Allegheny County Controller Chelsa Wagner today today released her audit of Corizon Health Inc., the health care provider at the Allegheny County Jail. The audit revealed that Corizon was unable to demonstrate that they have provided health care as required, and that staffing levels and medical record maintenance are inadequate. Corizon’s contract with the County costs $11.5 million.
“Despite the millions of dollars that County taxpayers invest into this organization, Corizon is not holding up its end of the deal,” Wagner said. “This is an issue of both money being wasted and public safety. The majority of the 2,700 inmates at the Jail suffer from mental health and substance abuse issues. Inadequate care of inmates impacts everyone involved – jail guards, health care professionals, other workers at the jail, as well as the greater community – when inmates are released without help.”
The audit’s findings show that Corizon is severely noncompliant with its contract, that money has been spent on services that have not been provided, the Jail is not monitoring the contract to ensure that Corizon complies with its responsibilities, employees are subjected to unsafe working conditions, and more. Below are a few of the audit’s most critical findings.
THE COST TO ALLEGHENY COUNTY IS HIGH
Although Corizon Health’s contract with Allegheny County Jail is $11.5 million, the County bears additional costs relating to health care services at the Jail. Per the contract with Corizon, the County is required to fund half of the cost of an electronic medical system, which will cost the County $434,850. Additionally, the Jail faces challenges with family medical leave and worker’s compensation occurrences, which costs taxpayers $2 million annually. Furthermore, Allegheny County is at greater risk monetarily from litigation as a result of inadequate care.
CLINICAL AND MENTAL HEALTH CARE IS NOT BEING PROVIDED
Documents studied during this audit indicate that many inmates had not received basic clinical services, including intake and physical exams, immunizations, ultrasounds, chronic care services and other services. No proof existed that Corizon provided prescribed medications. In some cases, there were prescriptions but no documentation to show medications were provided; in other cases, medications were ordered without practitioner’s orders. Failure to provide adequate health care to an inmate could affect their long-term health, could put employees in danger, and could be detrimental to public health and safety.
INADEQUATE STAFFING, DESPITE CONTRACT REQUIREMENTS
In addition, the Controller’s audit found consistently inadequate staffing levels. Of all days tested in the Controller’s audit, Corizon did not maintain required staffing levels by a significant margin. When staffing levels are low, employees become overworked and stressed. The Controller’s research revealed numerous occasions at the Jail where nurses were responsible for medicating nearly 700 inmates per shift or working unreasonable amounts of overtime.
“We need to make sure that the jail is a safe environment, not only for the inmates but for those responsible for guarding them and administering care,” Wagner said.
CORIZON IS NOT FULLY PROVIDING INMATES WITH RE-ENTRY SERVICES AS THEY TRANSITION OUT OF THE JAIL, AS REQUIRED
Per its agreement with the County, Corizon is required to create discharge plans that detail post-release care and provide medications during the transition of care to a community provider or other correctional institution. This important step is critical in offenders’ release back into the community. When transitioning inmates from the Jail, certain documents are required to be completed to document any medical conditions, the medications prescribed and instructions for follow-up medical care. There is no evidence that Corizon provided inmates with re-entry services upon release. Of the 60 records reviewed for the audit, 56 did not contain the required documentation. Inmates are not only being left untreated, or undertreated, while in jail, but they’re also not receiving the services they need – that Corizon is bound by contract to provide – to help transition inmates from the Jail.
APPEARANCE OF UNFAIR LABOR PRACTICES
The audit revealed contradictory communications from Corizon and the Jail regarding the revocation of the security clearance of Sr. Barbara Finch, the individual who was organizing employees within the Jail. While the Jail indicated that the disciplinary action was directed by Corizon, Corizon refuted that assertion, and emails reviewed by our auditors revealed that both the Jail and Corizon acted to revoke Sr. Finch’s security clearance. The Jail confirmed that no other employee had been disciplined in the same method previously. Therefore, all information reviewed indicates that Sr. Finch’s security revocation was in retaliation to her efforts to organize employees, and that both the Jail and Corizon participated in the efforts to discipline Sr. Finch for such activity.
The controller’s audit report can be found at the bottom of the page here.
In addition to the recommendations provided in the audit report, Controller Wagner recommends that a committee be created to ensure a deadline for improvements by Corizon and, if not met, should direct Jail health services elsewhere. The committee should include representatives from the Allegheny County Health Board, Allegheny County Jail, Judicial Courts and the Controller’s Office. Wagner also recommends continued oversight of Jail health care, a level of governance that was lost when the County shifted to Corizon from a non-profit provider.