State's costs for inmates' health care could rise 60%

Officials OK contracts for $110 million a year

June 02, 2005|By Gus G. Sentementes | Gus G. Sentementes,SUN STAFF

After five years of relatively stable health care costs for inmates, the state Board of Public Works approved an increase in spending of more than 60 percent yesterday that could push the annual tab to $110 million as officials try to improve medical services for the state's 27,000 prisoners, particularly in Baltimore's troubled jail facilities.

State corrections officials said the increases were driven by several factors: new, costlier treatment for inmates suffering from AIDS and hepatitis C; the need to hire more health care staff; and greater state responsibility for unexpected increases in medical expenses.

"I believe we've created something that will work for all of us," Mary Ann Saar, secretary of the Department of Public Safety and Correctional Services, told the board members: Gov. Robert L. Ehrlich Jr., Comptroller William Donald Schaefer and Treasurer Nancy K. Kopp.

"We are required to give adequate care," Saar said.

Contracts were awarded to five for-profit companies, which will run different segments in the prisons' privatized health care system, such as medical, mental health and pharmaceutical services. Last year, the state spent $68 million on inmate health care, state corrections officials said.

Of the new contracts, Schaefer remarked, "It's a shame to pay $100 million for people who go out and rape and kill ... and there are [law-abiding] people who don't have any medical care at all."

Largest contract

Correctional Medical Services Inc. of St. Louis won the biggest contract, a two-year, $125.6 million deal that involves providing medical services to state prisons and Baltimore's state-run jail facilities - a total of 32 facilities. Under a state contract signed in 2000, the company has provided comprehensive medical care services for the past five years to three prisons in Hagerstown.

The state's main prison health care contractor since 2000, Prison Health Services Inc. of Brentwood, Tenn., did not win any piece of the state's business in the latest round of bidding. Prison Health, which provided health care services to more than 20 state correctional facilities, had been criticized by inmate advocacy groups for skimping on services, particularly in Baltimore's jails.

Officials with Prison Health, a subsidiary of publicly traded America Service Group Inc., said the company lost a total of $14 million in Maryland, mostly over the past year, as skyrocketing medical expenses significantly outpaced the fixed amount of revenues it received from its state contract. But the company has strongly denied that its financial losses led it to cut its services to inmates.

Richard Rosenblatt, assistant secretary for treatment services for the Public Safety Department, said that Prison Health's performance in Maryland was not a factor in the recent selection process.

He said three of the five companies that won - including CMS - offered the best level of services for the lowest price.

In selecting CMS, the state swapped a major correctional health care provider for its top competitor.

CMS has a long record in Maryland: It has operated in the state since 1987. Rosenblatt said the state had few issues with CMS during its tenure at the Hagerstown prisons.

"We're very comfortable with CMS," he said. "We've been very happy with the way they've operated" in Maryland.

CMS has been the target of inmate advocacy groups and unfavorable media coverage over quality of care in the past, including an investigative series in the St. Louis Post-Dispatch in 1998. The newspaper reported incidents of alleged medical negligence that, in some cases, led to inmate deaths in Missouri and elsewhere.

"Correctional Medical Services' history of cutting corners to maintain profits jeopardizes the lives of thousands of incarcerated people across the country," said Elizabeth Alexander, director of the American Civil Liberties Union's National Prison Project, in a statement opposing CMS' selection as Maryland's inmate medical provider.

"Many states have already learned a painful lesson from their dealings with Correctional Medical Services," she said.

Ken Fields, a CMS spokesman, said the company, founded in the late 1970s, has a long record of satisfied customers, including the state of Missouri for the past 12 years.

He said the Post-Dispatch stories were "inaccurate, misleading and not reflective of the quality of care" that CMS provides in more than 280 correctional facilities across the country. As of March, he said, the company provided health care under contract to 229,000 inmates in various jails and state prison systems nationwide.

Underfunded system

CMS will take over a system of inmate health care that, critics say, has been underfunded by the state since at least 2000. Under the contract signed that year, the state essentially paid a flat monthly fee to Prison Health and CMS for medical, pharmaceutical, mental health, dental and other services.

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