County OKs privatizing inmate medical service; doctor cries foul

LACONIA — The cost for providing medical services for inmates at the Belknap County Corrections facility will be more stable and liable to fewer cost overruns under a contract with a correctional healthcare firm approved by the Belknap County Commission.

But Thursday’s decision to award the contract to Pennsylvania-based PrimeCare Medical Inc. drew criticism from a doctor who currently provides physician services for inmates. The doctor, Christopher Braga, said his firm was not given a reasonable opportunity to submit its own bid to provide full medical services.

With the new contract taking effect on June 15, Corrections Superintendent Adam Cunningham estimates that the total medical costs for the year will total $699,998. That is about $20,500 higher than the projected cost if the department had remained with the current medical services arrangement, and $55,224 more than the amount authorized for medical expenses in the budget.

In a previous meeting, Cunningham told commissioners that by privatizing healthcare services the county would be better able to control costs because there would be fewer unanticipated expenses for medical care.

But in a memo he presented to the commissioners Thursday he cautioned that the cost projections under the new contact do not take into account any “increases to the inmate population, unexpected medical expenses, or outstanding billings (charges for medical services already provided but for which no invoices have so far been submitted to the county for payment).

Currently, the Corrections Department has a bifurcated system of health care. It employs two nurses as well as a head nurse, and it contracts with American Institutional Medical Group of Manchester to provide doctor care. American Institutional has provided the physician services for the past 11 years, according to Braga, a co-owner of the practice.

Braga told commissioners his firm was given two weeks to submit a bid to provide a comprehensive services proposal, significantly less time, he said, than PrimeCare had to draw up its proposal.

“We were not given ample time to come up with a revised proposal,” Braga said later in the meeting, after the commissioners had already approved the PrimeCare contract. “We just want a fair opportunity to make a competitive bid.”

He said his company only “found out through the grapevine” that the Corrections Department was in conversations with PrimeCare.

Braga further alleged that PrimeCare’s level of service is inferior.

“The care is poor, I’ve witnessed it firsthand,” he said.

Commission Chairman Peter Spanos told Braga that the commission approved the contract because it had full confidence in Cunningham’s leadership.

“You were given two weeks (to submit the proposal). I’m sorry it wasn't enough time,” Spanos said. “We’ve made our decision.”

Cunningham has said the major problem with the current arrangement has been the inability to have consistently adequate nursing coverage at the facility. He said the current staff of three nurses does not provide for coverage when nurses are either on sick leave or vacation. He said last year the Corrections Department was without nurse coverage for 1,100 scheduled hours. So far this year the facility has been without nurse coverage for 366 hours, he said in a memo to the commission.

At the meeting he told commissioners that, because of the lapses in coverage, corrections officers have sometimes been required to distribute medications to inmates.

“That’s a lawsuit waiting to happen,” Commissioner Hunter Taylor said. “We have little choice but to go down this route” of privatization.