After 5 inmates die, Fulton County dumps jail health care provider

Cynthia Metts gathers balloons from her car for she and her siblings to take to their mother’s grave on her mother’s (Renee Metts) birthday, Monday, Nov.13, 2017 in Palmetto, Ga. Fulton County is terminating a contract it had for Morehouse School of Medicine to provide medical care for its inmates because, according to a letter, its doctors had failed to provide adequate care. Jail officials attribute at least five inmate deaths to that sub-par care. (Contributed by John Amis) AJC FILE PHOTO

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Cynthia Metts gathers balloons from her car for she and her siblings to take to their mother’s grave on her mother’s (Renee Metts) birthday, Monday, Nov.13, 2017 in Palmetto, Ga. Fulton County is terminating a contract it had for Morehouse School of Medicine to provide medical care for its inmates because, according to a letter, its doctors had failed to provide adequate care. Jail officials attribute at least five inmate deaths to that sub-par care. (Contributed by John Amis) AJC FILE PHOTO

Fueled by complaints of inadequate care and the death of five inmates at the Fulton County jail, county commissioners on Wednesday moved to oust the facility’s health care providers.

Commissioners voted to replace Tennessee-based Correct Care Solutions and the Morehouse School of Medicine, in Atlanta, with Alabama-based NaphCare. The health care contract, worth $20.7 million, will be the county's third in three years.

Fulton County's Chief Jailer, Mark Adger, previously told The Atlanta Journal-Constitution that Morehouse has been in over its head since coming aboard.

“Morehouse is not qualified to do any of this. They have no correctional health care experience,” Adger said.

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Fulton Commission Vice Chairman Bob Ellis said he expected the county sheriff’s office to increase its own oversight of the health care provider.

“It repeats itself over and over,” Ellis said of issues with health care at the jail. “I’m just tired of it. What is going to be done differently?”

The county had the option to renew the contract with CCS and Morehouse for the next several years, but said in an August letter that the pair had not met minimum staffing requirements and inmates were supervised inadequately. In October, Fulton purchasing director Felicia Strong-Whitaker said in another letter than she planned to terminate the $19.8 million contract.

Strong-Whitaker said the groups had “reached a mutual agreement” not to renew it.

Between Aug. 12 and Oct. 26, five inmates died in the Fulton County jail, including three who committed suicide while they were believed to be in withdrawal from opioid addiction. Two other inmates died within eight days of each other. One was a diabetic man whose glucose levels were spiking. The other was a woman who complained of trouble breathing.

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The chief jailer said they????have????called in the Georgia Bureau of Investigation to look into the deaths.

The Georgia Bureau of Investigation is investigating the death of the woman, Ligwenda Metts, and may look into other deaths, as well. Adger said he has not yet gotten any report from the GBI, and the county has not done its own, internal investigation.

“It’s safe to say the sheriff has concerns about the medical care that has been provided,” Adger said.

Dr. Valerie Montgomery Rice, president of the Morehouse College of Medicine, pushed back against the assertions that the school was at fault.

She said Adger mischaracterized the care Morehouse provided and that CCS provided most of the staff at the jail. Morehouse, according to the contract, was responsible for 14 percent of the staffing – or five doctors who shared shifts as well as nurses and physician assistants. She said they did not provide any mental health care.

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“The nurse practioners and physician assistants have all undergone documented training,” Montgomery Rice told the AJC. “He (Adger) is erroneous in saying Morehouse School of Medicine hired people who did not have correctional care experience. “

And County Manager Dick Anderson added that most of the blame lay at the feet of CCS.

“From our perspective, CCS is the prime provider and provided the most significant portion of the staffing,” he said.

Still, county commissioners, on Wednesday, signalled they were eager to move on.

Emma Darnell, a county commissioner, said she wanted “to do something other than express shock and amazement” every time an inmate died in custody.

“Historically, we’ve had problems with this service,” she said. Darnell said health care at the jail “has never been adequate since I’ve been here.”

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August 15, 2012 ATLANTA Fulton County Officer Niasha Cooper observes through the open cellblock door as inmates return in the 5 south detention zone at the Fulton County Jail Wednesday, August 15, 2012..KENT D. JOHNSON / KDJOHNSON@AJC.COM

August 15, 2012  ATLANTA Fulton County Officer Niasha Cooper observes through the open cellblock door as inmates return in the 5 south detention zone at the Fulton County Jail Wednesday, August 15, 2012..KENT D. JOHNSON / KDJOHNSON@AJC.COM

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August 15, 2012 ATLANTA Fulton County Officer Niasha Cooper observes through the open cellblock door as inmates return in the 5 south detention zone at the Fulton County Jail Wednesday, August 15, 2012..KENT D. JOHNSON / KDJOHNSON@AJC.COM

Darnell was first elected in 1992. The jail opened in 1989, and houses about 2,800 inmates.

Federal court oversight of the jail ended in 2015, 11 years after the Southern Center for Human Rights filed a lawsuit alleging crowded, dirty and dangerous conditions. That suit followed one the Southern Center brought in 1999 that claimed the jail provided inmates with inadequate health care.

And in 2015, the jail lost its accreditation, which it blamed in part on another health care provider, Corizon. The CCS and Morehouse contract was, in part, a rebuke of Corizon’s services.

The cost, and the amount of time spent on jail health care planning, have long been a source of frustration for county leaders. Corizon’s contract was extended for a year, over Adger’s objections, while the county tried to rethink its jail health care model. The CCS and Morehouse contract was supposed to solve a number of problems with how inmates were treated.

The NaphCare contract runs through 2018, with four renewal options. NaphCare will provide both physical and mental health services. The county did not re-bid the health care contract, but used NaphCare’s proposal from 2016, when it finished second in scoring for its proposal.

Adger said he could not comment on the county’s decision to change providers. Still, he said, “We finally got to where we need to be, so we’re happy.”