Inmate health: The county jail needs affordable, quality care

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After a dozen years of providing health care at the county jail, Allegheny Correctional Health Services will have to get in line to bid for the next contract when the current one expires on Dec. 31. That's a good thing.

Although the fate of the 100-plus employees of ACHS, a nonprofit offshoot of the county health department, is on the line, bigger things are at stake for Allegheny County taxpayers -- cost efficiency and service quality at the lockup that houses 2,500 inmates.

Last year the county paid $11.6 million to ACHS to deliver medical services. Not only was that 2-1/2 times the $4.6 million it cost in 2000, the agency's first year of operation, ACHS' standard of care has also come under fire in recent years.

In a two-part series in May 2011, Post-Gazette staff writer Rich Lord chronicled the repeated shortcomings in health care delivery at the jail. The stories revealed that the jail had five deaths in both 2010 and 2009, which was more than twice the state average per inmate population among the other large jails in Pennsylvania. Between 2000 and 2007, the jail had the 11th-highest mortality rate among the nation's 50 largest jails and the second-highest suicide rate.

Former inmates of the county jail and survivors of prisoners who died there have sued ACHS, claiming inadequate health care. A nurse filed suit in September in federal court, saying she was fired by the agency after threatening to tell the Health Department about treatment she felt contributed to an inmate's death.

ACHS was launched by then Allegheny County Health Department director Bruce Dixon as a way to improve medical care at the jail while holding down costs. He was the nonprofit's interim executive director and the chairman of its board of directors; in recent years he became an apologist for the jail's health care deficiencies. Last March Dr. Dixon was fired as county health director by the Allegheny County Board of Health.

Next year Allegheny County wants to spend less on inmate health care -- $10.9 million. County Executive Rich Fitzgerald is right to try to save money, but he also must seek a provider that promises better care. Not only is it the humane thing to do, but in the long run it could also be more cost-effective.

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