Youth Prison Watchdog Calls For Audit Of Medical Contractor

May 27, 2018

A private health care company that treats inmates at Maine’s youth prison has come under scrutiny in a new report from the facility’s independent oversight group.

The watchdog report also echoes cries for a comprehensive review of the state systems that have filled the South Portland prison with young people battling mental illnesses.

In its report to lawmakers, the Board of Visitors for the Long Creek Youth Development Center recommended creating committees to audit the work of health care contractor Correct Care Solutions and, in an accelerated time frame, suggest changes to the full range of youth services.

“Correct Care Solutions has been under fire from advocates for many years because we have received so many complaints from prisoners about medical treatment,” said Joseph Jackson, head of the Maine Prisoner Advocacy Coalition.

The call for a comprehensive review of how Maine helps troubled young people is part of a chorus of such proposals. They have risen in the wake of Long Creek’s first suicide in decades and the revelation that many of the teens held there have disabilities and mental illnesses beyond what corrections staff are able to treat.

But the suggestion that Correct Care Solutions’ contract should be reviewed adds a new facet to the debate over the prison. It has become public as the Tennessee-based company and Maine Department of Corrections are facing a lawsuit that claims an 11-year-old boy was denied emergency dental care after two Long Creek guards allegedly knocked out his teeth.

The company and department, neither of which answered questions for this story, have denied these charges in court filings. They follow what the head of the visitors board characterized as a precipitous decline at the prison.

“In the last few years, Long Creek has gone from being an exemplar among juvenile justice developmental facilities, to a program that’s had serious safety and quality concerns, despite the best efforts of committed, hardworking and well-intended staff,” Tonya DiMillo, the board chair, wrote in the group’s most recent annual report.

‘This unfortunate road’

The visitors board places this decline in the context of Maine’s troubled history with corrections and mental health care, including alleged abuses at the youth prison that preceded Long Creek and the federal government’s 2013 decertification and subsequent condemnations of the Riverview Psychiatric Center.

“We have been down this unfortunate road before,” wrote DiMillo, whose group is empowered by law to inspect, review and report on the prison. “I think we can all recognize the parallels in how we have treated our most vulnerable.”

Corrections officials have acknowledged that the facility was at the brink of a crisis last summer, but say things have improved significantly since then, with a staff shortage being filled and new positions created to help young people with mental illness.

On Friday, the department announced that a triennial audit had found the prison to comply fully with the American Correctional Association standards. In a statement, Commissioner Joseph Fitzpatrick said he “is proud of the efforts underway at Long Creek to provide the best care and service to the juveniles in our custody.”

Nevertheless, the problems there have led advocates to call for Long Creek’s closure. In its report, the visitors board states that “simple closure does not find a solution” but suggests moving youth programs from under the umbrella of the adult corrections system.

In an interview, DiMillo said that the purpose of her recommendations is to build mechanisms that can assure the quality of services for youth throughout Maine. At Long Creek and other prisons, the quality of health care is a frequent complaint from inmates, according to Jackson.

“People feel their conditions aren’t treated or are treated improperly,” said Jackson, who served time in the Maine correctional system before becoming a prisoners’ rights advocate.“These are consistent among many of the [inmates’] complaints.”

Last winter, top corrections officials responded to an independent audit that found “dangerous and harmful conditions” at Long Creek by saying that they were working with the Department of Health and Human Services to quickly open secure, regional psychiatric facilities that would take some of the pressure off the prison.

In December, Fitzpatrick said these centers might serve nearly a third of the young people then at the prison and that they could be opened by this spring. But there’s so far been little evidence to suggest that this timetable will be met.

This spring, the corrections department and a nonprofit group did open the state’s first publicly funded halfway house for youth leaving Long Creek. And last week, the Department of Health and Human Services began a process of making rules that would govern “psychiatric residential treatment facilities.” But details about these new centers are scant.

Despite remaining vague, the proposed treatment facilities have drawn criticism from Disability Rights Maine, which argues that they would be overly restrictive and costly. The organization contends that what is actually needed is more community-based care.

“Many children have been waiting for home- and community-based services, sometimes for years,” said Peter Rice, the advocacy group’s legal director, adding that Maine should develop an overarching plan to help young people with mental health needs.

‘Restricted, non-transparent and siloed’

The Department of Health and Human Services has confirmed that the mental health treatment facilities are in the works but has not responded to repeated questions about their specifics. In its report, the Long Creek visitors board suggests that this tight-lipped approach to a much-discussed problem ill serves Maine kids.

“In our current governing environment we must shift away from what appears to be a restricted, non-transparent and siloed approach,” the board’s report states.

Indeed, the report was difficult to obtain. Maine law requires that the visitors board for each prison send an annual report to the Department of Corrections and the Legislature’s committee on criminal justice and public safety.

DiMillo said she did this in April. The Bangor Daily News sent the Corrections Department a Freedom of Access Act request for the report that month. To date, the department has neither provided the report nor claimed it is exempt from the public records law.

A criminal justice committee staff member, who previously said she did not have the report, provided it to the the Bangor Daily News on Thursday, saying that it had been sent to the committee chairs but mistakenly not circulated to other lawmakers.

DiMillo said that one mechanism for such collaboration used to be the Children’s Cabinet, a council in which the heads of state agencies could coordinate policies to help children, from education initiatives to criminal justice reforms.

Although it is established in law, the cabinet has been inactive under Gov. Paul LePage. The Republican governor has supported interdepartmental collaboration but does not see the need for the cabinet’s “duplicative reporting structure,” his press secretary, Julie Rabinowitz, told the BDN in February.

This story appears through a media sharing agreement with Bangor Daily News.