How Privatization Destroyed an Illinois Jail's Award-winning Suicide Prevention Program
There is a current debate in Champaign County, where the twin cities of Champaign-Urbana are home to the University of Illinois, about whether to allocate millions of dollars toward a new jail. Sheriff Walsh has frequently cited the large percentage of those with mental illness (as much as 20 percent of the daily population) and argued for the need to expand the jail's mental health facilities. More than just bricks and mortar, this issue demands that we look into quality of services provided by the private company HPL. We have something to learn from looking back at the Crisis Team, a local success story of how we can effectively treat prisoners with mental illness.
Worth Their Weight in Gold
In August 1980, the downtown jail opened on the north side of Main Street in Urbana, replacing an antiquated facility from the 1890s. Within the first 18 months after the new jail opened, there were three prisoner suicides. Then superintendent of the jail, Captain David Madigan, lobbied the county board to approve a 1983 contract with the Mental Health Center of Champaign County to form what would become known as the "Crisis Team."
The Crisis Team was so successful that it was featured as "A Model Suicide Prevention Program" in a 1990 newsletter out of Mansfield, Massachusetts. According to the article, the responsibilities of the Champaign County jail were taken over in 1985 by Captain Gary Turner, who formally outlined a program for the Crisis Team. "A correctional officer must be more caring," Turner said, "almost displaying a social work approach to the job."
David Madigan, who was elected sheriff in December 1990, said that such mental health programs were "worth their weight in gold," providing important services but also saving taxpayers millions in potential lawsuits.
I was recently able to track down the woman who first told me about the Crisis Team, Heidi Reible, who worked at the jail from 1992 to 2002. According to Reible, they had a "stellar" program. During the time she was at the jail there were no successful suicide attempts. In April 2000, Reible was presented an award by U.S. Attorney General Janet Reno for her work.
New Sheriff in Town
In 2002, local attorney and former Urbana police officer Dan Walsh, a Republican, won an uncontested race for sheriff, replacing Madigan, who had retired. In 2004, three prisoners committed suicide at the jail – Joseph Beavers, Marcus Edwards and Terrell Layfield. In response, Sheriff Walsh put out a request for proposals (RFP) to expand the jail's mental health services. In 2005, he abandoned the not-for-profit Mental Health Center in favor of a private provider, Health Professionals Ltd., a company that was already providing medical services at the jail. HPL offered 3.5 positions at a cost of $225,000 per year. The Mental Health Center had made two proposals for even more staff, but the sheriff chose HPL because they were cheaper.
Despite the change in providers there have still been several deaths at the jail. In 2006, Quentin Larry died after ingesting a bag of cocaine. In 2007, Janet Hahn died due to a diabetic emergency. In 2009, Todd Kelly was on suicide watch but managed to hang himself. In 2011, Jesse Masengale committed suicide the night after he was given a 30-year sentence.
Meanwhile, Sheriff Walsh quietly cut back the staffing hours for mental health services after the recent economic downturn. Currently, the contract includes 84 hours of mental health counseling – a significant rollback from the original contract which provided for 140 hours.
Jail Industrial Complex
How were conditions in the jail for those with mental illness allowed to deteriorate in such a short time? There was a convergence of several factors – mass incarceration, a shrinking safety net and the emergence of a private corrections industry – that led to the current crisis at the Champaign County jail.
In the last three decades we have seen the rise of mass incarceration, with some 2.2 million people locked up in the United States. Locally, the daily population in the Champaign County jail went from 115 in 1985 to 158 in 1989. This growing demand led to the construction of a second jail which was built in 1996. The population continued to grow so that in 2005 there were 325 people held in both the downtown and satellite jails.
These were also the years when we saw an erosion of the social safety net – the restructuring of public housing, cuts to public health and welfare reform/deform. There was the shuttering of two mental health facilities in central Illinois, leaving only the McFarland Mental Health Center in Springfield, which has 118 beds, for the entire region.
The term "prison industrial complex" captures the nexus of publicly-funded prisons and private companies that are profiting from the current prison boom. The increasing number of privately-run prisons has gained much attention. Yet most county jails are still publicly operated. Lesser known are the many jail services which have been privatized, what might be called the "jail industrial complex." At the Champaign County jail, Aramark has a contract for food and laundry services, and Evercom [Securus] provides the phone system.
There are several motivations for outsourcing jail services. For example, private companies claim they can free public bodies of legal responsibility. Nevertheless, the sheriff has still been sued. In the case of Quentin Larry, it cost $57,710 in attorney fees to fight the case, which ended in an out-of-court settlement of $40,000. While there has been no settlement in the Janet Hahn case, it cost $132,993 to litigate. The bulk of these expenses went to the Urbana law firm of Heyl, Royster, Voelker & Allen, which currently charges $185 an hour. The belief that privatization saves money may not, in the end, prove to be true.
HPL's founder and chief physician, Dr. Stephen A. Cullinan, has had some 30 lawsuits filed against him in Illinois alone, plus HPL has faced litigation in other states. [See, e.g.: PLN, July 2013, p.24]. In March 2013, Cullinan, who recently retired, received a 60-day suspension of his medical license in a case involving a man who died from a bleeding ulcer in the Sangamon County jail. He previously had been fined or reprimanded in three other cases from 2009 to 2012 in both Illinois and Michigan.
HPL is a good example of the rapidly expanding private corrections industry. Founded in 1995, today HPL has contracts with more than 100 jails and prisons. In 2007, HPL was purchased by Correctional Healthcare Companies (CHC). According to the firm's website, two of CHC's top executives, Don Houston and Wendy Dunegan, came from The GEO Group, one of the largest private prison corporations in the world.
In December 2012, CHC was subsumed by GTCR, a multi-billion dollar private equity firm in Chicago. Today, mass incarceration is big business.
You Get What You Pay For
It appears there's a growing consensus in Champaign County that mental health services should not be outsourced. I spoke with Diane Zell, president of the local chapter of the National Alliance on Mental Illness (NAMI). "We need to return to local providers at our jails," she said. "We need people who are likely to have contact with those who end up in the jail." Zell believes we must find funding. "You get what you pay for," she stated. "Doing something because it's cheaper is the worst reason to do something."
There is recent good news. On May 22, 2013, the Champaign County Mental Health Board passed a resolution to extend more services to those who get caught up in the criminal justice system. Two job positions have been posted and a drop-off center has opened.
Dr. Deloris Henry, President of the Champaign County Mental Health Board, spoke optimistically: "It's going to really be a nice start. It's not the panacea of all the needs we have but it's a step in the right direction."
Brian Dolinar is an independent media journalist based in Urbana-Champaign, Illinois. This article was crowdfunded by contributions from nine individuals totaling $425. A longer version is posted at www.ucimc.org, where it was first published.