Department of Public Safety and Correctional Services Secretary Carolyn J. Scruggs, right, and Deputy Secretary of Administration Joseph W. Sedtal in a file photo from a March hearing. Photo by Bryan P. Sears.
Frustration grew during a committee hearing on state audits Tuesday as lawmakers learned that a recent contract between the state’s correctional agency and a health care provider does little to address staffing and documentation issues identified by state auditors in a previous contract with a different provider.
“We seem to not be necessarily in a better place than we were,” Del. Jared Solomon (D-Montgomery) said in an interview. “We’re just sort of rearranging the deck chairs on the Titanic.”
Solomon’s comments came in a meeting of the Joint Audit and Evaluation Committee, which he co-chairs, following a tense discussion with officials from the Department of Public Safety and Correctional Services. Lawmakers in the hearing raised fears that the department’s new contract may have pitfalls similar to those of a previous contract.
A November report from the Office of Legislative Audits evaluated DPSCS contracts and procurements from 2018 to 2023, when the department contracted with YesCare to provide medical and mental health care for the state’s incarcerated population.
State officials in June agreed to a new contract with Centurion for Maryland, after complaints arose about YesCare’s ability to provide adequate staffing and health care services it promised under its contract.
But lawmakers say that some of those concerns are present in the new contract with Centurion. The November audits noted that YesCare’s contract functioned on a fixed-fee payment structure, for example, which auditors recommended against in future contracts.
“A fixed fee model for these services may not be in the State’s best interest because it guaranteed the contractors payment regardless of the level of staffing provided and the actual costs incurred for equipment, supplies, and hospital visits,” the audit said. “Under this model DPSCS’ healthcare costs increased from $120 million to $168.7 million (41 percent) between fiscal year 2018 and 2023 even though the average number of individuals incarcerated during this period declined by 18 percent.”
Sen. Clarence Lam (left) and Del. Jared Solomon (right), co-chairs of the Joint Audit and Evaluation Committee. Photo by William J. Ford.
Joseph W. Sedtal, deputy secretary of administration for DPSCS, confirmed that the new contract with Centurion also uses a fixed-fee pay structure, although “there are avenues for renegotiations” in certain circumstances.
Sen. Clarence Lam (D-Anne Arundel and Howard), the other committee co-chair, was not comforted.
“I think we are very wary of the fact that while this audit was going on … the state reentered into a fixed-fee contract, while the prior fixed-fee contract didn’t seem to pass muster,” he said.
Solomon worried that Centurion does not have enough staff to fulfill the medical and mental health needs of the current incarcerated population, as previous audits of YesCare contracts noted.
Renard Brooks, assistant secretary for programs, treatment and reentry services, told the committee that Centurion has employee recruitment plans in the works, but that it is currently missing about 50% of the staff it promised in its contract. YesCare was also short-staffed, the November audit noted, and had 81% or less of the positions filled each month since 2022 while it was under contract with the state.
“Last figure I saw was 53% overall, but that’s across the entire spectrum,” Brooks said, noting that some positions may have better vacancy rates.
Solomon asked for a more concrete timeline for Centurion to be fully staffed. Brooks was unable to provide one at the committee meeting.
“Well, their plan is to do it as quickly as possible,” Brooks said.
“But at what point? I mean, 50% is pretty terrible,” Solomon said.
DPSCS Secretary Carolyn Scruggs told the committee that it’s difficult to recruit medical professionals into correctional facilities.
“I think all of us in this room are aware of the challenges with hiring individuals – especially in the medical field,” Scruggs said. “What’s enticing to make you come and work in a prison? Many people don’t want to.”
After the meeting, Lam said that DPSCS will likely need to report to the committee again with an update on staffing levels and other issues raised in Tuesday’s meeting.
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“We’re very concerned about how this department is going to follow-up with a new vendor to address similar concerns in a contract that’s structured similarly to before,” Lam said in an interview.
“This contract with the prior vendor seemed wholly inadequate to address the health care needs of our state’s inmates, who are under the care of the state. You can’t get health care in any other way when you are in prison,” he said. “We have a responsibility to address the most basic health care needs, ensure that these individuals receive adequate care.
“I think it’s pretty evident from the audit report that these individuals under the care of the state are not receiving adequate health care,” Lam said. “And it’s really troubling that in spite of all that, some of the missteps that took place, that led to all of the audit findings, are continuing with the new contract that has just been signed earlier this year.”