HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Monday, August 1, 2005

Privatization of Prison Health Care

The New York Times continues a series examining the work of Prison Health Services, the biggest commercial provider of medical care to inmates.  It seems quite clear that privatization is not the answer to better care for prisoners at least not when involves corruption and failure to keep promises, the firing of whistleblowers and more.  Somehow shareholder value and prisoner health don't work in that type of environment  - at least not for the prisoners.  The Times reports,

Even within the troubled Alabama penal system, this state compound near Huntsville was notorious for cruel punishment and medical neglect. In one drafty, rat-infested warehouse once reserved for chain gangs, the state quarantined its male prisoners with H.I.V. and AIDS, until the extraordinary death toll - 36 inmates from 1999 to 2002 - moved inmates to sue and the government to promise change.

Passing time in 2003 at the H.I.V. unit of the Limestone prison, where all Alabama inmates known to have AIDS or H.I.V. are segregated.

Alabama's solution was to fire the local company in charge of medical care and hire Prison Health Services, the nation's largest commercial provider of health care behind bars. Prison Health's solution was to recruit Dr. Valda M. Chijide, an infectious-disease specialist who arrived last November with a lofty title: statewide coordinator of inmate H.I.V. care.

She was an unlikely candidate for the job in one sense, having never stepped inside a prison. But it did not take her long to conclude that the chaos was continuing, and that much of the problem was Prison Health itself.

Though the company had promised the help of other doctors, she said, she was left alone to care for not only the 230 men in the H.I.V. unit, but the 1,800 other prisoners, too. Nurses were so poorly trained, Dr. Chijide said, that they neglected to hand out life-sustaining drugs or gave the wrong ones. Medical charts were a mess, she said, and often it was impossible to find such basic items as a thermometer, or even soap.

Dr. Chijide lasted barely three months. After she complained in writing, Prison Health suspended her for reasons it would not disclose, and she quit.

Her short, frantic stint - battling for drugs, hospitalizations and extra food for skeletal inmates, she said - was not unusual in the world of Prison Health Services, which has had a turbulent record in many of the 33 states where it has provided jail or prison medicine. But her story, a rare firsthand account of a doctor in charge of a prison's health care, offers an intimate glimpse of the company's work at a moment when the need for change could not have been more pressing, and the spotlight on Prison Health could hardly have been more intense.

Related articles from the New York Times series:

Harsh Medicine: As Health Care in Jails Goes Private, 10 Days Can Be a Death Sentence (February 27, 2005)

In City's Jails, Missed Signals Open Way to Season of Suicides (February 28, 2005)

A Spotty Record of Health Care at Juvenile Sites in New York (March 1, 2005)

State Board Calls Rikers Suicide a Glaring Case of Poor Care (April 4, 2005)

Medical Group for City Jails Is Investigated (May 11, 2005) .


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