Florida’s newly-minted corrections chief Julie Jones has announced that her department will rebid $1.4 billion worth of private contracts to provide healthcare to approximately 100,000 inmates across the state.
The majority of those contracts are held by the nation’s largest and most controversial prison medical provider, Corizon Health Services. Another private provider, Wexford Health Sources, will have its contracts put up for bidding as well. Under those agreements, Florida was to pay Corizon $229 million per year until June, 2018 and Wexford $48 million per year until December, 2017.
Corizon and Wexford were fined $22,500 by the state at the end of January for providing ‘deficient care’ to its prisoners. Shortly thereafter, Jones threatened to cut ties with both contractors unless they negotiated a new deal “with an eye to enhancing prescription drug delivery, mental health services and nursing care [including] requiring more registered nurses to be on hand rather than less-skilled staffers.” Apparently those demands could not be met.
The Florida Department of Correction notes that rebidding the contracts will cause healthcare spending in prisons to increase. Considering these companies have been known to engage in cruel profit-maximizing strategies (such as hiring and underpaying too-few and often underqualified staff or changing / denying inmates’ prescriptions) this was somewhat inevitable without further-compromising inmate healthcare.
Some of these problems were baked right into the contracts themselves; for instance, Corizon agreed to the ridiculous term that its services would cost the state “7% less [to provide care] than what it cost in 2010,” despite a growing prison population and rapidly increasing healthcare costs. As a result, incarcerated people in Florida and their families and loved ones have greatly suffered: Corizon and Wexford were found to have withheld reports on inmate deaths, some of which were the result of extreme neglect, and were sued for facilitating the ‘systemic abuse’ of mentally ill prisoners.
Jones has said the department is not only rebidding the contracts but working to improve their terms to avoid problems in the future. According to the Tampa Tribune:
Jones is seeking “enhanced elements” to the current contracts that will include “the ability to ensure that appropriate staffing is provided by our contractors that enables a proper mix of administrative and institutional-level direct care, the presence of medical staff who possess the proper skills and qualifications to provide quality care to our inmate population and clinical oversight and supervision.”
Jones wants the contractors to perform internal audits of staffing levels, which also will be monitored by the state Correctional Medical Authority and the department’s health services staff.
She also intends to demand higher penalties for the companies if they fail to meet minimum staffing or standard-of-care levels.
Why such basic elements are considered “enhanced elements” and were excluded from the original, 5-year, billion-dollar contracts is unknown, but it’s alarming given Florida’s disgraceful past delivering healthcare to inmates. We do know, however, that the absence of such policies allowed private contractors to quietly reap millions while incubating horrendous conditions in the country’s third-largest prison system, and we should welcome their overdue inclusion.
But ending and reforming these contracts are only a few parts of this gargantuan puzzle. Florida would do well to compliment these efforts by seeking to reduce the number of incarcerated people in the state, particularly those suffering mental illness and approaching the end of their lives. Not only is their incarceration inhumane and immoral, but it’s also extremely expensive.
The priorities need to change, and individual healthcare needs need to be put first. That includes questioning whether some of these people can be rehabilitated in prison.
Brian Sonenstein
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