Monday, May 27, 2024

Maryland to pay $1.7 billion for new prison health care provider

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Maryland will part ways with its troubled provider of medical care in state prisons, following a decision Wednesday by the Board of Public Works to forgo contracting with the company again.

Over objections from the state’s current provider, YesCare — and that company’s predecessor, Wexford Health Sources — the board awarded a $1.7 billion contract to Lutherville-based Centurion of Maryland to provide medical and mental health care services to those incarcerated in state prisons.

Centurion Group, based in Vienna, Virginia, already provides mental health services to those incarcerated in state prisons and state-run jails.

Joseph Sedtal, deputy secretary of administration for the state’s Department of Public Safety and Correctional Services, called the new contract “nothing less than a reimagining of how medical and mental health care can and should be provided to the incarcerated population in our charge.”

Under the new contract, Centurion will expand telemedicine care and on-site specialty care at prisons and improve continuity of care to better help incarcerated people reenter their communities upon their release, Sedtal said. According to meeting materials from the Department of General Services, Centurion also will provide workers with higher hourly wages in hopes of attracting more qualified professionals, solving vacancy problems and providing better care to incarcerated patients.

Additionally, under the new contract, Centurion will provide both medical and mental health services — a departure from how treatment is delivered now in state prisons and jails, where YesCare provides medical services and Centurion Group provides mental health care. Under this model, Sedtal said, there have been difficulties coordinating continuity of care between the two companies.

Moving forward, there will instead be two separate contracts issued for care provided at state-run prisons and care at state-run jails.

Centurion also is positioned to win a $724 million contract for providing medical and mental health care services at the state-run pretrial detention centers, according to meeting materials, but board members deferred discussion of that contract to their meeting in June.

The health care provided at the state-run Baltimore City Booking and Intake Center has been controversial, sparking a long-running federal case known as Duvall v. Moore with court-imposed mandates and deadlines for improving care.

David Fathi, one of the ACLU lawyers on that case, expressed optimism about having one company responsible for both medical and mental health services. However, he said, the root problem with the prison system’s delivery of health care will remain.

“The problem with privatization isn’t really this company or that company,” he said. “The problem is an incentive structure that sets up powerful incentives to delay or deny care in an attempt to maximize profits. That problem is going to exist regardless of who has the contract.”

Wednesday’s meeting follows a heated Board of Public Works meeting in March, where Gov. Wes Moore and Treasurer Dereck Davis begrudgingly voted to extend YesCare’s contract with the state to give the Department of Public Safety and Correctional Services more time to complete its procurement process.

Comptroller Brooke Lierman, however, cast a protest vote against the extension, citing dozens of medical malpractice lawsuits in Maryland — and thousands more across the country — filed against Corizon Health. She also took issue with Corizon’s use of a controversial corporate restructuring strategy. According to reporting by The Marshall Project, Corizon moved most of its debts to a new company, which then declared bankruptcy, and created the company YesCare to continue doing business.

“I do not believe that YesCare is a contractor that aligns with our values,” Lierman said, according to an unofficial transcript of the meeting, “and I do not believe it’s a contractor that deserves a unanimous vote from the Board of Public Works.”

YesCare filed a protest with the Department of Public Safety and Correctional Services in April about the department’s decision to go with Centurion, and the department denied it. YesCare then appealed the department’s denial to the Maryland State Board of Contract Appeals. However, Sedtal said, the department wants to move forward with awarding the contract to Centurion, despite YesCare’s appeal.

“We recognize that the board often frowns upon this method,” Sedtal said. “We would not be doing this if we did not have the utmost faith in the procurement process that led to these recommendations and the substantial state interest in immediately moving forward with more innovative, more comprehensive and frankly better health care for the approximately 18,400 individuals in our care.”

John Dougherty, a lawyer representing YesCare, told the board on Wednesday that the company was the low bidder on both contracts by $350 million. He asked members to let “due process run its course” by allowing the appeal to proceed before they made a decision.

The Board of Public Works is not a court of law, Davis told Dougherty. He also questioned the company’s low price tag, considering the challenges it has had in making timely payments to local hospitals treating incarcerated patients.

“The feeling I’m getting from it, it’s probably a lowball bid to win the contract,” Davis said. “What confidence would the board have that — even at an alleged substantial savings — that the quality of care could be met by YesCare, when they point blank have proven that there is some financial distress that is going on or the appearance of financial distress?”

Dougherty denied the bid being a lowball, telling board members that YesCare had the money to do the work. He added that someone could dig up the sorts of details aired about YesCare about any other company.

“Centurion has its own long history,” he said. “I encourage you to type their name into Google, and you’ll see what the history is.”

In June 2022, an Arizona judge ruled that the medical and mental health care system in that state’s prisons violated the constitutional rights of those incarcerated, according to court filings. At the time of the ruling, Centurion of Arizona was the health care contractor for the state prison system, although health services at the prisons had not yet been privatized when a group of incarcerated people filed the lawsuit in 2012.

At Wednesday’s meeting, Dr. Uchenna Achebe, a representative of Centurion, said the company is guided by principles of integrity and professionalism and meets challenges with a sense of urgency and an “out-of-the-box and a results-oriented mindset.”

“Should the board approve our selection,” Achebe said, “we look forward to continuing close partnership with both the department and administration to ensure that no justice-involved Marylander is left behind in terms of their clinical care.”

Bruce Bereano, a lobbyist for Wexford Health Sources — the second-place bidder for the state prison contract — had his own complaints about the procurement process. He raised alarm that the corrections department completed the process solely based on paperwork, rather than inviting the finalists to make final presentations about their bids.

“That’s not the way procurement should be done, particularly one of a seven-year duration of over a billion dollars,” he said.

Sedtal said the contract will last for five years — from June of this year to June of 2029 — with a two-year renewal option. He added that Wexford had “every opportunity” to air its complaints about the procurement process, but that window, mandated by state law, has passed.

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