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Unhealthy Proposal Lawsuit alleges doctors fired for refusing prison work
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Unhealthy ProposalLawsuit alleges doctors fired for refusing prison work.by Dan FroschTwo New Mexico doctors have filed a lawsuit against Lovelace Health Systems, charging that the company fired them because they wouldn’t go along with a plan to provide substandard care to state inmates. Dr. Bradly Jay Keller and Dr. Jolynn Muraida say Lovelace Health System axed them because they refused to provide “telepsychiatry” services to inmates. The telepsychiatry was part of a proposed contract between Lovelace and Wexford Health Sources. Wexford, a private Pennsylvania company, has handled health care for New Mexico state inmates since 2004. According to the lawsuit, the contract with Wexford would have required the doctors to treat inmates by “seeing them remotely for about five minutes each via a television screen, assessing and evaluating them, and prescribing medication for them.” Lovelace’s outpatient behavioral health department, of which Keller was medical director, collectively agreed that the contract called for providing “substandard treatment to patients,” the lawsuit says. According to the lawsuit, the State of New Mexico would have been billed for the telepsychiatry services. The lawsuit also alleges that the contract was initially proposed because one of Wexford’s directors is “a friend” of David Vandewater, president and CEO of Ardent Health Services. Ardent is Lovelace’s parent company and based in Nashville, Tenn. Once the doctors were confronted with the proposed contract last fall, Muraida, herself a former medical director of Lovelace’s outpatient behavioral health department, called Ardent’s ethics line to complain. Shortly after Muraida and others voiced opposition, the entire department — consisting of approximately 70 employees — was targeted for closure. Vandewater informed Muraida that the department was being closed because of its refusal to participate, the lawsuit says. Carol Dominguez Shay, attorney for the plaintiffs, sent SFR an Aug. 21 email on the matter: “We think that the factual allegations in the Complaint about the proposed Wexford contract state the essentials about what the doctors were asked to do — i.e., provide substandard psychiatric care to New Mexicans,” Dominguez Shay writes. “As the Wexford contract was proposed to them, the doctors were asked to see inmates with psychiatric problems for about five minutes each. From even a layperson’s perspective, this is inadequate on its face and would be merely a façade of treatment.” Dominguez Shay says her clients do not wish to comment on the lawsuit. Susan Wilson, director of public relations for Lovelace, says the company is aware of the lawsuit but cannot comment because of the pending litigation. Wilson confirms that Lovelace decided to “discontinue” its outpatient behavioral department at the end of 2005. She says the decision was made because of changes in how the state provides care to Medicaid recipients, financial difficulties and “some conflicts within the department.” Calls to Ardent Health Services were not returned. Via email, Wexford Vice President Elaine Gedman said Wexford had no comment “as we are not a party to the suit and we do not know the detail of the case.” Wexford is not a defendant in the case. But the company has come under fire from former employees for its health care practices. On Aug. 9, SFR reported that six ex-employees allege that Wexford shirks basic health care for inmates in order to save money [Cover story, Aug. 9: “Hard Cell?”]. According to the story, the former Wexford workers also claim that the New Mexico Corrections Department does not sufficiently monitor its multi-million dollar contract with the company. Both Wexford and NMCD deny the charges. One of the primary allegations levied by the six ex-Wexford employees is that Wexford does not adequately staff the nine New Mexico correctional facilities where it operates. Both a US Justice Department investigation of Wexford’s operations in Wyoming during the late 1990s and a 2004 Florida legislative assessment of the company’s contract in that state cited staffing as a paramount concern. Psychiatry services has been a particular problem for Wexford in New Mexico. Last fall, a $35,000 agreement was reached between NMCD and Wexford related to the state’s concerns that the company didn’t provide enough work hours for full time employees, especially psychiatrists. According to NMCD spokeswoman Tia Bland, the State Corrections Department has no knowledge of the lawsuit against Lovelace nor of any relationship between Lovelace and Wexford. “Overall, Wexford is currently doing a satisfactory job meeting staffing and other contract requirements for inmate psychiatric services,” Bland wrote to SFR in an Aug. 21 email. “The Corrections Department has a contract monitoring team to ensure accountability.” The lawsuit originally was filed in the Second Judicial District Court in Bernalillo County on June 21. Attorney Dominguez Shay says she expects to hear back from the defendants some time in September. “The fact that the Lovelace Behavioral Health Department as a whole rejected the proposal is a testament to the professionalism and decency of the providers,” Dominguez Shay writes in her email to SFR. “Because the Department refused to participate in this sham, it was shut down and all of the providers were terminated.” #
Legislator also questions prison contract.by Dan FroschA Santa Fe dentist and his assistant say they quit their jobs at the Penitentiary of New Mexico in 2004 because of concerns that state inmates were not receiving adequate dental care.
complaints” from former Wexford employees. But Bicoll and Daily’s issues with Wexford relate to the company’s staffing shortages in New Mexico, one of the company’s most pervasive problems, according to ex-employees. While both NMCD and Wexford have consistently played down such shortages, according to Wexford’s own website, there are currently 47 vacancies for medical personnel in New Mexico. That number comprises close to half of the 117 total positions Wexford, the nation’s third largest private correctional health care company, is currently advertising for. Such vacancies not only include a range of nursing positions but also critical, high ranking administrative posts. According to the website, Wexford is looking to hire a director of nursing and medical director at the New Mexico Women’s Correctional Facility in Grants. The medical director position is also open at Southern New Mexico Correctional Facility in Las Cruces and Lea County Correctional Facility in Hobbs. The Penitentiary of New Mexico needs a director of nursing. Only Illinois has more Wexford job vacancies than New Mexico — 61, according to the website. But in that state, Wexford’s operation is far larger; the company handles health care in 27 correctional facilities in Illinois, according to the Illinois Department of Corrections. Despite the appearance of systemic staffing shortfalls, Corrections’ Bland maintains that the situation is satisfactory. “As far as vacancies go, the Corrections Department does not oversee Wexford employee recruitment strategy,” Bland says. “Today the staffing numbers are OK.” But State Sen. Cisco McSorley, D-Bernalillo, co-chairman of the State Legislature’s Courts, Corrections and Justice Committee, says his committee has been concerned with Wexford’s performance for “quite a while.” McSorley says the contract with Wexford is not satisfactory and that NMCD is not doing enough to ensure that the company does its job. He says it’s up to the governor to scale back privatization in the prison system, before things get worse. “As long as Wexford is assured that NMCD is going to keep signing its contract, then there is no pressure on Wexford to deliver what it promises,” McSorley says. “It’s a convenient excuse to say they can’t find staff. But it’s interesting that when the health care in the prisons wasn’t privatized, we could always staff positions even in the remotest parts of New Mexico.” Ken Kopczynski, executive director of the Private Corrections Institute watchdog group in Florida, says charges of compromised prison health care in New Mexico warrant federal involvement. “It would be good to get the Department of Justice involved if there are allegations of lack of care on behalf of the inmates,” he says. “The New Mexico Corrections Department and the Legislature can’t hide their heads in the sand and say they didn’t know about these problems if there’s ever a lawsuit. The inmates are ultimately the responsibility of the state, and you can’t contract that away.” #
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