July 18, 2007

BY DAWSON BELL

FREE PRESS STAFF WRITER

Michigan's troubled and high-cost health care system for prison inmates, which has been blamed for several prisoner deaths, is headed for the scrap heap in favor of a first-in-the-nation plan using health maintenance organizations, Department of Corrections officials said Tuesday.

The plan calls for up to six regional HMOs to provide health care coverage to the state's 50,000 inmates on a contractual basis, much like employer health care contracts in the private sector.

In an interview with Free Press reporters and editors, Corrections Department Director Patricia Caruso said the system will replace a statewide, managed care contract in which costs have spiraled and problems persist.

As documented in a series of Free Press editorials during the last two years, prisoner health care in Michigan is fraught with delays, misdiagnoses and bungled communication, leading to inmate suffering and death.

One inmate, 21-year-old Timothy Souders, a mentally disturbed shoplifter, died of hunger and thirst after being restrained on his bed for four days, a case brought to national attention by CBS's "60 Minutes."

Caruso said other innovations are planned in patient record-keeping and staff training. Also, there will be increased use of telemedicine.

The HMO contracts are scheduled to be awarded early next year for implementation in March, when the current contract expires.

Caruso declined to estimate potential savings, but said, "I absolutely think our costs can come down."

The department is expected to pay at least $300 million in health care costs this year, she said. That does not include the security and transportation costs related to doctor and hospital visits. The problem of cost control is exacerbated by the relatively poor health of the people who go to prison, she said.

The care of a single, very ill inmate last year cost the department $800,000, Caruso said, and the 300 most expensive inmate patients, in terms of medical costs, account for $30 million of overall spending.

State prison inmates are not eligible for Medicaid or Medicare. Department officials said they hope some of the more seriously ill inmates -- so sick they pose little or no risk to re-offend -- will have their sentences commuted by Gov. Jennifer Granholm so they can return to civilian life and government health care.

Caruso said she understands public resentment over free health care for felons when so many law-abiding citizens go without insurance.

But "prisoners are virtually the only people in our society with a constitutional right to health care," she said.

Contact DAWSON BELL at 313-222-6604 or dbell@freepress.com.