The company that provides health care to Cumberland County jail inmates was doing such a poor job that prisoners repeatedly failed to receive important medicines, say jail officials.
Because of the deficiencies, Sheriff Mark Dion has moved to replace Prison Health Services; the county has already charged the company $35,000 in penalties for inadequate care.
'They didn't staff to the level they should have so they could not meet all their responsibilities on a given shift,'' Dion said. Sometimes no nurse was available to distribute medications and, at other times, a single nurse was forced to work 24 hours straight or else the jail would have no medical staff at all, he said.
The situation led jail inmates to file 560 grievances alleging inadequate medical care so far this year, a sharp increase over previous years, Dion said.
The county and Prison Health Services are in the midst of a two-year contract under which the company was to be paid $826,000 last year and about 5 percent more in the coming year. Over the years, the county moved to private health-care providers, and specifically to Prison Health
Services, as a way to save money.
Now the company says rising personnel costs, a growing jail population and the acute medical needs of the jail's inmates mean it will lose more than $350,000 on the contract.
'We have a team right now on site working around the clock with the sheriff's staff to resolve the on-site issues,'' said Gerard Boyle, president of the Tennessee-based company. 'We are trying to resolve the issues there regardless of the fact we're losing money.''
The county is exploring other options for providing medical care at the jail, including other private vendors, area hospitals or county staff that would be hired to do it in-house.
Prison Health Services' inability to attract and keep trained nurses and administrators for the jail program is at the heart of its problems. The company's latest health services coordinator was fired recently, Dion said, and the program was in such disarray that experienced staff were jumping ship.
'Experienced nurses left in frustration. People didn't give notice, they just quit,'' he said, a situation that aggravated the problem. 'We went months without appropriate dental care.''
Problems with medical services forced the county jail to hold off on its pursuit of national accreditation, Dion said.
Dion said he felt obligated to work with the company toward improving its performance. Two months ago, he assigned a captain on his corrections staff to oversee the operation.
But the closer scrutiny just uncovered more problems, including lax procedures for managing medications in the pharmacy, he said. That led Dion to call in the federal Drug Enforcement Administration, which is conducting an audit of the pharmacy and its records.
Dion and county officials concluded over the last few days that the situation is beyond repair.
Boyle said the statewide shortage of nurses has created staffing problems at state prisons and Maine Youth Center, where Prison Health Services also is the health-care provider. The company is paid $5.2 million this year for providing health care in the state facilities and will get a 4percent increase in the coming year.
Denise Lord, a spokeswoman for the Maine Department of Corrections, said the company has had trouble filling vacancies, but has not had anywhere near the problems it has had in Cumberland County's jail.  Servicing the state's 2,000 prisoners , the company enjoys economies of scale and a more stable population with more predictable medical needs, she said.
Besides the difficulty in keeping trained staff, Boyle also laid some of the blame for lapses in care on the growing jail population. When the company bid on the contract, the jail housed 285 inmates. As of September 6th, the jail had 371 and it has held more than 400 on some occasions.
Providing health care in a county jail is expensive. Almost half of today's county jail inmates are on some type of medication and 95 inmates are prescribed psychotropic drugs to combat mental illness, Dion said.
Prison Health Services and its related companies provide health care in 251 jails in 27 states. Cumberland County jail is among the smallest facilities it serves.