Plans to de-privatize prisoner healthcare

by Ashleigh Dye

On December 11, 2021, the Virginia Department of Corrections (DOC) announced that the state Supreme Court had denied an Emergency Motion to Stay and Petition for Review filed by Armor Correctional Health, the private contractor whose termination DOC announced the previous July.

The Miami-based company had held the contract since 2014, earning $84 million annually before the cost rose to $90 million in the last fiscal year. Under DOC’s original exit plan, Armor would have remained on the job at state prisons another year after that.

But DOC moved to immediately terminate the contract after Director Harold Clarke wrote in October 2021 to advise state House and Senate leaders that the agency’s “relationship and correspondence with the vendor has degraded significantly.”

Armor CEO Otto Camp shot back that “[t]his decision is consistent with a well-documented pattern of mismanagement at [DOC],” and the company went to court to continue providing healthcare to the state’s 25,000 prisoners.

A Richmond Circuit Court judge ruled against Armor, however, saying that DOC did not act arbitrarily and capriciously in its decision to cancel the contract and Armor did not carry its burden to prove the need for a temporary injunction. The decision by the state Supreme Court affirmed that ruling, clearing the way for VitalCore Health Strategies to take over prisoner healthcare in the state on an interim basis while DOC completes plans to take it in-house again.

A Rare Example of De-privatization in Corrections

Bucking the trend of increasing privatization in corrections, Clarke insists the decision was not due to Armor’s failure but was based on studies and cost analyses. Yet one such study in 2018 found understaffing issues were prevalent in Armor-run facilities, which had a staff turnover rate twice that of DOC-run facilities.

DOC’s pull-back can be traced to 2016, when the state settled a lawsuit over allegations of poor health care at Fluvanna Correctional Center for Women (FCCW). See: Scott v. Clarke, 2016 U.S. Dist. LEXIS 14192 (W.D. Va.).

Since then, DOC has appointed a doctor at the University of Virginia (UVA) as its Director of Health. But the agency still has far to go in meeting the settlement terms, according to Dr. Homer Venters, the court-appointed monitor over the 2016 settlement.

Part of the plan to de-privatize relies on help from state-funded university hospitals. The plan will not be completed until 2025, but since 2019 lawmakers have established two such partnerships, pairing FCCW with UVA Health and State Farm Correctional Center with Virginia Commonwealth University (VCU) Health.

Driving these changes is frustration of state lawmakers such as Sen. Creigh Deeds (D-Warm Springs), who said about the dire situation at FCCW in 2019, “Every couple of months we hear about someone else dying at Fluvanna. Why would we continue to hear about inmates needlessly dying there? Tell us what you’re going to do to make things better.”

Agreed Judge Norman Moon, who oversees the FCCW lawsuit filed in U.S. District Court for the Western District of Virginia: “The prison system’s position seems to be that because it could take a long time, it will take a long time.”

Meanwhile FCCW’s infirmary remained an area of great concern in a November 2021 monitoring report submitted to the Court by Dr. Venters, who noted problems including patient repositioning, linen changes and toilet access for bed-bound patients, which created fall risks. He concluded that the infirmary “is a place of considerable physical risk and ongoing injury due to falls for the patients who are housed there.”

Another area of noncompliance at FCCW was the inpatient mental health unit. Because it is used for two separate groups of prisoners—those with severe mental illness and those who have potentially suicidal behaviors—FCCW is unable to “provide women who are placed on this unit with an appropriate level of care,” Venters reported. Instead, prisoners spend most, if not all of the day, locked in their cells.

The report noted plans to hire and train staff to address the needs of these women and enable them out-of-cell time. Venters also found areas of compliance, including Physical Therapy. He concluded that FCCW staff had an understanding of what needs to be done and plans to achieve it, scheduling another visit for early 2022. See: Scott v. Clarke, USDC (W.D.Va.), Case No. 3:12-cv-00036-NKM-JCH.

FCCW’s healthcare problems may be well-publicized, but there are other troubled facilities. Deerfield Correctional Center, Sussex 1 and 2, State Farm Correctional Center, and Greensville Correctional Center have all had issues in recent years—many resulting in penalties for Armor. The decision by DOC and lawmakers to de-privatize health care is one which all hope will bring about much needed change.

“I believe working together, we can ensure we provide appropriate health care to our inmate population,” Director Clarke said.

This appears to be the first time in which a prison system that had privatized its health care system ended its relationship with private contractors and reassumed responsibility of its own health care system.  

Additional sources: Virginia Mercury, WHSV

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