Monday, December 11, 2017
Health

Florida's privatization of prison health care still locked up in disputes

TALLAHASSEE — Change never comes easily to Florida's prison system.

It has been more than a year since the Legislature ordered the agency to privatize inmate health care to save money, the largest project of its kind ever attempted in the United States.

It still hasn't happened, leaving unfulfilled Gov. Rick Scott's campaign promise to "competitively bid health care contracts."

In the past year, Scott ousted the corrections secretary who initiated the project, and two unions filed suit to derail it.

Florida's new fiscal year began Sunday with state employees still dispensing drugs, giving checkups and tending to the aches and pains of the 100,000 men and women in the nation's third-largest prison system.

Treating the health needs of inmates is costly. Some prisoners are HIV-positive, others have mental health needs that require psychotropic medications and the inmate population is aging.

After months of red tape, Corrections Secretary Ken Tucker approved hiring two for-profit companies to provide health care for the next five years. The first-year cost: $359 million.

Corizon Health would treat inmates in North and Central Florida; Wexford Health Sources would manage inmate medical care in South Florida.

The firms can't start work until the action is ratified by a panel of legislators, which has no meetings scheduled.

Attorneys for unions challenging privatization argue the project is dead because it was created with fine-print language in a budget that expired Saturday. The state counters it has the authority to privatize health care on its own, but that action would likely trigger more legal problems.

The Legislature tied Tucker's hands by cutting the prison budget by $14 million to reflect the mandated 7 percent cost savings through health privatization.

"Obviously, if we don't privatize, we are in the position of triggering a significant budget deficit," Tucker said.

This is the third time in the past 12 years that the state has embarked on the privatization of prison health care. Both attempts ended badly.

Six years ago, the Department of Corrections privatized health care in South Florida. The vendor, Prison Health Services, said it was not told of unexpected costs and it exercised its option to cut ties with the state. (Prison Health Services has since been acquired by Corizon.)

In 2000, the state hired Wexford to handle health care in South Florida prisons, but things soon went downhill.

Wexford sued the state to get a rate increase and won, and the state ended the partnership when the five-year contract expired. The vendor also said that medical and psychological needs of some inmates exceeded the terms of its contract.

A 2010 Senate staff report noted "numerous start-up difficulties" with the project, but improvement came later.

Corizon already has a state contract to provide mental health care to inmates in South Florida. An inmate at Dade Correctional Institution in Miami, Darren Rainey, 47, died June 23, and prison officials have declined to discuss the circumstances, saying the death is under investigation.

Rainey was serving a two-year sentence for cocaine possession in Pinellas County.

Nearly 3,000 state workers provide inmate health care. Their union has expressed concerns that they would be fired, but both vendors said they would rely on state employees to create a new workforce.

Wexford chief executive Mark Hale said his company typically hires "98 percent" of existing employees.

Hale said his firm does not cut workers' pay, but also does not offer a pension plan like the Florida Retirement System. Workers can invest in a 401(k) plan.

"It's a misnomer," added Jon Walker, a Corizon executive. "In every transition I'm aware of, they always start with the current staff."

Tucker wants to allow Corizon and Wexford to prove they can save the state money.

"Our core mission is security. I'm not a hospital administrator," he said.

Tucker, who was Scott's pick to replace the ousted Ed Buss as leader of the prison system last summer, hopes to complete the project before he retires in March 2013, but he isn't sure it will happen. Tucker, a 57-year-old career cop, is already the agency's fifth leader in the past six years.

"That's not a formula for success," Tucker said.

Steve Bousquet can be reached at [email protected] or (850) 224-7263.

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