The city of New Orleans has put out a request for proposals for companies interested in providing healthcare services for the nearly 1,000 people detained in the city’s jail on any given day — a task that has long been the subject of scrutiny and criticism from court-appointed monitors, civil rights attorneys, and people incarcerated at the facility.
Since 2014, healthcare at the jail has been provided by the largest correctional healthcare company in the country, Nashville, Tennessee-based Wellpath (formerly known as Correct Care Solutions), which has faced criticism around the country for substandard care and cost-cutting at the expense of providing necessary services.
In New Orleans, Wellpath has been named in several wrongful death suits filed by families of individuals that have died in custody at the Orleans Justice Center — including that of Colby Crawford, a 23-year-old diagnosed with schizophrenia, bipolar disorder, and substance use disorder, who died of a drug overdose at the jail. A lawsuit filed by Crawford’s mother claimed that healthcare workers at the jail failed to respond to Crawford’s deteriorating mental state, and refused to place him on a psychiatric tier despite his request.
That lawsuit, like several others where the company and the Sheriff’s Office were named as defendants, was settled out of court.
More recently, however, Wellpath has partnered with Tulane University to provide psychiatric care at the facility, and federal monitors — appointed by a judge as part of the jail’s eight-year-old consent decree — have noted some improvements in provision of care overall since the contract began.
Bids are due in early December. In a statement to The Lens, Kip Hallman, the president of Wellpath suggested that the company would be seeking to remain the provider at the jail, and are using the RFP as an opportunity to rethink their contract and their relationship with the Sheriff’s Office.
“With the unprecedented changes that the COVID pandemic has brought to the healthcare field, RFP opportunities like this one give all bidders a chance to demonstrate to our government contract partners how contracts must change and adapt to such changing conditions,” Hallman said. “For example, nursing and other healthcare providers’ compensation has increased markedly during the past two years, and so we believe that the RFP is an opportunity work with OPSO to ensure that we have the opportunity to attract and retain the dedicated frontline workers who are at the core of our business.”
Records show that two Wellpath representatives attended a mandatory pre-submittal conference for the RFP. Neither the city, nor a spokesperson for the company, responded to questions from The Lens regarding whether or not the company has submitted a proposal yet.
Initially, the Wellpath contract was managed by the Orleans Parish Sheriff’s Office, but in 2016 was taken over by the city. Since that time there have been several extensions, and in 2019 the city signaled that it would attempt to secure a “long-term” deal with Wellpath.
But in late September of this year, the city put out a request for proposals for the contract.
A spokesperson for the city said that it was necessary due to laws requiring it to open up public bidding for any contract that has been extended for five years. But the spokesperson also suggested that Chief Administrative Officer Gilbert Montaño had the authority to approve an indefinite extension of the contract beyond the five years if he desired. It is unclear where that authority comes from, however, and the spokesperson did not respond to follow up questions from The Lens.
“The original agreement between the City and Wellpath (then CCS) was effective in March 2016 and thus this five year period elapsed this past March,” the spokesperson said. “The CAO approved an exception to allow for continuity of operations while the City went through a public RFP process, but has not approved an open-ended exception that would allow the contract to be extended indefinitely with no public competition.”
The submission deadline was initially Nov. 24, but has been moved back to Dec. 8 due to “the volume of questions received from interested vendors,” according to a spokesperson for the city. A document attached to the RFP includes a list of vendor-submitted questions and answers from officials.
According to the RFP, the contract services “shall be comprehensive, and shall include, but not be limited to, medical, mental health, and dental services.”
“The goals are to provide comprehensive care and treatment starting at intake and being maintained throughout the incarceration,” the request reads. “The services are to be designed with the objective of improved health care outcomes and to address the health care needs of Detained Persons as they are prepared for re-entering society.”
Sheriff Marlin Gusman, who will be facing a runoff election against former Independent Police Monitor Susan Hutson in December, said in a statement to The Lens that his office “worked closely with the City administration to draft the RFP” but that “it would not be appropriate to comment during the proposal/RFP review period.”
But in a Tuesday interview with Newell Normand on WWL radio, Gusman praised Wellpath, saying that his office had developed a “lockstep” relationship with the medical provider while navigating the COVID-19 pandemic at the jail — during which there were significant outbreaks among both detainees and staff.
“We really bonded a whole lot more during this period where, you know, everybody had to be vaccinated — the medical staff as well as the security staff and all of the deputies,” Gusman said. “We had to make sure that we vaccinated as many of the inmate residents here as possible.”
He said that the jail had vaccinated “917 people that are in our custody.”
“Those kinds of things can only happen when you have, you know, a good close working relationship,” Gusman said.
Gusman’s handling of the pandemic in the jail has elicited praise recently from federal judge Lance Africk, who oversees the jail’s consent decree. At a recent court hearing Africk called the sheriff’s efforts “remarkable” and “nothing short of life saving.”
‘Community leadership and community outcry’
Hutson, however, has made ending the contract with Wellpath one of the key components of her election campaign. She has proposed that the jail should “instead partner with public health organizations to provide medical care.”
“The issue isn’t with the contract, but with the care that’s been provided,” Hutson told The Lens on Tuesday.
In their most recent consent-decree progress report, jail monitors found that while there was “continuing positive progress with Tulane’s interface with Wellpath … the provision of adequate and timely mental health and medical care and services has declined, as has compliance with suicide prevention training, management, and monitoring.”
“Wellpath continues to have difficulty with counting, for example, calculating the total mental health caseload consistently and counting the number of patients with acute and chronic disease who need and receive counseling, and tracking discharge medications,” the report reads.
The privatization of healthcare in correctional facilities across the country has become more common in the last several decades, and an October 2020 report from Reuters estimated that over 60 percent of jails in the U.S. utilize private companies to provide health care.
But that same report found that between 2016 and 2018, jails with private health care contractors had higher rates of death that those who utilized government agencies to provide services.
Hutson said she hoped that healthcare agencies already providing care in New Orleans would bid on the contract for the jail.
“We want people who provide care in a community, because again, we want them to be able to provide that care when people leave the jail,” Hutson said. “We want them to be subjected to community leadership and community outcry if they don’t provide proper care.”
The city spokesperson said that the city itself “does not have the capacity to provide the services internally,” but that “the City and OPSO have considered all available options to ensure we continue to meet the appropriate standard of care regarding OPSO inmates.”