NEW YORK CITY — State investigators admonished the medical provider for New York's jails and prisons on four separate occasions after Rikers Island inmates in its care died — yet government officials still repeatedly renewed its contract, DNAinfo New York has learned.
The New York State Commission of Correction, which is responsible for setting and overseeing standards for the state's correctional facilities, ordered the provider, Corizon, to review its treatment practices four times between 2010 and 2012, each time prompted by a different inmate death, according to records obtained by DNAinfo under a Freedom of Information Law request.
Yet during the same period of time, the Tennessee-based private prison healthcare company, which formerly operated at Rikers under the name Prison Health Services, won two new contracts from the city's Department of Health and Mental Hygiene, which oversees Rikers healthcare, to provide mental health and physical health care to the more than 11,000 inmates, records show.
On Aug. 5, 2009, an inmate died, sparking a yearlong investigation that ended with a state order in December 2010 calling for Corizon to review its mental health diagnoses and group therapy practices, according to documents filed with the Mayor's Office of Contract Services.
Another inmate died in October 2009, sparking an investigation that concluded with a state order for the company to launch a “comprehensive quality improvement review” of treatment of acutely suicidal patients.
In August 2010, a third inmate died, sparking a probe that led to an order for the company to work with the city's departments of Health and Correction to evaluate the circumstances that led to patients no longer receiving their medications and why some patients weren't brought to their medical appointments.
And in February 2011, after a fourth inmate died in Corizon's care, an investigation led to an order for the company to fix its psychotropic medication administration process as well as review its pharmacists’ qualifications.
But in January 2011, after the first investigation had already concluded and the second was underway, the Department of Health granted Corizon a $67.6 million, two-year contract extension instead of issuing a general request for alternatives.
It awarded Corizon another a three-year contract in January 2012 after the first three investigations had concluded, records show.
Insiders said that while officials had been deeply concerned about Corizon's quality of care for years and had tried to work with local hospitals to take over the Rikers health care contract, they were forced to remain with the company because none of the hospitals were interested.
According to Louise Cohen, who oversaw the Health Department’s bidding process as deputy commissioner between 2004 and 2007, the department wanted to replace Corizon and tried to attract other bidders. But no major city hospitals or community organizations stepped forward.
The department even offered to divide the Rikers contract into smaller, more manageable clinics, offering, for example, the women’s facility to organizations that work with women, she said. But still there were no takers.
"Discussions were held between high-level officials at the NYC Health Department and a number of the largest NYC hospitals and health centers to encourage them to respond to every RFP for health services for people incarcerated in city jails issued since 2004," Cohen said.
"In spite of this, there were no large NYC health centers or hospitals who responded in the, at least two, RFP processes since 2004."
In the past, New York hospitals St. Barnabas and Montefiore had held the contract, she said.
The city's Department of Correction did not respond to requests for comment.
The city Department of Health did not respond to requests for comment.
The New York State Commission of Correction declined to comment.
Corizon did not respond to a request for comment on the reviews or the findings.
Rikers and the Department of Correction, which does not oversee health care at the jail, have come under threat from federal investigators in recent months for not responding quickly enough to address problems at the massive jail complex, including evidence of widespread violence and abuse against its youngest and most vulnerable inmates.
U.S. Attorney Preet Bharara warned Rikers administrators and Mayor Bill de Blasio on Monday that they had not done enough to address concerns raised by his office, which he said is "ready to take legal action to compel long-overdue reforms at Rikers, if that becomes necessary to get the job done."
Corrections commissioner Joseph Ponte has brought in the corporate consulting firm McKinsey to evaluate the department and suggest reforms.
Bharara's report is the latest to document ongoing failings at Rikers. In 2013, a team of psychiatrists from New York University and Yale sent a report to the state Board of Corrections showing Corizon was continuing to fail at reforms ordered by the state, such as group therapy practices and treatment plans.
City Councilman Corey Johnson introduced a bill demanding information on the quality of health care at the city's jails in August, giving the city until April 2015 to reveal the history of Corizon investigations.
And the American Civil Liberties Union and the Southern Poverty Law Center are suing the company in Arizona and Alabama for giving substandard care to inmates there.
Corizon mental health workers, speaking on condition of anonymity, said even under the increasing scrutiny, treatment at the facility remains substandard. They said a large part of the problem is that Corizon administrators reward good paperwork instead of good treatment.
"It's all based on how the record looks," said one Rikers mental health worker, speaking on condition of anonymity for fear of retaliation from management. "Some clinicians care, but not because it's part of the culture."