Alabama Department of Corrections
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
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
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
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