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Quality of jail's inmate health care questioned as contract set to expire

The guard tower of the Nassau County jail

The guard tower of the Nassau County jail in East Meadow is shown in this photo from March 2, 2012. Credit: Ed Betz

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Nassau County is trying to extend the contract of a private company that provides medical care at the jail, even as a former bar association president recently called health services for inmates "inadequate and dangerous" in a letter to the sheriff.

Meanwhile, a Nassau judge has voiced concerns about defendants not getting their prescription medications in the East Meadow facility, and in one case, lowered an inmate's bail after her lawyer said the woman hadn't gotten diabetes medication for several days despite the court's instructions.

County officials have called the health care deal a money-saver and want to continue Nassau's partnership with Miami-based Armor Correctional Health Services when the existing contract expires later this month.

"There is no intention of discontinuing the existing relationship at this time," sheriff's department spokesman Capt. Michael Golio said.

But a local civil liberties group that tracks inmate complaints says the quality of care is being sacrificed for a population that is generally powerless while behind bars to seek any independent means to stay healthy.

"They've marketed themselves in terms of cost savings," Jason Starr, director of Nassau's New York Civil Liberties Union chapter, said of Armor, a company that provides medical care for more than 40,000 inmates in several states. "That has motivated them to what we feel like is to make decisions not in the best interest of inmates' health, but to save expenses."

An Armor spokeswoman wouldn't comment on individual cases but said the company's policy is to "strictly adhere" to proper medical protocols.

Mineola attorney Marc Gann warned in an April 6 letter to Nassau Sheriff Michael Sposato and Armor that the shortcomings of the health care provided by the company "must be addressed before an inmate is seriously injured or dies."

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Gann, a past president of the Nassau County Bar Association, said in the case of one of his clients, the inmate repeatedly had asked for medical attention because of pain and swelling in his leg. But the attorney said jail medical staff ignored the requests for about 10 days before diagnosing his client with a blood clot.

"Untreated, it is not an understatement that the clot could have killed him," the criminal defense lawyer wrote. "The inattention and neglect is deplorable."

Gann also said the "apparent cost-saving measures" by the county in engaging Armor's services "will actually cost the county substantially more when an individual is either seriously injured or killed."

A spokesman for County Executive Edward Mangano referred a request for comment to the sheriff's department.

Golio, the sheriff's spokesman, said the department couldn't comment on the medical care of any particular inmates because of privacy laws. But he said that officials rely on Armor to provide appropriate care, and inmate complaints "are immediately forwarded to Armor staff for their review and follow-up as may be medically required."


Issue raised in court

The issue of health care at the jail also has come up repeatedly in a Nassau County courtroom, with acting State Supreme Court Justice Jerald S. Carter expressing concern about a problem with inmates getting prescription medication.

On April 9, Carter set bail at $150,000 bond or $100,000 cash for Janice Jessup, 67, a disbarred attorney whom Nassau prosecutors charged in an alleged $1.2 million grand larceny scheme.

While arguing for bail, defense attorney Henry Jones of Jericho explained Jessup was a diabetic and gave her medical records to the court. Jones also told Carter he was concerned Jessup, who takes five different medications, would experience health complications if she were incarcerated after her arraignment.

The judge said he would provide specific information to the jail about the medications Jessup was taking and warned he might have to reconsider his decision about bail if Jessup didn't get her medication behind bars.

"I want to make it very clear because we've had problems at the jail, and I'm not putting her in there from the perspective that she goes to the jail and all of a sudden those medications cease for whatever reason," Carter said.

He continued: "If, in fact, she is not receiving her medication . . . let me know, because then I may have to revisit this whole incarceration."

Before the arraignment ended, Carter stressed that he would be keeping an eye on the defendant's medical concerns, saying, "I'm just trying to make sure this medication thing is taken care of."

On April 14, Jessup returned to Carter's courtroom and he lowered her bond to $50,000. Jessup, who already had surrendered her passport, also has to wear a GPS monitoring device and stay in New York State while awaiting trial.


Medication delay?

Jones told Newsday that Jessup hadn't gotten her diabetes medication until the sixth day she'd been behind bars, the same day the judge cut her bond. The attorney also said outside court he believed the medication problem "might have played into" Carter's decision. A court spokesman said on Carter's behalf that it wouldn't be appropriate for the judge to comment on the issue.

Records show that in a separate case in March, Carter also sent instructions to the jail that a different inmate should be examined for ADHD after the defendant struggled to keep his composure and sit still in court. The defendant's attorney told the judge her client hadn't gotten his medication, and a family member who was in court said the defendant was supposed to be on ADHD medication.

Starr, from the NYCLU, said complaints about inmates not getting prescription medications are among the most common gripes his agency has heard.

"The kind of complaints we're receiving, and frankly the volume, show care is not being provided in a way that is constitutionally required," said Starr.

Golio said county officials were seeking a two-year extension to a contract that ends May 31, which the Nassau legislature must approve.

An Armor spokeswoman said the company's team of caregivers is committed to delivering quality patient care. But she said the vendor wouldn't respond specifically to Gann's letter or alleged problems with Jessup's medication.

"Armor Correctional Health Services' policy is to strictly adhere to medical protocols for individual situations, diagnoses and incidents. As a result of our commitment to adhere to these policies, all of which are designed to meet governing agency guidelines, including HIPAA regulations, and out of respect for our patients' privacy, we cannot respond to your request," Armor spokeswoman Teresa Estefan said.

Golio said Armor's contract has meant a greater number of inmate health services are provided at the jail, "thereby enhancing overall facility security and increasing public safety by dramatically reducing off-site transportation of inmates to unsecure community health services providers."

In 2011, county officials called it a cost-cutting move when awarding the first two-year contract, worth about $11 million a year, to Armor. The deal privatized work Nassau University Medical Center previously had handled, and Mangano has publicly spoken of the contract saving $7 million annually.

Records show Nassau County renewed Armor's contract for another two years in 2013, and has paid the vendor nearly $43 million since mid-2011.

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