by David M. Reutter
Florida’s Correctional Medical Authority (CMA) declared a health care emergency at the Florida Women’s Reception Center (FWRC). The crisis at FWRC is just another red flag since Florida officials privatized it in 2013.
CMA conducted an audit of FWRC between September 15-17, 2015. The number and seriousness of the deficiencies “could not be properly addressed with the standard corrective action plan process due to the lack of organizational structures apparent at this institution and an emergency notification was utilized," states the October 12 report.
“The [s]urveyors had difficulty getting the needed records for review. When received, the records were disorganized, with necessary documentation frequently misfiled or missing altogether."
FWRC held 958 prisoners during the audit, and 558 of them were in a chronic are clinic that requires assessment every six months. Another 119 require assessment every three months. Several areas of physical health care were found to be deficient in their treatment.
Among them were “multiple examples” where prisoners were evaluated and treated less frequently than required by their assigned medical grade. The surveyors found numerous instances of “delays in care were noted in consultation, follow-up for diagnostic services, the review of abnormal labs, and prescription refills."
In one case, a prisoner with a brain aneurysm had to remind staff of a follow-up visit, which was ultimately delayed by three months. In another, a prisoner “complained of a golf ball sized lump behind her ear in June”. After an X-ray, an MRI was requested, which Corizon’s utilization management denied. An alternative plan was for the prisoner to see a surgeon, but that had not been requested or completed when the CMA’s report was issued.
In May, a prisoner with a history of cancer had an abnormal screen. A colonoscopy was not done until three months later, and the results were not in the file. The prisoner further complained of symptoms consistent with metastatic disease, but her sick cell requests netted no results. She was seen in an emergency clinic. A referral for consultation was not issued until Sept. 9.
Problems of these types were detailed for five other prisoners. In all, the surveyors only reviewed 17 records in their consultation record review. They also found a diabetic prisoner had not received insulin for two to three months.
The surveyors further found delays in mental health care. It noted concerns “with regards to the frequency of clinical contacts for inmates receiving both inpatient and outpatient mental health services."
The Florida Department of Corrections (FDOC) said all the major issues identified were addressed. “I do know additional staff were brought in”, said FDC spokesman McKinley Lewis. “They came from central office here, and I believe Corizon did bring in some additional staff as well to handle some issues, but I can’t speak specifically to what Corizon’s actions were.”
Less than 45 days after the CMC report was issued, Corizon invoked a clause in its contract to give FDC 180 day notice of cancellations. “We appreciate the contracts for inmate health services permit very little of the flexibility that Secretary Jones would like in order to address issues such as staffing, mental health care and electronic records”, said Corizon CEO Karen Witty. “We have tried to address the department’s concerns, but have found the terms of the current contract too constraining.”
To its credit, FDC was not allowing Corizon to shirk its obligations under the contract. Corizon’s business model, as PLN has reported, is to reduce staff and cut medical care to the point that it results in higher profits. It utilizes confidential settlements for the few lawsuits that survive to a trial level. FDC has not forgotten that it spent over 20 years under federal oversight of its medical and mental health care. Florida prisoners are thankful FDC is apparently not willing to allow those systems to deteriorate to that point again. The CMC’s report, Physical & Mental Health Survey of the FWRC is available on PLN’s website.
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