The Daily Item, Sunbury, PA

The Rave

March 18, 2013

Procedures must be followed to the letter

It turns out that "Plan B" for medical services in the Northumberland County Prison may have some serious hitches, according to former healthcare providers who say their employment there ended over irreconcilable professional differences.

Specifically, the former workers say that a private medical contractor for the jail was unable to supply regular medicine doses in a prescribed manner to inmates. When the nursing staff complained about treatment and medical record keeping, the healthcare professionals say they were ignored or intimidated.

This information comes from former employees who would be in a position to know. It has been delivered to Northumberland County's Commissioners, who have a contract with a prison medical care provider through 2018 that ranges from $500,000 to nearly $700,000 a year.

That provider is taking the complaints seriously and has initiated an internal review.

Northumberland introduced private management care to the jail in 2010, following the settlement of a $1.5 million class action based on a record of unsafe and inadequate medical decisions.

That decision to outsource professional services probably affords Northumberland County some insulation from mistakes or mismanagement by inserting third party responsibility for healthcare between the county and inmates.

Northumberland County's ability to withstand successive risk exposure, however, was weakened following the previous class action debacle.

In order to acquire insurance against further risk, the county had to agree to a yawning $100,000 deductible before an insurer would agree to absorb risk expenses.

That turned nearly every misstep or inmate nuisance lawsuit into a potential $100,000 bet. Ultimately, that weakened the county's ability to resist settlement pressures from plaintiffs and prisoners.

How the commissioners and the medical provider will address the immediate issues cited by the former workers is not yet clear. That may depend on how much documentation the former workers can produce to substantiate their allegations.

What seems clear, however, is that the stakes for greater professionalism, backup and documentation have grown to the point where quality, compliance and cooperation are critical elements for cost-effective operations.

Under such demanding conditions, administrators, officers, staff and outside service providers have to work as a highly proficient team to reduce risk by following professional procedures to the letter.

Everybody counts. Everybody must be heard. That is today's operational environment at the jail.

However antithetical that may sound to a traditionally paramilitary culture, feedback from front lines has been consistent lately.

It is time to adapt.

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