A performance audit of the Michigan Department of Corrections’ (MDOC) contract with Corizon Health for the provision of prison medical, dental and optical services uncovered a number of deficiencies.

Among other issues, the Michigan Office of the Auditor General’s findings, detailed in a July 2015 report, found the MDOC had “inappropriately paid $1.7 million for care of 349 prisoners” after they were released from prison or paroled. The audit also found failures in chronic care assessments, which “may have jeopardized [MDOC’s] ability to manage and treat potentially serious medical conditions before they became more severe and costly.”

The report analyzed the performance of the MDOC’s medical contractor, Corizon Health, which has a long and sordid history of operational problems. [See: PLN, March 2014, p.1]. The first finding concerned chronic care assessments, which involved 39.3% of MDOC’s 45,000 prisoners between October 1, 2013 and April 30, 2014.

“Improvements are needed to timely complete and consistently document chronic care condition medical assessments,” the audit stated. The MDOC was unable to provide auditors with a facility-specific listing of all prisoners who had at least one chronic care condition.

The report found that “22% of the chronic care condition medical assessments are not completed timely.” MDOC policy requires Corizon to “annually assess all prisoners with chronic care conditions in their birth month.” On average, however, those assessments were 69 days late, and ranged from 1 to 288 days late.

The audit further determined that the MDOC “did not charge prisoner co-payments for 57% of the health care visits.” Michigan law requires a $5.00 co-pay for all prisoner-initiated non-emergency medical, dental or optical services. Yet in 48 of the 84 health care visits reviewed by state auditors, the co-payment was not assessed. The audit did not address whether requiring a co-pay was a good idea, since it may cause some prisoners to avoid seeking medical care until their condition becomes more serious and thus more expensive to treat.

Additionally, the MDOC had completed only 50% of the required service level agreement audits of Corizon’s contractual performance. Improvements, the report noted, were necessary to ensure prison officials were not overlooking other service level agreements the company may not be fulfilling.

In its fourth finding, the audit report found the MDOC had paid $1.7 million for offsite services for 349 released or paroled prisoners; investigators had uncovered similar problems in a prior audit, and the MDOC had agreed to remedy such improper payments.
Corizon recouped $1.1 million of the payments through a subcontractor. “They will continue working on that end until all the money is recouped,” said MDOC spokesman Chris Gautz.

The final audit finding related to a failure to disable accounts used to access electronic medical records when employees were terminated or transferred. Policy requires that such accounts be disabled after they are inactive for 120 days; however, auditors found 12 users had unnecessary access to prisoner medical records up to six months after they left.

The MDOC acknowledged the findings in the report and agreed to make recommended corrections.

In February 2016, state officials announced their intent to continue partnering with Corizon, awarding the company a new five-year, multi-million dollar contract that began in June of that year.

Despite the shortcomings in prisoner health care services and the improper expenditure of taxpayer funds as noted by the state’s Auditor General, the MDOC not only extended its contract with Corizon but expanded it to include the provision of pharmacy and mental health services in Michigan’s prison system.

Sources: Michigan Office of the Auditor General Performance Audit Report, Prisoner Medical, Dental and Optical Services (July 2015); Detroit News; www.corizonhealth.com