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New York City Comptroller William C. Thompson, Jr. is urging the Department of Juvenile Justice to correct troubling problems with health care services at the city's juvenile justice detention centers. A review by the Comptroller's Office revealed that the contractor, EMSA Correctional Medical Services, an affiliate of Prison Health Services, Inc., failed to provide required psychiatric services and quality assurance reports. Additionally, EMSA/PHS misrepresented in supplied documents critical data such as how often it medicated children. EMSA/PHS also failed to develop a system to provide medication to detainees temporarily removed from juvenile detention centers.

"The Department of Juvenile Justice mishandled its oversight role by inadequately monitoring this contract and in so doing may have placed children at risk," Thompson said.

The Comptroller pointed out that Prison Health Services is the firm actually performing the work at the DJJ sites. The 14 non-secure, "group home" facilities and three secure detention centers have a daily population of about 500.

In an April 8th letter to DJJ Commissioner Neil Hernandez, the Comptroller's Office raised additional concerns about a pattern of problems with Prison Health Services. Within the last week, the New York State Commission of Correction issued a critical report on PHS's services in Albany County. Additionally, the commission has issued eight earlier reports criticizing PHS for its training, hiring, and health care procedures. Five other Commission reports - triggered by inmate deaths - faulted PHS for failures in health care, including improper supervision and accreditation. A March 22, 2001 Commission report recommended that the New York State Department of Health review whether PHS should be able to continue providing health care in New York State.

"This troubling history should not go overlooked," Thompson said. "The Department of Juvenile Justice must carefully evaluate whether youths at the centers are receiving the proper medical attention."

EMSA/PHS's contract renewal expired March 31st, and DJJ currently is seeking a one-year extension. The Comptroller strongly recommends that DJJ improve its monitoring before a new contract is extended and pursue breach-of-contract damages from EMSA/PHS. The Comptroller's Office reviewed documents supplied by EMSA/PHS to the Department and found glaring gaps. Among them:

· EMSA/PHS inaccurately reported its performance. For instance, records indicated that no over-the-counter drugs were administered to any youths at the Bridges, Crossroads and Horizon detention centers from May to November 2001. This would be a most unlikely occurrence.

· Similarly, the number of children with illnesses that EMSA/PHS reported were admitted to DJJ's Medical Specialty Housing Unit, which is an isolation unit, does not reflect all of the children actually treated there.

· EMSA/PHS did not file required monthly or annual Quality Assurance Reviews detailing care.

· EMSA/PHS provides seven part-time psychiatric social workers and the full-time equivalent of 1.4 psychiatrists for the 500 youths in the system daily. EMSA/PHS offers only individual counseling, although the contract calls for it to provide both individual and group counseling.

· EMSA/PHS additionally provides only one part-time medical doctor to treat all of the non-mental health needs in all of DJJ's facilities.

The Comptroller is urging the department to closely review the effectiveness of having only one part-time medical doctor, who also has other responsibilities, under the contract; and reports submitted by EMSA/PHS to ensure that it increases counseling services. He also wants EMSA/PHS to establish a system to provide medication to juveniles who are away from DJJ facilities during the day. Additionally, the Comptroller indicated his concern that the DJJ facilities lacked appropriate medical accreditation and recommended that DJJ immediately complete the necessary requirements to receive such accreditation.

Since the contract extension is for one-year, Comptroller Thompson recommends that DJJ also start the next selection process immediately to encourage competition for these critical medical services. During the last process, EMSA/PHS was the only contractor to submit a proposal.

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