Kansas Prison Health Contractor Piling Up Penalties For Poor Performance | KCUR

Kansas Prison Health Contractor Piling Up Penalties For Poor Performance

Feb 26, 2019

The company hired to provide health care in Kansas prisons is getting paid millions less than its contracted amount after failing to meet the agreement’s terms.

State officials reduced payments to Corizon Health because the company failed to hire enough nurses and other health workers. Corizon lost additional money after audits found it fell short of performance standards for a range of medical services.

Now, the Kansas Department of Corrections says the contractor has one more year to look after the health of 10,000 people in its prisons.

The department’s executive finance director, Keith Bradshaw, told lawmakers this month that for now, his agency intends to renew its contract with Corizon for only a year — rather than the two-year option included in the original contract.

“If things continue to improve, we’ll go ahead and pick up that second year,” Bradshaw said. “If we continue to have issues, then we’ll look at doing a rebid.”

The state currently has a $68.8 million contract with Corizon. Kansas penalized the company $534,880 for not meeting performance standards in 2018.

The state also cut $2.82 million from its payments to Corizon because the company didn’t deliver an agreed-upon number of employees and work hours last year. 

Documents provided by the Kansas Department of Corrections show thousands of hours of missing work each month, due to unfilled jobs for nurses, behavioral health professionals and other medical staff.

Corizon currently faces 22 federal lawsuits regarding the care it provides to people in Kansas prisons. Complaints include inmates being refused medication and care for conditions such as hepatitis C. The state first awarded a contract to the company in January 2014.

The University of Kansas Medical Center audits Corizon’s performance for the state corrections department. KU Med tracks medical services such as intake health assessments, sick calls and group therapy and passes the information to the department. The state can deduct money from its payments to Corizon if the company does not meet performance standards.

According to an agreement provided by the Department of Corrections, the state penalizes Corizon $100 per incident when the company falls below 90 percent compliance with any of its 12 performance standards.

That penalty increases if the company doesn’t fix the problem within six months. It goes up again if the company doesn’t meet compliance standards in subsequent months.

Specialty services — X-rays, dermatology, chemotherapy, and obstetric and gynecological services — are penalized at a higher rate.

If the company doesn’t meet 90 percent compliance for those services, the state imposes a penalty of $300 per instance, with higher penalties the longer the problems persist.

In 2018, KU Med audited nine out of 12 performance standards. Out of those nine standards, Corizon was found to be 100 percent compliant on only one: specialty services. The company’s compliance rates for the other standards were well below the threshold of 90 percent.

Mental health groups, defined as group therapy and workshops on topics such as anger and addiction, were found to be nearly 70 percent compliant. But other services that were audited, including sick calls, intake health assessments and chronic care for conditions like diabetes and HIV, were compliant at rates of less than 10 percent.

Credit Kansas Department of Corrections

At a presentation at the Kansas Capitol this month, state officials said the audits reviewed a small sample of the total number of medical services and do not accurately represent the overall quality of inmate health care. 

Bradshaw told lawmakers there were too few workers to conduct extensive evaluations for all 12 performance standards.

Much like its shortage of corrections officers, the state’s prisons also face a shortage of health care workers. It relies heavily on overtime and asking administrators to cover shifts.

Bradshaw said the state was having trouble hiring, despite offering signing bonuses of up to $7,000 for registered nurses and $10,000 for psychologists.

“Corizon is also facing the impact of low unemployment rates throughout the state,” he said, “as well as competition in the highly competitive health care industry.”

Documents provided by the Department of Corrections show that wages for nurses, psychologists and other health professionals working in Kansas prisons are similar to average and entry-level wages for those jobs throughout the state.

Registered nurses working for Corizon in Kansas make $25 an hour. On average, registered nurses in Kansas make an hourly wage of $28. Corizon pays dental assistants $15 an hour, while statewide average pay for the same job is $16.86 an hour. Behavioral health professionals working for Kansas prisons make $24 an hour, while average hourly wages for various mental health and counseling jobs in Kansas range between $16 and $24 an hour.

Registered nurses and behavioral health professionals comprise half of all health-related job openings, Bradshaw said.

Credit Kansas Department of Corrections

Inmates’ health needs can also be time-consuming for corrections officers, who must accompany inmates to expensive off-site medical appointments in pairs. Bradshaw said those appointments often add to officers’ overtime shifts and to vehicle costs.

“With the small staff that we have and the size of this contract and the services being provided,” Bradshaw said, “it’s not realistic to expect every facility and every outcome to be looked at every month.”

Bradshaw said the state didn’t penalize Corizon for noncompliance from June 2017 to December 2017 because the state was moving inmates between facilities and didn’t want to blame the company for any performance issues during that period.

In an interview, he said a better measure of health care quality was the number of medical grievances filed by inmates. 

“We’re actually seeing that trend going down, while at the same time the population’s going up,” he said. “I think we have to look at it more holistically.”

People incarcerated in Kansas prisons can file a written grievance with their prison’s warden if medical issues aren’t addressed within 10 days. If the issue is still not resolved, the next step is an appeal to the secretary of corrections, Roger Werholtz.

Credit Nomin Ujiyediin / Kansas News Service

David Tatarsky, director of health services at the Department of Corrections, said KU Med frequently fielded calls from inmates, their family members and prison staff.  He said those complaints and concerns informed where and when KU Med conducts audits of Corizon’s work.

Tatarsky told lawmakers that staff needed to be selective.  “We look for trends. We try to get the most bang for our buck,” he said.  “We try and focus where we think the need is greatest.”

In an emailed statement, Corizon spokeswoman Eve Hutcherson said the company was evaluating information from the state.

“We take all requirements very seriously in our mission to provide exceptional care to the patients we serve as the DOC’s partner,” she said. “Corizon remains committed as a strong partner with Kansas Department of Corrections and the patients we serve.”

Nomin Ujiyediin is a reporter for the Kansas News Service, a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio covering health, education and politics. You can reach her on Twitter @NominUJ.

Kansas News Service stories and photos may be republished at no cost with proper attribution and a link to ksnewsservice.org.