NM promises better oversight of prison health contract
The state is inviting new vendors to provide healthcare to about 7,000 men and women held in the prison system
The Santa Fe New Mexican
SANTA FE, NM — The New Mexico Corrections Department is inviting new vendors to take a crack at providing health care to the about 7,000 men and women held in the state’s prison system.
The current provider, Centurion LLC, won the contract away from Corizon Health in 2016, amid a flurry of medical malpractice lawsuits from inmates and an investigation by The New Mexican that revealed the latter had largely operated without state oversight for years.
But as Centurion’s contract — worth more than $41 million per year — nears its November expiration date, the state still has not completed a comprehensive audit of Centurion’s services at each of New Mexico’s 11 prisons, making it difficult to find an objective measure of the company’s performance.
Newly appointed Corrections Secretary-designate Alisha Tafoya Lucero declined to rate her level of satisfaction with Centurion, saying she wasn’t “comfortable” doing so.
Observers of the state’s prison system say the contract is key for the future of the department, in part because inmates’ medical care — or the lack of it — is a civil rights issue and can be the subject of costly litigation that can drag on for years.
Matthew Coyte, a civil rights attorney who regularly sues the state and has won six-figure awards for clients doing time in New Mexico prisons, says inmate medical care is an issue all taxpayers should care about, even if they don’t know anyone in prison.
“From a purely practical standpoint, it costs us more money when their conditions worsen and they leave the facility and we end up having to pay for them anyway,” he said. “It’s cheaper to pay for their medical care before it gets to a crisis point.”
Decades ago, the state employed a team of doctors and nurses who audited the medical care services annually or quarterly. But over the years, comprehensive audits of the vendor by the department’s own staff grew more rare. Between 2012 and 2015, of the approximately 160 audits that should have been done, the department could produce records of only 20, according to a 2016 investigation by The New Mexican.
Although Corrections Department officials pledged to do a better job overseeing the medical care contract vendor in recent years, a records request for the department’s most recent audits of the vendor revealed the state hasn’t completed a comprehensive audit of medical care services since Centurion won the contract.
Corrections Health Services Administrator David Selvage said his staff is working on an assessment that should be completed in the fall but that the department, with few exceptions, relies largely on the vendor to audit its own performance.
According to documents obtained under a public records request, Centurion reported:
• No medical grievances had been received from inmates at more than half of the state’s 11 prisons during a specific 12-month period.
• At facilities where inmates had filed medical grievances, they were resolved in favor of prisoners only a fraction of the time.
• Of the 157 medical grievances filed at the Lea County Correctional Facility in Hobbs, the 66 medical grievances filed at the Guadalupe County Correctional Facility in Santa Rosa and the 28 medical grievances filed at the Northeast New Mexico Detention Facility in Clayton, not one was decided in favor of the inmate. Grievance officers consult with medical staff to determine if a complaint can be substantiated.
Inmates can appeal a decision to the Corrections Department’s central office. If they lose there, they’ve exhausted the grievance process, leaving a civil lawsuit as their only remedy.
The period Centurion reviewed is not clear because company documents supplied by the Corrections Department in response to a public records request contained dates from 2017, 2018 and 2019.
Tafoya Lucero, named last week to the department’s top job after spending part of the year as its interim head, said she found the self-reported data “interesting” and said it was something she would look into.
She also said she would need to check the facilities’ records to determine if the number of grievances reported was accurate.
Based in St. Louis, Centurion serves more than 300 correctional facilities across the nation, according to its website. The company did not respond to email and phone requests seeking comment.
The state has monitored at least some pieces of the inmate health contract — it reviewed facilities for compliance with American Correctional Association standards, and it has invited the state Department of Health to review its infection control processes once in the past four years.
Twice since 2016, the state has paid a private firm, HealthInsight, $50,000 to conduct a review of the medical intake processes in state prisons to determine, among other things, whether inmates received proper medical assessments when entering the system.
In the company’s most recent report, dated June 1, 2018, HealthInsight found:
• 175 of the 203 inmate medical charts it reviewed had one or more “deficiencies.”
• Inmates’ health assessments were not always completed within required time frames.
• In multiple cases, the records provided by the department for review were missing or were for time frames other than the one requested by reviewers.
• An inmate prescribed medication for a communicable disease in May 2017 still had not received the medication by April 2018.
Tafoya said she’s committed to streamlining the audit process and developing screening tools that will accurately reflect the vendor’s performance.
“One thing we are looking at would be to establish an electronic health care record,” she said. “We really feel like that would simplify a lot of things.”
Online court records show Centurion has been the subject of fewer medical negligence lawsuits than its predecessor. Corizon faced at least 138 lawsuits in the last four years of its contract with the state. Centurion has been sued at least 65 times since taking over the contract in 2016.
But about half the lawsuits against Corizon in that period related to the actions of one doctor who was accused of sexually assaulting more than 60 inmates. If the cases against that doctor are removed from the total, the number of medical negligence claims filed against the two vendors are roughly the same.
Centurion still has about half a year on its contract, and new lawsuits continue to be filed with regularity, according to court records.
“We are very busy,” said Albuquerque lawyer Parrish Collins, who has nearly a dozen medical care-related cases pending against Centurion and the Corrections Department. “There are no shortage of these cases, and I don’t expect the phone calls to stop today or anytime soon. We are in the business of suing prisons for medical negligence, and right now, business is good.”
Lawsuits against Centurion have included a variety of claims of inadequate medical care, and several families have filed lawsuits claiming their loved ones died in prison because they were not given proper attention.
Under the terms of the state’s contract with Centurion, the company is required to handle malpractice claims itself. But in many cases, inmate plaintiffs also name the state and state employees as defendants in lawsuits.
A spokesperson for the Governor’s Office said he couldn’t say definitively if the contract’s indemnification clause protects the state against liability in all cases.
State officials have said keeping settlements confidential protects inmate privacy and ensures the costs of litigation fall on the private company.
But Coyte and Collins say the arrangement also allows Centurion — a private company not subject to open-records laws — to keep the terms of its out-of-court settlements with plaintiffs confidential, thus obscuring important information about where problems could be brewing.
What’s needed, Coyte contended, is better monitoring by the state.
“We need absolute oversight from the [Corrections Department] that every dollar we spend on the medical care contract is actually being spent on medical care,” he said. “I don’t think we have that to this day.”
Tafoya-Lucero acknowledged there is room for improvement in the state’s monitoring of the contract and said she would make those improvements going forward.
“We take this very seriously,” she said. “We want to make sure we are working hard to make sure those services are improved and we are able to uniformly monitor our contract and we are getting the data that we need. I don’t think that was necessarily true previously.
“But with certainty and sincerity,” she added, “I can tell you it’s our absolute priority to make sure we are providing proper service, and in the event that something is happening with our vendor, we are able to see it and address it quickly.”
The inmate medical care contract
The state Corrections Department has given would-be bidders until 3 p.m. Aug. 21 to submit proposals for a contract to serve as the health care provider for inmates in New Mexico prisons. The Governor’s Office said a committee made up of Corrections Department staff will evaluate and score the proposals and make a recommendation about which company should be granted the award.
©2019 The Santa Fe New Mexican (Santa Fe, N.M.)