AG Investigation Finds Pennsylvania-Based Correctional Medical Care, Inc. Provided Poor Medical Care; Settlement Agreement Requires Independent Monitor To Oversee Services

Schneiderman: We Will Continue To Take Action Against Businesses That Abuse The Public Trust

Last week, Attorney General Eric T. Schneiderman announced an agreement between New York State and Correctional Medical Care, Inc. (CMC), a Pennsylvania-based, for-profit prison health care contractor that provides medical services in jails in 13 upstate counties. The agreement comes on the heels of an investigation by the Attorney General’s office that found CMC, which holds over $32 million in contracts with the New York counties, violated key provisions of its contracts with two of the counties, Monroe and Tioga. CMC understaffed facilities and shifted work hours from physicians and dentists to less qualified and lower-wage staff, including, in one case, a nurse with a felony conviction. The settlement agreement requires that an independent monitor oversee that CMC meets its obligations to provide medical care in jails in all the counties where CMC is contracted to with for a period of three years, and requires the company to pay restitution and penalties.

“Tax dollars meant to cover medical care of our county prisoners must not be wasted-- and substandard care and mismanagement are not an option,” Attorney General Schneiderman said. “Shortchanging medical services provided to jail populations can lead to direct harm to individuals and misses a public health opportunity to provide care to individuals who often have undiagnosed, untreated medical needs. We will bring to justice contractors who line their pockets while failing to uphold their obligations to the people of New York.”

New York State Assembly Health Committee Chairman Richard N. Gottfriedsaid, “This is a clear example of the dangers of business corporations providing health care. Attorney General Schneiderman has won an important victory that matters not only to jail inmates but to all New Yorkers.”

Commissioner Phyllis Harrison-Ross, M.D., chair of the Commission's Medical Review Board,said, "The Commission of Correction and its Medical Review Board have consistently raised serious concerns about the medical care provided by Correctional Medical Care and has documented those concerns in reports issued a result of its investigations into deaths at CMC-served facilities. Incarceration should not prevent an individual from receiving competent care and all medical care providers in New York must conform to the state’s laws, rules and regulations governing medical care delivery. The Commission will continue to monitor CMC, other private health care providers and locally-provided jail health services to ensure a standard of quality care."

New York State Education Commissioner John B. King, Jr.said, "Every tax dollar must be spent the right way to provide the best services. When unqualified personnel make important medical decisions, public safety is compromised and tax dollars are wasted. Attorney General Schneiderman's investigation will make sure qualified medical personnel are on the job, providing the appropriate medical services and protecting the public health and safety."

The Attorney General’s investigation of CMC began as a result of a referral from the New York State Commission of Correction and the New York State Education Department. The Commission of Correction found significant lapses in medical care provided to six prisoners who died in custody between 2009 and 2012 at five county jails contracted with CMC. The board also found that medical records lacked evidence of physician or psychiatrist oversight and did not include required information. In addition, CMC staff dispensed medications without medical orders.

An ensuing investigation by the Office of the Attorney General found that CMC was understaffing facilities and shifting work hours from physicians and dentists to less qualified and lower-wage staff. CMC also hired several unlicensed and inexperienced staff members, including one nurse with a felony conviction. Despite CMC’s contract violations, it continued to charge New York counties more for its services. Its contract with Tioga County nearly doubled, to approximately $331,000 in 2013, from about $193,000 in 2008.

Quality correctional health services are critical to inmate safety and health, and to safeguard the health of communities that inmates return to. Medical services provided at jails and prison also offer a chance to track -- and forestall -- the spread of infectious disease and to stop chronic health problems faced by inmates from becoming debilitating conditions.

Soffiyah Elijah, executive director of the Correctional Association of New York,said, “Given the extensive health needs of people incarcerated in New York county jails, it is crucial for them to receive quality medical and mental health services. This would be in the best interests of overall public health. We commend the Attorney General, the State Commission of Correction and the Education Department for working together to identify, make public and hold CMC accountable for the improper care being provided to its patients.”

Attorney General Schneiderman’s investigation also found that CMC violated New York’s prohibition of the corporate practice of medicine, which bars corporations from practicing medicine or employing physicians to provide medical services. The law aims to ensure that a licensed medical provider is ultimately responsible for health care and that profits never override sound medical opinion. CMC’s owner is not a licensed medical provider – nor is the owner’s husband, who is an officer of the company.

The agreement provides for the restructuring of CMC contracts, oversight of CMC by the independent monitor, restitution to Tioga County, and civil penalties. Monroe County has already received restitution for staffing shortages in January 2011 through June 2013, totaling $340,017. Tioga is receiving restitution for CMC’s failure to meet its contractual obligation to hire a licensed social worker from 2009 to 2012. Provisions include:

• CMC will pay for an independent monitor for a period of three years to ensure compliance with its contracts.
• CMC will submit all 13 county contracts to an initial audit and then annual audits by the independent monitor.
• CMC will pay $100,000 in restitution to Tioga County and $100,000 in civil penalties to New York State.
• CMC will provide only administrative services to bring operations into compliance with New York law prohibiting the corporate practice of medicine, and will create a separate professional medical corporation to provide medical care.

The agreement does not prohibit Tioga, Monroe or any other county from seeking additional restitution from CMC.

The case was investigated by Assistant Attorney General Dorothea Caldwell-Brown of the Attorney General’s Health Care Bureau, which is led by Bureau Chief Lisa Landau. Executive Deputy Attorney General for Social Justice is Alvin Bragg.