Privatized prison medical care is sick

But will cutting costs cure it? Joe Ponte's balancing act
By LANCE TAPLEY  |  December 14, 2011

For years complaints that the privatized medical care at the state's prisons was inadequate and abusive have poured into the mail and email boxes of prisoner advocates, the state's Corrections commissioner, and the press.

Last month, finally, state officials, including new Corrections commissioner Joseph Ponte, agreed at a meeting of the Legislature's Government Oversight Committee that inmate medical care — most of it provided by Corizon, a national corporation operating in 400 prisons and jails — must be reformed. This was the reaction to a report presented by the Office of Program Evaluation and Government Accountability, the Legislature's investigative arm.

OPEGA found that responses to prisoner health complaints were slow; that administration of prescription drugs, including narcotics, was poorly controlled; that medical files were not complete; that the department hadn't "remembered," agency director Beth Ashcroft said, that annual dental exams were required for prisoners; that prisoners didn't get physical exams they should have gotten; and that staff training was insufficient.

The report narrowly focused on how well the care was overseen by the Department of Corrections. It didn't examine issues such as the three Maine State Prison inmates who in recent years died while receiving medical care in circumstances advocates have called suspicious.

But committee members did examine, with dismay, the financial consequences of the lack of oversight. The department says medical costs had ballooned to $20 million for the last fiscal year — over $9000 a prisoner. Corizon got $15 million of this sum. Most of the rest went to state employees providing care and the pharmaceutical supplier, Correct Rx Pharmacy Services, which got $2.6 million, nearly $500,000 over budget.

On average, Commissioner Ponte said, inmates had been on seven prescribed drugs, while the national average for prisoners is two or three (he reported he already had brought the number down to five). Psychiatric medications, he said, cost $35 an inmate in Maine, while $8 is the national average.

It was as if, under Democratic Governor John Baldacci's Corrections commissioner, Martin Magnusson, the department had never monitored these contractors. OPEGA's Ashcroft said the relationship between Corrections and Corizon had not been "arms-length" but more a "partnership." Under Magnusson, her investigation even received "pushback" from department officials, she said.

And it was as if Baldacci and previous Democratic Legislatures had never monitored the department. Committee members expressed dismay at their own past acceptance of what had been going on. "What does it really mean?" that the prisons are accredited, asked Democratic senator Bill Diamond, wondering aloud.

Prison-issues activists have an answer: The chief accrediting organization, the American Correctional Association, is "a taxpayer-funded lobby for the prison industry which sells meaningless accreditation as a form of lawsuit insurance so prisons and jails can try to avoid judicial scrutiny and accountability," says Paul Wright, editor of Prison Legal News.

But now, under Ponte, Ashcroft said, there has been "a change of philosophy."

A big change. Ponte is reforming the 2,100-inmate system in many ways, most notably in reducing solitary confinement and making prison discipline more humane (see "Reducing Solitary Confinement," by Lance Tapley, November 4).

Ponte described another reform to the oversight committee. He is putting out to bid the medical-services contract for the first time in nine years, seeking one company to provide, beginning July 1, both medical and pharmaceutical services.

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