Report Critical of Maine DOC’s Medical Contractors

by Joe Watson

For nine years, Corizon had a lucrative monopoly on prison healthcare in Maine. But after a November 2011 state agency review cited persistent “deficiencies,” the company appears headed for a bidding war.

After reviewing medical files for at least two dozen prisoners at the Maine Correctional Facility and Maine State Prison, the state’s Office of Program Evaluation and Government Accountability (OPEGA) reported that prisoners are being denied their prescribed medications and providers are effectively unresponsive to sick-call requests.

The inspected files also indicate that half of the prisoners surveyed aren’t receiving their required annual physicals or, at least, they aren’t consistently tracked. Staff training, OPEGA reported, has been insufficient and poorly documented. And Maine’s Department of Corrections (MDOC) has failed to hold Corizon, as well as pharmacy contractor CorrectRX, accountable on most of these issues, thanks to their non-competitive state contracts worth millions of dollars.

Now both companies will have to bid for those coveted contracts like everyone else.

“The long-term relationship between MDOC and its contractors appears to be a contributing factor,” according to OPEGA’s review, “as the delivery of health care has become more of a partnership than an arms-length arrangement.”

But under Commissioner Joseph Ponte, who took over MDOC in 2011, the department is now “taking positive steps toward improvements in the quality and cost of prisoner health care,” OPEGA reported. For Republican state Senator Roger Katz, the chairman of the legislature’s Government Oversight Committee, the only way forward is by refusing to renew Corizon’s $12 million annual contract.

“My question to you is in light of this history, why should the state seriously be considering any proposal your company might make to get this contract back again?” Katz asked Corizon Regional VP Larry Amberger at a committee meeting in January 2012.

Amberger responded that, in spite of the OPEGA report, he believes that Tennessee-based Corizon has provided a high quality of service. He also challenged OPEGA’s methodology –claiming the agency’s review of medical files was too stringent – and implied that state investigators appeared too willing to cite Corizon’s problems as “systemic.”

OPEGA, however, stressed the importance of attention to detail in prison healthcare.

“Prisoners have legal rights to receive adequate and timely care,” the report stated. “The prisoner population tends to have issues that make delivery of health services in a correctional setting more challenging than in a community setting.”

Some of those issues, according to OPEGA’s report, include a lack of good preventive medical or dental care for many prisoners prior to their incarceration; prisoners’ high-risk lifestyles, which lead to the early on-set of medical conditions; prisoners seeking narcotic-level pain meds because of their histories of substance abuse; some prisoners’ distrust of medical caregivers; and the challenge of establishing a continuum of patient care after prisoners are released.

The report also recommended that the MDOC develop a better monitoring system for private contractors and offer better staff training.

“MDOC has not had a strong and effective system for monitoring contractor performance and compliance or held the contractor sufficiently accountable for resolving issues when they were identified,” the report said.

Although OPEGA praised the MDOC’s new leadership, prisoner advocates have already taken issue with Ponte’s focus on cost reduction, potentially at the expense of quality care. John Patterson, president of the Maine chapter of the American Civil Liberties Union, told the state’s oversight committee that, based on OPEGA’s report, he believes the MDOC is denying prisoners their constitutional right to medical care.

“The Eighth Amendment prohibits infliction of cruel and unusual punishment on convicted prisoners,” Patterson said, “which has been interpreted to include deliberate indifference to basic human needs such as medical care.”

Certain medical procedures for prisoners have already been discontinued, including knee replacement surgery. And previously, prisoners averaged seven prescribed medications each. Since Ponte took over, that has been reduced to five. Whether that’s a byproduct of Ponte’s commitment to stem wasteful spending or indifference toward prisoner care is debatable.

Sources: Office of Program Evaluation & Government Accountability of the Maine State Legislature, November 2011 Final Report. “Health Care Services in State Correctional Facilities,” www.maine.gov/legis/op, www.mpbn.net, Bangor Daily News, www.bangordailynews.com

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