There are currently over 2.2 million adults incarcerated in U.S. prisons, immigration detention centers and county jails. For about half those prisoners, their healthcare needs have been outsourced to private medical contractors.
One of the largest prison healthcare companies is Corizon Health, Inc. Government officials claim these contracts save money but at what cost?
Judges, advocates and even the public are beginning to realize that the putting of profits above patients can have disastrous results. This post examines Corizon Health and looks at how they are endangering the health and wellbeing of the patients they were hired to heal.
American prisons and jails currently house an estimated 2,230,000 adults. That ranks us number one in the world in terms of rates of incarceration. We lock up more people (and often for longer periods) than any other country in the world including China.
Half of U.S. Inmates Receive Private Healthcare from Prison Contractors
This post doesn’t debate the wisdom of such high incarceration rates or what society should be doing to prevent more people from getting entangled in our justice system. While many Americans already know that we have high incarceration rates, few know that almost half those prisoners receive private healthcare while in jail.
For the general public, the concept of private healthcare in the prison sounds pretty good. After all, we all know someone on the outside struggling to find affordable healthcare.
Why should prisoners get “better” healthcare than those struggling to pay for their child’s medicine? The reality, however, is that privatized prison healthcare is both expensive and dangerous.
So just how good is the private healthcare for prisoners provided by Corizon and other vendors? It is a disaster in our opinion.
We learned that in one prison system, doctors make just $5 for each prison visit. One of two things happen with such a compensation plan. Either you get horrible doctors or doctors that can only spend a few seconds with a prisoner if they want to make enough money to feed their families. Often prisoners get the worst of both worlds; a horrible doctor and a 30 second infirmary visit.
A few people in society still think that prisoners have it too easy. While we acknowledge that people make mistakes and many of those mistakes are serious enough to warrant prison, we hope that most folks recognize that everyone living person has rights.
It is important to remember that not everyone in prison or jail has been found guilty of a crime. Many are awaiting trial and can’t make bail. (Remember high school civics? “Innocent until proven guilty?”) And even the guilty ones still have basic human rights. Also, often the folks that wind up in jail are people suffering with serious mental illness.
U.S. Supreme Court – Inmates Have Right to Basic Healthcare and No Deliberate Indifference
According to the U.S. Supreme Court, all inmates – both pretrial and those serving sentences – have the right to basic healthcare. In 1976, the U.S. Supreme Court in Estelle v. Gamble established that health care for prisoners is a right embodied in the eighth amendment of the U.S. Constitution.
While the court didn’t specify the extent the state must go to provide such care, the court did note that prisoners have a right to be free of “deliberate indifference” to their health care needs.
In deciding Estelle, Justice Thurgood Marshall said,
“An inmate must rely on prison authorities to treat his medical needs; if authorities fail to do so, those needs will not be met. In the worst cases, such a failure may actually produce physical ‘torture or a lingering death’ . . . In less serious cases, denial of medical care may result in pain and suffering which no one suggests would serve any penological purpose . . . The infliction of such unnecessary suffering is inconsistent with contemporary standards of decency as manifested in modern legislation.”
Providing healthcare to prisoners is challenging.
Those incarcerated often have higher medical needs than those outside prison. Specifically, prisoners often lack a history of preventative healthcare. Some have not had a physical or visited with a doctor in years. Many already have serious illness when first locked up. Many have mental health and / or substance abuse issues.
Don’t forget the many prisoners serving life sentences and their likely need for costly end of life care. The high-risk lifestyles that many have lived often means they are already suffering from prior gunshot or stab wounds when brought into a facility.
Private Prison Healthcare Provider Corizon Inc.
Corizon Health Inc. is one of the largest private companies providing medical care to prisons and jails. It is a for-profit company. That means the company’s board of directors answer to investors and stockholders, not to their patients.
Corizon’s healthcare workers are constantly pressured to do more with less. And many are underpaid. Working in a prison is already dangerous and depressing, low pay only worsens morale.
Some private companies come up with innovative ways to deliver quality services for lower cost. In our opinion, Corizon, in contrast, seems to make a profit through cutting corners and delivering less.
Corizon Health and Florida “Soaring fatalities and substandard care”
In 2013, Florida Governor Rick Scott announced he wanted to privatize healthcare in the state prison system. At the time, Florida’s prison system was the third largest in the nation and housed over 100,000 inmates. Corizon was chosen to provide much of that care. In 2013, Corizon was already providing care to 317,000 inmates nationwide.
Corizon claimed it could provide better healthcare for millions of dollars less than its nearest competitor. To state corrections officials and jails throughout the Sunshine State, those claims were music to their ears. Ultimately, Corizon got most of the business.
By 2016, they were on their way out despite a $1.2 billion contract.
Corizon may have been the low bidder but they couldn’t deliver services profitably. By 2016, the state and Corizon were flooded with claims about poor treatment. A class action suit was filed claiming the company denied hernia operations simply to save money. The Palm Beach Post reported that prisoners under Corizon’s care had “soaring fatalities and substandard care.”
Corizon Health and Idaho – “Inhumane”
Florida may have been Corizon’s biggest contract but the company suffered problems everywhere. (To be accurate, the ones really suffering were the prisoners in Corizon’s care.)
A court appointed expert in Idaho said Corizon’s care of prisoners in the Idaho State Prison was “inhumane.” His report said that terminal and long-term inmates sometimes “went unfed, nursing mistakes or failure likely resulted in some deaths, and one inmate wasn't told for seven months that he likely had cancer.”
Some patients were left in soiled linens, others were denied pain medication even though they were dying.
His report says that one patient was unconscious and having “serious breathing problems.” A nurse didn’t take his vitals and didn’t administer oxygen. The patient died.
The report also claims that sometimes guards would call Corizon seeking help in medical emergencies only to receive a phone call from an on-call nurse.
What did Corizon say? They were “disappointed” in the court special master’s opinion and said his conclusions were erroneous. Remember, the person making that report was a respected prison healthcare physician who was appointed by the court as an impartial special master. He was not appointed or selected any of the litigants in the case.
It’s not just the bigger state prison systems where Corizon has struggled.
The Maine State Legislature’s nonpartisan Office or Program Evaluation and Government Accountability looked at prison healthcare in the Pine Tree State. Specifically, they looked at Corizon Inc. who held the state’s prison healthcare contract. (At the time of the audit, Corizon was known as Correctional Medical Services)
The Legislature’s findings?
- Medications Not Properly Administered and/or Recorded
- Medical Files Not Complete or Consistently Maintained
- Required Annual Health Exams Not Consistently Tracked and Sometimes Not Performed
- Response to Sick Calls Not Timely and/or Inadequately Documented
- Staff Training Insufficient and Poorly Documented
Just looking at the first of the bullet points, the state auditors found that of 24 randomly selected patients, there was no record that 11 received their doctor prescribed medications. For 2 of the patients, medical staff could not even find the inmate’s medical records!
As jail death and prisoner rights lawyers, our biggest concern is the inmates, of course. But taxpayers also seem to be getting hurt. The entire point of privatizing prison healthcare is to save tax dollars. Few people ever argued that private physicians would do a better job than state doctors. The Legislature and Congress was sold on the savings of tax dollars.
Did these contracts actually save money? No!
The Maine legislative committee found that “[Maine Department of Corrections] contracts with CMS [Corizon] and CorrectRx have not been structured or managed to maximize cost savings to the State. [The state’s] use of long-term, open-ended contracts diminishes vendor incentives to continually reduce costs.”
And the Florida contract? As originally drafted, Florida’s contract with Corizon was only designed to save a mere 7%. While in a state the size of Florida that means millions of dollars, union officials representing state corrections workers say those savings were never realized. We personally believe the alleged “savings” are not worth the lawsuits and human suffering.
Worse, we are told the contracts in Florida and Maine were No Bid!
Beyond the Statistics – Human Tragedy and Corizon
The Tragic Death of Kelly Green
It was cold February night in Oregon. A concerned convenience store worker called police when a homeless man entered the store and behaved erratically. Police across the nation confront this situation daily.
Because many cities and towns don’t have a robust mental health system, it is the police and justice system that are often compelled to deal with the homeless, vagrancy and the petty crimes that accompany these social issues. This is especially true on nights and weekends.
Police in Eugene, Oregon arrested Kelly Green and took him to the Lane County lockup. Green continued to act confused and irrational. The intake deputy wrote in her log book, “May be bipolar / schizophrenic. No meds … talks to himself … not making sense.”
Normally upon intake, new prisoners are sent for medical screening. Jail and prison officials need to know if the person has serious health issues, is on life savings medications, may go through withdrawals or has a communicable disease.
In Lane County, the contract for jail health services was held by Corizon Health Inc.
Kelly Green never received a medical screening that night or received any medical care. In the morning, he was taken to court where he continued to display irrational behavior. Ultimately, he lowered his head and ran headfirst into a concrete wall. The Southern Poverty Law Center described the sound of Green’s head meeting the concrete as that of “throwing a watermelon at a wall.”
Even though Green’s neck was broken, he still wasn’t taken to a hospital for 6 hours. Deputies took him back to the jail.
Corizon healthcare workers did nothing to stabilize his broken neck or spine. For hours, he laid in a cell, incontinent and not moving. By the time he was transported to the hospital, he was a quadriplegic.
Ultimately, he died in the hospital after being on a ventilator for 6 agonizing months.
Corizon Faces Justice in Green’s Death
Kelly’s family didn’t take the news well. Their son was mentally ill, not a dangerous criminal. And he needed help. The Green family wanted answers. Lane County blamed Corizon while Corizon blamed the county. Tired of the runaround, the Greens filed a lawsuit.
Corizon claimed that they did everything by the book. Essentially, their defense was that tragedies happen and not all such tragedies are preventable.
Did they really do everything by the book?
A federal magistrate judge said in an opinion that despite a Corizon’s nurse’s testimony that she performed a comprehensive neurological exam on Green after his head ramming incident, her notes say nothing of such an exam.
“In contrast to [Corizon physician assistant Kirstin White’s] deposition testimony, her chart note did not note a neurological exam and did not include the level of detail noted above from her deposition. Epperson [another Corizon employee] did not recall White performing a neurological exam, but does remember her checking his neck... The judicial assistant in the courtroom, Tracy Tomseth, states that no one immobilized Green's neck and that no one performed a neurological exam. Tomseth did not see anyone do anything with Green's legs, put hands to his feet, or grab his hand to squeeze.
Three Lane County deputies present, Darryl Davis, Kelly Rahm, and Angela Dodds recall that White was asked if Green should be transported to the hospital and White responded that he could be treated at the jail. Deputy Angela Dodds stated that White specifically answered no, that Green would be treated at the jail and that it was ultimately White's decision. Deputy Kelly Rahm stated that medical did their assessment and determined that Green did not need to go out in an ambulance and White stated she could stitch or staple the wound on his head and that it was okay for the deputies to move Green because ‘He's fine, he's fine.’”
In a motion seeking to dismiss the case, Corizon actually suggested that the court clerk, Tracy Tomseth, bore some responsibility in Green’s death! They say that because the court clerk had medical training from a previous employment, she could have called 9-1-1 but didn’t.
Corizon wasn’t able to get the case dismissed.
Ultimately, the lawsuit was settled. Lane County paid $400,000 while Corizon paid an additional $7 million.
When Jails House Mentally Ill Patients
Jails have long been the dumping ground for the mentally ill. When no one will take them in, police are called. One clinic manager said she often goes to the local jail on Monday mornings to find her clients. With no weekend social services available, the severely ill often wind up in jail.
Another mental healthworker described the situation as follows, “Some people, they get caught for criminal trespass and they’re just like, ‘Take me in. I haven’t eaten in four days. Go right ahead, I need something.’”
Jails and their healthcare providers don’t always have a say in who ends up in their care or custody. That decision frequently belongs to the courts and police. But once a mentally ill patient is in jail, corrections officials and healthcare workers can’t simply ignore their needs.
As noted above, the Supreme Court and societal norms dictate that all prisoners and detainees are entitled to basic care.
Corizon and the Tragic Death of Martin Harrison
It’s not just people with mental illness who are dying in prisons. Often people with severe substance abuse problems find themselves behind bars. On August 13, 2010, Martin Harrison was picked up in Oakland, California for jaywalking. Police found he a warrant for failure to appear on a drunk driving charge.
Harrison was booked into an Alameda County jail. Inmate healthcare in Alameda County is performed by Corizon. A licensed vocational nurse (LVN) performed Harrison’s intake screening. She was unsupervised, a point which would later become critical at trial.
Evidence suggested that Harrison told people at the jail he was suffered from alcoholism and has a history of alcohol withdrawal. For reasons unknown, the nurse didn’t follow the jail’s protocol for prisoners with alcoholism. Harrison was instead sent to general population.
Two days later, Harrison went into severe Delirium Tremens (DT’s), a condition that is fatal in 35% of cases if not immediately treated. Deputies in the pod may not have known that Harrison was in DTs.
Allegedly when a deputy entered Harrison’s cell, he “tensed.” A deputy shot Harrison twice with a Taser and called for backup.
Harrison was most likely out of his mind at this point and not making any sense, let alone being in a position to comply with the deputies. Nine more deputies entered the cell. Harrison was beaten and tasered multiple times. After lapsing into unconsciousness, he was transported to Valley Care Medical Center where he died hours later.
While the behavior of the deputies was certainly questionable, the deputies maintained that they had no idea that Harrison was suffering from DTs and should not have been in general population. They say they were confronted by an incoherent, out-of-control inmate. (That is difficult to believe as Harrison weighed just 142 lbs. and was out numbered 10 to 1 by deputies who were armed with Tasers.)
Harrison’s minor child settled privately for $1 million but the remainder of the case went to trial. In 2015 and in the midst of the trial, Corizon and Alameda settled for $8.3 million.
The news stories discuss the horrible abuses that Harrison suffered while in jail but they don’t tell the whole story. The story of Martin Harrison the man.
At the time of his arrest for jaywalking, Harrison was 49 and unemployed. He had four kids with his wife Rosemarie Martinez. He would later divorce and have a fifth child with another woman. That child is still a minor so we are not disclosing his / her name.
Despite the divorce and new relationship, family members say that Harrison remained close with his kids and his ex-wife. In 2008, after his mother passed away his kids say that Martin began drinking excessively and became alcohol dependent.
Just before his jaywalking arrest, Martin was involved in a minor accident. After being arrested for drunk driving, he told his kids he needed to get help. He never got the chance. Arrested for jaywalking, he died in jail days later.
We learned from that case that vocational nurses are not allowed to work unsupervised and can’t make patient assessments. So why would Corizon allow LVNs to work outside the scope of their practice and to work unsupervised? We think the answer is obvious. Money.
Corizon is a for profit institution. It pays registered nurses (RNs) much more than LVNs. By cutting corners and saving a few bucks, Corizon could add to its profits.
Corizon Health and Medical Malpractice
Malpractice and poor healthcare claims seem to follow Corizon.
The Florida Bulldog, a nonprofit watchdog group, said that Corizon refused to disclose its history of malpractice claims when bidding for the jail healthcare contract in Broward County, Florida.( It’s close competitor, Armor Correctional Healthcare Services, admitted it had been sued for malpractice 150 times in just over a 4 year period.)
Why wouldn’t Broward County compel Corizon to disclose its lawsuit history? After all, it is tax dollars that pay for the prison health contract. (Other sources say that Corizon has been sued for malpractice 660 times and that was just through 2013!)
Corizon Health Today
Corizon still has dozens of prison healthcare contracts around the nation. As of 2016, the company reported that it was covering 345,000 prisoners in 534 jails and prisons in 27 states. (After a series of scandals, it appears that Corizon’s lock on the prison healthcare market may be slipping. As of this writing, the company’s website says it serves over 220,000 patients in 22 states.)
Corizon became the leading name in prison healthcare in 2011 following the merger of Correctional Medical Services and Prison Health Services. The new company became Corizon Health Inc.
We have dozens of additional stories about Corizon, some actually worse than the ones above.
Prisoners and their families have the right to expect that patients will receive good healthcare while in prison. The Supreme Court declared adequate healthcare was a right secured by the Constitution. Basic common sense and norms of decency dictate that healthcare providers strive to provide the best healthcare possible.
We believe that Corizon knows it can’t deliver on promised cost savings without cutting corners.
That means inmates don’t receive the basic care they deserve.
In many instances, we believe the bad care stems from poor salaries, using medical professionals outside their scope of practice (e.g. using vocational nurses in roles that require a higher level of care) and in understaffing their contracts. It also occurs when Corizon tries to treat seriously ill patients in the prison despite the clear medical necessity for surgery or hospitalization.
Injured or Loved One Died While being Treated by Corizon Health?
As jail death lawyers, nothing we do can bring back a loved one who needlessly died because of medical malpractice. We also can’t erase their needless pain and suffering. But we can achieve justice, we can hold Corizon accountable and we can help prevent future tragedies.
For profit prison healthcare companies are responsible for medical malpractice. And courts are juries are beginning to understand that our jails and prisons aren’t exactly “country clubs.” With 3 in 100 adults presently in prison, on parole or on probation, many families have a loved one who has made mistakes or suffered from addiction or mental illness and wound up in jail.
Our network of jail death and jail injury lawyers can help you find justice. How? By bringing an lawsuit for damages and helping make sure these tragedies don’t occur again. For example, after the wrongful death lawsuit filed by Martin Harrison’s family settled for $8.3 million, Alameda County and Corizon made some important reforms including hiring RNs to make assessments instead of vocational nurses.
Unless people stand up and step forward, these tragedies will repeat daily.
What Can You Do?
If a loved one has suffered a wrongful death while in custody or if you suffered a life threatening, catastrophic injury or illness requiring extensive hospitalization because of poor medical care or medical malpractice, give us a call.
Although our practice is primarily geared to death cases, we sometimes will take a serious injury case. Prisoners who became quadriplegics or suffered permanent brain injuries because of poor medical care are the type injury cases we consider.
For more information, contact us online, or CALL US 866.836.4684
The time to bring claims against jails and prisons is often extremely limited. Please don’t delay.