Prison health care in Delaware is not improving, report says

Health care offered to prisoners in Delaware has not been improving.

That’s one of the findings of an investigation by the state’s biggest hospital system into how the Department of Correction provides care to its prisoners. Workers from Christiana Care spent six weeks looking at how people who are incarcerated receive health care.

For the past 34 years, seven different vendors have provided medical care to Delaware prisoners. And in that time, Department of Correction Commissioner Claire DeMatteis said, there was no assessment of how to deliver better care.

When asked how that could be possible, she had a simple answer:

“Welcome to state government.”

In the summer, she ordered the review just completed by Christiana Care.

“I am confident that offenders are getting good health care in our correctional facilities. What this report will do is help us make that better, and hold our vendor accountable,” DeMatteis said.

The report found that the correctional health care system “siloed” into departments that limit coordination and accountability. Much like the trouble the state has had hiring and retaining correctional officers, the prison health care system has been plagued by persistent staff turnover and vacancies. 

The study also identified difficulties in getting supplies that cost less than $500. 

“It was not unusual to hear that when a box of supplies arrives on site, it is like ‘opening presents on Christmas,’” the report stated.

DeMatteis ordered the evaluation in August following increased scrutiny on the issue from lawmakers, as well as demands for improvement from prisoners and their families. She said the department has to do a better job of communication between administrators and those on the front lines providing care. 

“I’ve seen this before, and I’ve seen how training and a culture change can change [an organization],” she said.

Earlier this year, the Attorney General’s Office confirmed it was investigating allegations that the Correction Department’s medical contractor, Connections Community Support Programs, had ordered staffers to forge documents to falsely state prisoners were getting mental health treatment they never received. Connections also faces a host of prisoner lawsuits. DeMatteis said the Attorney General’s Office told her department that investigation is ongoing.

In July, the family of Luis Cabrera sued Connections, alleging that prison staff ignored his symptoms, and that his death in November 2018 could have been prevented.

DeMatteis said most of the report’s recommendations can be implemented without extra funding. One exception is its finding of an inadequate electronic health records system, which hinders effective communication among health care providers. 

She estimated fixing the e-records could cost between $3 million and $5 million.