As health care in Onondaga County’s jails goes private, concerns about employees’ new working conditions and inmates’ care are rising.
“We looked into the records of the companies that provide correctional healthcare around the country and in New York State and those records raise some serious questions about the quality of care. We’re gambling with public health,” said Barrie Gewanter, director of the local chapter of the New York Civil Liberties Union.
But county officials maintain that that outsourcing of health care in the jails will improve care and lower cost. “Change is difficult. But we think this is going to be better for everybody, for the inmates, for the employees and. of course, for the county residents,” said Cynthia Morrow, the Onondaga County health commissioner.
The outsourcing comes after two deaths of inmates in the past year in the Onondaga County Justice Center. The deaths have prompted controversy around and investigations into the quality of care in the jails.
The outsourcing has also drawn criticism from workers’ unions and human rights organizations. Unions say that the new company may not hire back all the employees working at the jails. And civil rights groups argue that by cutting costs and the number of employees, the inmates’ care will be compromised.
“These are for-profit companies and they try to make profit by essentially squeezing out what they can out of the contract,” said Mark Genovese, spokesman at the New York State Nurses Association.
But county officials deny connections between the deaths and the decision to outsource the health care. They maintain the decision was sparked by human resources issues. The county also downplays the unions’ and civil rights’ groups concerns.
On Nov 15, Correctional Medical Care Inc., a private correctional health care provider, began to take over health care at the Onondaga County’s three correctional facilities. The company should completely take over by Dec 31, according to the health commissioner, Morrow. The company declined to comment for this story.
The jails include the Onondaga County Justice Center downtown, which houses inmates while they await their trial; the Jamesville correctional facility, which is for 510 prisoners convicted for non-violent offenses with sentences up to five years; and the Hillbrook Juvenile Detention Center in Syracuse, which can house up to 32 youths between the ages of 10 and 16 while their cases are judged in Family Court.
The company, Correctional Medical Care, was founded in 2002 and it is now managing health care services for seven local jails throughout New York State.
In Onondaga County, the county legislature has approved a three-year contract renewable up to five years. Under the contract, the county will pay the company $24.6 million for health care for over 2,000 prisoners. The health care services include mental care, dentistry, check-ups, medications and obstetrical-gynecological visits.
The outsourcing was triggered by the difficulties to fill two high-level administrative posts the jails, including medical director, said Morrow, the county’s health commissioner. “When there is a change at the management level, it is a good time to make a change,” Morrow said.
The county expects to save about $1.5 million in the first three years, Morrow said. That’s because, she said, a correctional health care company such as Correctional Medical Care has a stronger bargaining power compared to the county. The company would be able to negotiate better prices with pharmacies or labs.
The county also is relying on the company’s expertise in inmate medical care to improve the correctional care in Onondaga County, she said.“Inmate medical care and inmate mental health care is an extremely challenging field. It is in the best interest of everybody to have people that are experts at it do it,” Morrow said.
Two inmates, Raul Pinet Jr and Chuniece Patterson, died at the Justice Center in the last year. Pinet Jr from what officials described as “cocaine-induced excited delirium in August 2010. Patterson died in November 2009 from complications from an ectopic pregnancy. In an ectopic pregnancy, the fertilized egg implants outside the uterus, usually in the fallopian tubes.
Investigations by state and local governments raised concerns that both deaths could have been avoided with better health care. The victims’ families are suing the County.
Over the last few years, the Syracuse chapter of New York Liberties Union has been receiving complaints from the inmates at the Justice Center regarding medical care, said the group’s director, Gewanter. Because of the lawsuits and the complexity of health care the county should not have outsourced the services, she said.
Health care in jail is more intense than regular public health, she said, because of the population’s exposure to HIV/AIDS and tuberculosis. Many prisoner also have from hypertension, advanced cancers, diabetes and are pregnant.
Health care for inmates, said Gewanter, is part of public health and should remain under the umbrella of the county.“The public-health interest is ensuring continuity of care. Most of the people in jail come from the community and go back to the community. Their health is a public health issue,” Gewanter said.
On behalf of jail employees, the New York State Nurses Association and the Civil Service Employees Association are suing the county. The New York State Nurses Association represents registered nurses and the Civil Service Employees Association represents psychiatric social workers, licensed practical nurses and the clerical workers in Onondaga County.
The unions fear that many employees lose their jobs or will get lower wages. As many as 30 nursing positions would be abolished, predicted Mark Genovese of the nurses’ association. “So fewer nurses would have to deal with the same amount of patients,” Genovese said.
Mark Kotzin of the civil service workers’ union suggests the privatization will reduce the taxpayers’ control on the cost and the quality of the service provided. “County taxpayers have had a direct voice through their elected officials on how this care is provided,” said Kotzin. “With a private contractor, that’s moved one step away.”
(Marie Claudet is a graduate student in broadcast and digital journalism.)
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