Inmate medical care enters new era at Fresno County Jail

The Fresno BeeJune 21, 2014 

This is the drug dispensary at the jail. Corizon, the new contractor for jail medical services, takes over in Fresno County beginning June 23.

MARK CROSSE — THE FRESNO BEE Buy Photo

Fresno County Jail's medical services, under fire last year over inmates' health and the target of a federal lawsuit, enter a new era Monday when contractor Corizon Health begins providing services to inmates.

County supervisors in March approved a five-year contract worth up to $98.8 million with Corizon. The final two years of the contract are single-year extensions that could allow the county or Corizon to terminate the pact.

Each year has a 3.3% escalator to pay higher costs over the life of the contract. The cost for the first year is $18.8 million, which climbs to nearly $21 million in the fifth year. Corizon's first year will cost the same as under existing county staffing plans.

Fresno County Jail's medical services are the subject of a lawsuit that is in settlement negotiations between the county and the Berkeley-based Prison Law Office. The county was accused of improperly diagnosing and meeting medical and psychiatric needs of jail inmates, which was chronicled in August by The Fresno Bee in its "Locked In Terror" watchdog project.

"There have been some positive changes," Prison Law Office attorney Kelly Knapp said. "More needs to happen, but we are encouraged we will reach a settlement and we have no reason to believe Fresno is not committed to making more positive changes."

County officials chose to go out to bid for jail and juvenile medical services because there are companies that provide the service and have personnel with expertise to manage and improve the program.

Corizon was the less costly of two bids. The other bidder was Monterey-based California Forensic Medical Group, which provides jail medical services to Madera and Kings counties.

County officials said California Forensic's bid was preferred, but it came in $2.9 million higher and county health officials said they could not justify the expense.

A third study showed the costs would be $5 million more if the county continued to run the jail medical services program.

Tennessee-based Corizon is the nation's largest inmate medical services company, working in 608 correctional facilities in 29 states. In California, the company runs jail medical services in Alameda, Santa Barbara and Tulare counties.

Nearly all jail medical staff applied for positions with Corizon. The county had 114 full-time equivalent positions in the jail, 74 full-time and 40 part-time or extra-help workers.

Of those who previously worked in the jail medical services division, 106 were offered positions with Corizon, said David Pomaville, Fresno County director of public health. Of those, 96 accepted jobs with the contractor, two were still considering jobs and 28 were going to fill vacant positions within other departments in Fresno County, he said Friday.

"We were very pleased with the number who applied and the number of offers that went out," he said. "We were able to place almost everyone who was affected by the transfer."

Pomaville said there have been some retirements and that county staff is "working hard to place others in jobs with the county."

While salaries are similar, full-time employees who transfer to Corizon will no longer get county retirement but are enrolled in a 401(k) plan with a percentage of company cash match, Pomaville said. The health insurance also is comparable, he said.

About half the employees hired by Corizon served in extra-help or part-time capacities for the county, so their benefits will improve, Pomaville said.

When Tulare County switched its jail medical services to Corizon a year ago, most employees were hired by the company, officials said.

"In general, it's been working extremely well," said Cheryl Duerksen, Tulare County's health and human services director.

She said top county staff holds regular monthly meetings with Corizon corporate and local jail medical services staff to keep updated on medical issues in the jail.

Company officials said they look forward to operating in Fresno. They said their program will be similar to the one in Tulare County, but in a larger jail.

"We are going to hit the ground running," Dr. Harold Orr told the Fresno County Board of Supervisors in March. "We know how to do this piece of medicine. … This is a contract that fits what it is we do."

The results the company has had in other counties, he said, "are reproducible."

One way the company saves money is by using on-site services instead of sending patients to hospitals.

Corizon spokeswoman Susan Morgenstern said Friday that the company will increase its on-site health services.

A concern in the lawsuit was a failure to maintain prescriptions when an inmate arrived at the jail or returned from a state hospital.

Morgenstern said Corizon will keep state hospital treatment plans in mind "to ensure continuity of care when an inmate returns from (a) specialized treatment program."

Fresno County Assistant Sheriff Tom Gattie said medical care for inmates is a constitutional guarantee and that Sheriff Margaret Mims wants to run "a constitutional jail."

"Corizon is a professional organization. They know what they're doing and they're updated on all new laws and requirements, probably more than the county was," Gattie said. "The county was OK at doing a lot of things but didn't have resources and expertise to keep up on correctional health like Corizon does. Their expertise and prior experience is beneficial for everybody."

He said he expects Corizon to improve the jail's quality of care while reducing problems and grievances.

 

The reporter can be reached at (559) 441-6166, mbenjamin@fresnobee.com or @beebenjamin on Twitter.

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