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Health, Science & Tech

Wagner Releases 'Damning' Audit of Corizon Health

The Allegheny County jail houses about 2,700 inmates, many of whom by one person's estimation are not being provided with efficient health care.

Allegheny County Controller Chelsa Wagner Monday released the audit of Corizon Prison Health Management Inc., which she claims yielded some “damning” findings.

She said this not only impacts the health of the inmates and prison employees but also the larger community.

“If you think about the fact that over $12 million a year is spent with Corizon Healthcare…you realize that for just about every man, woman and child in this county, they are getting $10 of our taxpayer money,” Wagner said.

With 534 facilities in 27 states, the Tennessee-based for profit calls itself the “foremost provider of correctional healthcare” in the United States.  The company signed an $11.5 million per year contract in 2013, replacing the non-profit Allegheny Correctional Health Services.

Wagner listed 14 findings from the audit ranging from inadequate staffing to inmates not receiving basic clinical services such as physical exams, immunizations and ultrasounds.

Corizon is also not providing the inmates with re-entry services as they transition out of jail, according to Wagner, whose office collected a sample of 60 records – 56 of which did not contain the required documentation.

“Ninety-five percent of those records, they did not contain a release summary or a transfer summary,” Wagner said. “That’s a 95 percent fail rate, and that’s something that quite frankly I have never seen in terms of the audits that we have conducted.”

She is asking the County Executive to hold Corizon accountable to pay back the $20,000 that is required if they fail to comply with their contract.

Wagner said while the audit was initiated in February, her office revisited the samples as recently as October and found no progress.

“If at that time we would have found anything different in terms of trends, it would be noted in here,” Wagner said, referring to the audit. “But we recognized that the same findings, the same observations stood in October as they did in our initial sampling period.”

The American Civil Liberties Union (ACLU) of Pennsylvania said they have received the same complaints Wagner has listed.

“The information we have received from prisoners, jail medical staff and even outside providers indicates that these problems are ongoing and continue to threaten the health and well-being of inmates. The ACLU-PA is asking Allegheny County to provide within the next 30 days a plan for moving forward on fixing the dire situation in the county jail,” Vic Walczak, ACLU Legal Director, said.

The ACLU is calling for the creation of a high-level, independent monitor to provide oversight and make regular, publicly available reports as well as a mechanism for stakeholders who are impacted by the findings to provide feedback on the health care services at the jail.

Wagner is calling on the county to implement an oversight committee to ensure that jail health is being provided and the services Corizon guaranteed are being delivered.

But as of now – Wagner said taxpayers should feel “ripped off” because Corizon was hired under the justification that they provided healthcare to prison systems throughout the country, including ones that are bigger than the Allegheny County prison.

“So the notion that they need more time to basically just get to status quo, I think is just outrageous,” Wagner said.

Corizon issued the following statement.

Allegheny County Controller Chelsea Wagner today released audit results that are not accurate and do not reflect the partnership that ensures healthcare for inmates. It's important to correct the inaccuracies from the report, so the taxpayers understand that the County and Corizon Health work together daily utilizing all available resources in providing quality care to inmates at the Jail.

The last audit was performed in 2006. Corizon Health assumed the contract in September 2013. The Controller’s audit covered Sept. 1 to Feb. 28, 2014, only and did not take into account the tremendous amount of work we’ve done to bring this contract up to Corizon’s high standards for quality care.

The audit was conducted by individuals with limited healthcare experience, limited correctional experience and no experience of how healthcare is optimally provided in this environment. Corizon Health knows what is required to bring a facility like Allegheny County to accreditation and has done so many times nationwide.

We'd like to note a few inaccuracies in their report:

* Clinical care. Our mission is to provide quality care, and we have done so since day one. There are built-in processes and backup systems to ensure that inmates get the care they need. The audit's accusations and generalizations are misleading. Corizon Health practices evidence-based care, and our minimum standards align with the standards of the ACA and the NCCHC.

* Accreditation. Corizon Health inherited an aggressive three-month timeframe to attain accreditation that was based on the fact the prior vendor postponed the reaccreditation survey that was due seven months prior.  Additionally, the previous healthcare vendor left no supporting documentation to substantiate compliance for the prior three years.  Hence, the accreditation was compromised from the start and Corizon Health was left to remedy a challenging situation that we did not create. Despite these challenges, Corizon Health has worked closely with the accrediting body, the NCCHC, and the Allegheny County Jail site leadership to develop a new action plan that will work.

* Staffing. The Auditors' claims are misleading. Although there have been staffing challenges, Corizon Health has worked to overcome them, and in fact, is providing executive leadership and nurse staffing levels above those required by the contract, at no additional cost to the County or the taxpayers.

* Labor practices. The Controller is inappropriate in her remarks, because labor issues are outside the scope of the audit and her authority. The matter she refers to was successfully resolved in the appropriate setting with no finding whatsoever that Corizon Health engaged in any unfair labor practice.

* Finally, the monitoring of the contract. We can assure the public that the contract has had robust monitoring since the beginning, along with weekly meetings and progress checks to assure compliance. It's inaccurate to say that there has been a monitoring void.

Corizon Health will continue to work in partnership with the County to enhance clinical operations and provide quality, cost-effective services to the ACJ inmates and will continue to work collaboratively with representatives appointed by the County to provide oversight services.