a community-based health system that got its start in a Massachusetts correctional center. Several studies have shown that the model Dean is using can lead to cost savings, improved inmate and public health, reduced recidivism and improved public safety. The $4.9 million that would have gone to PHS will instead go to OCC to cover costs for its first year of service. The board will meet annually to look at the previous year's expenses and decide on next year's budget. They hope the nonprofit system will help them keep costs at or below what would have been paid to a private company.

December 16, 2007 Ocala Star-Banner
Thoughts of suicide began to form in James Johnson's mind. He felt nauseous. He couldn't sleep. He was confused. "Please give me my Paxil," he begged the jail's corrections officers. Johnson, 50, had been booked into the Marion County Jail in March on a charge of driving with a suspended driver's license. It wasn't his first time. This time, though, he was charged as a habitual offender and held without bail. He admits he was at fault. What he didn't understand then - or now - is why the jail's medical staff refused to give him the legally prescribed medications he had taken for years for his clinical depression, including the anti-depressant Paxil, an anti-psychotic called Seroquel and the sedative Trazodone. "The psych nurse came to me and said, 'You're not going to get this medication,'" Johnson said in a recent interview. "I said I'd get violently ill." And so he did. He began throwing up. He grew increasingly agitated. Nurses wrote in his medical records, day after day, that he was asking for his medication; that Johnson was "doubled over in anguish evidenced by facial expressions"; that he was making suicidal statements. His father, James Johnson Sr, called the jail to share his fears that his son was "very suicidal." He was taken in and out of a suicide prevention cell. At one point, he sat on the floor and began to pray with his cellmates. The Lord is my shepherd, I shall not want He maketh me to lie down in green pastures, he leadeth me beside the still waters. Johnson's son, Jordan, said an off-duty corrections officer called and pleaded with him to do something. "She was in tears and she said I need to get my dad out and get him a lawyer. She said they were torturing him," Jordan recalled. As Johnson's pleas for help went unanswered, he became more desperate. By the seventh day, he was wailing and flinging himself headlong into the concrete walls hoping to either lose consciousness or alert the guards to the depth of his agony. "He started going crazy in front of my eyes," said Kyle Morrill, one of his cellmates. "I woke up in the middle of the night and he was running from one side of the cell and banging his head on the other side." Johnson's frightened cellmates begged officers to do something - anything - to relieve his suffering. But nothing changed. So when officers opened Johnson's cell on the 10th day after his arrest, he bolted up a nearby stairway and leapt off the balcony, crashing onto the hard floor 14 feet below and shattering his right leg. That jump earned him a trip to the hospital, where a psychiatrist put him back on an anti-depressant and painkillers and sent him back to jail. Johnson eventually was released after 90 days on the same combination of medication he was on before he was incarcerated: an anti-depressant, an anti-psychotic and a sedative. His son said Johnson looked like a zombie the day he walked out of the jail. And Johnson says for the first time he's dealing with a new manifestation of his illness - paranoia. A SICK HEALTH SYSTEM? Johnson's harrowing story isn't unique to the Marion County Jail, or for that matter, to many jails across the country. Correctional health care is complex, costly and politicized. And many times it is outsourced to large private companies. Critics say the profit motive that drives these companies leads them to cut corners on inmate care to save money and keep their investors happy. Prison Health Services, Inc., a Brentwood, Tennessee-based private company, has been providing medical care at the Marion County Jail for the past two years. As one of the largest providers of correctional health care in the nation, PHS is a frequent target of complaints about the quality of the care it provides. Just last week the company was sued by a Volusia County family accusing PHS of failing to provide suitable medical cSince PHS has been at the Marion County Jail, many inmates and their families say injuries often go untreated, serious medical conditions go undiagnosed and inmates are routinely denied necessary medications, even with a legal prescription. During a seven-month inquiry, the Star-Banner spoke to nearly a dozen inmates, reviewed hundreds of pages of medical records and invited medical experts not affiliated with the jail to review the policies and procedures of PHS. The newspaper found: * PHS is often reluctant to prescribe medication to mentally ill inmates. Some, like Johnson, arrive with legally prescribed medications, but are taken off of them. PHS officials say that's a part of "evaluation and observation during a period of abstinence from illicit drugs and alcohol." Some medical and legal critics call the practice irresponsible or even unethical, and say it's more about saving money on prescription medications than about performing a sound medical evaluation. PHS says the allegations aren't true, and that like all health care providers, including public and private hospital systems, it works to improve efficiencies and manage costs to be good stewards of taxpayer dollars. * Twenty-five inmates have died while in the jail's custody in the past five years, including six who took their own lives. By comparison, Orange, Palm Beach and Pinellas counties, all of which have populations at least three times that of Marion County, have similar jail death figures. During the period from 2000 through 2005, the Orange County Jail reported 21 deaths, Palm Beach reported 25 deaths, and Pinellas reported 28 deaths, while Marion had 20 deaths in that same period, according the federal Bureau of Justice Statistics. Meanwhile, Miami-Dade County reported 89 deaths, and Broward reported 49 deaths. Sheriff Ed Dean attributes the deaths here to the graying of the jail population and the fact that many people who come to jail have life-threatening illnesses. "Any death in jail is one too many," he said. "What we need to do is do anything possible to extend life, but only the giver of life knows when their time comes." No formal link has been shown between the deaths in Marion County and the care provided by PHS. Herman Tucker's death, however, is one that his family blames on the lack of appropriate treatment provided by PHS. Tucker was arrested at a local mental health facility in 2002 for attacking a doctor. At the Marion County Jail, he received a cocktail of drugs to subdue him, but no treatment. Deputies shocked Tucker with a Taser, pepper-sprayed him and bound him to a chair. Thirty-six days after his arrest, they found him unresponsive on the floor of his jail cell, his esophagus filled with half-chewed food. He was pronounced dead a short while later. The cause of death was asphyxiation. His family is now suing PHS, jail staff and Sheriff Ed Dean for what it says is criminalization of mental illness. * Many of the jail's medical staff and guards are skeptical of inmates' medical complaints, because some inmates fake symptoms for a variety of reasons. As a result, though, legitimate health complaints sometimes are overlooked or ignored. Anita Lesner, who was jailed in April 2007 for fraud charges, began showing symptoms of a debilitating neurological disease and lost her ability to walk. Jail staffers called her a faker and put her in suicide prevention when she wouldn't stop crying. Shortly after her release, she was diagnosed with Guillain-Barre syndrome, a severe nerve disorder. * PHS has been the subject of numerous lawsuits. Private Corrections Institute, a Florida-based nonprofit devoted to highlighting the pitfalls of privatization of correctional institutions, keeps rap sheets on companies like PHS, documenting allegations and lawsuits from around the nation, ranging from Alabama to Florida to Maryland. And the attorney general waged an unsuccessful campaign to keep PHS from working in New York State. * No state health agency oversees the medical operation of jails, mainly due to budget cuts. Although there are a variety of accreditations and standards that spell out minimum requirements for medical operations, critics say most of them are just paperwork and policy standards, not performance audits for care. The sheriff says he knew of the PHS checkered track record when he agreed to a contract with the company two years ago and said he added two extra layers of oversight: an independent contract monitor, and a medical doctor to go over PHS operations regularly. PILLS AND PROFITS The sheriff decided not to renew that contract earlier this year because he could only offer a 2.6 percent increase in the health care budget for next year and PHS was seeking a 6 percent increase. Dean insists the decision to part ways with PHS was a strictly financial one and that inmate care was not an issue. And both Dean and PHS insist that ailing inmates receive adequate care and dismiss allegations of poor medical treatment. PHS officials, however, would not agree to be interviewed for this story. The company would only respond to questions submitted in writing. Dean said in a recent interview that PHS provided community standards of care, and he had in place several layers of oversight. "Perfect health care does not exist," Dean said. "With 16,000 inmates going through MCJ [each year], you'll have issue where someone missed a diagnosis." Neither PHS nor the sheriff would answer questions about individual inmates' medical care. For example, why would an inmate like James Johnson with a medically diagnosed mental illness be denied prescribed medication? Critics say the answer is as simple as dollars and cents. "The biggest problem is that often the profit motive gets in the way of providing medical care," said Randall Berg Jr., executive director of Florida Justice Institute in Miami. Berg's experience with PHS began more than two decades ago, when the company was one of the first private correctional medical providers to come to Florida. "My first experience dealt with [PHS's] refusal to provide medication to an indigent inmate ... since then I've sued them a number of times for failing to provide needed care," Berg said. Johnson's attorney, David Kerce of Daytona Beach, is also suing PHS, alleging the company failed to administer psychotropic medication. Kerce represented eight inmates in Volusia County in a class-action lawsuit, alleging they, too, were denied their psychotropic medication. A federal judge dismissed the case without prejudice, meaning it could be refiled, but Kerce doubts the families involved could afford to hire an expert or a doctor to examine their cases individually. He said he will pursue Johnson's case because Johnson suffered a physical injury. "Pulling patients off medication is not acceptable and Hager has a history of it," Kerce said of Dr. David Hager, a psychiatrist who serves the Marion County Jail and also the Volusia County Branch Jail. "From my understanding, it's just not safe. You've got to step them down." Johnson, for instance, was told by the jail's medical staff that he had to go through a "30-day wash" period and that's why he was taken off of his medication. PHS says the term is not accurate. And there is no documentation of it in Johnson's records. Two independent psychiatrists, one of whom reviewed Johnson's records, said cutting patients off of their psychotropic medications is not common practice. "Most commonly, antidepressants are discontinued in a step-wise fashion so as to avoid 'withdrawal' symptoms, such as increased anxiety, depression, etc.," wrote Dr. Louis W. Solomon, assistant clinical professor of psychiatry at the University of Florida in an e-mail. He did not review Johnson's records. He added that a psychiatric examination is used to determine whether medications should be changed. Johnson never received such an examination at the time he was booked and taken off of his medication. Dr. Hager, who agreed to respond to the Star-Banner's questions via e-mail, wrote: "The '30-day washout period' has become an overused and misunderstood catchphrase. It refers to the process of evaluation and observation during a period of abstinence from illicit drugs and alcohol. It is not a rigid 30 days. It may be more or less depending on each patient's situation and does not apply to every patient referred to the mental health team. The determination to apply a washout period is fully dependent upon gathering reliable information and observations, including our ability to obtain outside medical and pharmacy records." Hager referred to the American Psychiatric Association's Practice Guidelines and Diagnostic and Statistical Manual of Mental Disorders, 4th. Edition, or DSM-IV, which requires that patients be clean of drug addiction so that the provider can make accurate diagnoses of major psychiatric syndromes such as schizophrenia, major depression or bipolar disorder. Johnson's records do not show that he was using illicit drugs. Dr. Don Sherry, a psychiatrist who practices here, said he doesn't suddenly cut off his patients' medication. He said even if Johnson had been taking illicit drugs, he could have been kept on his psychotropic medication. "This is [Hager's] standard of practice, and it's fine, as long as he doesn't hurt people," Sherry said. "[As a doctor] you have authority, but you also have the responsibility ... this jail psychiatrist is hurting people by doing things his way." NO SIMPLE CURE Even critics of PHS and other private correctional services say there is no simple solution to the problem of providing adequate medical care to inmates. Sherry has a motto: "Cheap ain't good; good ain't cheap." "When you start putting profit motive ahead of medical care, medical care becomes bad," he said. But with tight budgets, counties don't have many good options for jail health care. "You've got people who haven't taken care of themselves and have to be taken care of, and you just can't let them die. And they're a burden for the taxpayer," said Ken Kopczynski of Private Corrections Institute, a Florida-based nonprofit organization that opposes the for-profit private corrections industry. "The county commission looks and sees it getting expensive, so they go to private groups, because their price is lower. But not only do they have to look at care, but also profit for shareholders. And that's no way to operate the jail." While health care is an inmate's legal right, most people in jails and prisons are poor, lack education, have high rates of mental illness and chronic illness and are frequently substance abusers or addicts. Many are uninsured and have not seen a doctor or dentist for years. "Rarely you find someone who has one illness. Providing service to these individuals is complex and costly, because they haven't received quality health care. And it's expensive, outside and inside the prison," said Dr. Melvin Delgado, author of the 2006 book Health and Healthcare in Prison. In addition, prescribing medication to inmates is not a quick process, because inmates are not allowed to use the medication they bring in to the jail. "[Jail staff] don't know what the medication is. They didn't hand it to the person, so its puts them in a Catch-22. They should have the doctor to say 'yes, they are psychotic and need XYZ,'" said Kopczynski. Meanwhile, many people have little sympathy for those behind bars. "Inmates don't have a very large advocacy group, or lobbying group. Nobody is clamoring at the sheriff's door to provide better care to inmates," said Paul Sheehan, chief operating officer of Community-Oriented Correctional Health Services, a nonprofit group whose mission is to help correctional facilities use local resources for providing medical care. The U.S. adult correctional population - incarcerated or on some form of community control - reached 7.2 million, increasing by 159,500 this year, the Justice Department's Bureau of Justice Statistics announced earlier this month. About 3.2 percent of the U.S. adult population, or 1 in every 31 adults, was in prison or jail or on probation or parole at the end of 2006. Another report by the Justice Department shows the inmate population in jails increased by 306 percent, from 184,000 in 1980 to 748,000 in 2005. The spike in the number of people behind bars is largely a result of sentencing and correctional policy changes over the past 30 years involving tougher sentences for a variety of crimes, and particularly for drug-related offenses. COSTLY, COMPLICATED ... AND NECESSARY While privatized correctional health care might control costs in the short run, cases such as Johnson's show that in the long run, it potentially can pose a higher cost to taxpayers and the community, inmate advocates say. Even if inmates who sue over alleged poor care lose their case, the county still must pay to defend against those lawsuits. And sick inmates who go untreated in jail can endanger public health when they're released back into the community. Taxpayers also share the burden if those inmates land in a publicly-funded hospital. Medical care at jails is costly and complicated, "but it's necessary and required," said Alex Friedmann, associate editor of Prison Legal News, an independent monthly magazine that provides a review and analysis of prisoner rights, court rulings and news about prison issues. "Once you remove a person's freedom, you're required to provide that medical care for them. "People in jail are people, they're neighbors, brothers, daughters. Ninety-five percent of them get out," Friedmann said. "When people think of jail, they think of rapists and murderers, but that's not representative of the jail population." With the pending departure of PHS, Sheriff Dean is about to launch a community-collaborative nonprofit group, called Ocala Community Care, that will take over medical care at the jail. "I concluded that the future of inmate health care needed a change," he said. "We needed to embrace the community and figure out how $5 million of taxpayers money could be better utilized for delivery of care to inmates." His initiative is uncommon and it remains to be seen if it will help people like James Johnson. Editor's note: Since his release, James Johnson has been living in motels, trying to hold down a job. He told the Star-Banner he didn't want his picture printed, because he was afraid he would lose his job. But he said he wanted people to hear his story.

November 22, 2007 Ocala Star-Banner
Marion County Sheriff’s Office is finalizing its contract with a locally formed non-profit group that will provide medical care to Marion County Jail inmates. Ocala Community Care Inc. will take over the responsibilities of the private company Prison Health Services on Jan. 2, 2008. Sheriff Ed Dean did not renew PHS’ contract for a third year, because the two could not agree on compensation. The nearly $5 million that would have gone to PHS, will go to OCC instead. The non-profit company came together in less than six months under Dean’s leadership. OCC has evolved as a result of collaboration of community’s health care leaders, such as Munroe Regional Medical Center, The Centers and Marion County Health Department. OCC’s short-term goal is to provide medical care to more than 2,000 inmates incarcerated the jail. In the long run, OCC”s board hopes to link with the Federally Qualified Health Center, a federal grant that the county is applying for. The ultimate goal is to create continuity of care for inmates after they’re released back to the community.

July 27, 2007 Ocala Star-Banner
Sheriff Ed Dean has officially terminated his agency's contract with the jail's medical provider, Prison Health Services, after the two parties could not reach an agreement over pay. Countywide budget constraints forced Dean to renegotiate the contract with PHS, offering it a 2.6 percent increase in compensation for the coming year instead of the planned 6 percent. PHS has not agreed to renegotiate. "Therefore, the Marion County Sheriff's Office must proceed with an alternative plan to deliver healthcare to inmates at an affordable cost," Dean wrote in a letter to Rodney Holliman, group vice president for PHS. The letter, he wrote, was the official notification that the contract will terminate. PHS' second-year contract with the Sheriff's Office will end on Oct. 1. However, the actual date and time of termination are yet to be determined. Dean has also sent a letter to local health-care leaders to find out if they would be willing to attend a meeting to "discuss the creation of a new model for healthcare delivery to inmates in Marion County."

December 20, 2006 Ocala Star-Banner
An inmate at the Marion County Jail, who was known by the medical staff to have a life-threatening illness, died Monday. But no one called an ambulance for an hour-and-a-half after the man first collapsed. He reportedly appeared to be conscious after that incident, but officials did call 911 after he fell a second time. Alan V. Williams, 42, was pronounced dead shortly after arriving at Munroe Regional Medical Center. Williams was taken from the jail at 8:38 a.m., a little more than two hours after he first collapsed. He arrived at the emergency room about 10 minutes later, according to a Marion County Sheriff's Office report. Two Emergency Medical Services Alliance employees tried to resuscitate him on the way to the hospital. At 8:53 a.m., a doctor performed CPR on Williams. He was pronounced dead at 9:03 a.m.

September 16, 2006 Ocala Star-Banner
The estate of Herman B. Tucker, a mentally ill 24-year-old Inverness man who died in jail custody in September, 2002, filed suit Friday against Marion County Sheriff Ed Dean, jail officials, an employee of The Centers, and Prison Health Services employees, asking the court to declare the jail's policies toward Baker Act patients illegal. At the time of his death, Tucker was on a suicide watch at the Marion County Jail. According to the suit, Tucker had been taken by deputies under Florida's Baker Act to the Marion-Citrus Mental Heath facility on Aug. 10, 2002, at the request of his mother, who feared he was a danger to himself. Under the Baker Act, mentally ill people may be involuntarily evaluated or hospitalized. The suit alleges that Kevin Dahmen, then the director of The Centers' crisis unit, forcibly administered drugs to restrain Tucker without determining the appropriateness of the medications, and had Tucker arrested. Karen Gievers, lead attorney for the family, said in a telephone conversation Friday that Dahmen alleged that Tucker had bitten him, but police reports indicate there were no bite marks or bruises. Gievers said that no assessment of Tucker's condition was made. The suit further alleges that when he arrived at the jail, Tucker, who had no signs of injury when he left the mental health facility, was mentally incoherent and suffered injuries as a result of drug overdose and force used during the arrest. While being booked for allegedly assaulting Dahmen, it was feared that Tucker suffered a concussion and he was transported briefly to the hospital for an assessment. According to court papers, Tucker received no mental health services while in custody at the jail from Aug. 10-Sept. 15, 2002. Instead he was given drugs by employees of Prison Health Services, to subdue him. PHS is under contract with the jail to provide inmate health care. Anxiety and aggressiveness are among the side effects of the drugs given to Tucker. On seven occasions Tucker allegedly was injected with "agitation cocktails" including combinations of Ativan, Haldol and Benadryl.

July 9, 2006 Ocala Star-Banner
A Marion County Jail inmate was pronounced dead at Munroe Regional Medical Center, where he had been transported due to medical distress early Saturday morning. The Marion County Sheriff's Office has not released the cause of death for Frank Keesler, 43, of Silver Springs, pending results from toxicology tests. Jail personnel found Keesler in his cell unresponsive but breathing at about 2 a.m. Saturday. Keesler, who was awaiting trial on a charge of sexual battery on a minor, suffered from diabetes and high blood pressure, according to Capt. Tommy Bibb with the Marion County Sheriff's Office Major Crime Bureau. Bibb said Keeslar was being treated for his illness. A week before his death, Keeslar was treated for a seizure, he said. "There are no signs of foul play, trauma or marks on his body," Bibb said Saturday. The Florida Department of Law Enforcement is investigating Keeslar's death, which Bibb said is normal procedure. Bibb said FDLE officials are reviewing Frank Keeslar's medical history as part of the investigation. The medical care provided to inmates at the jail has come under scrutiny before. Just last year, Prison Health Services Inc., a Tennessee firm that provides the jail's medical services, released a statement saying they would not prevent inmates from getting their medication. The release was in response to a doctor's claim that an inmate's suicide was due to him not receiving psychological counseling and antidepressant medication on time.

March 19, 2006 Ocala Star-Banner
The 34-year-old woman accused of setting a home fire that killed her husband and stepfather in 2001 said she wants to move on with her life. In a jailhouse interview, Deborah Decker professed her innocence in the deaths and said she wants closure. She is charged with two counts of first-degree murder and with arson of a dwelling. Decker has been on suicide watch for the last 14 months. She has tried to commit suicide numerous times. Scars on her wrist and arms show at least one attempt. According to Decker, her last attempt was in August. It was then that a jail inspector, who was investigating her suicide attempt, heard about inappropriate sexual encounters between the inmate and Prison Health System mental health counselor David Gerald Ownby, 58. Ownby has a pending case and was charged with sexual misconduct. Decker said she took 72 pills and had stopped eating for 30 days when she tried to kill herself. She also said that since the sexual allegations came out jail staff have made "snide comments" referring to meeting people in their offices. She said that even though she didn't fight Ownby off she did not want to have sex.

March 3, 2005 WESH
Marion County's sheriff has raised questions about the quality of health care an inmate who committed suicide last month received and whether a lack of medication may have played a role in that death, WESH NewsChannel 2 reported. NewsChannel 2 has learned that the company that handles the inmates' health care is the target of complaints all over the country. The major complaint is that inmates are not getting the medication they need. None of the doctors or nurses at the medical infirmary at the Marion County Jail work for the sheriff or the jail or even Marion County. They work for a private health-care provider called Prison Health Services, which is based in Brentwood, Tenn. Marion County pays PHS nearly $4 million a year to provide medical care to inmates. Last month, PHS staffers stopped giving an antidepressant medication to inmate Milton Oakes, according to a report by an independent doctor. The sheriff's report also found that Oakes did not receive scheduled psychiatric counseling set up in Lake County. Also, when Oakes began banging his head in his jail cell wall, he was given no medication nor placed in the infirmary. He committed suicide on Feb. 22. Sheriff Ed Dean stops short of blaming Oakes death totally on his medical care, but he did say that PHS did not provide the care he expects. "From my own layman's view, if you're on a certain medication and you take it away from someone and it has to do with bizarre behavior, maybe you ought to keep it and not take it away," Dean said. PHS serves more than 80 jails and prisons in 27 states, including over a dozen jails in Florida. In a series published this week, the New York Times reported numerous instances where medications were withheld from inmates, just like this case in Marion County. "This is a shortfall that the doctors tell me have to be shored up," Dean said. According to a PHS spokesman in Tennessee, the company has hired a public relations firm in New York City to respond to these problems and deaths, but no one from the public relations firm has returned NewsChannel 2' s requests for comment.

Maryland Department of Corrections
June 10, 2005 Baltimore Sun
In mid-March 2002, Marcella N. Leski, 39, was jailed for failing to appear in court on a drug-possession charge. Twelve days later, she was so ill that her legs were amputated below the knees. Her family alleges in a lawsuit that the prison contractor's doctor failed to diagnose and treat an infection that can be cured with antibiotics. While the question of legal responsibility is in dispute, what is not in question is that Leski's condition deteriorated while she was in the custody of the state-run Baltimore Women's Detention Center. Maryland's prisons are no place to get sick. The state's own audits and correctional system records show that the prison health care system has been underfunded, understaffed and poorly run. A Sun investigation found that many inmates over the past five years have received inadequate medical attention, according to interviews, independent state audits, internal state records and other documents. Maryland corrections officials acknowledge underfunding and providing spotty oversight of the state's main medical contractor, Tennessee-based Prison Health Service Inc. As of June 30, Prison Health, one of the nation's largest for-profit correctional health care providers, will no longer be providing inmate health services in Maryland. Its contract expires on that date, and the state recently selected other vendors to provide services for the state's 27,000 inmates in a totally restructured system. Prison Health executives say they pleaded to get out of the contract two years ago but the state refused, and that Maryland continued to pay far less for services than it was costing Prison Health to deliver. The company says it was paid more than $260 million in Maryland over the past five years, but lost $14 million. State audits, lawsuits, internal memos and other documents reveal a grim picture of inmate heath care since 2000, when Prison Health got its contract. The problems include: Insufficient staffing. Staff shortages have caused lengthy delays in prisoners being seen by physicians, psychiatrists and nurses, according to audits of prison infirmaries done by the state Office of Health Care Quality, an independent state agency that monitors health care facilities in Maryland. And records that are kept are not always reliable. For example, state corrections officials discovered in March that Prison Health staff members apparently had altered records to falsely indicate that they had conducted required checks on suicidal inmates every 15 minutes at the Women's Detention Center in Baltimore, according to e-mail between state and Prison Health officials. The employees involved resigned, Prison Health executives said. Failure to examine closely enough and follow through on inmate medical complaints. For example, Ricky Scearce, 48, reported in 2001 all the classic signs for colon cancer to a prison doctor on the Eastern Shore, according to a lawsuit he filed against Prison Health. Although his symptoms persisted, no colonoscopy was ordered to test for the disease until two years later, as Scearce's release date approached, the lawsuit said. The diagnosis then: advanced-stage, terminal colo-rectal cancer. Prison Health settled the lawsuit last year for an undisclosed sum and declined to discuss Scearce's case. The problems of drug delivery were also the subject of internal discussions among Prison Health's staff in Baltimore. At a Feb. 13, 2003, meeting, Prison Health's nursing managers complained that critical documents that doctors and nurses rely on to track drugs given to inmate patients were "not being completed properly," according to minutes of the meeting. In interviews this year, Prison Health executives insisted that they met their obligations and did not cut corners on care - despite losing millions on the Maryland contract. They said the audits reflect occasional mistakes they worked to correct, not deliberate neglect. But what turned out to be a bad deal for Prison Health was a good one for the state, at least in financial terms. One of the few detailed analyses done by the state showed that Maryland was spending $2,293 per inmate on health care in 2002 - well below the national average of $2,722. "Most of the states at that level are poor states, like Alabama and Mississippi," said Elizabeth Alexander, director of the ACLU's National Prison Project. "I think it should bother the citizens of Maryland to be in that category." She noted that Maryland is a wealthy state. The ACLU is a lead plaintiff in a civil rights lawsuit alleging poor health care services and deplorable living conditions at the state-run Baltimore jail facilities. As costs rose much faster than Prison Health had projected, the company pleaded to be released from the contract at the end of three years. But the state exercised its option to extend the contract for two years. Alexander and other critics say that decision ultimately compromised inmate health care. The ACLU's Alexander said state officials demonstrated a "lack of concern" for the welfare of inmates by extending the contract - even after serious problems with medical care at the Baltimore City Detention Center were highlighted in a highly critical U.S. Justice Department report in 2002. Dr. Ronald Shansky, a nationally recognized expert on prison health care, said a state cannot be excused from its responsibility to deliver an appropriate level of health care services to inmates in its custody. "If a contract is underfunded, and not just poorly managed, that's also a state responsibility," he said. "They should know what it takes per capita to provide the services ... and shouldn't support any bidder whose proposal is too low" to do the job properly. Staffing was another daily challenge. Prison Health officials say they had trouble hiring and retaining staff because the state's prisons were perceived as dangerous and recruiting in the medical field was highly competitive. In a May 2004 e-mail, Benjamin Brown, assistant commissioner for the Division of Pretrial Detention and Services, complained of continual disputes with Prison Health over staffing and how medical evaluations of new arrivals at the facilities would be conducted. "Their cavalier attitude to their contractual and ethical responsibilities is unacceptable; their inability or unwillingness to communicate effectively is equally unacceptable," Brown wrote to a state corrections official who oversaw inmate medical services. In one highly publicized case last year, Prison Health reprimanded and reassigned four employees who failed to perform their duties properly in the case of a female inmate who died Sept. 14 from an advanced case of cryptococcal meningitis. Deborah Epifanio, 34, who had been held at the women's prison in Jessup and the women's jail in Baltimore, had experienced fainting spells for days before Prison Health staff sent her to an emergency room. State corrections officials have not released additional details about the circumstances surrounding her death. Both Prison Health and its main rival, St. Louis-based Correctional Medical Services Inc., submitted bids for the medical service component, the largest of the contracts, with CMS winning. Prison Health's contract expires June 30. A separate company, Wexford Health Sources Inc. of Pittsburgh, was chosen to manage and oversee the use of hospitalization and other care to keep costs in check, Rosenblatt said. He said the contract gives Wexford financial incentives to hold down costs.

June 2, 2005 Baltimore Sun
After five years of relatively stable health care costs for inmates, the state Board of Public Works approved an increase in spending of more than 60 percent yesterday that could push the annual tab to $110 million as officials try to improve medical services for the state's 27,000 prisoners, particularly in Baltimore's troubled jail facilities. Contracts were awarded to five for-profit companies, which will run different segments in the prisons' privatized health care system, such as medical, mental health and pharmaceutical services. Last year, the state spent $68 million on inmate health care, state corrections officials said. Correctional Medical Services Inc. of St. Louis won the biggest contract, a two-year, $125.6 million deal that involves providing medical services to state prisons and Baltimore's state-run jail facilities - a total of 32 facilities. Under a state contract signed in 2000, the company has provided comprehensive medical care services for the past five years to three prisons in Hagerstown. The state's main prison health care contractor since 2000, Prison Health Services Inc. of Brentwood, Tenn., did not win any piece of the state's business in the latest round of bidding. Prison Health, which provided health care services to more than 20 state correctional facilities, had been criticized by inmate advocacy groups for skimping on services, particularly in Baltimore's jails. CMS has been the target of inmate advocacy groups and unfavorable media coverage over quality of care in the past, including an investigative series in the St. Louis Post-Dispatch in 1998. The newspaper reported incidents of alleged medical negligence that, in some cases, led to inmate deaths in Missouri and elsewhere. "Correctional Medical Services' history of cutting corners to maintain profits jeopardizes the lives of thousands of incarcerated people across the country," said Elizabeth Alexander, director of the American Civil Liberties Union's National Prison Project, in a statement opposing CMS' selection as Maryland's inmate medical provider. "Many states have already learned a painful lesson from their dealings with Correctional Medical Services," she said.

May 10, 2005 Baltimore Sun
A Tennessee-based company that has provided medical services to most of Maryland's prisons for the past five years announced yesterday that it failed to win a new contract for inmate medical care potentially worth tens of millions of dollars. America Service Group Inc. of Brentwood, Tenn., said in a statement that it had not yet received formal notification from Maryland officials that its subsidiary - Prison Health Services Inc. - lost the state's business in a bidding process that began last fall. But the company said it was its "understanding" that contract awards would be made to other companies. Prison Health has held the contract to provide medical services to most of Maryland's prisons, as well as Baltimore's jail facilities - a total population of more than 20,000 inmates. The for-profit company has been criticized in Maryland and other states over the quality of care it has provided. Prison Health signed an inmate medical contract with Maryland in 2000 worth about $270 million over five years, company officials have said. But the contract - known generally as a flat-fee model -left Prison Health vulnerable to the vicissitudes of the health care industry. As health care costs skyrocketed, the company increasingly lost money in Maryland and other states where it had signed similar contracts. Last year, the company warned investors that significant increases in hospitalization and prescription drug costs for Maryland inmates would cause it to lose roughly $1 million a month until its contract expires June 30. Prison Health officials said they had asked to be released from the Maryland contract two years ago because of the losses, but the state had the unilateral right to renew the contract. Maryland corrections officials have said that they renewed the contract with Prison Health at the time because it represented a good deal for the state. Inmate advocates allege that Prison Health cut corners on inmate health care to reduce its financial losses - a criticism that company officials reject. Critics have also blamed the state for allowing a for-profit company to operate the inmate medical system in Maryland while absorbing heavy losses.

Maryland Legislature
March 9, 2005 City Paper
A consultant hired by the state of Maryland to write the parameters for a new prison health-care contract is a co-founder of Prison Health Services Inc., the Brentwood, Tenn.-based company that has the contract now. Jacqueline Moore, of Jacqueline Moore and Associates, co-founded Prison Health Services in 1978 with her then-husband. Prison Health Services has held the Maryland prison contract since 2000 and is paid about $53 million annually to care for the 24,000 inmates. The company says it’s losing about $1 million per month on the contract. The company and other observers estimate the new contract will total about $100 million annually. Moore’s company was hired in September to help write the request for proposal—a set of specifications that prison health companies can use to guide their bids for the contract. Critics say Moore has a conflict, even though she says she has not been associated with Prison Health Services since 1990, and her ex-husband has since founded at least two other prison health-care providers. The new bid specifications include a cost-sharing arrangement between the vendor and the state, Moore says: “In the past, RFPs had a lot of fines, and there was a lot of risk associated for the vendors. They were trying to do something different in this RFP.”

Mecklenburg County Jail, Charlotte, North Carolina
November 28, 2007 Charlotte Observer
A Brazilian woman, jailed for four days on shoplifting and immigration charges, has been reunited with her 8-week-old son, and now Mecklenburg jail officials are asking their health care provider to review its policy on inmates who are lactating. Danielle Ferreira, 29, was not allowed to nurse her son or provide breast milk for him while she was in jail. She was released Tuesday, after the Observer reported her son was spitting up baby formula, and Ferreira was complaining of pain and fever. Immigration officials, who were holding Ferreira for deportation, agreed to let her go until her hearing date. Then, District Court Judge Phil Howerton unsecured her $500 bond on the shoplifting charge, so she could leave the jail. Ferreira was reunited with son Samuel on Tuesday and is staying with a Brazilian couple that had come to her aid. She was glad to have a shower and a change of clothes, but said the baby was having some trouble nursing. "He has some difficulty to get the breast," she said. Jail officials would have arranged for the woman to be released shortly after she was arrested Friday, said spokeswoman Julia Rush, if they'd known about recently approved federal guidelines allowing the release of pregnant or nursing mothers in the country illegally. Ferreira said that in jail she repeatedly asked for a breast pump because she was worried her milk would dry up. She said the guards gave her hot towels and told her: If you were worried about that, you shouldn't have gotten in trouble. "All the time I was in pain because my breasts were full," she said. The Mecklenburg jail does not allow women to express milk without a court order, Rush said. It's a policy of Prison Health Services, the company that provides health care to inmates and is partly due to liability issues if the milk got contaminated and made the baby sick, she said. Sheriff Jim Pendergraph, who retires after this week to take a federal immigration job, has asked the health care company to review its policy. A check of area jails found that many have no policy on expressing breast milk and consider the request on a case-by-case basis. Ferreira and her brother were arrested Friday afternoon at Eastland Mall and charged with shoplifting. When she got to the jail, officials learned that she is from Brazil and entered the country on a visa that expired in April 2005. Since last year, the Mecklenburg jail has participated in a federal program that identifies illegal immigrants after they are arrested and turns them over to immigration officials. Ferreira signed a waiver saying she wanted to return to Brazil voluntarily, so she was being held in the jail for deportation. Earlier this month, U.S. Immigration and Customs Enforcement formally adopted guidelines that allow pregnant or nursing women to be released under supervised conditions. But Rush said jail officials had not been made aware of it. "Both Sheriff Pendergraph and I have spoken with ICE officials and are working to ensure this does not happen again," she said.

December 12, 2006 Charlotte Observer
A 29-year-old man died while in custody at the Mecklenburg County jail over the weekend, and his family is concerned that he wasn't given prescription medication for the seizure disorder that apparently killed him. Calvin Bernard Edge died Saturday afternoon, less than 24 hours after he was brought to the county's central jail in uptown Charlotte on a misdemeanor warrant charging him with failing to pay child support. A preliminary autopsy showed he died of a seizure disorder. His mother, Elizabeth Edge, 60, said her son had suffered from seizures since he had brain surgery for a head injury about five years ago. He was supposed to take medicine twice a day, she said, and the jail knew he had the medical problem. It's not clear, though, whether officials at the jail checked his medical record when he was brought in late Friday night. A nurse checked out Edge when he was brought to the jail, as is done with all inmates, Mecklenburg County Sheriff's Office spokeswoman Julia Rush said. But Rush said Edge falsely told the nurse he had diabetes and did not mention the seizures. However, Edge had told jail officials about the seizure disorder on at least one past stay at the jail, Rush said. He had been there at least two other times in the past two years, records show. That means his disorder should have been listed in his medical records. Rush said inmates' medical records are sealed to all jail staff except for the medical professionals hired by its private health care provider, Prison Health Services. Susan Morgenstern, a spokeswoman for the Tennessee-based company, declined to discuss the case itself, citing patient confidentiality. She also said she could not comment on whether staff routinely check past medical records during inmate screenings. Rush told the Observer that Edge did not bring his medicine to the jail when he was arrested. However, Morgenstern said people aren't required to bring their pills to the jail. Medical staff ask each inmate about any medications they take, she said. The staff must verify that the prescription remains valid. Then they can give the inmate the required dosage during the jail stay. Elizabeth Edge told the Observer that her son still had four refills left of Depakote, a drug commonly used to treat epilepsy. She said she was looking at his bottle of pills at their Charlotte home as she spoke to a reporter on the phone. The Edge family wants answers. Mary Edge, 36, said her brother's medical records should have been reviewed. She also wants to know why officers didn't check on him earlier.

May 6, 2006 Charlotte Observer
The estranged husband of a Mecklenburg County jail inmate who died Tuesday of an apparent infection is calling for the private health service that treated her to be shut down. And George Henderson said he plans to talk to a lawyer. "They should have known what was going on," Henderson told the Observer on Friday. "They ought to be sued. Put them out of practice." Carol Henderson, 51, died inside a medical unit at the Mecklenburg County jail early Tuesday morning after spending nearly a month in custody awaiting trial on a misdemeanor charge of violating a domestic violence restraining order. A preliminary autopsy shows she died from sepsis, an overreaction to infection that has high mortality rates. It also found she had severe heart disease. A full autopsy won't be available for months. A Mecklenburg sheriff's report, released Friday at the Observer's request, shows that 28 minutes elapsed from the time a detention officer found Henderson unresponsive to when medical staff arrived. A quicker response at that point might not have saved her, said Dr. A.J. Patefield, Presbyterian Hospital's medical director of intensive care. He did not treat the woman. However, he said, treatment for sepsis in even the four hours leading to her death could have made a difference. Charlotte-Mecklenburg police, the Mecklenburg County Sheriff's Office and the jail's private health-care provider, Prison Health Services Inc., are each conducting investigations. That is standard procedure after the death of an inmate.

May 3, 2006 Charlotte Observer
A 51-year-old woman awaiting trial on a misdemeanor charge died Tuesday morning while in custody at a Mecklenburg County Jail, prompting routine investigations into whether officials did all they could to help her. A detention officer found the woman unresponsive in a medical unit at the county's central jail around 3 a.m., said Mecklenburg County Sheriff's Office spokeswoman Julia Rush. Medic, the county's ambulance service, was called at 3:17 a.m., with reports that CPR was in progress. The ambulance crew arrived at 3:24 a.m., but they did not take the woman to a hospital because she had died. The preliminary cause of death was sepsis, a blood infection caused by bacteria, according to the Mecklenburg County Medical Examiner's Office. The woman also had severe heart disease. A full autopsy report won't be available for months. Jail officials had not located the woman's family by Tuesday evening so they would not release her name. She was arrested April 7 and charged with violating a domestic violence restraining order, jail records show. Charlotte-Mecklenburg police are investigating the death, Rush said. She added that the guard checked on the inmates in the health-care unit as required that morning. But she said the Sheriff's Office will conduct a full investigation once the police department completes its inquiry. Prison Health Services, the jail's Tennessee-based private health care provider, is conducting its own investigation into how its employees responded, said company spokesman John Van Mol.

Metro Jail, Nashville, Tennessee
August 23, 2005 Tennessean
In the wake of criticism about the care it provides to inmates locally and across the country, Brentwood-based Prison Health Services has been replaced after 10 years as the health provider for Metro Jail inmates, company officials said yesterday. Instead, Metro inmate health care will be handled by Correct Care Solutions of Nashville, which was awarded a five-year contract that would pay it more than $36 million. The company is led by Jerry Boyle, a former president and CEO of Prison Health Services who left in 2003 to form his new Nashville firm. The contract award comes seven months after the death of inmate Ricky Douglas because of diabetic complications. His body was found in a Metro Jail cell Jan. 19, hours after he asked a guard for medical attention that he never received. He was among three diabetic inmates alleged to have become ill after receiving substandard care since January. Metro city officials said they hoped the new deal would help them move past the recent problems. Meanwhile, for the first time yesterday, Prison Health Services disclosed that it paid an out-of-court cash settlement to former inmate Paul Burton, who was hospitalized with a diabetic illness, only days before Douglas' death. Doctors later determined Burton was not receiving a sufficient dosage of insulin. Aside from its problems in Nashville, Prison Health Services had been dogged by criticism in recent months. A series of articles in The New York Times earlier this year was highly critical of the company's services nationwide and accused it of putting profits ahead of inmate needs. In May, the company announced that it would no longer provide services in Maryland. In a report issued by a Nashville committee that evaluated proposals from Prison Health Services and other bidders, the committee members expressed concern about the company's pending legal woes and about a shortage of nurses. Douglas' death in January could have been prevented if health workers at the Metro Jail had followed policy and properly documented their interactions with prisoners, according to a March 17 report by the Metro Health Department. That report blamed Douglas' death on Prison Health Services nurses' failure to properly document the prisoner's medical problems when he was booked, losing track of his medical history, improperly treating his diabetes, and ignoring his repeated requests for care.

May 13, 2005 Tennessean
The death of a diabetic inmate could have been prevented if health workers at the Metro Jail had followed policy and properly documented their interactions with prisoners, according to a report by the Metro Health Department obtained by The Tennessean yesterday. Ricky Douglas died of complications of diabetes on Jan. 19, hours after asking for medical attention that he never received. The March 17 report blames the death on myriad failures by the jail's nurses, who work for Brentwood-based Prison Health Services, the nation's largest provider of health care in jails and prisons. ''There were missed opportunities where health interventions could have taken place,'' the Metro report states. ''The policies and procedures in place at the time of the event should have prevented such an outcome.'' Nurses failed to properly document Douglas' medical problems when he was booked, lost track of his medical history, improperly treated his diabetes, and ignored his repeated requests for care, the report states. In one example, a nurse saw Douglas being treated for a toe injury, and improperly assumed that he was also being treated for his diabetes, according to the report. But despite the blame placed on the nursing staff, no one has been disciplined for the deadly mistakes, officials with the prison health firm said. Instead, the health workers involved have been counseled. On the night before his death, Douglas and several other inmates told a jail deputy that a nurse had failed to make her scheduled rounds to distribute medications. The deputy told the inmates that a nurse would come by later. Douglas, who was from Nashville, was found dead four hours later, lying on his stomach with his face to the side and his tongue protruding between his teeth. As a result of their investigation, Metro health officials also ordered Prison Health Services to implement new training and procedures by April 15. But as of yesterday, the company had not met those deadlines, Prison Health Services officials said, saying their nurses had been too busy to undergo the training. Douglas' death was among three local cases this year involving allegations that diabetic inmates received substandard care at the Metro Jail. One of those inmates, Paul Burton III, was hospitalized with severe diabetic complications eight days before Douglas died after receiving a lower dosage of insulin than he should have received. The Metro cases come at a time when Prison Health Services is under fire for the care it has provided to prisoners throughout the country, and particularly in New York state. A series of articles in The New York Times earlier this year was highly critical of the company's services. Memphis lawyer Archie Sanders III, who is investigating Douglas' death for the inmate's relatives, said the Metro Health Department report appears to be an attempt to blame individual employees for problems that are clearly systemic. He said the Metro Health Department also shares blame for providing poor oversight of the health care in the county jail. ''I have issues with respect to whether the Health Department was providing proper supervision, and whether, in fact, all procedures that the Health Department should have put into effect, which could have prevented something like this, were put into effect,'' Sanders said.

April 21, 2005 Nashville City Paper
At least four companies are interested in competing against Brentwood-based Prison Health Services (PHS) to provide health care for Metro Sheriff’s Department inmates. This week, Metro began taking proposals for the contract, which currently is worth about $3.5 million annually and ends June 30. The new contract, unlike the old, will encompass health care for women inmates. PHS was forced to revise some of its procedures after a March 17 report issued by Metro Health found the January 19 death of Davidson County inmate Ricky Douglas — resulting primarily from complications arising from diabetes— could probably have been prevented. The report said that some individual PHS employees failed to adhere to established practices and missed opportunities to address Douglas’ health conditions, but found no intentional neglect of his care or any system-wide pattern of neglect.

March 18, 2005 Tennessean
Yesterday should have been Ricky Douglas' 40th birthday. Rather than a day of celebration, it was the day Douglas' autopsy report was released, revealing for the first time that the diabetic Metro Jail inmate died after not receiving medicine to treat his illness, even after requesting it from his cell. His autopsy report follows a recent admission by the city's private health-care provider for inmates, Brentwood-based Prison Health Services, that the company made critical errors in providing care for Douglas in the hours before his death Jan. 19. Until yesterday, Metro officials had maintained that they did not know exactly what caused Douglas' death and were waiting for the medical examiner's findings to be released before placing blame. ''It does appear that there were individual failings in following policies, and you had this adverse result,'' said Bob Eadie, deputy director of the Metro Department of Public Health. ''Whatever consequences come from Mr. Douglas' death, Prison Health Services will be