Looming in the background in the legislative debate over prison reform is a question that could come into new focus: How productive was the move to privatize prisons and inmate health care and how much farther should it go?
Florida legislative leaders last week tentatively agreed to the creation of a joint legislative oversight board with the power to investigate and monitor the performance of Florida’s troubled Department of Corrections. It’s goal is to secure the safety of inmates in the face of mounting reports of suspicious inmate deaths, excessive use of force and allegations of cover-ups at the agency that houses more than 101,000 prisoners, said sponsors of the measure, Sen. Greg Evers, R-Baker, and Rep. Carlos Trujillo, R-Miami.
But the legislative panel could also open the door to an evaluation of the recent shift in priorities that has led the state to open seven private prisons, contract out services for 21 inmate work camps, and shift mental healthcare and substance abuse treatment and inmate health care to private vendors.
“We are responsible for supervising every single person who is incarcerated in the State of Florida,’’ said Trujillo, sponsor of the House bill. “Our intention isn’t to privatize more facilities,” said Trujillo. “It is to look at inmate safety and some of the organizational problems that have led to the lack of inmate safety.”
The call to action was prompted by a series of reports in the Miami Herald and other news organizations that showed suspicious inmate deaths were covered up or never reviewed, inmate grievances and complaints of harmful medical care were dismissed or ignored, and internal controls were inconsistent.
Audits conducted by the state’s Correctional Medical Authority also found problems with inadequate medical care, nursing and staffing shortages, and hundreds of pending lawsuits claiming inadequate medical care.
Last year, 346 inmates died in Florida prisons — 176 of them listed with no immediate cause of death. It was the highest number on record, even though the number of inmates in Florida prisons has declined.
“There are a lot of issues with the quality of care and the lack of quality of care and we need to address that,’’ Trujillo said. “Once we make headway on inmate safety we can focus on other issues.”
Under the gun are two private companies that took over healthcare for the state’s 101,000 inmates in 2013. Wexford Health Services is being paid $48 million a year until Dec. 20, 2017 to provide health services to about 15,000 inmates at nine prisons in South Florida and Corizon Health, which provides healthcare to 74,000 inmates in North and Central Florida, receives $229 million per year until June 30, 2018. Both companies are required to provide medical care to inmates for 7 percent less than it cost the state in 2010 but both have already sought and received increases in the terms of their original agreement.
After visiting prisons in the Panhandle and hearing reports of inadequate medical care and nursing shortages, Evers ordered Department of Corrections Secretary Julie Jones to renegotiate the contracts with the private prison providers to demand higher standards of care and hold them accountable for deaths and injuries.
In a report entitled the “First Year Scope of Work,” published by the department on March 31, Jones indicated that she is in the process of renegotiating the health insurance contracts but won’t have new contracts in place until January 2016.
“We need to have policies in place that hold our vendors accountable,’’ she wrote.
Evers now believes that if there is a reduction in the number of “unnatural” deaths at state-run prisons, while the numbers don’t change at privately run facilities, “this could actually reduce the number of privates” or at least require changes in existing private contracts.
The move to privatize medical care in Florida prisons was not done in open committee hearings but quietly inserted into budget language during the governor's first term. The effort was challenged in court but ultimately was upheld and the contracts were allowed. Jones has subsequently criticized the contracts as too lenient for the vendors.
Rep. Katie Edwards, D-Plantation, said she blames Florida’s weak contracts with the healthcare companies on the access their high-profile lobbyists have had to the governor and key lawmakers. Bill Rubin, the lobbyist at the time for Wexford, worked for Scott when he was head of the hospital giant HCA, and Brian Ballard, lobbyist for Corizon, was head of Scott’s political finance committee.
“If we get hauled back into federal court because of inmate violations based on healthcare, I place the blame squarely on Corizon and Wexford,’’ said Edwards who counted 1,092 malpractice lawsuits that have been settled across the country against Wexford and another 600 for Corizon. “We are giving these individuals — lobbyists — access and they have never once come and testified to defend themselves.’’
Attempts to reach Rubin and Ballard to discuss the issue were unsuccessful.
In 2011 and 2012, Scott and legislative leaders also tried twice to privatize 27 prisons and work camps in 18 South Florida counties. They were stymied by a lawsuit and a vote against the plan in the state Senate, but several legislators remain committed to more prison privatization.
In 2013, the state closed or consolidated 19 prisons and work camps while it completed new work camps and opened privately run Blackwater River Correctional Facility in Santa Rosa County and Graceville Correctional in Jackson County. The state has also authorized 21 work-release centers operated by private providers to serve minimum-security inmates who are being trained to be released back into the community.
A provision of the proposed prison reform by Evers and Trujillo could open the door to more private prison contracts by allowing the state to transfer as many as one third of the inmates in the state prison system to county jails.
Under the current system, anyone sentenced for more than a year and a month serves in the Florida Department of Corrections. Under the bill, judges could sentence people to the county jail for up to 24 months under a pilot program. The counties could then contract with private providers to offer those services.
Pinellas County Sheriff Bob Gaultieri said the Florida Sheriff’s Association supports the idea as an attempt to give counties with available jail beds more options while allowing prisoners to stay closer to home. But he hopes it does not become an opportunity to expand prison privatization.
“The trend in Florida is actually to go in the opposite direction,’’ he said, noting that Hernando County used to contract with private prison vendor Corrections Corporation of America, but backed out.
“The experience with county jails does not work,’’ he said. “There are certain things that are a government function and the care and custody of inmates is something the government should do, the sheriff should do. It’s not a profit-motivated activity and when you inject profit into that, you have problems.”
He said the Hernando jail “wasn’t kept up” and the company “cut corners.”
Evers said he hopes that with more monitoring, and better oversight from the legislative panel, private vendors will face the same scrutiny as the state-run prisons and legislators can make better-informed decisions.
“If the numbers don’t match up, there may be less demand to shift to the privates,’’ he said.
Mary Ellen Klas can be reached at meklas@MiamiHerald.com and @MaryEllenKlas