Deep cuts to drug treatment, mental health and community re-entry programs across Florida are heightening scrutiny of a lucrative, prison health care contract poised to be finalized this month.
The $375 million deal now on the table with Centurion of Florida allows it to take an 11.5 percent “administrative fee” that can not only cover a variety of costs, but also be pocketed by the company as profit.
Centurion, whose parent company, Centene, is a sizable campaign contributor to Gov. Rick Scott and the Florida Republican Party, began treating the 97,000 inmates in Florida’s prison system two years ago.
Centurion is the only company that agreed to negotiate with the state on a health care contract, set to take effect by July 1.
“When you’re only negotiating with one contractor, he can drive up the prices. It’s not like the Corrections Department is in a good bargaining position — it’s kind of held hostage to whatever Centurion wants,” said P.J. Brooks, vice-president of outpatient services at First Step of Sarasota.
First Step is one of 33 community programs cut by the Corrections Department to make money available to finance the Centurion health care contract. First Step is losing almost $500,000, and will reduce its two Sarasota residential treatment centers — a women’s facility losing four of its 10 beds and a 52-bed men’s center eliminating 22 beds.
While Centurion is looking at an 11.5 percent, “costs-plus” contract, earlier prison health care companies were denied this extra incentive, and claimed to be losing millions while working with the Department of Corrections.
These firms, Corizon Correctional Healthcare and Wexford Health Services, along with others in the industry showed no interest in bidding on the latest contract to care for inmates in the nation’s third largest prison system.
Centurion and DOC, though, seem happy together. And Florida Corrections Chief Julie Jones fought hard to make sure the company stayed on board.
Jones last month ordered $50 million in department cuts and reductions to key community services in a scramble to find cash for the health care contract after state lawmakers low-balled funding for the prison system.
But those cuts are roiling most community services and ending needed treatment and re-entry programs for offenders nearing the end of their sentences.
As many as 500 inmates may be sent back behind bars, while programs are shuttered and centers lay-off hundreds of counselors, treatment specialists and even kitchen workers.
“It’s devastating,” said Michelle Bateman, facility director of the Jacksonville Bridge Transition Center, where a 165-bed substance abuse program is closing at the end of this month.
Bateman’s center is part of Bridges of America, which is losing $4 million in state contracts and eliminating 300 beds from substance abuse centers in Jacksonville, Bradenton, Orlando, Pompano Beach and Auburndale.
Bateman has let 50 staffers go this month and saw about 100 offenders return to prison since the DOC cuts were announced in May.
“We’d seen such progress,” she said. “The people we work with won’t have a chance if they’re just let out on the street without any help. They’ll be right back in prison.”
The slashing of drug treatment programs for those about to leave prison comes even as the state is pouring millions of dollars into fighting a raging opioid crisis that prompted Florida Attorney General Pam Bondi to join other states in suing big pharmaceutical companies accused of contributing to the problem.
DOC spokeswoman Michelle Glady said the agency regretted imposing almost $30 million in cuts to 33 community providers, along with another $20 million reduction in prison operating costs.
But Glady said the department is obligated to fund inmate health care. She added that there were few places to find money when the Legislature shorted the prison system in the state’s $88.7 billion budget for the year beginning July 1.
Meanwhile, she said the department considers it a success that the new contract reduces to 11.5 percent the current, 13.5 percent administrative fee Centurion collects in a $321 million contract that is set to expire.
The $55 million contrast boost for next year reflects, “the rising cost of health care, naturally,” Glady said.
For his part, Scott said that he asked the Legislature for enough money to properly fund prisons, inmate health care, and maintain community services.
But when lawmakers didn’t pour enough in, Scott declined to take any action when program-slashing began across the state — although the state is sitting on $3.3 billion in budget reserves.
By contrast, when the Zika virus was coursing through Florida two years ago, Scott used his emergency authority to put more than $60 million toward prevention and treatment.
Centurion’s parent company, Centene, also is a major health care provider in the state’s Medicaid managed care program through its subsidiary, Sunshine Health.
The company’s Florida interests have helped prompt more than $750,000 in contributions to the Florida Republican Party since Scott took office in 2011, and another $205,000 to the Florida Republican Senatorial Campaign Committee in the past three years, state campaign finance records show.
Scott’s Let’s Get to Work political committee took in $125,000 from Centene last year, along with $35,000 during his 2014 re-election campaign.
That year, the company also contributed $175,000 to the Republican Governors Association Florida PAC, which mostly went to helping re-elect Scott, records show. Term-limited as governor, Scott is now challenging Democratic U.S. Sen. Bill Nelson.
Sen. Jeff Brandes, a St. Petersburg Republican who chairs the Appropriations Subcommittee on Criminal and Civil Justice, tried to use some budget maneuvers on the Centurion contract to keep the community program cuts from happening.
But neither the House nor Centurion would go along, he said.
A problem, he added, is Centurion’s position as the only company providing prison health care — to the entire state.
“If you squeeze them too hard, do they walk away?” Brandes said. “That’s the situation we’re in. And we’ve got to come up with something better.”
Brandes said he’d like to avoid having one contractor for all Florida prisons, recommending, instead, that a portion of prison health care could be provided by the state.
Florida has only used outside firms for inmate care on a large scale since 2012, when Scott pushed to privatize the system.
Corizon and Wexford, the contractors before Centurion, left the state under bad terms following wholesale complaints about patient care, Brandes pointed out.
“I believe you never want to deal with just one vendor,” Brandes said. “But we’re looking at a situation now where next year, we’re going to have to revisit the health care contract and also rebuild these community programs we’ve cut, somehow.
“It’s the worst of both worlds,” he added.