In 2011, the State of Illinois signed a 10-year, $1.36 billion contract with Wexford Health Sources, a for-profit company, to provide medical services to Illinois prisoners. Since the contract went into effect there have been numerous complaints concerning the level of medical care that prisoners are receiving – or rather not receiving. In fact, more than 170 federal lawsuits have been filed against Wexford by Illinois prisoners since the company’s contract was announced in September 2011.

The relationship between the Illinois Department of Corrections (IDOC) and Wexford has been in the spotlight before. Six years ago, former IDOC director Donald Snyder pleaded guilty to accepting $50,000 in bribes from lobbyists, including a lobbyist for Wexford. He was sentenced to 24 months in federal prison; Wexford was not implicated in the bribery scandal. [See: PLN, March 2009, p.50; Dec. 2007, p.40].

Last year the John Howard Association, a prison watchdog group, released a report which found that Wexford had never been audited prior to the $1.36 billion contract award and that no one is currently reviewing the quality of care the company provides to Illinois prisoners.

The report recommended a number of remedial actions, including increasing external oversight of prison healthcare services; improving medical records and data collection and sharing; increasing availability of substance abuse treatment within IDOC facilities (and as an alternative to incarceration); abolishing or modifying the co-pay system for prison medical care; increasing bi-lingual staff and improving access to services, particularly healthcare services, for Spanish-speaking prisoners; instituting opt-out HIV and hepatitis C testing at IDOC reception and classification centers; and providing HIV and hepatitis C treatment to more prisoners.

Additionally, the report suggested that IDOC officials “reassess and increase staffing levels of physicians, nurses, psychiatrists, mental health professionals, dental staff, optometrists and security and clerical staff as needed to ensure that inmates receive timely access to quality healthcare.”

State Rep. Greg Harris has sought proof that Wexford is fulfilling its contract with the IDOC, but has not been satisfied with the results of his inquiry. “I got a one-page response from the Department of Corrections saying that they’re doing it…. We need to dig beyond what people tell us that there’s no real problem here, keep moving, there’s nothing to see,” he stated. “We as legislators need to do our jobs and monitor these contracts.”

The complaints against Wexford have included severe cases of medical neglect. Chris Clingingsmith, an Illinois state prisoner who was housed at the East Moline Correctional Center, alleged in a federal lawsuit that he was assaulted by a fellow prisoner and kicked in the face. Afterward, he approached prison guards and told them he had fallen and broken his jaw on a counter. Due to lying about the assault, he was placed in segregation and not taken directly to medical. “I was nauseous, I had migraine headaches, my jaw hurt, I couldn’t sleep, I had blood in my urine. I was just a mess,” said Clingingsmith.

While in segregation he requested to see a doctor for his injuries. The first time he was examined by Dr. William E. Rankin, a prison physician, it was only for a few minutes. He was prescribed aspirin. Clingingsmith went back a second time and informed Dr. Rankin that he thought he had a broken jaw. Dr. Rankin allegedly quipped in response, “Where did you get your medical degree?”

Several weeks later, Clingingsmith was transferred to a higher security state facility. He was examined by a dental assistant, who took X-rays. According to Clingingsmith, upon reviewing the X-rays she stated, “Oh my gosh. You have a broken jaw.” He replied, “I know.” After the injury was confirmed, Clingingsmith endured drastic surgical treatments. His face was cut open, a hammer was used to re-break his jaw and titanium plates, six screws and a tension band were utilized. It took eight weeks after the initial injury to obtain adequate medical care. During that time, according to Clingingsmith, he lost 60 pounds due to not being able to eat. “If he can’t even diagnose a broken jaw … I don’t think that he should be doing that job. That’s not the right gig for him,” he said of Dr. Rankin.

Clingingsmith has since been released. His lawsuit remains pending; on March 13, 2013, the district court denied the defendants’ motions for summary judgment. The case is set for trial in January 2014. See: Clingingsmith v. Rankin, U.S.D.C. (N.D. Ill.), Case No. 4:11-cv-04037-SLD-JAG.

Another Illinois state prisoner, Jeff Elders, who has a hard growth on his hand that is causing his fingers to curl up, said, “They tell you flat out, they can’t do nothing for you. Unless it’s an immediate issue, they’re not doing nothing for you. [The doctor] said, well, I’ll give you some aspirins and I suggest you take care of it as soon as you can when you get out or you’re going to end up like this, all crippled up, but there’s nothing we’re going to do for you here.”

Situations like this aren’t surprising to Alan S. Mills, legal director of the Uptown People’s Law Center on Chicago’s North Side. “It’s absolutely representative of the level of care. That sort of delaying of treatment until things get worse is typical,” he said. “[T]hat unfortunately is what we see all the time in the Department of Corrections: putting off care that would be very simple at the beginning and putting it off and putting it off and putting it off until it becomes a serious problem which nobody can ignore anymore.”

Mills has several clients who alleged similar mistreatment by Wexford employees. Consequently, in October 2011 the Uptown People’s Law Center, in conjunction with the law firm of Seyfarth Shaw LLP, filed a federal class-action lawsuit over the lack of meaningful medical care in Illinois state prisons.

According to a Seyfarth Shaw press release, the suit was filed “on behalf of plaintiff Donald Lippert, a diabetic prisoner incarcerated in the Statesville Correctional Center, and all inmates with serious medical conditions who are continually denied treatment.”

The complaint describes examples of medical neglect and deliberate indifference to prisoners’ medical needs, and alleges that “lack of treatment goes beyond the indifference of specific medical personnel and is the consequence of overarching policies and procedures put in place and executed by the IDOC and Wexford Health, which manages health care services for the prison system.

The case remains pending; on January 10, 2013, the district court denied the defendants’ motion to dismiss the plaintiffs’ third amended complaint. See: Lippert v. Ghosh, U.S.D.C. (N.D. Ill.), Case No. 1:10-cv-04603.

Rep. Harris has not taken the issue of prison medical care lightly, either. He introduced House Resolution 1248, which would require an examination of the IDOC’s contract with Wexford and the quality of medical care being provided to Illinois state prisoners. The resolution calls for either the Illinois Auditor General or the National Commission on Correctional Health Care to monitor Wexford’s provision of medical treatment in IDOC facilities. While company officials said they were open to third-party oversight, others remain skeptical.

The real question that people are trying to answer is how best to enforce the state’s prison medical care contract. Wexford said through a spokesman, “We assure you that Wexford Health holds our employees accountable just as any other company would.” Given that most companies are motivated by profit rather than accountability, however, that statement is less than reassuring. As Mills noted, “You have to enforce a contract or it doesn’t mean anything. There’s nobody holding them [Wexford] accountable other than the courts.”

John Maki, director of the John Howard Association, agreed. “Right now we’re relying on court cases to provide oversight, which should be taking place at the institutional level. If we get to the point of litigation, the problem’s already happened, right? Someone’s already suffered grievous injury. We want to prevent injury.”

Unfortunately, it looks like litigation is the only thing that state officials and for-profit companies like Wexford understand. For example, in 2009, Wexford paid $300,000 to settle a lawsuit over the wrongful death of an Illinois prisoner who died after suffering an asthma attack. [See: PLN, Dec. 2010, p.27].

But there are limits to what lawsuits can accomplish. “Here’s what court cases can’t do.

They can’t create a more effective system,” Maki noted. “They can chip away at it, they can restore someone who’s been hurt but they’re not good at building better systems of oversight. We need government to do that.”

Sources: www.wbez.org; www.wexfordhealth.com; www.seyfarth.com; “Unasked Questions, Unintended Consequences: Fifteen Findings and Recommendations on Illinois’ Prison Healthcare System,” John Howard Association of Illinois (Oct. 2, 2012)

(First published by Prison Legal News and used here by permission)

About Christopher Zoukis, MBA

Christopher Zoukis, MBA, is the Managing Director of the Zoukis Consulting Group, a federal prison consultancy that assists attorneys, federal criminal defendants, and federal prisoners with prison preparation, in-prison matters, and reentry. His books include Directory of Federal Prisons (Middle Street Publishing, 2020), Federal Prison Handbook (Middle Street Publishing, 2017), Prison Education Guide (PLN Publishing, 2016), and College for Convicts: The Case for Higher Education in American Prisons (McFarland & Company, 2014).

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