Murder Incorporated: Profits from Privatized Prison Health Care

Gregory Jennings, Jacqueline Reich, Lorenzo Ingram, Sr., Henry Simmons, Calvin Moore, Billy Roberts and Kathy S. Kearns didn't know each other in life, but they shared a common bond in death: All died in U.S. prisons, the victims not of the death penalty, or at the hands of fellow inmates or guards, but in the allegedly negligent care of a single provider of privatized health services.

Correctional Medical Services (CMS) is a St. Louis, Missouri-based for-profit corporation that contracts to provide health care services to over 270,000 inmates at more than 330 prison sites in 29 states. At its Web site, the company claims to be "the nation's leading provider of contract healthcare services to prisons and jails." It also says it "designs a wide range of correctional healthcare programs and services to meet individual client needs."

CMS offers additional services including "24-hour physician and nursing coverage, specialty physician services, sick call and infirmary care, dental care, chronic care, and laboratory/radiology services. " It also performs administrative services as well, including "utilization management, medical affairs management, inmate health education, and infectious disease protocols for AIDS and tuberculosis."

It's difficult to get a sense of the company's current activities from their site since it contains only one press release for 2001 -- an announcement of a contract with the Tennessee Department of Corrections to provide health care service to more than 17,000 inmates at 14 state-run facilities. There are two press releases for 2000 and three for 1999.

However, a 1998 in-depth investigative report done by the St. Louis Post-Dispatch, its hometown newspaper, shed light on the downside of prison care privatization. The Post-Dispatch's investigative team spent five months "visiting prisons and jails; gathering hundreds of police, court and medical records and other documents; and interviewing doctors, nurses, inmates, lawyers, scholars, prison and health experts and families of inmates who died behind bars."

Published in September 1998, "Death, Neglect and the Bottom Line: Push to Cut Costs Poses Risks," found that while CMS successfully reduced the cost of health care to several states, there were "more than 20 cases in which inmates allegedly died as a result of negligence, indifference, understaffing, inadequate training or overzealous cost-cutting."

While the St. Louis Post-Dispatch report is an excellent starting point for looking into CMS's operations, several recent updates indicate that the company hasn't done much to clean up its act. The American Civil Liberties Union, the Media Awareness Project and the Twin Cities Independent Media Center have all reported on CMS' sorry record.

At the ACLU web site, the civil liberties organization posts a late-January 2001 letter it sent to the Connecticut Department of Correction (CDOC) that claims CMS's health care services -- medical, mental health and dental care -- at the Wallens Ridge State Prison in Big Stone Gap, Virginia, is woefully "inadequate." The letter charges the Virginia Department of Corrections with conditions that "violate the Constitution," and maintains that Connecticut prisoners currently at Wallens Ridge are subject to a number of "unconstitutional" situations. (The ACLU was trying to prevent Connecticut from sending any more of its prisoners to Virginia.)

The ACLU writes: "The health care provided by Correctional Medical Services, the contract provider at [Wallens Ridge], was considered so grossly inadequate that [Virginia Department of Corrections] recently fined CMS nearly one million dollars. The Virginia State Auditor specifically found that CMS did not provide a dentist at [Wallens Ridge] for over three months, and never provided an optometrist. Medical privacy and confidentiality is non-existent at [Wallens Ridge]; as a matter of policy, prisoners are required to discuss their most private medical and mental health issues in the presence of security staff and other prisoners."

A June report posted at the Media Awareness Project web site talks about the case of Keith Griggs. At the Woodstock Regional Correctional Facility in Vermont, Griggs was refused methadone treatment for his heroin addiction. At the time he was in the eighth day of a 15-day sentence for failing "to complete an assignment‚ "in a Corrections program for non-violent offenders with substance-abuse problems." CMS, which contracts to provide medical services in the state prisons, cited state rules in refusing Grigg's methadone treatments.

In 1998, the Minnesota Department of Corrections contracted with CMS for health care services in its state's prisons. According to the Twin Cities Independent Media Center, the NAACP called a press conference in mid-October to publicize a lawsuit "over the death of Gregory Jennings, who died in Stillwater prison on April 6, 2001 because the medical staff were indifferent to his complaints of symptoms of diabetes." Reporter Jordan Kushner writes: "It was public knowledge that CMS, in its short history, already had an extensive record of lawsuits and administrative actions against it for failure to provide adequate medical care to prison inmates." Yet, despite this record, the Minnesota Corrections has renewed the contract through at least 2003.

In addition to providing poor health care services, CMS is a union-buster. According to a June 2000 Associated Press story in the Detroit News, the United Auto Workers Union, which represents doctors, physician's assistants and nurse practitioners employed by the Michigan Department of Corrections, "sued over Michigan's privatizing health care for prison inmates, claiming prisoner health could suffer if the state expands its contract with the for-profit provider scrutinized in several states."

Privatization has been one of the Right's most enduring ideas during the past several decades. A quick trip to the web site of the Heartland Institute, a conservative think tank and information clearinghouse for right-wing policy papers and research studies, came up with more than 260 references to documents about privatization, including papers advocating privatizing education, a bevy of social services including child welfare services and foster care, social security, prisons and more.

The federal government's response to the September 11 suicide attacks has caused some conservatives to voice concern that the era of big government may not be quite over yet. That's what the congressional showdown over the federalizing of safety operations at airports is pretty much all about. House Republican leader Tom DeLay told one of the Sunday morning talk shows that as long as he's in Washington he will do his best to make sure the federal government doesn't expand. Kenneth L. Connor, head of the Family Research Council, a conservative lobbying group said, "It's important that government protect its citizens. But that shouldn't be a pretext for growing government."

Should Calvin Moore, in custody for less than a month at the Kilby Correction Facility in Alabama, have died from being ignored while he lost fifty pounds and exhibited severe symptoms of mental illness, dehydration and starvation? Should Diane Nelson, a 46-year-old mother of three, have died because her request to receive her heart medicine prescribed by her doctor was refused? And what of Charles Guffey, who died of a perforated ulcer because nurses at the Tulsa County Adult Detention Center in Oklahoma refused to pay attention to his complaints of severe abdominal pain?

If these folks were around today they'd have a lot to say about the human cost of the growing privatization of prison health care services. One hopes that privatization will begin to receive the close scrutiny it deserves. That is the least we can do. The deaths of these men and women, while tragic, should not have been in vain.

Many thanks to Randy Gould's always informative Oread Daily for a heads up on CMS. To receive the Oread Daily, contact:

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