The cash-rich pharmaceutical lobby and the rising cost of drugs for Medicare seniors

By Stuart Silverstein, FairWarning 

President George W. Bush signing the Medicare Prescription Drug Improvement and Modernization Act of 2003.

President George W. Bush signing the Medicare Prescription Drug Improvement and Modernization Act of 2003.

When the Republican-controlled Congress approved a landmark program in 2003 to help seniors buy prescription drugs, it slapped on an unusual restriction: The federal government was barred from negotiating cheaper prices for those medicines. Instead, the job of holding down costs was outsourced to the insurance companies delivering the subsidized new coverage, known as Medicare Part D.

The ban on government price bargaining, justified by supporters on free market grounds, has been derided by critics as a giant gift to the drug industry. Democratic lawmakers began introducing bills to free the government to use its vast purchasing power to negotiate better deals even before former President George W. Bush signed the Part D law, known as the Medicare Modernization Act. (more…)

Fort Lauderdale federal grand jury subpoenas Broward Health’s purchasing records

By Dan Christensen and Buddy Nevins, FloridaBulldog.org gjpic

A Fort Lauderdale federal grand jury has slapped a subpoena on Broward Health, demanding records related to an ongoing FBI investigation focused on its purchasing practices, two knowledgeable sources have told FloridaBulldog.org.

The subpoena, served earlier this month, is said to seek information about former hospital district procurement officer Brian Bravo and 16 companies that do business with Broward Health. They include MedAssets, a Georgia-based group purchasing organization for the Broward system and other hospitals (NASDAQ: MDAS) with a market capitalization of $1.87 billion.

The subpoena seeks those records going back 10 years. The name of veteran Assistant U.S. Attorney Neil Karadbil is on the subpoena.

“I’m told the (administrative) staff is on shutdown, spending hours finding all these documents,” one source said.

Broward Health’s attorneys declined to release a copy of the federal grand jury subpoena, saying it is exempt from disclosure under Florida’s public records law.

Fort Lauderdale Assistant U.S. Attorney Neil Karadbil

Fort Lauderdale Assistant U.S. Attorney Neil Karadbil

Commissioner Joel Gustafson, asked if he was aware of the grand jury’s subpoena, said, “I don’t know if I’m allowed to answer that question. We’ve been admonished not to talk about any alleged investigation. If I find that I can, I’ll call you back.”

At the same time, FloridaBulldog.org has learned that top Broward Health staff – chief executive Kevin Fusco, general counsel Lynn Barrett and security director and ethics officer Carlos Perez-Irizarry – have phoned board members to privately update them on the status of the criminal investigation. The move avoided a public discussion of those details.

Commissioners were told that district administrators, criticized in Miami-based investigator Wayne Black’s email for having blocked the FBI’s investigation, are cooperating and turning over requested records, although no time frame for compliance was given. They were also told that general counsel Barrett has waived a claim of privilege to certain documents, facilitating their production.

One of the items turned over: Bravo’s laptop.

The decision by Fusco and the others to brief commissioners individually, thus possibly outside the Sunshine Law, is problematic.

Sunshine law

Florida’s Government-in-the-Sunshine Manual, compiled by the attorney general’s office, cites a 1979 appeals court ruling that held a series of private meetings between a school board superintendent and individual members of the school board were subject to the Sunshine Law.

“While normally meetings between the school superintendent and an individual school board member would not be subject (to the Sunshine Law), these meetings were held in ‘rapid-fire succession’ in order to avoid a public airing of a controversial redistricting problem,” the manual says.

Joe Jacquot, a lawyer with the Foley Lardner law firm that represents Broward Health, said private updates for commissioners don’t violate the Sunshine Law. “As you say, staff appears to be updating individual board members in the normal course,” said Jacquot.

Broward Health officials have said Bravo was fired in December. On Sunday, hospital district board chairman David Di Pietro told This Week In South Florida that Bravo received an “unbelievable” severance package while he was under investigation by the FBI. The deal included a $17,000 payout for personal leave time, plus Bravo remains on Broward Health’s payroll until June.

Black, the private investigator hired last year to look into corruption allegations at Broward Health, told commissioners in a recent email that Bravo “was bragging about getting $75,000 BH (Broward Health) to pay his criminal defense attorney.”

Bravo did not respond to detailed requests for comment. Joel Hackney, chief executive officer of MedAssets, also did not respond to a detailed voicemail requesting comment.

Broward Health spends tens of millions of dollars on medical supplies every year. The district hired MedAssets in December 2007 in an effort to reduce the cost of supplies.

An undated company press release quotes Bravo: “MedAssets has been very effective in working with our leadership team, departments and physicians to review utilization and to implement strategies to reduce physician preference item supply costs while maintaining the quality of patient care.”

Supply costs can represent as much as 31 percent of a hospital’s cost per case, according to a 2006 academic study cited by the Milbank Quarterly, a healthcare journal.

“Gaining control of the hospital’s supply chain – the flow of products and associated services to meet the needs of the hospital and those who serve patients – presents special challenges,” the journal reported. “This is because the most expensive materials – up to 61 percent of the total supply expenditures – are for items about which physicians have a strong preference.”

In wake of El Sanadi suicide, Florida IG probes every Broward Health contract since 2012

By Dan Christensen, FloridaBulldog.org 

Dr. Nabil El Sanadi's casket leaves Friday's funeral service at First Baptist church in downtown Fort Lauderdale. Photo: Sun-Sentinel

Dr. Nabil El Sanadi’s casket leaves Friday’s funeral service at First Baptist church in downtown Fort Lauderdale. Photo: Sun-Sentinel

As Gov. Rick Scott and hundreds of others paid their final respects Friday to Dr. Nabil El Sanadi, Broward Health’s late president, Florida’s chief inspector general quietly opened a wide-ranging investigation into how the hospital district hands out millions of dollars in contracts.

“I have received Governor Scott’s full support to conduct a thorough review of every contract North Broward Hospital District/Broward Health has entered into since July 1, 2012 and all correspondence, in any form, related to these contracts,” Chief Inspector General Melinda M. Miguel said in a Jan. 29 letter to district chairman David Di Pietro.

“The purpose of the review is to determine any possible improprieties or inappropriate actions including any violation of law, rule, regulation, charter, bylaws or procedures associated with these contracts,” Miguel wrote.

The letter says the probe of taxpayer-supported Broward Health was begun based on “reported allegations,” but it does not elaborate. Miguel, who reports directly to Gov. Scott, did not respond to a request for comment Monday.

FloridaBulldog.org also has confirmed the FBI is conducting a separate, though possibly overlapping criminal investigation into allegations of corruption in Broward Health’s purchasing department. Details were not immediately available.

“The FBI does not confirm/deny the existence of an investigation,” said Miami FBI spokesman James Marshall.

State, fed probes are newest blows to Broward Health

News of the state and federal probes are the latest blows to the county’s largest and most troubled safety-net hospital system. Last September, Broward Health paid more than $69.5 million to settle federal whistleblower allegations that for more than a decade its administrators and doctors had conspired in an illegal kickback scheme to defraud Medicare and Medicaid.

El Sanadi’s shocking death – he shot himself in a public restroom at his Lauderdale-by-the-Sea condominium on Jan. 23 – led to an immediate outpouring of affection for a man described as both a compassionate physician and a dedicated leader. Friends and acquaintances, however, have been unable to explain why the Egyptian-born El Sanadi would commit suicide.

Broward Health’s board – appointed by Republican Gov. Scott – hired El Sanadi 14 months ago to replace Frank Nask. El Sanadi had little executive experience, but he and his wife, Lori, were sizable contributors to Scott’s 2014 re-election – giving a total of $16,000 to the governor’s campaign and his Let’s Get to Work political action committee. El Sanadi gave another $36,529 to the Republican Party of Florida Over in 2014.

Dr. Nabil El Sanadi

Dr. Nabil El Sanadi

El Sanadi arrived amid what was then a mostly secret, yet intense whistleblower investigation that had surfaced in May 2011 when U.S. Department of Health and Human Services agents subpoenaed Broward Health records about its contracts with more than two dozen doctors. Broward Health ultimately produced millions of documents.

El Sanadi played a key role in negotiations that led to the settlement. Indeed, at last Wednesday’s board meeting a clearly emotional chairman Di Pietro told the audience that El Sanadi was responsible saving Broward Health millions by relentlessly chipping away at the government’s demands.

Last August, Broward Health’s seven-member board voted unanimously to bring an end to the embarrassing investigation by agreeing to pay the $69.5 million and accept the imposition of tough new ethics rules over five years. The payout was atop another $10.2 million paid to an out-of-state law firm for legal advice about how to deal with the probe.

The settlement was a relief to both the board and El Sanadi.

“This is just a resolution of something that’s been on the table for the last four or give years and goes back as far as 2001. It’s always good to get things like this over with,” El Sanadi told FloridaBulldog.org after the deal was made public on Sept. 15.

The inspector general’s letter to Di Pietro notes that state law imposes a duty to cooperate on every state officer and employee, agency and special district – Broward Health is an independent special taxing district that collected $140 million in property taxes in 2015.

Likewise, Broward Health was asked to identify a contact to act as a liaison. Broward Health’s internal auditor is Vinnette Hall.

Billions in Medicare Advantage overcharges likely gone for good

By Fred Schulte, Center for Public Integrity doctorsmoney

Four years ago, Medicare auditors came to an alarming conclusion: the federal government shouldn’t have paid a half-dozen insurance plans hundreds of millions of dollars to treat seniors in especially poor health.

The findings signaled that billing errors could be deeply rooted within private Medicare Advantage plans — which contract with the federal government to care for nearly 16 million elderly Americans — and that these abuses could be wasting taxpayer dollars at a ferocious clip. (more…)

Medicaid contracts, a close friend, big money and Gov. Scott’s re-election campaign

By Dan Christensen,BrowardBulldog.org 

Gov. Rick Scott

Gov. Rick Scott

Before the Legislature convenes in Tallahassee next Tuesday, Coral Gables healthcare tycoon Miguel B. “Mike” Fernandez will host a Sunday afternoon BBQ with Gov. Rick Scott, his wife Ann, and key members of the governor’s campaign finance team.

Fernandez, dubbed “Florida’s newest billionaire” last year by Florida Trend, was named finance co-chair for Scott’s campaign in January. In the announcement, the governor called Fernandez a “close friend.”

But Fernandez, chairman of MBF Healthcare Partners, is more than Scott’s friend. He’s also a huge contributor to his re-election campaign and the owner or co-owner of fast-growing healthcare companies that under Scott’s administration have been awarded multiple, multi-year state contracts potentially worth hundreds of millions of dollars.

Most of those lucrative contracts involve Florida Medicaid, which is implementing managed care changes, including the Managed Medical Assistance program. The program is expected to begin in May.

fernandezinvite.jpgBetter Health Plan, which does business as Simply Better Health and is an affiliate of Fernandez’s $450 million Simply Healthcare Plans, won contracts from Florida’s Agency for Health Care Administration (AHCA) last year to provide general services in three of Florida’s 11 Medicaid managed care regions, including Broward County.

Clear Health Alliance, a Medicaid plan offered by Simply Healthcare Plans, was awarded AHCA contracts to provide “specialty” services to Medicaid patients who are HIV positive or have been diagnosed with AIDS.

The Florida Times-Union first reported Fernandez’s ties to Better Health and Clear Alliance in January after Scott appointed Fernandez to his campaign team.

AHCA disclaimed any partiality in contract awards in a statement released by agency spokeswoman Shelisha Coleman.

“Every company that won an award in SMMC (Statewide Medicaid Managed Care program) rightfully earned its award. No companies received an award as a result of favoritism. The agency followed Florida’s strict procurement laws…in letter and in spirit at all times.’

Fernandez, reached Tuesday via email, said, “Companies in which I have invested in have Medicaid contracts, totaling in the billions since 1990. This includes contracts with the State of Florida under the leadership of multiple governors, including a contract under Governor Crist. All contracts save the state much needed funds and improved care to our patients.”

In October 2012, BrowardBulldog.org reported that Fernandez was a silent partner in a $44.8 million contract awarded by Florida’s Department of Children and Families (DCF) to manage mental health services in Broward.

The multi-year department contract went to the Broward Behavioral Health Coalition, a nonprofit led by former DCF boss and state attorney general Bob Butterworth, and its for-profit partner, Concordia Behavioral Health of Miami.

Fernandez was a major Concordia shareholder. His name was disclosed to top department officials, but was omitted from DCF records about the procurement.

Fernandez’s invisibility regarding the Broward procurement meant that no one took note of his $125,000 contribution to Let’s Get to Work, a fundraising organization set up with the governor’s support, on Jan. 25, 2012 while the procurement was pending.

Previously, during Scott’s 2010 campaign, Fernandez and his MBF Family Investments gave Let’s Get to Work $500,000.

Asked about those large contributions in 2012, Katy Sorenson, head of the Good Government Initiative at the University of Miami, said, “It sounds like maybe Gov. Scott is running Florida like a business – doing business with his friends.”

Fernandez’s money continues to gush the governor’s way.

On November 2, 2013, as the governor’s re-election campaign was stirring, Fernandez personally gave $1 million to Let’s Get to Work. No one else has written a check that large in support of Scott’s re-election.

Little River Plantation home

Little River Plantation home

Sunday’s get-together at Fernandez’s opulent Little River Plantation, not far from Tallahassee, is a by invitation only event. The public is not invited.

Miami Herald political reporter Marc Caputo recently obtained a copy of the invitation and accompanying email:

“As an important member of Governor Rick Scott’s finance team, Mike Fernandez is opening his home to you. He is not a public person and believes we need to meet each other in person and in a social setting…Nothing formal (casual jeans and casual setting.) We will chat, have BBQ and see beautiful horses…We need to come together so we can deliver victory together,” the email said.

Little River Plantation features a 7,000 square foot home with six bedrooms, seven baths, a full gourmet kitchen and a great room, according to its web site. There’s a smaller lake house nearby.

“Your every whim will be coddled within the walls of our fabulous homes away from home,” prospective guests are told.

A psychiatric hospital for North Ridge site? Oakland Park commission set to decide

 

UPDATE: FEB. 21 —  With anxious residents watching at city hall and at home on computers and cable television, Oakland Park has put off for two weeks a decision on whether to approve a controversial psychiatric and drug rehabilitation hospital. The reason: Wednesday night’s hearing ran too late to finish the hearing.

About 40 persons spoke for and against the project.

Resident and former Mayor Steven Arnst was critical of a letter sent to the city by a West Palm Beach lawyer for the developer instructing commissioners on their “duty” to grant Palm Partners’ application and warned that they faced a possible discrimination lawsuit if they did not. Arnst called it a “threat.”

Fort Lauderdale lawyer Wilson Atkinson, who represents another rehab facility, Fort Lauderdale Hospital, informed commissioners that Palm Partners does not have a Florida Agency for Health Care Administration license needed to operate a 300-bed psychiatric/behavioral health hospital.

Atkinson said that should the city approve the project, and Palm Partners is unable to obtain such a license, the city would be stuck with a facility that would operate under less stringent Department of Children and Families regulations for residential treatment facilities. Those facilities allow patients to freely come and go outside specific treatment hours — a nightmare scenario for residents and one that Palm Partners has said it would not allow.

The five-member city commission will pick up the quasi-judicial hearing regarding the proposal to open the North Ridge Behavioral Health Center on March 5.

By Dan Christensen, BrowardBulldog.org 

notice

Revised plans for a controversial psychiatric/behavioral health hospital on the site of the old North Ridge Medical Center in Oakland Park are to be presented to the city commission Wednesday before a final up or down vote.

The changes, including additional fencing and assurances that it would not admit convicted sexual offenders to its residential treatment programs, were made to satisfy the concerns of nearby residents.

If approved, the proposal by Palm Partners LLC promises to reinvigorate a working hospital facility vacant since its purchase and closure by nonprofit Holy Cross Hospital in 2008. It would also create 300 new jobs and return the property to the tax rolls, promising “a significant increase in revenues to the city,” according to the proposal.

Today, Palm Partners operates a small, upscale drug and alcohol rehabilitation facility in Delray Beach. Its plan for a much larger, 300-bed facility to be known as the North Ridge Behavioral Health Center has provoked a strong negative reaction from wary residents in Oakland Park’s North Andrews Gardens neighborhood.

City Hall, located at 3650 NE 12th Avenue, is bracing for a crowd at Wednesday’s 6:30 p.m. public hearing.

“We are expecting a lot of people,” said Kristen Nowicki, an Oakland Park senior planner.

Two elementary schools and a high school are in the neighborhood. Several parents said in interviews that they fear their children will not be safe.

Opposition to the psychiatric facility has also come from the Broward School Board, which recently notified the city of its concern about “spillover effects” from the proposed psychiatric facility on nearby Northeast High School.

“The district’s position is that the proposed project is incompatible with the school,” said a letter from the School Board’s growth monitoring unit.

Last month, the city’s five-member planning and zoning board unanimously recommended the commission deny Palm Partner’s application to the city for its approval. If the city commission votes no, Palm Partners, owned by company chief executive Peter A. Harrigan, would have to go to court in an attempt to make the project happen.

Palm Partners signed a contract last year to purchase the 11-acre site on North Dixie Highway, between Northeast 56th and 58th streets, from Holy Cross Hospital for an undisclosed sum.

The company has said it hopes to operate an inpatient detoxification and rehab facility that will cater to a well-heeled class of psychiatric patient. The hospital would also treat other maladies such as eating disorders and sleep apnea.

“Our facilities and services fill a significant gap in our society, providing much-needed help to those suffering with addiction and behavioral health. These illnesses are life threatening and tear families apart. Our facilities provide a foundation for recovery,” Harrigan said in a statement on Monday.

“We often hear that people know someone who needed help, including family, but were unsure what to do. Education is key and we will work with the neighboring high school and other community organizations to provide educational and outreach programs. We are here to help, and I will work hard every day to ensure this hospital is a community partner that the City of Oakland Park can be proud of,” Harrigan said.

Palm Partners has told city officials it will not accept Medicaid patients, Baker Act patients, other indigent care patients or walk-ins. All patients will pay through private insurance, third-party reimbursement or cash.

In an interview, Harrigan said most patients would stay 30-90 days. The cost of a 30-day stay would be $24,500, he said.

Harrigan has sought to assure neighbors that the hospital intends to make sure that its patients pose no threat to local residents.

“I appreciate the neighbors’ concerns and share in the need to keep our communities safe. Safety is paramount to our mission,” Harrigan said in Monday’s statement. “We have operated in Florida for 20 years and have never had a security incident involving the surrounding neighborhood.

“Our plans to invest $20 million to restore this facility, which has been vacant since 2008, will serve as a catalyst for economic growth, drawing businesses back to the area and creating thousands of jobs for the City of Oakland Park. Our investment will restore the hospital into a leading, cutting-edge facility, which will provide substantial tax revenue to the City.”

 

Payments to CEO raise new conflicts at top health quality group

By Marshall Allen, ProPublica 

Dr. Cristine Cassel, President and CEO of the National Quality Forum, speaking before the Senate Committee on Health, Education, Labor, & Pensions. Dr. Cassel was paid hundreds of thousands of dollars in additional outside compensation after she was hired in December 2012. (help.senate.gov)

Dr. Cristine Cassel, President and CEO of the National Quality Forum, speaking before the Senate Committee on Health, Education, Labor, & Pensions. Dr. Cassel was paid hundreds of thousands of dollars in additional outside compensation after she was hired in December 2012. (help.senate.gov)

The top executive at the country’s pre-eminent health care quality organization is being paid hundreds of thousands of dollars by two large medical companies that have a stake in the group’s work.

The payments to Dr. Christine Cassel raise new conflict-of-interest concerns at the National Quality Forum, which endorses benchmarks that Medicare uses to compensate hospitals based on performance. (more…)

Post traumatic stress crisis ignored: Americans wounded in their own neighborhoods

By Lois Beckett, ProPublica 

A shooting victim is rushed to the hospital in Miami. Photo: CBS4

A shooting victim is rushed to the hospital in Miami. Photo: CBS4

Chicago’s Cook County Hospital has one of the busiest trauma centers in the nation, treating about 2,000 patients a year for gunshots, stabbings and other violent injuries.

So when researchers started screening patients there for post-traumatic stress disorder in 2011, they assumed they would find cases.

They just didn’t know how many: Fully 43 percent of the patients they examined – and more than half of gunshot-wound victims – had signs of PTSD. (more…)

Oakland Park commissioners likely to decide soon on controversial psychiatric hospital

The former North Ridge Medical Center Photo: BrowardBulldog.org

The former North Ridge Medical Center Photo: BrowardBulldog.org

 

UPDATE: Jan. 16 — Shot down unanimously by Oakland Park’s planning and zoning board on Monday, a Delray Beach drug rehab operator’s controversial plan to develop a 300-bed psychiatric hospital on the site of the old North Ridge Medical Center is expected to go before the city commission soon for a final decision.

A hearing could be held at City Hall in as soon as three weeks.

“The applicant wants Feb. 5,” said senior planner Kristin Nowicki. “I don’t see why we wouldn’t be able to do that, but we have to make sure all the requirements are fulfilled. If not, then it would be the 19th.”

The applicant is Palm Partners LLC, which operates a small, upscale drug and alcohol rehabilitation facility. The company’s owner, Peter A. Harrigan, has said he expects to create 300 jobs at the North Ridge site.

“We had a packed house at our hearing,” said Caryl Stevens, a former mayor who now chairs the zoning board. “The area around this site is a working class neighborhood and it is by design: easy accessibility to schools. People are concerned.”

UPDATE: Jan. 13 — Declaring that a proposed psychiatric hospital is not compatible with nearby Northeast High School, the Broward School Board notified Oakland Park today that it “must compel the applicant to ensure” the facility “will not negatively impact” the school.

“The subject sites are in close proximity to Northeast High School. The district’s position is that the proposed project is incompatible with the school due to potential spillover effects from the proposed establishment,” said the letter sent to the city clerk boy Mohammed Rasheduzzaman, a planner in the growth School Board’s monitoring unit.

The high school is about a block away from the site, which once housed North Ridge Medical Center. Many children heading to and from school must walk by the property.

The School Board’s decision to wade in on the matter only hours before tonight’s public hearing before the city’s planning and zoning board could jeopardize chances for approval that had earlier seemed likely.

By Dan Christensen, BrowardBulldog.org 

A proposed 300-bed “psychiatric/behavioral health facility” on the site of the shuttered North Ridge Medical Center in Oakland Park is stoking fear among jittery neighborhood residents, and assurances of strong oversight and security from the prospective new owner.

Palm Partners LLC, which operates an upscale drug and alcohol rehabilitation center in Delray Beach, hopes to operate a similar facility on the 11-acre campus that would take advantage of the hospital setting to provide not only inpatient detoxification and rehab, but treatment for other maladies such as eating disorders and sleep apnea.

“We run a very tight ship,” said Peter A. Harrigan, owner and chief executive of for profit Palm Partners. “I think we’ll be a great asset for the community.”

Harrigan said he expects to create 300 new jobs.

City planning staff is recommending approval, with several minor conditions like improved landscaping and the addition of bus shelters. A public hearing before the planning and zoning board is set for Monday at 6:30 p.m. The city commission is to take up the issue in February.

Palm Partners owner Peter Harrigan

Palm Partners owner Peter Harrigan

Monday’s agenda item about the new North Ridge psychiatric hospital does not use inflammatory words like “drug” or “alcohol,” nor is there any discussion of Palm Partners’ existing drug rehab center and treatment program.

Rather, the document indicates Palm Partners will cater only to a well-heeled class of psychiatric patient.

“Palm Partners will not accept Medicaid patients, Baker Act patients, other indigent care patients or walk-ins. All patients will pay through private insurance, third party reimbursement or cash,” the agenda says.

Most patients will stay “30-90 days.” The cost of a 30-day stay at Northridge would be $24,500, Harrigan said.

Holy Cross Hospital bought the site at 5757 N. Dixie Highway from healthcare giant Tenet Healthcare in 2008 for a reported $20 million, including an adjacent medical office building. It has agreed to sell to Palm Partners for an undisclosed sum, but the sale is conditional on the city’s approval of Palm Partners’ plans. While there has been some confusion about the status of the office building, which is occupied, it is not part of the proposed sale, according to city officials.

Once the purchase by the for profit Palm Partners closes, the property now owned by the non-profit Catholic hospital would return to the city’s tax roll.

northridgenoticeThe facility, originally an acute care general hospital built in 1974, is near three public schools: Rickards Middle, Northeast High and North Andrews Gardens Elementary. Children walk by every day on their way to and from school.

Signs have been up at the site for more than a month disclosing the upcoming hearing, but several people interviewed for this article were critical of what they said were the city’s inadequate notification efforts.

Kristeena Chace’s daughter attends Northeast and her son is a third-grader at North Andrews Elementary. She and her mother, Tina, believe Palm Center’s plans to draw psychiatric patients for treatment puts local children at risk.

“I have major concerns,” said Kristeena Chace. “I am an alumni of all these schools and I stayed in the neighborhood. I wanted to bring my children up in a safe environment. However, if a hospital like that is put in there my children will not be safe.”

Shannon Thompson, who has a first-grader at North Andrews Elementary and a seventh-grader at Rickards Middle, agrees.

“I’m not happy at all about this. It will expose our children to things that are probably not very safe,” said Thompson. “They’re claiming they’ll have good security, but I don’t foresee that as being 100 percent.”

Oakland Park Mayor John Adornato did not return a phone call seeking comment.

Harrigan says neighbors’ concerns are groundless. With 24-hour security and “a tremendous amount of psychiatric staff, doctors and nurses, we will provide the highest level of care.

“The biggest thing people need to recognize is that this is a voluntary program. They want to be there. They’re not court-ordered,” said Harrigan. “We are investing a tremendous amount of money in the neighborhood. We want the quality of the neighborhood to stay intact and we want to help it get better.”

A Palm Partners advertisement

A Palm Partners advertisement

Palm Partners’ program summary offers further safety assurances.

“No patients will be permitted to leave the facility without staff ascertaining the patient’s present status and ability. In the event a patient wishes to leave prior to the end of their treatment, arrangement will be made for them to be taken to their intended location off premises, in a safe and responsible manner,” the summary says.

The program summary says the new hospital will feature an array of health care practitioners including medical doctors, psychiatrists, chiropractors, acupuncturists, pharmacists and massage therapists.

Should the city commission approve the psychiatric hospital, the only remaining requirement will be a site license from the state.

Harrigan, who has other smaller facilities in Lantana and Miami, hired lawyer/lobbyist Pam Kane, a partner in Fort Lauderdale’s Panza Maurer & Maynard, to represent Palm Partners before the city.

In November, Palm representatives met with residents of the surrounding North Andrews Gardens and Embarcadero Condominium neighborhoods. Harrigan said “we’ve gotten a very favorable response.”

The stakes are high for Harrigan, who said he will relocate his corporate office to North Ridge.

“There is a lot of competition in this business,” he said. “Fort Lauderdale will be the cornerstone. This will double the size of our company.”

Harrigan said getting fully up and running would take “a couple of years.”

“After we close (the sale), it will be another 60 days before we take our first patient,” he said. “There will be 60 people on staff on opening day. It will be a slow ramp up.”

Florida prison officials didn’t ask, companies didn’t tell about hundreds of malpractice cases

By Dan Christensen, BrowardBulldog.org prison

The Florida Department of Corrections awarded a five-year, $1.2 billion contract to provide medical care for thousands of state prisoners in north and central Florida to Corizon, a Tennessee company that was sued 660 times for malpractice in the last five years.

Nearly half of those cases remain open. Of those that are closed, 91 – one in four – ended with confidential settlements that Corizon declined to discuss. Corizon began work in August providing care at 41 correctional facilities.

A second contractor, Pittsburgh-based Wexford Health Sources, signed a five-year, $240 million contract in December to provide medical services to state inmates in nine institutions in South Florida.

Wexford, however, was hit with 1,092 malpractice claims – suits, notices of intent to sue and letters from aggrieved inmates from January 1, 2008 through 2012. Records say Wexford settled 34 of 610 closed matters for a total of $5.4 million, as well as another case that ended in a $270,000 jury verdict against the company.

The Department of Corrections, headed by Secretary Michael D. Crews, hired Corizon and Wexford to lead Florida toward millions of dollars in savings promised by the massive privatization of inmate healthcare enacted by Gov. Rick Scott and the Republican-controlled Legislature.

Along the way, however, the corrections department never asked the corporations bidding for those lucrative jobs to disclose their litigation histories — how often they’d been accused of malpractice, where those cases were filed and the outcomes.

Neither Crews nor Dr. Olugbenga Ogunsanwo, the assistant secretary for medical and health services, agreed to be interviewed for this story. Corrections spokeswoman Misty Cash, however, called the state’s contracting process “comprehensive.”

Florida Corrections Secretary Michael D. Crews

Florida Corrections Secretary Michael D. Crews

“The selection of Wexford and Corizon was transparent,” she said. “Both companies provided the required and requested documentation as outlined in the procurement and bidding process.”

Government agencies elsewhere in Florida typically require corporate bidders to provide litigation histories in order to assess the quality and reliability of their services, as well as their ability to limit potential liability.

Prisons are obligated under the Eighth Amendment to provide prisoners with adequate medical care.

The problematic litigation histories of Corizon and Wexford raise questions about the quality of inmate care promised by those companies and paid for by Florida’s taxpayers.

“What really troubles me about this is the fact that the department didn’t ask these very basic, elemental questions any system would ask,” said Eric Balaban, a staff attorney for the National Prison Project of the American Civil Liberties Union. “These two vendors were taking over Florida’s massive health care system and you’d think they would have asked hard questions to determine if these companies can provide these services within constitutional requirements.”

BrowardBulldog.org obtained the litigation records from the Broward Sheriff’s Office using Florida’s public records laws.

BSO obtained them from Corizon and Wexford during their unsuccessful bids this summer to provide healthcare services for inmates at the Broward County Jail. Each company complied, to varying degrees.

Prison companies don’t like to discuss lawsuits filed against them, and neither Corizon, created by the 2011 merger of competitors Prison Health Services and Correctional Medical Services, nor Wexford would comment for this article.

LITIGATION AS ‘TRADE SECRET’

Corizon, in fact, initially tried to block the release of its litigation history by claiming it was exempt from disclosure as a “trade secret.” The company rescinded that claim in late August, after its work for the state had begun and after being told litigation was being contemplated by this news organization to force disclosure.

While Corizon told BSO it had been sued 660 times, it did not provide the requested list of cases.

One example, however, can be found in the court file of 24-year-old Brett Fields.

Fields was sent to the Lee County Jail on July 6, 2007 after being convicted of two misdemeanors. He was healthy, except for a bump “about half the size of a tennis ball” on his left arm – the result of a spider bite, the court records say.

On Aug. 6, after a month of sporadic, ineffective and “lax” treatment by Corizon staff, Fields “felt his back go sore and numb.” The next day, his legs began to twitch uncontrollably, with the pain becoming unbearable after midnight on Aug. 8, records say.

Fields could no longer walk by the time he saw a physician’s assistant about 9 a.m. who checked Fields’ his leg and foot reflexes and found none. Fields was given Tylenol and returned to his cell.

Early on Aug. 9, Fields “felt his intestines escaping from his rectum.” Fellow inmates begged Corizon’s staff to take him to the hospital. Instead, nurse Bettie Joyce Allen “obtained some K-Y Jelly, and pushed the intestines back in,” the records say. Hours later, at a local hospital, doctors found an abscess compressing his spine.

A jury awarded Fields $1.2 million in 2011 after finding Corizon solely responsible for what happened. The award included $500,000 in punitive damages. Fort Lauderdale attorneys Gregg Lauer and Dion Cassata represented Fields.

The verdict was  upheld last year by an appeals court that observed prompt treatment “could have averted permanent damage to his legs, but he did not receive that treatment because Prison Health (Corizon) delayed his treatment.”

PROBLEMS ACROSS THE U.S.

In addition to the lawsuits and claims filed against them, Corizon and Wexford both have faced withering official criticism about the delivery of care to inmates.

  • Idaho – In 2011, the Associated Press reported that Corizon was fined $382,000 by the state “for failing to meet some of the most basic health care requirements outlined by the state.” Last year, an expert appointed by a federal judge to review Corizon’s medical care at one prison near Boise found “inhumane” conditions.
  • Pennsylvania – Corizon paid a $1.85 million fine to Philadelphia after investigators determined the company had used a front company as a subcontractor to meet city requirements for minority-owned vendors.
  • Maine – In 2011, a state agency review of Corizon’s operations there found that the company maintained medical records poorly and had failed to fulfill contract obligations. The head of Maine’s American Civil Liberties Union later told the state’s Public Broadcasting Network that those problems rose to “a systemic constitutional dimension.”
  • Mississippi – In December 2007, the joint legislative committee criticized Wexford and the state’s Department of Corrections for failing to ensure that all inmates received timely access to quality medical care. Wexford was also assessed more than $930,000 in fines for maintaining staffing levels that were not in compliance with contract minimum – fines the committee said had not been collected.
  • Arizona – Wexford and the state’s corrections department agreed in January to terminate Wexford’s medical services contract in the wake of accusations the company improperly dispensed medicine to inmates and wasted state resources, according to the Arizona Republic. Wexford was awarded a three-year contract seven months earlier. Arizona hired Corizon to replace Wexford.

Florida has had its own problems with the two companies.

In 2006, Corizon, then known as Prison Health Services, backed out of a 10-year state prison healthcare contract saying it wasn’t making enough money. The company had won the contract only months before with a bid that was millions lower than its competitors.

In 2004, Florida legislative auditors called Wexford’s medical care “problematic,” according to the Miami Herald. In 2002, the newspaper reported that the Florida Correctional Medical Authority had reprimanded Wexford the year before for poor medical care following the deaths of two inmates.

Florida let bygones be bygones when it hired Corizon and Wexford to help achieve the 7 percent in cost savings mandated for privatization by the legislature. Corrections spokeswoman Misty Cash said taxpayers would save $3 million a month because of those contracts.

Some contend Florida’s emphasis on savings has eclipsed questions about the quality of the medical care for inmates that taxpayers are purchasing.

Michael Hallett is a professor of criminology at the University of North Florida in Jacksonville who has written about prison privatization. He said quality of care simply isn’t much of a concern when it comes to prisoners.

“Most people feel, as long as they achieve their 7 percent savings who cares how they treat inmates?” he said.

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