IT’S NO SECRET Multnomah County is strapped for cash. County Chair Ted Wheeler was even moved to quote former President of Czechoslovakia Václav Havel in the introduction to the county’s 2010 budget.
“Hope is a state of mind, not of the world,” wrote Wheeler, cutting $46 million out of the $1.2 billion budget because of the recession. Of those cuts, the sheriff’s office took a $1.8 million hit, losing 26 positions and negotiating a wage freeze for some employees. Available jail beds have also plunged from 1,690 in 2007 to just 1,367 today, and there’s little sign of improvement on the horizon. Unless….
A revived proposal by the district attorney’s office suggests outsourcing health care in the county’s jails to a private contractor. The idea could save between $4 million and $5 million a year, says Deputy District Attorney Chuck French, who convened the 2009 corrections grand jury, which made the recommendation last December in its report.
“One of the problems in our mental health system is that there has been no support for community mental health,” says French. “And that’s really where you get the best bang for your buck.”
As such, the jury suggested shifting the savings to support community mental health services like Project Respond—which aims to treat mental health problems before people act out in ways that could be construed as criminal, and end up in the county’s jails [“The Criminalization of Mental Illness,” Feature, Jan 14].
French first made the recommendation as part of a corrections review in 2006, which highlighted a contract between nearby Washington County and a company called Prison Health Services, Inc. (PHS), based out of Tennessee.
“A huge benefit of the contract signed by PHS and Washington County is that by the terms of the contract, PHS accepts all legal liability for judgments against the county involving legal actions for inadequate jail medical care,” reads French’s report.
“Recent events have demonstrated just how significant a contract clause like that might be,” the report continues. “As Multnomah County is now facing the prospect of defending against a probable multi-million dollar lawsuit involving the death of an arrestee brought to the jail.”
Since then, the county has settled its portion of the lawsuit mentioned for $925,000, relating to the 2006 death in custody of James Chasse Jr.—a man with schizophrenia.
Mental health advocates agree that Chasse should have had better care in the community before he was arrested, but they are also concerned about farming out jail health services to corporations just to save money on potential lawsuits.
“This is the canary in the mine,” says Roy Silberstein, president of the Mental Health Association of Portland, saying PHS has faced more than 1,000 lawsuits at facilities across the country.
“The expense of these settlements is merely the acceptable cost to PHS of doing business,” Silberstein continues. “But our association believes the efficiencies and savings PHS provides are at the expense of systemic and unconscionable paucity of quality health care.”
For example, PHS paid $1.5 million in December to the widow of a Virginia man with mental illness who died of pneumonia and dehydration in one of its jails. In November 2008, an Idaho jury awarded $3.6 million to a woman who gave birth on a prison ramp in a PHS jail. Her baby was run over by a wheelchair, and now has cerebral palsy. Meanwhile the New York Times branded PHS care “flawed and sometimes lethal” at the conclusion of a 12-month investigation back in 2005.
Interim Multnomah County Sheriff Dan Staton is looking into the grand jury’s suggestions, and will make recommendations to Chair Wheeler on March 2. Staton says people have suggested to him that he might be in favor of contracting out, but that such a characterization is “totally inaccurate.”
“I have no intention of making any move on this until a full and thorough study has been done,” says Staton, emphasizing that the quality of health care inmates receive “is obviously going to be foremost.”
Wheeler says the county considered this idea before, back in 2006, but that the potential savings did not justify the risks.
“The question is: What are you giving up?” says Wheeler. “There are some cost savings that can’t be justified as a matter of conscience.”
“I would be opposed to anything that would give the jail inferior services,” French responds.
PHS spokesman Pat Nolan says the company is aware that Multnomah County is “considering the option of outsourcing its corrective health care,” but adds, “I really don’t want to get into some big long debate before there’s actually an RFP [request for proposals] process”—if the contract is opened up for bids.
“If there is an RFP process, I suspect that oversight will be a part of that,” Nolan continues. “We feel good about our record.”
Some of us are still waiting for Ted Wheeler to help the public hold Multnomah Verity Community Mental Health Services accountable for the past 8 year long mess of OHP contracts. The only reason that government administration is interested in inmate mental health is because mental illness is a marketable commodity, thanks to contracting.
I do volunteer work teaching job skills to “victimless criminals” who have served jail time for drug offenses and are now in recovery. The average time of my clients’ incarceration varied from 6 months to two years under these conditions.
I’ve heard and read a lot of stories, reports, and official descriptions about health care in Washington and Multnomah County jails. Plans, statistics and fudged deliverables are one thing, but it’s nothing like being there yourself. My conclusion on the ground is- there is NO HEALTH CARE in jails except for stab wounds and other life threatening health crises.
For dentistry, you either live with a bad tooth or get it pulled. There are no fillings, dentures, caps or crowns, cleanings, or even dental floss. For all your incidentals beyond a bar of Ivory and one roll of no-ply toilet paper, you have to pay for shampoo, toothpaste, dental floss, aspirin, advil, antifungals, and ALL your prescriptions.
These incidentals and prescriptions are not at Costco prices, its more like the Beverly Hilton gift shop, marked up at least double. Most inmates go without as most don’t have friends and a mother on the outside where the avg outlay by a family member is around $800 a month to keep their daughter barely comfortable.
How can you expect jails to offer “preventative health” when the county jail diet consists of lukewarm soybean and a gravy substance that was put in a blender and served colorless, fruitless (unless you count RED KOOL-AID as a fruit), and vegetableless 3x a day (4am, 10am, 4pm with lights out at 7pm PERIOD). Of course, its served in plastic and eaten with plastic.
If you can afford it, you can supplement your pig slop meals with stuff from the snack bar- all worse than a 1975 trip to the 7-11 chip and candy rack- at triple the price of Safeway today. A popular favorite I hear is Pringles at $5 for a tin the size of cat food.
Exercise, if the guards want to let you out (about 50% of the time), is 20 minutes a day if you still have time to get your mail, take a shower, and sort out other duties like AA meetings.
Mental health?
You can live with one inmate, but if they snore, your stuck. Most settle for solitude- 22 1/2 hours a day locked in a windowless room the size of the three bathroom stalls (without the doors). The only source of diversion is dog eared paperback books found at truckstops or goodwill.
As a way to manage immates, the temperature is between 62 and 64 degrees as “research shows” inmates are less violent at low temperatures. You don’t get a pillow or sheets- just a thin mat and a scratchy wool blanket. You get to wash your gray PJ’s once a week in common with all the other inmates- everything comes back grayer, greasier, and stinkier. Most inmates choose to wash their own clothes in their toilets with shampoo (if they can afford it).
Most of my clients said you get used to being hungry but the cold is unbearable. And, don’t think you can cuddle to keep warm- with camera and guard eyes on you 24/7 you cannot so much as give a handshake to an inmate or it will delay your release- a full on hug is punishable by no exercise time for a week.
If you do not have a doctor on the outside who prescribed you antidepressants or antianxiety pills BEFORE you entered the system, you WILL NOT get diagnosed or treatment inside. Bernie Madoff must be in a chemical never never land, but if you don’t have money and have a splitting headache too bad. Not even an aspirin for you.
Of course any sane person faced with months on end of living a life not fit for cattle, would try to off herself. But there is nothing to cut, slice, dice, or strangle yourself with. Fair enough.
But don’t even so much as tell anyone that, “I feel like dying” or “I wish I was dead” because then you get to wear “The Bell”. Its not suicide counseling, medication, or arts and crafts, its an obnoxiously large foam outfit that makes tella tubbies like anorexic. It never gets washed or sanitized so if the previous user puked on it, tough cookie.
It is kind of a new generation straight jacket designed to “conserve the clients dignity and prevent muscle strain and dislocation of shoulders,” according to its sales brochure (retail cost: $1275).
You can’t reach to scratch anything, and a guard has to wipe your ass for you- which of course she only takes one smear at it- all this and you are just begging to poke your eyes out (and hers) but can’t.
Needless to say, everyone chuckles and you are trapped in humiliation to suffer for days until you swear, |I promise I won’t hurt myself. I was just kidding anyway.” After that, no one and I mean no one dares to even talk with you.
So if Multnomah County can’t afford to charge inmates $5 for a small package of two Grandma’s Oatmeal Cookies, why should we let some corporation with a horrible track record come here so they can charge $6?
Who at the city is being hoodwinked now? Cops and jailors don’t take kickbacks, so they must be getting hypnotized by slick power point presentations. Did they wear pinstripe suits and drive off in Hummers?
Didn’t some idiot and his wife scrape off hundreds and thousands of dollars off of their contractual deliverables to the Oregon State Penn outsourced food service program several months ago? Just by pinching on catsup and fudging on dairy they ripped off the State and importantly, sacrificed the already meager diets of inmates.
Whatever county workers have to put up with, our food and healthcare employees are unionized and have full benefits. Not only will these contractors rip off inmates and cut corners, they will bust the local union and put people out of work.
This country must legalize all victimless crimes and wake up to the fact that rehabilitation is CHEAPER, MORE HUMANE, and EASIER than locking up and throwing away the key for a mother smoking pot in front of her kids. Seriously, I know a woman that lost her three kids for this very offense. Her estranged husband narked on her and thought he would get the kids. No luck though, he is a meth head and still on the run.
For all its faults- PLEASE DO NOT TURN OVER THE CARE TO OUR MOST FRAGILE POPULATION TO MARRIOT, INC or any other corporation that needs to be more concerned about profits than deliverables.
If the in-house county system is broken, fix it. Change laws to not incarcerate drug crimes. If the county wants to make money, let the county manage addicts by selling their drugs of choice to them. Why is a methadone ( a powerful opiate in its own right) clinic legal for herion addicts, but not a pot or meth clinic for those addicts?
Everyone deserves to be chemically balanced- we can make herbs, medicines, illegal drugs (just chemicals, that’s all) work for people and have it not work against us. I am sober and I love it, but I would never deny anyone the right to explore what they need chemically to feel like I do. We are all not blessed with the brain chemistry of 19th century Quaker housewives!
Whatever outside contractors promise- it ends of being like the much touted – the cheapest and most efficient commercial aircraft ever! The Boeing DreamLiner! That was two years ago at their roll out. Today, the DreamLiner is the most expensive and delayed project by Boeing ever.
Three years ago, Boeing looked like it was going to be in black for decades once more. Today, all promises and slick marketing aside, Boeing is on the verge of bankruptcy.
Boeing is a state of the art innovative company that has the brightest people in the entire world working for it. Maybe I would let them run the local county jail, but these guys? No way.
If men will say anything to get laid, they will certainly say anything to sell pig slop to jailbirds.