BALTIMORE — According to a recent audit released by Maryland’s Department of Public Safety and Correctional Services, there have been significant failures in the management and oversight of contracts with private companies providing medical and mental health services to inmates in state-operated detention facilities.
The audit highlighted multiple issues, including numerous missed suicide risk assessments and a lack of mental health examinations, issues that emerged from the state auditors’ review of three contracts over the past five years starting in 2018.
One of the key concerns identified in the report was understaffing, which may have exacerbated these challenges. Furthermore, the audit raised doubts about whether the contracts were designed to favor the companies involved, without sufficiently ensuring that they were delivering quality services to the inmates.
The outsourcing of healthcare in prisons is a growing trend across the United States, yet this practice has faced backlash along with lawsuits alleging negligence, malpractice, and inadequate care.
In the case of Maryland, the system has led to a “consistent failure” in maintaining the minimum staffing levels necessary and completing essential health assessments for incarcerated individuals, as detailed in the audit.
An example cited mentioned a patient who lodged a complaint in June 2023 regarding the medical contractor’s negligence in conducting sexually transmitted disease tests despite the inmate showing symptoms. The resolution of this complaint was not reached until January 2024.
In reaction to some of the audit’s findings, officials from the Department of Public Safety and Correctional Services offered some pushback but largely agreed to implement its recommendations. They indicated that several issues have already been addressed under new contract agreements.
Earlier in the year, state officials made a decision to change the health care providers for inmates, moving away from YesCare, which had encountered substantial criticism, and instead aligning with Centurion of Maryland.
Department leaders mentioned that they have established new written protocols to guarantee that contractors are meeting deadlines for medical and mental health assessments.
An earlier audit noted that the department had more than 20% of positions unfilled in recent years, along with a vacancy rate of 13% as of June 2023. This department is responsible for the health care of thousands of inmates across 18 facilities, including state prisons and Baltimore’s jail, which holds individuals awaiting trial.
Despite a decrease of about 18% in the state’s average incarcerated population, the agency’s healthcare expenses surged from $120 million in 2018 to $168.7 million in 2023, as reported by the Maryland Office of Legislative Audits.
Auditors pointed out that the corrections department could not substantiate a fixed fee arrangement that ensured companies received payment “regardless of staffing levels or actual costs incurred for supplies, equipment, and hospital visits.”
Additionally, the contracts did not establish competitive hourly wages for the medical and mental health personnel, a factor which likely hindered recruitment and retention efforts. For instance, a registered nurse working under a medical contractor would have earned $25,500 less than the state average in 2023.
In their formal responses, correction officials stated that the new contracts would introduce minimum wage stipulations and a payment framework incorporating fixed price incentives. They also committed to ensuring that all patient grievances regarding inadequate medical care would be thoroughly investigated.
