by Matt Clarke
In 2018, Corizon Health was the largest for-profit provider of prisoner health care in the country. It contracted with 534 correctional facilities in 27 states holding about 15 percent of the nation’s prisoners. According to the American Civil Liberties Union, Corizon was sued for malpractice 660 times within five years. It was also subject to millions of dollars in fines and penalties by the governmental entities it contracted with — usually for inadequate staffing. Yet the understaffing and substandard health care continues unabated and prisoner deaths continue to mount while Corizon treats fines, penalties, settlements and jury awards as merely a cost of doing business —not as a catalyst for change to providing adequate health care.
Corizon provides prisoner health care for the Kansas Department of Corrections (DOC). Unlike most entities contracting with Corizon, Kansas provided for oversight of Corizon’s performance by a third party. The University of Kansas Medical Center (UKMC) reviews a sample of health-care records at DOC prisons each year. Perhaps that is why Kansas has assessed Corizon penalties of $1 million for underperformance and $6.4 million for short staffing between July 2015 and December 2018.
When asked for records about its provision of health-care services, Corizon nearly always refuses to produce them, citing medical privacy issues. However, the records obtained by UKMC are public records that are available with the patient identifiers redacted. That is how the Kansas City Star was able to investigate Corizon’s health-care services in the DOC.
The Star found that the short-staffing penalties were mostly for lack of psychiatrists. Despite almost 20 percent of DOC prisoners being prescribed psychotropic medications, several prisons went months without reporting any hours worked by a psychiatrist — the person who oversees psychotropic medication and adjusts dosages.
Further, prisoners often complained of the same ailment three or four times without being allowed to see a physician or mid-level health-care provider such as a physician’s assistant or advanced practice nurse — a violation of the contract that requires an appointment with a health-care provider be scheduled if a prisoner complains of the same ailment twice. The most common type of noncompliance with the contract was referrals to health-care providers taking more than seven days. Often, the referrals took weeks or months. The delays in treatment sometimes had deadly consequences.
DOC prisoner Marques Davis, 27, complained for months about growing weakness and numbness in his legs only to have his complaints ignored by Corizon staff. Then he said it felt like something was eating his brain.
Davis was right, but Corizon staff at the DOC’s Hutchinson Correctional Facility continued in their belief that he was faking illness as a fungal growth in his brain progressed, causing his vision to blur, his speech to slur, and his cognition to become so disoriented that he drank his own urine. Finally, on April 12, 2017, Davis suffered a heart attack and was taken to the Hutchinson Regional Medical Center. There, a CT scan revealed “dramatic swelling of the brain sufficient to force the upper part of the brain down into the lower part of the brain,” The next day, he was declared brain dead.
The UKMC records and what happened to Davis show “a clear and consistent pattern of [Corizon] delaying, postponing or not providing necessary medical treatment,” according to Kansas City attorney Leland Dempsey, who is representing the mother of Davis, Shermaine Walker, in a lawsuit against Corizon. “That’s what this is showing (and) that’s what our lawsuit is all about.”
Corizon is paid between $70 million and $80 million to provide health care services to the DOC’s approximately 10,000 prisoners. Thus far, fines, penalties, and court awards have not taken a large enough bite out of Corizon’s bottom line to cause it to fulfill the terms of its DOC contract.
“Corizon is simply writing off the liquidated damages they’re having to pay as the cost of doing business in this state without doing anything meaningful to improve,” said Eric Balaban, a senior staff attorney with the American Civil Liberties Union’s National Prison Project.
Meanwhile, the Star’s review of 42 months’ worth of medical documents from the prison where Davis died showed 251 of the 452 charts did not meet the standards of the contract with Corizon. That 29.5 percent rate of noncompliance is similar to the statewide rate the Star found. Throughout the DOC, 1,062 of 3,695 charts (28.7 percent) were deficient.
The UKMC documents showed other serious flaws in Corizon’s provision of health care. An El Dorado Correctional Center prisoner was given an antibiotic after reporting to the prison infirmary with an infected insect bite on his arm but there was no follow up. A week later, he returned to the infirmary with a severely swollen arm and suspected antibiotic-resistant staph (MRSA), but was not fully assessed. He was sent away without treatment that night. Later that night, he was admitted into the infirmary where he remained for six days due to “complications from MRSA.”
A prisoner at Hutchinson had a tooth extracted, but the dentist left part of the tooth in the jaw. He went to the prison infirmary with an infected and badly swollen jaw, but was told that was normal and merely given Ibuprofen. A week later, he had to be taken to an outside hospital for medical care.
An Oregon federal judge recently awarded $10 million to the family of a young women who died of heroin withdrawal after Corizon employees ignored her pleas for medical attention. The Southern Poverty Law Center has a lawsuit pending against Corizon over inadequate medical care in Alabama prisons.
Corizon was formed in a 2011 merger of Correctional Medical Services and Prison Health Services (PHS).
In 2012, a federal court of appeals upheld a jury verdict that PHS had a policy of not sending prisoners outside of prison for medical care except in emergencies without clearly defining what constituted an emergency.
In 2018, an Arizona federal court held Arizona prison officials in contempt because, despite their having fined Corizon $1.4 million, it continued to provide substandard health care in the state’s prisons. This is the type of performance that caused Tennessee, Pennsylvania, Maine, Maryland, Minnesota, New Mexico, and New York City to stop having Corizon provide health care for their prisoners. It also is what led to thousands of lawsuits being filed against Corizon, including 660 between 2012 and 2017.
Sources: kansascity.com, legalreader.com, kansas.com
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