By ESTEBAN PARRA and LEE WILLIAMS
The News Journal
10/21/2005
The Department of Correction's former medical provider owes nearly $1 million to St. Francis Hospital and late last month other state health care providers were boycotting the department's current provider because of past-due bills, according to documents obtained by The News Journal.
The unpaid medical expenses were run up by First Correctional Medical of Arizona, which held the contract to provide inmate health care in Delaware prisons from 2002 until July. The firm's owner and founder, Dr. Tammy Kastre, did not return calls for comment.
Delaware taxpayers may be asked to pay the prison's delinquent bills, state Auditor R. Thomas Wagner Jr. said.
"The fact that the government is stiffing the public bothers me greatly," said Wagner, who is considering an audit of medical spending by the DOC.
The $1 million owed to Wilmington's St. Francis was disclosed in the minutes of the DOC's Medical Review Committee, which is composed of correction officials and private medical providers.
"The fact that the government is stiffing the public bothers me greatly," said Wagner, who is considering an audit of medical spending by the DOC.
The $1 million owed to Wilmington's St. Francis was disclosed in the minutes of the DOC's Medical Review Committee, which is composed of correction officials and private medical providers.
"Per St. Francis FCM owes them close to one million dollars and St. Francis' perception is that the DOC owns part of this problem and is not willing to go forward with [Correctional Medical Services] in this agreement with [the Department of Health and Social Services] until this matter gets resolved," the minutes state.
The committee last met Sept. 22, three days before The News Journal published a six-month investigation highlighting AIDS-related inmate deaths and suicides over the past four years; allegations by inmates of poor medical treatment for cancer, meningitis and hepatitis; and a no-bid $25.9 million contract awarded this year to St. Louis-based Correctional Medical Services to manage health care in the state's prisons, replacing FCM.
Prompted in part by the newspaper's series, the U.S. Department of Justice's Civil Rights Division has launched a preliminary inquiry into the Department of Correction's management and inmate health care.
Kate Bailey, Gov. Ruth Ann Minner's spokesperson, referred questions about the unpaid bills to the DOC. Department spokeswoman Beth Welch did not know why St. Francis believes the hospital is owed $1 million or why the committee's minutes would suggest the hospital accused the DOC of dragging its feet.
"I'll have to look into that," she said.
Correction Commissioner Stan Taylor has claimed the DOC does not owe money to any medical vendor.
"This has not changed," Welch said Thursday. "I'm not sure exactly why St. Francis thinks we owe them."
According to the minutes, CMS regional manager Mike Hooper told members of the committee the company is having difficulty contracting "with a number of providers in the community ... [and would] provide an updated list of vendors refusing to sign with CMS due to FCM."
Welch disputed accounts by the DOC's medical committee that other vendors are unwilling to treat inmates because of FCM's delinquent bills.
"I don't believe we're finding that to be the case," she said.
She did not know if the DOC plans to put stricter financial controls in place with CMS.
"I'll have to get back to you on that," she said.
When Delaware inmates require advanced medical care or tests they are transferred to local hospitals, including Kent General, Beebe and St. Francis. The DOC's medical provider is supposed to pay for the inmate's hospital care.
But a number of former inmates say they have recently been billed for medical care they received while in the custody of the Department of Correction.
In an e-mail, Welch wrote: "The DOC continues discussions with sub-vendors to identify the amounts of outstanding medical bills and reconcile the issue. The DOC is working with the Attorney General's Office, the Budget Office and FCM to resolve this issue. While the outstanding obligations are the responsibility of First Correctional Medical, the DOC will continue to work with all parties to reconcile outstanding disputes."
The murky debts
Ken Fields, spokesperson for CMS, could not provide specific figures about how much is owed by FCM.
"I understand that has been a topic of concern for some potential providers," he said.
Mark Thompson, spokesman for St. Francis, would not confirm the amount FCM owes his employer. "It's in the reconciliation process," Thompson said. "We're going through financial records to determine the amount owed for various services. We're trying to work pro-actively. We are trying to work with the DOC and Medicaid to get these numbers -- whatever they are -- resolved."
Kent General Hospital representative Carol Candor, confirmed FCM owes them money, but "it's not as much as you report that they owe St. Francis." Candor said Kent General has not signed a contract with CMS, but they are in negotiations.
Sharon Harmon, Beebe Medical Center's director of public relations, said the Lewes hospital accepts inmates from Sussex Correctional Institution. However, she would not disclose the amount owed by FCM, if any. Kent and St. Francis also continue to accept inmates for treatment, despite the financial disputes.
Jay Lynch, spokesman for the Delaware Department of Health and Social Services said DHSS owes nothing to St. Francis or any vendor. Lynch and the department's Medicaid director checked the accounts back to 2003.
"The day they started billing, we started paying," Lynch said.
DHSS, Lynch said, is collaborating with CMS and the Department of Correction.
"We are helping the DOC get their bearings straight with the new provider," he said.
Closed audit report
Taylor and the Delaware Attorney General's Office have blocked the public release of a recent audit by the National Commission on Correctional Health Care -- the group that has accredited health care in Delaware prisons, and is highly touted by Taylor and Minner as the guarantor of effective prison medical care.
But Taylor and state attorneys contend the accreditation report is not a public document.
On Thursday, the state auditor said he will ask the DOC for the report.
"If nothing else, it's a good document to learn about the bottom-line of prison health care," Wagner said.
Sen. Charles L. Copeland, R-West Farms, one of the founding members of the Delaware Coalition for Prison Reform and Justice, said he was "pleased to see that Tom Wagner is going to take a look at this."
Contact Esteban Parra at 324-2299 or eparra@delawareonline.com. Contact investigative reporter Lee Williams at 324-2362 or lwilliams@delawareonline.com.
