By Dan Christensen, BrowardBulldog.org
Broward Sheriff Scott Israel is expected soon to award a contact worth as much as $145 million over the next five years for the delivery of healthcare services to the county’s approximately 5,000 jail inmates.
The road to a deal has been full of turns, with intrigue and suspicion around every curve.
Seven companies submitted sealed proposals last month in what amounted to a second round of bidding after BSO canceled its initial solicitation last March. The cancellation, after proposals were received, opened and bidders shortlisted, allowed vendors to see each other’s prices and plans.
Three companies are on BSO’s current shortlist: incumbent Armor Correctional Health Services, Corizon Health (formerly known as Prison Health Services) and Wexford Health Sources.
One that’s not: Nashville-based Correct Care Solutions, a previous finalist with a five-year price that was $8.5 million lower than Miami-based Armor’s offer. Correct Care did not get a single vote from the three-person BSO selection committee that evaluates proposals and makes a recommendation to the sheriff.
Bid records obtained by BrowardBulldog.org using Florida’s public records law also show that Armor has lowered its one-year price for comprehensive medical, dental and mental health care by $400,000 since learning it was previously underbid. Still, its current proposal of $26.7 million is $1.9 million higher than its nearest remaining competitor, Corizon, which also cut its bid price. It is also $1.5 million, or nearly six percent higher, than the $25.6 million it currently charges BSO.
Wexford was the highest bidder at $26.8 million.
Each company also offered slightly lower price options if BSO agreed to assume more risk for providing certain offsite services that are now covered.
CONTRACT UP TO FIVE YEARS
The bidding is for a three-year contract with two one-year renewal options. Last time, BSO’s bid specifications called for bidders to supply annual pricing for five years. This go-round, only one-year prices were sought.
The lack of specificity about prices beyond the contract’s first year makes it difficult to compare costs over the term of the deal, and offers BSO – and Broward’s taxpayers – no assurances as to future contract costs.
“Even though price proposals were provided, the entire contract, including contract amount, is subject to negotiation,” said sheriff’s spokeswoman Keyla Concepcion. “Subsequent years after the initial year will be negotiated based on the contract amount for the initial year.”
The sheriff’s pricing formula for the contract’s later years, if there is one, was not disclosed.
In the initial round of bidding, the vendors calculated price by tacking on between 3.5 and 4.0 percent for each additional year. Armor, for example, offered BSO a five-year price of $145.6 million.
Five-year prices were not provided this time. But using the same factors, Armor’s projected five-year price would be $2 million less than it bid six months earlier.
Here’s a comparison of the projected five-year proposals for the current finalists compared with their original five-year price offers:
Current November 2012
Armor: $143.6 million $145.6 million
Corizon: $130.0 million $133.6 million
Wexford: $144.6 million did not bid
While BSO would save millions by accepting Corizon’s bid, there are numerous considerations in choosing a vendor, including staffing and care management.
One key tool to evaluate the competency and reliability of vendors is to require them to disclose their recent litigation history.
LACK OF TRANSPARENCY
In various ways, transparency is an issue is BSO’s current inmate care solicitation.
Most significantly, BSO does not post proposals online or solicit public input. By law, proposals are secret for 30 days after they are opened, or until BSO announces an intended decision. After that, they are available, but not online.
Transparency is also a problem regarding the vendors’ litigation histories, an indicator of past performance and competency.
Armor supplied BSO with a 14-page list of 150 malpractice lawsuits that it said were filed against it in Florida and elsewhere since 2009, including 22 cases in Broward.
Armor did not provide BSO with requested case numbers, and identifies plaintiffs only by their initials – making it difficult to track cases. But in its proposal, Armor noted that while nearly half of those lawsuits were dismissed it has never had a judgment against it and “we have settled only nine lawsuits companywide since 2004.”
A record of 150 lawsuits in three years, most filed by aggrieved inmates without a lawyer, is not a confidence builder. But it is at least a record that’s available for the public to see and scrutinize.
BSO has declined to release the litigation histories submitted by Corizon and Wexford, indicating without elaboration that they are exempt from disclosure under Florida’s public records laws. Corizon asserted in its proposal that its court litigation history is “confidential and proprietary.”
BrowardBulldog.org has asked BSO to reconsider its decision and release the records.
Questions about the inmate healthcare procurement are not confined to the proposals themselves.
One of the three members of BSO’s selection committee who voted to recommend Armor is Dr. Nabil El Sanadi.
El Sanadi is BSO’s chief medical director. He is also chief of emergency medicine for Broward Health.
CONFLICT OF INTEREST
El Sanadi had an apparent conflict of interest when he cast a vote for Armor. The reason: Broward Health, his employer, wants Armor to win the contract.
Armor’s proposal, which includes Broward Health’s endorsement, says that it currently contracts with Broward Health to provide 24-hour hospital services to county inmates.
Should Armor prevail it “will continue to use…the North Broward Hospital District (Broward Health), encompassing Broward Health Medical Center, Broward Health North and Broward Health Coral Springs,” says Armor’s proposal.
Another disturbing, yet unconfirmed report from insiders says that another top BSO official had a private meeting with one vendor’s representatives during the “cone of silence” period when such contact is illegal.
Then there is the presence of William Rubin, a paid lobbyist for both Armor and BSO.
The sheriff’s lawyer, Ron Gunzburger, has said Rubin has been told that neither he nor his Fort Lauderdale firm, The Rubin Group, can lobby BSO on behalf of Armor. Rubin, however, is a friend and supporter of Israel and Rubin’s contract with BSO does not prohibit such lobbying.
Sources have said Rubin is working with ex-Sheriff Ken Jenne, who first hired Armor in 2004 after receiving substantial campaign contributions from Armor and its owner Dr. Jose Armas, to help Armor prevail. Jenne later served time in federal prison on unrelated corruption charges.
Armor is currently supporting Jenne’s son, Evan Jenne, in his run for a state house seat from South Broward. On June 17, the company contributed $500 to Jenne’s campaign.
The Rubin Group contributed $500 to Evan Jenne’s campaign in March.