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Prison Audit Ahead Review of inmate health services could take up to six months
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Prison Audit AheadReview of inmate health services could take up to six months.by Dan FroschThe New Mexico State Legislature is one step closer to an audit of Wexford Health Sources, the private company that administers health care in New Mexico’s prisons. On Oct. 24, the Legislative Finance Committee (LFC) tentatively approved the audit, which will evaluate Wexford’s contract with the New Mexico Corrections Department (NMCD) and also assess the quality of health care administered to inmates. The request for a review of Wexford originated with the state Legislature’s Courts, Corrections and Justice Committee, which voted unanimously on Oct. 20 to recommend the audit after a hearing on prison health care in Hobbs [Outtakes, Oct. 25: “Medical Test”]. A subsequent Oct. 30 letter sent to the LFC by committee co-chairmen Rep. Joseph Cervantes, D-Doña Ana, and Sen. Cisco McSorley, D-Bernalillo, refers to “serious complaints raised by present and former employees” of Wexford. The letter cites this newspaper’s reportage of the situation and notes that on a recent tour of Lea County Correctional Facility in Hobbs, “committee members heard numerous concerns from inmates about medical problems not being addressed.” It also refers to confidential statements Wexford employees provided to the committee that were then turned over to the LFC. The decision to examine Wexford and NMCD comes on the coattails of months of reports that state inmates are suffering behind bars due to inadequate medical services, documented in an ongoing, investigative series by SFR. Over the past three months, former and current employees have alleged staffing shortages as well as problems with the dispensation of prescription drugs and the amount of time sick inmates are forced to wait before receiving urgent care [Cover story, Aug. 9: “Hard Cell?”]. The timing, Manu Patel, the LFC’s deputy director for audits, says, is ideal, because the LFC already planned to initiate a comprehensive audit of NMCD, the first in recent history. Regarding the medical component of the audit, Patel says: “We will be looking at how cost-effective Wexford has been. Also, we will be looking at the quality of care, how long inmates have to wait to receive care and what [Wexford’s] services are like.” Patel says the LFC plans to contract with medical professionals to help evaluate inmates’ care. As per a request from the Courts, Corrections and Justice Committee, current Wexford employees will be given a chance to participate in the audit anonymously. The audit’s specifics require final approval from the LFC in December; the committee will likely take up to six months to generate a report, according to Patel. In a Nov. 6 email to SFR, Wexford Vice President Elaine Gedman cites 14 successful, independent audits performed of Wexford in New Mexico since May 2005. “Wexford is proud of the service we have provided to the Corrections Department as documented in these independent audits and looks forward to continuing high quality health care services in New Mexico,” Gedman writes. NMCD spokeswoman Tia Bland echoes Gedman: “We welcome the audit and plan on cooperating any way we can,” she says. Meanwhile, former employees continue to come forward. Kathryn Hamilton, an ex-NMCD mental health counselor, says she worked alongside Wexford staff at the Pen for two months, shortly after the company took the reins in New Mexico in July 2004. Hamilton alleges that mentally ill inmates were cut off psychotropic medicine for cheaper, less effective drugs and that inmates waited too long to have prescriptions renewed and suffered severe behavioral withdrawals as a result. Hamilton, who had worked at the Pen since April 2002, says she encountered the same sorts of problems under Addus, Wexford’s predecessor, but quit shortly after Wexford’s takeover because the situation wasn’t improving. “They would stop meds, give inmates the wrong meds or refuse to purchase meds that were not on their formulary, even if they were prescribed by a doctor,” Hamilton says. “I felt angry, sometimes helpless, although I always tried to speak with administrators to help the inmates.” Hamilton married a state inmate by proxy last month, after continuing a correspondence with him following her tenure at the Pen. Hamilton says she did not serve as a counselor to the inmate, Anthony Hamilton, but met him after helping conduct a series of mental health evaluations. Hamilton has been a licensed master social worker under her maiden name since 2000 (according to the New Mexico Board of Social Work Examiners). She emphasizes that her relationship with her husband did not begin until after she left the Corrections Department. According to Hamilton, her husband, still incarcerated at the Pen for aggravated assault, recently contracted methicillin-resistant staphylococcus aureus (MRSA), a serious staph infection. In a previous story, four current Wexford employees specifically mentioned MRSA as a concern to SFR because they allege Wexford does not supply proper protective equipment for staff treating infectious diseases like MRSA [Outtakes, Oct. 18: “Corrections Concerns”]. Wexford Vice President Gedman did not address Hamilton’s claims when queried by SFR. Corrections spokeswoman Bland also says she can’t comment on Hamilton’s allegations because she had not spoken with Hamilton’s supervisor at the time of her employment. Says Hamilton: “I initially called the newspaper as the concerned wife of an inmate, not as a former therapist. With all the stories the Reporter has done, I wanted to come forward with what I had seen at the Pen.” #
Another employee leaves prison alleging poor care for inmates.by Dan FroschThe medical director of a state prison in Hobbs has stepped down from his post less than a month after a legislative committee requested an audit of the corrections health care in the state. Dr. Don Apodaca, medical director of Lea County Correctional Facility (LCCF), turned in his resignation on Nov. 6 due to concerns that inmates there are not receiving sufficient access to health care. According to Apodaca, sick inmates are routinely denied off-site visits to medical specialists and sometimes have to wait months to receive critical prescription drugs. Apodaca blames the policies of Wexford Health Sources, the private company that contracts with the state to provide medicine in New Mexico’s prisons, for these alleged problems. Wexford has been the subject of a four-month SFR investigation, during which a growing number of former and current employees have contended that Wexford is more concerned with saving money than providing adequate health care, and that inmates suffer as a result. On Oct. 24, the Legislative Finance Committee (LFC) tentatively approved an audit that will assess Wexford’s contract with the New Mexico Corrections Department (NMCD) and also evaluate the quality of health care rendered to inmates [Outtakes, Nov. 8: “Prison Audit Ahead”]. LCCF’s medical director since January 2006, Apodaca is one of the highest-ranking ex-Wexford employees to come forward thus far. His allegations of Wexford’s denials of off-site care and the delays in obtaining prescription drugs echo those raised by other former and current employees during the course of reporting for this series [Cover story, Aug. 9: “Hard Cell?”]. Specifically, Apodaca says he personally evaluated inmates who needed off-site, specialty care, but that Wexford consistently denied his referrals. Apodaca cites the cases of an inmate who needed an MRI, another inmate who suffered from a hernia and a third inmate who had a cartilage tear in his knee as instances in which inmates were denied off-site care for significant periods of time against his recommendations. When inmates are actually cleared for off-site care in Albuquerque, they are transported in full shackles without access to a bathroom for the six- to seven-hour trip, Apodaca says. “Inmates told me they aren’t allowed to go to the bathroom and ended up soiling themselves,” he says. “The trip is so bad they end up refusing to go even when we get the off-site visits approved.” When it comes to prescription drugs, there also are significant delays, Apodaca says. Inmates sometimes wait weeks or even months for medicine used for heart and blood pressure conditions, even though Apodaca says he would write orders for those medicines repeatedly. “Wexford was not providing timely treatment and diagnoses of inmates,” he says. “There were tragic cases where patients slipped through the cracks, were not seen for inordinately long times and suffered serious or fatal consequences.” Apodaca says he began documenting the medical problems at the facility in March. After detailing in writing the cases of 40 to 50 patients whom he felt had not received proper clinical care, Apodaca says he alerted Dr. Phillip Breen, Wexford’s regional medical director, and Cliff Phillips, Wexford’s regional health services administrator, through memos, emails and phone calls. In addition, Apodaca says he alerted Wexford’s corporate office in Pittsburgh. Neither Breen nor Phillips returned phone messages left by SFR. Apodaca says he also informed Devendra Singh, NMCD’s quality assurance manager for health services. According to Apodaca, Singh assured him that he would require Wexford to look into the matter, but Apodaca says he never heard a final response. “Wexford was simply not receptive to any of the information I was sending them, and I became exasperated,” he says. “It came to the point where I felt uncomfortable with the medical and legal position I was in. There were individuals who needed health care who weren’t getting it.” Singh referred all questions to NMCD spokeswoman Tia Bland; Bland responded to SFR in a Nov. 20 email: “If Don Apodaca has information involving specific incidents, we will be happy to look into the situation. Otherwise, we will wait for the LFC’s audit results, review them and take it from there.” Wexford Vice President Elaine Gedman would not comment specifically on Apodaca’s allegations. In a Nov. 20 email to SFR, she wrote that Wexford will cooperate with the Legislature’s audit and is confident the outcome will be similar to the 14 independent audits performed since May 2005 by national correctional organizations. “Wexford is proud of the service we have provided to the Corrections Department as documented in these independent audits and looks forward to continuing to provide high quality health care services in New Mexico,” Gedman writes. Members of the Legislature’s Courts, Corrections and Justice Committee, which requested the forthcoming audit, toured LCCF on Oct. 19 and were told by both Wexford and NMCD officials that there were no health care problems at the facility. On the same tour, however, committee members heard firsthand accounts from inmates who complained they couldn’t get treatment when they became sick [Outtakes, Oct. 25: “Medical Test”]. That visit, along with Apodaca’s accounts, calls into question Wexford’s and NMCD’s accounts, State Sen. Cisco McSorley, D-Bernalillo, says. “We were told on our tour that nothing was wrong. And now to hear that there is a claim that Wexford and the Corrections Department might have known about this makes it seem like this information was knowingly covered up,” McSorley, co-chairman of the committee, says. “We can’t trust what’s being told to us. The situation may require independent oversight far beyond what we have. This should be the biggest story in the state right now.” #
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