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PLN editor quoted in article about privatized prison medical care

Tampa Bay Times, Jan. 1, 2013.
PLN editor quoted in article about privatized prison medical care - Tampa Bay Times 2013

Pinellas jail signs medical deal with firm that paid in Hillsborough death

Peter JamisonPeter Jamison, Times Staff Writer

Friday, October 4, 2013 4:52pm

The Pinellas County Sheriff's Office has hired a South Florida company to oversee key medical services for inmates at the county jail, beginning the privatization of prisoners' health care even as the same company is facing questions over its role in the death of a jail patient in neighboring Hillsborough County.

Armor Correctional Health Services of Miami has signed a $6.5 million contract to staff the Pinellas County Jail with roughly 20 upper-level health practitioners such as doctors, dentists and psychiatrists, as well as a medical director to supervise all patient care. The company could potentially secure a more comprehensive contract — including the jail's front-line nurses, who for now will remain county employees — if it performs well, Pinellas Sheriff Bob Gualtieri said.

Armor recently made headlines in the Tampa Bay area, but not for welcome reasons. The Tampa Bay Times reported in July that the company had quietly paid an $800,000 wrongful death settlement to the children of a Tampa man who suffered a fatal stroke that went untreated in the Hillsborough jail system. Later that month, the Florida Department of Health opened an investigation into the incident.

Jails across Florida have outsourced the medical treatment of prisoners. But the move has special resonance in Pinellas County, which has an unusually troubled history with privatized health care. Almost two decades ago, former Sheriff Everett Rice expelled the jail's last contractor amid scandal, including inmate deaths and a nurse's nationally publicized joke to colleagues: "We save money because we skip the ambulance and bring them right to the morgue."

Since then, the Sheriff's Office has employed its own doctors and nurses. But the skyrocketing cost of prisoners' care, compounded by difficulty finding doctors to staff the jail, has made the current arrangement untenable, according to Gualtieri. He said he is confident Armor will not repeat the missteps of Prison Health Services, the company whose lapses drove jail officials to bring health care in-house.

"That was the 1990s. We're in 2013 now. The world has changed," Gualtieri said. Increasing competition among private contractors has led to a superior level of care than that available 20 or 30 years ago, he said.

Nevertheless, he said his decision to award only partial control of his medical staff to Armor at the outset was influenced by the disastrous result of the jail's last experiment in privatized medicine. (The notorious "ambulance" joke was described in a deposition by a nurse who watched a jail inmate suffer a fatal heart attack in 1994 after not receiving heart medication.)

"I want to take things one step at a time," Gualtieri said. "I just wasn't ready at this point to jump in with both feet into contracting the whole thing, based on our experience in the past."

Armor will take over at the jail on Nov. 1. The contract, which was signed last week, will stay in effect through the end of 2015 unless it is terminated early. The Sheriff's Office will pay the company $488,000 for the remainder of this year, then roughly $3 million annually for the next two years. Either party can end the contract without penalties with four months' notice.

"Armor's total focus is to deliver the highest patient care standards in the most effective manner," company spokeswoman Yeleny Suarez said in a statement responding to questions about the new contract.

Gualtieri acknowledged he initially had concerns about Armor employees' treatment of Allen Daniel Hicks Sr., the 51-year-old Tampa man whose death last year has led to scrutiny from state regulators. The investigation is ongoing.

Hicks was found lying in his own urine on the floor of his cell at the Falkenburg Road Jail 36 hours after he was booked. His care at the jail was later criticized by a neurosurgeon who treated Hicks at Tampa General Hospital before he slipped into a coma and died.

However, Gualtieri said he was impressed by Armor's decision to pay a sizable settlement to Hicks' heirs instead of contesting their wrongful death claim in court. "Armor stepped up and did the right thing," he said. "If things do happen, and mistakes are made, the next most important thing is how you handle it."

Gualtieri said he was also reassured by praise for Armor from sheriff's officials in Hillsborough and Broward counties, both of which have sprawling urban jail systems bigger than that in Pinellas. The Pinellas jail had an average daily population just under 3,000 in 2012.

Yet Armor's reviews among public officials are not all positive. In July, an employee of the Broward Public Defender's Office criticized the firm in an internal memo, stating that "Armor practically spits in the face of nearly all common assumptions of what compassionate care in general should be."

The memo by Shane Gunderson, director of client services for the Public Defender's Office, also faulted the company for improper treatment of patients with HIV and AIDS, and said Armor "is slow, late and in some cases unwilling to provide dental services, hernia operations and optometry."

Paul Wright, a prisoner-rights activist and editor of Prison Legal News, said he questions whether private medical contractors for jails and prisons have substantially improved their methods since Pinellas County's first experiment in outsourced care in the 1990s.

"Their business model is the same, which is to charge as much money as they can and provide as little services as they can," Wright said.