Delaware Prison Medical Care

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Summary
Summary: 

In 2005, the Delaware Department of Correction signed a contract with the company Correctional Medical Services (CMS) to provide medical services to inmates in state prisons.  The promise of cost savings quickly evaporated, and the state was left with low quality healthcare for inmates.  Inmate health deteriorated under the new contractor and several deaths resulted from lack of adequate medical care.   The contractor's performance has forced the state to spend extra time and money associated with litigation arising from the substandard care.

 

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History
History: 

In 2005, the Delaware Department of Correction signed a contract with the company Correctional Medical Services (CMS) to provide medical services to inmates in state prisons.  The promise of cost savings quickly evaporated, as the state paid the company more than $130 million over three years for poor quality inmate healthcare.

In March 2006, the U.S. Department of Justice's civil rights division launched a formal investigation of Delaware's prison system following reports of problems in the prison health care system, including high inmate death rates, especially from AIDS.  After the federal investigation determined the substandard medical care violated inmates' civil rights, the state agreed to improve the care and allow a federal monitor to closely watch and evaluate the state's progress.  In the progress report released in January 2009, Delaware prisons earned a rating of "substantially compliant" in 38 areas, partially compliant in 163 areas and non-compliant in 15 areas.  Many state officials believe that the medical care will not improve until CMS is no longer the prison medical care vendor, but the company's contract with the state was extended once again in January 2009 until June 2010 for $39.8 million.

The state announced in October 2009 that it will split the work into multiple contracts  next time, to allow smaller companies to bid.  It also will introduce a "shared risk" model for the medical costs because, the DOC statement says, the current model of a contractor receiving a fixed price for all inmate care "provides the potential for contractors to limit inmate care in order to maximize profits."

 

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Key Issues
Key Issues: 

In an October 2009 letter to the Department of Justice, members of the Delaware General Assembly expressed continuing concerns about the quality of medical care in prisons, along with other civil rights violations.  The letter outlined several examples of medical negligence, including one instance where a man had both legs amputated due to "improper care and complications resulting from his untreated diabetes."  In another example, Daniel Kern, who was in prison for a drunk driving conviction, died of treatable pancreatitis.  The medical examiner determined that the death was "due to neglect."  Detailed reports about the amputation and pancreatitis cases are included in this case.  Reports of other cases of under- or untreated illness in prison inmates continue to surface.  In another indication that the contractor continues to skimp on medical care, prison personnel who work for the private contractor report that they were not given the required medical training to recognize mental or physical illness.  The training is required by law to help prison personnel identify illness in early stages. 

Unfortunately, substandard medical care has becomes common in Delaware prisons.  The performance of the state's medical vendor continues to harm many inmates and holds the state in violation of federal mandates.   

 

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Advocacy
Advocacy: 

The Ceasar Rodney Institute, a nonprofit, nonpartisan research and education organization, has issued a series of special reports to bring awareness of the abuses occurring within the state's prison system.  Delaware officials have looked to these reports to understand the state of medical care within its prisons and referenced their findings in letters to other policymakers.