Iowa abandons plan for private health care services in prisons, union leader says

DES MOINES — The state no longer is considering contracting with a private company to provide health care services in Iowa’s nine prisons, according to a union leader whose group represents prison officers.

Todd Copley, president of AFSCME Council 61, said Tuesday that prison officers who work for the Iowa Department of Corrections — many of whom are represented by the union — were told Friday in a virtual meeting that all the submitted bids were considered too expensive for the state.

The Iowa Department of Corrections did not respond to The Gazette’s requests for information.

Iowa Public Radio, as part of The Midwest Newsroom, first reported the news from the virtual meeting on Friday.

The state corrections department in early July notified staff of its intention to seek a private company to provide health care services in Iowa’s nine state-run prisons. The DOC email said the goal was to “explore a sustainable, high quality health care system that meets the needs of (incarcerated individuals) while aligning with the IDOC’s mission of public safety and rehabilitation.” A request for proposal issued July 9 cited an aging prison population with increasing health care needs as a primary driver of the search.

Roughly 300 Iowa Department of Corrections health care workers would be impacted by such a change, according to the RFP. The document stated that any private company chosen “must allow opportunity for all current, permanent status employees working for DOC at (sic) as medical personnel to be considered for employment.”

The RFP closed Sept. 26. As of Oct. 15, the state was still reviewing the RFP responses, a corrections department spokesman said in response to a Gazette query at the time. The spokesman said then that the department would not share more information until a contractor was chosen.

During Friday’s meeting, DOC staff were told the state is not going to choose any of the companies that submitted proposals because the costs were too high, Copley said Tuesday.

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Copley said his understanding was the state was expecting bids in the range of $50 to $70 million, and instead the bids all surpassed $100 million.

“They made a very good decision,” Copley said. “I am not one to commend the governor’s office or the Department of Corrections leadership, but in this situation, they dodged a bullet. And I’m glad they did.”

Staffing shortages may be magnified

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The Iowa Department of Corrections may be facing pronounced staffing issues, according to Copley and The Midwest Newsroom’s reporting.

Staffing shortages already were an issue acknowledged by the state; it was listed among the reasons the department was looking for a private health care services vendor, according to the RFP.

Once the RFP became public, hundreds of corrections workers sought transfers to other state jobs or quit, according to Copley. He estimated — conservatively, he said — that a third of corrections department staffing left their positions over the past six months.

The Midwest Newsroom reviewed two internal Iowa Department of Corrections staffing reports and determined that more than 60 of approximately 300 employees in Iowa’s prison medical care system resigned, and reported that many others left for other state employment.

The Midwest Newsroom also reported that one of the documents it reviewed showed that at least 40 health care workers resigned from the Iowa Medical and Classification Center in Coralville. Copley said the facility lost 17 workers in one day alone and estimated that the total number of workers who have left is now near 50.

Copley said he believes the corrections department may encourage some of those workers to return.

The RFP also highlighted the department’s desire for an updated electronic health record (EHR) system. The RFP described the Iowa Department of Corrections’ current system as “aging,” and one that requires “significant technical adaptability from providers” because of its age.

It is unclear whether the department will continue to pursue an electronic records vendor.

The private prison health care landscape

A handful of companies provide a large portion of privatized health care services to prisons, according to media and advocacy organization reports: Wellpath Holdings Inc, NaphCare Inc, Corizon, PrimeCare Medical Inc., and Armor Correctional Health Services Inc.

While there is no definitive source that details the extent of the privatization of prison health care in the U.S., the Petrie-Flom Center for health law policy, biotechnology and bioethics at Harvard Law School found that a Pew Charitable Trusts study showed that by 2015 a total of 20 states had fully outsourced prison health care services to private companies and eight more states privatized at least a portion of those services. And in 2020, a Reuters review of health care data from 523 U.S. jails between 2008 and 2019 found that 62 percent had outsourced prison health care to private companies.

The Reuters report found that, between 2016 and 2018, prisons who relied on one of the five leading private prison health care companies saw higher death rates than facilities with government-run health care services.

A report earlier this year from the Prison Policy Initiative, a nonprofit, nonpartisan research organization that advocates for “a more just society” and highlights “the broader harm of mass criminalization” argued that private prison health care companies stress lowered costs and savings over providing appropriate health care.

Comments: (515) 355-1300, erin.murphy@thegazette.com

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