Florida corrections officials scrap prison health contract

click to enlarge Florida State Prison in Raiford - Photo via Florida Department of Corrections
Florida State Prison in Raiford
Citing shortcomings in mental-health services at a South Florida prison, state corrections officials are terminating a contract with a private health-care provider months before the deal was set to expire.

Department of Corrections Secretary Julie Jones on Wednesday canceled the contract with Wexford Health Sources, giving the Pittsburgh-based company a required 180-day notice of termination. The cancellation notice means that Wexford will have to pull out of Florida prisons before its contract was set to expire in December.

Jones cited a scathing review this month from the Correctional Medical Authority about "the apparent lack of psychotropic medications prescribed and administered" to most of the patients receiving mental health services at a Doral facility.

The report, sent to Jones this week, included examples of inmates' medications being cut off and inmates getting put in restraints instead of being treated with medications.

At the time of the correctional authority's survey over a two-day period this month, only one of 37 inmates was prescribed psychiatric medications, according to the report.

"Although, not all inmates may meet the criteria to be placed on medications, the clinical justification for discontinuation was not always present in the medical record and often occurred without consideration of titration or possible withdrawal symptoms. Furthermore, there was no evidence in the records reviewed, that medications were considered when the inmate's mental status continued to decline," the report found.

But in an email to The News Service of Florida, Wexford took "strong exception" to the findings and accused Jones of not allowing the company to respond to the allegations before terminating the contract.

"We treat every patient under our care with respect and dignity, and with the full hope that we can help restore them to mental health. Isolated cases involving inmates with histories of mental problems would not appear to be the basis for termination of an entire contract," Wexford spokeswoman Wendelyn Pekich said in an email.

But the report draws attention to the types of cases that have earned the department a black eye after reports of inmate abuse at the hands of prison guards and of corrections' officers lack of training in how to handle mentally ill prisoners.

For example, the report documented the case of one inmate whose medications were discontinued after he was processed into the prison.

After entering the facility, the inmate's "behavior escalated, as evidenced by smearing feces, multiple self-inflicted lacerations to his arm, as well as banging, threatening, and continuing to cut himself," according to the report sent to Jones.

The behavior "continued for hours" until a clinician was notified, according to the report.

The patient was placed in restraints, but "there was no documentation that emergency medications were considered," the evaluators reported.

"Secretary Jones is absolutely outraged at Wexford's lack of performance and delivery of services" described in the report, the department said in a statement Thursday. "The department has been committed to meaningful health care reforms and takes the issues detailed in the CMA's notification extremely seriously. Following this medical emergency notification, the department immediately deployed a mental health ombudsman and behavioral health risk management team to review all inmate mental health needs handled by Wexford at South Florida Reception Center."

Wexford objected that, while privacy laws restricted the company's ability to respond to the specific examples cited in the report, "there was nothing in the treatment of these inmates that should, or could, justify contract termination based on medical considerations alone," Pekich said.

"It is extremely disappointing that the department acted without consulting with our psychiatric providers regarding the affected inmates, in order to determine why our personnel, relying on their professional judgment, pursued the chosen course of treatment. Instead, the department relied on CMA's non-psychiatric auditors, who —- without being licensed psychiatrists —- told the department how they thought these patients should have been treated. These allegations led to the declaration of an emergency situation," Pekich said.

Jones move to sever ties with Wexford came after after Corizon Health in late 2015 notified the state that it was walking away from a five-year, $1.2 billion deal three years early. The Tennessee-based company claimed it was losing money on its contract with the state.

Corizon managed health care for about three-fourths of the state's 100,000 inmates, while Wexford —- lauded by prison officials until recently for its performance —- handles about 18,000 prisoners in the southern portion of the state.

Jones came under fire for signing a no-bid, $268 million contract with Centurion of Florida LLC in January 2016 to take over for Corizon. Wexford's contract with the state was unaffected by the Centurion deal.

Jones decided to redo the health care services contracts in 2015, and issued an invitation to negotiate for select companies to submit proposals. Wexford and Centurion are two of the three companies vying for the contracts, which Jones has broken up into pieces, including mental health services.

Wexford, Centurion and Correct Care Solutions are all in the running to deliver mental health services to the state's prison system. Centurion and Wexford are also vying to provide medical services, according to the corrections department.

The cancellation of Wexford's contract is the latest twist in a drawn-out controversy over health care for Florida prisoners.

Earlier this month, the state and Corizon agreed to pay about $2.1 million to settle a class-action lawsuit filed by inmates who claimed the state agency and the company denied hernia operations to save money.

The embattled corrections agency has been under scrutiny for several years in the wake of reports of inmate deaths at the hands of prison guards, cover-ups regarding inmate deaths and allegations of retaliation against whistleblowers.

Appearing before lawmakers, Jones has stressed the need to beef up mental health services for inmates, citing treatment issues as a safety concern for prison guards as well as inmates.


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