Five of eight prisoner deaths since 2011 at the Metro Corrections jail in Louisville, Ky., are currently under investigation, all of them involving allegations against private healthcare contractor Corizon Inc. that it provides inadequate treatment to maintain its revenues.
Investigations into two of those deaths last year–of prisoners Samantha George and Savannah Sparks–led to the resignations of six Corizon employees in December 2012, after Metro said they "may" have contributed to the deaths. Jail officials and Louisville police, however, are continuing to investigate.
Meanwhile, as Corizon faces lawsuits from prisoners and their families throughout Kentucky and many of the other 28 states where the company has jail contracts, Metro and its director, Mark Bolton, are considering how they could conscionably renew Corizon's $5.5 million contract. Bolton said in February he believes that Tennessee-based Corizon waited too long to have one of its doctors treat George and Sparks.
"The more we looked into it, the more disturbed I was getting as to some of the service delivery gaps in the healthcare of those individuals," Bolton told the Nashville Tennessean.
George reportedly died Aug. 8, 2012 of complications from a severe form of diabetes, compounded by heart disease and, Bolton argued, a delayed evaluation by Corizon medical staff.
Four months earlier, Sparks, 27, was being held at Metro on a theft charge while also detoxing from heroin. But on April 12, 2012–six days after her arrest–Sparks died at University Hospital in Louisville from opiate abuse and withdrawal, according to the Jefferson County, Ky., coroner's office.
Bolton said he noticed in January 2012 that more prisoners were undergoing detox in the jail, and that Corizon employees were unprepared to treat Louisville's supposedly growing population of heroin addicts. To save money, Corizon only took Sparks to the hospital to allow her to die in one, though a Corizon executive disputes that assessment.
"We have no incentive not to provide the hospital trip," said Levin Jones, Corizon's vice president of operations. "There is no financial incentive to avoid it. None... The financial responsibility for all off-site care falls to the county."
The Tennessean reported, however, that when Corizon (then called Correctional Medical Services) renegotiated its contract with Metro in 2010, it glorified its record of minimizing prisoners' trips to the hospital, thereby saving the city money.
A graph in Corizon's proposal showed that it had reduced the total length of hospital stays for prisoners from 38 days in 2007 to 20 days by late 2010; Corizon had also cut trips to the emergency room in half.
In 2008, however, Corizon surprisingly diverted 135 people arrested in Louisville to the hospital emergency room before they had been booked. Corizon claimed that, because each emergency room trip costs $855 on average, complaints from Louisville's fire department and EMS forced them to reduce ER visits.
By 2009, calls for EMS to take Metro prisoners to the ER had dropped by 20%–and not because prisoners had inexplicably become healthier. Nor was it Metro, according to Bolton, who pressured Corizon to save money at the expense of prisoners who needed emergency care.
"I don't want to send anybody to the hospital for stitches... or non-emergency services," Bolton said, citing ER and transportation costs, and overtime for Metro employees. But, he added, "If someone needs to go to the hospital, by God, that is Corizon's call and they better be sending them. We rely upon them to make those decisions. That's why we are paying them."
Corizon, through a public relations firm, said it was "working to improve the way we manage patients in keeping with the major recent changes in drug abuse" in Louisville. Since last year's deaths, according to the Tennessean, substance-abuse screening has been expanded; 15 new nurses, including a substance-abuse nurse, have been hired; and a treatment dorm for prisoners detoxing has been created.
Bolton said also that the National Commission on Correctional Health Care went to Louisville in January 2013 to audit Corizon, and gave the company "an outstanding exit review."
Which should put Bolton at ease, by God, should he renew Corizon's contract.
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