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Grassroots Leadership, Sc Cms Report, 2004

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A GRASSROOTS LEADERSHIP
SOUTH CAROLINA FAIR SHARE
SPECIAL REPORT
PRESCRIPTION FOR DISASTER:
COMMERCIALIZING PRISON HEALTH CARE
IN SOUTH CAROLINA
by
Marguerite G. Rosenthal, Ph.D.

Grassroots Leadership
400 Clarice Avenue, Suite 400
P.O. Box 36006
Charlotte NC 28236
704-332-3090
www.grassrootsleadership.org

South Carolina Fair Share
1338 Main Street, Suite 301
P.O. Box 8888
Columbia SC 29203
803-252-9813
www.scfairshare.org

April 12, 2004
Prescription for Disaster: Commercializing Prison Health Care in South Carolina
Executive Summary
South Carolina’s Department of Corrections, despite a previous costly, inefficient and
troubled experience with commercialized health care in a portion of its prison medical
services system, has announced that it will soon be privatizing all of its prison health care
services. This report documents the many problems—from seriously deficient services
provided to prisoners to cost over-runs and unpredictable,unstable contracting
arrangements—associated with privatized prison health services in South Carolina and
the nation at large.
From 1986 to 2000, South Carolina contracted with Corrections Medical Services
[hereafter, CMS], a private corporation with a checkered record of providing
comprehensive health services—that is, medical and psychiatric care-- to prisons and jails
around the country. CMS’ contract with the Department of Corrections [hereafter,
SCDC] initially provided services to three prisons (Coastal Pre-Release Center, Lieber,
and MacDougall); by 1999, its contract covered ten facilities and it received $31 million
from the state in the two fiscal years ending in June, 1999.
As the South Carolina General Assembly’s Legislative Audit Council’s report, A Review
of the Medical Services at the SC Department of Corrections1, documents with great
clarity, the experience of privatized health care in the S.C. prison system was rife with
problems that ranged from medical care of very poor quality to failures of the Department
to exercise its mandated oversight responsibilities to cost over-runs and substantial funds
expended on services that were never provided.
The record of the CMS contract with the State of South Carolina is a dismal one, and
though it is clear that the state failed in its monitoring responsibilities, CMS nevertheless
complained that monitoring was “excessive and disruptive” in citing its reasons for
terminating its contract. This attitude is likely to prevail in any future privatized prison
health system and bodes ill for both sick prisoners and for the state’s taxpayers.
South Carolina has already had a bad experience with commercial prison health care, and
there is no doubt that it has wasted many thousands of dollars on shoddy care to the
nearly 24,000 people in its prisons. Instead, this money could have been spent on better,
state-provided health services and on vigilant monitoring to assure those services were, in
fact, being given. The sorry experience that other states have had with privatized prison
health care should be caution enough to halt the drive toward re-privatizing South
Carolina’s system.
Indeed, we agree with a recent editorial in The State which cautioned: “…officials should
not rush to privatize health care at prisons—or any other public function…out of
desperation because of a tight budget.” South Carolina has the opportunity to learn from
its own past mistakes and from the problems experienced elsewhere. It also has an
opportunity to examine effective and humane improvements that it and other state
governments have achieved that have modernized and made more efficient their prison
medical services without sacrificing quality or cost.
2

Introduction
South Carolina’s Department of Corrections, despite a previous costly, inefficient and
troubled experience with commercialized health care in a portion of its prison medical
services system, has announced that it will soon be privatizing all of its prison health care
services. This report documents the many problems—from seriously deficient services
provided to prisoners to cost over-runs and unpredictable, unstable contracting
arrangements—associated with privatized prison health services in South Carolina and
the nation at large.
The South Carolina Experience: It Didn't Work Then, Why Would It Work Now?
From 1986 to 2000, South Carolina contracted with Corrections Medical Services
[hereafter, CMS], a private corporation with a checkered record of providing
comprehensive health services—that is, medical and psychiatric care-- to prisons and jails
around the country. CMS’ contract with the Department of Corrections [hereafter,
SCDC] initially provided services to three prisons (Coastal Pre-Release Center, Lieber,
and MacDougall); by 1999, its contract covered ten facilities and it received $31 million
from the state in the two fiscal years ending in June, 1999.
As the South Carolina General Assembly’s Legislative Audit Council’s report, A Review
of the Medical Services at the SC Department of Corrections1, documents with great
clarity, the experience of privatized health care in the S.C. prison system was rife with
problems that ranged from medical care of very poor quality to failures of the Department
to exercise its mandated oversight responsibilities to cost over-runs and substantial funds
expended on services that were never provided. Some of the many serious deficiencies
documented in the audit were:
• A comparison of medication provision to chronically mentally ill inmates at a
SCDC operated prison and one run by CMS showed timely provision at a 92% rate
at the state run facility but only 54% at the one where CMS was responsible.
Further, CMS failed completely in its discharge planning responsibilities for the
mentally ill leaving prison: either there was no discharge summary at all or
summary documents were not sent to the agencies responsible for follow-up.2
• Mental health staff at both CMS and SCDC-run institutions did not meet
minimum requirements, but since CMS had contracted to employ appropriately
credentialed staff, it violated its agreement.3
• SCDC did not adequately monitor, with the result that CMS was not held
accountable for the services it was contracted to provide. For instance, there were
no behavioral health audits between July 1998 and May 1999, no medication audits
of 7 of 8 institutions where they were supposed to be done, and no re-audits of the
preponderance of institutions where a corrective plan was required. There were also
virtually no audits of SCDC-provided health care during FY 97-98 and 98-99.4
• SCDC did not monitor staffing levels at the facilities where medical services
were contracted and failed, through inadequate auditing, to ensure that contracted
health care was adequate.5
• In those situations in which audits were done, compliance rates were very low
(46% for medication delivery in one case).6
• An improperly executed contract by SCDC and its lax monitoring health care
delivery at levels far below contract specifications resulted not only in inferior
services to the incarcerated but also in fiscal loss to the state, perhaps running to
millions of dollars.7
3

The record of the CMS contract with the State of South Carolina is a dismal one, and
though it is clear that the state failed in its monitoring responsibilities, CMS nevertheless
complained that monitoring was “excessive and disruptive” in citing its reasons for
terminating its contract.8 This attitude is likely to prevail in any future privatized prison
health system and bodes ill for both sick prisoners and to the state’s taxpayers.
Paying More for Less
Privatized health care, despite being inadequate, is apparently also more expensive. As
an example, when state health regulators forced the SCDC to close five prison infirmaries
in January 2003, 20 prisoners were moved to the infirmary at Kirkland Correctional and
18 went to Columbia Care, run by a private health care corporation, Just Care Inc. of
Alabama. SCDC’s chief accountant, Bruce Burnett, was quoted as estimating that private
care would cost the state $20,000 more per prisoner per year. Two of Just Care’s top
officers were former employees of CMS, and the company had contributed $3,500 to
former Governor Jim Hodges’ re-election campaign.9
As will be demonstrably documented below, South Carolina’s bad experience with
commercialized prison health care is not unique. On the basis of its own experience, the
state and the SCDC should surely be extremely wary of repeating the experience. Indeed,
we must ask: why would the State and the Department even be considering privatization
again?
Experiences in Other States: A Costly Experiment That Has Failed
Bad Medicine
The U.S. Supreme Court has ruled that the 8th Amendment requires that the incarcerated
receive adequate health care, including mental health and dental care, and that these
requirements obtain whether the services are provided directly by the state or by
contracted medical personnel.10
Commercialized—often called “privatized”--prison health care has become a popular
development around the country. Companies have argued that it is a cost-saver for the
states and localities that employ it. But an examination of the record shows that this
method has been a disaster, not only for the incarcerated whose care has been precarious
at best and too often injurious at worst, but also to the responsible governments that have
been repeatedly sued, losing millions in damages awards and settlements. A review of
published investigations, newspaper reports and academic literature reveals that
commercialized prison health care is rife with abuse and malfeasance. There are
numerous examples of defective privatized care; we cite only a few examples.
An exhaustive 1998 5-month study “Death, Neglect and the Bottom Line: Push to Cut
Costs Poses Risks,” of the St. Louis-based, national corporation CMS revealed “a picture
of an industry that, at best, is still trying to find its way through the complex problems
posed by health care in a prison environment. At worst, it was a picture of an industry
that takes advantage of the public’s ill will toward people in prison to give poor care
while making a profit.” More than 20 cases of deaths through “negligence, indifference,
understaffing, inadequate training or overzealous cost-cutting” were cited.11 This report
also found that prison doctors include some who have been disciplined in the past, and
4

some of them are not allowed to practice on the general population; distant managers
make decisions based on the economic bottom line rather than on patients’ needs; health
personnel express attitudes that prisoners fake illnesses and consequently ignore
legitimate complaints; and medical records are altered to look like doctors have issued
orders when, in fact, nurses have.12
Hepatitis C is epidemic in the nation’s prisons, yet, according to another investigation of
CMS, which has responsibility for 214,000 prisoners throughout the country, “As a
matter of formal company policy, CMS discourages treatment for hepatitis, and the
[onerous] protocol pathway [imposed on prisoners who request help] is just a way of
making it harder for prisoners to demand it.”13 The same report cited examples of
prisoner deaths resulting from medical neglect or malfeasance on the part of CMS
doctors ranging from dehydration and starvation, discontinued insulin, and injection with
wrong medication.14
Yet another investigation of CMS, this one done by a former editor of the Journal of the
American Medical Association (JAMA) focused on the checkered backgrounds of some
of the doctors the company has employed. For instance, the writer found that 9 CMS
prison doctors in Missouri, or one in 4 of all CMS doctors in that state, had been
disciplined by licensing boards. This figure compared to one in 40 of the nation’s total of
689,000 physicians.15 In Alabama, CMS hired two “key” doctors with shady pasts: one
had had his license revoked in Michigan and the other had a history of sexual assault on a
minor, mentally retarded boy in Tennessee.16
A 2003 investigation noted that CMS had been cited the New York State Commission of
Correction’s Medical Review Board, as having “revealed numerous and significant
quality care issues, including violations of nursing practice rules, severe understaffing…a
resistance to oversight scrutiny and some severely problematic outcomes” (including 2
suicides) at the Broome County facilities where CMS had the contract. This news report
also stated that “The Commission questions whether Correctional Medical Services, and
other for-profit companies doing similar work in jails and prisons, can hire licensed
medical professionals to provide services to jail inmates because state law does not
authorize such activities.”17
CMS, as the nation’s largest prison health contractor, has logically been the subject of
many investigations. But it is not alone. For instance (and there are examples too
numerous to cite in this brief report), the August. 27, 2003 Decatur Daily (Ala) reported:
“Dozens of HIV-infected inmates have died prematurely and miserably due to grossly
negligent medical care at Limestone Correctional Facility.” The findings were in
conjunction with a lawsuit against the provider, NaphCare, and the state.18. A three-part
series on injurious health care provided by Prison Health Care [PHS] in Philadelphia’s
jails criticized DePaul Health Care, the contracted monitor, and cited instances of
suspicious deaths and failure to provide mental health care.19 PHS was also cited as
bearing responsibility for deaths in several county facilities in Florida.20
As for hiring practices, another company, ESMA Correctional Care, employed as a jail
psychiatrist in Westchester County, NY, a doctor who had served a sentence for killing a
college sophomore in a botched illegal abortion in the 1960s and then covering it up by
“cutting her up and flushing her down his toilet.” This “doctor,” Lothringer, took a 175

year old incarcerated young woman off anti-depressants, and she subsequently killed
herself. A lawsuit by the girl’s family resulted in a wrongful death settlement, the
company paying $700,000 and the employing county, $745,000.21
Finally, an exhaustive study of medical practices at an unnamed county facility that
contracted with three different private medical companies from 1992-1997 found “a
persistent pattern of medical ill-treatment…which extended over the entire five-year
period.”22
Law suits have remedied some medical abuses
Prisoners and their families have a hard time bringing lawsuits for medical malpractice
and wrongful death. Not only are they burdened by isolation and stigma, they must also
prove intention or “deliberate indifference.”23 Nonetheless, there have been numerous
successful lawsuits and judgments that have been costly to private prison health
companies and governments alike. Two such cases have been mentioned above. In
addition, North Carolina has prosecuted CMS for involuntary manslaughter stemming
from short-staffing resulting in an inmate’s death.24 In 1993, the U.S. Department of
Justice’s Civil Rights Division cited CMS for providing “grossly inadequate” care at
Virginia’s Norfolk County Jail; from 1981-1994, the company paid out $4.1 million in
indemnity claims, and in 1997, it had 500 suits pending against it throughout the
country.25 Prisoners in Youngstown, Ohio won a $1.5 million judgment against CMS for
a variety of medical care abuses, 26 and other suits against CMS and NaphCare have been
filed by the ACLU, the NAACP, the UAW representing public correctional officers in
Michigan, the Southern Poverty Law Center, and lawyers hired privately by prisoners’
families. The ACLU has also notified several state correctional departments about gross
deficiencies in privatized prison health care.27
Prison Health Services has settled several lawsuits in Florida, including one for $3
million bought by the family of an inmate who was beaten and then medically neglected
and another by a nurse who sued after being fired for refusing to falsify medical
records.28 PHS and its purchased company, EMSA Correctional Care, are facing over
1,100 lawsuits.29
Clearly, advocates for the incarcerated have recognized the many medical abuses they
have suffered, and lawyers have sought to redress their injuries in court. These lawsuits
have been costly not only to the medical corporations but also to the state, county, and
municipal governments that have hired them.
The Problems with Commercialized Prison Medical Services
The Bottom Line is What Counts
Contracted prison health care is just another form of HMOs, the increasingly dominant
form of health care delivery that is widely criticized by both professionals and
consumers. As one critic put it: “HMO systems have established a direct conflict
between the interests of patients and medical servers.”30 As in other aspects of privatized
incarceration, commercial prison health care seeks to make the greatest profits it can for
both its executives and its shareholders.31 Prison health care companies promise reduced
health care costs; the many articles and reports reviewed for this paper show that they
attempt to cut their costs by creating obstacles to care, hiring too few staff, employing
6

staff who are not licensed to practice on the general public (and thus will work for less
money) or unqualified or inexperienced staff, and skimping on medication (including
using expired medication). Prison health care in general is notoriously bad; it stands to
reason that when the private sector becomes the provider at reduced costs, the quantity
and quality of services decline. For example, the company hired to provide health
services to the Miami-Dade County Detention Center employed one doctor and one
nurse-practitioner for 1,800 inmates instead of the required staffing pattern of one doctor
or nurse-practitioner for 500.32
Hidden Costs of Privatized Prison Healthcare Are Substantial
Commercial prison health care also incurs additional costs to the state, including
administrative costs associated with procuring and administering contracts, monitoring,
and legal fees and settlements associated with litigation. For example, when Albany
County (NY) privatized its jail’s medical services, county officials asked for a doubling
of insurance protection “in case the county is sued for improper medical care at the
jail.” 33
An additional problem is paying for overcharges, some of which are undoubtedly never
uncovered because of lax monitoring. In Massachusetts the state auditor accused EMSA
of $1.5 million in overcharges by inflating the numbers or AIDS patients in an 18-month
period in the early 1990s.34 In Florida, PHS is currently under investigation by the
Florida Attorney General’s Office for $3.25 million in Medicaid overcharges.35
Finally, many press reports comment on the apparently common practice of switching
providers, a practice that undoubtedly incurs additional administrative costs and wasted
funds as health records and prescriptions are duplicated and medical personnel are
changed.
When the Going Gets Tough: Commercial Providers Are Unreliable
Private prison health companies are known to renege on their contracts when costs
exceed their contracted reimbursement rates. For instance, early this year, Corrections
Corporation of America [CCA], which had a contract with the state of Nevada to run the
Women’s Correctional Facility, sought to get out of its contract unless the state took over
the medical care that the company deemed too expensive. CCA claimed it couldn’t find
qualified staff locally, although it had claimed, when competing for the contract, that it
would have less difficulty than the state in attracting medical personnel.36 In
Pennsylvania, Wexford Health Services, Inc. pulled out of its five-year contract with the
state one year after its initiation, citing growing costs and hoping to negotiate a more
lucrative contract. 37
In this regard, South Carolina’s own previous experience is instructive. CMS had a 2year contract to provide medical and mental health services to prisoners in 10 of the
state’s facilities. In April, 1999, three months before the contract was up for renewal,
CMS announced that it did not want to renew the contract. Until January 31, 2000, CMS
continued, on a month-to-month basis, providing services while the state sought,
unsuccessfully, for another provide vendor. The SCDC assumed all medical services in
February 2000. 38

7

Some Governments Have Rejected Private Providers
Several jurisdictions are becoming disillusioned with commercialized prison health
services, and they have found alternative ways to economize on prison health care. In
2003, Utah contracted with a prison privatization expert to evaluate whether or not to
contract its health services. The consultant recommended against privatization,
concluding that the state was already running its system comparatively efficiently.39
In January 2004, a legislative panel in Alabama blocked three state contracts with
medical contractors (providers and monitors). The reasons included that contracts are too
costly in a time of budget problems; they were agreed to two months before being
properly submitted to lawmakers for review; the contracts were struck without an open
bid process; and contractors were from out of state.40 In February of this year, the sheriff
in Leon County, Florida threatened to discontinue PHS’ contract for medical services
because of persisting complaints about the quality of care.41
Hard Questions, Uneasy Answers
South Carolina has already had a bad experience with commercial prison health care, and
there is no doubt that it has wasted many thousands of dollars on shoddy care to its
prisoners. Instead, this money could have been spent on better, state-provided health
services and on vigilant monitoring to assure those services were, in fact, being given.
The sorry experience that other states have had with privatized prison health care should
be caution enough to halt the drive toward re-privatizing South Carolina’s system.
Indeed, we agree with a recent editorial in The State which cautioned: “…officials should
not rush to privatize health care at prisons—or any other public function…out of
desperation because of a tight budget.”42 South Carolina has the opportunity to learn
from its own past mistakes and from the problems experienced elsewhere. It also has an
opportunity to examine effective and humane improvements that it and other state
governments have achieved that have modernized and made more efficient their prison
medical services without sacrificing quality or cost.
ABOUT THE AUTHOR: Marguerite Rosenthal is a Professor of Social Work at Salem
State University in Salem, Massachusetts. She holds a Ph.D. in Social Work and Social
Welfare from Rutgers University. She has received awards and grants from the National
Institute of Mental Health, the National Association of Social Workers and the U.S.
Department of Health and Human Services. Early in her career, she served as a juvenile
probation officer with the Onondaga County Probation Department in Syracuse, New
York. She has published and presented widely on issues of social policy, privatization,
managed care, welfare reform, residential care, juvenile corrections and faith-based
initiatives. She is currently serving as Senior Research Fellow for Grassroots Leadership
while on sabbatical from Salem State University.

8

References
1.
South Carolina General Assembly, Legislative Audit Council (2000). A review of
the medical services at the SC Department of Corrections. Summary. Retrieved from:
http://wwww.state.sc.us/sclac/Reports/20000/SCDS.htm on 3/31/2004 and Full Report
(LAC/SCDC-98-7), retrieved at http://wwww.state.sc.us/sclac/Reports/20000/SCDS.htm
on 4/1/2004.
2.

Full Report, pp. 28-29.

3.

Full Report, p. 31.

4.

Full Report, p. 3. 14 and 20.

5.

Full Report, p. 3.

6.

Full Report, p. 15.

7.

Full Report, pp. v-vi, 13-19, and 26.

8.
Catoe, W.D., (March 14, 2000). “Response to LAC Review of Medical Services
at the South Carolina Department of Corrections. retrieved at
http://wwww.state.sc.us/sclac/Reports/20000/SCDS.htm on 4/1/2004.
9.
The Post and Courier (Jan. 27. 2003). “Corrections closes 5 prison infirmaries.”
Retrieved at http://wwww.charleston.net/cgi-bin/printme.pl on 3/31/2004.
10. Estelle v. Gamble, 429 U.S. 97, 103 (1976); West v. Atkins, 487 U.S. 42, 57-58
(1988); Richardson v. McKnight, U.S. 399, 117 S. Ct. 2100 (1997). See Rountree, M.M.
(March 31, 2003). ACLU of Texas, “White Paper Regarding Privatizing Texas
Department of Criminal Justice Facilities and House Bills 1480, 1669, 1852, and 2190.
Retrieved at
http://www.ACLU%TX%202003%20Leg%20Agenda%20includes%20med.htm on
3/27/04.
11. Allen, W. and Bell, K. (September 27, 1998). “Death, Neglect and the Bottom Line:
Push to Cut Costs Poses Risks.” St. Louis Post-Dispatch. Retrieved at
http://www,wrongfuldeathinstitute.com/links/articles/prisonarticle.html on 3/27/04.
12.

Ibid.

13. Hylton, W.S. (2003). “Correctional HMOs and the Coming Prison Plague.”
Harper’s Magazine (August).
14.

Ibid.

15. Skolnick, A. and Bell, K. (Sept 27, 1998). “Prisoner, doctor who treated him, both
had drug arrests.” St. Louis Post-Dispatch. Retrieved at
http://www.aaskolnick.com/baddoc3.htm on 3/29/2004.
9

16. Skolnick A. (Sept 27, 1998). “Two key posts in Alabama were filled by doctors
with checkered histories.” St. Louis Post-Dispatch. Retrieved at
http://www.aaskolnick.com/baddoc1.htm on 3/29/2004.
17 Goodman, J. (November 21, 2003). “Jail med firm challenged.” Democrat and
Chronicle (Rochester, NY). Retrieved at
http://www.democratandchronicle.com/news/forprint/1121R82E6SU/
Prisonhealthnews.s on 3/29/2004.
18. Fleischauer, E. (August 27, 2003). “Poor prison care causes HIV deaths, report
says.” The Decatur Daily, Alabama. Retrieved at
http://www.patrickcrusade.org/HIV_deaths.html on 3/29/2004.
19. Shaffer, G. (August 23, 2001). “Cruel and Unusual, part 3: Inmates say city prisons
provide dangerously shoddy medical care.” City Paper. Retrieved at
http://citypaper.net/articles/081609/cs.coverstory3.shtml on 3/29/2004.
20. Boulton, G. (March 17, 2004). “Prison Health Contractor Grows Quietly.” Tampa
Tribune. Retrieved at http://health.tbo.com/health/MGAUCZ7WWRD.html on
3/29/2004.
21. Skolnick, A. A. (Sept 27, 1998). “Physicians with troubled pasts have found work
behind bars.” St. Louis Post-Dispatch. Retrieved at
http://www.aaskolnick.com/baddoc1.htm on 3/29/2004.
22. Vaughn, M.S. and Smith, LG. (1999). Practicing Penal Harm Medicine in the
United States: Prisoners’ Voices from Jail.” Justice Quarterly 16(1) (March), p. 219.
23. Hylton, W.S. (2003). “Correctional HMOs and the Coming Prison Plague.”
Harper’s Magazine (August); Vaughn, M.S. and Carroll, L. (1998). “Separate and
Unequal: Prison versus Free-World Medical Care.” Justice Quarterly 15 (1) (March),
pp. 8-12.
24. Suhr, J. (May 26, 2000). “Union Sues over State’s Privatizing Prisoner Medical
Care.” The Associated Press State & Local Wire (Detroit).
25. Allen., W. and Bell, K. (September 27, 1998). “Business is Booming for CMS due
to States’ Efforts to Cut Costs and Lots of Inmates” St. Louis Post-Dispatch G4.
Retrieved at http://groups.yahoo.com/group/workersdemocracy/message/876 on
4/1/2004.
26.
Rountree, M.M. (March 31, 2003). “White Paper Regarding Privatizing Texas
Department of Criminal Justice Facilities and House Bills 1480, 1669, 1852, and 2190.”
p. 6. Retrieved at
file://A:\ACLU%20TX%292993%20Leg%Agenda%20includes%20med.htm on
3/27/04.

10

27. Associated Press (January 6, 2004). “Substance Abuse, Mental Illness Top
Prisoner Complaints.” Maine News. Retrieved at
http://news.mainetoday.com/apwire/D7VTF6HO0-5.shtml. on 3/29/2004. Berkowitz. B.
(November 6, 2001). “Murder Incorporated: Profits from Privatized Prison Health Care.”
AlterNet. Retrieved at http://www.alternet.org/story.html?StoryID=11870 on 3/27/2004;
McNamara, E. (September 7, 2003). “A Back-Page Prison Death.” The Boston Globe;
Hodges, S. (May 3, 2003). “DOC ends NaphCare contract.” Mobile Register. Retrieved at
http://www.patrickcrusade.org/NAPHCARE_CONTRACT.html on 2/21/2004; Paul, E.
(April 5, 2000). “Doctors fighting state’s plan to privatize prison health care.” Lansing
State Journal.
28. Boulton, G. (March 17, 2004). “Prison Health Contractor Grows Quietly.”
Tampa Tribune. Retrieved at http://health.tbo.com/health/MGAUCZ7WWRD.html on
3/29/2004.
29. McLachlin, M. (March 22, 2004). “Jail Medical Firm Under Fire: Ex-Inmate Says
Neglect Behind Bars Left Him Blind. Palm Beach Post.
30. Herman, E. (1997). “Privatization: Downsizing Government for Principle and
Profit.” Dollars and Sense 212 (July-Aug). Retrieved at
http://www.thirdworldtraveler.com/Third_World_US/Privatization_DS.html on
3/29/2004.
31.
For the many problems associated with privatized prisons, see generally Mattera,
P., Khan, M. and Nathan, S. (2003). Corrections Corporation of America: A Critical
Look at its First Twenty Years. Charlotte, NC: Grassroots Leadership.
32. Rhor, M. (March 10, 2002). “Inmate medical service: troubles aplenty; Provider
BSO has spotty record.” The Miami Herald.
33.
Martineu, K. (November 24, 1999). “Privatization of jail infirmary advances.”
The Times Union.
34. Allen, W. and Bell, K. (September 27, 1998). “Death, Neglect and the Bottom
Line: Push to Cut Costs Poses Risks.” St. Louis Post-Dispatch. Retrieved at
http://www,wrongfuldeathinstitute.com/links/articles/prisonarticle.html on 3/27/04.
35. McLachlin, M. (March 22, 2004). “Jail Medical Firm Under Fire: Ex-Inmate Says
Neglect Behind Bars Left Him Blind. Palm Beach Post.
36.
Vogel. E. (January 29, 2004). “CCA seeks help to pay medical care for inmates.”
Review-Journal. Retrieved at http://www.reviewjournal.com/Ivrj…home/2004/Jan-29Thu-2004/news/23101579.html on 3/29/2004.
37. Ransom, L. (June 7, 2003). “Wexford ends inmates’ health care contract.”
Pittsburgh Tribune-Review. Retrieved at http://www.pittsburghlive.com/x/tribunereview/yesterday/print_138547.html on 3/9/2004.

11

38.
South Carolina General Assembly, Legislative Audit Council (2000). A review
of the medical services at the SC Department of Corrections. Full Report (LAC/SCDC98-7), , pp. 4-5. retrieved at http://wwww.state.sc.us/sclac/Reports/20000/SCDS.htm on
4/1/2004.
39.

(July 21, 2003). “Care for prisoners.” Salt Lake Tribune.

40. Barrow, B. (January 9, 2004). “Prison medical contracts blocked.” Mobile
Register. Retrieved at
www.al.com/news/mobileregister/index/ssf?/base/news/1073643352129560.xml on
3/29/04.
41. A Tallahassee Democrat Editorial (February 17, 2004). “Privatization Pickle:
Spotlight on Jail Health Services Firm.” The Tallahassee Democrat.
42. Editorial (March 26, 2004). “Officials must not rush to privatize prison health care.”
The State.

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