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Alabama Department of Corrections
Sep 8, 2014 al.com

A competitor for Alabama's $224 million inmate health care contract claimed in a letter critical of the process that a costly stipulation helped push the firm out of the bidding race. The Alabama Department of Corrections required that the winning vendor had to buy a $5 million performance bond in order to get the contract. But when the deal was signed two years ago, the Alabama Department of Corrections scrapped the requirement altogether. Private prison health care firm Corizon was then awarded the 34-month contract after it submitted the only bid for the work. AL.com is examining the health contract in light of a lawsuit the Southern Poverty Law Center filed against the state. The suit, which is pending before a federal judge, alleges that inadequate healthcare was provided to the state's 25,000 inmates. Corizon has hired powerful lobbying firm Maynard Cooper & Gale to fight the lawsuit on behalf of Alabama. Two lobbyists at the firm, a fundraiser for Gov. Robert Bentley and Bentley's former special counsel, have represented Corizon in 2012, and 2013 and 2014, respectively. A lawyer from the firm, William Lunsford, wrote that the SPLC's lawsuit relies on "inaccurate characterizations and apparent misunderstandings." A little more than two years before the lawsuit was filed, Edward McNeil, an executive at prison health care company Wexford Health Sources, wrote a letter to Alabama's top prison health care official Ruth Naglich to explain why Wexford did not compete for the work. Among other concerns, McNeil wrote that the $5 million performance bond required by the ADOC's bid proposal is "out of proportion." "We feel this amount not only far exceeds any reasonable estimate of the liquidated damages a contractor might be liable for during the course of a contract; but is also not in line with current industry standards," McNeil wrote. Three months later, ADOC attorney Anne Hill disputed the claims in a letter to McNeil, calling them "misunderstandings." She wrote that Arkansas, Illinois, Indiana, and Missouri all required vendors to submit substantial letters of credit, performance bonds, or performance guarantees. "In addition, the performance bond was not required to be posted until the time a contract was executed," Hill wrote. "It was not required for your company to submit a proposal." Hill wrote the letter eight days after Gov. Robert Bentley executed Corizon's 34-month $224 million contract to provide health care to the state's 25,000 inmates. Corizon's predecessor firm held the prior contract from 2007 to 2012. Nevertheless, Corizon was not required to submit a $5 million performance bond at the time the contract was signed. That's because Naglich wrote a letter to Corizon executive James Marvin Courtney in October 2012 asking if the firm would consider stripping the item from the contract. Courtney responded two days later saying that the change would "create an annual savings of $31,000." Naglich, the prison system's top health official, worked as an executive for two of Corizon's predecessor firms including Correctional Medical Services, AL.com previously reported. Her husband was employed by two firms that Corizon hired to X-ray Alabama's inmates. ADOC spokeswoman Kristi Gates issued a statement on Thursday saying that firms are typically required to post a performance bond to show that they are well funded. To secure a performance bond from an issuer, the buyer would typically have to pay a portion of the total amount. In case the contractor becomes insolvent, the bond money is used to help pay for their services. "Corizon was the incumbent provider with a strong reputation in Alabama," Gates wrote. "The department was confident in Corizon's financial strength and position, and we chose to drop the performance bond requirement in final negotiations with Corizon." Robin DeMonia, of the Birmingham-based public relations firm Direct Communications, issued a statement on behalf of Corizon. The statement said that the bond requirement was eliminated during contract negotiations. "At the time of this decision, Corizon already had a five-year track record of delivering on its obligations in Alabama," the statement said. "Given Corizon's history of performance, it made logical sense for the state to reduce the amount of the bond."

Aug 31, 2014

The bidding process for Alabama's $224 million inmate health care contract may have been biased towards the sole vendor that bid for it, a letter sent to prison officials alleges. Wexford Health Sources executive Edward McNeil wrote the letter to Alabama's top prison health care official Ruth Naglich in August 2012 to explain why Wexford did not compete for the work. Three months later, Alabama Department of Corrections attorney Anne Hill refuted the claims in a letter to McNeil, calling them "misunderstandings." Hill wrote the letter eight days after Gov. Robert Bentley executed Corizon's 34-month $224 million contract to provide health care to the state's 25,000 inmates. Corizon's predecessor firm held the prior contract from 2007 to 2012. AL.com is examining the health contract, which was awarded after Corizon submitted the only bid for the work, in light of a lawsuit the Southern Poverty Law Center filed against the state. The suit, which is pending before a federal judge, alleges that inadequate healthcare was provided to the state's 25,000 inmates. Corizon has tapped powerful lobbying firm Maynard Cooper & Gale to fight the lawsuit on behalf of Alabama. Two lobbyists at the firm, a fundraiser for Gov. Robert Bentley and Bentley's former special counsel, have represented Corizon in 2012, and 2013 and 2014, respectively. Corizon did not respond to multiple messages for this story. McNeil wrote in his letter that Corizon's predecessor firm, Correctional Medical Services, submitted a "significantly higher" price than a lower bidder in 2007 for the ADOC inmate health care contract.  However, the overall scoring of Correctional Medical Services' technical proposal, which measures the services provided, led the firm to win the award. In response, Hill wrote that the ADOC changed its bid weighing formula to ensure that a proposal's cost played a greater role in the overall score of a bid. "The Department appreciates the importance of price and, therefore, this time made it a larger percentage of a proposed vendor's scores in hopes of not compromising the quality of care," Hill wrote. Additionally, McNeil wrote that the ADOC's bidding process was flawed in 2007 because the bid evaluation committee members examined the cost proposals before the technical proposals. Knowing the cost of the proposals may have influenced their scoring of the technical proposals. In response, Hill wrote that the ADOC changed its bidding laws in 2012 so that vendors are required to include their technical proposals and cost proposals in separate envelopes. Bid evaluation committee members must first evaluate the bids' technical proposals before proceeding to the cost proposals. McNeil claimed that the amount of money the contractor would have to guarantee for contract-related damages – a $5 million performance bond – is "not in line with industry standards." Hill replied that other states' prison systems such as Arkansas, Illinois, Indiana and Missouri required similar performance bonds. The ADOC also did not require the health care companies to put up the performance bond until the contract was executed. McNeill alleged that short turnaround time for an interested vendor to submit a bid for the work "combined with the aggressive timetable" to begin the job also favored Corizon, the incumbent, the letter states. Hill wrote almost six weeks had passed from when the bid was issued until it was due. It was similar to past ADOC medical bids. "Furthermore, across the country, incumbents – including Wexford, when in that position – do have an advantage no matter how much time is allotted to formulate a proposal," Hill wrote. State Sen. Arthur Orr, R-Decatur, told AL.com he planned to meet next week with Commissioner Kim Thomas, the head of Alabama's prison system, to get answers about Corizon's contract and Naglich's relationship with the firm. Previously, AL.com reported that Naglich, the prison system's top health official, worked as an executive for two of Corizon's predecessor firms including Correctional Medical Services. Her husband was employed by two firms that Corizon hired to X-ray Alabama's inmates.

Aug 17, 2014 al.com
Powerful firm lobbies for Alabama prison health contractor, then defends company in court Initially hired to politick for inmate health care provider Corizon, the powerful Alabama firm is now defending the quality of the company's medical care in federal court. AL.com is examining the ties between the state's $224 million prison health care contract with Corizon and it supporters in light of a lawsuit filed against the state. The Southern Poverty Law Center filed the suit in federal court two months ago that claimed the medical care provided to the state's 25,000 inmates was unconstitutional. Corizon and MHM Health Services, the prison system's mental healthcare provider, tapped the law firm Maynard, Cooper & Gale to fight the case at no cost to the state. Maynard Cooper & Gale employees Linda Maynor and Clay Ryan lobbied for Corizon in 2012, and 2013 and 2014, respectively, Alabama Ethics Commissions reports show. Both lobbyists are veterans of Alabama politics. Ryan served as special counsel to Gov. Robert Bentley three years ago, a volunteer position. Maynor, a volunteer on Bentley's campaign finance committee, earned the designation of "super ranger" after raising more than $300,000 for President George W. Bush's 2004 re-election campaign, her Maynard Cooper & Gale profile states. In 2003, she was named Alabama Republican of the Year and she served as the Alabama Republican Party's finance chair. When Maynor worked as a lobbyist for Corizon in 2012, the firm won a 34-month $224 million contract to provide health care for the state's 25,000 inmates. It was the only firm to submit a bid for the work. Corizon and MHM Health Services, the state's inmate mental health care provider, hired Maynard Cooper & Gale to defend the state against a lawsuit the Southern Poverty Lawsuit filed against it in June that claimed the medical care provided to inmates was unconstitutional. A report the SPLC released in the wake of the lawsuit described gruesome prison stories about amputated feet and toes, gangrenous testicles treated only with ice, scabies outbreaks, and staph outbreaks. The Alabama Department of Corrections, ADOC Commissioner Kim Thomas, and the prison system's top health care official Ruth Naglich, a former executive at two of Corizon's predecessor companies, are all named as defendants in the SPLC lawsuit. AL.com previously reported that two firms that employed Naglich's husband were hired by Corizon to X-ray Alabama inmates since 2007. State Sen. Arthur Orr, R-Decatur, vowed to question prison officials in the upcoming weeks about the quality of Corizon's healthcare and the X-ray work. The Lobbyists In addition to serving as Bentley's special counsel, Ryan served as Bentley's transition coordinator, where he oversaw cabinet hiring and inauguration planning, his Maynard Cooper & Gale website profile states. He was also counsel for the governor's emergency relief fund, which was established by Bentley to aid those harmed by the 2011 tornados, Maynard Cooper & Gale's website shows. Jennifer Ardis, Bentley's spokeswoman, said Ryan de-registered as a lobbyist when he volunteered as Bentley's special counsel. Maynor has been active in politics since 1986 and has managed political campaigns and fundraised for Republicans at the state and federal levels. Former Gov. Bob Riley selected her to serve on his Education Spending Commission and Riley also appointed her to serve on the Alabama Certificate of Needs Board. Maynor also works with members of the United States Senate and the U.S. House of Representatives. Bentley's campaign spokeswoman, Rebekah Mason, said Maynor helps raise money for Bentley "like hundreds of other volunteers who believe in the Governor's successful record of job creation." Messages for Corizon, Ryan and Maynor were not returned.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Allegheny County Jail, Pittsburg Pennsylvania
September 5, 2014 waysandmeans.house.gov

The same issues have been raised at Allegheny County Jail Oversight Board meetings for months, said Common Pleas Judge Joseph Williams, a board member, on Thursday. Medical staff for Corizon Health Inc., the Brentwood, Tenn.-based company, attend the meetings and say that Corizon is understaffing health services at the jail, and that some inmates are not receiving correct medications, or medications on time. Judge Williams questioned whether the issues are related to the ongoing contract negotiations between Corizon and its staff. “If I look at it objectively, this is just a labor dispute,” Judge Williams said, a statement that was met with opposition by health staff members listening to the meeting. The medical staff voted in February to unionize under the United Steelworkers. Judge Williams suggested that an objective third party meet with both groups and return to the oversight board with recommendations. The chair of the oversight board, Judge Donna Jo McDaniel, said she would ask county Executive Rich Fitzgerald’s office to look into that recommendation. “We appreciate the judge’s concern and interest,” said county spokeswoman Amie Downs when reached by phone after the meeting, adding that the county executive’s office would wait to see what the judge’s suggestion was. She said William McKain, the county manager, will continue to monitor the contract Corizon has with the county to ensure that its provisions are met. Mr. McKain has said he meets regularly with Corizon representatives about the jail. Corizon, a for-profit prison health care provider that has an $11.5 million contract with Allegheny County, took over running the jail on Sept. 1, 2013. Since then, the company has been the focus of complaints about the delivery of medication and working conditions. An audit of the contract is underway by the Allegheny County controller’s office. Prior to the oversight board meeting, members of the medical staff and their union representatives gathered in the County Courthouse courtyard for an “information picket” to present their complaints about Corizon. “This is not a hospital. This is a jail,” said Sister Barbara Finch, a nun and registered nurse. But most of the inmates at the jail need some form of medical treatment, and she said Corizon should increase their staffing to better meet inmates’ needs. At the meeting itself, State College hairdresser Bill Harbadin told members of the prison board that his son, in jail for DUI charges, did not receive the Lithium he needed for his bipolar treatment for 21 days after arriving at the jail in May. Orlando Harper, the warden for the jail, said he would address operational concerns the staff brings to him. “We are confident in our staffing levels to meet patient care requirements, including giving out required medications on schedule,” said Corizon spokeswoman Susan Morgenstern in an email. She said patient confidentially issues prevented her from speaking about the bipolar medication case. Corizon has about 147 employees at the jail, as well as regional support staff. She said Corizon believes on-site labor management meetings, begun this week, will aid in resolving differences between employees and management. “This is not a labor dispute,” said Randa Ruge, an organizer for the Steelworkers union. She said the issue is health care workers advocating for the supply and medication to do their jobs.


Jun 8, 2014 post-gazette.com

Nurses tasked with medicating nearly 700 inmates per shift at the infirmary at the Allegheny County Jail are not sleeping at night due to "trepidation" over facing their daily workload, their colleagues testified Thursday before the county's Jail Oversight Board. Board members said they want to form a subcommittee to examine staffing concerns and questions about inmate care arising after Corizon Health Inc. took over management of the infirmary Sept. 1. Common Pleas Judge Joseph K. Williams III -- presiding over the meeting in the absence of Judge Donna Jo McDaniel, board president and Common Pleas judge -- said county officers, board members and Corizon officials could "put their heads together" and come up with strategies to present at the board's next meeting, scheduled for September. He said he believes Judge McDaniel intends to have these discussions over the summer. "This is the third time I've been here, and I've heard innuendo that care is being compromised," Judge Williams said. "I'm not interested in Corizon's philosophy of care. I'm interested in dealing with the reduction in staff and smaller inventory of drugs available." Two nurses at the infirmary, Teresa Latham and Sister Barbara Finch, said nurses dispensing medication are responsible for six or seven pods apiece, each of which includes 100 inmates. Because nurses do not pre-pour the medication, they said, rounds are considerably arduous and time-consuming. Corizon officials presented board members with a health services report detailing improvements in intake procedure and pre-screening. Jail medical director Michael Patterson said doctors are working with the Allegheny County Health Department to develop more comprehensive screenings for sexually transmitted infections. Currently the infirmary only screens based on symptoms presented. That practice may miss a portion of the jail's "high-risk population," he said. Dr. Patterson added that a persistent concern is the long waiting list for referral for psychiatric care at Torrance State Hospital. Close to 20 inmates are currently awaiting mental health treatment at the state hospital, though that number has recently been as high as 30 or 40, Corizon officials said. Though Corizon's mental health director recently resigned, the Tennessee-based firm is looking for a replacement, officials said. They also reassured board members that a mental health nurse is available at the jail even off-shift and during weekends. "Recruitment is not the same as hiring," Marion Damick, the Pittsburgh representative of the Pennsylvania Prison Society, said in frustration. Board member Claire Walker, former executive director of the Pittsburgh Child Guidance Foundation, thanked Corizon officials for the report, saying the level of attention and transparency was "so much better" than when the for-profit firm first took over last fall. No mention was made at Thursday's meeting of the suspension of five jail guards following an incident in which an employee entered the jail with a personal handgun. Ms. Walker said personnel issues are the province of jail management, not the oversight board.


Mar 15, 2014 triblive.com/news

Allegheny County restored the security clearance of a union organizer who worked at the county jail, allowing her to return to her former position, county spokeswoman Amie Downs confirmed Tuesday. Sister Barbara Finch lost her county security clearance at the jail in January, a move she interpreted as a firing. Finch was a lead organizer among employees of Corizon Correctional Healthcare, a Tennessee-based medical contractor that serves the jail. Corizon and the United Steelworkers are expected to begin contract negotiations soon, according to a joint statement from both organizations. In a prepared statement, Corizon's interim chief operating officer, Carla Cesario, said the company had no control over the removal of Finch's security clearance. “We are moving forward and will remain focused on our mission of providing quality care,” Cesario said.


Mar 2, 2014 post-gazette.com

Allegheny County Controller Chelsa Wagner announced today that she plans to conduct an audit of the contract between the county and Corizon Health Inc., which was hired last year to run the infirmary at the Allegheny County Jail. Earlier this month, Ms. Wagner sent a letter to the CEO of Tennessee-based Corizon, saying she had “grave and serious concerns” about health care and working conditions at the jail. In a statement from her office today, she said she remains concerned. “I remain gravely concerned by the credible reports our office has received regarding substandard care at the jail,” she said in a statement. “I’ve raised these concerns publicly, including at the Jail Advisory Board and in writing to Corizon. Yet, the responses to my questions have likewise been substandard and certainly not what I would expect from an entity that receives more than $11 million in taxpayer money annually.” Corizon, which is a national prison health care provider, signed a contract with the county last summer that pays $11.5 million for the first year. Its management of health services at the jail began Sept. 1. The audit will cover the period from Sept. 1 through today. “We have received the letter indicating the Controller wants to conduct an audit," said Corizon spokeswoman Susan Morgenstern. ."It’s important to note that we are working in close partnership with the county and jail leadership to fulfill our mission. Our focus remains on supporting our staff who provide quality care to patients in the jail every day.” Allegheny County Executive Rich Fitzgerald said his office welcome's the audit. "We welcome audits of any department that result in recommendations that add value, are measurable and improve our county operations," county spokeswoman Amie Downs said in a statement. "This contract just was entered into in September of 2013, so it may be difficult to measure its compliance with such a short window being available for review, but we look forward to the results."

 

Feb 15, 2014 triblive.com

Allegheny County Controller Chelsa Wagner threatened to penalize the jail's new health care provider if it does not improve its performance. Wagner said her office has received complaints that Tennessee-based Corizon Health Inc. failed to distribute medication and treat inmates with some mental health problems, according to a letter she sent to Corizon CEO Woodrow A. Myers. Corizon started offering care Sept. 1, but its “period of transition” has expired, Wagner wrote in the letter dated Monday. “I regard the current situation as intolerable and outrageous, and I fully expect necessary changes to be urgently implemented,” Wagner wrote. A Corizon spokeswoman said the company plans to respond to Wagner's concerns in writing. “We certainly share her focus on taking good care of patients at the Allegheny County Jail,” spokeswoman Susan Morgenstern said. Wagner, who is on the county's Jail Oversight Board, said the county could impose financial penalties outlined in Corizon's contract. Wagner's office could withhold payments to Corizon and audit its work at the jail, she said. Corizon's five-year contract could cost the county more than $62.55 million. Wagner expected a response soon and said waiting 60 or 90 days would be “stretching it.” Corizon officials did not attend the board's Feb. 6 meeting. Allegheny Common Pleas Judge Donna Jo McDaniel, head of the oversight board, met with Corizon Tuesday. McDaniel did not return calls. Corizon employees at the jail are to vote Friday on whether to unionize under a branch of the United Steelworkers. Wagner said she supports the efforts of workers to unionize. Aaron Aupperlee is a staff writer for Trib Total Media.


Feb 8, 2014 Pittsburg Post-Gazette

A nun who worked for five years as a registered nurse at the Allegheny County Jail infirmary was fired last week for spearheading unionization efforts, an organizer for the United Steelworkers union said Monday. Sister Barbara Finch, a Sister of St. Joseph of Baden, had her security clearances revoked and was dismissed from her job Thursday after she expressed concerns about staffing, safety issues and patient care during meetings at the jail, said Randa Ruge, the union organizer. "It became clear that she was one of the leading activists in the organizing drive," Ms. Ruge said, referring to ongoing unionization efforts at the jail. Ms. Ruge described Sister Barbara as a "sacrificial lamb" and said that the union is "concerned that taxpayer dollars are being used for union-busting." The Steelworkers union on Friday filed an unfair labor practice charge against Corizon Health Inc., the Tennessee-based firm that manages county jail health services. The charge, sent to the National Labor Relation Board, is that Corizon dismissed her in retaliation for participating in union activities. "This is a clear case of intimidation and union-busting at its worst," United Steelworkers International president Leo W. Gerard said in a statement. "Sister Barbara has been an outspoken advocate of change for these courageous workers and their patients, and this kind of illegal and unjust action, unfortunately, is par for the course with Corizon." "It is our policy not to discuss personnel issues in the news media. I can confirm that we abide by all labor laws; if there is a question to address with the NLRB, we will do so," said Susan Morgenstern, a Corizon spokeswoman. An Allegheny County spokeswoman also declined comment. Union members, jail employees and other union advocates held a protest Downtown Monday, bringing attention to Sister Barbara's complaint and making known their support for the right of workers to unionize. Corizon took over management of Allegheny County Jail health services in September, after signing a contract with Allegheny County last summer for $11.4 million a year. Steelworkers representatives have said that, since Corizon took over, they've received reports of bad working conditions. In January, the union filed a labor petition to unionize about 110 members of the Allegheny County Jail medical staff. The National Labor Relations Board has scheduled an election Feb. 14.

 

December 8, 2013 Pittsburgh Post-Gazette

The company hired to improve health care and cut costs at the Allegheny County Jail has struggled with one of its basic functions -- distributing medicine -- due to difficulties staffing the busy infirmary. Tennessee-based for-profit firm Corizon Health Inc., hired to replace the nonprofit Allegheny Correctional Health Services, would not discuss the problems last week, nor its decision to slash physician staffing at the jail to roughly one-third of its prior level. Emails between county jail staff and Corizon, though, document a string of medication distribution problems that one jail watcher called "terrifying." "I was just informed by the Captain on shift, the majority of the jail has not received medication AT ALL," wrote Deputy Warden Monica Long in an email to Corizon and jail staff on Nov. 17 at 1:03 p.m. "Staffing is at a crisis." The Post-Gazette obtained the internal emails and other documents through a request to the county under the right-to-know law. Asked about the emails on Thursday, following a meeting of the county Jail Oversight Board, Lee Harrington, Corizon vice president of operations, claimed no knowledge of any problems. "We're constantly adjusting our services to make sure that we provide the services as contracted," he said. He declined to detail the adjustments. Reading the emails, frequent jail visitor Marion Damick, the Pittsburgh representative of the Pennsylvania Prison Society, called the problems "abnormal. That never happened under Allegheny [Correctional], never. "That's terrifying, actually. There is absolutely no reason that they would ever miss medication," she said, adding that such shortcomings can only increase costs in the long run. She added that she is "not hearing bad news" about Corizon from inmates to date. Corizon took over the jail infirmary Sept. 1, following a lengthy process meant to pick the successor to Allegheny Correctional. Allegheny Correctional drew a steady stream of lawsuits stemming from inmate deaths and injuries, including some related to alleged failures to give inmates the right medicines. The nonprofit, which ran the infirmary since 2001, also allowed annual costs to creep up to around $12.5 million a year. Corizon agreed to take on the 2,500-inmate jail for $11.5 million the first year, with annual increases of 4.25 percent. Corizon said it would do a better job of staffing the infirmary. In a pre-takeover email dated Aug. 16 explaining why some Allegheny Correctional employees would soon lose their jobs, another Corizon vice president of operations, Mary Silva, wrote that "I ... really feel it is imperative to have adequate staffing on ALL shifts, not just day shift." After Corizon's Sept. 1 takeover, though, staffing did not stabilize. That led to disruptions to the daily "medication passes" to the jail's 35 pods. An Oct. 10 email from Ms. Long to Mr. Harrington and others asked for a "plan for successful implementation of medication passes" -- the term for the nursing staff's several-times-daily distribution to pods of medicines in packets stamped with the names of the receiving inmates. On Oct. 21, Warden Orlando Harper wrote to Mr. Harrington and others: "We are continuing to experience issues pertaining to the following: 1. Staffing, 2. Medication distribution." An email from Ms. Long complained that on Oct. 18 and 19, medication on Level 3 was passed out "after 11:00 p.m.," and on Oct. 20, "2 pods did not receive medication at all." She added that two pregnant inmates were "left in intake 24 hours" because Corizon nurses "did not know what to do" with them. An inmate on oxygen who "was supposed to be processed immediately" was left in the intake area for two shifts, she wrote. On Nov. 16, a jail sergeant wrote that "Level 7 hasn't received Medication" by almost 2 p.m. "This is on going [sic] problem." That day the person charged with solving the problem, longtime jail nursing director Kim Mike-Wilson, quit with no notice, according to the emails. The next day, Ms. Long characterized the situation as "a crisis." In a response email, Corizon assistant health service administrator Michael Barfield blamed the day's crisis on Ms. Mike-Wilson's departure and a nurse's mid-shift departure due to illness. The county declined to provide a list of Corizon staff inside the jail, indicating in a response to a right-to-know request that such information "is not directly related, or even relevant to" a contractor's performance of a governmental function. A Nov. 20 meeting of jail and Corizon officials on medication passes and other issues failed to iron out the problems. Ms. Long wrote to Mr. Harrington two days later saying she "Just received another call that [pod] 5E has not received medications thus far." Reached by phone Friday, Mr. Harper declined to detail his staff's interactions with Corizon. "Right now we're doing everything possible to make sure that our inmates receive the proper medical care," he said. In an email response to questions Friday, county manager William D. McKain wrote that Corizon's leadership has been responsive to concerns. He added that when transitioning from Allegheny Correctional to Corizon, "we expected that there will be a period of time in which there are problems and issues to be addressed.." There are often disruptions when a jail changes its medical provider, said Mark Stern, former medical director at the Washington Department of Corrections, now an assistant affiliate professor at the University of Washington School of Public Health. "It's not acceptable," said Dr. Stern, who worked briefly around 2000 for a company that merged into 35-year-old Corizon. "This is not [Corizon's] first rodeo. These problems are predictable and preventable." Failing to deliver necessary medicines regularly would be "a serious violation of the constitutional right of inmates," he said. "There are some medications where a deviation of a few hours or even a day or so may not make a difference. There are other medications were the timing is much more critical. "If we're treating tuberculosis and we don't treat it well in prison, then when they get out in the community, they're going to spread it." Mr. Barfield told the Jail Oversight Board Thursday that Corizon had "ramped up the clinic visits." He said the key was hiring more nurse practitioners. Jail medical director Michael Patterson highlighted for the board his focus on detecting and treating diabetes. Dr. Patterson appears to be the lone remaining full-time physician in the jail under Corizon. The firm's contract calls for one additional part-time physician, and former jail medical employees who quit recently said that Eugene Youngue is filling that role. Both Dr. Patterson and Dr. Youngue served the jail full time under Allegheny Correctional, along with physicians Lucille Aiken, Miguel Salomon and part-timer Morris Harper. Dr. Aiken in September filed a state Human Relations Commission complaint against the county and Corizon, claiming that she was sent packing before the firm's takeover as retaliation for her efforts to ensure quality care for inmates, and because of her gender and status as an immigrant from Italy. Allegheny Correctional also employed three psychiatrists and one psychologist. Corizon's contract requires that it provide one full-time psychiatrist and a part-time psychologist. Mr. Harrington would not provide a raw number of physicians working in the jail following the board meeting Thursday, and on Friday failed to respond to an email and hung up when reached on his cell phone. "We have a full complement of doctors," he said Thursday. "That's what we are contracted to provide."


American Service Group
, Brentwood, Tennessee
May 18, 2013 nashvillepost.com

Prison health management company Corizon is going after a former consultant for testifying against it in a Florida court case. Brentwood-based Corizon claims in a U.S. District Court of Middle Tennessee filing that it hired Lindsay Hayes, a Massachusetts-based prison expert, for consultation work in 2005. Then, unbeknownst to the company, he allegedly served as an expert witness in a court case against the company in 2008. Corizon executives also claim that Hayes was serving as an expert witness against them in a separate case when they brought him back for more consulting work in 2010. Hayes didn’t tell Corizon about the conflict of interest, the suit claims. The complaint is seeking to enforce the confidentiality agreement Hayes signed as part of his consultant work. Corizon also is requesting an injunction to prevent him from further testifying at the Florida trial. Hayes couldn't be reached for comment Thursday.

March 3, 2011 The Street
America Service Group Inc. (NASDAQ: ASGR), the parent company of PHS Correctional Healthcare, Inc., and Valitás Health Services, Inc., the parent company of Correctional Medical Services, Inc., announced today the signing of an agreement and plan of merger (the “Merger Agreement”) under which the two companies would be combined, bringing together two leading companies in the correctional healthcare field – America Service Group's PHS Correctional Healthcare and Valitás’ Correctional Medical Services. Upon completion of the transaction, the combined company will have approximately 11,000 employees and independent contractors and will serve more than 400 correctional facilities. The combined company’s annual revenues are expected to total approximately $1.4 billion for 2011.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Arizona Department of Corrections
Sep 10, 2014 acluaz.org

PHOENIX – Nearly two dozen expert reports that detail widespread problems with the Arizona Department of Corrections’ healthcare system, as well as its use of solitary confinement, were made public late Monday. “I observed locked, dark and empty rooms that I was told were exam rooms, but lacked basic medical equipment,” wrote Dr. Robert Cohen, an expert in correctional medicine, in one of his reports (11/8/13 report, page 5). “Medical equipment was broken, covered in dust, and in some cases based on logs attached to them, had not been repaired or checked in more than a decade.” Dr. Cohen found that almost half of people who died “natural deaths” while in ADC’s care over a six-month period received “grossly deficient” medical care (2/24/14 report, pages 1-2). Every week, on average, a patient who has been neglected or mistreated dies in the Arizona prison system, according to these expert reports. “In some of these cases, the poor care clearly caused or hastened their death,” Dr. Cohen wrote (2/24/14 report, page 1-2). “It is alarming that almost half of the natural deaths occurring during the brief half year period under review would reveal such significant problems with delivery of basic medical services.” Dr. Cohen uncovered shocking delays in treatment including the case of a 38-year-old prisoner whose death from cancer was avoidable according to ADC’s own documents (2/24/14 report, pages 19-25). Another prisoner died of untreated lung cancer after being accused by nurses of lying about his medical condition; they said in his medical records that he was “playing games” and “seeking attention” (2/24/14 report, pages 25-32). A 24-year-old man died of AIDS-related pneumonia after his AIDS went undiagnosed and untreated for a year, despite his pleas for HIV tests and treatment, Dr. Cohen found (2/24/14 report, page 52). These are not isolated cases. Dr. Cohen’s findings, and the findings of the plaintiffs’ other experts, point to systemic deficiencies in ADC’s healthcare. “[T]here were multiple cases in which the lapses were so shocking and dangerous that I felt ethically obligated as a medical professional to bring them to the immediate attention of the ADC and Corizon staff,” Dr. Cohen said (11/8/13 report, page 4). Corizon is the company contracted by the state to provide healthcare to prisoners. The other experts made equally damning discoveries. The 23 expert reports, which were previously confidential, were made public yesterday pursuant to a court order in anticipation of an October trial relating to ADC’s failure to provide more than 33,000 prisoners in 10 prisons healthcare and conditions of confinement that meet constitutional standards. “[T]he chronic shortage of mental health staff, delays in providing or outright failure to provide mental health treatment, the gross inadequacies in the provision of psychiatric medications, and the other deficiencies identified in this report are statewide systemic problems, and prisoners who need mental health care have already experienced, and will experience, a serious risk of injury to their health if these problems are not addressed,” wrote Dr. Pablo Stewart, another expert hired by plaintiffs’ counsel to tour ADC’s prisons and review prisoners’ medical records, in one of his reports (11/8/13 report, page 10). Dr. Stewart, a psychiatry professor with expertise in prison mental health care, uncovered numerous preventable suicides by prisoners, lengthy and serious delays in care, insufficient and unlicensed staff and inadequate medication protocols. One prisoner hanged himself after ADC neglected to give him his prescribed mood stabilizing drugs for more than three weeks, Dr. Stewart found (11/8/13 report, pages 21-23). The reports also detail significant, dangerous problems with ADC’s use of solitary confinement. Some people, for instance, are put in isolation simply because other beds are full (Vail 11/8/13 report, page 9). Mentally ill prisoners are often isolated because ADC does not have treatment alternatives, according to one expert (Vail 11/9/13 report, page 13). “[T]he ADC health care delivery system is fundamentally broken and is among the worst prison health care systems I have encountered,” Dr. Cohen wrote (11/8/13 report, page 3). “[U]nless ADC dramatically reverses its course, it will continue to operate in a way that harms patients by denying them necessary care for serious medical conditions.” Plaintiffs in the class action lawsuit, Parsons v. Ryan, are represented by the American Civil Liberties Union’s National Prison Project, the ACLU of Arizona, the Prison Law Office, Jones Day, Perkins Coie LLP and the Arizona Center for Disability Law. A trial is scheduled to begin Oct. 21. More expert reports will be made public prior to the trial. The complete reports now available can be found here. Reporters can email the ACLU of Arizona to request report summaries.


May 29, 2014 america.aljazeera.com

SAFFORD, Ariz. — Regan Clarine found out she was pregnant just two days before she was sentenced to two and a half years behind bars for possessing a narcotic for sale. Giving birth to her baby daughter while she was incarcerated at the state prison complex near Tucson was an experience she says nearly killed them both. Clarine says her first indication things were not right with her health care was when she asked prison officials for an ultrasound. She was worried she wasn't gaining enough weight, but they never gave her one. Instead, Clarine said that after about nine months, prison doctors sent her to the hospital to induce labor, but when the baby still didn’t come, they performed a cesarean section against her wishes. When Clarine went back to her cell, her C-section wound re-opened. “It was big enough for me to put my fist in there,” she said. “It was the worst pain I’d ever been through in my life.” Clarine said she alerted guards, but they refused to let her see a doctor, leaving her on the prison yard with a gaping wound for two weeks. When she finally saw medical staff, she said they told her that she was lucky to be alive. They treated her with a wound vacuum. Then, she said, they employed an antiquated medical treatment. “They decided to use sugar … like McDonald’s sugar,” she said. “They would open it and pour it inside [the wound] and put gauze over and tape it up. And I had to do that for like three weeks.” Clarine’s story is one of dozens. Like many other states, Arizona privatized its prison health care system two years ago. In a six-month investigation, “America Tonight” found disturbing cases of inadequate treatment, and evidence that Wexford Health Sources, the first private company Arizona contracted to provide prison health care, was aware that it was violating prisoners’ constitutional rights. Arizona’s system is currently run by Corizon Health, the largest private prison health care provider in the country. Now, for the first time ever, one of its former employees is blowing the whistle about its failures. Teresa Short was a patient care technician for Corizon, but lost her job in late March for refusing to go to work while suffering from a case of scabies she caught from a prisoner. Short said she thought it would be unethical to treat patients while she was still contagious. She had already infected a family member, she said, and feared her son could contract it and bring it to his high school. According to Short, Corizon and Arizona prison officials have been trying to cover up the outbreak, which now includes the original prisoner and seven staff members. (Read Corizon's response.) But the most persistent problem at Corizon, Short said, was staffing. “We have a lot of dementia patients that take time in feeding,” she said, “and because of the short staff we'd have to stand there for hours to try to feed them and it was just not permitted.” Sometimes, those patients would go unfed, she said. Others who were incontinent would sit for hours in their own feces, she said. And still others died. Short described one dementia patient who had a vascular catheter in his arm for dialysis treatments. He didn’t understand what it was and kept playing with it, she said, so she repeatedly told senior staff he needed additional supervision. Instead, they sent him back to his cell, alone. At 5 a.m., she went in to check on him. Former Corizon patient care technician Teresa Short said some Arizona prisoners have died because there weren't enough medical staff on duty. Former Corizon patient care technician Teresa Short said some Arizona prisoners have died because there weren't enough medical staff on duty. America Tonight “[I] could smell blood before I even went into the room,” she said. “And when I turned on his light, it looked like somebody had been murdered. There was blood all over the room. I screamed for help.” Short said the man had unplugged the catheter and quickly bled out. If Corizon had employed more staff to monitor patients, she said, he might still be alive. There are some numbers to back up Short’s claims. Since the state privatized its prison health care, medical spending in prisons dropped by $30 million and staffing levels plummeted, according to an October report from the American Friends Services Committee, a Quaker social justice organization. It also found a sharp spike in the number of inmate deaths. In the first eight months of 2013, 50 people died in Arizona Department of Corrections custody, compared with 37 deaths in the previous two years combined. According to a 2012 lawsuit filed by the American Civil Liberties Union, the health care in Arizona’s prisons now amounts to cruel and unusual punishment, with prisoners at serious risk of "pain, amputation, disfigurement and death.” The suit cites examples of Arizona health officials telling prisoners to pray to be cured and drink energy shakes to alleviate cancer symptoms. “People are often sent to prison for two-year, three-year sentences that have turned into death sentences because of the absence of the basic minimal care,” said Dan Pochoda, legal director for the ACLU in Arizona. He said in his 40-year career, he’s never seen a worse prison health care system. In an emailed statement, Corizon spokeswoman Susan Morgenstern said that the company could not discuss individual cases because of privacy laws, but that “the vast majority of our current staff levels exceed contract requirements,” and that their care follows the guidelines of the National Commission on Correctional Health Care and the American Correctional Association. “Our goal is always to provide quality care while being good stewards and making the best use of public funds,” she wrote. “As for lawsuits, we treat hundreds of thousands of patients in millions of healthcare encounters each year,” she added. “… The majority of lawsuits are brought by inmates without an attorney representing them and are dismissed or resolved prior to trial.” (Read the company’s full statement.) 'He had plans' After his cancer, inmate Tony Brown's pain medication was switched from morphine to less-powerful Lortab. After his cancer, inmate Tony Brown's pain medication was switched from morphine to less-powerful Lortab. America Tonight Tony Brown is another inmate who died since Arizona privatized its prison health care. He was serving a 10-year sentence for aggravated assault and was due to be released last September. “They were supposed to come down for Thanksgiving this year,” his daughter Jenna Jumper said. “He never got to meet my husband and he wasn't there when I got married, so they were going to come visit.” Brown was in remission from esophageal cancer, according to his medical records, and had been prescribed morphine for the pain. But in October 2012, the prison ran out of the drug. Medical staff switched him to Lortab, a weaker painkiller. In a video taken by prison guards and obtained by “America Tonight,” Brown is seen just after he was put on the new medication, writhing in pain while handcuffed to a gurney. His medical records show that guards told nurses his condition was worsening and that he "needed to be checked out." But there is no record of medical staff visiting his cell. In another video taken two days later, a prison chaplain checks on Brown at his wife’s request. “Inmate Brown, I spoke with your wife earlier today,” the chaplain is heard saying. “Can you communicate with me please? I’d like to speak with your wife later on. Is there something I can tell her?” Brown, face down on a bunk, barely moves and doesn’t respond. A guard can be heard saying, “Is it me or does this just not feel right to anybody else?” The guards started CPR and nurses came to assist, but 40 minutes passed before they realized no one had called an ambulance. He died in a hospital the next day. Two days later, his widow Jami Brown said she finally received a call back from Wexford, the private prison health care company in charge at the time. “My biggest thing is that if people would stop to realize that he did have family,” his daughter said, “and that he did have a child and he did have a wife and he had plans.” The official cause of death was listed as complications from cancer. But Brown's family is suing Wexford, claiming he died from lack of adequate medical care. In a statement, Wexford attorney Ed Hochuli said he couldn’t discuss details of the case because of the lawsuit and health care privacy laws, but wrote: "Based on the limited information we have at this time, though, I am very confident Wexford Health and its employees acted appropriately, and further investigation of this claim will demonstrate and prove the lack of any wrongdoing or negligence by Wexford Health.” But there are signs that Wexford was aware of problems. “America Tonight” obtained a copy of a PowerPoint presentation written by top Wexford executives for a meeting with the Arizona governor's office in November 2012 – four months after the company started providing care in the state. It warned that the care it and the Department of Corrections were providing was "not compliant with … requirements" and that "the current class action lawsuits are accurate." It recommended an overall operational cleanup, staffing reassessment and the appointment of a governor’s office liaison. The PowerPoint presentation also says that the department's "transparency" policy with the media could "encourage negative press." 'A grain of sugar' State Rep. John Kavanagh said Clarine’s story about being treated with sugar didn’t seem like a “true allegation,” adding that it “sounds ridiculous.” State Rep. John Kavanagh said Clarine’s story about being treated with sugar didn’t seem like a “true allegation,” adding that it “sounds ridiculous.” America Tonight Prison officials deny any problems with privatized care. Richard Pratt, the interim director of the health services division of Arizona’s Department of Corrections, told “America Tonight” that staffing levels since privatization were “basically the same.” “Corizon staffing levels have been coming up on a monthly basis to the point even last month the hours that they were working with their existing staff exceeded the contract requirements,” he said. He also denied there was a scabies outbreak, as Teresa Short had charged. But Pratt emphasized that privatizing health care wasn’t a decision made by the Department of Corrections. “It was legislated and mandated and it was the law,” he said. “So we were forced to do this.” Legislators who supported the privatization promised that it would save taxpayers money, while maintaining adequate levels of care for inmates. The majority of states have privatized prison health care, rewarding private companies for keeping costs down. “I mean, people die in prisons,” said state Rep. John Kavanagh, who wrote the legislation that privatized the state’s prison health care. “I receive a lot of handwritten notes from prisoners. I receive emails from prison families with all sorts of allegations of crazy behavior. And then, you call the prison people up and they usually have a reasonable explanation for it.” Kavanagh said Clarine’s story about being treated with sugar didn’t seem like a “true allegation,” adding that it “sounds ridiculous.” “You know prisoners have 24/7 to think up allegations and write letters,” he said. “I'm not saying that some of them can't have a basis in fact. But you got to take them with a grain of salt or in the case of the hospital, with maybe a grain of sugar.” Kavanagh was also dismissive of the ACLU lawsuit. “I think most people who get into [class-action lawsuits] wind up with nothing and the lawyers walk away in limousines with their trunks full of cash,” he said. No bid, nothing: Richard Pratt, interim health services director for Arizona’s Department of Corrections, denies that there’s a scabies outbreak in prison and says that Corizon’s staffing levels have exceeded the requirements of the contract. Richard Pratt, interim health services director for Arizona’s Department of Corrections, denies that there’s a scabies outbreak in prison and says that Corizon’s staffing levels have exceeded the requirements of the contract. America Tonight Before Tony Brown’s death, Wexford was already coming under fire after a contract nurse exposed more than 100 inmates to hepatitis C by using dirty needles to deliver medication, according to the Department of Corrections. Four months later, Arizona severed ties with Wexford and awarded the three-year, $369 million contract to Corizon, which has similar contracts in 28 states, according to its website. But it has faced problems in many of them; in the last five years, Corizon has been sued for malpractice 660 times. Arizona Democratic House Minority Leader Chad Campbell said the Legislature didn't properly vet Corizon before signing the contract. “No bid. Nothing,” he said. “It was deemed an emergency situation by Department of Corrections so they didn't have to go through the normal process.” Campbell also noted that Corizon had just hired the former head of the Department of Corrections, who was the mentor of the current head of the department. That’s not the only tie that members of the state government have to private prisons. Charles Coughlin, the former campaign strategist for Gov. Jan Brewer, runs a lobbying firm called HighGround Public Affairs Consultants, which represented one of the country’s largest private prison companies. HighGround donated $5,000 to Jan PAC, Brewer's super PAC. Then in late March, Kavanagh allocated $900,000 in state funding to the private prison company GEO Group Inc., even though the Department of Corrections said it wasn’t needed, according to the Arizona Republic. “They're profiting on taxpayer dollars and to me, if I'm going to hand out money to a private entity, I want to make sure it's being spent wisely,” said Campbell, who is now calling for an investigation. The governor's office declined a request from “America Tonight” for an interview and referred us back to Kavanagh, who said the allegations that Brewer accepted bids because of personal relationships were “baseless.” “I think they're propaganda,” he said. “I mean, people say to me I've gotten campaign contributions from private-prison people. Well, yeah. I got from a lobbyist who represents them but that lobbyist also represents 40 other clients in different industries. It's smoke and mirrors. It's a façade.” In the meantime, allegations of wrongdoing continue to mount. According to the American Friends Service Committee report, an inmate at the Whetstone Unit of the Arizona State Prison Complex tested positive for tuberculosis in August. But Corizon did not test other prisoners, even those who were doing community service outside the complex. A healthy baby: Clarine walks out of prison, escorted by her father Clarine walks out of prison, escorted by her father America Tonight Earlier this month, Regan Clarine completed her sentence. “America Tonight” met her as she was released into the waiting arms of her father, Paul. “It’s one of the happiest days of our life,” he said. “Hopefully we’ll never have to do this again.” They drove to a nearby hotel to reunite with the rest of the family, including her 11-month-old daughter, Rylan. They’d met a handful of times on brief prison visits, but Rylan didn’t recognize her mother. Still, Clarine was happy to see her so healthy. She responded to Kavanagh’s allegation that she was probably making up her story with a laugh, saying, “That’s crazy. I don’t think I could even come up with something like that … Sugar?” To add insult to injury, her mother, Lori, said the prison has billed her $2,000 for Rylan’s birth. She is disputing the charges but fears it could hurt her credit if she doesn’t pay them. She says privatized prison health care simply isn’t working. “You know, she got her just punishment,” Lori said. “But, oh my goodness, they're still human beings. Take care of them.”

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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
November 13, 2010 Naples Daily News
A 24-year-old woman who lost her baby while she was an inmate at the Collier County jail has sued the sheriff and the jail’s medical provider, alleging they violated her civil rights by denying her necessary medical treatment. Joan Small, a former Bonita Springs woman now known as Joan Graeber, is suing Tennessee-based Prison Health Services and Collier County Sheriff Kevin Rambosk after suffering pregnancy complications that led to her baby’s death. Prison Health Services is the target of pending lawsuits in Collier and Lee counties — and nationally — involving denial of medical care in jails. Publicity over baby Elena’s death in February 2009 ended in other pregnant inmates with complications getting released in the weeks afterward. The lawsuit was filed this month in Collier Circuit Court by Naples attorneys Sharon Hanlon and Ted Zelman. It’s been assigned to Judge Cynthia Pivacek. Hanlon declined comment.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Florida Department of Corrections, Tallahassee, Florida
September 26, 2014
CONTACT: Florida Department of Corrections Communications Office
(850) 488-0420tel:(850)%20488-0420

DOC TAKES STEPS TO ENSURE ADDITIONAL ACCOUNTABILITY FOR HEALTH CARE PROVIDER

Tallahassee, Fla -- Today Secretary Crews sent a letter to Corizon CEO Dr. Myers to convey the Florida Department of Corrections' serious concerns about inmate health care and to direct immediate, specific measures be taken to ensure that appropriate health care is provided to those in the Department's custody. Secretary Crews has maintained a clear message to the leadership of our health providers that inmate care is the number one priority.

The letter is as follows:

September 26, 2014

Woodrow A. Myers, Jr., M.D.
Chief Executive Officer
Corizon, LLC
12647 Olive <Boulevardx-apple-data-detectors://3>
St. Louis, Missouri 63141x-<apple-data-detectors://3>

Dear Dr. Myers:

Re: Contract #C2757 - Formal Communication 08-14

The purpose of this letter is to bring to your attention concerns the Florida Department of Corrections has with the level of care being provided by Corizon Health. These concerns have arisen out of our contract monitoring and auditing process, as well as from meetings between our respective teams. Our audits have produced findings in multiple areas, including medical care, nursing, mental health and administration. Regular meetings have occurred between DOC and Corizon's clinical and administrative teams where the results of these audits and the corrective action plan that Corizon is required to put in place to resolve them are discussed in detail. All too often, we are finding that these corrective action plans are not being carried out and that the level of care continues to fall below the contractually required standard. On September 11, 2013, Corizon convened an Expectations Meeting with our agency's leadership team. The purpose of this meeting was to identify specific expectations that DOC had for Corizon during the transition and through the life of the contract. An action plan was developed by Corizon leadership to address each of the expectations and create "accountability for Corizon". As of this date, many of the most critical expectations including complete and full staffing, responding to DOC concerns and reducing the number of grievance are often not being met (please see attachment). When we met in person on December 18, 2013, I expressed concern about issues that appeared to be developing during the first two months of our partnership. At that time, we specifically discussed patient care issues, utilization management, and communication. All three of these areas continue to be cause for concern. As I have told your Florida management team on several occasions, ensuring that the appropriate level of care is being provided to those in our custody is our top priority in health services. By early October, each institution where Corizon provides health care services will have been through at least one DOC monitoring audit. In order to ensure accountability and to make sure that appropriate care is being delivered, the Department is taking the following steps effective immediately: Any institution that fails to meet at least 80% of applicable auditing standards will have a programmatic hold placed on the payment for services at that institution. This hold on payment will remain in place until a corrective action plan is executed and the applicable standards for care are met. Institutions that fail consecutive audits or that have audits with exceptionally high levels of non-compliance will be subject to deletion from the contract under SectionII.W.2, and the appropriate adjustments will be made to the per diem. I would like to meet with you to discuss our concerns as well as the additional accountability measures listed above as soon as possible. Your staff can reach my <office850-717-3456tel:850-717-3456> to coordinate an agreeable date. I look forward to hearing from you.

Sincerely,
Michael D. Crews
Secretary, Florida Department of Corrections

Cc: Olugbenga Ogunsanwo, M.D., Assistant Secretary of Health Services
Long Do, M.D., Director of Medical Services
Thomas Reimers, Director of Health Services Administration and Operations
David Randall, Contract Manager
Contract File


Oct 12, 2013 BrowardBulldog.org

The two top executives of a state vendor who negotiated a $1.2 billion contract with the Florida Department of Corrections to provide medical care for thousands of state prisoners were abruptly dismissed on Wednesday. Tennessee-based Corizon, operating subsidiary of Valitas Health Services, declined to discuss the reason for the departures of Chief Executive Officer Rich Hallworth and President Stuart Campbell. The move, however, followed a Sept. 23 announcement by Moody’s Investors Service that it had downgraded approximately $360 million in Valitas’s corporate debt securities – changing the company’s rating outlook from stable to negative and increasing the likelihood of default. Last week, BrowardBulldog.org reported that Corizon, which began work in August at 41 state correctional facilities in north and central Florida, was sued 660 times for malpractice across the country in the last five years. Nearly half of those cases remain open. Of those that are closed, 91 – one in four – ended with confidential settlements. Wexford Health Sources, which has a five-year agreement worth $240 million to provide health services to state inmates in South Florida, was hit with 1,092 malpractice claims – suits, notices of intent to sue and letters from aggrieved inmates – from January 1, 2008 through 2012. Wexford paid a total of $5.4 million to settle those cases. Among the reasons cited by Moody’s for Valitas’s deteriorating financial position are the recent loss of prison health contracts with Maine, Maryland, Tennessee and Pennsylvania, as well as “competitive pricing pressure” elsewhere. Corizon/Valitas is the nation’s largest provider of healthcare services to correctional facilities, in charge of medical care for 410,000 inmates in 29 states. The company could be upgraded financially next year if earnings increase, according to Moody’s. Yet the sudden departure of the two executives who landed the enormous Florida contract, and Moody’s generally weak financial portrait of the company, are raising prior concerns about Corizon’s performance. In 2006, when known as Prison Health Services, Corizon walked away from a 10-year, nearly $800 million contract with Florida to provide healthcare to thousands of inmates in state prisons in South Florida. The Sun-Sentinel reported then that a spokesman said the contract had “underperformed financially.” “The company said higher than anticipated use of hospitals located off prison grounds was the main reason it was ending the agreement,” the newspaper reported. The Department of Corrections awarded Corizon the contract in 2005 “despite protests from legislators and competitors who said the company’s bid was too low to provide quality service.” That bid was $80 million less than its nearest competitor, the newspaper said. While there is concern that history might be repeating itself, a Corizon spokesman offered reassurance that was not the case. “This change in company leadership should not impact day-to-day operations with Corizon’s clients. The company will continue to focus on patient safety and exceeding client expectations in every aspect of our service delivery,” said spokesman Pat Nolan. Florida Corrections spokeswoman Misty Cash said the state is not concerned about Corizon’s future performance. “The placement of a new CEO at Corizon will have no impact on our contract with the company. The Department of Corrections looks forward to working with new CEO Woodrow A. Myers Jr., M.D. and his leadership team.” Corizon announced the appointment of Myers as CEO on Thursday, effective immediately. Myers is a Valitas board member and former executive vice president and chief medical officer of Indiana-based WellPoint. Valitas is majority owned by Beecken Petty O’Keefe & Company, a Chicago-based private equity management firm. It reported revenue of approximately $1.2 billion for the twelve months that ended June 30.


July 25, 2013 cjr.org

MIAMI — With Florida embarking on an ambitious effort to privatize much of the state’s prison healthcare—the largest such undertaking in the nation—the time is ripe for journalists to take a deeper look into the history of such programs, and the companies getting massive contracts for taxpayer dollars. Newspapers in Florida have nibbled around the edges of this complex story, and problems with privatization efforts in prisons have been investigated periodically by news outlets around the country. (There are also, of course, plenty of problems with publicly-administered jails and prisons—more on that to come). Yet despite problematic records in other states, and even in Florida, the two companies privatizing healthcare at Florida prisons—Corizon Inc. and Wexford Health Sources—have received little recent scrutiny here. The Tampa Bay Times/Miami Herald statehouse bureau has written about the court fight to stop the privatization, which state workers ultimately lost in June. The Times/Herald team has also noted that Corizon, the company that is about to take over healthcare at every Florida prison north of Palm Beach, to the tune of $230 million, has faced problems with contracts “from Maine to Idaho.” But these companies can be hard to track. Corizon was created in 2011 with the merger of Prison Health Services and Correctional Medical Services, companies that have had their own issues in the past. For example, Prison Health Services had to pay $5 million in fines and restitution in 2004 to resolve a Florida Medicaid fraud case, and has periodically lost contracts around the country because of concerns about cost overruns or problems with service. Correctional Medical Services has had its own difficulties in other states, and even in Florida. It has lost or walked away from contracts as close to home for Florida reporters as Palm Beach County. The for-profit prison healthcare industry is hard to penetrate, with tangled relationships and complex histories. A year before Palm Beach County dumped CMS in favor of a local company, Armor Correctional Health Services, Broward County dumped another company, Wexford Health Sources, in favor of Armor (which also has a contract with Hillsborough County jails). Armor was founded by the founder of Prison Health Services, and is “politically connected,” according to a story this month by The Tampa Bay Times that looked at the challenges and high costs of jail healthcare. Wexford hasn’t been written about as much in Florida, though it recently took over health services at nine state prisons in South Florida with, as the Tampa Bay Times wrote, “a five-year contract starting at $48 million a year.” But it has faced issues in other states. Corizon replaced Wexford in Arizona earlier this year, less than a year into Wexford’s conract, after Wexford was fined by the state and drew a class action lawsuit by the ACLU alleging “grossly inadequate medical care.” Corizon has seen a dramatic uptick in lawsuits filed against it, but those numbers may only reflect the dramatic increase in contracts Corizon has gotten recently. A deeper look is warranted. Wexford, too, appears to be seeing an increase in lawsuits, though its name is not as unique, and easily searchable, as Corizon’s. Again, there’s an opportunity there for an enterprising reporter to dig into the data. For-profit health companies serving prisons and jails aren’t the only piece of this puzzle that is ripe for investigation. Private companies running entire facilities have also come under scrutiny by reporters, prisoner advocates, and the Department of Justice. Last month the Atlanta Journal Constitution noted that a company running a juvenile lock-up in Georgia was singled out by a Justice Department survey that found it had the highest percentage in the country of sexual contact between the children and staffers— with 32 percent of inmates reporting such contact. The AJC noted the company, Youth Services International, has had problems in every state where it has a contract.

December 4, 2012WLRN
Private Prison Plan Is Flawed, Judge Rules The Florida Legislature has struck out again with an attempt to privatize some or all of the state prison system. FAIL: A judge rules Legislature must pass a law, not use a committee, to privatize prisons. A Tallahassee judge ruled today that lawmakers chose an unconstitutional method to turn prison health care services over to private contractors. As Mary Ellen Klas reported for The Miami Herald and Tampa Bay Times: The lawsuit was filed by the unions that represent prison employees, the American Federation of State, County and Municipal Employees and the Alliance of Health Care Employees, who argued that the state was not authorized to make the change through the 14-member Legislative Budget Commission but instead needed to make the shift through a full vote of the Legislature. (Leon County Circuit Judge John) Cooper agreed and ruled that the $229 million contract the budget commission approved for Nashville-based Corizon Correctional Healthcare, a for-profit company, was illegal. The ruling will keep about 1,900 prison workers on the job, instead of requiring them to apply for work with the new contractor. Early this year, under pressure from the prison guard union and dissident Republicans, the state Senate defeated a bill to privatize most of the prisons in the southern part of the state. A privatization plan in the 2011 Legislature succeeded briefly before it, too, was struck down as unconstitutionally designed.

July 31, 2012 News Service of Florida
A Leon County circuit judge has agreed to hold a hearing next week in the long-running dispute about whether the Florida Department of Corrections will privatize prison health services. Circuit Judge Kevin Carroll has scheduled an August 8 hearing, according to an online court docket. The Florida Nurses Association and the American Federation of State, County and Municipal Employees filed a lawsuit in January challenging a legislative move last year to privatize inmate health services. Carroll early this month declined to rule on the constitutionality of the Legislature’s decision because it was included in budget fine print, known as “proviso” language, which expired at the June 30 end of the fiscal year. The nurses association and AFSCME, a state employees union, asked Carroll for a rehearing. Subsequently, the DOC said it would go ahead with the privatization, regardless of the expiration of the proviso language. The DOC said it had the authority to contract with two private companies under existing state law.

July 26, 2012 Tampa Times
Senate Democratic Leader Nan Rich, D-Weston, has lodged a formal objection to the Legislature giving final approval to budget transfers that would allow the prison system to privatize health care for 100,000 inmates. Rich wrote a letter (posted below) to Sen. JD Alexander, R-Lake Wales, who chairs the 14-member Legislative Budget Commission. The prison system has asked the LBC to approve a transfer of $58 million between budget categories so the agency can move forward with the privatization and implement it by Jan. 1, 2013. The LBC generally functions as a rubber-stamp for mid-year changes to agencies' budgets, and in the past, an objection from a single lawmaker has carried great weight. The outsourcing of health care in Florida prisons has a checkered history, and this latest venture is highly controversial because it was created under budget proviso language that expired June 30 when the previous fiscal year ended. "But for the proviso, the appropriation would not be made," Rich wrote. "Consequently, I believe the DOC does not have the authority to privatize health services in prisons." Unions representing state workers and nurses in the prison system have threatened to file a new lawsuit seeking to block the project from going forward. Rich's effort to block the privatization comes as the leading vendor, Corizon Health, has agreed to pay a $1.85 million fine to the city of Philadelphia because of irregularities in its handling of a contract in that city's jail system.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Guadalupe County Correctional Facility, Santa Rosa, New Mexico
Nov 2, 2013 abqjournal.com

A former prison physician accused of fondling multiple inmates during medical exams at two contract men’s prisons in New Mexico is under criminal investigation by the U.S. Department of Justice. Dr. Mark Walden has also been suspended from the practice of medicine and has filed a notice of bankruptcy. The Justice Department’s notification to Walden that he is the target of an inquiry into the alleged violation of inmates’ civil rights is revealed in documents filed in three civil lawsuits now consolidated in U.S. District Court. Documents say Walden was notified in writing that “he is the target of a criminal investigation regarding alleged sexual abuse of male inmates at the Northeastern New Mexico Correctional Facility in Clayton and at the Guadalupe County Correctional Facility in Santa Rosa.” The prisons are privately operated by Corizon Inc. The civil lawsuits against Walden, Corizon and others were filed on behalf of about three dozen current or former inmates at the two prisons by attorneys Katie Curry, Brad Hall and Frances Crockett Carpenter. Defendants moved the case to federal court. Walden’s attorney in the civil lawsuit said she does not comment on pending litigation. But in an answer she filed on behalf of Walden in one of the civil lawsuits, he denied performing any digital rectal exams that were not medically necessary or that were inappropriate in length or methodology. He denies sexually abusing inmates at anytime or that any conduct on his part was unreasonable, cruel or harmful. Walden also contends that the claims are barred by the statute of limitations and the Prison Litigation Reform Act and the New Mexico Tort Claims Act. The inmates have made claims in U.S. Bankruptcy Court to protect any recovery they may receive in the civil litigation. U.S. Magistrate Judge Alan Torgerson stayed the civil cases in August until the bankruptcy is resolved. Walden was entitled to an automatic stay by virtue of his bankruptcy filing. Torgerson extended the stay to other defendants, including Walden’s former employer The Geo Group Inc., now called Corizon, wardens Erasmo Bravo and Timothy Hatch, and the health services administrator. There are no details on the Justice investigation, which has apparently been underway since before the civil litigation began in March. According to a statement from Corizon, the company “is unaware of any criminal proceedings being filed at this time. We will cooperate fully with any investigations related to this matter.” The wardens, Geo and Corizon filed answers in the civil cases in which they have denied allegations of negligent hiring and supervisions, medical malpractice and civil rights violations. The inmates have asked the court to permit the litigation to go forward without revealing the names of the plaintiffs because of the potential of greater harm and victimization. But one of Walden’s attorneys in the civil suits has denied sexual abuse allegations contained in the request and opposed the request for anonymity, saying inmate lawyers are engaged in a media campaign to “impact the pending litigation.” Walden’s attorney Nicole Charlebois said in a written filing that the unnamed plaintiffs attacked Walden in the media before even serving him with the complaint. Plaintiffs’ lawyers, she said in the filing, are “manipulating the underlying litigation, tainting the public perception and tainting the potential jury pool,” and that Walden has a right to know his accusers, “especially in light of their aggressive media tactics.” Suspension: The New Mexico Medical Board suspended Walden from practice in July, after sending him notice of contemplated action and getting input from two physicians hired as experts who reviewed available records. The board ordered Walden to undergo a thorough psychological evaluation arranged by the New Mexico Monitored Treatment Program, which was to send its findings and recommendations to the board for review. The recommendations “must demonstrate to the board’s satisfaction that (Walden) is fit to safely practice medicine.” The board will then determine his further licensure status. The board hired as experts a urologist with 33 years experience, including 5½ years participating in a prison clinic, and an emergency medicine physician described as having expertise in correctional medicine. The urologist said his review of the evidence indicated “sexual contact with a patient” by Walden on many occasions that were not legitimate medical procedures and constituted sexual abuse. The second physician found that Walden had not breached the standard of care and that his treatment of inmates was appropriate for the patient complaints documented in medical records. That doctor questioned the credibility of the inmates’ statements “because several of them indicated (Walden) had examined them without gloves, which (he) found very unlikely to have actually occurred.” Walden invoked his Fifth Amendment right and refused to testify at the medical board hearing.

Among over 40 pages of proposed factual findings:

•Walden regularly performed digital rectal examinations of inmate patients in their 20s and 30s. The Clayton prison offered exams routinely for men over age 50 and for men under 50 if they had specific complaints warranting such an exam.

•He did twice as many rectal exams each month as any other doctor at the Clayton facility, according to a prison nurse.

•A 40-year-old patient at the prison in Clayton asked a corrections officer as the inmate left the medical unit in July 2012 “if (Walden) was gay, and expressed discomfort with the examination he had received.” The officer prepared a statement based on the inmate’s statements that the doctor had turned him over and stroked his genitals. That was the only comment about any presumed sexual orientation of the doctor.

•Another patient reported on Aug. 5, 2012, that Walden had “played with” his testicles without gloves.

•A 28-year-old inmate reported that Walden called him for medical exams for three weeks straight on a Friday or Saturday, gave him a rectal exam and studied his penis.

•Another inmate filed a grievance about an Aug. 20, 2012, incident in which he said Walden asked him to drop his pants, rubbed his genitals and asked if it felt good.

•In patient statements provided by the facilities in response to a subpoena by the board, Walden diagnosed a prostate condition not confirmed by an independent analysis.

•Inmate patients are generally not referred out because of time, expense and safety issues in transporting prisoners off site.

•Only one patient at Santa Rosa filed a grievance with a nurse.

The hearing officer noted inmates “may be manipulative and will commonly do things for purposes of secondary gain,” such as getting strong pain medicine, special shoes or mattresses.


Mar 17, 2013 abqjournal.com

A New Mexico inmate claims he got an overly long and intrusive rectal exam when he went to the prison doctor for a torn meniscus in his knee. And his complaint isn’t the only one. Eighteen inmates in two separate civil lawsuits claim they were fondled or given intrusive exams – even when they weren’t needed – by Dr. Mark E. Walden, the prison physician at the time. The claims that Walden used his position to sexually abuse inmates are being made by men incarcerated at prisons in Santa Rosa and Clayton. Both prisons are operated under contract with the state by the Boca Raton, Fla.-based GEO group, a firm that operates detention and re-entry facilities in Australia, Canada, South Africa and Britain, as well as the U.S. Walden was an employee of Corizon, a private contractor that provides healthcare services at over 349 correctional facilities across the country. The company, which is based in Tennessee, has a four-year, $177.6 million contract to provide prison medical services in New Mexico at both public and privately run prisons. Katie Curry of the McGinn Law Firm in Albuquerque, attorney for one group of prisoners suing Walden, GEO Group Inc., Corizon, prison wardens Erasmo Bravo and Timothy Hatch, and health administrator Sherry Phillips, said another attorney represents another 10 or so clients with similar complaints. “That’s who has come forward, but these guys move around a lot (to other prisons),” Curry said. “I can imagine there are others who are reluctant to come forward.” The lawsuit filed by Curry alleges at least 25 known victims. The New Mexico Medical Board is investigating Walden and, on Feb. 18, issued a notice of contemplated action. No hearing has been scheduled, but it is likely to take place in April or May, a board spokeswoman said. “As a matter of standing company policy, Corizon does not comment on any litigation. However, Corizon can confirm that Dr. Walden is no longer on staff,” said Courtney Eller of DVL Public Relations & Advertising in Nashville, which handles media inquiries for Corizon. GEO Group spokesman Pablo Paez said in an email that the company, as a matter of policy, “cannot comment on litigation related matters, but we can confirm that Mr. Bravo and Mr. Hatch are employed by GEO and Dr. Walden is not employed by GEO.” Walden, who is now working in a medical practice in Raton, did not return a call for comment. He also allegedly failed to use proper hygiene and disease prevention techniques by not using gloves when he examined inmates. Prison administrators and Corizon didn’t ensure that a third person was present to protect the integrity of the exams, according to at least one of the suits. The potential for sexual abuse and sexual misconduct toward inmates by prison employees is well-known institutional problem, the lawsuits say, and administrators have a duty to protect the inmates. Inmates often view reporting abuse as futile because of the humiliation and retaliation they risk and the prospect of losing access to medical services, the complaints say. Doctors have far greater social status than inmates, further exacerbating the imbalance, they say. GEO and Corizon should have known about the abuse through inmate reports and the perceptions of staffers such as nurses, “or kept themselves willfully blind” to it, according to Curry’s lawsuit. “Corizon and GEO did not encourage reporting or documentation of these incidents, and enacted no discipline or retraining of … Walden,” the lawsuit says. Curry said there was a written complaint about Walden by an inmate in September 2011, “and apparently nothing happens, so it’s literally like the Catholic church where they know something and transfer him someplace else.” She said lawyers know a copy of the complaint went to State Police and that GEO was made aware of it. Walden initially worked at the Guadalupe County Correctional Facility in Santa Rosa and was later transferred to the Northeastern New Mexico Detention Facility in Clayton. One of the consequences of the alleged abuse, Curry said, was that some inmates stopped going to see Walden, even though they needed medical treatment. The lawsuit says staff became suspicious after Walden was hired “based on observations including a sudden notable increase in volume of digital rectal exams being performed, unindicated digital rectal exams on young inmates (and) refusal by defendant Walden to have a third party present.” An inmate who went to Walden for urinary tract issues and had an examination that was “excessive and inappropriate” and conducted without gloves reported the incident and had a sexual assault exam performed in Santa Fe, which revealed two anal tears, according to the lawsuit. “Corizon and GEO did not encourage reporting or documentation of these incidents, and enacted no discipline or retraining of … Walden.” - McGINN LAW FIRM: A separate lawsuit filed by Frances Carpenter of Albuquerque on behalf of nine more inmates says the abuses began in 2010 and continued through July 2012 during both routine and “symptom specific” examinations. They included digital anal penetration and probing and stimulation of the genitals. One inmate who saw Walden with a request for hemorrhoid cream was told he need to be examined first, the lawsuit says, and during the exam was penetrated by the doctor’s “entire ungloved fist.” The inmate, who reported the incidents to prison officials, continues to have nightmares and anxiety related to the alleged assault. Both lawsuits, filed in 1st Judicial District Court in Santa Fe, allege negligent hiring and retention, civil rights violations, negligence and breach of contract. They seek unspecified compensatory and punitive damages. Meanwhile, the medical board is expected to set a hearing this spring based on allegations that Walden, during prostate exams on some 17 inmates, “touched or attempted to touch these inmates in an inappropriate, sexual manner.” The board notice says Walden was subject to a “corrective action” for incomplete medical records that led the Union County General Hospital to terminate his privileges, and he did not report it to the board. The notice also says Walden’s professional medical liability insurance was canceled and that he gave incorrect information about it on his license renewal in 2011. Inmates say routine exams turned into horrific assaultsSee PRISON on PAGE A9from PAGE A1Prison doctor accused of sex abuse; inmates claim assaults”Corizon and GEO did not encourage reporting or documentation of these incidents, and enacted no discipline or retraining of … Walden.”<quote_attribution>McGINN LAW FIRM

Guilford County Jail, Greensboro, North Carolina
Sep 6, 2014 courthousenews.com               

The nation's largest provider of correctional medical care ignored a North Carolina inmate's agonized pleas for help as he suffered excruciating pain and vomited blood for 10 days, causing a heart attack that left him in a permanent vegetative state, his family says in a federal lawsuit. Glenda and Calvin Simmons, the parents of Bryan O'Neil Simmons charge in a lawsuit filed in the Federal Court in Greensboro, N.C., that Corizon Health Inc., a firm based in Brentwood, Tenn., and no stranger to lawsuits accusing it of providing inadequate care to prisoners, violated both national and state standards of care established for inmates. And they assert these lapses were aided and abetted by co-defendants, Guilford County, N.C., its Sheriff, B.J. Barnes, and the Guilford County Sheriff's Department. Bryan Simmons, 36, a newlywed with no history of health problems, was serving 90 days at the Guilford County Jail for a parole violation when he became ill shortly before Thanksgiving Day 2012. In a phone call to home that day, Simmons told his parent that he was unable to go to the bathroom for several days and that he had been throwing up blood. Two days later, Simmons was found on the floor of his cell, apparently unconscious, the Simmons say. Despite the presence of blood on his clothing and floor, Simmons "was not examined by a physician and his request to be seen at a hospital was denied by the Corizon staff," his parents say. Nurses on duty at the jail did draw Simmons' blood, but the lab work was not reviewed until after he suffered his heart attack. Simmons' parents say that on Dec. 1, 2012, they received a call from a cellmate that told them their son had collapsed on the floor, was unable to move and had urinated on himself. The Simmons say they immediately drove to the jail but their request to see their son was denied. Despite assurances that their son was fine, the Simmons say they pleaded for him to be taken to the hospital, explaining that he must be seriously ill because he was going to be released in two days. In the meantime, unbeknownst to his parents, Simmons was moved from a general cell to a medical cell where he was placed on video surveillance because it was believed he was "Suicidal." According to the lawsuit, this action was taken "[a]round 4:55 P.M. on December 1, the jailers and nurse reported that Bryan had a bloody rag in his mouth and wanted to kill himself due to the pain he was experiencing."The videotape from the jail purportedly shows Simmons unable to walk, begging for help and writing "HELP" in the air with his finger. The complaint says nurses told Simmons he couldn't go to the hospital until he saw a doctor. However, no physician was scheduled to visit until after Simmons was released from the jail. Fred DeVore, attorney for Simmons' family, said Corizon was contracted to provide emergency care 24 hours a day, 7 days a week. "It's just a practical matter that if there is an emergency, you go to the hospital," DeVore said. "Just because a doctor isn't on call doesn't mean you don't fulfill your obligations." Corizon's attorney did not return calls to comment on the case. Despite his worsening condition, Simmons jailers allegedly continued to prepare for his release. At 1 p.m. on Dec. 2, 2012, the complaint says, Simmons was removed from his cell and escorted to an elevator. According to Simmons' parents, a video camera in the elevator showed their son collapsing in the elevator and being pull to his feet by his handcuffs by a guard accompanying him. On the way to a cell on the medical ward, Bryan collapsed again from the elevator, and again was pulled to his feet by the jailer ... approximately eight minutes later, Simmons went into cardiac arrest caused by excessive internal bleeding from a perforated ulcer," his parents say. At that point, an emergency 911 call was made, but, Simmons' parents say, "According to EMS notes, the responding medics asked for any complaints from Simmons before he collapsed. Recorded in their notes they were told, 'According to staff, patient was reported to have vomited once last night however has not had any complaint today.' There is no mention of the previous days or the preceding night wherein Simmons had complained of pain, distention, his concern about internal bleeding or his constant vomiting of blood for at lest four days ..."The Simmons say that after their son's heart attack jail and Corizon staff were slow to provide emergency care and failed to give him oxygen for 34 minutes. "Due to the lack of oxygen after his collapse, Simmons is profoundly disabled and is in a permanent vegetative state," his parents say. William Hill, who is representing the Guilford County Sheriff's Department, said the detention officers could do nothing to help Simmons because they had to follow the directives of the Corizon staff.  "We relied completely on their judgment," Hill said. "They were contracted to provide medical care. This allowed the detention staff to do their job of running the jail." Under Corizon's $6.9 million contract with Guilford County, which ended on June 30, if a prisoner was transferred to a hospital from the jail for medical treatment, Corizon had to pay the expense. DeVore said believes this requirement was a critical role in the staff's decision-making: If their son had been sent to the hospital from the jail, Corizon was contractually responsible for paying for it. A Florida jury came to that same conclusion in March 2011 when it found that Corizon, then doing business as Prison Health Services, was deliberately indifferent to a Lee County inmate's medical needs and awarded him $1.2 million in damages. In his complaint, Brett Fields, said he had an infection on his arm that refused to heal, despite treatment with antibiotics. He complained to jail personnel over several weeks, insisting that the medications weren't helping the open wound. He was sent to a medical block that dealt with MRSA infections, but, the "lax" treatment didn't work. Despite Fields' worsening symptoms, including his legs twitching uncontrollably, back pain, and partial paralysis in his lower body, PHS did not send him to the hospital. An MRI later showed that an abscess was pressing on his spine and had damaged his spinal cord. Fields is now partially paralyzed. In 2012, the 11th Circuit affirmed the jury's verdict and held that it was reasonable for the jury to conclude that the company had delayed medical care to save money. More recently the 9th Circuit ruled that a class of inmates may advance claims Arizona's prison health care system is dangerously understaffed and negligently managed. According to a report from Al Jazeera America, a former Corizon employee turned whistleblower claims that staff shortages resulted in mentally ill prisoners going unfed or sitting for hours at a time in their own excrement; and that in some cases prisoners died from lack of proper treatment. Corizon responded to these allegations with a lengthy statement from Susan Morgenstern, a company spokesperson, that said in part, "As for lawsuits, we treat hundreds of thousands of patients in millions of healthcare encounters each year. Unfortunately, some of those patients are prone to filing lawsuits, which are simply allegations and not proven. The majority of lawsuits are brought by inmates without an attorney representing them and are dismissed or resolved prior to trial." The company has also run into trouble for not protecting employees from workplace violence and assault. The company was fined $71,000 last month by the Occupational Safety and Health Administration for its plain indifference to worker safety and health at Rikers Island prison in New York. "Corizon failed to address the serious problem of assaults against its employees until OSHA began its inspection," said Robert Kulick, OSHA's regional administrator in New York. "Corizon needs to develop and implement an effective, targeted workplace violence prevention program that includes administrative and engineering control, as well as personal protective equipment and training, to reduce the risk of violence against its employees."

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Idaho Department of Corrections
April 29,2013 idahobusinessreview.com     

Idaho’s prison system will increase payments to its medical and mental health care provider by hundreds of thousands of dollars after the company demanded a raise. However, the Idaho Department of Correction said it will only extend its $27 million annual contract with Corizon Correctional Healthcare until January, not another 12 months as previously announced. By then, the state Board of Correction hopes to have a new contract in place with a provider whose price tag better fits Idaho’s budget. During the six months starting July 1, Idaho will pay Tennessee-based Corizon about $250,000 more than currently budgeted. The move, approved at a Board of Correction meeting Thursday, came after Corizon President Stuart Campbell told state prison Director Brent Reinke he wouldn’t sign an extension for less money. On April 26, Reinke said Corizon told him its contract with Idaho wasn’t sufficiently covering the company’s costs and it needed more to continue providing service. “It’s just gotten more expensive to do business, and they just couldn’t afford to subsidize,” Reinke said, recalling Campbell’s justification for the hike. “The contract had just become too costly.” Corizon officials in Brentwood, Tenn., didn’t immediately comment. The rate Idaho has paid to Corizon has already increased about 20 percent in the past three years. Idaho has had a rocky relationship with the company in recent years, a period in which the state has been under pressure from a decades-old federal lawsuit to improve medical and mental health care for prisoners. The state fined Corizon $200,000 for missing contract benchmarks, and a federally appointed expert concluded its medical care was so bad it amounted to cruel and unusual punishment. Corizon commissioned its own report released in May 2012, indicating it was meeting national prison standards with the care it was providing in Idaho. In 2012, the Department of Correction asked companies to submit proposals on providing medical treatment to prisoners — a preliminary step to putting the contract out for bid. Five companies responded, and Corizon was one of two that gave price estimates. Based on that response, Reinke now says he’s optimistic that an offer will emerge before January that Idaho can better afford. “There are other providers that responded that are very interested in this contract,” he said. “So we hope it’s in a very close range of the existing budget amount.”

May 11, 2012 AP
The national prison health care company Corizon says a scathing court-ordered report on the care provide at an Idaho prison is full of errors and that a review they commissioned themselves proves it. But a close review of both reports show that they largely focused on different aspects of the health care system and that they noted some similar problems. The medical care at the Idaho State Correctional Institution south of Boise is a major part of a long-running lawsuit brought by inmates against the state 30 years ago. Over the years the inmates won many of their claims, forcing the state to make changes to operations and procedures at the lock-up. And a federal court has continued to oversee some aspects of the prison. Last year, U.S. District Judge B. Lynn Winmill appointed correctional health care expert Dr. Marc Stern to review the health care at the prison in hopes of finally bringing the lawsuit to a close. Stern's report found several problems. He said terminal and long-term care inmates sometimes went unfed and were left in soiled linens. The report also said nursing mistakes or failures were likely to have resulted in some deaths and one inmate wasn't told for seven months that he probably had cancer.

April 2, 2012 KTVB
The Idaho Department of Correction is telling a federal judge that a scathing report about health care at a Boise-area prison isn't accurate and doesn't reflect current conditions. Attorneys for the state filed their response to the report late last week, saying a court-appointed health care expert didn't do a thorough review at the Idaho State Correctional Institution. Dr. Marc Stern was appointed by the federal court to examine the care at the prison as part of a long running lawsuit between inmates and the state. U.S. District Judge B. Lynn Winmill has said he will use Stern's findings to help him decide whether to end the lawsuit. Stern's report was damning, finding that the medical care was so poor that it amounts to cruel and unusual punishment.

March 20, 2012 AP
Medical care is so poor at an Idaho state prison that it amounts to neglect and cruel and unusual punishment, according to a report that was unsealed Monday. Correctional health care expert Dr. Marc Stern said there have been some improvements at the Idaho State Correctional Institution south of Boise. But terminal and long-term inmates sometimes went unfed, nursing mistakes or failure likely resulted in some deaths, and one inmate wasn't told for seven months that he likely had cancer, he said. The Idaho Department of Correction and the prison health care provider, Brentwood, Tenn.-based Corizon, said they're disappointed and are preparing a response that will show the care delivered to inmates meets constitutional and health care standards. Stern was appointed to study the care prison near Boise as part of a long-running lawsuit brought by inmates. Some of the medical problems described in the report are disturbing, including Stern's findings that inmates who were terminal or required long-term care and who were unable to move on their own were sometimes left in soiled linens, given inadequate pain medication and went periods without food and water. Stern said those conditions were ``inhumane.'' Emergency care was also found deficient in the report, with medical staffers routinely failing to bring parts of a basic resuscitation device — a ventilator mask for rescue breathing — to inmates experiencing medical emergencies. Prison guards reported to Stern that they sometimes had to call the health staffers multiple times to get them to respond to inmate emergencies, and sometimes the nurses only responded by phone, telling the guards to have the inmates request care the following day. In another case described by Stern, a nurse who found an inmate unconscious and having serious breathing problems didn't take any other vital signs and failed to give the man oxygen. ``Such evaluation was critically important at this point because it was highly likely the patient was not getting enough blood to his brain and required resuscitation,'' Stern wrote. Instead, he contends, the nurse moved the patient to the health unit and only assessed him a few minutes later, when he was having a heart attack. The patient died. ``It is impossible to know if immediate application of life saving measures in the living unit would have saved this patient,'' Stern wrote. ``However, failure to provide these measures greatly reduced any chance for survival.'' The report focuses only on the Idaho State Correctional Institution, though Corizon provides medical care for all inmates in Idaho's state-run prisons. Inmates at the Idaho State Correctional Institution, called ISCI, sued more than 30 years ago, alleging that they were subject to violence and rape by fellow inmates, denied adequate medical care, subjected to poor diets and forced to deal with extreme overcrowding. Over the next three decades, they won several rulings designed to improve conditions at the prison, and the federal court continued to oversee operations to make sure that the state was complying with all of its orders. But U.S. District Judge B. Lynn Winmill is eager to end the court's babysitting role, and the Idaho Department of Correction hopes the lawsuit will be closed for good. The inmates, however, said some of the rulings still aren't being complied with — particularly the orders to improve access to medical and mental health care. Complicating matters is that the prison has grown and changed over the years, and the state now says it's difficult to apply the old rulings to the facility as it now stands. Attorneys for the state argued against releasing the report, saying the public could confuse Stern's findings with the court's opinion. The state said the report should be sealed until both sides had responded to the findings in court. Corizon is not named as a defendant in the case. But in a joint statement released moments after the report was unsealed Monday, officials from the company and the state acknowledged a few of the allegations in the report ``may be well-founded but unfortunate anomalies'' but most of them have been or are being addressed.

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

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

Indiana Department of Corrections
Feb 1, 2014 therepublic.com

INDIANAPOLIS — A lawyer on Tuesday blamed a culture of indifference for the death of a severely ill woman who was passed from one Indiana prison to another so often that the state Department of Correction lost track of her. Michael K. Sutherlin, the Indianapolis attorney who filed the lawsuit on behalf of Rachel Wood's family, blames the prison agency and Corizon, the Tennessee-based company hired to provide health care at the prison. Corizon has been accused of providing poor care at prisons it serves in other states. "That is just the attitude of these guys, is saving money rather than providing health care," Sutherlin said. Wood, 26, was serving time for a first-time drug offense when she died in April 2012, court documents said. She had lupus and another immune system disorder, a blood clotting disorder and depression, the lawsuit filed Jan. 21 said. "Notwithstanding the duty of the prison medical staff to provide adequate medical care to Rachel and to treat her very serious life threatening conditions, prison medical staff willfully and callously disregarded her condition, and allowed Rachel to deteriorate and die," said the lawsuit, saying that Wood's treatment amounted to cruel and unusual punishment. "It's just an attitude of meanness," Sutherlin said. "They're not just insensitive, they're mean." "Our goal is to provide quality health care to all our patients, and our teams work hard every day to fulfill that mission," Corizon spokeswoman Susan Morgenstern said in a prepared statement, and declined further comment. Bryan Corbin, a spokesman for the Indiana attorney general's office, said the office would defend the state prison agency and would address the lawsuit in court. Wood's father, Claude Wood, 57, of Carmel, said prison officials misled him about the severity of her illness despite his repeated phone calls inquiring about her well-being and shuffled his calls from one facility to another and back again. Documents claim that the Department of Correction lost track of Wood's whereabouts at one point and declared her an escapee while she remained in prison. "They lied. We felt they hid her from us. Every time we got close they hid her from us," Wood said. The lawsuit filed this month in a Marion County court alleges that Rachel Wood was moved between prisons in Rockville and Madison and the Indiana Women's Prison in Indianapolis, as well as several hospitals, after one of her fellow inmates told her father she had been taken away in an ambulance, bleeding from her eyes and mouth. "She died a horrible death and she died alone," said her father. It isn't the first time the care Corizon provides for prisoners has drawn fire. Last October, Corizon made headlines when one of its nurses at an Arizona prison potentially exposed as many as 24 inmates to hepatitis and HIV by repeatedly using the same needles. Ten of the 24 were among a group of inmates who were involved in a similar scare at the same prison in August 2012. The same month, Corizon lost a bid to renew its contract with the Minnesota Department of Corrections following staff complaints of substandard care and legal action against the company. A 2012 Star Tribune investigation found that at least nine Minnesota inmates had died since 2000 due to denial or delay of care while Corizon was the state's prison medical contractor. More than 20 had suffered serious or critical injuries during that period, the newspaper's investigation found. The state's three-year contract with Corizon sets a per diem fee of $9.41 per prisoner, with a cap of about $293 million over the three-year period from January 2014 through the end of 2016. Privately held Corizon, whose website says it is the nation's largest health care provider for prisons in the United States, was formed in 2011 by the merger of PHS Correctional Healthcare and Correctional Medical Services, its predecessor in Indiana. The company, based in Brentwood, Tennessee, says it provides medical, dental, and mental health care to about 381,000 inmates in 28 states.

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

Jackson Health System, Miami, Florida
July 28, 2011 Miami Herald
Jackson Health System announced Thursday it is reversing course and will not out-source inmate healthcare – ending two years of planning, hearings and appeals involving a plan once considered a major initiative to turn around the struggling hospital group. Executives last year were so convinced that out-sourcing would save money that they placed the estimated $8 million savings in the budget for this fiscal year, which ends Sept. 30. When Jackson’s new chief executive, Carlos Migoya, arrived in May, he reviewed the program, which covers 6,000 Miami-Dade County inmates. After the final bids came in earlier this week – the second set of final bids -- he decided the proposals were “notably higher” than what his team thought it would cost Jackson to perform the same service, he said Thursday. “There was a big difference,” he said. Chief Financial Officer Mark Knight said the lower of the two bids was $60.5 million. Executives now believe Jackson can provide the same services for no more than $58 million – and perhaps considerably less next year with reduced labor costs. The decision-making was long and torturous because Jackson has been struggling to determine its exact costs of inmate care, as it had with many of its services at its three hospitals and four clinics, which lost $337 million the past two years and $71.7 million so far this year. The out-sourcing quest began in the summer of 2009, when then-Chief Executive Eneida Roldan projected huge savings if Jackson made the change. She originally wanted the out-sourcing done within 90 days, but the county’s formal competitive bidding system stretched the process out, ending with a battle between two bitter rivals, Prison Health Services and Armor Correctional Health Services. A selection committee spent months studying the bids. In January, the committee decided PHS, now known as Corizon, had submitted the best proposal and began negotiating final contract terms. Lobbyists for Armor protested to county commissioners and Jackson board members that it was unfair to allow PHS to negotiate final terms without Armor being allowed to counter. Jackson executives agreed and reopened negotiations with both companies. One major problem was that Jackson couldn’t determine if an outsider would save them money if it didn’t know its own costs.

May 20, 2011 Miami Herald
In his first major step toward cost-cutting, Carlos Migoya, Jackson Health System's chief executive for three weeks, said Thursday he is eliminating 189 positions for an annual savings of $13.3 million. Most of those positions are vacant. Forty-nine employees will be affected, Migoya said, but some will be able to move to other vacancies within the system, which has lost $337 million during the past two years. Coral Gables Migoya said the eliminations would not change patient care. He didn't offer details on what kinds of positions would be cut. The reductions amount to 1.7 percent of Jackson's 11,100-member workforce. Also at Thursday's meeting of the new Financial Recovery Board, members heard that Jackson plans to start over in its attempt to out-source inmate healthcare — an arduous process that has been going on for more than a year and a half in attempt to save the system money. Former Jackson chief Eneida Roldan originally wanted the out-sourcing to begin in October 2009. That was delayed by a formal bidding process that attracted Miami-based Armor Correctional Health Services and a national firm, Prison Health Services. A formal bidding council made up of Jackson and county managers spent months studying the competing bids before declaring PHS the winner. In January, Jackson started negotiating with PHS to get the best possible deal. Lobbyists and attorneys for Armor complained that Armor, too, should be allowed to talk to Jackson about improving its bid. On Thursday, the board voted to waive the competitive bidding process and begin negotiations anew with the two companies. Jackson's 2011 budget projected that inmate out-sourcing would save the system $8 million this fiscal year, but board members said Thursday they were uncertain how much inmate care now costs Jackson and whether any money could be saved by out-sourcing. Board Chairman Marcos Lapciuc said he had heard that inmate care costs about $70 million a year, while board member Joaquin del Cueto said he'd "heard it was as low as $25 million," the figure shown in some Jackson financial statements. Nine months ago, The Miami Herald asked Jackson how much inmate healthcare cost and has yet to receive an answer.

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

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

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

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

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

Lane County Jail, Oregon
Oct 28, 2013 registerguard.com

The guardian for a former Lane County Jail inmate who sustained a catastrophic spinal injury while in custody is suing the county and a private health care contractor for $30 million. Kelly Conrad Green II is now a quadriplegic as a result of the neck injury, according to a suit filed in U.S. District Court in Eugene. He accuses the county and Corizon Health Inc. of negligence and violation of his constitutional rights. Green, who evidently was mentally ill at the time, broke his neck after lowering his head and running into a concrete wall at the jail, the suit says. It accuses Corizon and the county of ignoring his neck injury and leaving him naked, paralyzed and incontinent in a jail cell for six hours before calling an ambulance. Corizon took over the job of providing health care for inmates at the jail last year. The Lane County Sheriff’s Office, which used to handle inmate health care with its own medical employees, switched to a private contractor as a money-saving move, saying it could save the cash-strapped county as much as $650,000 a year. A Lane County spokeswoman said the county has a policy of not commenting on pending litigation. A spokesman for Corizon did not immediately return a call seeking comment. The suit claims the treatment of Green by the county and Corizon violated Green’s rights under the U.S. Constitution’s 14th Amendment, which provides for equal protection under the law for all citizens and the right to due process in matters that could result in the loss of life or property. It also claims the county and Corizon were negligent in caring for Green and that Corizon is guilty of gross negligence and reckless misconduct. Other defendants named in the suit include the national medical director, chief mental health officer and national nursing officer for Corizon, five local Corizon employees and three Lane County sheriff’s deputies working at the jail. It also names 10 unidentified jail health care workers. According to the suit, Green was booked into the jail on Feb. 11 after being arrested on a warrant. The suit doesn’t identify the charge, but court records show the only pending case involving Green at that time was a citation for possession of less than one ounce of marijuana, and that Green had failed to show up for an arraignment on the charge in January. From the time he was booked, Green showed signs of having mental health problems, the suit says. He appeared to be experiencing paranoid schizophrenia, was talking to himself and inanimate objects and, according to jail records cited in the lawsuit, “barely made it through the booking process.” While being arraigned at the jail, Green began to talk to himself, the suit says. As described in the lawsuit, he then ran toward a concrete-block wall 8 to 10 feet away, lowered his head and hit the wall, collapsing and bleeding heavily from his head. Corizon workers were called, and Green reportedly told them he was paralyzed. But the suit claims they made no effort to stabilize his neck or spine and instead loaded him on a wheelchair and took him out of the jail courtroom with his feet dragging behind the chair. A physician’s assistant sutured the head wound but did not do a neurological exam, did not arrange for an exam by a physician and took no neck or spine precautions, the lawsuit alleges. It said Green, who had lost control of his bowels, was returned to his cell, stripped of his clothes and put on the bed. Over the next six hours, Green allegedly told several jail workers that he was paralyzed and unable to move and needed help. When he was interviewed by a Corizon mental health specialist several hours later, the suit claims the specialist said he didn’t believe Green was seriously injured. At one point, the lawsuit claims, a Corizon employee told a deputy who reported that Green was not moving that as long as he was breathing there was “no immediate concern.” After about six hours, a jail worker called an ambulance and Green was taken to Sacred Heart Medical Center at RiverBend in Springfield. He was diagnosed with a neck fracture and spinal cord injury and underwent three hours of surgery that evening. The suit alleges a long list of failures and shortcomings in Green’s treatment. It claims Corizon staff failed to provide prompt or adequate treatment, and aggravated Green’s injury by carelessly dragging and moving his body after the injury and leaving him naked and paralyzed in a cell for six hours. The defendants also are accused of failing to screen mentally ill inmates, providing inadequate medical treatment and failing to meet accepted standards for medical care. The suit accuses Corizon of gross negligence and reckless misconduct for refusing to attend to Green and for saying he didn’t need medical attention as long as he was breathing. Corizon provides medical services at more than 400 facilities in 31 states and handles health care at two other county jails in Oregon, in Clackamas and Washington counties. Its corporate headquarters is in Brentwood, Tenn., and it has a regional office in Hillsboro.


Lee County Jail
, Naples, Florida
Feb 20, 2013 news-press.com

The widow of a Lee County jail inmate, who died in 2009 after being repeatedly pepper-sprayed while in custody, reached a $4 million settlement , her attorney said Tuesday. Joyce Christie, who lives in Ohio, settled out of court last week with Lee County Sheriff Mike Scott, Prison Health Services Inc. and deputies and nurses at the jail. The suit claimed those involved were guilty of assault and battery, excessive force, and deliberate indifference to Nick Christie’s medical condition. Joyce Christie will receive part of the $4 million, after expenses and other fees are paid, according to her attorney, Nick DiCello. “She’s happy she stuck with it after all these years,” he said. “The civil system has done its job.” Nick Christie, who was in Southwest Florida to visit his brother, was 62 when he was arrested on a disorderly intoxication charge March 25, 2009, and March 27 on a trespassing charge. Christie was taken to the hospital March 29 and died two days later. After Christie’s death, the medical examiner termed it a homicide and pointed to restraint and pepper-spraying by guards as factors. Christie’s widow told The News-Press on Thursday that she’s glad it’s over. “There has not ever been justice for Nick, so to speak,” she said. “Nobody was ever found guilty, nobody was ever relieved of their job, which upsets me.” In 2010, the state attorney’s office cleared five corrections deputies — Kurtis Calhoun, Daniel Falzone, Monshay Gibbs, Frank Hansen and Dathan Pyle — of criminal wrongdoing in the case. DiCello was unable to say how much each portion of the settlement was costing the sheriff’s office, which Scott said comes out of a risk management fund, and Prison Health Services, which provides health care to county inmates. Scott said the sheriff’s office portion was paid through the Florida Sheriff’s Risk Management Fund, a self-insurance program administered on behalf of many agencies across the state of Florida. Prison Health Services is now known as Corizon and is based in Tennessee. The company provides services to 283 correctional facilities , according to its website. Courtney Eller, Corizon spokeswoman, said the company doesn’t comment on lawsuits, especially those involving inmates. “It’s a very sensitive area,” she said. In 2011, The News-Press reported that more than 30 lawsuits had been filed against the company in Lee, Collier and Charlotte counties.

September 9, 2012 News-Press
A federal appeals court has upheld a $1.2 million settlement given to a Fort Myers man after he was partially paralyzed because of inadequate care during a stint in the Lee County Jail. On July 6, 2007, Brett Allen Fields, 30, was booked into the jail with a spider bite that became infected but was never properly treated, according to the ruling from the U.S. Court of Appeals for the Eleventh Circuit “Like clockwork, or maybe as if by pact, all the nurses agreed on the same approach: They did nothing,” the ruling reads. The suit was filed against Corizon Health, formerly known as Prison Health Services. One nurse, Betty Joyce Allen, testified it was not the company’s policy to treat paralysis as a medical emergency that would warrant transport to a hospital. Fields filed suit in August 2009, stating he requested medical attention for a wound in his left arm on July 10, 2007. A nurse identified his wound as a boil caused by staphylococci and tried to treat it. Two weeks later, Fields filled out an inmate medical request form stating the medication didn’t work, but he claims his request was ignored. Shortly after, Fields began to suffer from severe back pains and weakness in his lower extremities, the lawsuit said. On Aug. 7, a nurse examined Fields and scheduled an appointment for the next morning. On Aug. 8, he was confined to a wheelchair. The physician's assistant ordered Tylenol and returned Fields to his cell. The next morning, Fields tried to use the toilet by dragging himself across the floor. His intestine started to escape from his bottom and when Allen responded she allegedly used K-Y Jelly to shove them back in, according to the ruling. Twelve hours later, a doctor examined Fields, who was taken to Southwest Florida Regional Medical Center, the lawsuit said. Medical staff diagnosed Fields with MRSA (Methicillin-resistant Staphylococcus aureus) and he underwent surgery to remove an abscess compressing his spine. According to the lawsuit, Fields suffers partial paralysis in both legs.

March 18, 2011 Naples News-Press
Brett Fields shook his head in disappointment today when he heard a jury determined his pain and suffering from being paralyzed after a delay in medical care at the Lee County Jail was worth $100,000. After a four-day trial, a federal jury deliberated a little more than 3 hours before finding in Fields’ favor in the amount of $1.2 million against Prison Health Services, the company contracted to provide health care for the sheriff’s jail facilities. The jury found nursing supervisor Bettie Joyce Allen and physician’s assistant Joseph Richards Jr., both of whom treated Fields at the jail, were not liable. Fields, 28, shook his head in frustration as the dollar amounts were read aloud by U.S. District Judge John Steele. The jury awarded $600,000 for lost earnings, medical bills and loss of future earnings, $100,000 for pain and suffering and $500,000 to punish the company for its conduct. Fields’ attorneys didn’t ask jurors for a specific amount — they decided to allow the jury to decide, said Fields attorney Dion Cassatta of Fort Lauderdale. They didn’t have a dollar amount in mind, Cassatta said. “I’m a little surprised the pain and suffering was $100,000,” said Fields’ other attorney, Greg Lauer of Fort Lauderdale. “The pain and suffering I’ve seen my client endure — it’s beyond computation.”

March 17, 2011 Naples Daily News
A 28-year-old North Fort Myers man broke down in tears Thursday as he told jurors how his pleas for help as he became paralyzed at the Lee County jail were repeatedly ignored. “I just didn’t understand why it was taking so long ... to have someone examine me and make the call to take me to a hospital,” Brett Allen Fields Jr. told jurors in U.S. District Court in Fort Myers. “I just wanted help.” Fields, a once-healthy construction worker, broke down and wiped tears as his mother, Toni Silvers, and girlfriend, Amanda Duhamel, sobbed nearby. Judge John Steele let attorneys Greg Lauer and Dion Cassata take a break with Fields as Silver and Duhamel consoled him. Fields’ testimony came the third day of trial in his 2009 civil rights lawsuit against the jail’s medical provider, Tennessee-based Prison Health Services; Joseph A. Richards Jr., its former physician’s assistant; and nurse Bettie Joyce Allen, who retired. Today, Steele will instruct jurors on the law, they will hear closing arguments from Lauer and defense attorney Gregg Toomey and then begin deliberations. On Thursday, defense medical expert Dr. Arthur Fournier, University of Miami’s associate dean of community medicine, the only defense witness, testified Richards and Allen provided good care. He said he was impressed with Allen’s empathy toward Fields when she’d opted to keep him in observation the morning of Aug. 9, 2007, until he could be seen by a doctor, rather than take him to an emergency room, where Allen said Fields would wait for care and tie up deputies.

December 14, 2010 News-Press
Brett Fields walked into the Lee County Jail on July 6, 2007, a healthy 25-year-old. He left a month later, paralyzed. That's according to a pending federal lawsuit filed against two jail medical staffers and Prison Health Services, the Tennessee-based company contracted to provide care at the Lee County Jail. Fields, of North Fort Myers, is one of 33 inmates who have filed federal lawsuits against Prison Health Services in Lee, Charlotte and Collier counties, where it runs health care at the jails. The company says its rate of lawsuits is low. But advocates say inmates are often ignored because they have legal and financial hurdles in the way of successfully bringing a lawsuit. "They have a constitutional responsibility to provide minimally adequate health care," said Dion Cassata, Fields' Fort Lauderdale attorney. "They do get sued. It doesn't mean all of those lawsuits have merit. Some have merit and some do not." Lee County Sheriff Mike Scott, recently dropped as a defendant from Fields' lawsuit, said he believes Prison Health Services provides good care, considering the clientele. "Generally speaking, they're doing a good job. Mistakes are made. But that's anywhere," Scott said. "I give these guys a little bit of room because of the baseline they're dealing with." Lawsuit details Fields was arrested on charges of criminal mischief and violating a protective injunction. According to his lawsuit, Fields was diagnosed with a staph infection that caused a pus-filled boil on his arm four days after he was booked. Within weeks, he began to suffer from back pain, numbness and weakness in his lower extremities but was ignored. Physician's assistant Joseph Richards Jr., a defendant in the lawsuit, saw the wheelchair-bound Fields and ordered Tylenol and a follow-up a week later. The next morning, Fields' rectal muscles were visible outside his body and he was taken from his cell on a sheet, the suit says. Nurse Betty Joyce Allen, another defendant, noted Fields was in pain but didn't order a doctor's visit until 12 hours later, when he was transferred to the hospital and diagnosed with a methicillin-resistant Staphylococcus aureus-related abscess in his spine, the lawsuit states. He had surgery and has undergone two years of physical therapy, although the father of three suffers partial paralysis in his legs, the lawsuit states. He is seeking an undisclosed amount. "There never is any justification for a delay when an otherwise healthy person shows signs of loss of motor skills," said Cassata, who refused a News-Press request for an interview with his client. Carla Cesario, Prison Health Services division vice president, said the company's policy is not to discuss litigation.

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

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

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

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

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

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

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

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

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


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

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

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

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

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

Louisville Metro Corrections, Louisville, Kentucky

Mar 9, 2014 wdrb.com

LOUISVILLE, Ky., (WDRB) -- The family of a former Metro Corrections inmate has filed a wrongful death lawsuit against jail employees and its former medical provider, among others, claiming negligence was a "substantial factor" in her 2012 death. The lawsuit, filed in Jefferson Circuit Court Tuesday on behalf of LaKenya Porter, claims Corizon, the private company that provided the jail's medical care at the time, and Metro Corrections director Mark Bolton failed to properly train and supervise staff, who provided Porter with inappropriate medical care.  The lawsuit comes weeks after the Louisville Metro Police's Public Integrity Unit completed its investigation into Porter's July 24, 2012, death, with prosecutors finding no criminal conduct but criticizing both Corizon and Metro Corrections for their care. While the lawsuit comes after the one-year statute of limitations on filing civil action, Brandon Lawrence, who is representing Porter's estate, said the family didn't know about the myriad problems with Porter's care until the police investigation was released in January.  "The jail gave them no information" on Porter's death, he said in an interview.  Bolton has said only that Porter, 33, died of natural causes, and neither jail officials nor Corizon have commented further on Porter's death because of the potential of litigation. A request for comment from Corizon on Thursday was not immediately returned. Bill Patteson, a spokesperson for the county attorney's office, which will represent Metro Corrections, said he could not comment on the pending litigation. The lawsuit is seeking compensatory and punitive damages as well as a jury trial. In total, seven inmates died in Metro Corrections in 2012. Criminal investigations have concluded in each of those cases, with no charges being filed. Last year, Tennessee-based Corizon decided not to rebid for its $5.5 million annual contract, though it had been the medical provider at Metro Corrections for most of the past two decades. According to the police investigation and conclusions from the Jefferson Commonwealth's Attorney's office, Corizon medical staff recommended not booking Porter into jail on July 21, 2012, because of her health. She had arrived from Jewish Hospital on a stretcher, so weak she could not stand and her legs were seeping a yellowish fluid. But Metro Corrections Deputy Director Dwayne Clark overruled the medical staff and ordered Porter to be booked. Clark later told investigators he was not aware of how serious Porter's condition was. Porter died later at University Hospital following a "negligent" lack of care during her 27 hours at Metro Corrections, according to the records released records from Metro police. Porter, who had been diagnosed with liver failure and congestive heart failure, never should have been taken into jail in the first place, investigators concluded. Officials with Corizon said Porter needed more care than the jail could provide. And during her incarceration, Porter was never given her medications. Dr. William Smock, a forensic  examiner who acted as a consultant for Louisville Metro Police in the investigation, concluded that Metro Corrections' decision to overrule three medical providers, including the jail doctor, and admit Porter to jail, "directly compromised (Porter's) health and welfare." And he said the failure of medical staff to provide Porter any of her prescribed medication or have a jail physician evaluate her also "contributed to her death." At 2 a.m. on July 22, the charge nurse at Metro Corrections "again" called the jail's doctor, identified only as Dr. Kad, about taking Porter to the hospital emergency room, according to police records. The charge nurse noted Porter "was not an appropriate fit for level of care at the jail," according to the police investigation. But the jail doctor "refused," saying Porter "would not be admitted" to the hospital. In fact, it wasn't until the power went out in the jail 20 hours later -- about 10 p.m. -- that Porter was taken to University Hospital. She died there on July 24.


Sep 4, 2013 courier-journal.com

The Tennessee company that’s provided medical treatment to inmates at Metro Corrections for most of the past two decades is ending its ties with city government following the death of seven sick jail prisoners last year and subsequent lawsuits over the company’s care. Metro Corrections officials, who have been reviewing two of the deaths for several months, said they did not pressure Corizon to let its $5.5 million annual contract lapse by missing a July 30 deadline to seek a renewal. Courtney Eller, a spokeswoman for Corizon, declined to answer questions about its decision, saying only that the company would help ensure a successful transition to the next provider. Metro Corrections Director Mark Bolton said he was surprised by Corizon’s decision, as it had indicated it would offer a proposal but, without explanation, chose not to do. Bolton, who had criticized Corizon staff’s handling of previous cases, said last week that the company had “put a completely new management team in place over the last year ... and I have been very, very happy with them.” A new provider would be chosen in the next 15 days or so from six companies that made proposals, he said. Corizon’s decision comes as three more lawsuits have been filed in recent months over deaths of sick inmates. The lawsuits contain claims that Corizon staff dismissed inmates’ complaints and were slow to put physicians on the case or take inmates to a hospital. The most recent lawsuit, filed in August in Jefferson Circuit Court, claims Samantha George was moved from the Bullitt County jail to Metro Corrections last August on a charge of buying a stolen computer. George told a Corizon nurse at the jail that she was a severe diabetic, needed insulin, and was feverish and in pain from an MRSA infection, according to the suit, filed on behalf of George’s mother. George said she could not even keep water down and a nurse asked an on-call jail physician whether George should be taken to the emergency room, according to jail records that were part of a police investigation. The doctor said he would see the prisoner the next day and that she should be monitored, according to the records. But there was a mistake with the paperwork for corrections staff to make regular observational checks, according to the police investigation. George’s condition worsened and she was refused medical treatment, the suit claims. The Corizon jail doctor never saw her despite promises he would check on her, according to the lawsuit, which names Corizon and Bolton as defendants. Theresa George, Samantha George’s mother, said she called had Metro Corrections and told them how serious her daughter’s condition was and that she had to have a shot every hour. “They said, ‘I’m looking at her right now and she’s fine,’” Theresa George said. “Four hours later, she was dead.” Samantha George was found unresponsive on Aug. 8, 2012, and she was pronounced dead a short time later at University of Louisville Hospital. An autopsy concluded she died of complications from a severe form of diabetes, compounded by heart disease. Problems with Corizon’s work came to light when Metro Corrections announced in December that six unidentified Corizon workers resigned amid an investigation by the jail that found that the workers “may” have contributed to last year’s deaths of George and inmate Savannah Sparks. The investigations of those deaths by the jail and prosecutors are ongoing, and Metro Corrections officials would not talk about specific details. Corizon officials also would not talk about specific cases. Just weeks after George died, Kenneth Cross arrived at Metro Corrections. An unidentified friend had been taking him to the hospital when he was pulled over by police, according to a lawsuit filed earlier this year on behalf of Cross’ estate. The suit claims officers believed Cross, who was arrested on a warrant for a drug possession charge, was faking an overdose and would get any help he needed at Metro Corrections. A nurse at Metro Corrections documented that Cross had “slurred speech” and fell asleep “several times during his interview,” according to jail records. Cross told the nurse he had only one beer that day and was fine. He was found unconscious hours later, according to jail records in the suit. Cross was pronounced dead a short time later. “Nodding off ... clearly should raise a red flag in the case of someone who was arrested for drug possession,” said Gregory Belzley, who represents Cross’ family. “Either hospitalize him or put him under very careful observation in which he is not allowed to go to sleep.” Cross, 43, died of a drug overdose, according to a state medical examiner. Bolton said there was no investigation into Cross’ death because there was “no suspicion of foul play” or other red flags. He declined to comment further on the Cross case. The commonwealth’s attorney’s office reviewed the case and sent it back to Louisville police. Dwight Mitchell, a police spokesman, said no charges were filed in the Cross case. In an email to his staff in December about the deaths, Bolton said, “Mistakes were made by Corizon personnel and their corporation has acknowledged such missteps” in terms of the deaths, according to records in the George lawsuit. Investigations by police and jail officials into the deaths of George and Sparks, who died from opiate abuse and withdrawal six days after arriving at Metro Corrections in April 2012, are still ongoing, Bolton said. Previously he had said he believed that Corizon medical staff took too long to have a company doctor look at Sparks and George. A wrongful-death lawsuit was filed in April of this year on behalf of Sparks’ grandmother, Karen May. Filed in Jefferson Circuit Court, it claims Corizon Inc. and dozens of Metro Corrections employees were negligent in treating Sparks, 27, while she was in jail on a theft charge. Her attorney, Brian Cook, declined to comment. Commonwealth’s Attorney Tom Wine, whose office reviewed six of the deaths, said the jail has made many improvements caring for ill inmates. A recent audit by a correction health consultant and accreditation report by the National Commission on Correctional Health Care both indicated improvements, including in the handling of inmates who are detoxing or diabetic. The new detoxification process, which includes a heightened awareness in monitoring inmates, is a “model program which should be presented at conferences and seminars,” according to the audit. Theresa George said she hopes her daughter’s death and the subsequent lawsuit will spur change. “That could be your child,” she said. “If we can change the way they treat people when they go to jail, that’s what I hope for.”

 

Feb. 3, 2013 The Courier-Journal

Karen May talked almost daily by phone with her granddaughter, Savannah Sparks, as the 27-year-old was detoxing from a heroin addiction while being held on a theft charge at Metro Corrections in Louisville, Ky., last April. “I thought she would get the care she needed,” May, 67, said in a recent interview. “I thought they would help her.” But on April 12, six days after arriving at the jail facility, Sparks died at University Hospital in Louisville from opiate abuse and withdrawal, according to the Jefferson County coroner’s office. Sparks’ death is one of five under investigation — along with a handful of cases in court — at least some of which involve allegations of inadequate inmate health care by employees of Corizon Inc., the Brentwood-based company that bills itself as the leading provider of correctional health care services in the country. After seven deaths in the jail last year and one in 2011, Metro Corrections is reviewing the practices of Corizon, whose $5.5 million annual contract is up for renewal at the end of this month. The company, which has jail contracts in 29 states, is facing other lawsuits in Kentucky from inmates and has come under harsh criticism elsewhere for providing inadequate medical care, allegations the company has denied. In December, Louisville Metro Corrections announced that six unidentified Corizon workers resigned amid an investigation by Metro Corrections that found they “may” have contributed to the deaths of Sparks and Samantha George, who died Aug. 8 of complications from a severe form of diabetes, compounded by heart disease. The investigations of those deaths by the jail and police are ongoing, and Metro Corrections officials would not talk about specific details. But Metro Corrections Director Mark Bolton said he believes that Corizon medical staff took too long to have a company doctor look at Sparks and George. Bolton said in an interview that if Corizon doctors had evaluated the inmates sooner, they may have been taken to the hospital more quickly. Jail staff sifted through medical records and found that there were delays in delivering medication and getting inmates to see a nurse and doctor. “The more we looked into it, the more disturbed I was getting as to some of the service delivery gaps in the health care of those individuals,” Bolton said. Officials with Corizon, which has started louisvillejailnews.com to address questions about its care in Louisville, said patients who need hospitalization receive it. “We have no incentive not to provide the hospital trip,” said Levin Jones, vice president of operations for Corizon. “There is no financial incentive to avoid it. None. ... The financial responsibility for all off-site care falls to the county.” However, when the company was renegotiating its contract in 2010, Corizon, then called Correctional Medical Services, touted its track record of saving the city money by minimizing inmate trips to a hospital. The company included a graph in its proposal showing that it had reduced inmate days in the hospital from 38 in 2007 to 20 as of late 2010. It reduced emergency room runs by nearly half. And it added that in 2008, 135 people arrested were diverted to the hospital emergency room before being admitted to the jail, which Corizon said prompted the fire department and EMS to request a review, as each trip is costly — an average of $855 per trip — time-intensive and often unnecessary. By 2009, after the medical staff was challenged to reduce emergency room visits, Corizon said, the number of calls for EMS to take inmates to the emergency room instead of being booked into the jail had dropped nearly 20 percent.

January 8, 2013 WHAS11.com
LOUISVILLE, Ky. (WHAS11) -- Changes have arrived at Louisville's Metro Corrections in the last several months and more will come in 2013 after the jail saw an unprecedented increase in deaths there. Seven inmates died while in custody in just seven months last year. WHAS11 first broke the story last fall and our I-Team investigation continues as families of two of those deceased inmates--Savannah Sparks, who died in April, and Kenneth Cross, who died in August--have hired attorneys. Sparks' family attorney, Seth Gladstein, said they have not filed a lawsuit but are considering one. Sparks' grandmother, Karen May, spoke exclusively to WHAS11's Bryan Baker about trying to find the answers surrounding her granddaughter's death, five days after she was arrested for shoplifting. Sparks was a 27-year-old mother of three boys and was addicted to heroin. May hoped the April arrest would help turn Sparks' life around. "She was going to check into the hospital again, and so when she called me and she said that she had been arrested, I thought, well, this will help her," May cried. "She'll be ok. (Five) days later they called me that she was dead, and they couldn't give me any answers." In Sparks' case  -- jail leaders told us it began with a "medical triggering event" in her cell. She died later at the hospital. The cause of death according to the death certificate WHAS11 obtained is "Complications of Chronic Substance Abuse with Withdrawal" even though she had been off the streets and supposed to be under supervision for almost a week. The man tasked with overseeing everything that happens inside the walls at Metro Corrections is director Mark Bolton. The seven deaths are the most in one year since he took over late in 2008. In some of those deaths Bolton tells WHAS11 drugs are factor even though the jail has an extensive inmate detoxification program funded by your taxpayer dollars.  "How do people die in the jail if they are under detox?" asked WHAS11's Bryan Baker of Bolton. "Bad things happen in jail, Bryan. We've got 2,000 inmates in here, most of whom don't take care of themselves," Bolton said. "Unfortunately we had some folks die in the hospital and there are folks that die in the jail. That's something that I don't like, that's something that we are trying to improve upon." WHAS11 dug deeper and found that medical attention Sparks and other inmates need is provided not by Metro Corrections but by a contractor.  Metro Louisville pays Corizon Correctional Healthcare $5.3 million dollars -- paid for by you, the taxpayer. Corizon is a Tennessee company, providing health care to inmates in more than 400 jails in 31 states, according to its website. We also found multiple wrongful death lawsuits filed against Corizon in the past two years, including one after an inmate's death in the Lexington-Fayette County jail in 2012, according to court records and media reports. Five Corizon employees resigned from their post at Louisville Metro Corrections from the top-down including supervisors, an on-site jail administrator and nurses after, according to a Metro Corrections release, their actions "may have may have contributed" to the deaths of Sparks in April and Samantha George in August. "There were some health care issues with these two inmates where there were some delays in being seen by the doctor, I think there were some delays in having some vital signs checked, and I think that these delays were more than what I would like to see regarding a reasonable level of healthcare in a corrections facility," Bolton said. According to the jail's own policy obtained by WHAS11 through public court records, if there are signs of withdrawal the inmate is supposed to be examined and transferred to the jail's medical unit. Severe or life-threatening symptoms shall send the inmate to the hospital. We asked director Bolton if those procedures were followed in the case of Savannah Sparks. He said he could not talk about open investigations but told us care for inmates is much more complicated. "They may report it," Bolton said. "They may not. Many times we don't even know what kind of drugs they're on or what their detox issues are. We deal with those folks everyday. What we are doing -- we are upping the ante. We are increasing our knowledge base, our resource base, and we're trying to prevent similar issues from occurring at the rate that they have been." After Bolton hired a consultant to review Metro Corrections Policy Corizon, a full-time detox nurse is on staff for the first time at the jail -- Bolton says at his request. He also wants a healthcare compliance monitor. Corizon declined an  interview and would not specifically address the inmate deaths but sent WHAS11 this statement: "At Corizon we are committed to providing quality health care services and we welcome the opportunity to work with an independent contract monitor who will assist Louisville Metro Corrections and Corizon in our ongoing efforts to continuously improve the delivery of health care services to our patients."

Dec 13, 2012 Courier Journal
Six people who provided medical care at Jefferson County’s jail have resigned after an internal investigation found they “may” have contributed to the deaths of two inmates earlier this year, Louisville Metro Corrections said. The six, whose names were not released, include nurses, supervisors and an on-site administrator. They worked for Corizon Inc., a private company in Tennessee that has a $5.5 million contract to provide medical care at the jail. Corizon bills itself as the nation’s leading provider of medical care for jails and prisons and serves about 400,000 inmates in 31 states, according to its website. It has come under harsh criticism in other states, however, for providing inadequate medical care to inmates, allegations the company has denied. Not much is publicly known about the circumstances of the two inmates who died in Jefferson County. Savannah Sparks, 27, died April 12 from opiate abuse and withdrawal, according to the Jefferson County coroner’s office. Samantha George, 27, died of complications from a severe form of diabetes, compounded by heart disease, the office said. They were among seven Metro Corrections inmates who have died in custody this year after only one such death in 2011. Corrections Director Mark Bolton said Wednesday that the health care of the seven who died — and all other inmates — is handled by Corizon employees, not Louisville Metro Corrections employees. He said jail employees may notify medical staff if they see a problem, but don’t oversee or direct any medical decisions. Bolton said routine investigations shortly after the deaths of the two inmates by the Louisville Metro Police were taking longer than usual and prompted him to open his own internal investigations. He said he looked at records and “concluded there were some delays relative to medical protocols.” “I felt it took too long to get these people in to see a doctor,” Bolton said. Louisville Metro Police spokesman Dwight Mitchell said the department could not comment on its ongoing investigation. Bolton said he believes that, if the inmates had seen a doctor sooner, they may have been taken to the hospital more quickly, but he didn’t know if that would have saved their lives. “That’s a tough question,” he said. “I have no way of knowing that.”

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

Manatee County Jail, Bradenton, Florida
Dec 21, 2013 heraldtribune.com

MANATEE COUNTY - It started with complaints of shoulder pain. The nurse at the Manatee County Jail gave the inmate, Jovon Frazier, Tylenol and sent him on his way. Not quite two weeks later, Frazier again completed an inmate medical request form, citing “sharp pain” in his left shoulder and concern about a possible fracture. “It really hurts! HELP!” Frazier wrote. Frazier was once again treated routinely and given some Tylenol. Later that month, on Aug. 26, 2009, Frazier submitted his third request for medical care. His vital signs were recorded. In the next two months, Frazier submitted a dozen more requests for care for his shoulder. eventually, he was taken to Manatee Memorial Hospital, where doctors found a mass, “most likely osteosarcoma.” Bone cancer. He was 19 when his arm was amputated, and just a couple of weeks past his 21st birthday when he died on Sept. 18, 2011. Now his family has filed federal and circuit lawsuits against the Manatee County Sheriff's Office, Corizon Health — a health care company contracted by the jail at the time — and Karen Worthington, the licensed practical nurse who saw Frazier on numerous occasions. The federal civil rights complaint filed in September, and amended in November, by Frazier's grandmother, Shirley Jenkins, alleges that “deliberate indifference” to Frazier's medical needs led to his untimely and wrongful death. The family did not wish to comment for this story. Attempts to contact their attorney, Bill Hutchinson, were unsuccessful. 'I need a doctor' Frazier was taken to jail in February 2009, charged with grand theft auto, possession of marijuana and cocaine and possession of a firearm and ammunition by a convicted felon. He pleaded no contest to the narcotics charges, and the other counts were dropped. He was released that following January, and arrested again on another drug charge in July 2010. He remained in jail through April 8, 2011. On Sept. 17, 2009, he had an X-ray completed at the jail that showed normal results — negative for a fracture. But the pain persisted. Eleven days later, he wrote on his eighth inmate medical request form: “I need to see a doctor! I've been having sharp pain in my left shoulder and I didn't need pills. I done put a lot of sick calls in and y'all keep sending me back and aint tell me nothing. I need a doctor.” Frazier was given more medication and an exercise for his shoulder. Another X-ray was done on Oct. 29, 2009, and a doctor suggested he would need an MRI. Frazier was taken from the jail to Manatee Memorial Hospital for additional tests. He had a “large soft tissue mass” on his shoulder, “most likely osteosarcoma,” the doctor wrote. In November, Frazier was taken to Moffitt Cancer and Research Center, where he later returned 13 times for treatment that included chemotherapy and amputation of his left arm.The cancer spread to his lungs, eventually causing his death in 2011. Motions to dismiss: The Sheriff's Office and Corizon Health Inc. earlier this month filed almost identical motions to dismiss. Both say that some of the time period falls outside a four-year statute of limitations, and that it is unclear what medical need went untreated. “The best Corizon can conjure is that its employees should have diagnosed Frazier's cancer or sent him to specialists in a more timely manner,” the company's motion states. The motions state that Frazier received medical care but his family disputes whether the treatment was adequate. Case law stating that “federal courts are generally reluctant to secondguess medical judgments,” is cited in both motions. The family's complaint alleges that staff made no attempts to determine the cause of the shoulder pain or to diagnose the condition before it was too late. Corizon's last point is that it cannot be held accountable for allegations against an employee without having an established policy that led to the alleged violation of constitutional rights. Similarly, the Sheriff's Office argues that a department employee is not accused of any wrongdoing, only a person hired by its contracted medical provider, relieving the department of any liability. The Sheriff's Office attorney could not be reached for comment. A representative for Corizon declined to comment, citing a company policy to withhold statements about pending litigations. Neither complaint lists a specific amount of money being sought for restitution, citing that the family has lost perspective of accumulated expenses resulting from the alleged delay or lack of adequate treatment.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

March 18, 2005 Tennessean
Yesterday should have been Ricky Douglas' 40th birthday. Rather than a day of celebration, it was the day Douglas' autopsy report was released, revealing for the first time that the diabetic Metro Jail inmate died after not receiving medicine to treat his illness, even after requesting it from his cell. His autopsy report follows a recent admission by the city's private health-care provider for inmates, Brentwood-based Prison Health Services, that the company made critical errors in providing care for Douglas in the hours before his death Jan. 19. Until yesterday, Metro officials had maintained that they did not know exactly what caused Douglas' death and were waiting for the medical examiner's findings to be released before placing blame. ''It does appear that there were individual failings in following policies, and you had this adverse result,'' said Bob Eadie, deputy director of the Metro Department of Public Health. ''Whatever consequences come from Mr. Douglas' death, Prison Health Services will be held accountable for those.'' On the night of Jan. 18, Douglas and several other inmates told a deputy that a nurse had failed to make her scheduled rounds to distribute medications. A deputy told the prisoners that the nurse would make her rounds later and continued his routine count. The Nashville man was found unresponsive in his cell four hours later, his face turned to the side, and his tongue protruding between his teeth. According to the autopsy report, Douglas' blood sugar soared at the time of his death. In a report issued last month, officials with Prison Health Services identified several errors with its process for handling Douglas' medical records and administering treatment for his illness. The company vowed to revamp procedures and retrain its staff. Under its contract with Metro government, Prison Health Services assumes liability in the event an inmate sues over a health-related problem. It was unclear whether Metro could be held partially liable because a jail deputy failed to do more to help Douglas in the hours before his death. Prison Health Services was the subject of a scathing series of articles in The New York Times last month, in which the company was accused of mishandling numerous cases involving prisoners in New York. The company's five-year contract expires June 30. Since Douglas' death, two other diabetic Metro inmates say they have been hospitalized with severe diabetic-related illness because they did not receive the correct amount of insulin.

March 6, 2005 Tennessean
Inmate Glen Lee uses a walker to make his way gingerly around the Metro Jail in Nashville. He's constantly groggy, weak, uncomfortable. That's a far cry from the man who walked in without assistance after his November arrest on theft and assault charges. What happened to Lee during the past three months is the subject of a recent internal review by Metro's Department of Public Health, aimed at determining whether systemic problems are denying diabetic Metro Jail prisoners the medical care they need. City officials said Lee has received appropriate medical treatment. But in a jailhouse interview last week, Lee claimed that a variety of missteps by jail medical staff left him in a diabetic coma and hospitalized for three weeks, leaving him fragile and concerned for his health. ''Somebody made a mistake,'' he said. ''But I don't know what it was and what was wrong.'' Lee's case marks the third in recent months in which a diabetic Metro Jail inmate or his relatives have alleged that jail staff failed to treat their disease properly. On Jan. 11, inmate Paul Burton III was hospitalized for three days in what he described as a diabetic coma and accused jail staff of giving him much less insulin than he was receiving on the outside. After his illness, jail staff increased his insulin levels, jail records show. Eight days after Burton was hospitalized, another diabetic inmate died in January, hours after requesting medical attention that he did not receive. An internal report by Prison Health Services, the private firm that contracts to provide medical care to inmates, found myriad errors with the care given to Ricky Douglas in the days before he died.
Lee, who also has a seizure disorder, claims that he fell into a three-day diabetic coma in early January after jail officials refused to give him the correct dosage of insulin and fed him an inappropriate diet. About two weeks after his arrest, he was hospitalized for about three weeks because his blood sugar reached 520, well above the 120 level required to keep him stable. Even before Lee's case, however, concerns over the cases of inmates Douglas and Burton had caught the attention of federal authorities, health advocacy groups and community organizations, who have contacted jail officials or the prisoner's families in recent weeks. FBI officials confirmed recently that agents have been talking with the Davidson County Sheriff's Office about the problems. Douglas' relatives said the FBI also has contacted them. Doug Riggin, special agent in charge of the Nashville FBI office, declined to discuss details of the FBI's involvement. The American Diabetes Association has been in touch with attorneys for Burton and Douglas, seeking information about their medical care at the Metro Jail. In the past, the ADA has been involved in other lawsuits to ensure proper treatment of diabetic prisoners elsewhere. Other cases: Glen Lee is the third Metro Jail inmate recently whose case raises concerns about the quality of medical care. The others: Ricky Douglas: Douglas died in custody Jan. 19. Four hours before that, he had asked a deputy for medical help that never arrived. In a recent report, the jail's health-care provider, Prison Health Services, found a number of mistakes in the care Douglas received. Sheriff's officials and health department officials have not released a final report on his death. Paul Burton:  Paul E. Burton III, 40, was hospitalized in a diabetic coma eight days before Douglas' death. Burton's Nashville attorney David Raybin says the inmate went into a diabetic coma after the jail's staff failed to give him enough medicine. After he returned, hospital physicians ordered Burton's insulin level increased tenfold.

March 1, 2005 Tennessean
The private company that provides medical care to Metro Jail inmates says its staff made critical errors before the death of Ricky Douglas, a diabetic inmate who died Jan. 19 after asking for his medication, according to an internal report released yesterday. In the report, an official at Brentwood-based Prison Health Services Inc., the nation's largest provider of health care in jails and prisons, described how a series of mix-ups and poor practices led medical staff to lose track of Douglas' medical history, improperly treat his diabetes, and ignore his requests for care. The report also details new procedures and additional training the company plans to implement in the hope of preventing similar problems. Douglas' family has retained the Memphis law firm led by Johnnie Cochran. ''Many of the things in this report support the position the family has been taking since this tragic incident first happened,'' said attorney Archie Sanders III, who is investigating the case for the family. ''It's clear that the prison health system failed Ricky Douglas and did not provide him with anything close to medical care.'' The findings also come amid reports of other health-care problems at the Metro Jail. Inmate Paul E. Burton III, 40, was hospitalized in a diabetic coma eight days before Douglas' death. Burton's Nashville attorney David Raybin says the inmate went into a diabetic coma after the jail's staff failed to give him enough diabetic medicine to treat his illness. The statements released in the internal report on Douglas' death run counter to previous statements made by Prison Health Services. In a January interview with The Tennessean, Ben Purser, ethics and compliance officer for Prison Health Services, said the company conducted an internal investigation into both incidents and believed at the time its employees did nothing wrong. ''The personnel at the Davidson County jail provided timely, effective and appropriate care,'' in both Burton's and Douglas' cases, Purser told The Tennessean. The new memo, by health administrator Norman Crawford and sent to Bob Eadie, deputy director of the Metro Health Department, indicates otherwise. Douglas was found unresponsive in his cell about 2:40 a.m. by a deputy. Four hours earlier, he and other inmates complained that a nurse had failed to administer scheduled medications, according to a report by the jail guard. The prisoners also asked for blankets. The deputy apparently continued his count without providing blankets or summoning the nurse, according to a report the officer filed. Douglas, who also had cerebral palsy, was booked into Metro Jail on charges of arson and assault. An internal probe after the Jan. 19 death of inmate Ricky Douglas found numerous problems with the medical care he received in the Metro Jail: Jan. 15 • A booking nurse ''did not see or acknowledge information'' on a medical booking document that indicated Douglas was a diabetic. • Sheriff's deputies and jail medical staff failed to notice that Douglas was wearing a hospital wristband until he was found dead, four days later. • A sheriff's deputy reported that two nurses checked Douglas for seizures in the hours after he was booked. They wheeled him to the clinic on a stretcher, but later told medical supervisors that they thought Douglas was faking. The nurses never documented Douglas' five-hour stay in the clinic. Jan. 17 • When Douglas asked for diabetes medication two days after arriving, a nurse could find no record in his file that he was diabetic. The nurse failed to check jail records, which would have shown that Douglas was having his blood sugar monitored. She later saw Douglas receiving treatment for a cut to his toe and figured he was receiving his diabetic medication. Those encounters were not documented by medical staff. Jan. 18 • On the day before Douglas was found dead, he went for a medical appointment with a doctor. Instead, a medical assistant told him his medical record was not available and she needed to reschedule his appointment after his health information was found. He left without being seen. There is no documentation showing the medical assistant rescheduled the appointment. Jan. 19 • Douglas was found dead in his cell at 2:35 a.m.

February 1, 2005 Tennessean
For the second time in a month, officials with the Metro Health Department and the sheriff's office were forced to answer questions yesterday about whether inmates are receiving appropriate medical care in the Metro Jail. Paul E. Burton III, 40, was hospitalized Jan. 11 in a diabetic coma after he requested higher doses of insulin than jail staff would provide, his Nashville attorney David Raybin said. Eight days later, another inmate with diabetes, Ricky Douglas, was found dead four hours after telling a deputy that he had not received his scheduled medication. His death remains under investigation. Raybin said the two situations together raise questions about whether prisoners are receiving adequate medical care from Prison Health Services, the private, Brentwood-based firm that contracts to provide health care to inmates. ''I don't see this is just a weird coincidence,'' Raybin said. ''I see this is a pattern based on other information I'm seeing.'' According to his lawyer, Burton had a doctor's prescription that he take 50 units of insulin twice a day. But when he was admitted to the jail, medical staff gave him just four units, Raybin said. He pleaded with jail staff for a higher dose, to no avail, Raybin said.
He complained to relatives that his arms were numb, he had severe stomach pain and was vomiting violently, said his sister, Jennifer Economy.

January 26, 2005 Tennessean
Police and health-care officials are investigating the death of a Metro Jail inmate who died last week hours after requesting medical attention that he never received, authorities said yesterday. Ricky E. Douglas was found lying on his stomach with one arm hanging from his bunk about 2:40 a.m. Jan. 19. Four hours earlier, the 39-year-old inmate — who had cerebral palsy and diabetes — had asked deputies about the whereabouts of the duty nurse. Douglas and several other prisoners said they had not received their scheduled medications.
Health care for Metro Jail inmates is provided by Prison Health Services, a private firm working under a $3.5 million contract with Metro government. The Health Department is conducting its own investigation into Prison Health Services' conduct. Health officials said it was unclear whether a nurse had made rounds in the hours before Douglas' death.

Miami-Dade County Jail, Miami, Florida
August 19, 2010 Miami Herald
After months of delays, two bitter rivals have emerged this week as the lone bidders in Jackson Health System's quest to privatize the healthcare of Miami-Dade's jail inmates. Miami-based Armor Correctional Health Services proposes to do the job for five years for $286.1 million to $365.6 million, depending on services provided. Tennessee-based PHS Correctional Healthcare's bid is $371.6 million to $466.4 million for the same time frame. Jackson solicited the bids hoping to cut the costs of jail healthcare, one of the ``unfunded mandates'' its executives complain was dumped on them by county commissioners. Even under the new structure, however, Jackson will still pick up the tab. In Broward County -- and most other places -- prison medical treatment is paid for by the sheriff's office. Jackson officials say it will take days to analyze the details of the hundreds of pages in the proposals, but one thing is certain: The two companies don't like each other and are mired in a courtroom battle over ethical accusations. For the past three years, PHS has been suing Armor in Sarasota County, accusing the Miami company of wooing the sheriff with meals and a fishing trip to get the contract. The sheriff awarded the no-bid deal to Armor on the day he announced his retirement. The judge in the case recently ruled that the former sheriff and Armor's former chief executive intentionally deleted files on their computers in violation of a court order. At the upcoming trial, the judge decided jurors could be told they can assume the destroyed information would have hurt Armor's case. Armor has faced other accusations of playing politics to get contracts, including in Broward County, but a larger issue is the quality of healthcare private companies provide to inmates. Howard Finkelstein, Broward's public defender, puts it this way: ``Armor is not worse than its competitors, and occasionally they're better. But in the end, they stink. . . . To sum it up, you don't want anyone you know to get treatment in their care. . . . For every dollar of treatment, it's $1 less of profit. So the incentive is not to provide treatment.'' PHS Chief Executive Rich Hallworth said Wednesday that the company's profit margin is small -- about 2 percent -- and the company believes ``in doing the right thing -- for the patients, for the client.'' Armor did not make an executive available for an interview. Its filing with Jackson notes its work in Broward won an award in 2009 from the National Commission on Correctional Health Care. Miami-Dade's costs are substantial. In fiscal 2008, Jackson spent $74 million handling a population of about 6,000 prisoners -- about $12,000 an inmate. In Broward, the sheriff's office reports it paid Armor $25.2 million in 2009 to treat a population of 4,600 to 5,100 -- averaging $4,900 to $5,400. Armor is owned by Jose Armas, a Cuban-American physician who has a group of medical companies that he reports have $600 million in annual revenue. Armor has 15 operations in Florida, Oklahoma and Virginia. It had $96 million revenue in 2009, with net income of $3.5 million. PHS is the largest subsidiary of America Service Group, a publicly traded company that earned $3.3 million on revenue of $606 million in 2009. It provides healthcare at 160 jails and prisons in 20 states. In fighting for contracts, the two companies have butted heads for years. Many of Armor's original executives were former PHS executives. In 2004, just a few months after it was founded, Armor won a five-year, $127 million Broward contract that PHS had once held. Miami Herald articles at the time noted that Armor had contributed $8,000 to then-Sheriff Ken Jenne's campaign and hired one of his close friends as its lobbyist. The BSO altered the bid requirements to make it easier for Armor, then based in Coconut Creek, to gain an advantage. Armor spokeswoman Yeleny Suarez said Wednesday the company viewed The Herald's coverage at the time as ``extremely biased.'' After Broward, Armor's business quickly expanded in the state. In 2005, Herald reporter Dan Christensen wrote that former Hillsborough County Sheriff Cal Henderson said that, shortly after he left office, Armor hired him as a consultant who then lobbied sheriffs in six other counties. One of those was Sarasota. After Armor won that contract in 2007, PHS sued Armor and former Sheriff Bill Balkwill, saying the company had unduly influenced him by paying for meals at a fine restaurant and taking him on a $748 Lake Okeechobee fishing trip. Balkwill and Armor have repeatedly denied wrongdoing. ``Armor has maintained and will show at trial that the case is really about a disgruntled losing bidder looking for someone to blame,'' Suarez said. In the Jackson bidding process, Armor appears to have an advantage because local companies often are given special consideration in bidding for county contracts if other factors are close to being equal. In this case, Armor has strengthened its local ties by subcontracting with two Miami-Dade clinics -- Borinquin Health Center in Miami to handle obstetrics-gynecology and Citrus Health Network in Hialeah to handle mental health. Miami-Dade Judge Steven Leifman, who has spent years working on inmate mental health and is a special advisor on inmates for the Florida Supreme Court, said Citrus has done ``a very good job'' for the past several years in diverting the mentally ill from jails to community programs. PHS' Hallworth said his Brentwood, Tenn., company has also subcontracted with some South Florida providers, including GEO Care, a Boca Raton provider of mental health services. He said Armor's bid may seem lower on the surface, but when details emerge, PHS will be seen as offering more value at a better cost.

Michigan Department of Corrections
February 21, 2010 Jackson City Patriot
Kenneth Rhinehart has known since he was convicted of first-degree murder in 1973 that he likely will die in prison. But he always expected to see a doctor when the time came. Rhinehart, 58, of the G. Robert Cotton Correctional Facility in Blackman Township, has irreversible liver disease and probably cancer, too. A prison doctor filed a request in September for a surgical biopsy, but Rhinehart is still waiting to see a specialist. He has no official cancer diagnosis, no treatment plan, no pain pills and no explanation for the delay. "The doctors up north found a mass in my abdominal cavity the size of a grapefruit. This will not go away," Rhinehart said. "I'm dying and I am in a lot of pain. I need them to do something." Treatment for inmates -- Sick inmates like Rhinehart often are transferred to the Jackson area because Jackson is the center of the prison health-care system. Medical advantages in Jackson include the state's only secure hospital unit for treating inmates, located on the seventh floor at Allegiance Health. Prison Health Services Inc., a national company based in Tennessee, runs medical services in Michigan prisons under a three-year, $326 million contract. No one at Prison Health Services would comment on Rhinehart's case, citing factors including his right to medical confidentiality. The company responded in writing to more general questions by saying cancer cases "are treated according to medical necessity and in compliance with Michigan Department of Corrections policies. Chemotherapy and radiation treatment may be part of this treatment regimen." PHS, which has had the Michigan contract less than a year, "is committed to providing quality health care in an efficient manner throughout the Michigan corrections system." How much care? -- It's a job filled with difficulties that begin with a debate over how much medical attention prison inmates deserve. Michigan cannot afford and does not intend to provide "the gold standard of care" to prisoners, said Corrections Department spokesman Russ Marlan. But Michigan must provide enough care to meet the standard of prisons without cruel and unusual punishment. "We try to be somewhere in the middle," Marlan said. "We try to provide good-quality care because that keeps the long-term health-care cost down." Critics often say medical care in prisons falls short. A study earlier in this decade — well before PHS had the contract — found more than 30 percent of Michigan inmates with cancer had their treatment interrupted, said Elizabeth Alexander, a Washington, D.C., lawyer active in inmate-rights cases. "I don't know why they don't treat people," Alexander said. "But there is a particularly terrible history of not treating cancer." Rhinehart has been in prison long enough to have some idea of how the inmates' view of the medical care has changed over time. "There were always a lot of complaints, but at least the guys were being treated," Rhinehart said. "They weren't crazy about the quality of the care, but they got care."

February 10, 2009 AP
Michigan has awarded a three-year, $326 million contract to a Tennessee company to treat prisoners with medical problems. A state board approved the contract Tuesday, which means the company currently overseeing prison health care will be replaced starting in April. Brentwood, Tenn.-based Prison Health Services will take over for St. Louis-based Correctional Medical Services. CMS has hired doctors and others to see Michigan prisoners for about a decade. But a year ago, an independent review found that most doctors, nurse practitioners and physician assistants were seeing too few prisoners a day. The review was ordered by Gov. Jennifer Granholm in 2006 after reports of inmates dying because of inadequate care.

Monroe County Jail, Monroe County, New York
The care provided by Prison Health Services was sharply criticized by the Commission of Correction in 2001 in its review of the circumstances surrounding the death of inmate Candace Brown. Brown died in September 2000 at the county Correctional Facility after her opiate withdrawal went untreated. The commission blamed Brown’s death on “grossly and flagrantly inadequate” medical care. This past May, according to court records, a settlement was reached after Brown’s daughter sued Prison Health Services and Monroe County officials. Prison Health Services agreed to pay $450,000 to Brown’s family. (Democrat and Chronicle, November 22, 2003)

Inmate Candace Brown's death has raised questions about the private company Monroe County lawmakers hired two years ago to run the jail's medical operation. In 1999, county lawmakers approved a three-year, $9 million contract that turned over the jail's medical services to Prison Health Services of Tennessee. Until then, county employees had provided most of the services. Sheriff Andrew Meloni had urged the contract even as jail medical personnel and union leaders warned that the company had a checkered past and would likely rely on less-experienced staff as a way to save money. A report released yesterday by the state Commission of Correction about Brown's death indicated that the county ought to reconsider whether the private company should continue running the jail's medical operation. (Democrat and Chronicle, March 30, 2001)

New York Department of Education
May 11, 2005 New York Times
State officials have opened an investigation into whether the corporation that provides health care for more than 100,000 inmates each year in New York City jails is violating state law governing medical services. The State Department of Education, which regulates the practice of medicine, is examining the terms of the three-year, $300 million contract renewal the city signed in December with the corporation, Prison Health Services. The inquiry will determine whether the contract complies with a state requirement that for-profit corporations providing medical services be owned and controlled by doctors - a law intended to prevent business considerations, like maximizing profits, from influencing medical decisions. Prison Health executives and the city officials who oversee the company's work say they believe that the contract is in compliance. But state education officials say the matter of who is in charge is a serious one, with grave repercussions for the well-being and survival of inmates, as well as the public health. The investigation, in fact, marks a renewed effort by the Education Department, which first began to look into the Tennessee-based corporation in 2001, after several inmate deaths in upstate jails staffed by Prison Health began to draw stinging criticism from the State Commission of Correction, which monitors jail conditions. The department's investigators concluded then that Prison Health was violating the state law, saying that company executives were ultimately responsible for medical decisions and profiting from medical services. The two agencies asked the state attorney general, Eliot Spitzer, to halt the company's operations in New York, but Mr. Spitzer's office has declined to investigate. Now, however, education officials have decided to look into the company's largest contract of scores across the country, providing medical and mental health care at nine city jails on Rikers Island and a 10th in Lower Manhattan. On April 20, Education Department investigators met with three state assemblymen, city health officials and Richard Rifkin, a deputy to Mr. Spitzer, to discuss Prison Health's legal status. The Assembly members at the session were Richard N. Gottfried, chairman of the Assembly's Health Committee; Jeffrion L. Aubry, chairman of the Correction Committee; and Ron Canestrari, chairman of the Higher Education Committee. Assemblyman Canestrari said Prison Health appeared to be in violation of the state law governing for-profit medical services. "My understanding is their structure doesn't comply with the law," he said in an interview last week. "There have been attempts to meet the legal standard, but they have fallen short." But company officials insist doctors are in charge of medical decisions. In New York City, Prison Health says it provides only administrative services to a doctor-run corporation, P. H. S. Medical Services P. C., that directs all medical care at Rikers. But that corporation is run by Dr. Trevor Parks, who is a regional medical director for Prison Health. State education investigators have called Dr. Parks's corporation a sham, and said that when they questioned him, he had only a vague idea of his role in it. Several Prison Health employees at Rikers said in interviews that Dr. Parks recently gathered a group of supervising doctors there and informed them that they were employees of his corporation. Dr. Parks declined to comment yesterday.

Northeastern New Mexico Detention Facility Clayton, New Mexico
Mar 17, 2013 abqjournal.com
A New Mexico inmate claims he got an overly long and intrusive rectal exam when he went to the prison doctor for a torn meniscus in his knee. And his complaint isn’t the only one. Eighteen inmates in two separate civil lawsuits claim they were fondled or given intrusive exams – even when they weren’t needed – by Dr. Mark E. Walden, the prison physician at the time. The claims that Walden used his position to sexually abuse inmates are being made by men incarcerated at prisons in Santa Rosa and Clayton. Both prisons are operated under contract with the state by the Boca Raton, Fla.-based GEO group, a firm that operates detention and re-entry facilities in Australia, Canada, South Africa and Britain, as well as the U.S. Walden was an employee of Corizon, a private contractor that provides healthcare services at over 349 correctional facilities across the country. The company, which is based in Tennessee, has a four-year, $177.6 million contract to provide prison medical services in New Mexico at both public and privately run prisons. Katie Curry of the McGinn Law Firm in Albuquerque, attorney for one group of prisoners suing Walden, GEO Group Inc., Corizon, prison wardens Erasmo Bravo and Timothy Hatch, and health administrator Sherry Phillips, said another attorney represents another 10 or so clients with similar complaints. “That’s who has come forward, but these guys move around a lot (to other prisons),” Curry said. “I can imagine there are others who are reluctant to come forward.” The lawsuit filed by Curry alleges at least 25 known victims. The New Mexico Medical Board is investigating Walden and, on Feb. 18, issued a notice of contemplated action. No hearing has been scheduled, but it is likely to take place in April or May, a board spokeswoman said. “As a matter of standing company policy, Corizon does not comment on any litigation. However, Corizon can confirm that Dr. Walden is no longer on staff,” said Courtney Eller of DVL Public Relations & Advertising in Nashville, which handles media inquiries for Corizon. GEO Group spokesman Pablo Paez said in an email that the company, as a matter of policy, “cannot comment on litigation related matters, but we can confirm that Mr. Bravo and Mr. Hatch are employed by GEO and Dr. Walden is not employed by GEO.” Walden, who is now working in a medical practice in Raton, did not return a call for comment. He also allegedly failed to use proper hygiene and disease prevention techniques by not using gloves when he examined inmates. Prison administrators and Corizon didn’t ensure that a third person was present to protect the integrity of the exams, according to at least one of the suits. The potential for sexual abuse and sexual misconduct toward inmates by prison employees is well-known institutional problem, the lawsuits say, and administrators have a duty to protect the inmates. Inmates often view reporting abuse as futile because of the humiliation and retaliation they risk and the prospect of losing access to medical services, the complaints say. Doctors have far greater social status than inmates, further exacerbating the imbalance, they say. GEO and Corizon should have known about the abuse through inmate reports and the perceptions of staffers such as nurses, “or kept themselves willfully blind” to it, according to Curry’s lawsuit. “Corizon and GEO did not encourage reporting or documentation of these incidents, and enacted no discipline or retraining of … Walden,” the lawsuit says. Curry said there was a written complaint about Walden by an inmate in September 2011, “and apparently nothing happens, so it’s literally like the Catholic church where they know something and transfer him someplace else.” She said lawyers know a copy of the complaint went to State Police and that GEO was made aware of it. Walden initially worked at the Guadalupe County Correctional Facility in Santa Rosa and was later transferred to the Northeastern New Mexico Detention Facility in Clayton. One of the consequences of the alleged abuse, Curry said, was that some inmates stopped going to see Walden, even though they needed medical treatment. The lawsuit says staff became suspicious after Walden was hired “based on observations including a sudden notable increase in volume of digital rectal exams being performed, unindicated digital rectal exams on young inmates (and) refusal by defendant Walden to have a third party present.” An inmate who went to Walden for urinary tract issues and had an examination that was “excessive and inappropriate” and conducted without gloves reported the incident and had a sexual assault exam performed in Santa Fe, which revealed two anal tears, according to the lawsuit. “Corizon and GEO did not encourage reporting or documentation of these incidents, and enacted no discipline or retraining of … Walden.” - McGINN LAW FIRM: A separate lawsuit filed by Frances Carpenter of Albuquerque on behalf of nine more inmates says the abuses began in 2010 and continued through July 2012 during both routine and “symptom specific” examinations. They included digital anal penetration and probing and stimulation of the genitals. One inmate who saw Walden with a request for hemorrhoid cream was told he need to be examined first, the lawsuit says, and during the exam was penetrated by the doctor’s “entire ungloved fist.” The inmate, who reported the incidents to prison officials, continues to have nightmares and anxiety related to the alleged assault. Both lawsuits, filed in 1st Judicial District Court in Santa Fe, allege negligent hiring and retention, civil rights violations, negligence and breach of contract. They seek unspecified compensatory and punitive damages. Meanwhile, the medical board is expected to set a hearing this spring based on allegations that Walden, during prostate exams on some 17 inmates, “touched or attempted to touch these inmates in an inappropriate, sexual manner.” The board notice says Walden was subject to a “corrective action” for incomplete medical records that led the Union County General Hospital to terminate his privileges, and he did not report it to the board. The notice also says Walden’s professional medical liability insurance was canceled and that he gave incorrect information about it on his license renewal in 2011. Inmates say routine exams turned into horrific assaultsSee PRISON on PAGE A9from PAGE A1Prison doctor accused of sex abuse; inmates claim assaults”Corizon and GEO did not encourage reporting or documentation of these incidents, and enacted no discipline or retraining of … Walden.”<quote_attribution>McGINN LAW FIRM

Orient Road Jail, Tampa, Florida
August 26, 2005 Yahoo
America Service Group Inc. announced that its subsidiary, Prison Health Services, Inc. (PHS), has been informed today by the Hillsborough County (Florida) Sheriff's Office that, as a result of a rebid process, it has not been selected to enter negotiations for a new inmate healthcare services contract scheduled to start October 1, 2005. The Company believes that Hillsborough County is negotiating with a Florida-based company for the new healthcare services contract. PHS' current contract with Hillsborough County, representing annualized revenues of approximately $17.0 million, expires on September 30, 2005.

May 21, 2004 Tampa Tribune
The pinkie on Sean Norbury's right hand sticks up at an odd angle. The bones running from that finger to his wrist are visibly displaced. He can't make a fist, hold a pen, throw a football or properly grasp objects. His hand swells and pain shoots through it. He blames the medical staff at Orient Road Jail. ``They just completely ignored me, didn't get my hand X-rayed or treated, and now I'm left with permanent damage.'' Norbury's ordeal began Oct. 3 when he got into a fight with a neighbor outside his mother's northwest Tampa home. When emergency crews were called to the scene, the paramedic who evaluated Norbury's hand said it was broken, Norbury said. Norbury was arrested and charged with aggravated battery. It was his first arrest. In the 24 hours he was in the booking unit, he repeatedly complained to guards that his hand was hurting and he needed a doctor, jail records show.
On Oct. 4, nurses noted that the hand was swollen, bruised and cut, records show. Four days later, a nurse made notes in Norbury's records that his hand was still swollen and ordered an X-ray. Norbury was told to keep his hand iced and elevated, but there is no evidence in records that an X-ray was done. On Oct. 10, Norbury's mother posted his $2,500 bail, and he was released. He went to the emergency room, where a doctor saw him less than an hour after his release. He acknowledges he was wrong to punch his mother's neighbor. He also said he expected better treatment from the jail. Prison Health Services has a $12 million, three-year contract to provide medical service for Hillsborough inmates. Norbury's complaint is the latest criticism of a jail health care system that has been receiving increased scrutiny. PHS has been cited by auditors in the past year for failing to provide adequate medical staff at jail infirmaries and not responding quickly enough to requests for medical attention. The company failed 15 audit categories and amassed $58,000 in fines.

Hillsborough sheriff's Col. David Parrish agreed Wednesday to consider creating a standard operating procedure for treating pregnant inmates in county jails. Hillsborough County Commissioner Ronda Storms peppered Parrish with questions during a board meeting, saying she was concerned about the death of a boy born in the jail on March 5. Inmate Kimberly Grey, 34, gave birth to the boy over an infirmary toilet.  The premature baby died before reaching Tampa General Hospital.  ``Those babies being born and being carried by those mothers deserve a fighting chance,'' Storms said.  Parrish said the death was not indicative of systemic problems. ``It was an anomaly,'' he said.  Storms said she wants Parrish to consider developing standard procedures for treating pregnant inmates. Parrish said he would take the idea to officials with Prison Health Services, the company awarded a $12 million, three-year contract to provide health care at the jail.  Medical records obtained by The Tampa Tribune and WFLA, News Channel 8, show that Grey complained for nearly 12 hours about labor pains and repeatedly asked to be taken to the hospital. Jail nurses gave her Tylenol and were performing the first pelvic exam when the baby emerged.   An investigation led to the firing of the supervising nurse. Two other nurses were reprimanded and asked not to return to work in the Hillsborough County jail system.  Prison Health Services made several policy and staffing changes after the baby's death.  (Tampa Tribune, April 22, 2004)

A former inmate who endured  a troubled pregnancy says substandard medical care at the Hillsborough County jail forced her into emergency surgery to repair a ruptured fallopian tube.  The allegation comes at a time when Prison Health Services, which contracts with the Hillsborough County Sheriff's Office to provide medical care for more than 4,000 inmates in the county's jails, is under investigation in the death of a newborn last month.  The second claim of poor jail medical practices involves Angela M. Cintron, 21, who was arrested Oct. 19 on drug and prostitution charges.  She said this week that her pregnancy was grossly mishandled by Prison Health Services nurses and doctors at the jail in December.  (Tampa Tribune, March 25, 2004)

Palm Beach County Jail, Palm Beach, Florida
January 28, 2007 Sun-Sentinel
A former Palm Beach County Jail inmate sued the jail's former healthcare provider and one of its doctors on Thursday, accusing Prison Health Services of negligence for allegedly denying him care for a medical condition, resulting in permanent injury. Stockbroker James Hirschfeld, who was in jail on a probation violation, says that he was denied medication to treat hyperparathyroidism and as a result suffered a grand mal seizure that caused him pain and suffering and bodily injuries. Hirschfeld now stutters, according to lawyer Robert Saylor. Prison Health Services spokeswoman Martha Harbin said patient confidentiality prohibits her from commenting on the case. Prison Health Services no longer has the contract with the jail.

October 11, 2006  Palm Beach Post
There was a pleasant surprise during Friday's disciplinary hearing for a doctor who in 2003 prescribed a blanket and Tums for an AIDS patient whose organs were failing. The doctor-dominated state medical board stood up for the profession and the public. The Florida Department of Health's recommended punishment for Dr. Edgar N. Escobar had not included suspension of his license. That rightly infuriated Roseanne Scarola-Bilello. Her husband, Patrick Bilello, was that AIDS patient. He was in the Palm Beach County Jail. Dr. Escobar worked for Prison Health Services, which at the time provided medical care at the jail. Ms. Scarola-Bilello called the proposed settlement an "insult." Rather than dismiss her, the board listened. One of the 12 doctors on the 15-person board called the failure to treat Mr. Bilello "terribly egregious." Dr. Escobar, who has settled other malpractice cases, admitted that he hadn't looked at the lab report on Mr. Bilello. So the board suspended Dr. Escobar's license, along with fining him $10,000. To practice again in Florida, he must earn his way back by passing a competency exam. Board members noted Ms. Scarola-Bilello's passionate testimony as a key factor in their decision. In fact, her presence shouldn't have been needed. Whatever the reason, medical justice was done.

September 5, 2006 Palm Beach Post
Kevin Coleman is putting his faith in the judicial system again. The last time he did that, he ended up in prison for 13 years, convicted of a murder he has maintained he didn't commit. "You never know which way it's going to go," Coleman said of his feelings about the court system and his pending lawsuit against Prison Health Services. According to the lawsuit, PHS misdiagnosed his diverticulosis as gas and treated him with antacids. Coleman required emergency surgery. His intestines had strangled a portion of his colon. Sections of both were removed. "Whether it's the truth or not, you never know," Coleman said of going back to court. Robert Harper, a Tallahassee lawyer who has sued PHS before, filed Coleman's lawsuit on Aug. 21. It has been almost two years since Coleman — sick and recovering from abdominal surgery — reluctantly agreed to plead guilty to a murder he said he didn't commit rather than go back to jail, under the care of PHS. "I said I'd rather die on the street than in there," Coleman said. "Just let me die on the street." Coleman's case grabbed headlines in 1992 after he refused a deal that would have set him free if he pleaded guilty to killing a man outside a Riviera Beach bar in 1991. Coleman, then 19 years old and with no criminal record, refused the deal, saying he was innocent and couldn't plead guilty to a crime he didn't commit. Although the case was weak and no physical evidence linked him to the shooting, a jury rejected his alibi that he was selling crack cocaine at the time of the murder. He was found guilty of first-degree murder and sentenced to life in prison. Coleman's conviction so outraged the local criminal defense Bar that prominent attorneys — including now-Public Defender Carey Haughwout — volunteered to handle his appeal. He won a new trial in 2004 after a judge ruled that the lead detective in the case had suppressed evidence. The judge called the investigation "shameful" and Coleman's conviction "a stain on this court." When Coleman returned to the county jail to await his new trial, he told PHS nurses that his stomach hurt. They said he had indigestion and gas and gave him antacids, according to the lawsuit. Coleman lost 30 pounds and couldn't eat. Finally, he was rushed to a hospital for surgery. Back at the jail, a penicillin-resistant staph infection was so rampant that the Palm Beach County Health Department threatened non-specific legal action against PHS if the company couldn't control the infection. Rather than return to jail and risk a staph infection and care by PHS, Coleman decided to do the unthinkable and plead guilty to the 1991 murder. The judge reluctantly agreed to accept the plea. Coleman was free. Two days after his release he visited a doctor. "If you weren't as young and healthy as you are, this would have taken you out," Coleman said Dr. Lloyd LaGrange told him. PHS eventually ended its contract in Palm Beach County and recently ended its contract with the Florida Department of Corrections. "We at PHS have not seen the lawsuit so we cannot comment," said Martha Harbin, a PHS spokeswoman. "However, we are proud of our track record of providing quality health care to patients. Our medical professionals work hard every day to deliver that quality care, and we are proud of the work they do."

February 12, 2006 Palm Beach Post
A former jailhouse doctor who ignored a critical lab report on an inmate who later died still practices medicine despite a year-old state recommendation to discipline him for gross malpractice. It has been one year as of Friday since the Florida Department of Health referred Dr. Edgar N. Escobar to the Board of Medicine, saying he failed to care adequately for Patrick Bilello, an inmate with complications of AIDS and Hepatitis C. "I am absolutely outraged," said Bilello's widow, Rosanne. "The public is out there not knowing they are being treated by him. Why is it taking so long to do anything?" Health Department spokeswoman Thometta Corzart said she did not know why Escobar has not been disciplined. Escobar received the lab report on Oct. 20, 2003, showing intense anemia and signs that 47-year-old Bilello's organs were failing, according to the department's administrative complaint. Escobar ordered antacid and an extra blanket for Bilello, who was in jail on burglary charges. Four days later, Escobar sent Bilello, who was struggling to breathe, to Columbia Hospital in West Palm Beach on a non-emergency basis. At the hospital, Bilello had five heart attacks and died. Escobar, in a sworn statement on April 29 in Bilello's lawsuit, said he did not look at the lab results on Bilello. "I just initialed and stamped without looking at the page," Escobar said. The administrative complaint said Escobar failed "to recognize the urgency of P.B.'s medical condition" and did not give him a proper evaluation or timely care. The jail's medical provider in 2003, Prison Health Services, hired Escobar despite five malpractice suits against him. Four ended in settlement. Escobar lost one at trial.

November 15, 2005 Palm Beach Post
If voters demand more information about a doctor or a hospital's mistakes and complications, but lawmakers disagree, patients will get - as three judges have determined - "an absurd result." That's the effect, as Palm Beach County Circuit Judge Jeffrey Winikoff correctly described it this month, of the Legislature's attempt to thwart Amendment 7. By a 4-1 margin, voters a year ago approved the constitutional amendment to make public records of investigations into "adverse medical incidents." In June, legislators limited those open records to cases only since the Nov. 2, 2004, vote. A patient seeking records from Nov. 1, 2004, or earlier would not be entitled to any information. Judge Winikoff's ruling affects only Rosanne Bilello's case against Prison Health Services, the Tennessee-based company that was providing medical services at the Palm Beach County Jail when Ms. Bilello's husband, Patrick, died in 2003. She says that her husband's pleas for medical help were ignored while he was an inmate. The doctor had been named a defendant in five prior medical malpractice lawsuits, including two that involved deaths, but those records had been blocked by the June law.

September 22, 2005 Palm Beach Post
It took 20 months, $15.6 million, the deaths of several inmates after receiving questionable care and an epidemic staph infection for former Sheriff Ed Bieluch finally to replace the private medical provider at the Palm Beach County Jail. To the benefit of jail and court employees, lawyers, contractors, inmates and the public, current Sheriff Ric Bradshaw is not as indifferent or incompetent with the new company. Just 10 months into its two-year, $20 million contract, Correctional Medical Services Inc. has been warned that Sheriff Bradshaw will not tolerate cost overruns and poor service. The sheriff invited a competing company to tour the jail last week and offer an "assessment." CMS had been told to expect an external auditor, not a competitor. But the unusual, if sneaky, tactic was effective. As Sheriff Bradshaw said, "We got their attention." CMS, low bidder last summer to replace Prison Health Services, contracted to spend $900,000 for care of inmates needing treatment at a hospital or clinic. Already, that cost has reached $3.3 million. Prescription-drug costs also are over CMS' budget. Not surprisingly, CMS blamed its predecessor for higher-than-budgeted expenses. "Quite frankly," a CMS spokesman said, "there were a number of cases left by the previous provider that needed to be addressed." There are other remnants of Prison Health Services' poor performance. Just last week, a circuit judge ruled that Rosanne Bilello could sue Prison Health Services, a former jail doctor employed by the company and the sheriff's office for punitive damages in the 2003 death of her husband, Patrick Bilello. Ms. Bilello says that while her husband was an inmate at the jail, he begged for medical treatment, but Prison Health Services ignored him. Other inmates had complained that PHS denied medications to patients, particularly drugs for psychiatric care. In one case, a county judge released a schizophrenic inmate after learning that PHS had failed to give him any medicine. So Sheriff Bradshaw is correct to not wait for things to get worse with CMS. Sheriff Bieluch hired CMS with more emphasis on cost than quality, refusing even to consider a bid by a Wellington-based team of doctors who missed the deadline by a mere seven minutes. Notably, he hired CMS just months before leaving office. Sheriff Bradshaw's attention to a new prospective bidder should remind CMS that the incumbent is replaceable.

September 21, 2005 Palm Beach Post
The health provider for county jail inmates could be in danger of losing its contract because of cost overruns. Jail officials fired a warning shot to Correctional Medical Services Inc. this month by announcing that external auditors would be examining its operation as part of a contract review. Instead of auditors, a team of executives from a competing health provider showed up at the the jail last week for a tour of CMS' operation. "We got their attention," Sheriff Ric Bradshaw said. CMS took over inmate health care Oct. 1 with a two-year contract for about $10.1 million a year. In just 10 months, the costs of sending inmates out for hospital and clinic care soared to $3.3 million. CMS is responsible for $900,000 of the costs under its contract. But during a full 12 months, the cost to the sheriff's office could reach more than $3 million. In addition, pharmaceutical costs slipped over CMS' contract ceiling, meaning the sheriff's office will pay about $326,000 out of its own pocket for inmate medications. CMS pays the first $800,000 for medicines. CMS blames the previous provider, Prison Health Services Inc., for the cost upsurge. CMS officials said they were surprised that the notice of a visit by "external auditors" turned out to be for executives from Armor, a competitor based in Coconut Creek in Broward County.

September 16, 2005 Palm Beach Post
Next month, it will be two years since Rosanne Bilello watched her husband suffer three consecutive heart attacks, then die. Patrick Bilello, 47, was a Palm Beach County inmate at the time, jailed on a theft charge. A doctor at the Palm Beach County Jail, in a sworn statement, has said he overlooked critical lab results that showed Bilello should have been immediately sent to a private hospital. This week, a circuit judge ruled Rosanne Bilello could seek punitive damages against Dr. Edgar Escobar and the company that employed him, Prison Health Services of Nashville. The sheriff's office, also a defendant, replaced PHS last year as the jail's health-care provider. The decision to drop PHS came after months of other inmates coming forward alleging the company was not providing medicines or adequate care to those incarcerated at the jail. Circuit Judge Jeffrey Winikoff said in Monday's ruling that there was a reasonable expectation for recovery of punitive damages in the case. "We believe a jury will see that the actions of all these defendants are so egregious it will want to send a message to the corporate parent of PHS that profits should not rule over the sanctity of human life," said Bilello's attorney, Gary Susser. In an August hearing, a PHS attorney contended PHS wasn't liable because its corporate office knew nothing of Bilello's treatment. Winikoff appeared skeptical. "Something certainly went wrong," the judge said. "The man died."

December 21, 2004 Sun-Sentinel
A man who was an inmate at the Palm Beach County Jail in 2001 filed suit Monday against the Sheriff's Office and Prison Health Services, alleging that he suffered permanent injury after jail staff denied him his epilepsy medication. Peter Ulchak, 57, was arrested in October 2001 on charges of selling prescription drugs, probation violation and driving under the influence, according to jail records. His lawsuit states that he informed jail staff of his epilepsy but the drugs were taken from him anyway. Over the next few days, the suit states, Ulchak suffered a series of small seizures but was ignored. On Nov. 12, 2001, Ulchak says he had a major seizure, which left him with a severely fractured hip.

October 13, 2004 Palm Beach Post
Providing health care at jails and prisons is a tough business. Inmates often are uncooperative and sometimes hostile. Medical records are hard to find. Substance abuse complicates treatment efforts. But none of this excuses the manner in which the Palm Beach County Jail's private medical provider, Prison Health Services, ignored Patrick Bilello in the weeks before his death last year. Bilello, who had a history of heroin abuse, also had HIV, hepatitis C, anemia, abnormally low blood pressure, pneumonia and heart problems. Yet he was in jail for 53 days without seeing a doctor. By the time he was examined, it was too late. PHS transferred the 47-year-old man to the emergency room at Columbia Hospital as a non-emergency patient. Bilello died there after his heart stopped five times. His widow, Rosanne Bilello of Palm Springs, is suing PHS and its corporate parent, America Service Group Inc., as well as two doctors — jail medical director Erin Cody and her interim replacement, Edgar Escobar — and Sheriff Ed Bieluch. PHS has fired Dr. Escobar but announced no disciplinary action. Sheriff Bieluch has fired PHS and hired its rival, Correctional Medical Services, the lowest bidder for a two-year contract that began Oct. 1. The case for firing PHS went beyond Bilello. Several inmates had died after receiving questionable care; judges ordered other inmates released to receive private care; and PHS was slow to respond to a persistent staph infection at the jail. PHS has contracts in 22 Florida counties, including St. Lucie, where the firm also provides health care at the jail. Palm Beach County prosecutors considered pursuing criminal charges and presenting the Bilello case to a grand jury. They pulled back, saying investigators had not uncovered sufficient evidence. Boynton Beach lawyer Gary Susser, who represents Ms. Bilello, said he was pleased with the depth of the PBSO's internal investigation, which confirmed that none of the jail's doctors saw Bilello. In statements to lawyers, Dr. Escobar admitted that he only stamped his name, initialed and dated a critical lab report that showed a dangerously low level of oxygen in the blood. Ms. Bilello and Mr. Susser repeatedly sent PHS letters, imploring the company to give Bilello all his medication. It took an order from Circuit Judge Kenneth Stern to force PHS to give him his medication three weeks before his death. Prosecutors may be waiting until the civil case uncovers more evidence to consider filing charges. But if 53 days of neglect, indifference and intransigence aren't enough to suggest criminal behavior, how many days does it take?

September 22, 2004 Palm Beach Post
Lying in the jail infirmary with a 1 1/2-foot incision in his belly and a warning sign about staph infections on the door, inmate Kevin Coleman decided to do something he vowed never to do — confess to murder in exchange for freedom. On Tuesday, all that stood between Coleman and the free world was a judge who vowed not to allow a person who claims he is innocent to plead to a crime.
"My obligation is to accept only pleas that I believe are in the best interest of justice," Circuit Judge Lucy Chernow Brown told Coleman, who stood in court Tuesday with tears streaming down his cheeks. "I don't accept a plea from someone who says, 'I'm an innocent person and I want to get out of jail.' " The turning point for Coleman came three weeks ago, when stomach pains he had been complaining about for weeks became unbearable. Jail health workers — who Coleman said had dismissed his complaints as indigestion — finally allowed him to see a doctor. Coleman was taken to the hospital with what seemed like a ruptured appendix. Surgery revealed that Coleman's intestines had strangled a portion of his colon, and segments of both were removed. Prison Health Services, the company that provides health care to inmates at the Palm Beach County Jail, is under investigation after an inmate died in October 2003. Coleman's father, Robert, said his son was scared by it all: "He doesn't want to take the plea deal, but (the jail) can't take care of him like a real medical doctor." Defense attorney Murrell was more direct: "How would you like to be in a facility with a public health notice stamped on the front door? How safe would you feel with an open wound that big?"

A bond hearing for Kevin Coleman was canceled Wednesday after Coleman was rushed to Palm West Hospital with a ruptured appendix.  Coleman had been complaining to jail officials for weeks about abdominal pain and was given antacids to treat it. Coleman's attorney, Donnie Murrell, said Coleman had emergency surgery Wednesday morning.  Murrell intends to file court papers to extend Coleman's hospital stay until his wound heals for fear of a staph infection that has plagued inmates at the jail for months.  Prison Health Services, the company that provides health care to inmates at the Palm Beach Detention Center, faces lawsuits and allegations of inadequate care. The company is under investigation in Missouri for its services at a women's prison where two inmates died.  (Palm Beach Post, September 2, 2004)

Ernesto Benavidez, a 35-year-old father of two from Greenacres, died in the Palm Beach County Jail on July 16, becoming the third inmate this year to die for medical reasons while in custody.  Benavidez, who was accused of drug trafficking, died from a massive pulmonary embolism due to deep vein thrombosis, the sheriff's office said. A blood clot had formed in his leg and settled in his lungs, filling them with fluid and stopping his heart.  Benavidez's wife, Nilda, said she did not know how her husband died but said he suffered from an infected cyst on his groin that the jail's medical provider, Prison Health Services, did not drain, as outside doctors had done with previous cysts.  Rodney Holliman, a regional PHS vice president, said the company's preliminary review found that employees followed protocol. PHS said it is investigating Benavidez's death and awaiting autopsy and sheriff's reports.  But William Amlong, a Fort Lauderdale attorney who represents Nilda Benavidez, disputes that.  "Mr. Benavidez was not a very sick man," Amlong said. "He was a man who was prone to cysts. People generally don't die of cysts. People, however, can die of neglect."  (Palm Beach Post, July 27, 2004)

The number of dangerous staph-infection cases doubled in the Palm Beach County Jail last month, leading county health officials to threaten to take the jail and its private medical provider to court if the outbreak isn't under control within two weeks.  Jean Malecki, director of the Palm Beach County Health Department, said Wednesday that her office will "review legal options" if Prison Health Services Inc. does not follow hygiene procedures to quell the spread of methicillin-resistant Staphylococcus aureus, known as MRSA. The same recommendations were made in April and May.  "This is a difficult outbreak," Malecki said. "We've seen it throughout the United States. You have to be very, very careful what you do."  Malecki said the spike in the staph strain -- which can be fatal -- is due to a failure to follow federal Bureau of Prisons guidelines written to control the infection. Health department teams found serious violations during inspections on June 24 and June 30, she said.  Malecki said her staff saw nurses failing to use gloves while examining inmates or failing to change gloves when examining different inmates; failure to provide liquid soap rather than bar soap; and inmates sleeping on torn mattresses that could harbor the bacterium.  Inmates also were seen laundering their underwear by hand and drying them on sinks or floors.  "PHS is aware that this practice impacts the MRSA situation," Malecki wrote in a letter sent Wednesday to sheriff's department and company officials.  (Palm Beach Post, July 8, 2004)

A nurse practitioner who cared for pregnant inmates at the Palm Beach County Jail abruptly quit two weeks ago, saying her pregnant patients weren't receiving adequate care from the jail's private medical contractor.
Nurse practitioner Debbie Ranes worked part-time at the jail for nine months, evaluating the medical needs of pregnant inmates. She said she quit April 24 because she feared her state nursing license would be jeopardized should something happen to one of her patients. A perinatal specialist, Dr. Ruel T. Stoessel, also quit his job at the jail last month. Stoessel's office said he had no comment. Neither has been replaced.  The nurse joins a number of critics of Prison Health Services Inc., the medical provider at the jail. The company has been accused by some inmates and their families of failing to provide adequate medication and treatment.  In January, a federal court jury awarded $500,000 to a former Broward County inmate who spent three weeks in severe pain and nearly died from a tubal pregnancy misdiagnosed as constipation and pelvic inflammation.  The award was against EMSA Correctional Care, a sister company of Prison Health Services that previously held the contract in Palm Beach County.   A defendant in the case, which is being appealed, was Dr. Erin Cody, now the physician in charge at Palm Beach County.  Prison Health Services is facing two wrongful-death lawsuits from families of inmates in Palm Beach County.  (Palm Beach Post, May 9, 2004)

Katrina Mueller's mother and father thought she was safe, at least -- off the streets and out of reach of heroin and crack cocaine. She had two artificial heart valves, and she'd said something didn't feel right in her chest, but there were doctors and nurses around the clock at the Palm Beach County Jail, so how dangerous could it be?  They found out at 6:30 on a Sunday night in April 2002. The phone rang just as they got home from their afternoon tennis game.  "I hope you're sitting down," said the voice on the other end of the line.  Katrina, middle daughter of Karl and Maureen Mueller, had died of a heart attack, six days before her 40th birthday. The Muellers have given notice that they intend to sue, alleging the jail's private medical contractor, Prison Health Services Inc., caused her death by interrupting the blood-thinning medicine she needed daily.  The medical examiner's report says she died of "embolic complications" -- blood clots clogging the artificial valves surgically implanted a year earlier.  "She received no medication for seven days after being incarcerated in February 2002, and then she received no medication for the entire month of March 2002," Boynton Beach attorney Gary Susser said in a notice sent April 5 to Sheriff Ed Bieluch.  "This medication (Coumadin) had been prescribed to her by her cardiologist and had to be taken every day by Katrina Mueller for the rest of her life," the notice said. "The failure to properly dispense her prescribed medication cut her life short."  (Palm Beach Post, April 18, 2004)

An outbreak of highly contagious staph infections at the Palm Beach County Jail has raised new questions about the performance of its medical provider and also the administrative oversight of Sheriff Ed Bieluch.  The county health department has confirmed 339 cases of infections from the antibiotic-resistant bacteria known as MRSA (methicillin-resistant Staphylococcus aureus) since September. One was an assistant public defender who works at the main jail courthouse. Attorneys have complained about seeing open sores on inmates. Last week, Prison Health Services, which has the medical contract at the facility, ordered a ceiling-to-floor scrub-down with a bleach solution to counter the spread of the staph. A newly installed glass partition also will separate inmates during court appearances.  Despite health department advisories to culture all wounds to ensure proper diagnosis, some infected inmates claim the jail was dismissing their problems as spider bites as late as February. The assistant public defender, Carol Bickerstaff, has complained that jail officials didn't warn her about the outbreak. Sheriff Bieluch has insisted that his office took the problem seriously and responded appropriately. But the scope of the infections and the complaints from public officials suggest otherwise.  PHS, which also has contracts with one state prison and jails in St. Lucie and 18 other counties, has a record that invites skepticism. Sheriff Bieluch's office investigated the company for failing to provide adequate treatment to an HIV-infected inmate who later died, and a grand jury is considering the case. The Florida Attorney General's Office is looking into PHS over $3.25 million in disputed Medicaid billings. The company is facing more than 1,100 lawsuits nationwide, some of them inherited with the takeover of EMSA Correctional Care Inc., another provider. Most cases allege denial of medicines or treatment for inmates. One former Palm Beach County inmate, for example, claims he lost his eyesight because jail officials denied him treatment for glaucoma.  Sheriff Bieluch runs the jail, but the county commission has budgetary oversight and ultimately has responsibility for what goes on there. Commissioners have to take a hard look at the performance of PHS and the sheriff in providing medical care for inmates, and in ensuring the safety of the facility's visitors and employees.  (Palm Beach Post, April 9, 2004)

Inmate grievances obtained by The Palm Beach Post show just how powerless those incarcerated at the Palm Beach County Jail are in trying to get their medication. • David Bradley of Boynton Beach, in jail as a habitual traffic offender, complained on March 18, 2003, that he needed his psychotropic medications to protect him from "severe violent psychotic thoughts of homicidal dreams and visions."  Irene Moodie, health services administrator for Prison Health Systems, wrote on the response sheet: "The psychiatrist will not prescribe medications until you address and deal with your drug issues and dependence. He will not add more chemicals when you continually abuse chemicals. Address your drug dependence." • Robbery suspect Frank W. Hughes of Fort Walton Beach was taking several medications for depression and was hearing voices in his head before his arrest. In an October grievance, he said it appeared he had to hurt himself to get treated.  "In other words, you are willing to let the situation get progressively worse before you are willing to take any action. Why?" he asked. • Keith Tribble of Delray Beach, arrested on a robbery charge, complained in October that he had not seen a psychiatrist for five months and needed an adjustment of his medications, which included Thorazine. Moodie responded: "You may think you can practice medicine, but while you are in the jail, the licensed providers will prescribe the appropriate medication." • Not included in the grievances but illustrating one of the more graphic incidents of inmate desperation, prisoner Alfred Sica bit his own arm in a psychotic fit in 1995 after being denied psychiatric medication. The bite went untreated and became septic, spreading infection through his body. Sica ended up near death, curled in a fetal position his cell, according to court documents.  "He was literally dying, and he asked somebody to tell his mother that he loved her, and that's when they finally brought in the paramedics," said F. Kendall Slinkman, Sica's attorney. "If you have ever seen a cadaver, that's what his arm looked like."   Sica sued EMSA, which settled with him under confidential terms.  (Palm Beach Post, April 5, 2004)

After years of using cocaine to escape from the chaos in his head, Guy Giovia finally seemed to be getting his life under control.  Giovia, who turned 39 Thursday, was diagnosed as bipolar two years ago, at last putting a name to the dark depressions and manic episodes that had tormented him since his brother died of leukemia when they were young. Buoyed by therapy and medication, he started a construction company. He had a new home. He got engaged.  But under stress, he gave in to the disease and turned again to his favorite self-medication -- and got caught.   Giovia soon found himself in a common predicament for mentally or physically ill people who wind up behind bars in Palm Beach County: All his medications were cut off immediately, and a doctor for the jail's medical contractor, Prison Health Services Inc., overruled the diagnosis of bipolar disorder by outside specialists and gave Giovia a new diagnosis -- "mood disorder" -- and put him on Prozac and trazadone, widely used antidepressants.  Nationwide, Prison Health Services and its corporate parent, America Service Group Inc., face more than 1,100 lawsuits, most by inmates or their families alleging inadequate care. The Brentwood, Tenn.-based company reported $580 million in revenue and $11.9 million in profit last year from contracts with 330 jail and prison facilities across the country. Its current 20-month, $15.6 million pact with the Palm Beach County Sheriff's Office ends Sept. 30.   Prison Health Services and other companies that receive contracts to provide inmate health care function like HMOs. They get a basic fee and make their profit by holding down costs as much as they can.  Jean Reid, a former psychiatric nurse at the Palm Beach County Jail for four years, said staffing was cut and use of more expensive medications was discouraged after former Sheriff Richard Wille retired in 1995 and EMSA was totally in charge of psychiatric care.  "EMSA had a budget, and they wouldn't go over that budget," Reid said. "Then it kind of went from bad to worse."  Withholding medications continued when Prison Health Services took over in 1999, according to former jail nurses and grievances filed by inmates.  (Palm Beach Post, April 5, 2004)

By the time the open sore appeared on Robert McGrath's back at the Palm Beach County Jail, officials there already knew an outbreak of highly contagious staph bacteria was running through the cellblocks. Still, McGrath said, jail medical personnel told him on Feb. 9 that it was only a spider bite and not to worry about it. Then it swelled to the size of a softball, with an open pit the size of a quarter.  "This thing felt like there was a knife in my back," said McGrath, who spent 38 days behind bars for driving repeatedly on a suspended license. "Let me tell you, this is no bite."  McGrath, of Boynton Beach, is one of a growing number of inmates at the county jail diagnosed with staph infection, according to documents.  As health and jail officials try to get the outbreak under control, inmates such as McGrath say they are being released with the infection. McGrath was released from jail March 10.    A former nurse practitioner at the jail, who asked to remain anonymous, said she alerted Dr. Erin Cody, the physician who runs the medical unit, that the open sores appearing on inmates late last summer were not spider bites. The sores were hard and large with white or black centers, and four cultures she had done came back from the lab as MRSA.  "Her exact words to me were that 'We don't need to do any more cultures because the cultures are not accurate,' " the former employee said. "I have no idea what she was talking about."  The nurse practitioner left the jail recently because she said she was fed up with inadequate medical care there.  Lawrence Pomeroy, senior vice president for Prison Health Services, the medical contractor at the jail, said there is no record of MRSA cultures being done at the jail in late summer.  The county health department advised Prison Health Services to start doing wound cultures in December. The county has since provided "background" assistance.  "We continue to work closely with the health department identifying and treating any cases," Pomeroy said. "This is not a jail medical issue per se. This is a national public-health issue that's not confined to Palm Beach or any other jail."  But the nurse practitioner joins a growing number alleging that Cody is not providing adequate medical treatment to inmates.  Cody and Prison Health Services are both under investigation by the Palm Beach County Sheriff's Office in the October death of an inmate with hepatitis and HIV. A grand jury is hearing the case.  Cody has been a defendant in at least four lawsuits when she was medical director at the Broward County Jail for Prison Health Services and its predecessor, EMSA Correctional Care.  In January, a federal court jury ruled against Cody and EMSA, awarding $500,000 to a former Broward County inmate who nearly died of tubal pregnancy.  Cody could not be reached for comment.  Prison Health Services, owned by America Service Group of Brentwood, Tenn., has contracts at jails in Palm Beach, St. Lucie and 18 other counties in Florida. Prison Health Services is under investigation in two other cases.  The Florida Attorney General's Office is looking into Prison Health Services over $3.25 million in disputed Medicaid billings.  Prison Health Services also is under investigation by sheriff's officials in Hillsborough County in the death of an inmate's newborn on March 5. The inmate gave birth to the premature baby after complaining for 12 hours of extreme back pain and that she was leaking amniotic fluid.  (Palm Beach Post, March 28, 2004)

Stafford Wilder served 10 months behind bars for beating his wife, but he left the Palm Beach County Jail under a lifetime sentence for which there is no appeal or pardon: blindness. In a lawsuit against the jail's private medical company, Wilder says he complained time after time about increasingly blurred vision, but the medical staff never examined, diagnosed or treated him for the glaucoma that destroyed more than 90 percent of his sight before he was released in February 2003. "I put in 26 medical request forms, four or five of them specifically for my eyes," Wilder said in an interview at the state Rehabilitation Center for the Blind in Daytona Beach, where he's been learning to live with his disability. "They kept saying they were going to refer me to (a doctor), but it never happened." Wilder, 51, lived in West Palm Beach and earned his living as a truck driver before losing his sight. In October, he filed a lawsuit in Palm Beach County Circuit Court against EMSA Correctional Care Inc., the company that held the jail medical contract before being bought and absorbed by Prison Health Services Inc. Prison Health Services is a subsidiary of America Service Group Inc., based in Brentwood, Tenn. The parent company reported $580 million in revenue and $11.9 million in profit last year from contracts with 330 jail and prison facilities across the country. The combined companies face more than 1,100 lawsuits nationally and announced last month they were under investigation by the Florida Attorney General's Office over $3.25 million in disputed Medicaid billings. The sheriff's office also is investigating PHS because of the October death of inmate Patrick Bilello, 47, a hepatitis and HIV patient. Bilello's family and lawyer say medical staff denied and delayed treatment until he was so anemic and emaciated that his heart failed. They have given notice they intend to sue. (Palm Beach Post, March 22, 2004)

The company that provides medical care to Palm Beach County and St. Lucie County jail inmates says it made a profit of $11.9 million last year -- and that the Florida Attorney General wants it to repay $3.25 million in wrongful Medicaid claims. America Service Group Inc. told stockholders three weeks ago that its subsidiaries, Prison Health Services Inc. and EMSA Correctional Services, were under investigation for Medicaid billings going back to 1998 and that the outcome could have a "material impact" on its financial status. (Palm Beach Post, February 25, 2004)

An outbreak of highly contagious staph infection at the Palm Beach County Jail -- which affected 54 prisoners at one time in November -- has caused jail officials to isolate inmates. Jail officials are isolating about 18 inmates from the general population at the jail, officials say. Staphylococcus, a germ carried on the skin of healthy people, is not unusual in dirty jails where hygiene is questionable. But once it starts settling in wounds, it can spread quickly, according to medical experts. "My leg where I was bit by this... phantom spider we'll call it, was twice the size of my other leg, swollen red and I could hardly walk," wrote Clinton Walker on Oct. 22. Walker was in jail on drug charges. PHS came under fire by families of former inmates who said their loved ones died because of lack of medical care at the jail. PHS denies the accusation. (Palm Beach Post, February 18, 2004)

Philadelphia Prison System, Philadelphia, Pennsylvania
February 12, 2013 philly.com
CITY COUNCILMAN Jim Kenney is demanding that someone from the Nutter administration testify at his hearing on the city's prison health-care contract and is threatening to subpoena the city or withhold funding from the Law Department if the city doesn't cooperate. In a letter to City Solicitor Shelley Smith on Friday, Kenney said that he was "prepared to use all resources and powers available to me as a councilperson" to compel the city to answer his questions about why Corizon Health - fined for violating the city's minority-contracting rules last summer and frequently criticized for poor care - is getting a new $42 million contract. Kenney's letter came after the Daily News reported that the city will not provide a witness for the Feb. 27 hearing. Responding to questions from an attorney representing a Corizon competitor that lost out on the contract, Smith wrote in January that she would look into his complaints. In the meantime, she wrote, the city would not make anyone available for Kenney. Smith declined to comment for this story. "We will respond directly to Councilman Kenney on this issue and not through the Daily News," she wrote in an email Friday. Kenney, in his letter, wrote that "City Council, the inmate population, as well as the public at large, have a right to know how a vendor who fraudulently benefited from laws established to assist legitimate minority-owned businesses, is awarded a contract over a legitimate minority-owned local business." The administration said that the other vendor, a smaller company called Correctional Medical Care, was deemed inadequate to care for 8,600 city inmates.

January 09, 2013 By Sean Collins Walsh The Philadelphia Daily News
PHILADELPHIA, Pa. — Philadeplphia's prison system is set to renew its contract for providing inmate health care with a company that last year was found to have violated the city's minority-participation requirements and has been accused of neglecting patients in many states. Corizon, the largest prison health-care company in the nation, recently agreed to a new $42 million year-to-year deal for Philly's prison health care beginning in March, although the contract has not been finalized. Now, before ink has touched paper, a councilman is asking why the city is still doing business with a questionable firm, and a rival company is asking why it didn't get the job after offering to do it for less. In July, Corizon agreed to pay the city $1.85 million after an investigation found that the company was using a sham female-owned subcontractor to say it met city requirements for participation by firms owned by minorities, women or disabled people. Corizon declined to comment. Mayor Nutter's spokesman, Mark McDonald, said that the company has reformed its practices for minority participation in Philadelphia and elsewhere. He added that the prison health facilities have maintained national accreditation under Corizon. Councilman Jim Kenney on Tuesday asked the city to delay signing the contract so that Council can hold a public hearing on the issue. By using a renewable one-year agreement, and not a longer-term deal, he said, the administration avoided having the contract reviewed by Council. "This is a way to get around City Council," Kenney said. "It's all being done behind the door." McDonald, however, said that renewable contracts are standard and allow the city to better manage the vendor. The new contract originally was to begin last September, but was pushed back six months so that the city could evaluate Corizon after resolving the settlement, McDonald said. Correctional Medical Care, a Corizon rival owned by a woman, said that it placed a bid that would have cost the city $3.5 million less per year and couldn't have started on the original date. Its lawyers now are asking the city why it went out of its way for Corizon when CMC was ready to go. McDonald said that CMC's offer, although cheaper, was "deemed not to be up to the standard of care of the prison system." The Philadelphia Prison System, which has about 9,000 inmates, did not return requests for comment. Corizon donated $1,000 to Mayor Nutter's campaign committee in April, according to city records. Prison Health Services, which merged with another company to form Corizon in 2011, had donated $5,000 to Nutter in 2008. PHS also had given Kenney $1,000 in 2010 and $500 in 2007. Corizon has run into serious issues in recent years, including a class-action lawsuit on behalf of Idaho inmates that alleged extreme cases of negligent care over 30 years. The Tennessee-based company also has been probed in Vermont and other states.

August 28, 2012 Philadelphia Daily News
TONY WILLIAMS felt his leg snap when he jumped off a top bunk in a Philadelphia prison cell two years ago and landed awkwardly on the concrete floor. But a prison doctor called the injury a sprain and sent him back to his cell. That misdiagnosis of a broken leg was just the beginning. Williams, incarcerated for a parole violation, was made to wait weeks for treatments, didn't receive rehabilitation after surgery and was repeatedly ignored when he complained of pain, according to a suit he has filed against the city and Corizon, a for-profit private firm that provides health care to the city's roughly 9,047 inmates. "Trying to see a doctor is like trying to get out," said Williams, 30, who needs a brace and a cane because his leg didn't heal properly. According to a doctor's review ordered by his attorney, Williams' injuries are "both serious and permanent." Williams is one of many who have filed suit against Corizon - a Tennessee-based firm formerly known as Prison Health Services - over the years. But city officials say they are satisfied with the service. And Corizon is looking to keep its multimillion-dollar contract, which recently expired, with the city. "We do offer the same range of services someone would get in the community," said Prison Commissioner Louis Giorla, who said he didn't know the particulars of Williams' case. "In correctional health care, the level of complaints is very high." Corizon last month paid a $1.8 million fine to the city for allegedly skirting minority-participation guidelines, but worked out a deal that preserved the right to bid on contracts. The previous contract expired, but the city granted an extension to Corizon while it seeks bids. Giorla said the new contract will be issued soon. A spokesman for Corizon declined to make anyone available for an interview, saying in a statement that the firm wanted to stay out of the media during the contracting process and does not comment on pending litigation. "What we can say is that our caregivers work hard every day to provide quality, compassionate care to our patients in the Philadelphia Prison System," spokesman Brian Fulton said. Since 1995, the firm has been paid $196 million by the city for providing medical and pharmacy service. That includes hiring doctors and nurses, assessing inmates, doing sick calls and providing medication. The local complaints over Corizon - which provides prison health care to 345,000 inmates in 29 states - are not unique. A recent court-ordered report in Idaho blasted Corizon, saying a poor quality of care constituted "cruel and unusual punishment" - allegations the company disputed. Attorney Geoffrey Seay, who represents Williams, said he has seven current or pending suits against Corizon and the city. "There is a pattern of negligence," he said. "They're not getting the proper evaluation, the proper treatment." The city has paid out at least $1 million since 1995 to settle suits brought by former inmates over medical care, according to the city law department. Among the biggest settlements was $300,000 paid to a man who never received needed eye surgery while in prison and went blind in one eye. When a suit is settled, Corizon typically pays additional damages to the victim, the city said. Corizon's contract with Philadelphia was terminated for several months in 2002 after complaints from prison advocates about a diabetic inmate, who died in 2000 after missing insulin treatment. But the city ultimately signed with Corizon again, citing affordability and pledging oversight. Experts agree that prison health care is a challenge that requires catering to a growing population that often has serious health concerns like chronic illness and drug addiction. Ballooning costs have led many cities and states to outsource health care. But prison advocates caution that you get what you pay for. "I think we need to start with the proposition that if it sounds too good to be true it probably is. The private providers say they can do the same job, do as good a job, save money and generate profits for their shareholder," said David Fathi, director of the American Civil Liberties Union National Prison Project. "If they're going to try to do it more cheaply and at the same time generate a profit, they are going to cut corners." Officials said that outside monitors visit the prisons twice a year and that the facilities meet national accreditation standards. Bruce Herdman, chief of medical operations for the prisons, said the full-time medical staff makes 145,000 sick-call visits every year. Still, former inmate Lisa Holland says she didn't get adequate treatment during a recent jail stint. Holland, 46, was arrested July 12 on drug charges. Seay, who also represents Holland, said she is innocent but got taken into custody because her son was arrested for drugs. When Holland was arrested, she wasn't permitted to take a dose of the morphine she needs to manage severe pain she has struggled with since a 2000 car accident damaged her spine and crushed her leg. By the time she got to prison, she was in severe withdrawal, vomiting and defecating. She said it was four days before a doctor sent her to the hospital. "Every shift, every person I asked to take me to the hospital. I laid on the floor soiling my clothes," said Holland, who plans to sue Corizon and the city. "They treated me like a dog. They made me feel terrible." Giorla said the prisons deal with a large number of substance-addicted people who experience withdrawal. He said inmates receive a medical evaluation to see if they need medications. "If it's therapeutic and it's necessary and there's no substitution, we'll provide it. If it's not necessary, we won't provide it," he said. Civil-rights attorney David Rudovsky said private health care in prisons requires substantial oversight. "Whether it's Corizon or [Prison Health Services] or a new provider, in my experience, the problems of inadequate medical care [will continue] unless the city provides an adequate amount of money, the provider has some integrity, and there's some very detailed oversight," he said.

July 26, 2012 Miami Herald
Florida prison vendor agrees to hefty fine in Pa. case The company awaiting final approval from Gov. Rick Scott's administration to privatize health care services for most Florida prison inmates has agreed to pay a $1.85 million fine in Philadelphia for skirting minority contracting requirements. The vendor, Prison Health Services, now known as Corizon Health, is accused of falsifying official documents and federal prosecutors are looking for evidence of mail and wire fraud. News accounts in Philadelphia newspapers report that the city's inspector general, Amy Kurland, as describing the arrangement as a classic "pass-through" in which health care for city jail inmates was subcontracted to JHK Inc,., a female-owned business in Indiana that handled pharmaceutical supplies. The company said it had permission from prison employees for the arrangement. Philadelphia Mayor Michael Nutter called the city's settlement with the company"a significant moment that sends a very, very strong message to everyone who does business with the city," the Philadelphia Inquirer reports. As the story was breaking in Philadelphia, Scott's Department of Corrections was formally asking the Legislature for approval to shift $58 million in health care funds across categories so that it can hire Corizon and a second private vendor, Wexford Health Sources, by January 2013.

Pinellas County Jail, Pinellas County, Florida
April 8, 2008 Tampa Bays 10
"We're talking my life here!" That's what Pinellas jail inmate Roy Daffron is saying about the medical treatment he says he is receiving. Daffron believes he has a highly contagious MRSA infection. The medical staff says that's not true, even though it hasn't done a culture on the infection on Daffron's stomach. While the medical staff at the jail has known about the problem since March 24th, Daffron says he didn't see a Doctor until Monday April 7th. Daffron calls it "neglect, mistreatment and abuse." A spokesperson for the Pinellas Sheriff's Office says Daffron received proper medical attention once it was brought to the staff's attention, but both Daffron and his attorney say that's not true. "Even if the Sheriff's Department thinks they might be treating the problem, there's still a problem with the resistance of the medical staff in the jail," says attorney Jason Bongos. A female inmate died earlier this year, apparently from the highly contagious MRSA. [Full Story] "It's not a safe place," says Gerald Green. "You won't get any medical treatment and people do die in jail." Green knows from personal experience. His father Orell died in 2006 after he was rushed to the hospital from the jail with jaundice and hepatitis. "I don't feel he received any medical care," says Green. Although extremely ill, Orell Green was only given Motrin in the jail. A professor of medicine at the University of Miami who investigated the autopsy and treatment wrote the jail and CMS were negligent in not getting the man to the hospital sooner. "Six weeks in jail, a person should not die," Green says, and then asks, "Why is Pinellas County is having these problems?" It is a question several are now asking about the medical staff . "I believe they're mishandling their power," says Daffron. And that's some who say they've experience it first hand want an outside investigation to make sure there are no more incidents.

Pocatello Women's Correctional Center, Pocatello, Idaho
November 21, 2008 The Olympian
Idaho jurors have awarded $3.6 million to a former inmate and her young son after a harrowing birth at the Pocatello Women's Correctional Center. Jamie Lysager alleged in her lawsuit that she was denied proper prison medical care and ended up giving birth on a prison ramp. In a verdict late Friday night in Pocatello, 6th District Court jurors awarded $375,000 to the woman. The award for her now-4-year-old son Taylor was $3.25 million. The lawsuit alleged that Prison Health Services, which formerly oversaw and staffed the Idaho Department of Correction's medical services, failed to properly diagnose Lysager, and that she was denied proper health care leading up to the Feb. 14, 2004, premature birth of her son. The lawsuit contends the birth occurred while she was being moved in a wheelchair, and that the infant fell from the mother, struck his head on a concrete ramp and was then run over by the wheelchair. The little boy has been diagnosed with cerebral palsy. Prison Health Services no longer contracts for medical care in Idaho's prison system. It has contended that Taylor's injuries were not caused by its actions or inaction.

November 21, 2008 AP
A jury is considering a $23 million lawsuit filed by a former inmate of the Pocatello Women's Correctional Center who says she was denied proper health care and ended up giving birth on a concrete ramp after being left in a holding room for 10 hours. The lawsuit alleges that Prison Health Services Inc., which formerly oversaw and staffed the Idaho Department of Correction's medical services, failed to properly diagnose Jamie A. Lysager, and that she was denied proper health care leading up to the Feb. 14, 2004, birth of her son. The lawsuit contends the birth occurred while she was being moved in a wheelchair, and that her son, Taylor, "fell from her body and the wheelchair, landing on the back of his head on the concrete ramp." It alleges the wheelchair then ran over Taylor and "that the umbilical cord and a portion of the placenta were ripped from plaintiff." Taylor spent two months in a hospital. Now 4 years old, the complaint says that he has been diagnosed with cerebral palsy. The jury began deliberating Wednesday. Lysager is seeking $3 million for pain and suffering and for her son's future economic needs. She's seeking $20 million in punitive damages. Lysager entered the correctional facility on Dec. 11, 2003, after violating her probation. She had pleaded guilty earlier that year in 7th District Court to fraudulently possessing a financial transaction card, and was sentenced in June 2003 to up to five years in prison. Lysager was told to expect her child on April 4, 2004. On Feb. 3, she told medical staff she had flu-like symptoms and diarrhea. The lawsuit contends the medical staff failed to treat her for the next 10 days. Lysager's attorney, Richard Hearn, told the jury before it began deliberations that Prison Health Services violated its own policies by not transporting Lysager to the hospital when she began having medical problems. According to the lawsuit, Lysager, at 5:30 a.m. on Feb. 14, told medical staff she was suffering from dehydration, diarrhea and stomach cramps. She was given an ultrasound to monitor the baby's condition. Then, after 10 hours in a holding cell, the suit said, she began screaming and kicking the locked door to get the staff's attention, and at 5 p.m. began giving birth while on the toilet. Attorney Joseph McCollum Jr., representing Prison Health Services, said Lysager was likely suffering from an inflammatory condition of the uterus that can cause a premature delivery without labor, contributing to physical and cognitive problems in children. He said that even if Taylor had been born in a hospital, the physical challenges he faces might not have been different. He said the medical staff thought they were treating Lysager for flu symptoms, not a possible early delivery. Though he said the staff didn't follow proper procedures, they didn't act with malice or willful disregard.

Portsmouth City Jail, Portsmouth, Virginia
October 7, 2010 Virginia-Pilot
A Circuit Court jury awarded $25,000 in damages to a former Prison Health Services nurse who filed a defamation suit against Sheriff Bill Watson. The civil jury found that Adrienne West was defamed by Watson in comments he made in a story that ran in The Virginian-Pilot in June 2007. The story, about an investigation into drugs being brought into the jail, reported that Watson suspected a nurse, who he said at the time had since resigned. The nurse was not named, but West had resigned after being questioned during the investigation, according to testimony that came out during the three-day trial. She felt Watson's statements identified her as the nurse referenced in the story. Watson testified that he told the reporter "contractors" were suspected and did not specify a nurse. Watson's attorneys argued that the statement attributed to Watson was not a direct quotation. To prove defamation, they said the plaintiff had to show that Watson had used the exact words in the story.

December 15, 2009 The Virginia-Pilot
Former medical providers for the City Jail will pay $1.5 million to settle a lawsuit filed by the widow of a mentally ill man who died of pneumonia and dehydration six days after he was jailed on a misdemeanor charge. Joseph Combs, a 57-year-old Vietnam veteran and shipyard worker, was in the midst of a bipolar episode in June 2006 when he was put in jail because authorities couldn't find a bed for him in a mental facility. A deputy found the man dead, naked and lying in the feces he had repeatedly smeared on himself and the cells he was housed in. In 2007 Combs' widow, Granada, filed a lawsuit against Prison Health Services, the jail's medical provider at the time, other medical professionals, Sheriff Bill Watson and other individuals. Last month, the suit against Watson resulted in a mistrial. Jurors could not come to a unanimous verdict on whether the sheriff was negligent in Combs' death. On Monday, Judge Thomas Shadrick approved the settlement between Combs' estate and Prison Health Services; two of its employees, Dr. Shawne R. Bryant and Emma Floyd; and Dr. Luis F. Ignacio. Pat Nolan, a spokesman for the Nashville, Tenn.-based Prison Health Services, said they had no comment. Ignacio could not be reached Monday. The settlement order says only the defendants have offered together to pay the $1.5 million. The largest part of the settlement - $600,000 - will go to attorneys who represented the Combs family from the law firms of Allen, Allen, Allen & Allen and Bricker Anderson. Another $192,711.21 will cover the costs and expenses incurred. Combs' widow will receive $424,373.27, and his four adult children will each receive $70,728.88. Granada Combs testified that during the days leading up to her husband's incarceration he had stopped eating and taking care of himself. At some point, he told her to leave the house or he might hurt her. She sought help and eventually called 911. Officer Richard Overstreet testified that he responded to the call and was going into the apartment with her when he saw Combs inside with a knife. He said he appeared to be coming toward his wife. The officer said Combs continued to make angry comments about his wife and he considered him a risk to her. He said after mental health workers could not find a hospital that would take the man, a police sergeant told him to secure a warrant for a misdemeanor charge of threatening bodily harm. Combs died of pneumonia and dehydration. The medical examiner testified during the civil trial last month that people suffering from bipolar disorder will sometimes ignore thirst. Deputies and officers in the sheriff's office testified about Combs' bizarre behavior and how they had helped him shower and moved him to a clean cell after finding smeared feces everywhere. They also testified about asking doctors, nurses and a worker from the city's Behavioral Health Services Department to examine him. Lawyers for the sheriff contend that it was Prison Health Services and the medical providers who were responsible for making decisions related to an inmate's health care. The case between the sheriff and Combs' estate is scheduled to be tried again in early May.

June 20, 2008 The Virginian-Pilot
A woman who worked as a nurse for a health care contractor at the city jail has sued Sheriff Bill Watson, charging that he defamed her in comments that were published in The Virginian-Pilot. Adrienne West sued in Portsmouth Circuit Court earlier this month, naming Watson and the Portsmouth Sheriff's Office as defendants. She is represented by attorney Jason C. Roper. In an interview, Watson called West's suit "frivolous" and said she had "nothing to stand on here." He said he had never mentioned the woman by name. West's suit says that when she reported to work on June 2, 2007, she was met by police detectives investigating illegal drugs in the jail. The suit says she cooperated with them because she had "nothing to hide." She was searched and questioned, and she agreed to take a polygraph exam. She was "extremely nervous" and the result was inconclusive; the test was given again and she passed. She consistently denied bringing drugs into the jail, her suit says. Her complaint says that the detectives were satisfied. Watson told her as she left he knew the results and "not to worry about it," her suit says. Watson said Thursday he didn't recall ever meeting West. West felt singled out and decided she no longer wanted the job and resigned, her suit says. Weeks later, the Pilot published two articles that contained statements attributed to Watson, now attached as exhibits to her suit. One reported that an inmate had told Watson that contractors were bringing drugs into the jail, and that Watson suspected two former employees, including a Prison Health Services nurse who had resigned. The other article reported the sheriff said two contractors he suspected of bringing drugs to the jail no longer worked there. West was not identified by name. Her suit says her identity was clear to people who knew her. It says people asked her about the articles and asked if she was a drug dealer. She says Watson's statements were defamatory. West seeks $3 million in compensatory damages and $1 million in punitive damages.

June 14, 2007 The Virginian-Pilot
Concerned that there might be drugs inside the city's jail, Sheriff Bill Watson used dogs earlier this month to search some inmates and deputies inside the facility. Though none of the roughly 35 deputies and inmates on duty was found to have drugs during the June 1 search, the dogs detected narcotic scents on two deputies, Watson said. Officers can pick up drug scents on their clothes during the course of duty, he said. However, later that night in an unrelated incident, one of Watson's deputies was arrested on charges of drug possession in Norfolk. The search, Watson said, was the first time he has brought in dogs to look for drugs on inmates and deputies at the jail since he took over as sheriff more than 18 months ago. Random searches will occur from now on, Watson said. Norfolk Sheriff Bob McCabe's office provided two K-9 dogs as a courtesy that night. They looked for evidence of drugs at the jail for about five hours, said Bonita Harris, a spokeswoman for McCabe's office. A small amount of contraband, ranging from cell phones to drugs, has made its way into the jail for years, Watson said. The investigation began nearly a month ago, after Watson received a tip from an inmate. The inmate told Watson that some contractors working inside the jail were bringing small amounts of marijuana and crack cocaine into the facility. Watson said he suspected that one of the contractors was a nurse who worked for Prison Health Services. She has resigned, he said. The other contractor worked for the food service company that supplies the jail, Watson said. He no longer works there, he said. Neither contractor has been charged.

December 1, 2006 The Virginian-Pilot
Joseph Combs was sent to the City Jail in June and died there six days later. Combs, 57 , died of severe dehydration and acute pneumonia, with bipolar disorder contributing, according to the medical examiner. Earlier this week, Portsmouth City Attorney Tim Oksman requested a federal civil rights investigation into Combs’ death. He wrote a letter to representatives of the U.S. Department of Justice and the Federal Bureau of Investigation , asking that they “determine whether any civil or criminal investigation is called for by either of your agencies.” Norfolk FBI spokesman Phil Mann said the department has received the letter and is reviewing it to determine whether to open an investigation. Oksman began to look into the case after being contacted by Combs’ widow, Granada Combs . She said in an interview last week that she sought medical attention for her husband after he was taken into custody on June 22. “This should not have happened,” she said. “His death could have been avoided had they taken him to a hospital.” In the past, her husband, who worked as a painter at Norfolk Naval Shipyard , had repeatedly been hospitalized for mental health treatment for weeks at a time, she said. Police and the city are conducting separate investigations into his death. The City Jail is run by Sheriff Bill Watson , whom Oksman copied on his letter to federal authorities. After several calls to Watson’s office for comment, Lt. Col. John Gomokey returned a phone call. He said the sheriff said to contact Prison Health Services Inc. , the jail’s medical contractor. “His position right now is that PHS needs to handle that,” Gomokey said. “It was their thing.” Emma Floyd , director of nursing for Prison Health Services at Portsmouth City Jail , said: “I don’t know why he would ask you to contact me.” Asked about Combs, Floyd said she remembered the case. But she declined to comment further and said to contact Prison Health Services’ corporate office in Tennessee . “Our mission is to provide quality health care to all the patients we serve,” company spokeswoman Susan Morgenstern wrote in an e-mail, responding to Oksman’s letter. “Anytime a patient dies, we are deeply saddened, and extend our heartfelt sympathy to the patient’s family and friends.” She added that, because of confidentiality laws, Prison Health Services can’t talk about details of the care provided to a patient. But she said the company would cooperate fully if there is an investigation.

Prison Health Services (now Corizon), Brentwood, Tennessee
Jun 29, 2014 startribune.com

Inmate settles suit claiming negligence by the medical staff at Stillwater prison. A state prison inmate will be paid $130,000 by the Department of Corrections to settle a lawsuit accusing its medical staff of negligence and destruction of evidence in a 2012 incident that left him with permanent nerve damage. Erick Thomas, 32, an inmate at Stillwater prison, was later diagnosed with Brown-Sequard syndrome, the result of extensive, prolonged compression of his spinal cord.

The settlement is the latest in a series of cases dating to 2011 in which the department has paid more than $827,000 to inmates and their families to settle claims of negligence and inadequate care. Attorneys who work in the field of inmates’ rights say the department’s contracts with for-profit medical providers have resulted in a rationed health care operation that resulted in critical medical mistakes. In February, Legislative Auditor James Nobles issued a report critical of the state’s prison health system, saying it lacks oversight and outside accountability. Department officials would not comment specifically on Thomas’ case and defended the quality of prison medical care. “Resolving litigation in this manner does not assume wrongdoing was found,” the department said in a statement issued Thursday.

‘Faker’ note in log destroyed:

The lawsuit stems from an incident in which Thomas was found partly paralyzed in his cell one evening. The examining prison nurse left him propped up in the cell and then wrote the word “Faker” in her medical log. Records produced for the case showed that, after writing that entry, the nurse, Ellie Fuller, did not call a doctor before she went home for the night. The next morning Thomas was found lying on his cell floor, unable to communicate, and was sent to a Twin Cities hospital for emergency surgery. After he had been sent off, the nursing supervisor, Sara Hard, read the note in Thomas’ medical file. She was so alarmed that she ordered another nurse, Cassie Rider, to destroy the document, not knowing that Rider had secretly made a photocopy. When Rider refused the order, Hard destroyed the note herself, Rider said in interviews and in an affidavit. “Hard ordered me to destroy the Checklist because, according to her, ‘We can’t write (expletive) like that on anything and Ellie knows better than that,’ ” Rider stated. Fuller has retired and Hard has been demoted to senior nurse status, a department spokesperson said. Thomas, who is serving a drug sentence in the prison, is expected to be transferred this fall to a minimum security facility that offers a “boot camp” program to teach inmates self-discipline and skills in preparation of their release. If he passes the requirements, he could be released on probation by next spring, cutting his prison time by three years, he said. Today, Thomas is permanently numb on the right side of his body as a result of a blood clot that surgeons found pressing on his spine, which nearly killed him.

‘I’ve got a bigger plan’

In a recent interview, Thomas said that when released he hopes to start a home renovation business. “There’s no reason for me to do anything else — I’m not looking back at that life I had,” he said. “It’s all good, and I’ve got a bigger plan.” Thomas’ attorney, Steve Meshbesher of Minneapolis, said he plans to file suit against Corizon Inc., the for-profit health care company that was providing medical care at the time to more than 9,000 of the state’s prisoners. Meshbesher alleges that a doctor employed by Corizon who was on call the night Thomas suffered paralysis was negligent by not ordering that Thomas be examined by a hospital physician. As outlined in the Corizon contract at the time, prison doctors throughout the state’s corrections system left at 4:30 p.m. and nurses were gone by 11:30 p.m., leaving only corrections officers to face the often daunting medical issues of inmates. Last fall, Corizon’s bid to renew its contract was rejected by the state, and the company was replaced by Centurion Managed Care of St. Louis. Today, medical staffing levels generally remain the same under the two-year, $67.5 million contract.


Mar 2, 2014 St. Louis Post-Dispatch

ST. LOUIS • The City of St. Louis this week settled a lawsuit that alleged that medical negligence and heroin withdrawal caused the death of a jail inmate. Isaac Bennett Jr. was jailed on July 23, 2007, and told a nurse that he was a heroin addict who had used heroin the day before his arrest, the lawsuit claims. Bennett died after two days of diarrhea and vomiting, “classic symptoms of heroin withdrawal,” the suit says, and “was not given even the most basic medical treatment.” An autopsy showed Bennett “died of metabolic changes secondary to withdraw from heroin causing disturbance of cardiac rhythm and resulting in cardiac arrest,” the suit says. The city and Correctional Medical Services denied Bennett's claims, which were filed in 2010 by Bennett's father, Isaac Bennett, and Christine Youell, the mother of his child. The city agreed to pay $10,000 to settle the case, according to a copy of the settlement agreement made public on Friday, the day after the settlement was approved by U.S. Magistrate Judge Terry Adelman. Correctional Medical Services agreed to pay a settlement amount that is confidential under terms of the agreement. Correctional Medical Services, now Corizon, provides healthcare at the two city jails, as well as state prisons in Missouri and 27 other states.


Jan 9, 2014 The Republic

An inexperienced nurse for Corizon Inc., the private health-care provider for the Arizona Department of Corrections, is being blamed for a hepatitis scare at three of the seven units at the Lewis Prison Complex near Buckeye. “Every indication is that the incident is the result of the failure by one individual nurse to follow specific, standard and well-established nursing protocols when dispensing injected insulin to 24 inmates,” Corrections Director Charles Ryan said in a statement released Thursday. Ryan said that Corizon, which has repeatedly declined to answer questions about the incident, suspended the nurse and access to any Corrections facility was revoked. The State Board of Nursing said a complaint was filed Thursday against the nurse, who was identified as Patricia Talboy of Surprise. The licensing agency said she is under investigation. Efforts to reach her were unsuccessful. A Corrections spokesman told The Arizona Republic that Talboy became a licensed practical nurse in August 2012 and a registered nurse in June. Corizon hired her in September. Nurses with limited experience typically are paid less than veteran nurses. Corizon, like other companies, can contain expenses and increase profits by hiring employees at a lower hourly rate. Doug Nick, a Corrections spokesman, said an investigation will determine whether the state will fine or take disciplinary action against the company, which last year was awarded a three-year, $372 million contract to provide inmate health care. Corizon spokeswoman Susan Morgenstern would not answer questions, but the company issued a statement with the Department of Corrections that provided more details on the incident. The company said the nurse used a needle to stick the fingers of inmate patients and check blood-sugar levels at the Eagle Point unit, a minimum-security facility. Corizon said that after the nurse cleaned the needle with alcohol, she used the same needle to draw insulin from the vials to administer the medicine. That potentially contaminated the remaining insulin. Each patient was treated with a new needle, which was then discarded. The company said the nurse committed the same protocol error with five patients Sunday night at Eagle Point and then put the vials in the main medical hub. On Monday, the nursing staff used the same potentially contaminated insulin vials on inmates in the Morey and Rast units, which house close-custody, or violent, prisoners. As a result, 24 inmates were potentially exposed to “blood borne pathogens that may include hepatitis B, hepatitis C and HIV,” the company said. However, Corizon said that “there is no indication that anyone was definitely exposed to the pathogens.” The company said that on Monday, a different nurse who was making insulin rounds at Eagle Point, learned about the breach from an inmate. The company removed all previously opened vials and notified the Department of Corrections and state Department of Health Services. A Department of Health Services official on Wednesday first disclosed to The Arizona Republic that inmates were exposed to hepatitis B and C, after Corizon and Corrections refused to provide specific details of the incident or disclose the seriousness. Following public criticism, Corrections and Corizon provided new details Thursday and a full account of what occurred. The company said it has “moved as quickly as possible to share the facts as they are confirmed with all concerned.” This incident is similar to one that occurred in August 2012, when a nurse with a different private health-care provider, Wexford Health Sources Inc., contaminated the insulin supply at the same prison. Corrections, in Thursday’s statement, said none of the 112 inmates potentially exposed 17 months ago tested positive for any blood-borne pathogens. That figure includes 10 inmates who also were exposed this week. It may take up to six months to determine if those exposed this week test positive. Ryan also said that Corizon has been directed to develop a comprehensive plan that will provide training and competency testing, nurse-peer reporting education and awareness education on injection protocols.

 

Jan 9, 2014 azcentral.com

A nurse working for Corizon Inc., the private health care provider for Arizona’s Department of Corrections, improperly injected and exposed at least 24 inmates to a “blood-born pathogen.” The company and the state have declined to provide specific details about the incident. Corizon disclosed Wednesday morning in a press release that one if its nurses on Sunday evening was involved in “inproper procedures for injections” for at least two dozen inmates at three units at the Arizona State Prison Complex-Lewis in Buckeye. This is the second time in about 18 months that a private prison contractor has improperly injected inmates at Buckeye. A nurse for Wexford Health Sources Inc., the prior health care provider, caused a hepatitis C scare in August 2012 by contaminating the prison's insulin supply. Susan Morgenstern, a Corizon spokeswoman, declined to say why the company waited three days to notify the public. Doug Nick, a Department of Corrections spokesman, also declined to answer questions about the incident, referring questions to Corizon. “It’s a medical issue. They are the doctors and nurses,” Nick said. “We are not aware of any correctional officers at risk.” Blood-borne pathogens are infectious microorganisms in human blood that can cause disease in humans. These pathogens include, but are not limited to, hepatitis B, hepatitis C and human immunodeficiency virus (HIV), according to the U.S. Occupational Health & Safety Administration’s website. Corrections last year hired Corizon after it agreed to terminate the medical-services contract to provide health care for inmates statewide with Wexford. That decision came amid accusations that Wexford improperly dispensed medicine to inmates and wasted state resources. To replace Wexford, the state agreed to a more expensive contract with Corizon of Brentwood, Tenn., to become the health-care provider at all Arizona-run prisons. Corizon, the country's largest provider of correctional medical care, took over March 4. Corizon, like Wexford, has a history of problems providing health care in other states. The three-year deal with Corizon cost taxpayers at least $372million, but Corizon has the option to seek additional funds in the final year. That contract is at least 6 percent higher than Wexford's $349 million, three-year deal.


December 08, 2013 The Jackson Sun

Lawsuits were filed this week in local State and Federal Courts over the death of a Madison County man who died while he was a prisoner at the Northwest Correctional Complex in Tiptonville, according to Jackson attorney Mike Weinman. The lawsuits claim that 21-year old-Walter F. McNeal died because of the prison medical staff’s failure to appropriately provide him with necessary and life saving medical treatment after he became seriously ill in December of last year. Weinman filed the lawsuits on behalf of McNeal’s family against the State of Tennessee, Corizon Inc, the company that contracts with the state to provide medical care to inmates at state prisons and the doctor and other medical staff at the prison. The lawsuits claim that the doctor and other medical staff at the prison were negligent in their treatment of McNeal, which led to his death. The lawsuits also claim that the state and Corizon violated McNeal’s civil rights because they failed to have adequate policies regarding treatment of medical emergencies like the one that McNeal faced, Weinman said. A separate civil rights lawsuit filed against Corizon claims that the company had a policy that discouraged referrals of inmates to emergency rooms for financial reasons. The lawsuits seek $10 million in compensatory damages as well as punitive damages against the defendants, Weinman said. The Jackson Sun is seeking comment from those being sued.


Nov 7, 2013 abc15

A 32-page report released by the American Friends Service Committee in Arizona, claims that the current private prison healthcare system is inadequate. “This includes delays in denials of care, lack of timely and emergency treatment and failure to provide medication,” said Caroline Isaacs, the author of the report." In addition, there's a case study of someone who was diagnosed with cancer, with completely no follow-up. The report points to the company in charge of the state’s private prison healthcare system, Corizon. Since March of 2012, the report claims that six of the fourteen inmate deaths that they investigated could have been prevented if given correct treatment. Eleanor Grant’s 70-year-old husband is currently serving five-life sentences in Tucson for armed robbery. She claims the prison will not provide him with adequate treatment, even though he was diagnosed with prostate cancer in July. "Why would they want to continue to supply him with leg bags and catheters and fight infections when all they have to give him is one pill so he can urinate on his own again?" said Grant. Rep. John Kavanaugh, an Arizona representative who helped pass the bill to privatize prison healthcare, says it’s unfair to blame Corizon for these findings since they’ve only been in charge of it since the start of the year. Corizon issued the following statement to ABC15 Wednesday afternoon: On any given day, Corizon provides for the healthcare needs of more than 410,000 inmate patients across 500 facilities nationwide. As with any large healthcare provider, litigation does arise from time to time. However, the vast majority of lawsuits filed against Corizon are without merit and are dismissed or settled with no findings of wrongdoing.  AFSCAZ is now calling for the Arizona Auditor General to look into the report’s findings.


Arizona prisons in health-care quandary: February 16, 2012, Bob Ortega, The Arizona Republic. Expose on for-profit health providers

Nov 5, 2013 The American Friends Service Committee

PHOENIX, ARIZONA — On Wednesday, November 6th, the American Friends Service Committee (AFSCAZ) and American Civil Liberties Union (ACLUAZ) will hold a press conference in front of the Arizona Department of Corrections Building to coincide with the release of a new report which documents that the same problems—delays and denials of care, lack of timely emergency treatment, failure to provide medication and medical devices, low staffing levels, failure to provide care and protection from infectious disease, denial of specialty care and referrals, and insufficient mental health treatment—have continued and, arguably, worsened under the current for-profit healthcare contractor, Corizon. WHO:  Caroline Isaacs (Report Author, AFSC Director), Daniel Pochoda (Legal Director, ACLUAZ), Eleanor Grant (wife of an Arizona prisoner with chronic health issues) WHAT:  Press Conference and Report Release - Prison Healthcare in AZ Worsens Under Corizon. WHEN:  Wednesday, November 6th.  11:30am LOCAL TIME WHERE:  Arizona Department of Corrections Building.  1601 W Jefferson St, Phoenix, AZ   The American Friends Service Committee (AFSCAZ) and American Civil Liberties Union (ACLUAZ) are decrying the continued deterioration of the quality of medical care in the Arizona Department of Corrections (ADC). In March of 2012, the ACLU filed a class action lawsuit against ADC, charging that prisoners in the custody of the Arizona Department of Corrections receive such grossly inadequate medical, mental health and dental care that they are in grave danger of suffering serious and preventable injury, amputation, disfigurement and even death. AFSC reports that there have been 50 deaths in Arizona Department of Corrections custody in just the first eight months of 2013. That is a dramatic increase from previous years. The Arizona Republic reported 37 deaths in 2011 and 2012 combined. The report charges that the deficiencies in quality of care are not isolated to one or two locations or individual “bad actors,” but clearly represent system-wide dysfunction. The report contains 14 specific case studies to illustrate these issues, as well as extensive documentation of the administrative, organizational, economic and political factors that are contributing to the problem. This includes the process of privatization of medical care. Delays and a reissue of the Request for Proposals (RFP) made the privatization process drag out for over two years. In the meantime, medical staffing levels plummeted and health care spending in prisons dropped by nearly $30 million. The departure of Wexford, followed by the award of the contract to Corizon created additional upheaval, delays, and changes in staff, procedures, and medications. The report concludes that contracting out the medical care at ADC has resulted in more bureaucracy, less communication, and increased healthcare risks for prisoners. “The Arizona Department of Corrections needs to get its own house in order,” says report author Caroline Isaacs. “Arizona needs to stop wasting millions of taxpayers’ dollars on cancelled contracts and wrongful death lawsuits and take responsibility for correcting these problems.” For more information, or for a copy of the report in advance, please contact Caroline Isaacs at 520.623.9141 or by email at cisaacs@afsc.org.

 

October 17, 2013 wday.com

ST. PAUL, Minn. (AP) — The Minnesota Department of Corrections has hired a new firm to manage medical care for the state's 9,000 prison inmates. The department hired St. Louis-based Centurion Managed Care, a Fortune 500 health care company that manages medical care under public contracts in several states. In a statement, the department said that Centurion Managed Care is expected to "deliver significant savings to taxpayers while improving the quality of care for offenders incarcerated in the state's prison system." The department severed ties with a national company that was the target of lawsuits and staff complaints over substandard care. A 2012 Star Tribune investigation found that at least nine Minnesota inmates had died since 2000 due to denial or delay of care while Corizon Health was the state's prison medical contractor. More than 20 had suffered serious or critical injuries during that period, the newspaper's investigation found. Since then, the department has paid more than $1.8 million in wrongful death and negligence cases, including a $400,000 settlement in May to the family of a Rush City inmate who died in 2010 after being left alone in his cell while suffering a nightlong series of seizures. The department's announcement did not address past cases. But Corrections Commissioner Tom Roy released a statement praising Corizon for introducing managed-care efficiencies to Minnesota's prisons and providing "excellent service to the state." The contract with Centurion takes effect Jan. 1 and will cost the state $67.5 million through 2016, the Star Tribune (http://bit.ly/17wef0H ) reported. It replaces a contract with Corizon, which has provided the Minnesota Department of Corrections with physicians, pharmaceutical services and medical specialists for the past 15 years.

05/22/2013 twincities.com

The Minnesota Department of Corrections has agreed to a $400,000 settlement in a federal lawsuit over the death of a 27-year-old St. Paul man. Xavius Scullark-Johnson suffered at least seven seizures in his prison cell through the night of June 28, 2010, and into the next morning at the Rush City prison. Nurses and correctional officers didn't provide medical care for eight hours, and a nurse turned away an ambulance, the lawsuit said. Scullark-Johnson died June 30, 2010. "Defendants' deliberate indifference to Mr. Scullark-Johnson's serious medical needs caused his death," said the lawsuit, which named Corrections Department officers and nurses, along with Corizon Inc., a private company based in Tennessee that the state contracts with for medical services, and one of the firm's doctors. The Corizon part of the lawsuit is ongoing. It is the largest settlement the Corrections Department has paid in a medical-negligence lawsuit in the past eight years, according to the department. The state defendants deny liability, the settlement agreement said. "We take our charge to incarcerate offenders in a safe and secure manner very seriously, so the premature loss of life of offenders in our care and control always causes us great concern," Corrections Commissioner Tom Roy said in a statement. Olivia Scullark, Scullark-Johnson's mother, filed the lawsuit in June. Her son, who was in prison for a probation violation, had a history of seizure disorders, which the department and its health care providers "were well aware of," the lawsuit said. After the June 2010 seizures, he was declared brain dead and removed from life support. "The conduct here was really horrendous, the way that someone who had serious medical needs was just ignored," said Jordan Kushner, Scullark's attorney. A nurse was suspended for five days without pay for failing to follow emergency medical procedures, according to John Schadl, a Corrections Department spokesman. The department reviews its performance, policies and procedures after every critical incident. As a result of the Scullark-Johnson case, the department has started working with the Epilepsy Foundation of Minnesota to increase training for correctional officers on how to recognize and respond to seizures, Schadl said. The department also has revised its procedures to ensure information is better communicated from one shift to the next, he said. Mara H. Gottfried can be reached at 651-228-5262. Follow her at twitter.com/MaraGottfried or twitter.com/ppUsualSuspects.


Apr 07, 2013 kpho.com

New questions are being raised about a contract state officials signed with a private company to provide healthcare to Arizona inmates. Corizon was recently awarded a three-year, $369 million deal to provide healthcare to Arizona prison inmates. CBS 5 News has learned one of the men on Corizon's payroll is former Arizona ADC Director Terry Stewart, who's been doing consulting work for Corizon since 2010. Current director Charles Ryan used to work for Stewart, raising questions about a possible conflict of interest. "With money of this sort and the amount of responsibility over people's lives, it should be looked into," said ACLU attorney Dan Pochoda. CBS 5 News asked Ryan directly if there was any conflict with the contract they signed with Corizon. "Of course there was not. Our process has been above board," Ryan said. "Terry Stewart had nothing to do with the RFP process. He was not involved, period." Ryan said that Wexford, the company the state hired last year to provide health services to inmates, suddenly wanted out of the deal, leaving the state with few options. Ryan said they could either start the request for bid process over again, which could take six to 12 months, or use one of the other two companies that submitted bids last year. Corizon was one of the other companies. "Of the two remaining vendors, they had the most reasonable proposal to consider," said Ryan. "The bottom line is that we had to maintain the continuity of inmate healthcare." Ryan also told CBS 5 News that the other company bidding for the contract made an offer far beyond what the state had allocated, leaving Corizon as the only realistic option. "It is a process that was endorsed and reviewed by the attorney general's office and state procurement office," said Ryan. "We followed the law to the letter." Another problem facing the ADC is a class action lawsuit filed on behalf of inmates, claiming they are not receiving adequate healthcare. A spokesperson for Corizon said that state officials were in no position to delay getting a company in to provide inmates with health services.

December 18, 2012 by PAUL McENROE , Star Tribune
Corizon and the state Corrections Department are named in the suit arising from an inmate's death after multiple seizures in 2010. The private contractor that provides medical care in Minnesota prisons has been sued for wrongful death in the case of an inmate who died from seizure complications in 2010 at the prison in Rush City. The suit, filed in federal court in Minneapolis, alleges that a doctor employed by Corizon Inc. initially failed to order an ambulance when Xavius Scullark-Johnson went into seizures late one night, and that the inmate received negligent care again after an ambulance crew was turned away by a prison nurse the next morning. Tennessee-based Corizon, which will receive $28 million this year to care for the state's 9,200 inmates, joins the Minnesota Department of Corrections as a second defendant in a case that throws a spotlight on the quality of medical care received by inmates. "Defendants left Mr. Scullark-Johnson lying in his cell by himself after he had suffered numerous seizures, was disoriented, unable to control his bodily functions and had injured himself from seizures," according to the suit, which was filed by Minneapolis attorney Jordan Kushner, who represents Scullark-Johnson's family. A Corizon spokesperson declined to comment, citing the pending litigation. Corrections officials have said that inmates in Minnesota receive the "community standard'' of medical care required by law -- similar to the level of care received by most Minnesotans. In addition to the allegations against the Corizon physician, the suit alleges that at least three Corrections Department nurses and four prison officers failed to provide adequate care while Scullark-Johnson suffered as many as six seizures in a four- to five-hour period. Previously undisclosed records show that the overnight corrections officers responsible for Scullark-Johnson's care failed to document his quickly deteriorating condition, even though they went so far as to remove his cellmate to segregation after he repeatedly complained that an ambulance should be ordered. The lawsuit reopens questions raised last month in a Star Tribune investigation which found that since 2000, at least nine state prisoners - including Scullark-Johnson - have died after medical care was denied or delayed and another 21 have suffered serious or critical injury. Staffing arrangements set out in the state's contract with Corizon played a role in many of those death and injury cases, the newspaper found. Under that contract, Corizon doctors and physicians' assistants exit prison grounds each weekday by 4 p.m., leaving just one on-call doctor to assess the condition of prisoners statewide by telephone. In addition, the state-employed nurses end their shifts by 11 p.m., leaving minimally trained corrections guards as the front-line medical responders. That is exactly the kind of situation that played out when Scullark-Johnson, 27, of St. Paul, struggled for his life on a June night two years ago. It is not disputed that Dr. Sharyn Barney initially did not call for an ambulance as Skullark-Johnson suffered a series of seizures the night she was assigned to be the on-call physician. In a statement given to Corrections investigators after the incident, Barney, who regularly works out of the prison in Moose Lake, defended her actions and said she was not provided with enough information from prison officers about Scullark-Johnson's condition. But a Corrections lieutenant told investigators he informed Barney that officers knew Scullark-Johnson had at least three seizures and that the cellmate reported that Scullark-Johnson had suffered at least six to seven seizures. Barney told him to simply let Scullark-Johnson sleep rather than call for an ambulance, according to court records. Only after an officer complained about an hour later that Scullark-Johnson was not improving did Barney agree that an ambulance should be called, according to documents previously obtained by the newspaper. When the ambulance arrived, however, a nurse turned it away, citing "protocols.'' When the nurse returned an hour later and found Scullark-Johnson face down in his cell and unresponsive, the ambulance crew returned and took him to Fairview Lakes Hospital in nearby Wyoming. He was declared brain dead that night and taken off life support the following day. A trial date for the case has not been set.

November 11, 2012  PAUL McENROE , Star Tribune
Lapses in prison medical care have produced tragic results for inmates. Erick Thomas lay in his bunk moaning in pain, too weak to make the night's final count at Stillwater prison. Alerted by guards, two nurses gave him a 10-minute exam and concluded he was merely suffering from a muscle spasm near his neck. One wrote "Faker!" in her shift report before going home for the night. By midnight, Thomas was writhing on the floor of his cell. The next morning, he was found paralyzed, drenched in urine and near death. After an ambulance rushed him to Regions Hospital in St. Paul, doctors discovered a blood clot pressing on nerves atop his spine. He underwent emergency surgery and a week later, at age 30, had to learn to walk all over again. "I felt like they were trying to kill me," Thomas said. "No human being should be treated like that." Thomas' ordeal last March is just one in a series of cases, outlined in court records and internal documents, in which Minnesota prison inmates in distress have been denied medical care -- with dangerous and sometimes deadly results. Since 2000, at least nine prisoners have died after medical care was denied or delayed by corrections staff, a Star Tribune investigation has found, and another 21 have suffered serious or critical injury. The state Department of Corrections and its staff have been held liable for nearly $1.8 million in wrongful death and negligence cases, court papers show. In addition, at least six nurses have been disciplined for countermanding doctors' orders, giving false statements or denying emergency care, and one surrendered her license to the state Board of Nursing after its investigators found she denied care to inmates in eight separate cases. Just last month, a jury in Washington County awarded an inmate more than $1 million after finding negligence on the part of Dr. Stephen Craane, a contract physician at the prison in Oak Park Heights. The inmate, Stanley Riley, was suffering from what turned out to be cancer and had written a series of pleading notes to prison officials. One read: "I assure you that I am not a malingerer. I only want to be healthy again." Jane Eskelson, who recently retired after more than 20 years as a corrections officer and witnessed the death of one inmate, said the medical staff was often overworked. "Stuff got dropped, they were apathetic and angry," Eskelson said. "You're just plain worn out at the end." Corrections Commissioner Tom Roy and his two top medical administrators declined to be interviewed for this story. The agency issued a statement saying prisoners receive medical services that meet the "community standard" of care required by law, and that its managed-care philosophy is a responsible approach widely used in American medicine. "Quality assurance issues are endemic to the health care industry as a whole," the statement said. "Our health care providers, like others, are constantly working to improve the quality of care we provide that is responsible to taxpayers." 'Vulnerable adults' Offenders in state prisons and county jails are the only Americans with a constitutional right to health care -- the result of a 1976 U.S. Supreme Court ruling which found them to be "vulnerable" adults. Because they are completely dependent on their guardians, the court said they are entitled to medical care comparable to that received by the general public in their community. To provide that care in Minnesota prisons, while controlling the system's ever-rising medical costs, the state Department of Corrections has contracted since 1998 with Corizon Inc., a private, for-profit corporation based in Tennessee. The firm, formerly known as Correctional Medical Services, is the nation's biggest prison health care company, holding contracts with 31 state and local prison systems. Although state officials are ultimately responsible for inmate care, Corizon's contract grants it broad authority over day-to-day prison medical operations. Corizon hires prison doctors; establishes the list of approved prescription drugs; determines doctors' daily caseloads, and oversees the use of such outside services as ambulances and medical specialists. Prison nurses are state employees, but they work in a command structure with Corizon doctors and physician assistants at the top. Working for a fixed annual fee -- $28 million last year -- Corizon has an incentive to maintain strict cost control. A review of Corizon's state contract shows how lean the operation can be. Doctors employed by Corizon leave their prison clinics after 4 p.m. and do not work weekends. Prison nurses generally finish their last shifts by 11 p.m. Except for the prisons at Oak Park Heights and Faribault, which hold inmates with complicated medical conditions, Minnesota prisons have no overnight medical staff, and clinics are closed.

May 23, 2012 Boston Globe
A federal judge on Tuesday dismissed a lawsuit that had been filed against Suffolk County Sheriff Andrea J. Cabral and the superintendent of the county jail to hold them responsible for the death of a 49-year-old immigrant detainee who was sickened while in the jail’s custody and who later died from a attack caused by a bacterial infection. But the judge did let a lawsuit proceed against Prison Health Services, the private Tennessee-based company that managed the jail infirmary.

May 11, 2012 AP
The national prison health care company Corizon says a scathing court-ordered report on the care provide at an Idaho prison is full of errors and that a review they commissioned themselves proves it. But a close review of both reports show that they largely focused on different aspects of the health care system and that they noted some similar problems. The medical care at the Idaho State Correctional Institution south of Boise is a major part of a long-running lawsuit brought by inmates against the state 30 years ago. Over the years the inmates won many of their claims, forcing the state to make changes to operations and procedures at the lock-up. And a federal court has continued to oversee some aspects of the prison. Last year, U.S. District Judge B. Lynn Winmill appointed correctional health care expert Dr. Marc Stern to review the health care at the prison in hopes of finally bringing the lawsuit to a close. Stern's report found several problems. He said terminal and long-term care inmates sometimes went unfed and were left in soiled linens. The report also said nursing mistakes or failures were likely to have resulted in some deaths and one inmate wasn't told for seven months that he probably had cancer.

April 2, 2012 KTVB
The Idaho Department of Correction is telling a federal judge that a scathing report about health care at a Boise-area prison isn't accurate and doesn't reflect current conditions. Attorneys for the state filed their response to the report late last week, saying a court-appointed health care expert didn't do a thorough review at the Idaho State Correctional Institution. Dr. Marc Stern was appointed by the federal court to examine the care at the prison as part of a long running lawsuit between inmates and the state. U.S. District Judge B. Lynn Winmill has said he will use Stern's findings to help him decide whether to end the lawsuit. Stern's report was damning, finding that the medical care was so poor that it amounts to cruel and unusual punishment.

March 20, 2012 AP
Medical care is so poor at an Idaho state prison that it amounts to neglect and cruel and unusual punishment, according to a report that was unsealed Monday. Correctional health care expert Dr. Marc Stern said there have been some improvements at the Idaho State Correctional Institution south of Boise. But terminal and long-term inmates sometimes went unfed, nursing mistakes or failure likely resulted in some deaths, and one inmate wasn't told for seven months that he likely had cancer, he said. The Idaho Department of Correction and the prison health care provider, Brentwood, Tenn.-based Corizon, said they're disappointed and are preparing a response that will show the care delivered to inmates meets constitutional and health care standards. Stern was appointed to study the care prison near Boise as part of a long-running lawsuit brought by inmates. Some of the medical problems described in the report are disturbing, including Stern's findings that inmates who were terminal or required long-term care and who were unable to move on their own were sometimes left in soiled linens, given inadequate pain medication and went periods without food and water. Stern said those conditions were ``inhumane.'' Emergency care was also found deficient in the report, with medical staffers routinely failing to bring parts of a basic resuscitation device — a ventilator mask for rescue breathing — to inmates experiencing medical emergencies. Prison guards reported to Stern that they sometimes had to call the health staffers multiple times to get them to respond to inmate emergencies, and sometimes the nurses only responded by phone, telling the guards to have the inmates request care the following day. In another case described by Stern, a nurse who found an inmate unconscious and having serious breathing problems didn't take any other vital signs and failed to give the man oxygen. ``Such evaluation was critically important at this point because it was highly likely the patient was not getting enough blood to his brain and required resuscitation,'' Stern wrote. Instead, he contends, the nurse moved the patient to the health unit and only assessed him a few minutes later, when he was having a heart attack. The patient died. ``It is impossible to know if immediate application of life saving measures in the living unit would have saved this patient,'' Stern wrote. ``However, failure to provide these measures greatly reduced any chance for survival.'' The report focuses only on the Idaho State Correctional Institution, though Corizon provides medical care for all inmates in Idaho's state-run prisons. Inmates at the Idaho State Correctional Institution, called ISCI, sued more than 30 years ago, alleging that they were subject to violence and rape by fellow inmates, denied adequate medical care, subjected to poor diets and forced to deal with extreme overcrowding. Over the next three decades, they won several rulings designed to improve conditions at the prison, and the federal court continued to oversee operations to make sure that the state was complying with all of its orders. But U.S. District Judge B. Lynn Winmill is eager to end the court's babysitting role, and the Idaho Department of Correction hopes the lawsuit will be closed for good. The inmates, however, said some of the rulings still aren't being complied with — particularly the orders to improve access to medical and mental health care. Complicating matters is that the prison has grown and changed over the years, and the state now says it's difficult to apply the old rulings to the facility as it now stands. Attorneys for the state argued against releasing the report, saying the public could confuse Stern's findings with the court's opinion. The state said the report should be sealed until both sides had responded to the findings in court. Corizon is not named as a defendant in the case. But in a joint statement released moments after the report was unsealed Monday, officials from the company and the state acknowledged a few of the allegations in the report ``may be well-founded but unfortunate anomalies'' but most of them have been or are being addressed.

October 31, 2011 Burlington Free Press
Two administrators for a Tennessee company that provided health care services at Vermont prisons in 2009 have been disciplined in connection with the death of a 23-year-old female inmate from Castleton who was denied medication for a severe eating disorder, state records show. The woman’s death came two days after she was incarcerated at a St. Albans jail to begin serving a 30-day sentence. The state’s action in response to the death: • Deborah Ploof Moore, a licensed practical nurse and the regional administrator for Prison Health Services at the time, was issued a warning by the Office of Professional Regulation. • Renee Louise Trombley, the contractor’s local clinical director, was issued a reprimand. Both orders became public this month. The inmate, Ashley Ellis, died Aug. 16, 2009, after she was found unresponsive in her cell at Northwest State Correctional Facility. Chief Medical Examiner Steven Shapiro later determined Ellis’ cause of death as “hypokalemic induced cardiac arrhythmia due to anorexia/bulimia nervosa and denial of access to medication.” She was being incarcerated on a misdemeanor careless and negligent operation of a motor vehicle conviction stemming from a 2007 accident that seriously injured a Mount Tabor man. She weighed 87 pounds when she arrived at the jail Aug. 14. Her lawyer and doctor forwarded Ellis’ medical records and medication needs to state Corrections Department officials just before she went to the St. Albans facility, family members and state officials have confirmed. According to the Office of Professional Regulation files, Trombley received the medical records and list of medication needs for Ellis prior to Ellis’ arrival at the prison. Trombley, however, was told to attend a meeting shortly before Ellis showed up, and the medication orders were never passed on to the intake nurse, the records state. “When she left the facility for the meeting, the orders remained on her desk,” Trombley’s stipulation and consent order said in part. “She did not inform staff of the orders or the possible admission of Inmate #1 that day or otherwise act to ensure that the orders would be processed upon Inmate #1’s admission.” Moore, as Prison Health Services’ top administrator overseeing its contract providing health care at Vermont prisons, neglected to tell the state that the intake nurse for Ellis, Wayne Hojaboom, was disciplined by Prison Health Services after the incident, the records state. Hojaboom was given “written counseling” and was suspended for two days without pay for his handling of the Ellis case, according to the case records. By law, Prison Health Services was required to make a report to the state whenever it disciplines an employee. The stipulation and consent orders indicate the two women did not admit wrongdoing but did agree that the state could prove the claims against them. An attorney for the two administrators, asked for comment Monday, said in a statement that both deny engaging in unprofessional conduct in the Ellis case. “Neither Ms. Moore nor Ms. Trombley played any clinical or decision-making role in the care provided to Ashley Ellis, and their Nursing Board stipulations reflect that fact,” attorney Eric Miller said. “Their ability to practice nursing remains unaffected by the Board’s actions. The Office of Professional Responsibility did investigate the nurses who were directly involved in Ms. Ellis’s care and declined to charge any of them with unprofessional conduct.” Prison Health Services later decided not to seek a renewal of its contract with the Vermont Corrections Department and was replaced by Correct Care Solutions as the provider of prison medical care in February 2010. The Ellis family sued Prison Health Services and reached an out-of-court settlement with the firm in 2010. The settlement amount was not disclosed. In August, the family sued the Vermont Department of Corrections and various state officials, alleging they failed to have procedures in place to ensure that a person with Ellis’ condition would received adequate care once she arrived at the prison and did not make sure the critical potassium medicine she needed would be there for her. The lawsuit, now pending in Rutland Superior Court, also alleges that the state’s prison medical director, Dolores Burroughs-Biron, required Trombley to attend the meeting that took Trombley away from the jail the day Ellis arrived. Burroughs-Biron also refused a request by Trombley to postpone the meeting, the lawsuit said.

June 3, 2011 Biz Journal
Valitás Health Services Inc. on Friday completed its previously announced acquisition of America Service Group Inc. for $250 million, and the merged, privately held company has changed its name to Corizon. Valitás, the St. Louis-based parent company of Correctional Medical Services Inc., announced in March that it planned to buy Brentwood, Tenn.-based America Service Group, parent of PHS Correctional Healthcare Inc. America Service Group shareholders, who are being paid $26 per share, approved the deal Wednesday. Valitás previously was one of the largest privately held companies based in St. Louis, with $750 million in 2010 revenue. However the newly named Corizon’s operational headquarters will remain in St. Louis, but its corporate headquarters will be in Brentwood, Tenn. America Service Group President and CEO Rich Hallworth is now CEO of Corizon, and Valitás Chairman and CEO Richard Miles is Corizon’s non-executive chairman. Stuart Campbell, formerly president and chief operating officer of Valitás and Correctional Medical, is Corizon’s president and chief operating officer. The combined prison health-care service provider has about 11,000 employees and independent contractors, and serves more than 400 correctional facilities. Corizon's annual revenue is expected to total $1.4 billion for 2011.

March 3, 2011 The Street
America Service Group Inc. (NASDAQ: ASGR), the parent company of PHS Correctional Healthcare, Inc., and Valitás Health Services, Inc., the parent company of Correctional Medical Services, Inc., announced today the signing of an agreement and plan of merger (the “Merger Agreement”) under which the two companies would be combined, bringing together two leading companies in the correctional healthcare field – America Service Group's PHS Correctional Healthcare and Valitás’ Correctional Medical Services. Upon completion of the transaction, the combined company will have approximately 11,000 employees and independent contractors and will serve more than 400 correctional facilities. The combined company’s annual revenues are expected to total approximately $1.4 billion for 2011.

November 1, 2010 Herald-Tribune
A civil jury ruled today that the Sarasota Sheriff's Office and former Sheriff Bill Balkwill did not unfairly award a jail contract for medical services to a company that took Balkwill on a fishing trip and bought him dinner. The plaintiff, Prison Health Services, sued Balkwill and the sheriff's office, arguing that the gifts to Balkwill improperly influenced him to award a $9 million contract to a competitor, Armor Correctional Health Services. The trial lasted almost two weeks; the jury deliberated for about 10 hours in all today and on Friday. Balkwill did not attend or testify. Jurors heard his statements regarding the deal via past depositions. The county argued that it followed normal bidding procedures and awarded the contract fairly because Armor was the low bidder.

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

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

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

May 25, 2010  Herald Tribune
A judge is considering whether or not to void a lucrative jail contract after former Sheriff Bill Balkwill erased thousands of files from his computer. The case, now entering its second year, returned to court Monday, as lawyers for Balkwill, the Sarasota Sheriff's Office and competing health care companies tried to sway Circuit Judge Robert Bennett. At stake is the $9 million deal to run health services at the Sarasota County jail. The company that lost out, Prison Health Services, says its rival, Armor Correctional Health Services, had an inside track to the contract because of a close relationship with Balkwill. PHS experts say that Balkwill and former Armor CEO Doyle Moore scrubbed their hard drives of thousands of files. Bennett could rule a number of ways, from deciding that the scrubbed files are so important that the contract should be void to simply telling potential jurors that someone tampered with key evidence.

March 15, 2010 Herald-Tribune
Last April, Gov. Charlie Crist assigned a special prosecutor to look into claims that Bill Balkwill, the former Sarasota sheriff, took home a department laptop and deleted key files about a jail contract. The investigation, rooted in questions of whether Balkwill awarded the contract to a company he had close ties to, was supposed to take a year. With the April deadline looming, however, the governor has granted prosecutors an extension, which suggests the inquiry could be heating up. After months of quiet work -- the investigation was ongoing, officials repeatedly said -- prosecutors will now be looking for additional computers and documents as they look into Balkwill and 11,000 files deleted from his laptop, according to people briefed on the investigation. Two people close to the case say authorities are expected to examine computers belonging to the former CEO of Armor Correctional Health Services, which won a hotly contested contract at the county jail. The company who lost the bidding filed a lawsuit, claiming that Armor had an inside track and gave Balkwill gifts during the negotiations. Lawyers asked for the computers of both Balkwill and Armor's former CEO, Doyle Moore, and found they had both scrubbed their hard drives of thousands of files by using an Internet program. Thus far, it is believed that prosecutors have only reviewed Balkwill's computer. They are expected to subpoena the computer for Moore as well. Lawyers for Prison Health Services, which is trying to have the jail contract overturned, say that they want to review specific files related to Armor's business dealings. Armor says these files are trade secrets and should not be made public. PHS says the files hold campaign contributions made by Armor, details of the $9 million contract and drafts of letters about the Sarasota County deal.

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

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

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

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.

November 3, 2006 Vermont Guardian
After losing more than $1 million in three months, the out-of-state company in charge of providing medical services to Vermont’s nearly 1,700 inmates has told corrections officials it wants out of its three-year contract. The state and Prison Health Services have been at the bargaining table for the past four months, but hit an impasse Monday, company officials said, and gave the state three months notice that it would not finish the last year of its contract. “As state corrections departments and county officials in charge of jails around the country know, the cost of providing healthcare – particularly nursing services — continues to rise,” said Susan Morganstern, a PHS spokeswoman. “We have chosen to give notice of termination to the Vermont Department of Corrections because the cost of providing healthcare to inmates has risen beyond the contract’s ability to cover that cost. Prison Health Services will never compromise the quality of our patient care because of financial reasons.” Morganstern said the contract talks between the state and PHS were collegial, but the two sides could not come to an agreement. In a report filed Oct. 31 with the Securities and Exchange Commission, PHS’ parent company — America Service Group, Inc. of Brentwood, TN — characterized the talks this way: “Throughout the last four months, the Company engaged in comprehensive, good faith discussions with this client in order to reach a mutually beneficial solution to this contract's financial underperformance.” America Service Group is one of the larger providers of prison health care in the U.S. Despite the $1 million loss in Vermont, the company reported nearly $500 million in revenues this year as of Sept. 30, but a loss of roughly $551,000. Corrections Commissioner Rob Hofmann said PHS approached the state about four months ago in an attempt to negotiate down some of the penalties it was being levied by the state, and receive higher reimbursement for services mainly due to high labor costs. At the time, Hofmann said he informed lawmakers, including the legislative Corrections Oversight Committee, and other state officials about the negotiations. “I think they were losing money because their bid was possibly too aggressive, but most importantly they were running into Vermont’s tight labor market, especially in terms of finding medical staff,” Hofmann said. This meant the company had to pay higher wages to attract staff, coupled with the already difficult problem of getting people to work inside a prison. Also, at the time of the negotiations, Hofmann said the state had levied substantial penalties against PHS because they had not met all contract requirements. For example, in some cases the contract called for the company to have a registered nurse on a shift, but instead used a licensed practical nurse. Hofmann said the penalties were in the “high hundreds of thousands of dollars.” Some of those the state was willing to negotiate down, but others it wasn’t. The department's previous contractor — Correctional Medical Services — was criticized by legislators, inmate advocates and family members for not providing adequate medical treatment to inmates. In some cases, independent investigations found that a lack of medical and mental health care resulted in inmate deaths.

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

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 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.

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.

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.

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
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, only one fell 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 questioning the 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.

May 23, 2005 Nashville Business Journal
A flurry of contract wins and losses resulted in America Service Group Inc. shedding almost 12 percent of their value Monday. On a down note, PHS has received notice it will not win renewal of a contract with the Idaho Department of Corrections that is set to expire July 11. The company has lost money on its Idaho contract so far this year and the competitor's bid included a full risk option. In recent years, America Service has reorganized its preferred contract structure, moving from a full-risk model to a shared-risk one. Under the shared-risk model, the company's exposure to hospitalization and other off-site medical expenses is capped. Likewise, the company was notified it was underbid on a contract with Guilford County, N.C.. That contract also has been a losing proposition this year for the company and is set to expire June 30.

March 1, 2005 Tennessean
Shares of America Service Group Inc. tumbled almost 9% yesterday in reaction to news stories by The New York Times that questioned the quality and effectiveness of medical care provided to prison inmates by the Brentwood company's Prison Health Services subsidiary. In lengthy front-page articles published Sunday and yesterday, the Times said a yearlong investigation of Prison Health Services revealed ''repeated instances of medical care that has been flawed and sometimes lethal.'' The company is among the biggest managers of health care and pharmaceutical services to prisons and jails in the country, with more than 80 contracts spread across 28 states. Specifically, the Times cited investigations into inmate deaths in upstate New York as indications that Prison Health Services failed to maintain adequate numbers of qualified medical staff, withheld prescriptions from inmates and failed to read patient records or discipline employees for misconduct. The stories also mentioned several lawsuits filed against Prison Health Services over inmate deaths in other states and linked the company's assumption of a lucrative contract to provide medical care to inmates at Rikers Island to an increase in suicides at the mammoth New York City prison during a six-month period in 2003.

Richland County Jail, Richland County, South Carolina
March 15, 2006 The State
Richland County officials plan to nearly double medical staffing and increase spending by 42 percent to help prevent inmate suicides and other problems that plagued the jail in recent years. The county is negotiating a $2.7 million annual contract with Tennessee-based Correct Care Solutions to provide medical and mental health services to the jail. "It's unfortunate that it took the deaths of three people to come to this position," said Dave Almeida, executive director of the state chapter of the National Alliance on Mental Illness, who lobbied the council to fire the old company. "Hopefully, this is the end of a very sad chapter." The county's previous contract with Prison Health Services Inc., also of Tennessee, was for $1.9 million. In September, the council fired the company following concerns about the deaths of three mentally ill inmates. Prison Health Services was given six months to pull out. Its last day is Friday. Correct Care Solutions is scheduled to start at 12:01 a.m. Saturday. From July 1, 2001, through Feb. 28, the county paid Prison Health Services $7.5 million for medical and mental health services. During that time, seven inmates died under questionable circumstances, including a mentally ill inmate who died of complications from hypothermia and two other mentally ill inmates who hanged themselves. Another inmate hanged himself in January, though investigators said he had no known history of mental illness. The families of the three mentally ill inmates -- Bobby Mott, Marc Washington and Antonio Richburg -- sued Prison Health Services. Mott and Washington's lawsuits were settled last year for a total of more than $600,000. Richburg's lawsuit has been partially settled for $500,000, court records show. An update on lawsuits filed by the families of three mentally ill Richland County jail inmates who died in custody: • Bobby Mott, whose age was listed as 58 or 61, died Jan. 22, 2003, at Palmetto Health Richland of complications from hypothermia he suffered a week earlier in his cell. Mott had been jailed on assault charges. Prison Health Services last year agreed to settle its part of the lawsuit for $375,000; the county agreed to pay another $50,000, court records show. • Marc Washington, 41, hanged himself Oct. 28, 2003, after being charged with criminal domestic violence of a high and aggravated nature. Prison Health Services last year agreed to pay $50,000 to settle its part of the lawsuit; the county and state mental health department agreed to pay $85,000 and $50,000, respectively, court records show. • Antonio Richburg, 29, hanged himself May 20, 2005, after not getting prescribed medication for his schizophrenia for seven days. He was facing armed robbery, assault and other charges. Prison Health Services recently agreed to settle its part of the lawsuit for $500,000, court records show.

September 9, 2005 AP
The Richland County Council has voted to terminate a contract with Prison Health Services, the largest U.S. provider of health care to inmates, following the deaths of three mentally ill inmates during the past three years. The company, which has been paid more than $6.5 million by the county since 2001, has come under fire for services in other parts of the country recently. The council voted unanimously this week to end the contract. Council member Val Hutchinson said the service was "unacceptable and inhumane" and chairman Tony Mizzell added the county was "terribly dissatisfied." Mizzell said the county wanted to act on the contract after a coroner's inquest into the May suicide of inmate Antonio Richburg. A special jury found that jail workers contributed to Richburg's death by not providing him with his prescribed medications. The inquest found the company was under a court order to follow a treatment plan for Richburg, who suffered from schizophrenia and bipolar disorder. Two other mentally ill inmates died in 2003 while under the company's care. The inmates' estates settled lawsuits against the company and the county earlier this year for more than $600,000.

August 31, 2005 The State
The widow of a Richland County jail inmate who hanged himself in May has sued the company hired by the county to provide mental health services to her husband. In the lawsuit filed Tuesday in circuit court in Richland County, Tiffany Richburg claims Prison Health Services Inc. failed to give prescribed medications to her husband, Antonio Richburg, for his schizophrenia and bipolar disorder. The lawsuit, which seeks unspecified actual and punitive damages, is at least the seventh Richland County lawsuit against the Tennessee-based company since 2003, including two other wrongful death cases that settled for a total of more than $600,000. A state mental health advocate Tuesday called on the county, which was not named as a defendant in the latest lawsuit, to cancel its contract with the company. “This is the third death of an inmate during the time Prison Health Services was responsible for mental health treatment,” said Dave Almeida, executive director of the S.C. chapter of the National Alliance for the Mentally Ill. “Three deaths later, it just defies explanation as to why those gaps were not addressed the first time.”
A special jury during a Richland County coroner’s inquest last month found that jail workers contributed to Richburg’s death. Coroner Gary Watts said the jury’s verdict gave him the go-ahead to pursue possible criminal charges. Richburg, 29, of Columbia, was found hanging in his cell May 20. In a letter to his wife the day before Richburg complained he had not received his medications for seven days. A copy of the letter was obtained by The State newspaper. The coroner’s inquest revealed that jail staff were under a Richland County probate court order to follow a treatment plan for Richburg. Besides Prison Health Services, Adriane Gillespie, a licensed practical nurse with Prison Health Services, is named as a defendant in the latest lawsuit.

July 16, 2005 The State
A special Richland County jury ruled Friday that county jail workers contributed to the May suicide of a mentally ill inmate.  The six-member jury found after the coroner’s inquest that Antonio Richburg died “due to a lack of standard of care by providers” at the Alvin S. Glenn Detention Center.  The verdict did not identify specific individuals.  Coroner Gary Watts, who presided over the rarely used court proceeding, said afterward the ruling gives him the go-ahead to meet with Solicitor Barney Giese’s office to pursue possible criminal charges through the county grand jury.  Asked who might be targeted, Watts replied, “I think it’s fairly obvious that the whole issue is about medical care, so it falls back on Prison Health Services.  “If it hadn’t been for the inaction of other people, he would still be alive,” Watts said.  The county has contracted with Prison Health Services since 2001 to provide medical services to inmates and has paid the Tennessee-based company a total of more than $5 million.  Critics nationally have accused the company, which serves about 270,000 jail and prison inmates in 38 states, of providing poor — sometimes fatal — medical care.  Testimony during Friday’s hearing revealed there were no jail records indicating Richburg, 29, a diagnosed paranoid schizophrenic, had received any anti-psychotic or antidepressant medications for seven days before he hanged himself in his cell May 20.  Harpootlian represented the families of Bobby Mott, who suffered hypothermia in his cell in January 2003 and died a week later; and Marc Washington Sr., who hanged himself in his cell in October 2003.  Prison Health Services and the county have faced at least six lawsuits since 2003 that contend jail inmates didn’t receive proper medical care, a State newspaper investigation found earlier. County attorney Larry Smith, who attended Friday’s hearing, declined comment on the verdict. He said he didn’t know whether Prison Health Services’ contract would be renewed, noting, “The whole situation needs to be shared with administration and (County) Council.” Efforts to reach Prison Health Services officials afterward were unsuccessful.  Watts engaged in a tense exchange with Adriane Gillespie, a licensed practical nurse who testified she made a “grammatical error” when she noted in Richburg’s medical records that she had received a prescription order for him on May 11, though she acknowledged the order wasn’t actually given until nearly a week later.  “Miss Gillespie, we’ve had nothing but misdocumentations,” Watts said. “It seems very strange to me that when the only time something is documented, it is the wrong date and the wrong time.”  Chief Deputy Coroner Ted Kennedy testified Gillespie told him that she and other staff nurses didn’t always follow protocols in administering medications, though he added she refused to admit to that in writing.  Watts would not let Gillespie’s lawyer, Kana Rahman, ask questions during the hearing.   Kennedy testified that another nurse, Vera Hanna, told him she had “never seen anything like the medical department at the jail,” and that she “knows a lot of information that could get a lot people in trouble.”  Hanna, a registered nurse who no longer works at the jail, testified that understaffing was a problem in the eight months she worked at the jail. She said she often was the only nurse on her shift for the entire jail, which she noted had an inmate population then of up to 1,100. But Hanna could not say how many inmates needed medication.  “When you have one medical staff (worker) for the whole facility, you can’t follow protocol,” she told jurors.

June 23, 2005 The State
The day before he hanged himself in his Richland County jail cell, Antonio Richburg said in a letter that he had gone seven days without his medication and that he was stabbing himself in the arm.  “I need for you to call down here and get on them for me,” the 29-year-old Columbia man wrote in the May 19 letter to his wife. The handwritten note, a copy of which was obtained Wednesday by The State newspaper, provides a stark glimpse into Richburg’s mental state before he killed himself. Advocates for the mentally ill want answers from county officials.  Richland County Coroner Gary Watts, who with the county Sheriff’s Department is conducting a joint investigation into Richburg’s death, said Wednesday he would hold a coroner’s inquest July 15 at the county courthouse.  The inquest is a rarely used proceeding the coroner presides over and in which he questions witnesses under oath. He can issue an arrest warrant if the six-member jury determines it is necessary.  The jail contracts with a Tennessee-based company, Prison Health Services Inc., to provide medical services, including mental health treatment, to inmates. Snowden said Wednesday she didn’t know how many Prison Health Services workers are at the jail. It is unclear what role, if any, the company had in Richburg’s death, though the firm has been named as defendant in at least six lawsuits in the county — three of which involved inmate deaths — since 2003. Six inmates have died under questionable circumstances since 2000, three of whom, including Richburg, hanged themselves.

June 10, 2005 AP
Richland County has been sued at least six times in the past two years by people who say the jail did not provide proper medical care. The county and the Tennessee-based private company that provides health care to inmates have settled at least two of the suits that involved mentally ill inmates, paying more than $600,000. "We have a lot of concerns about the types of treatment people with mental illnesses are receiving at the detention center," said Dave Almeida, executive director of the state chapter of the National Alliance for the Mentally Ill. Health care at Richland County's jail has been provided since 2001 by Prison Health Services Inc., a Brentwood, Tenn., company. Almeida sent a letter this week to county officials seeking more information about the deaths of three inmates, including Antonio Clarence Richburg, who was found hanging in his cell May 20 in what authorities say was a suicide. The other four lawsuits involve claims the jail didn't provide proper care to inmates with existing illnesses or injuries sustained behind bars, including a suit over inmate George King. The suit says King died from complications from pneumonia and renal failure after he wasn't properly treated for his injuries from a fight with another inmate.

Rikers Island, New York, New York
Sep 27, 2014 nydailynews.com

A health care worker at Rikers was charged with taking bribes after he provided contraband to inmates. A naughty nurse was busted for giving Rikers Island inmates too much TLC: tobacco, liquor and contraband drugs. Jeffrey Taylor, 48, of the Bronx, was arrested on felony charges for sneaking the banned products inside to prisoners over the last five months, the Department of Investigation announced Wednesday. A criminal complaint said the licensed practical nurse confessed to the crimes after his Tuesday night arrest. “I was approached by an inmate to see if I could do a favor for (another) inmate (to bring in tobacco),” Taylor allegedly said. “Out of curiosity and need, I agreed.” The nurse, who has worked at Rikers for the past four years, collected more than $2,200 in 28 payments via Western Union money orders for providing inmates with a selection of vodka, rum and flavored drinks. Taylor also furnished inmates with loose tobacco, and once delivered 20 strips of the prescription opiate suboxone for a $200 payoff, the complaint charged. Tobacco was seized at Rikers during the arrest of Jeffrey Taylor, a licensed practical nurse charged with taking bribes to provide contraband to prisoners. Tobacco was seized at Rikers during the arrest of Jeffrey Taylor, a licensed practical nurse charged with taking bribes to provide contraband to prisoners. He became the 11th city Department of Correction employee busted in an ongoing Department of Investigation probe of the Rikers Island jail, and remained jailed on $15,000 bond pending a Tuesday court date. Department of Correction officials, while declining to comment on the specifics, offered support of the DOI’s ongoing probe into criminal activity at the sprawling jail complex. “It should be clearly understood that there is no room for corruption in Commissioner (Joseph) Ponte’s reform agenda, and the department is fully cooperating with DOI’s ongoing efforts,” said a Correction Department statement. The Department of Investigation and Correction Department joined forces for several sweeps at Rikers in the last few months, including one last week in which several weapons — including razors and shivs — were recovered. Taylor was accused of taking bribes, official misconduct, conspiracy and promoting prison contraband. The criminal complaint against him charged that Taylor took orders from three inmates and stashed the contraband in an area where the trio worked on a cleaning crew. Jeffrey Taylor is the 11th city Department of Correction employee busted in an ongoing Department of Investigation probe of the Rikers Island jail. The three made the pickups and then delivered the products to other prisoners. The nurse received payments for all his services via wire transfers to a Bronx check-cashing business, in amounts ranging from $25 to $299.99, between May and September, authorities said. He works for Corizon Health, a private company contracted by the city to provide health care for inmates. The felony charges in the case carry a maximum prison term of seven years. Tennessee-based Corizon was awarded three contracts, totaling $367 million, to run health clinics at Rikers, beginning in 2008. Its most recent deal began last year and runs through 2015, with an anticipated cost to the city of $126 million.


Aug 23, 2014 dnainfo.com

RIKERS ISLAND — Andy Henriquez, a 19-year-old from Washington Heights, whispered through the walls of his solitary cell on Rikers Island that he was dying.He begged for a doctor while his fellow inmates screamed and kicked their doors in a fruitless bid to get help. It was April 7, 2013, and a tear in Henriquez's aorta, an artery that supplies blood to the body, was making its way down to his groin. After days of chest pain he could barely breathe, but he still cried out, asking for a chance to call his mother to say goodbye. A doctor who visited him that day prescribed him a hand cream and wrote the prescription in the wrong name. Henriquez was found dead on the floor of his cell hours later. This wrenching account is detailed in court documents filed by Henriquez's mother, Sandra De la Cruz, a home health aide, who said she watched her son suffer with no treatment. She is now suing Corizon, a national company that covers medical care at the city's jails. “I felt desperate. I felt despair, not being able to help my child,” De la Cruz told DNAinfo New York in Spanish from her lawyer's office recently. “They should have let him leave. They should have taken him to the hospital. If I could have, I would have.” De la Cruz is one of more than two dozen New Yorkers who have sued Corizon since 2012, accusing the company of negligence in medical care at Rikers and other correctional facilities. At the same time, the company raked in $1.2 billion last year in revenue, according to a Moody's report, including tens of millions of dollars paid by the city. Henriquez's death came two years after New York's Commission of Correction had already opened an investigation into other state inmates' deaths under Corizon's watch, city records show. The outcome of that investigation was unclear and the commission declined to say whether it had finished or what it had found. Corizon and the city's Law Department declined to comment. "Although we sympathize with Mr. Henriquez’s family for their loss, we cannot comment on ongoing litigation," the city's Department of Correction said in a statement. Henriquez was 16 when he entered Rikers in June 2010, charged with murder and gang assault in the death of 17-year-old Mohamed Jalloh in Washington Heights. Henriquez was accused of being part of a group which attacked Jalloh and two other people, though Henriquez was not the one who fatally beat Jalloh with a machete, according to the criminal complaint and police. Henriquez was still awaiting trial when he died nearly three years later. The teen first complained of chest pain in September 2012, seven months before his death, and a physician's assistant at the jail's medical clinic diagnosed him with costochondritis, or joint pain near his heart, court documents show. He was given that diagnosis at least eight separate times over the next seven months, but the Rikers clinic repeatedly sent him back to his cell without ordering a cardiac exam or any follow-up testing that could have revealed the tear in his artery, court documents show. “He used to say ‘I don’t feel right, my chest hurts, I feel like I can’t breathe,'" according to Jesus Ramos, one of six Rikers inmates who said in depositions this spring that they had tried to get help for Henriquez as he was dying. “I used to scream — bend down from under my door, scream under my door, ‘CO, CO, 5 cell needs medical attention.'" Henriquez's mother and girlfriend visited him on April 6, the day before he died, and were alarmed to see the teen slumped over and in pain. They called 311 several times that day begging for emergency treatment for him, according to court records. He was finally seen at the jail clinic later that night and was given the anti-inflammatory drug Naprosyn and the muscle relaxant Robaxin and sent back to his cell, according to court documents. Hours later, he was given a hand cream that was prescribed to a different name. Correction officers were supposed to check on everyone in Henriquez's section of the jail at 15-minute intervals, but officers admitted in depositions that the checks did not happen like they were supposed to. The officers denied hearing any calls for help. But Ernest Madison, who was in a nearby cell, said in a deposition that correction officers ignored Henriquez's cries. “Then [on April 7], he was screaming again and that’s when they said, ‘Look, we took you yesterday. The doctor said you’re fine,'” Madison said in a deposition. By the end of the night, Henriquez was dead. The cause was a tear in his aorta, the city's medical examiner ruled. It's a condition that could have been treated in a hospital, saving Henriquez's life, according to Dr. Michael Golding, who is certified in heart and lung surgery in New York and wrote an expert medical report that is part of the lawsuit Henriquez's mother filed. "It was a gross departure from proper medical standards" to put Henriquez in solitary confinement without a full medical exam and testing, Golding said in documents. If Corizon's medical team had followed "standard medical protocols for recurring chest pain...they could have easily established a diagnosis [and] prevented his suffering and untimely death." Henriquez was just one of many Rikers inmates harmed by medical failures there, advocates say. "We get calls complaining about access to medical care and inadequate medical care on a weekly basis," said Mary Lynne Werlwas, an attorney at The Legal Aid Society's Prisoners Rights Project. "We're not a fan of the way they've been doing their job...and there's just been egregious health care." Other lawsuits pending against Corizon include one from the family of a 32-year-old man who died of a bacterial infection in Rikers in May 2013, arguing that he would have survived if he'd received prompt medical care, court records show. Prisoners who have sued also include a man who claims staffers overlooked his worsening leg problems, leading him to need an amputation, and a man with epilepsy who lost his vision after an assault and waited more than a month for glasses, court records show. The city's Department of Health and Mental Hygiene has contracted Corizon for more than a decade, previously under the name Prison Health Services, city records show. The most recent three-year contracts pay a Corizon affiliate $280 million for medical care and more than $128 million for administrative support, according to the city comptroller's office. The two contracts are among the top 10 largest contracts in the city, according to a city report. Corizon has been the subject of multiple investigations by the state's Commission of Correction, according to city records, including inquiries into inmate injuries and deaths, but still received a new contract from the Department of Health last year. Corizon provides health services in correctional facilities across the country and has been the target of multiple probes involving its hiring practices and quality of care. In Philadelphia, the company paid a $1.8 million settlement to the city in 2012 for exaggerating its hiring of minority workers. In Suffolk County, Massachusetts, Corizon lost its contract for providing health care at a local jail after a federal report blamed the company for not properly treating a 49-year-old immigrant who had been detained. The man was suffering a bacterial infection and died in October 2009 after he was not taken to a full-service hospital until it was too late, according to reports. In New York, Corizon's contract ensures that the city will represent the Tennessee-based company in lawsuits and that taxpayers will cover the cost of medical malpractice judgments or civil rights violations, records show. Advocates said the contract raises concerns about whether the for-profit company would be motivated to provide better care. "These indemnification provisions create a perverse incentive for Corizon to provide substandard health care,” Carl Takei, an attorney with the American Civil Liberties Union, wrote in an email. “These provisions essentially shield Corizon from the financial consequences of malpractice and constitutionally deficient medical care, because the [government] will pay any judgment or settlement.” Corizon was also separately censured earlier this month by the federal Occupation Safety and Health Administration for failing to protect its staff at Rikers and was fined $71,000, the Department of Labor said in a statement. More than a year after Henriquez's death, his family said the loss is still fresh. The men who were there alongside Henriquez that night say they are "haunted." “He was screaming all day and all night,” Ernest Madison said in a deposition. “It’s not a joke. A little boy died. He was a kid." With reporting by James Fanelli and Gustavo Solis

 

Aug 23, 2014 nydailynews.com
A diabetic man died on Rikers Island after being denied medical treatment for two days, a new lawsuit charges. In papers filed in Manhattan Federal Court, Linda Mercado says her brother Carlos slipped into a diabetic coma and then died after guards were slow to respond to pleas for help from Mercado and other inmates. Mercado, 45, was arrested on Aug. 22 of last year for heroin possession, and was taken to Rikers the next day. The suit says he "requested medical treatment for his diabetic condition" after he got to the jail, but "none was provided," the suit says. Mercado family lawyer Mark Taylor said the jail's health care provider, Corizon Health, gave Mercado a preliminary exam, but no treatment — and it should have been clear his client needed help. "He was yelling and asking for assistance, and those cries were taken up by his cellmates," Taylor said. By the time he was treated, it was too late. Correction officers called for assistance at 9:17 a.m., after he'd passed out. He was pronounced dead at 9:36 a.m. The wrongful death suit charges both the Department of Correction and Corizon Health, the embattled medical provider for the city's jails, with negligence, and seeks unspecified money damages. In the hands of the guards at Rikers Island he couldn't get the treatment he needed. No human being should go out like that. "My brother had managed his diabetes for a long time, he knew how to take care of himself, but he could only do that if he had access to his medication. In the hands of the guards at Rikers Island he couldn't get the treatment he needed," Linda Mercado said. "No human being should go out like that."  Taylor said that Carlos Mercado had been locked up at Rikers once before, in 2007. He was denied treatment for his diabetes then as well, and eventually had to be treated at Elmhurst Hospital Center. A rep for the city Law Department said the suit would be reviewed once the city is served with the legal papers. "Corizon Health stands behind the quality of care provided by our medical professionals," a spokeswoman said. DNAinfo reported earlier this week that Corizon has been sued over medical issues at city jails over two dozen times since 2012. In one particularly troubling case reported by the Daily News, Andy Henriquez, 19, died in solitary confinement.



Aug 10, 2014 ohsonline.com

According to a DOL news release, Corizon Health Inc. knowingly failed to protect its employees adequately against workplace violence and assault. The medical, dental, and psychiatric provider was inspected by OSHA and new faces $71,000 in fines. OSHA has cited Corizon for one willful violation for allegedly failing to develop and implement an effective workplace violence prevention program for its employees at Rikers Island. "Corizon failed to address the serious problem of assaults against its employees until OSHA began its inspection," said Robert Kulick, OSHA's regional administrator in New York. "Corizon needs to develop and implement an effective, targeted workplace violence prevention program that includes administrative and engineering control, as well as personal protective equipment and training, to reduce the risk of violence against its employees." OSHA has listed effective workplace violence prevention techniques, such as: administrative controls, including job site hazard assessment, evaluation of existing controls, implementing policies, procedures, and incident reviews; engineering controls, including the installation of panic alarm systems and protective barriers and configuring treatment areas to maximize an employee's ability to escape from workplace violence; personal protective equipment, such as personal alarm systems for all staff and an appropriate system and way to contact security/correctional officers; training, encompassing workplace violence prevention, stress management, recognition of signs of potential violence; and post-incident procedures and services to treat employees traumatized by a workplace violence incident.

July 29, 2010 NBC NY
A Rikers Island doctor was charged with sexually abusing a female inmate, authorities said Wednesday. Dr. Frank Leveille, a 12-year employee at the jail, was arrested in the early morning hours on two charges of sexual misconduct. Leveille, a 70-dollar-an-hour doctor who worked with female inmates, is an employee of Prison Health Services, a private company that handles medical care at Rikers. “The physician is charged with... violating his fundamental professional responsibility,” said Department of Investigation Commissioner Rose Gill Hearn. A prison spokesperson declined comment and Leveille's attorney did not immediately return a call for comment. A female inmate alleges the sexual abuse occurred on March 28 at 2 a.m. New York law says it is illegal for a prison facility employee to have any sexual relations with an inmate. Leveille’s arrest marks the second medical scandal at Rikers in as many weeks. Dr. Trevor Parks resigned on July 14th amid allegations he was not certified to provide medical care to prison inmates -- yet he was managing the health care of 12,000 inmates. Critics charge Prison Health Services provides second-rate care in order to save money, the for-profit firm has a $123-million-dollar New York State contract. A PHS spokesman did not return calls for comment. Officials said Leveille also works as a family specialist at Brooklyn Medical Plaza. A woman who answered the phone there declined to comment. Leveille is charged with third degree sexual abuse and a third degree criminal sexual act. The doctor faces more than four years in prison himself, if convicted.

July 18, 2010 New York Times
The doctor in charge of medical care for 12,000 New York City jail inmates abruptly resigned last week after questions arose about his professional certification, forcing city officials and executives at the company that employed the doctor to race to find a temporary replacement. The doctor, Trevor P. Parks, resigned on Wednesday, a day after a reporter called the city’s Department of Health and Mental Hygiene, which oversees the delivery of medical care to jail inmates, with questions concerning Dr. Parks’s board certification for internal medicine. Dr. Parks, the medical director overseeing care at Rikers Island and the Manhattan Detention Center, worked for Prison Health Services, a Nashville company that holds a $123 million contract with the city’s health department for comprehensive jail medical care. The company, one of the largest for-profit correctional health care companies in the country, has held that city contract since 2001, but not without controversy. While city health officials have defended the company’s performance and dedication to improvement, Prison Health’s critics, including state medical officials and some company doctors and clinicians, have said its focus on cutting costs and staff led to substandard care. Not long after the company arrived in the city, the State Commission of Correction, which investigates each prison or jail death, began publicly criticizing Prison Health for what it called a pattern of providing care that repeatedly harmed inmates with acute physical or mental illnesses. In a telephone interview on Thursday, Dr. Parks said he had resigned to concentrate on appealing a recommendation last month by the American Board of Internal Medicine to suspend his certification, the reasons for which he declined to discuss. “They’re just concerned with something that I got caught up in, and I’d really rather not go into it,” he said. The internal medicine board, through a spokeswoman, declined to discuss its recommendation to suspend Dr. Parks. Dr. Parks said that he was proud of his record as the company’s chief medical officer in city jails, and that Prison Health, under city oversight, had improved by “leaps and bounds” during his 10-year tenure. “I have to honestly say to you, from where jail care was when I started in 2001 to where jail care is in 2010, we have turned that place around,” Dr. Parks said. “We used to lose 30 people a year when I started, and last year maybe we had 12,” he added, referring to inmate deaths. “We do not follow the guidelines as set up by P.H.S. in other parts of the country; we follow guidelines specific to Rikers Island.” The city requires the Prison Health medical director to hold a board certification. That Dr. Parks’s certification was in jeopardy was a surprise to city health officials who oversee Prison Health’s medical care and rate its performance. Susan Craig, a health department spokeswoman, said the agency learned of the certification issue on Tuesday only when a reporter called to ask about it. Dr. Parks resigned on Wednesday. By Thursday, Ms. Craig said, Prison Health had appointed a temporary replacement to run medical services at Rikers and the Manhattan jail: Dr. Luis Cintron. Dr. Cintron’s appointment, however, is only temporary because though he has passed his board exams, he is not yet board-certified, said Louise Cohen, the health department deputy commissioner in charge of overseeing Prison Health’s medical care in city jails. Dr. Cintron, in turn, will be overseen by two health department doctors who will ensure the proper continuity of care to inmates, Ms. Cohen added. A Prison Health spokesman said in a statement that the company was working with city health officials to ensure that Dr. Parks’s resignation would not adversely affect inmate care.

September 19, 2008 New York Sun
A former substance abuse counselor at Rikers Island faces felony charges after allegedly attempting to smuggle heroin and cocaine into the pris