vaughn prison

Delaware's prison health care system, which has been the subject of lawsuits, will now undergo an independent review.

Ordered by new prison commissioner Claire DeMatteis, the six-week review conducted by Christiana Care will include a close examination of the prison contractor's medical and behavioral health systems in Level IV and V facilities in an effort to seek recommendations to strengthen quality, patient safety, and data management.

"I think it's important for the Department of Correction to have an overall assessment by an independent, reputable organization to come in and understand how we're doing against certain industry clinical benchmarks--how are we delivering good, quality care? Are we focused on outcomes? Are we treating people when they come in with a medical condition? Are we keeping them safe? Are we keeping them from having additional medical problems? Are we preventing infectious disease outbreaks?"   

These are questions this review will seek to answer, according to DeMatteis.

The prisons' health care provider, Connections, has been the subject of inmate grievances and lawsuits filed in the wake of inmate death Luis Cabrera, 49, of Bear, who was serving a life sentence for a triple murder and was a potential witness in the James T. Vaughn prison riot trial. Dover attorney Steve Hampton represents the Cabrera family and has called Cabrera's death by a perforated ulcer completely preventable, noting the inmate "died in agony."

Cabrera's death is also the subject of a whistleblower lawsuit.

"I am confident that there is very high-quality medical care being delivered in our facility; I am also sure that there are areas for improvement," she told WDEL when asked about the current state of prison health care. "That's why bringing in a very reputable health care system like Christiana Care will help. They will hold the Department of Correction to the same high standards that they hold themselves and that will help us get better at what we're doing."  

"Connections is aware of the assessment and will cooperate," Department of Correction spokesman Jason Miller told WDEL.

The Delaware Department of Correction's contract with Connections for both behavioral and medical care expires in June of 2020, but DeMatteis wouldn't speculate on whether a change in provider is needed. 

"I'm not going to prejudge that, I'm honestly not," she said. "I think there's very high-quality care being delivered in our facilities; I think what's making news is just the one or two things you're hearing about that's negative. So I'm not prepared to prejudge it. I am prepared to say, let's bring in an independent, highly reputable health care system to help us understand what we're doing right, and where we can improve."

Connections CEO Cathy McKay said she's thrilled by the review that comes at a critical point as the Delaware DOC prepares to issue request for proposal for its correctional health care services.     

"This review will hopefully establish clear benchmarks for the quality of care, the equipment needed to provide that care, and the true costs associated with providing care in one of the most challenging environments imaginable.  We look forward to being a partner with Christiana Care and the Department of Correction in this review," McKay told WDEL in an email.  

Christiana Care to lead independent review--for free

"Christiana Care is recognized nationally for its clinical quality and safety expertise and maintains a strong commitment to serving the community, with a focus on improving health and advancing health equity in Delaware and the surrounding communities," DeMatteis said in a news release.

Christiana Care, while it does not have expertise specific to prison health care, will conduct the audit for the Delaware Department of Correction at no cost to the state and make recommendations based on health industry standards for quality and patient safety. Christiana Care will also be given full access to personnel, facilities, and files to perform the review, which will begin next month.  

"The goal is to open up everything to them," she said. "So they can come in and do chart reviews, case reviews, understand our policies and procedures and help recommend to us areas where they think we can do better."

She said Christiana Care will also have access to inmates.  

"At Christiana Care, we serve our neighbors as respectful, expert, caring partners in their health. We are especially focused on working with partners throughout our community to meet the physical and behavioral health needs of our most vulnerable populations,” said Bettina Tweardy Riveros, Christiana Care chief health equity officer and senior vice president, government affairs and community engagement. “We are glad to provide our health care expertise to the Department of Correction, and we hope that our recommendations will enable the DOC to ensure the delivery of quality care in its facilities and make a positive impact on the health of our community.”

Prison health care critic remains skeptical

Hampton, who's also leading a class-action lawsuit about inmate abuse and a lack of medical care following the 2017 riot at the Smyrna prison, said he's not "terribly confident" that this review will lead to any change in the prison health care system.

"If you look back, last year, there was a review of the sick call process...the report came out I think in May, sick call requests are now being ignored worse than ever," he told WDEL.

Hampton said he received emails Thursday from loved ones of inmates who can't get a sick call.  

"So that review did nothing, and it appears DOC learned nothing from that review. So a new review is going to--if it's done right--show a lot of problems. But if you have a review and don't fix anything, a review is worthless. Every review that I've seen them do so far has not resulted in any kind of improvement in care; in fact, care's deteriorating," said Hampton.

Hampton challenged Christiana Care and DOC personnel that a review isn't necessary to identify the problems.

"I can tell them what the problems are right now. Come down to my office, and I have boxes and boxes of letters and dozens of dozens of emails about the denial of care, the delay in care, and the fact that people are getting seriously injured because they're not getting treatment, or in some cases, dying because they're not getting treatment. This is not a surprise. This is well-known all across the system."

Hampton called a new health care vendor is "necessity."  

"I've seen a lot of vendors come and go. Some of them are tolerable--tolerably bad, I guess I should say--and some are just intolerable, and Connections fits into the intolerable group." 

DeMatteis said the results of Christiana Care's deep dive into the prison health care system will be made public. She also pointed to her record, prior to becoming commissioner, when she served as the special assistant to the Delaware DOC in the wake of the riot that killed correctional officer Lt. Steven Floyd.

"I ask you to look at my record, it was my job to help [then] Commissioner Phelps implement 41 recommendations from the independent review team report that people thought would sit on a shelf, and instead we implemented 41 reforms in one year, so I did ask you to look at my record, and that's what I'll do in this instance as well," she said.  

"I would love to see it result in change; I'm very skeptical it will," said Hampton. "I would love to see the system fixed, I have no confidence at this point."