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St. Louis County considers private medical services for its jails

St. Louis County jail
File photo
The St. Louis County Jail is located in the Buzz Westfall Justice Center in Clayton, Mo.

St. Louis County officials will soon decide whether to turn medical services at two county jails over to a private contractor. The decision is pending even as members of the medical community — including current justice center employees — have raised concerns over the dangers of privatizing healthcare in jail.

The county began taking bids over the summer for a three-year contract that would provide staffing, preventive health services and medical care to inmates at the Buzz Westfall Justice Center and the Family Court Juvenile Detention Center in St. Louis County. If the county decides to award a contract, the decision would be subject to approval by the County Council. 

“It’s an exercise that has been successful in many different municipal entities around the country,” said Faisal Khan, director of the St. Louis County Department of Public Health. “It’s about having the highest quality service while trying to save money in terms of taxpayer dollars.” 

On average, about 1,142 people are incarcerated at the Buzz Westfall Justice Center each day, serving short sentences or awaiting bond or trial. St. Louis County appropriates about $6.6 million a year towards “Corrections Medicine,” with about $3.8 million going towards salaries and wages of county employees, according to budget documents. Physicians and pharmacists from Saint Louis University and the St. Louis College of Pharmacy are hired on small-scale contracts to provide care at the facilities.

According to Khan, three companies submitted proposals during the county’s bidding process. An 11-member team from the Department of Public Health, Department of Justice Services and the county executive’s office is reviewing the bids and will make a recommendation to County Executive Steve Stenger and the County Council in early to mid-October.

Khan said any for-profit provider will be under contractual obligation to make sure it is providing quality care in the jail. The company will also be required to maintain accreditation standards.

Sister Carleen Reck, executive director of Criminal Justice Ministry, holds a "Welcome Back" bag of toiletries and supplies for people returning from prison.
Credit Durrie Bouscaren | St. Louis Public Radio
Sister Carleen Reck, executive director of Criminal Justice Ministry, holds a "Welcome Back" bag of toiletries and supplies for people returning from prison.

But Sister Carleen Reck, who assists former offenders at the Criminal Justice Ministry in St. Louis, said that complaints about care delayed and denied in Missouri’s prison system — where the healthcare provider is privatized — are frequent.

“The focus is no longer on the healing arts, the focus is on the bottom line. How can [the contracted companies] do the minimum [they] need to do for the minimum cost?” Reck said.

St. Louis County’s current program, Reck said, is the one example of what can be done with community resources. Inmates may receive their first diagnosis of a chronic or mental illness during a checkup in jail, or they may receive medication for the first time.

“If we have an opportunity for actual treatment and good healthcare, why would we trade it in for something that’s been proven to offer the minimum, or even less than minimum care?” Reck said.  

One likely bidder for the St. Louis County contract is Corizon Health, the country’s largest correctional health provider that is contracted to provide medical services for Missouri’s state prisons and the city of St. Louis. The company, which has corporate offices in Creve Coeur, has come under increased scrutiny in recent years. Most recently, Allegheny County, Pennsylvania terminated a contract with Corizon after the deaths of 11 inmates in two years. So far in 2015, more than 450 federal lawsuits have named Corizon or one of its physicians.

Dr. Fred Rottnek, an associate professor at Saint Louis University, serves as the medical director at the Buzz Westfall Justice Center. In an open letter, Rottnek wrote that the county’s attempt to outsource its correctional health services is a major step backwards during a national conversation about race, disparities, segregation and institutionalized violence.

“Certainly efficiency can be improved, staffing can be streamlined, and leadership can be strengthened. But the program is nationally recognized as excellent,” Rottnek wrote.

A recent addition to the county’s Request for Proposals required bidders to provide detailed staffing patterns for their contract proposals, and to give priority consideration to employment applications from current St. Louis County employees. 

Follow Durrie Bouscaren on Twitter: @durrieB