Star-Tribune Editorial Board

Wyoming's chapter of the American Civil Liberties Union doesn't think a for-profit company should provide health care services for state prisoners.

But the state ran its own health care system for inmates until 14 years ago, and it was inadequate for both the prisoners and the Department of Corrections. That's when the decision was made to hire a private company, with the goal of improving services while saving money.

The results have been mixed as the state has contracted since 1994 with Wexford Health Sources, then Correctional Medical Services, and now Prison Health Services Inc. Prisoners have consistently complained about inadequate medical care no matter which company has been in charge, and several have sued the state and won.

However, let's not forget that the in-house health care system also had its share of problems, and the state hasn't even remotely suggested going back to it.

Each of the state's correctional institutions acted independently to provide health services to inmates, either with a state staff or through contracts with local providers, or a combination of both. The agreements were fee-for-service, and the institutions paid whatever was charged. From 1990 to 1993, health care costs at the Wyoming State Penitentiary more than doubled. By 1993, the DOC facilities had a total of 100 different medical services contracts, which was an administrative nightmare.

At the same time, prisoners were being shortchanged. An independent consultant found that a physician working part-time under contract with the state prison in Rawlins was spending only an average of three minutes per patient. The prison infirmary was understaffed, and the emergency room at the Rawlins hospital and outside medical consultants were overused.

A growing geriatric prison population began dramatically increasing the cost of prison health care in the early '90s, and the trend continues today as older inmates with expensive health care needs make up a larger percentage of the prison population.

Prison Health Services was awarded the DOC medical contract in 2005, and will begin a two-year, $32 million contract next month. Company officials documented actual paid claims to doctors to justify the cost of the contract, which was approved by the Legislature.

The state has a constitutional responsibility to take care of its inmates and provide them adequate health care. In that respect, the prison population is better off than many Americans who cannot afford health care or health insurance.

An independent review of the state's inmate medical care by Consultants in Correctional Care has been positive for the past two years. The contract with Prison Health Services calls for the company to expand services for inmates with dual diagnoses and special needs. It also must provide a comprehensive inmate health care program, including medical, mental health, dental, vision and special needs.

ACLU Wyoming Director Linda Burt maintains, "You cannot provide these kinds of services for profit and do the kind of job you need to do."

But the state of Wyoming has shown it is unwilling to go back to a costly, in-house system that was deemed inadequate years ago. If it doesn't contract with a private company, who is going to provide these mandated services? It's absurd to suggest that the private company is not entitled to make a profit while it provides services the state itself won't offer.