Really, Florida, you can’t do both.
You can’t allow state prison guards to go about willy-nilly gassing and Tasering and scalding prisoners. Or allow them to ignore sick and injured inmates. Not while, at the same time, contracting with a chintzy and notoriously negligent prison healthcare provider.
You’ve just got to choose. Otherwise the combination of torture and cut-rate medical treatment creates an unseemly mess for the Florida Department of Corrections, what with the dead and injured and sick prisoners and the lawsuits and embarrassing newspaper exposés.
Come on, Florida. It’s public relations 101. If the FDOC insists on maintaining that proud 19th century tradition of sadistic mistreatment of inmates, state prisons need crack medical teams to keep the damn victims alive. Otherwise, inmates’ relatives and civil rights lawyers and newspaper reporters are gonna cause an unholy fuss.
Florida, of course, has a long history of torturing and killing inmates. At the turn of the last century, the awful, frequently deadly mistreatment of prisoners forced into peonage labor on behalf of North Florida’s turpentine industry was a national scandal. Life expectancy was only slightly better on the chain gangs used through much of the 20th century. And over the last two years, anthropologists from the University of South Florida have been excavating unmarked graves at the notorious Dozier School for Boys in North Florida, giving validation to former inmate allegations that during its 111 years of operation, Dozier guards abused and even murdered boys confined in the now-closed juvenile lock-up.
Apparently, FDOC guards regard those as the good old days. Prompted by a Miami Herald investigation, some 80 inmates’ deaths are now under investigation.
Over the last few months, the Miami Herald’s Julie Brown has written about the brutal deaths of prisoners in the state system, including that of Darren Rainey, a 50-year-old inmate who died after guards locked him in a scalding shower at Dade Correctional Institution in 2012 and Randall Jordan-Aparo, 27, who died after he was doused in aerosol chemicals at Franklin Correctional Institution in 2010.
Rainey, mentally ill and in a deteriorating psychological state, had been acting just as might be expected as a mentally ill person decompensates — crazy and in obvious need of medical intervention. What he got, instead, was a possibly fatal dose of sadism.
Jordan-Aparo, serving time for check forgery, had been feverish for days, suffering from the effects of a genetic blood disorder, pleading incessantly for medical help. After he cursed an unsympathetic nurse, guards blasted him with so much tear gas that his skin and clothes were stained orange. They didn’t notice until hours later that he had died.
And then there was sad case of Michelle Tierney, a 48-year-old inmate who died last month after she was transported from the Lowell Correctional Institution to Ocala Regional Medical Center without regard to her dangerously deteriorating health. A prison nurse told Julie Brown that she blamed Corizon Health, the nation’s largest private prison healthcare provider with a $1.2 billion, five-year contract to run the health services in 44 Florida prisons.
“You have to be on a deathbed before you can be sent to the emergency room because Corizon Health doesn't want to pay for it,” the nurse told Brown. She said prison medical services are mostly staffed with LPNs (Licensed Practical Nurses) “making life-and-death decisions.”
The giant Corizon Health contract came out of Gov. Rick Scott’s insistence that he could save the state gobs of money by privatizing prison medical services. But it was as if the state officials who negotiated the billion-dollar-plus medical privatization deal had not thought to Google “Corizon.” The company, and its predecessors (Corizon was born out of 2011 merger of Prison Health Services and Correctional Medical Services) has been dogged by a daunting string of lawsuits and investigations.
The Palm Beach Post reported last week that the company and its predecessors had generated a massive amount of criticism and legal problems by making critical cuts in prison medical services in states like Maine, Vermont, Arizona, Minnesota, Kentucky and New York.
In 2012, a court-appointed monitor’s report on medical care provided to an Idaho prison by Corizon was so scathing that state lawyers argued it shouldn’t be allowed to be seen by the public. The monitor had listed harrowing instances in which prison patients with serious medical problems suffered from inadequate and delayed treatment or were outright denied medical attention. The monitor said treatment regimes were postponed, sometimes for months, even when the medical staff were aware of a “potential danger to the safety of patients.”
The monitor said financial considerations seemed to trump medical needs.
A federal judge presiding over a class action suit filed by Michigan prisoners against Correctional Medical Services, one of Corizon’s predecessors, wrote that a prisoner “does not deserve a de facto and unauthorized death penalty at the hands of a callous and dysfunctional health care system.”
The Southern Poverty Law Center, suing Corizon on behalf of prisoners in Alabama, cited five inmates who had been persuaded by company employees to sign “Do Not Resuscitate” forms they did not understand, a tactic designed to spare the company from paying for expensive end-of-life care. One of the inmates who signed a form was blind. The SPLC, in an allegation that would be repeated in Florida, noted that Corizon had “failed every major audit of its health care operations in Alabama prison.”
And then there were a number of lawsuits in Florida, alleging the company had employed dangerously deficient — sometime cruel — deviations from standard medical treatment. (The Post cited two instances in which prisoners dying of cancer were given nothing more than acetaminophen or ibuprofen.) In 2012, a federal appeals court affirmed a $1.2 million jury verdict that found that a nurse for Corizon – back when it was operating as Prison Health Services – had followed company policy when she refused to send a Lee County inmate to hospital despite a harrowing episode that left him partially paralyzed, his intestines exposed and his fellow inmates screaming for help.
The common theme running through the allegations of deficient treatment against St. Louis-based Corizon has been a brutal reluctance to undertake the expense of referring sick or injured prisoners to hospital emergency rooms. Since Florida’s prison medical services were privatized, emergency room visits have fallen drastically. The Post reported that so far this year, ER referrals were down 47 percent compared to 2012.
When the Herald’s Julie Brown requested Corizon's performance review from the Department of Corrections in September, FDOC stalled for nearly a month, before releasing records that showed, much like in Alabama, the company had indeed failed to meet most of its contract standards.
DOC Secretary Mike Crews – as if he was shocked, shocked to discover that there was gambling in Casablanca – has now threatened to withhold payments if Corizon didn't do better. “All too often, we are finding that these corrective action plans are not being carried out and that the level of care continues to fall below the contractually required standard,” Crews stated in a warning letter to the Missouri contractor. “As of this date, many of the most critical expectations including complete and full staffing, responding to DOC concerns and reducing the number of grievances are often not being met.”
Perhaps Crews has finally grasped that FDOC can’t afford to provide lousy medical treatment. Not in a prison system given to torture. If mistreated prisoners die ... well ... it’s just really, really bad PR.