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Medical Care for State Inmates: Following departmental evaluations of responses to a request for proposals, the Department of Corrections entered into a contract with Wexford Health Sources, Inc. Inmates are transported to one of the three parent facilities for medical care.
Under this model, the contractor assumes responsibility for medical care rendered inside institutions, with the correctional agency taking responsibility for important functions such as specialty care rendered outside of the correctional institutions and utilization review.
This enables the correctional agency to manage the care given to the inmates, but exposes the correctional agency to additional financial and managerial risks, as the agency becomes responsible for providing certain forms of care.
In entering into the current agreement with Wexford, the department has assumed for the state an increased risk, as the department is now required to bear directly a greater share of the responsibility for delivering medical care to inmates. As the state assumes greater responsibility and control over the delivery of services, it has more opportunities for both controlling expenses and better managing the delivery of care.
To determine the quality of medical care state inmates received from January 1 through May 31, , PEER reviewed samples of medical records at each of the three parent facilities for compliance with standards of the medical services contract with Wexford and for compliance with accepted national standards regarding routine and chronic care, including mental health care.
During the period of review, MDOC and its contractor Wexford did not ensure that all state inmates received timely access to the sick call process and two-year dental prophylaxis within the intervals established by the medical services contract and by national correctional standards for medical care.
Wexford did comply with applicable standards for the medical care component of the inmate intake process. PEER analyzed the following areas of routine medical care during the period of review:. As shown in the exhibit, during the period of review, Wexford complied substantially with contract standards and national correctional standards in regard to ensuring that state inmates received adequate access to health care upon intake into the state correctional system.
However, Wexford did not ensure that all inmates had timely access to medical care through the sick call process in accordance with contract requirements and national correctional standards. Also, Wexford did not document whether all inmates had a dental prophylaxis every two years in accordance with contract requirements. As shown in the exhibit, during the period of review, Wexford did not comply with its own policies and procedures regarding timely access to chronic care and proper documentation of all chronic care follow-up referrals.
However, Wexford did comply with documentation of a medication treatment plan requirement. Wexford staff do not consistently file mental health records with records for chronic care. As a result, MDOC cannot assure continuity of care.
As of July 1, , Wexford is responsible for providing the following specialty care: MDOC is financially responsible for all other specialty care services for state inmates off site and is responsible for oversight of the utilization review process for specialty care for all state inmates. Also, neither Wexford nor MDOC has implemented an effective method of tracking inmates through the specialty care process. For the period of review, PEER noted the following deficiencies in the medical staffing of the correctional facilities:.
During the period of review, neither MDOC nor Wexford had a quality assurance program for contract compliance in place that ensured timely access and continuity of medical care through accurate and appropriate medical recordkeeping. The major areas of concern associated with quality assurance and medical recordkeeping are as follows:. This practice violates MISS. Inmates receive initial health assessment within one month of intake. Inmates receive initial dental screening within 7 calendar days of intake.
Inmates receive a physician visit within 7 calendar days. Inmates receive a chronic care visit at least every 6 months.