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Christiana Care to review state's controversial prison health care systems

Christiana Care will provide an independent review of the state's prison health care systems, which have come under fire following recent News Journal stories. 

The Delaware Department of Correction said Thursday that the hospital system, which does not have expertise specific to prison care, agreed to provide recommendations based on health care industry standards for quality and patient safety for six weeks starting in September. 

"It's important to have an independent review from an incredibly reputable health care system and Christiana Care fits that perfectly," DOC Commissioner Claire DeMatteis said.

Three months ago, the state Department of Justice said it was investigating Connections Community Support Programs, which provides physical and mental health care to all inmates inside Delaware’s state-run prison system. 

News of that probe came after The News Journal published an investigation into reports that the contractor falsified records to conceal inadequate addiction treatment at Crest South, a taxpayer-funded substance abuse program for drug offenders in Georgetown.

Claire DeMatteis, a former senior counsel to then-U.S. Sen. Joe Biden, became Delaware's DOC Commissioner last month.

Word of Christiana's review did not lift spirits of those who have been dealing with prison health care, such as Dover Attorney Stephen Hampton.

Any review that depends on interviewing the DOC and contracted medical personnel, but not the patients themselves, has no value, Hampton said. That's because the DOC and contracted medical personnel are the ones presiding over a system that fails to meet standards of care in almost every area.

He added that he received an email Thursday about an ill Sussex Correctional Institution inmate who has been requesting medical help, but he's not been seen by health care providers.

"There have been a number of reviews before this, and nothing was done to fix the problems identified," Hampton said. "All the studies in the world don't mean a thing if you aren't going to fix the problems. 'Let's do a study' gives me no confidence that anything will change."

The DOC has a troubled track record when it comes to medical care within state prisons. Lawsuits are filed nearly every week about issues with its health care, which is contracted through Connections.

Last year, Steven Sipple filed a lawsuit claiming he made more than 15 written requests for medical attention as he found blood in his stool and began suffering abdominal pain. According to his lawsuit, he got only cursory treatment, such as stool softeners and topical creams.

After his release, doctors diagnosed him with advanced, terminal colorectal cancer.

Steven Sipple, seen here in February 2018, was an inmate at Vaughn until April 2017, when he was released from prison and diagnosed with colorectal cancer on the same day. He submitted more than 20 grievances asking to be seen by doctors but little action was taken.

INVESTIGATION ORDERED: After reports of record falsification, Department of Justice investigating Connections prison services

RECORDS FALSIFIED: Prison contractor falsified records to conceal inadequate addiction treatment, sources say

LAWSUITS FILED: Lawsuit raises questions about prison health care

Christiana Care's review will conclude with a written report that provides recommendations on opportunities to enhance clinical quality and safety by adopting best practices regarding workflow management, data and analytics management and support.

The DOC will provide any necessary data, documents, information and access to personnel and facilities that Christiana Care needs.

The review will include interviews with DOC staff and contracted medical personnel, site visits and review of policies, procedures and process documentation at DOC facilities.

It will also seek to identify opportunities to enhance utilization of clinical data and analytics to facilitate management of chronic medical conditions. The review may include clinical chart reviews for a random sample of patients.

Christiana Care will not evaluate or make medical assessments or recommendations in individual diagnoses, treatment plans or other medical services made by individual health care providers or provided to individual patients. The assessment also will review existing prison Bureau of Correctional Healthcare Services measures dealing with infection prevention, general environment of care, pharmacy and equipment inventory.

The service, which is being provided at no cost, will help Delaware improve prison safety – an effort state officials said they are taking more serious since the February 2017 siege at James T. Vaughn Correctional Center that resulted in the death of correctional officer Lt. Steven Floyd. 

"This is another important step in the efforts we've taken since Feb. 2, 2017, to make sure our prisons are safe for both correctional officers and for inmates," Delaware Gov. John Carney said in a statement. 

DeMatteis, who reached out to the hospital system about this during her first week as commissioner last month, said the review will be made public after its completion. 

Under new leadership, the DOC has been working to implement changes regarding health care within the prison.

With the support of state funding and recently signed legislation, the DOC is expanding medication-assisted treatment – considered the standard of care in treating drug addiction – in all major prison facilities statewide and to all inmates who seek it.

BACKGROUND:Vaughn prison riot timeline, from the siege to charges being dropped

The prisons already had some medication-assisted treatment available to inmates, but it was only used by 39 people because inmates were reportedly declining the treatment or weren’t “medically cleared to receive it,” according to the department.

Earlier this year, Pew Charitable Trusts recommended making this treatment available in Delaware prisons because it would have the biggest impact on the addiction epidemic.

Few states nationwide make all three forms of medication-assisted treatment available to its incarcerated population, despite its high success rate at keeping people sober.

Rhode Island implemented a similar structure and saw a 61% decrease in post-incarceration overdose deaths – which translated to a 12% decrease in overdoses statewide.

Delaware’s formerly incarcerated population makes up a large percentage of drug overdose deaths here.

A review of the state’s 2017 drug overdose deaths found that more than half of all those who died had interacted with the Department of Correction at some point in their lives. About 35% had an interaction with the DOC in the year before their death, according to the report.

The state plans to begin parking a health outreach van outside the state’s prisons this fall to help connect people with their insurance immediately upon leaving the prison and ensure their treatment or medications don’t lag upon getting out, which many have reported to be the case.

"It's very costly for the state to not do these things," said Lt. Gov. Bethany Hall-Long, who chairs the Behavioral Health Consortium, when Pew's recommendations were released.

Contact Esteban Parra at (302) 324-2299, eparra@delawareonline.com or Twitter @eparra3. Contact Brittany Horn at (302) 324-2771 or bhorn@delawareonline.com. Follow her on Twitter at @brittanyhorn.