by John E. Dannenberg

Prison Health Services, Inc. (PHS) was granted a three-year, $366 million no-bid contract renewal to provide medical and mental health care services for New York City’s Rikers Island Jail, notwithstanding the company’s checkered record during its last three-year contract, which resulted in $793,000 in fines for non-performance. The contract renewal amounted to a 10% raise for PHS when adjusted for inflation.

As a result, the 100,000 prisoners admitted to Rikers Island each year can expect more of the same substandard medical care, since PHS has a long history of exacting its profits at the expense of prisoners’ health. [See, e.g.: PLN, Nov. 2006, p.1].

Quarterly audits of PHS’s performance, which revealed an average 15% non-compliance rate, were made by New York City’s Department of Health and Mental Hygiene (DHMH) based on a review of 9,000 case files. Principal areas that were reviewed included HIV, asthma, sexually transmitted diseases and women’s healthcare issues.

In six of the eight most recent quarters, PHS continuously failed to meet some health care standards, most notably follow-up on HIV treatment and testing. For five of the quarters, PHS failed to meet standards for taking intake prisoners’ medical histories; the compliance rate was 61%. Suicide watch was rated at 95%, but only a 100% rating might have prevented the three documented suicides that occurred during the reviewed time period. In three of the last four quarters, prisoners in segregation found themselves isolated from follow-up health care services, too.

There were some 100% ratings, however. PHS was given a clean audit review for cancer screenings, prenatal care and sonograms for female prisoners. But Dale Wilker, a staff attorney for the Prisoners’ Rights Project of the Legal Aid Society, said that the most serious complaints were from prisoners with the gravest ailments, including HIV, heart conditions and asthma – where failures to provide timely medication were reported.

The worst concerns came not in terms of volume, but in the seriousness of the omissions. “Since the city got away from using teaching hospitals and went to providers that are in some way to make money and to serve their stockholders, complaints have become much more frequent and much more serious,” Wilker stated.

Wilker further opined that since the contract was renewed without bidding, “that suggests to me that things weren’t bad enough for the Department of Health to not want to contract with them at all, or maybe they couldn’t find another provider.” DHMH deputy commissioner Louise Cohen stated, “We think PHS is performing adequately. We would love to have a local, nonprofit partner. One just isn’t stepping up to the plate.”

Plainly, a profit motive is inherently at odds with the interests of health care for affected prisoners. PHS is not a charitable organization, nor are prisoners generally popular subjects for adequate medical care. Prisoners do, however, provide an excellent opportunity for private companies to turn a profit.

PHS’s renewed Rikers Island contract runs through December 31, 2010.

Sources: Gotham Gazette, America Service Group press release