No rating improvement for New York City jail health provider
May. 11, 2015
NEW YORK (AP) — Overall performance of the private health care provider for New York City's jails failed to improve last year amid heightened scrutiny over inmate deaths that put the company's contract under review, according to an evaluation obtained by The Associated Press.
Corizon Health Inc., whose three-year, $126 million contract expires Dec. 31, received an overall rating of "fair" in 2014 for the second straight year after being downgraded from "good," according to the annual review conducted by the city health department.
Officials noted the Brentwood, Tennessee-based company improved its care of mentally ill inmates, who make up about 40 percent of the roughly 10,000-inmates in New York's sprawling Rikers Island jail complex. But the company did a "subpar" job prioritizing the sickest inmates to be seen in jail health clinics, the evaluation shows.
A spokeswoman for Mayor Bill de Blasio said in a statement that the Corizon contract is still under review. In March, the mayor said administration officials were taking "a hard look" at the contract. The city health department, which is charged with providing health care to the jail, has not issued any formal requests for proposals to solicit new bids.
But a person with knowledge of the administration's discussions, who spoke to AP on condition of anonymity because no final determination has been made on a contract, said it was likely the city's public hospital system would take over inmate care.
Corizon's flat ratings come amid heightened scrutiny of the jails in the wake of a series of AP revelations last year about gruesome deaths of mentally ill inmates at Rikers — including one left alone for hours in a cell that sweltered to 101-degrees because of malfunctioning equipment and another left unchecked, covered in feces, in his cell without medication for days, during which time he sexually mutilated himself.
Another AP report last year, based on hundreds of city and state documents, found that the timeliness and quality of jail health care was a factor in at least 15 inmate deaths deemed medical in nature since 2009.
Lawmakers subsequently held an oversight hearing to question Corizon executives, suggesting the city adopt a new model for jail health care.
"Big cities across the country are dropping contracts with Corizon because of its underperformance," said City Councilwoman Elizabeth Crowley, adding that the city's public hospital system, the Health and Hospitals Corporation, should take over care. "You're an inmate in jail, but when you're in that clinician's space you are a patient and you deserve the best quality health care for whatever your ailment is."
In a seven-page response to the city, Corizon officials said the company deserved a higher rating, noting it has improved the treatment of seriously mentally ill inmates in two therapeutic units for inmates who have broken jailhouse rules or are susceptible to doing so.
Company officials also noted that factors out of their control, such as the ability of jail guards to bring inmates to health clinics on Rikers Island, impacts the treatment inmates receive. Facilities are often locked down for security reasons, such as cell searches, and staffing limitations can affect how many correction officers are available to escort sick inmates to clinics. The city's contract evaluation notes that in some cases, only 50 percent of inmates in need of care are actually brought to clinics by guards.
Jail health care at Rikers and nationwide is notoriously difficult to provide. Experts say inmates come into lockups suffering from higher rates of diseases, such as hepatitis C, and chronic health conditions. In New York, nearly 90 percent of inmates have a substance abuse disorder.
The contract evaluation also comes as a report by state investigators on 37-year-old inmate Alan Williams' May 2013 death found problems with the care provided by Corizon workers. The report was made public this month.
Williams was prescribed a toxic combination of methadone and other drugs based only on a history of heroin use by Corizon workers who didn't properly diagnosis him and then failed to follow their own procedures, according to the state Commission on Correction report obtained via a public records request.