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Privatized Prison Medical Care in Mississippi Still Problematic

by David M. Reutter

Anyone looking for evidence that privatized prison health care is a complete failure need look no further than Mississippi. In 2001, the per capita death rate for Mississippi prisoners was around the national average. By 2006, however, the state’s prison death rate was the second highest in the nation, and prisoner deaths increased again in 2007. Only Tennessee had a higher death rate among prisoners.

Despite those statistics, Mississippi Dept. of Corrections (MDOC) Commissioner Chris Epps said he had full confi-dence in the prison system’s private medical contractor, Pittsburgh, PA-based Wexford Health Sources, Inc., which has a $95 million three-year contract to supply medical services to MDOC prisoners. PLN has previously reported on the inept care provided by Wexford, similar to other for-profit prison medical companies such as PHS and CMS.

In December 2007, the Mississippi Legislature’s Joint Committee on Performance Evaluation and Expenditure Review (PEER) issued a report critical of Wexford. The PEER report indicated the company had failed to meet medical care standards required by its contract with the state. [See: PLN, Nov. 2008, p.20].

A recurring failure cited in the report was not providing timely access to medical treatment for Mississippi prisoners. The PEER report found the MDOC could not ensure that Wexford had implemented a system of quality chronic medical care; further, medical staffing shortages of up to 20% were reported at state prisons in Pearl, Parchman and Leaksville.

Wexford’s failure to provide adequate medical care has turned some prisoners’ sentences into death sentences. That was what happened to William Morris Byrd, Jr., who died on November 21, 2008 at the Central Mississippi Correctional Facility.

The cause of Byrd’s death was Crohn’s Disease, a chronic but treatable inflammation of the digestive path that blocked his esophagus. In the months before he died, Byrd wasted away. “He literally starved. We watched him turn into a skeleton,” said his sister, Charlotte Boyd.

Commissioner Epps responded to claims that Byrd had received inadequate medical treatment by saying, “We provided timely, quality medical care for the inmate, as we do for all of our inmates.”

Former MDOC prisoner David McGowan, who spent seven years in Mississippi prisons, disagreed. McGowan had medical problems prior to his incarceration. After entering the prison system, obtaining the type of medical care he received in the free world was difficult.

“The nurses were telling me there wasn’t anything wrong with me,” McGowan said. “I was getting substitute medications. They weren’t controlling my blood pressure.” He suffered a heart attack and stroke while imprisoned and said he often was not provided any medication.

McGowan’s condition resulted in an early medical release. Such releases save the prison system money by transfer-ring the cost of treatment to the released prisoner or another public agency. From January through May 2008, MDOC re-leased an average of 13 prisoners a month due to medical conditions. That figure more than doubled from June to October last year, which saw an average of 31 medical releases.

Wexford’s failure to provide necessary, timely care to chronically ill prisoners has resulted in an influx in mail to Mississippi CURE, a state chapter of National CURE, a criminal justice reform group. “We are getting tons of letters from in-mates, for instance, who have been diagnosed with diabetes. They are not getting their [blood] sugar checked daily, as they are supposed to,” said Patti Barber, Mississippi CURE’s executive director. “Things just plain aren’t getting done.”

The first two years of incarceration are the most dangerous for MDOC prisoners, as half of all prisoner deaths occur in that period. “Natural causes” is listed as the reason for 93% of those deaths; however, the rate of violent MDOC deaths is three times higher than the national average and the prisoner suicide rate is 40 percent higher.

In 2002, thirty-three MDOC prisoners died. The number of deaths reached 78 in 2007 – a 236 percent increase. Commissioner Epps said the prison system was not to blame. “When you combine this with mandatory sentences, habitual sentences, a population entering prison that is not healthy anyway – 70 percent has an alcohol or drug problem or both, [the average education] level is sixth grade – this is what you end up [with],” he said.

Economics is almost certainly a contributing factor, too. In fiscal year 2007-08, MDOC spent $50.8 million on prisoner health care, or an average of $8.22 per prisoner per diem. That figure is expected to increase, as Mississippi’s prison population of 22,335 is projected to grow by 3 percent in 2008-09.

The bottom line that prison officials like to ignore is that private medical contractors cut costs by shorting staff, delaying treatment until medical release, or denying necessary medications and medical care. This has caused problems for Wexford in other states besides Mississippi.

On August 1, 2007, Illinois prisoner Brian Parks, 38, died at the Stateville prison in Joliet. Parks was addicted to pain killers, including Vicodin and Tramadol. When he complained about back pain, a prison doctor gave him 30 Tramadol pills. Parks died of an overdose about a day later; investigators found only 10 of the pills left in his cell.

“I don’t understand why they would give an addict pills while he’s in there for being a prescription drug addict,” said Elizabeth Green, Parks’ wife.

The physician who gave Parks the Tramadol, Dr. Constantine Peters, was employed by Wexford. Green has since filed a lawsuit, which is still pending; her attorney, Michael Clancy, said it was more cost effective for private medical companies to provide medications to prisoners in volume rather than having staff dispense the pills every day. Cost effective, perhaps, but it also cost Brian Parks his life. See: Green v. Wexford, Will County Circuit Court (IL), Case No. 09L-626.

In New Mexico, a federal lawsuit was filed on July 5, 2009 against Wexford, prison medical staff and state prison officials. The plaintiff, Martin Valenzuela, was incarcerated at a Santa Fe facility in 2006 when he developed a urinary tract infection. His suit alleges inadequate medical care resulting in the need for surgery, a lack of follow-up treatment, and the loss of his medical records. See: Valenzuela v. Breen, U.S.D.C. (D. N.M.), Case No. 1:09-cv-00561-GBW-WDS.

Another lawsuit against Wexford is being pursued by the estate of New Mexico prisoner Michael Crespin, who died on July 2, 2008. The suit accuses Wexford and prison medical staff of deliberate indifference, gross negligence, recklessness and medical malpractice. Crespin, who was serving a three-year sentence, had colon cancer. According to the federal lawsuit, while he was incarcerated at the Central New Mexico Correctional Facility, “Wexford essentially lost track of [Crespin] for purposes of his cancer treatment.” As a result he missed 14 to 16 medical appointments, most of which were for chemotherapy; additionally, Wexford was accused of delaying surgery to remove a tumor that had developed in Crespin’s abdomen. The lawsuit remains pending. See: Crespin v. Ulibarri, U.S.D.C. (D. N.M.), Case No. 1:08-cv-00246-WJ-RHS.

Following a May 2007 audit by New Mexico’s Legislative Finance Committee, Wexford lost its contract to provide medical care in the state’s prison system. The audit found major deficiencies in the company’s services, including staffing short-ages and a failure to file timely reports related to the deaths of 14 prisoners.

Despite similar findings in Mississippi’s 2007 PEER report, Wexford continues to provide medical services for MDOC prisoners. “Even a dog needs medical attention,” noted Charlotte Boyd, sister of William Byrd, the Mississippi prisoner with Crohn’s Disease who died after being denied care by Wexford.

It comes down to a matter of perspective. Dogs are seen as loveable and man’s best friend, while prisoners are viewed as contemptible trash to be locked up until they waste away and die. Private prison medical contractors such as Wexford have simply learned how to turn a profit within that context.

Sources: Clarion Ledger,, New Mexico Independent

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