Audit ABCs

State starts prison health evaluation.

At the behest of the Legislative Finance Committee (LFC), two correctional health experts have launched an extensive audit of the medical care in New Mexico’s state prisons.

SFR has learned that Dr. Steve Spencer and Dr. B Jaye Anno were hired late last month by the LFC to evaluate the level of medicine provided to state inmates. Their work is part of a larger audit the Legislature is conducting of the New Mexico Corrections Department (NMCD), slated for conclusion this spring.

“We needed medical expertise in our audit, because up until now we haven’t had any,” Manu Patel, the LFC’s deputy director for audits, says. “This way, it’s not just us second-guessing the Corrections Department. We can actually get a sense of what’s working and what isn’t.”

Patel says the contract with Spencer and Anno is worth approximately $21,000.

The health care component to the Corrections audit follows a six-month investigation by SFR into Wexford Health Sources, the private company that administers medical care to state inmates [Cover story, Aug. 9, 2006: “Hard Cell?”]. The investigation led to a request for the audit by the state Legislature’s Courts, Corrections and Justice Committee last October [Outtakes, Oct. 25, 2006: “Medical Test”].

SFR’s series also compelled Gov. Bill Richardson to terminate the state’s contract with Wexford in December, a process that will likely take until June, when the prison medical contract is up for renewal [Outtakes, Dec. 13, 2006: “Wexford Under Fire”].

Regardless of Wexford's fate, the LFC is pressing ahead with the audit.

"We are looking at this serving a long-term benefit to the Corrections Department, so that we can all better evaluate the medical program in the prisons and its services," Patel says.

Spencer, a former medical director of NMCD, and Anno, who co-founded the National Commission on Correctional Health Care, started work on Feb. 5, when they traveled to Lea County Correctional Facility in Hobbs.

"We're going to look at a number of things when we travel to the sights," Spencer says. "We'll look at the adequacy of staffing, the appropriateness of care, the timeliness and use of off-site specialists. We'll review inmate deaths and whether Corrections is adequately monitoring the contractor."

Moreover, the medical audit will involve a review of the contract between Wexford and the Corrections Department, as well as sifting through tuberculosis, HIV and other medical testing data. Various medical personnel will also be interviewed throughout the process, Spencer says.

Inadequate tuberculosis testing, chronic staffing shortages and a systemic failure to send inmates off-site have been among the concerns raised to SFR by former and current Wexford employees [Outtakes, Oct. 18, 2006: “Corrections Concerns”].

In an e-mail, Wexford Vice President Elaine Gedman said, in part, that Wexford plans to cooperate with the audit and is confident its outcome will be positive. She also said Wexford is cooperating with NMCD for a smooth transition.

NMCD spokeswoman Tia Bland tells SFR that Corrections is still working on a request for proposal, set to go out in March, that will kick off the agency's search for a new medical provider.

"We're providing [the auditors] with whatever they need, and whatever the results are, we'll use that information to our advantage in working with the next vendor," Bland says. Bland reiterates NMCD's contention that Wexford violated the terms of its contract with the state because of staffing problems. She says Corrections is still analyzing whether Wexford broke other contractual stipulations.

During the mid-1990s, Spencer and Anno were hired by the Wyoming Department of Corrections to conduct medical audits of its prisons. Wexford, which administered health care for the Wyoming DOC, eventually became embroiled in a US Justice Department investigation regarding prison health care in that state and lost its contract.

Recalls Anno: “There were a number of problems with Wexford’s operation in Wyoming.”

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