City submits prison health care contract
The city of New Orleans has issued a request for proposals for companies interested in providing health services to the nearly 1,000 people held in the city jail on any given day – a task that has long been the subject of close scrutiny and criticism from appointed controllers by the court, civil rights lawyers and people incarcerated in the establishment.
As of 2014, prison health care has been provided by the nation’s largest correctional health care company, Wellpath, based in Nashville, Tennessee (formerly known as Correct Care Solutions), which was the subject of critics across the country for lower quality of care and reduced costs to the detriment of providing the necessary services.
In New Orleans, Wellpath has been named in several wrongful death lawsuits filed by families of those who died in custody at the Orleans Justice Center – including that of Colby Crawford, a 23-year-old diagnosed with schizophrenia, bipolar disorder and drug addiction. use disorder, who died of a drug overdose in prison. A lawsuit brought by Crawford’s mother claimed that prison healthcare workers failed to respond to Crawford’s deteriorating mental state and refused to place him in a psychiatric level despite his request.
This trial, as several others where the company and the sheriff’s office were named as defendants, was settled out of court.
More recently, however, Wellpath has partnered with Tulane University to provide psychiatric care at the facility, and federal monitors – appointed by a judge under the prison’s eight-year consent decree – have noted some improvements in overall care delivery since the contract began.
Offers must be submitted at the beginning of December. In a statement to The Lens, Wellpath chairman Kip Hallman suggested that the company would seek to remain the supplier to the prison and use the RFP as an opportunity to rethink its contract and relationship with the sheriff’s office.
“With the unprecedented changes the COVID pandemic has brought to healthcare, bidding opportunities like this give all bidders a chance to demonstrate to our government contracting partners how contracts should change and adapt to such changing conditions, ”Hallman said. “For example, the remuneration of nurses and other health care providers has increased dramatically over the past two years. at the heart of our business.
Records show that two Wellpath representatives attended a mandatory pre-submission conference for the RFP. Neither the city nor a spokesperson for the company have responded to questions from The Lens about whether or not the company has submitted a proposal yet.
Initially, the Wellpath contract was managed by the Orleans Parish Sheriff’s Office, but in 2016 was taken over by the city. Since then there have been several extensions, and in 2019 the city reported that he would attempt to strike a “long-term” deal with Wellpath.
But at the end of September this year, the city put out a tender for the contract.
A city spokesperson said it was necessary because of laws requiring it to open public tenders for any extended five-year contract. But the spokesperson also suggested that chief executive Gilbert Montaño had the power to approve an indefinite extension of the contract beyond the five years if he so wished. However, it is unclear where that authority came from and the spokesperson did not respond to follow-up questions from The Lens.
“The original agreement between the city and Wellpath (then CCS) came into effect in March 2016 and that five-year period therefore passed last March,” the spokesperson said. “The CAO approved an exception to allow for business continuity while the City went through a public tendering process, but did not approve an unlimited exception that would allow the contract to be extended indefinitely without competition. public.
The submission deadline was initially Nov. 24, but was pushed back to Dec. 8 due to the “volume of questions received from interested vendors,” according to a city spokesperson. A document attached to the RFP includes a list of questions submitted by suppliers and responses from officials.
According to the RFP, contracted services “must be comprehensive and must include, but are not limited to, medical, mental health and dental services.”
“The goals are to provide comprehensive care and treatment upon admission and maintained throughout incarceration,” the request said. “Services must be designed with the aim of improving health care outcomes and meeting the health care needs of detainees as they prepare to reintegrate into society. “
Sheriff Marlin Gusman, who will face a run-off against former Independent Police Inspector Susan Hutson in December, said in a statement to The Lens that his office “has worked closely with the city administration to write the RFP “but that” it would not be appropriate to comment during the proposal review / RFP period.
But in an interview with Newell Normand on WWL radio on Tuesday, Gusman praised Wellpath, saying his office has developed a “lockdown” relationship with the healthcare provider while navigating the COVID-19 pandemic at the prison. – during which there were significant epidemics among both inmates and staff.
“We really bonded a lot more during that time when, you know, everyone had to be vaccinated – the medical staff as well as the security staff and all the MPs,” Gusman said. “We had to make sure to vaccinate as many residents detained here as possible. “
He said the prison had vaccinated “917 people who are in our custody”.
“This stuff can only happen when you have, you know, a good, close working relationship,” Gusman said.
Gusman’s handling of the pandemic in the prison recently garnered praise from Federal Judge Lance Africk, who oversees the prison’s consent decree. In a recent court hearing, Africk called the sheriff’s efforts “remarkable” and “nothing less than saving lives.”
“Community leadership and community outcry”
Hutson, however, terminated the contract with Wellpath one of the key elements of his electoral campaign. She proposed that the prison “instead partner with public health organizations to provide medical care.”
“The problem is not with the contract, but with the care that was provided,” Hutson told The Lens on Tuesday.
In their most recent progress report on the Consent Order, the prison monitors found that while there was “continued positive progress with Tulane’s interface with Wellpath … the provision of medical care and services and adequate and timely mental health has declined, as has adherence to suicide prevention training. , management and monitoring.
“Wellpath continues to have difficulty counting, for example, calculating the total number of mental health cases consistently and counting the number of patients with acute and chronic illnesses who need and receive counseling, and track discharge medications, ”the report reads.
The privatization of health care in correctional facilities across the country has become more common in recent decades, and an October 2020 Reuters report estimated that more than 60 percent of prisons in the United States use private companies to provide health care.
But that same report found that between 2016 and 2018, prisons with private health care providers had higher death rates than those using government agencies to deliver services.
Hutson said she hoped health agencies already providing care in New Orleans would bid on the prison contract.
“We want people who provide care in a community, because again, we want them to be able to provide that care when people leave prison,” Hutson said. “We want them to be subject to community leadership and community outcry if they don’t provide the proper care. ”
The city spokesperson said the city itself “does not have the capacity to provide the services in-house,” but that “the city and OPSO have looked at all available options to ensure that we continue. to adhere to appropriate standards of care for OPSO detainees ”.