More Jurisdictions Don’t Renew Corizon Contracts – Including Big Loss in New York City

by Greg Dober

Recent news for for-profit prison and jail healthcare provider Corizon with respect to contract renewals has not been good. In June 2015, it was announced that two of the company’s clients, the New York City jail system – including Rikers Island – and the Allegheny County Jail in Pennsylvania, would not be renewing their contracts with Corizon to provide medical services to prisoners. In both cases, the contracts were not renewed due to issues related to the company’s performance.

The jails are at opposite ends of the size spectrum, with Rikers holding approximately 11,000 prisoners and the Allegheny County Jail housing approximately 2,000. Yet Corizon was unable to effectively manage either facility, resulting in the loss of the contracts. Both New York City and Allegheny County chose not to have the contract rebid to any of the other large private medical care providers, such as Centurion, Naphcare or Wexford Health Sources.

Additionally, according to an April 2015 news report, “since 2012, Corizon has lost statewide contracts covering 84,000 inmates in Maine, Maryland, Minnesota and Pennsylvania.” [See: PLN, March 2014, p.1]. Corizon also lost its contract to provide medical care in Tennessee prisons, while the District of Columbia recently decided not to contract with the company for its jail system and the Florida Department of Corrections is rebidding Corizon’s medical care contract following reports of an increasing number of prisoner deaths.

New York City and Rikers Island

On June 10, 2015, New York City Mayor Bill de Blasio announced he would not renew Corizon’s contract to provide healthcare at Rikers Island and other city jails; the $126.6 million contract is set to expire on December 31, 2015. According to DNAinfo New York, the company’s contracts are actually worth over $400 million. Corizon was awarded a $126.6 million contract for management of medical services in the city’s jail system. The city also awarded Correctional Medical Associates of NY (CMA of NY) a $270 million contract to provide health care to jail prisoners, and awarded Correctional Dental Associates of NY (CDA of NY) $8.98 million to provide dental care. CMA of NY has the same corporate address as Brentwood, Tennessee-based Corizon, and prior to 2012, CDA of NY was registered as PHS Dental Services, Inc. PHS, or Prison Health Services, was a predecessor to Corizon. [See: PLN, July 2015, p.1].

Corizon (and previously PHS) had provided health care at New York City jails since 2001. According to media reports, Corizon is allegedly responsible for over a dozen prisoner deaths due to inadequate treatment. The most recent contract, which was renewed in 2012, was awarded despite poor performance by the company in prior years. Incredibly, New York City officials agreed to indemnify Corizon from lawsuits to induce the firm to renew its contract. The New York Times noted that Corey Johnson, a city councilman who held hearings on health care at Rikers in March 2015, said Corizon had been a “failure” and the city’s decision to indemnify the company was “unconscionable.”

Corizon and government officials often note that health care for prisoners is adequate so long as it meets a basic standard of care. At Rikers, even the basic standard was not always met by Corizon. For example, a 20-year-old prisoner who complained of chest pains and difficulty breathing for several days received no treatment for his condition. The prisoner died of a ruptured aorta. In another case, a 32-year-old prisoner complaining of stomach pain and blood in his stools was not given medical care. Only after other prisoners protested did he receive treatment. However, it came too late and the prisoner died from a bacterial infection.

The worst case of medical neglect at Rikers may be that of Bradley Ballard. Ballard, a diabetic prisoner with severe schizophrenia, was placed in a segregation cell on a mental observation ward on September 4, 2013 for dancing by himself and folding a T-shirt into the shape of a phallic symbol and waving it at a female guard. Little did Ballard realize that such simple, non-violent acts would result in his death at the jail.

Ballard died a week later on September 11, 2013 after he was deprived of insulin and locked in his cell without food or running water, including a working toilet, for several days. The New York Times noted that a warden, an assistant deputy warden, guards, doctors, mental health clinicians, nurses and other jail employees made at least 57 visits to Ballard’s cell as he slowly deteriorated. Despite his worsening condition, staff did nothing to assist him despite the abhorrent stench of urine and feces emitting from his cell.

Though guards, doctors and other employees were visibly repulsed by the smell, none would help Ballard. When medical personnel finally arrived to remove Ballard from his cell, they handed two prisoner workers a blanket and gloves and instructed them to go in and get him. The prisoners, covering their faces due to the stench, said later that Ballard tried to move but was unable to stand or walk. After he was placed on a gurney and wheeled into the hallway, the medical staff saw that he had tied a rubber band tightly around his genitals, where it had remained unnoticed until the flesh began rotting.

In a subsequent lawsuit filed by Ballard’s family, the complaint noted, “Mr. Ballard was clearly on the brink of death, yet he lay neglected on the gurney,” and medical staff “held back, unwilling even to touch his body. For an inexcusable period, they continued to stand idly by and do nothing.” The complaint also stated that “On June 3, 2014 following an autopsy ... the Medical Examiner declared Mr. Ballard’s death a homicide.” See: Griffin v. City of New York, U.S.D.C. (S.D. NY), Case No. 1:14-cv-07329-NRB.

In June 2015, the New York City Department of Investigations (DOI) released the findings of its review of Corizon’s performance. The report focused on mental health clinicians and aides employed by Corizon, and noted alarming gaps in the company’s hiring procedures, including criminal background checks. For example, a Corizon records clerk was arrested when he was caught smuggling a straightedge razor into Rikers; investigators from the DOI ran his prints and found he had done a 13-year stint in prison for kidnapping. Another applicant listed as many as 13 prior criminal convictions, but was hired without a detailed explanation regarding the circumstances of the convictions. Other findings by the DOI included failures to adequately check professional licenses, applicant references and prior employment history. The report criticized Corizon for hiring employees who had few qualifications or did not meet minimum qualifications for mental health aide positions. It also faulted the city’s Department of Corrections for requiring the company to obtain fingerprint cards from job applicants but failing to process hundreds of the cards over several years.

Corizon’s CEO said he “would have preferred to stay in New York,” adding, “If at all possible, one day we’d love to get back.”

After Corizon’s contract expires at the end of the year, medical care for prisoners in New York City’s jail system will be provided by the city’s public Health and Hospitals Corporation.

Allegheny County Jail

Following eleven deaths within an 18-month period at the Allegheny County Jail in Pittsburgh, Pennsylvania, county executive Rich Fitzgerald announced that the jail’s contract with Corizon would not be renewed after expiring at the end of August 2015.

In September 2013, Corizon was awarded a two-year, $23 million contract to provide health care services to prisoners at the Allegheny County Jail. However, problems with the company’s performance began almost immediately. A prisoner jumped from a tier at the jail in October 2013 and was severely injured; he was not transported to the hospital until the following day. Within hours of his transfer, he died at the hospital from injuries sustained in the fall. Early on in the contract there were problems related to the proper and timely distribution of medication to prisoners, lack of adequate recordkeeping procedures, and staffing cuts that resulted in fewer registered nurses, physicians and mental health care personnel.

In 2014 the jail recorded seven medical-related deaths, a rate well above the national average for a facility of its size. The inadequate care provided by Corizon resulted in health care workers organizing with the United Steel Workers of America (USW). That process became mired in litigation against Corizon when, in February 2014, a Catholic nun who worked as a registered nurse at the jail was allegedly fired for union organizing activities. Sister Barbara Finch was dismissed after she openly expressed concerns at a meeting regarding patient safety and care. The USW filed an unfair labor complaint against Corizon over Finch’s dismissal, and a settlement was eventually reached that allowed her to retain her job. [See: PLN, March 2014, p.1].

During the first five months of 2015, four more prisoners died due to health care-related issues. The first was Frank Smart, Jr., 39. Despite telling staff that he needed his seizure medications, Smart was told he would have to wait a few days. He died within 48 hours of his arrival at the jail; according to a medical examiner’s report, his death was caused by a seizure disorder and being “physically restrained in [a] prone position.” One of Smart’s nine children, Tiara Smart, filed a wrongful death suit against Corizon and the county in Common Pleas Court in July 2015.

Allegheny County Controller Chelsa Wagner conducted an audit of Corizon’s contract. The audit, released in December 2014, cited 14 areas in which the company allegedly failed to perform contractually-required services, ranging from failure to maintain emergency equipment and inadequate staffing to long delays in providing prisoners with physical exams and medication. [See: PLN, March 2015, p.30].

Apparently fed up with the many problems related to Corizon’s performance, Allegheny County decided not to renew its contract with the company. As of September 1, 2015, the Allegheny Health Network began providing medical care at the jail.

El Paso and Santa Barbara Counties

At the El Paso County Jail in Texas, Corizon had held the contract for health care services since 2009. However, county officials began negotiations with the University of Texas Health System and the Emergence Health Network of El Paso to provide prisoner medical and mental health services at the facility. Corizon’s contract expired and the company was granted a six-month extension until December 31, 2015 to continue to provide medical care for prisoners. The expired contract was worth approximately $8 million per year.

In Santa Barbara County, California, the county’s contract with Corizon expired on June 30, 2015. Although jail officials wanted to renew the contract, county commissioners granted only a 4-month extension, putting the $9.8 million annual contract on hold. At issue was deaths of prisoners at the facility, complaints of understaffing and medication shortages.

One of the prisoners who died, Raymond Herrera, 52, was serving 10 days in jail for probation violations. According to a news report, he started having convulsions in his cell in June 2015, then passed out, hit his face against a railing and had another seizure. He was “eventually” taken to a hospital, where he died due to a ruptured spleen caused by cirrhosis of the liver. A local group, Families ACT!, claimed that substandard care by Corizon employees was a contributing factor in Herrera’s death.

Conclusion

In a June 2015 interview with The Marshall Project, Corizon CEO Dr. Woodrow Myers noted that losing contracts is part of the business. When asked about contract losses at Rikers Island and in Maine, Minnesota, Pennsylvania and Maryland, Myers replied, “It’s a lumpy business, you win some, you lose some.”

That attitude may well describe the outcome of the smaller contracts in Allegheny, El Paso and Santa Barbara counties, but for a company that has had its rating repeatedly downgraded by Moody’s, a research and risk assessment agency, the loss of the $400 million Rikers Island contract may be more problematic. In Moody’s last downgrade of Corizon’s bond rating in August 2014, the agency stated, “The rating action reflects the company’s continued operating performance weakness and the further deterioration of credit metrics beyond Moody’s previous expectations, attributable to recent contract losses, margin declines from competitive pricing pressure on renewed contracts, and delays in the realization of earnings from certain start-up contracts.”

Thus, while sometimes “losing some,” the loss of the lucrative Rikers contract may become a larger issue for the ratings agency – and a bigger problem for Corizon – than Dr. Myers is willing to acknowledge.

Sources: www.DNAinfo.com, NY Daily News, The New York Times, Pittsburgh Post-Gazette, CBS2-NY, www.marshallproject.org, NYC Department of Investigations, El Paso Times, Santa Maria Sun, www.modernhealthcare.com, www.triblive.com

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