DOC changing health services, ending contract with Connections

Delaware Department of Correction Commissioner Claire DeMatteis announces the end of the agency’s contract with Connections Community Support Programs, Inc. The contracts have been awarded to Centurion of Delaware, which will take over operations in April. (Delaware State News/Brooke Schultz)

DOVER — In an effort to improve prison medical services, the state ended its contract with Connections three months early and hired a new firm that officially will take over April 1.

Department of Correction Commissioner Claire DeMatteis said Monday the change will come with a higher price tag, but that will bring more staff and higher education levels for the medical staff. The transition will maintain current staff members.

The DOC’s service provider, Connections Community Support Programs, came under fire in 2019 after the attorney general’s office confirmed that it was investigating allegations that the firm had ordered staffers to forge documents to falsely state inmates were getting mental health treatment they never received, the Associated Press reported.

Also in 2019, a review of the health care system, conducted by Christiana Care, examined the agency’s medical and behavioral health care systems and made recommendations to strengthen clinical quality, patient safety and data management practices.

The DOC, through its Bureau of Correctional Healthcare Services, is responsible for contracting medical and behavioral health services in all of its Level V (prison) and Level IV (work release and violation of probation) facilities and behavioral health services provided to individuals on probation after their release from incarceration, the agency said in a press release.

The same four firms — Centurion, Connections, Corizon Health and Wellpath — submitted to both requests for proposal.

“We had an extensive review … we scored them based on staffing levels, their expertise in correctional health care, national reputation, cost and other relevant factors,” Ms. DeMatteis said. “Centurion received the highest scores and the choice of Centurion was unanimous among everybody who reviewed the proposals.”

Centurion’s bid was $47.8 million for fully staffed medical services and $21.1 million for behavioral health. Both come in higher than what the department currently pays — $45 million and $15 million, respectively — but Ms. DeMatteis said that it is still within DOC’s budget.

“The difference in the higher price are higher staffing levels,” she said. “The second factor for the higher price is that where our current provider might have a nurse practitioner in the role, Centurion wants a physician. Where our current provider might have a psychologist with a master’s degree, Centurion wants to fill that with a PhD psychologist. Where some of the technicians have high school diplomas currently, Centurion wants to have people who have at least an associate’s but preferred bachelor’s degree.”

Within the Connections contract, medical and behavioral services are staffed fully. When Centurion takes over operations, the hope is to add about 30 more staff members to both medical and behavioral services, Ms. DeMatteis said.

She added that Connections’ bid in the RFPs process was not as competitive.

“When we wrote what we wanted in the RFP, meaning what we wanted in the contract, it was to correct what the Christiana Care’s report found needed to be improved,” Ms. DeMatteis said. “Those … eight key recommendations are the things we’re all focused on as we start this new relationship. That report was the foundation of us rebuilding our healthcare services.”

The eight areas the report recommended DOC address were:

• Restructure DOC’s health care bureau to focus on five key areas: compliance, quality, cost, patient experience and medical staff proficiency.

• Create a three-part leadership structure at each Level IV and V facility comprised of DOC, medical vendor leadership and behavioral health leadership, with mutual accountability to reach delivery of care outcome-based goals.

• Develop, track and analyze the process of delivery of care and outcome measures: in other words, how are we treating offenders and is the treatment effective?

• Invest in staff development and training in quality, safety and continuous process improvement.

• Promote a culture of transparency and an equal playing field such that leadership learns directly from and listens to the front-line of care delivery.

• Develop facility-based huddles to consistently and rapidly identify and mitigate upstream and downstream risk.

• Fix the electronic health record system to drive improved quality and safety.

• Recruit, retain and reward staff that embrace a safety, quality and performance culture.

As part of the contract, Centurion will establish a Delaware office, officials said. Its contracts are for three-year commitments, followed by two optional two-year renewals.

Current employees can transition to Centurion, Ms. DeMatteis said.

“The staff, the nurses, the doctors, the clinicians, the counselors — these are special people. These are skilled people, and the fact that their profession is to do it in a prison means we respect what they’re doing,” she said. “We want to make sure they understand that that transition will be seamless.”

Ms. DeMatteis called the split from Connections as “amicable and professional.”

“I think our mutual objective is that releasing Connections early from these contracts will help Connections stabilize their other operations and really rebuild the base of what they’re very, very good at in their community,” she said. “Releasing them really from the correctional health care contracts will help them refocus on their core mission.”

Connections provided medical health care since 2014, and behavioral health services since 2012.

Centurion provides health care services to correctional systems in 15 states, including Maryland and Pennsylvania.

“Centurion is pleased to partner with the Delaware Department of Correction, and we are committed to working with the DOC to improve the medical and behavioral healthcare, and substance use disorder treatment for individuals under DOC custody,” said Centurion CEO Steven H. Wheeler in a news release. “We look forward to bringing our innovative staffing and care solutions to Delaware’s unified state correctional agency.”