AZ DOC medical: Corizon not expected to be much improvement...

Excellent commentary by our friends at The Tucson Citizen's Cell Out AZ Blog (I believe the American Friends Service Committee in Tucson is behind that) on the recent announcement by Wexford and the AZ Department of Corrections that they're parting ways. This doesn't bode well for the DOC as far as Parson v Ryan goes, of course - I really don't think Corizon is about to pull the DOC's medical delivery system out of the toilet fast enough to make much difference...
 

 At Wexford's AZ HQ in Phoenix - time to go!!!

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Arizona Corrections Replaces Horrible For-Profit Prison Medical Corporation With…Another Horrible For-Profit Prison Medical Corporation

Tucson Citizen
by cell-out-arizona
on Jan. 31, 2013

On Wednesday, January 30^th, the Department of Corrections abruptly announced that it had severed its contract with Wexford Health Sources Inc. and had already reached an agreement with Corizon, Inc. of Brentwood, Tenn., to become the health care provider for all state-run prisons as of March 4.

Reportedly, the divorce was initiated by Wexford, which claims it’s “performance was hindered by state monitors and a lack of cooperation by corrections.” The company was also testy about the fact that ADC had threatened it with a $10,000 fine for failure to fix staffing problems, properly distribute medication, and communicate problems to the state. Not to mention the fact that one of their “nurses” managed to expose 103 inmates to Hepatitis C because she apparently didn’t know that you can’t stick a dirty needle back into a bottle of insulin you plan to give to other people.

Is Wexford at all apologetic for all this? Not in the slightest. And they don’t have to be. They know that there’s another state legislature somewhere that, like ours, is naïve enough to believe that privatization of prisons and prison medical care will save them money. Why put up with Arizona’s pesky monitors and pay fines when you screw up when you can go somewhere where everybody’s willing to look the other way for the promise of saving a few bucks?

After all, it’s not like ADC didn’t know Wexford’s dismal track record when they hired them. Bob Ortega reported in the Arizona Republic that:

• Wexford opted not to renew a contract with Clark County, Wash., that expired at the beginning of 2010 after an independent audit concluded that “Wexford has systematically failed to comply” with its contract and had failed to provide adequate staffing, properly licensed staff, and adequate and timely medical service.

• In Mississippi, a 2007 audit was harshly critical of both the company and state corrections officials for failing to provide timely, adequate medical care. It also found that Mississippi’s Department of Corrections failed to collect $931,310 in fines its chief medical officer recommended against Wexford after the company charged the state for more staff members than it actually provided.

• Wexford has also faced fines for similar problems in numerous other states, including a $12,500 fine by New Mexico’s Department of Corrections in 2006; a $106,000 fine by Ohio’s Correction Department in 2009; $50,000 by Chesapeake, Va., in 2006 for staffing shortages; three fines totaling $273,000 by Florida’s Department of Corrections in 2005 for what it described as “service-delivery issues that were resolved” before the contract’s end; and a $68,000 fine by the Broward Sheriff’s Office in Florida in 2003 for delays in providing medical services.

And now ADC would have us believe that Corizon will do better. Did anybody bother to do the due diligence on these guys?

A little background: Corizon was created after the merger of two other huge for-profit prison health care corporations—PHS Corrections and Correctional Medical Services (CMS). Prior to the merger, PHS had 57 contracts in 150 jails across 19 states, serving about 165,000 prisoners. CMS served 250,000 in 19 states. When the two merged, Corizon became the largest prison health care provider in the country, operating in 400 correctional facilities in 31 states. Now, about 400,000 prisoners are subject to Corizon’s “care.”

A quick internet search of just the last three years of articles on the corporation’s misdeeds yielded enough evidence of medical neglect, wrongful death lawsuits, financial shenanigans, and outright abuse to give any rational person pause. Here’s a brief rundown:

A wrongful death and malpractice lawsuit was filed in St. Louis last year over the death of a jail inmate from complications of a heart problem. The suit alleges that the prisoner collapsed and died an hour after a doctor instructed jail staff to send him to a hospital immediately. Records show that a Corizon nurse believed that the prisoner’s episodes were ‘staged,’ and point to numerous instances of doctor’s orders not being consistently followed. (“Suit blames St. Louis medical care in inmate’s death,” St. Louis Post Dispatch, 5/24/12).

In 2012, Corizon paid the city of Philadelphia a $1.8 million fine after an investigation found the company was using a sham female-owned subcontractor to falsely claim it was meeting city requirements for participation by firms owned by women or people of color. A rival company owned by a woman claimed that it submitted a bid that was $3.5 million per year less than Corizon’s. Despite the fine, Corizon retained its right to bid on contracts and is up for renewal. Meanwhile, the city has paid out at least $1 million since 1995 to settle lawsuits over negligent medical care.. (“With contract out to bid, prison health care questioned,” Philadelphia Daily News, 8/28/12 and “City questioned over prison health care firm,” Philadelphia Daily News, 1/10/13).

A federal lawsuit against the Minnesota Department of Corrections was filed last year after an inmate with a history of seizures was denied emergency care by a Corizon nurse who overrode doctors’ orders for an ambulance. Within an hour, the man suffered irreversible brain damage that led to his death. Records indicate that Corizon’s “rationed care philosophy” is at the root of many such problems. For example, no Corizon doctors work after 4pm or on weekends. Nurses employed by the state department of corrections end their shifts at 10:30pm, leaving the prisons without medical staff overnight. Under Corizon’s contract, there is just one on-call doctor to serve the entire state prison system, and this doctor cannot access the medical files because the health services units are shut down overnight. (“Prisoner dies after denial of care,” Minneapolis Star Tribune, 7/9/12).

Washington County, OR ordered an audit of Corizon’s jail health services after the county went $171,000 over its almost $4.6 million budget in FY 2011-12. Cost overruns were reportedly common over the past six years. However, the county ran into “legal roadblocks” in obtaining the needed documents from Corizon. The company’s lack of transparency prompted the county to amend its contract with Corizon in 2012 in order to ensure that the county will have access to financial records and other documents, as well as the ability to perform site reviews. (“Long-delayed Washington County audit of jail health services points to contract problems, new auditing approach,” The Oregonian, 8/20/12).

In 2011, Corizon was fined nearly $400,000 by the state of Idaho for failing to meet some of the most basic health care requirements outlined by the state. Among the problems listed were the fact that one women’s prison had gone without an OB/GYN for two years and another maximum security prison had no staff psychologies for at least 8 months. These lapses were in violation of Idaho’s contract, which requires that vacant positions be filled within 60 days. The Director of the Department of Corrections indicated that the steep fines were the only way to ensure that the corporation comply with its contract requirements. “They’re bottom-line driven,” he remarked. (“Idaho fines prison health care company $382K,” Associated Press, 6/5/11).

Then, in 2012, A Federal report on the Idaho State Correctional Institution charged that prison care under Corizon “amounts to cruel and unusual punishment.” The court-ordered report, part of decades of litigation by Idaho inmates, was released publicly even though the state had argued to keep the report sealed. The report states that Idaho Department authorities are “deliberately indifferent to the serious health care needs of their charges,” says corrections medical expert Dr. Marc Stern, who was appointed by the court to review Idaho prison care. According to the report, Corizon failed 23 of 33 audit categories in 2010 – and despite feedback and follow-up – failed 26 of 33 categories in 2011. (“Federal court unseals report on prison health care,” KIVI News, 3/19/12). You can read the full report here.

Here’s the take-home message to taxpayers: Privatization of anything in a corrections context will always result in fraud, waste, abuse, and neglect.

That’s because the profit motive is directly at odds with the purpose of correctional institutions. There will always be a perverse incentive not to rehabilitate, not to treat, and to prioritize the bottom line over public safety. Because it is in the corporation’s financial interest to keep prisoners coming back. And, if they get sick or even die, the worst your company will face will be a series of fines. Even if the state cancels the contract, there are always some schmucks in some other state or some other town, who want to believe the myth that you can have mass incarceration on the cheap and who really don’t give a damn what happens to incarcerated people.

Noted privatization expert Alex Friedmann, Associate Editor of Prison Legal News, said it best:

“If you take all the bad parts of the HMO [Health Maintenance Organization] and put it in a monopoly situation, then you have the private prison medical care industry…But prisoners can’t go to another clinic, can’t pick a plan.”

Wexford can't stand the heat: Corizon takes on AZ prison health care delivery.

 So, not to be a Debbie Downer, but here's Corizon's rap sheet...that's whose name will go on the next round of lawsuits.

                Think they'll be smart enough to introduce themselves to us, families?

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 Outside the Federal Courthouse in PHX, where the ACLU presented arguments for class designation of 

Parsons v Ryan from US Judge Neil Wake last week due to system-wide deliberate indifference to prisoner medical needs...

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CLASS ACTION: 'Parsons v Ryan' - Medical neglect and suicide at the AZ DOC

Join us to support 14 prisoners suing Charles Ryan, Director of the Department of Corrections and Richard Pratt, Director of Health Services for gross negligence, deliberate indifference, and unconstitutional conditions of confinement. 

CLASS ACTION Memorial Mural
Friday, Jan 25, 7:30-9:30am 
Sandra Day O'Connor Federal Courthouse 
401 W. Washington St. PHOENIX

We will make a chalk mural outside the Sandra Day O'Connor court house in solidarity with these 14 prisoners who are fighting to change the criminal neglect of health care of Arizona prisoners. The mural will remember those who have been lost under this administration.

These are the stories of those still fighting for their lives:

Victor Parsons has ADHD and bipolar disorder. In June 2010, his medication was abruptly discontinued without explanation. When he began to experience psychotic symptoms, he submitted a request for treatment. His medication was restarted abruptly without titrating, placing him at high risk for severe side effects. When his tooth filling fell out, they gave him a temporary filing which fell out weeks later. Each time he was seen, he was given a temporary filing again, forcing him to restart the process.

Shawn Jensen had an elevated score on a Prostrate Antigen Test and a nodule on his prostrate in November 2006. The prison doctor ordered a prostrate biopsy in 2007, but Shawn did not receive the biopsy until 2009. By that time, he had Stage 2 prostrate cancer, an aggressive form. He experienced delays of two months in getting medication prescribed by his urologist. He was not taken for surgery until July 2010, and as a result, suffered permanent injuries.

Stephen Schwartz was assaulted by another inmate in February 2010. He suffered eye injuries and extensive facial fractures, but was not referred to an opthamologist until January 2011, almost a year later. He filed numerous health care grievances for his pain, but waited months to learn whether pain medications would be approved. He was also diagnosed with bipolar and major depressive disorder, but has received inadequate mental health care while on suicide watch.

Dustin Brislan has bipolar disorder, schizo-affective disorder, and borderline personality disorder, with a designation of SMI (Serious Mental Illness). He engages in severe self-injurious behavior, including cutting, head banging, and self-starvation. As a result of his mental illness, he experiences depression, hallucinations, sucidal ideation, and paranoia. Despite the severity of his condition, the Dpt of Corrections has failed to provide him with minimally adequate mental health care. He has had medications delayed, has not been regularly monitored by a psychiatrist, and has been on suicide watch for excessive lengths of time without adequate supervision, where he committed repeated acts of self-harm.

Sonia Rodriguez is also designated as SMI, and experiences depression, anxiety and hallucinations. The Dpt of Corrections has failed to provide therapeutic treatment and has kept her in cruel and inhumane confinement in Perryville's and on suicide watch. The harsh conditions and extreme isolation of the Special Management Unit (SMU) and on suicide watch. On multiple occasions, her medicine has been abruptly changed without explanation. As a result, she has severe side effects, including uncontrolled shaking, difficulty sleeping, and worsening of her mental health symptoms.

Christina Verduzco is diagnosed with paranoid schizophrenia, bipolar disorder, and borderline personality disorder. She experiences auditory and visual hallucinations, anxiety, paranoia, and self-harm by cutting herself. She is confined in Perryville SMU and placed on suicide watch on several occasions. While on suicide watch, Christina is forced to wear a smock that barely comes up to the top of her thighs. The lights are kept on 24 hours a day, and she is subjected to 'safety checks' every 10-30 minutes a day where correctional officers wake her if she is asleep. She has minimal human contact, cannot go outside, cannot brush her teeth or bathe regularly. Outside of suicide watch, her experience is similar: extended isolation, limited exercise, and limited therapeutic treatment. Christina has asthma, but has been pepper sprayed repeatedly by correctional officers. After being sprayed, she has been dragged out of her cell, hosed down, and thrown back into her cell.

Jackie Thomas is diagnosed with depression and seizure disorders. Although Jackie did not have suicidal ideation when he first arrived at the SMU, his mental and medical health conditions have deteriorated during his isolation in the SMU. He was placed on suicide watch many times, where he received minimal mental health care. He has experienced many failures of his medical treatment, including improper cessation and initiation of psychtropic medications, failure to administer prescribed medication, repeated use of ineffective medications with severe side effects, lack of informed consent, and long delays in follow up and psychiatric evaluation.

Jeremy Smith has depression, aggravated by interruptions in his mental health treatment and prolonged isolation in the SMU. His medications have been abruptly discontinued without explanation and restarted at inappropriate times and after lengthy delays. Jeremy has also been prescribed powerful medications not indicated for depression.

Robert Gamez suffered a childhood head injury and was diagnosed with borderline IQ, possible Post-Traumatic Stress Disorder, and possible frontal lobe dysfunction, symptoms of which include major depression, panic and anxiety. Although his symptoms are consistent with frontal lobe dysfunction, the Dpt of Corrections never conducted follow-up tests to confirm his diagnosis. He has experienced multiple interruptions in care, received improper medications, and was not given psychological services for his pronounced mental health deterioration during his prolonged isolation in SMU. In August 2009, Robert began experiencing intense paranoia, anxiety, panic, and psychosis, asking to be taken off his medication and out of isolation. Despite his severe condition, he was not seen for five months.

Maryanne Chisholm has been diagnosed with hypertension but was not referred to a cardiologist for eight months, despite experiencing chest pain and shortness of breath. She has bipolar disorder, Obsessive Compulsive Disorder, and depressive disorder. Maryanne has experienced significant delays in psychiatric care, medications, and follow-up, which has contributed to worsening symptoms. In April 2011, she had a nervous breakdown and requested an adjustment of medication; she was not seen for a month. Her mental health condition is exacerbated by guard harrassment. She has been subject to repeated and frequent room searches, and her art supplies, which she relies on to manage metal health symptoms, were confiscated.

Desiree Licci has a family and personal history of cancer. In 2010, she observed multiple masses growing on her breasts, mouth, and arms. In December 2010, Desiree requested testing. In April 2011, the prison doctor referred her to an oncologist. However, she was not seen for a CT scan until September 2011. In the interim, she began experiencing diarrhea, nausea, exhaustion, weight loss, and pain. Desiree did not receive an MRI until December 2011 and it was not properly administered. She had to submit a grievance and wait another month until a proper MRI was done, confirming multiple masses on both ovaries.

Joseph Hefner's vision rapidly deteriorated after a Dpt of Corrections nurse gave him expired eye drops. In 2006 and 2008, Joseph did not receive timely doctor-prescribed eye medication following eye surgery. Although he has submitted numerous health care requests for eye pain and his doctor has referred him to the opthamologist, he has been waiting to see an opthamologist for over three years.

Joshua Polson has been diagnosed with bipolar disorder, mood disorder, and psychosis. He has a family history of suicide and has attempted suicide three times. Nonetheless, he is in isolation, where he has minimal human contact, which results in increased suicidal ideation. He has experienced repeated gaps in his medication and sporadic monitoring of his medication levels. Additionally, he has chronic ear infections, and permanent hearing loss in his right ear following significant delays in care. After losing hearing in his right ear, Joshua submitted health care requests for pain in his left ear, but was not seen for over a month.

Charlotte Wells has a history of heart disease and high blood pressure and suffered a heart attack prior to being incarcerated. She arrived in custody complaining of chronic chest pains, and continued to experience dizziness and high blood pressure, but was not seen by a cardiologist until she was hospitalized for a blocked artery four months later. Charlotts was not seen by a doctor or returned to the hospital thereafter, despite her history and the high risk of heart attack following the placement of a stent. Additionally, Charlotte experienced broken fillings in two of her teeth in 2010. She complained of pain and requested fillings be repaired, but was told the only option was to have the teeth pulled, or wait months to have the filling approved. She did this, and endured pain for several months before her fillings were replaced; however, when she got the filling, the dentist cracked an adjacent tooth.

The hearing will be in Judge Neil Wake's courtroom at 3 pm. The mural will take place the morning of the hearing, at 7:30 - 9:30 am.