A “Provider Handbook” for “Physicians, Psychiatrists, Dentists, Nurse Practitioners, and Physician Assistants” employed in Illinois state prisons by Wexford Health Sources warns that “[i]nmates can be very manipulative,” so healthcare workers are advised to “[n]ever take anything from or bring anything to an inmate.”

“Do not authorize special privileges,” the handbook continues. “Anything that raises a question about inmate relationships should be discussed with your healthcare unit administrator, or the responsible assistant warden.”

The handbook would have remained hidden from public view if Wexford had its way, but the firm lost a 2021 motion to seal the handbook after it was admitted in evidence as part of a prisoner’s lawsuit filed in federal court for the Southern District of Illinois. See: Russell v. Wexford Health Sources, 2021 U.S. Dist. LEXIS 6340 (S.D. Ill.).

Wexford holds the contract to provide healthcare to the state Department of Corrections (DOC) and the 29,245 people it held at the end of June 2023. After collecting over $1 billion in payments, the firm’s 10-year contract expired in 2021, but DOC continues to extend it, despite a federal class-action that led to a 2019 consent decree—amended in June 2022—mandating improvements in prisoner healthcare. [See: PLN, Jan. 2023, p.12.]

The federal monitor in that case said that half of Wexford’s positions at DOC prisons remained unfilled at the beginning of July 2023. At least three of the firm’s doctors didn’t have proper credentials. The waitlist for dental fillings at one lockup was 104 weeks long. An outside monitor reviewing 17 deaths found that in two of the cases, Wexford staff gave prisoners medications that contributed to their deaths.

“The care hasn’t improved,” said Harold Hirshman, an attorney representing plaintiff class members in the case. “It’s still lousy, there aren’t enough medical personnel, they don’t do the work and it’s sad.”

Almost as sad as that handbook, which instructs medical staff that “[e]very effort must be made to teach and reinforce [prisoners’] personal responsibility” for their own care. Comparing what the firm offers to worker’s compensation, the handbook says Wexford is obligated to address any medical condition that “occurs in conjunction with, or is aggravated by incarceration.” But other conditions “that are pre-existing, chronic and stable require monitoring only”—a list that includes not only arthritis, flat feet and “old knee and ankle injuries” but also age-related hearing loss (presbycusis), “lazy eye” (amblyopia) and tinea versicolor, a fungal infection that covers the trunk of victims with discolored spots.

In a particularly galling example, Santoin Russell—the prisoner who filed the suit that brought Wexford’s handbook to light—was misdiagnosed with allergies and treated by Wexford with Ibuprofen for what turned out to be nerve damage. Though the delay cost Russell some of his hearing, the firm successfully beat back his challenge by arguing he failed to exhaust his administrative remedies, as required by the Prison Litigation Reform Act, 42 U.S.C. § 1997e. See: Russell v. Wexford Health Sources, 2021 U.S. Dist. LEXIS 38463 (S.D. Ill.).

Earlier in 2023, DOC considered and rejected replacing a single profit-driven private corporation with a new medical staff organized into five geographic zones to improve prisoner healthcare. A pilot program was rolled out in a few prisons using staff from Southern Illinois University. “I think we need to be concerned anytime there’s a profit motive involved in taking care of people who are incarcerated,” explained Jennifer Vollen-Katz of the John Howard Association, a nonprofit prison watchdog. “The more money they do not spend addressing someone’s medical needs, the more money they put in their pockets as profit.”

In the end DOC decided to keep the status quo, arguing a statewide approach was needed “to ensure continuity of care is upheld no matter where or when an individual is placed,” spokesperson Naomi Puzzello said.

“The chances that you’re going to get anybody but Wexford are probably pretty small,” Hirshman allowed. “And why you would want Wexford again is, well, beyond me.”  

Additional source: WBEZ

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