Fresno County Contracts with Corizon Amid Lawsuits

FRESNO, Calif. — After the passage of Assembly Bill (AB) 109 in 2011, California county jails have seen a spike in inmate populations. The influx has strained facility resources, especially county-provided medical services.
When the state’s prisons came under fire for overcrowding and revolving-door offenders, legislators passed AB 109 to help ease conditions. But now the operations issues that plagued state prisons have trickled down to the county level, and several counties have been trying to negotiate settlements over lawsuits that claim jails are neglecting and improperly handling the medical and psychiatric needs of inmates.
One such case was in Fresno County, where Rachel Scherer, attorney at Disability Rights California said in 2013, “outpatient mental health services have been radically cut back and the jail has become a costly dumping ground for people with mental illness who need care but cannot find it elsewhere.” An investigative series by the Fresno Bee on the state of the jail’s mental health care further agitated the situation, and the claims prompted the Fresno County Department of Public Health to examine what actions the county could take in order to improve inmate health care.
“We had a number of different consultants come in and evaluate how services were being provided in the jail and as a result of that, we identified the areas that we needed to focus on going forward,” said county Department of Public Health Director David Pomaville.
At the same time, the department considered if it would be most effective to go ahead and partner with a private contractor to provide more comprehensive health care. That led to a significant RFP process, and in March, county supervisors approved a five-year contract worth almost $100 million with Saint Louis-based Corizon Health, one of the nation’s largest correctional health care providers. Corizon provides care to more than 377,000 inmates in 29 states. The provider signed another major deal with the state of Missouri for a seven-year contract potentially worth $1.1 billion if the state decides to renew after three years.
In 2013, Corizon signed on with Tulare County, just south of Fresno. The provider’s track record impressed Pomaville and the California Department of Public Health. Corizon would be able to provide medical services beyond what the county can provide.
“[Corizon] had very good policies and procedures in place and strong training programs for their employees,” Pomaville said. “They had good systems that had been developed and tested over time, but they were also willing to rethink and relook at how they were delivering services and the changes that are happening with regard to AB 109.”
Susan Morgenstern, a spokesperson for Corizon, said the health care provider plans to add new programs and services to Fresno’s correctional medical care system such as a comprehensive women’s health program, a telemedicine program, a communicable disease program and regular on-site training for staff in addition to on-site specialist care for certain high-demand specialty services.
Because most of the jail’s medical staff applied and were accepted as full-time employees for Corizon, the county didn’t experience a large net loss of jobs. Corizon will be providing training to those new employees coming over from the county.
“All new employees, from clerks to physicians, go through an extensive onboarding and orientation process,” Morgenstern said. “In addition, we provide ongoing mandatory education classes on relevant topics.”
Pomaville emphasized that the switch to Corizon doesn’t let the county off the hook. The county’s health officer, the probation department and the sheriff’s office are responsible for oversight and will work with Corizon to ensure inmates are receiving proper care.
“My belief is that [when] a private contractor [is] coming into a government system, really the only way to be successful is to make sure there’s a strong team that oversees the contract and works with the provider to make sure that the issues are addressed early,” Pomaville said. “We’ve developed a team that will be able to help [Corizon] make good decisions in our community as well as to demonstrate to us the value that we’re getting for the price that we’re paying. It’s not going to be on autopilot. We do not expect that this is just a hand-off and they take care of the issues. We expect to be involved and engaged and working with them going forward.”