Broward Sheriff picks Armor for lucrative jail contract; questions about cost, care linger

By Dan Christensen, BrowardBulldog.org 

Broward County Jail

UPDATE: Aug. 8 — Broward Sheriff Scott Israel has chosen Miami’s Armor Correctional Health Services for another lucrative term providing  medical, dental and other care to the county’s jail inmates despite complaints from the Public Defender’s Office, which represents many of the detainees, that the care is substandard.

Armor’s bid is also more than $13 million higher over five years than that of the low bidder.

“The sheriff has approved the recommendation…This means that BSO will begin negotiations with the top-ranked firm, Armor,” said BSO spokeswoman Keyla Concepcion.

If a contract can’t be reached, an unlikely prospect, negotiations would begin with the second-ranked firm, Corizon, formerly known as Prison Health Services.

If a contract with Armor can be finalized, it will likely cost Broward’s taxpayers about $143.6 million over five years — or $13.6 million more than what Corizon, the low bidder, offered, according to an analysis of bid proposals.

Armor has served as the sheriff’s jail healthcare provider since 2004.

An in-house selection committee recommended Armor to Israel last month. Neither the committee, nor the sheriff, has publicly explained why they preferred Armor’s more costly proposal.

Quality of care is as important as price in evaluating the jail healthcare proposals. Yet BSO’s selection committee also sought no independent local assessment of Armor’s performance from the agency that represents many of Broward’s inmates.

The opinion of the Broward Public Defender’s Office is that Armor’s care at the jail is substandard.

“Of all the jail healthcare providers I have worked with over the last 24 years, perhaps none challenge me in my role as a liaison quite like Armor,” said Shane Gunderson, the public defender’s director of client services, in a memo last month. “Armor practically spits in the face of nearly all common assumptions of what compassionate care in general should be.”

Gunderson serves as an intermediary between Armor’s staff and his office’s client-patients. He was asked to write the memo by Public Defender Howard Finkelstein.

“I thought it was strange that BSO never asked our opinion,” Finkelstein said.

Under Armor, Gunderson wrote, communication between the Public Defender and both Armor and BSO is constrained.

“Since October 2004 when Armor became the BSO jail heath care provider, I have had to follow a highly formal process of letter and email exchanges with no face-to-face contact and very little phone communication with Armor to solve inmate health complaints,” Gunderson wrote. Often, he said, the responses he receives are incomplete or unclear.

Gunderson reported having no contact with the BSO lieutenant in charge of monitoring contract compliance by Armor, but said he does regularly forward him copies of all medical complaints the PD’s office sends to Armor.

Gunderson said inmates contact him “because there has been a breakdown or flaw in the jail sick-call process.” He criticized Armor for insisting that inmates fill out a sick call request form when they should instead call him directly for help.

“Many of our clients are mentally ill and can’t understand written procedures. At jail intake, a client may not remember his or her doctor’s name and medical treatment information,” the memo says.

The six-page memo includes a number of examples of complaints about “poor treatment” by Armor. Several involve inmates who reported problems with their medications.

Problems have happened when Armor sought to substitute a medication that an inmate later refused to take because it made him sicker, the memo says.

“I have seen examples where Armor does not remedy this situation…does not offer an alternative or provide treatment in place of the drug that caused bad side effects,” Gunderson said.

Gunderson cited other kinds of allegedly poor care by Armor, including the improper treatment of inmates who need detox services or who suffer from HIV/AIDS.

“Armor is slow, late and in some cases unwilling to provide dental services, hernia operations and optometry. There are frequent delays involving these types of sick call requests, exams and follow up care,” the memo says.

Gunderson’s boss, Howard Finkelstein, says the underlying problem with the quality of care is the privatization of jail healthcare services, a practice that began in Broward in the early 1980s.

“It’s all about saving dollars,” said Finkelstein. “The only way these healthcare providers make a profit is by not providing services, because almost all of their costs are fixed with the exception of the medical care they provide.”