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PHS Medical Care at Rikers Fails in Evaluation

PHS Medical Care At Rikers Fails In Evaluation

by Paul Von Zielbauer

A recent evaluation of the company in charge of prisoner health care at Rikers Island, coming months after it was awarded a new $300 million contract, has found that it has failed to meet a number of the most basic treatment goals. City records showed that the company, Prison Health Services Inc., did not meet standards on practices ranging from H.I.V. and diabetes therapy to the timely distribution of medication to adequately conducting mental health evaluations.

The city Department of Health and Mental Hygiene, which oversees the company’s work at Rikers Island and at a jail in Lower Manhattan, found that during the first quarter of 2005, Prison Health failed to earn a passing grade on 12 of 39 performance standards the city sets for treating jail prisoners. Some of the problems, like incomplete medical records or slipshod evaluations of mentally ill prisoners, have been evident since 2004 but have not been corrected, according to health department reports.

Other problems identified in the department’s review, involving things as serious as the oversight of prisoners who have been placed on suicide watch, are more recent or had not been evaluated by city health auditors in the past.

As a result, the city is withholding $55,000 in payments to the company, the largest penalty for poor performance it has incurred since 2001, the first year of its work in New York City adult jails.

The evaluation came months after the health department gave Prison Health, the largest private provider of prison and jail health services in the nation, a new three-year contract to care for about 14,000 prisoners a day.

The company’s work at Rikers had been criticized by independent city and state monitors, but the health department had defended its decision to renew the contract, and said it had devised a more effective and demanding way of evaluating the company’s performance.

The company, in a statement, said it has provided sound care to prisoners at Rikers since taking over health care operations there. It described the shortcomings documented by the city as temporary, and said its poor evaluation was because of changes in the way the city had chosen to gauge its work.

“At all times during the first quarter, P.H.S. continued to deliver quality care to our patients,” Benjamin S. Purser Jr., the company’s vice president for ethics and compliance, said in the statement that was sent out via e-mail.

Robert Berding, the health department official in charge of overseeing Prison Health’s work, said the city’s medical standards are exacting—a company is required to meet the standards in every measured category at least 95 percent of the time over a three-month period. Each area that needed improvement, he said, would be closely monitored.
But some members of the city Board of Correction, a panel appointed by the mayor that sets jail standards, said the city’s review was disturbing .

“It seems like the needle is moving in the wrong direction, not the right one,” said Hildy J. Simmons, the chairwoman of the Board of Correction. Ms. Simmons made her remarks at the board’s monthly meeting in Lower Manhattan yesterday.

Another board member, Paul A. Vallone, criticized the health department’s decision to allow the company to come up with its own plan to correct the problems in care.

“It’s like a judge allowing a criminal to determine his sentence,” Mr. Vallone said, adding that the Board of Corrections should take a more active role in ensuring that the care would be improved.
Several board members seemed eager for a more comprehensive understanding about Prison Health’s performance, and about how closely city health officials were monitoring the company at Rikers.
“I think it’s time for us to be asking some questions and getting some clearer answers,” Ms. Simmons said.

Mr. Vallone and a third board member, Gwen L. Zornberg, said several Prison Health employees at Rikers believed the biggest obstacle to improving prisoner medical care were missing records that often forced doctors to examine patients without knowing their full medical histories, or what medications they took.

“Medical records seem to be getting lost over and over,” Dr. Zornberg said.

Colleen Roche, a Prison Health spokeswoman, said the company was planning to begin using computerized medical history forms in July, allowing doctors to more easily summon patient records. The company, she said, was also building a new computer server to track specialized medical care in jail, a chronic problem during Prison Health’s four-and-a-half-year tenure at Rikers.

[This article originally appeared in the New York Times. Reprinted with permission.]

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