City prisons lack staff, medicine, medical workers say Funds called wasted, inmates endangered

July 25, 1996|By Kate Shatzkin | Kate Shatzkin,SUN STAFF

A shortage of health care staff, delayed medication and changes in the way patients are seen at eight Baltimore prisons are putting inmates' health at risk and wasting taxpayers' money, medical workers and officials say.

An attorney for inmates and several current and former health care workers say the most critical problem now is an inadequate and ever-changing medical staff, which keeps inmates from receiving timely medication and delays emergency response. That has led, the workers say, to calls to 911 to send inmates who say they are sick to hospital emergency rooms -- an outside foray that is both costly and threatening to security.

Because of confusion about the location of medication and short staffing, some diabetic prisoners missed doses of insulin, and several had to be sent to local hospitals recently because of it, according to a licensed practical nurse who said she resigned in frustration July 15 after working 156 hours in the previous two weeks.

"I was concerned about the inmates as well as my license," said the nurse, Laura D. Contee of Silver Spring. "I felt that it was a time bomb for all those involved, because we're in the medical field and we're dealing with people's lives."

PHP Healthcare Corp. of Reston, Va., took over responsibility July 1 for 7,266 inmate beds in home detention, the Baltimore City Detention Center, the state's new Central Booking Center, and six prisons, including the Maryland Penitentiary and the Maryland Correctional Adjustment Center, better known as "Supermax." The $16 million contract calls for the equivalent of about 130 full-time employees to cover the inmates.

State health officials say many of the problems have to do with the transition between health providers and will be worked out soon. The company said it is providing adequate care and blames a previous contractor for some problems.

For a time, supplies of medication ran low in the East Baltimore prison complex. At one point, health care workers had trouble "finding" insulin that was in stock, said Dr. Anthony Swetz, director of inmate health services for the Maryland Department of Public Safety and Correctional Services. That problem has been corrected, he said.

Swetz said that difficulties are to be expected in any transition between medical providers and that the state is taking action. This week, the state ordered PHP to fire a subcontractor running pharmacy services for the complex and hire a new one.

PHP project administrator David Thompson, asked to describe the current state of health care in Baltimore prisons, said in a written reply yesterday, "PHP is providing a constitutionally adequate correctional health care program" and staffing is adequate to assure proper medication. He wrote that the contractor is committed to continual refinement of services and eager to improve where it can.

Many of the calls to 911 have come from the new Central Booking and Intake Center, which processes about 185 arrestees a day and holds up to 811 prisoners. At any given time, a maximum of two nurses are on duty there, though Thompson wrote that more nursing hours were being added.

Hector Torres, spokesman for the Baltimore City Fire Department, verified that 911 calls from the prison and jail complex had increased. Though he said he could not provide numbers or dates, Torres said officials were concerned enough to ask for a meeting with correctional managers.

But Swetz said there was really no increase in emergency calls. The difference, he said, comes from putting all the city's arrestees into Central Booking, which opened in November. "It's not clear to me they're really geared up to handle any kind of emergency," said Frank M. Dunbaugh, a lawyer who represents Detention Center prisoners in a 20-year-old consent decree covering overcrowding and other conditions. "It seems to me that the risk you're running is someone is going to end up being seriously injured."

"They want one nurse to cover the whole jail," said Flo Robinson of Towson, whose boyfriend is being held at the Detention Center. She said that for four days earlier this month, her boyfriend got none of the psychotropic medication he had been prescribed for mental illness. "How can they possibly do this?"

At one point in the past few weeks, prison officials set up a hot line for complaints about medical care in the prisons. Swetz said he received only five calls, most of them seeking appointments for treatment for problems that were not life-threatening.

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