On July 1 another for-profit firm, VitalCore, will replace Wellpath — and will require a similar level of vigilance by those who believe a prison sentence doesn’t mean leaving your right to decent health care at the prison gates.
“As with any for-profit contractor, DOC will need to provide a lot of supervision and oversight to assure compliance with the terms of the contract,” said Tatum Pritchard, head of litigation for the Disability Law Center, which monitors Bridgewater State Hospital, where Wellpath will continue for now to provide mental health services under a contract originally signed in 2017 but which has been extended through 2026.
That contract will be put out to bid sometime next year, according to the DOC press release..
But the bidding process in a field dominated by for-profit providers is no guarantee of better outcomes. VitalCore was one of only three bidders that also included Wellpath, all of them from the for-profit world, according to information from a public records request by Prisoners’ Legal Services of Massachusetts.
Wellpath has been the subject of more than 1,000 federal lawsuits nationally and dozens here in Massachusetts. It was also on Wellpath’s watch that the Justice Department initiated its civil rights probe of the treatment of prisoners in mental health crisis in state prisons.
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VitalCore, a newer company formed only in 2018, has at least two dozen lawsuits filed against it for work in prisons since 2019.
Nevertheless, Public Safety Secretary Terrence Reidy painted a rosy scenario for its future here.
“The Massachusetts Department of Correction’s new partnership with VitalCore reflects their deep commitment to delivering holistic health care to incarcerated individuals,” Reidy said in the press release.
The new health care provider promised the basics like medical, dental, and mental health services plus some add-ons that outside-the-walls patients have long taken for granted — like a telehealth system and an online patient portal accessible through DOC-issued personal tablets. Also promised was a “renewed focus” on geriatric care for a rapidly aging prison population.
All of this comes at a rather substantial cost — $770 million over the life of the five-year contract.
“It is an expensive contract,” Pritchard said, “and because it is, it’s in the best interest of the Commonwealth to make sure they are living up to their agreement.”
Senator Elizabeth Warren in a statement also noted that while “This new contractor selection reflects the Healey administration’s commitment to improve health care for people in state custody. I’ll continue to monitor the performance of this new provider to ensure accountability.”
But it will take eyes actually inside state facilities to do the job.
DOC’s Health Services Division, comprised of the department’s own licensed medical and behavioral healthcare professionals, will be responsible for monitoring contract compliance and conducting “frequent audits,” according to the agency.
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And some of those eyes will come from the already appointed monitor assigned under the settlement agreement reached between the Justice Department and DOC.
The well respected Reena Kapoor, associate professor of psychiatry at Yale Medical School, and her team are assigned to do twice-yearly reports on the way the system, its in-house personnel and its health care vendor deal with mental health issues.
Her most recent report filed in March basically gave the system A for effort for cooperating with the team and making “incremental progress” on compliance. “Nonetheless, mental health assessments and treatment remain inadequate at many institutions,” the report notes, a fact blamed largely on “inadequate staffing” and the “limited experience” of mental health staff, “leading to poor recognition of mental health symptoms and a narrow therapeutic repertoire.”
It’s not that DOC is incapable of actively engaging in self-monitoring. Pritchard said there was a time when its on-hands auditing and reviewing of the use of restraints and seclusion at Bridgewater “made an incredible difference.” But they also came in the wake of a class action lawsuit and, according to more recent reports from the Disability Law Center, were apparently short-lived.
The Center issued a statement saying it was “hopeful that selection of VitalCore for the DOC-wide contract will bring improvements.” However, they noted the organization was “deeply concerned that Wellpath has retained the contract for Bridgewater State Hospital for an additional year despite repeated DLC reports detailing substandard treatment, abusive practices, and repeated violations of Massachusetts law.”
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The ultimate solution to Bridgewater’s problems, they maintain, is a transfer from DOC to the state Department of Mental Health.
As for the future of health care in the rest of the prison system, change needs to bring more than a new name on the office door. And at $154 million a year, it certainly should bring better care for those who have nowhere else to seek it.
Editorials represent the views of the Boston Globe Editorial Board. Follow us @GlobeOpinion.
