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Shortage of health care staff in Florida prisons increases danger, retired nurse says

Negligent care in prisons costs taxpayers millions
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Posted at 8:07 PM, Nov 11, 2021
and last updated 2021-11-17 14:53:43-05

ZEPHYRHILLS, Fla. — Florida’s prison system is being pushed to the brink, with a critical shortage of correctional officers and struggle to staff health care workers, riddled with high turnover and high risk.

“If we can’t find nurses to work in our hospitals, it’s 10 times worse to work in our prisons,” Republican State Senator Jeff Brandes, of St. Petersburg, told the I-Team. “We have a huge shortage of nursing staff, of physicians, and that is creating problems throughout the entire system. Especially when the state has a responsibility to provide healthcare for these individuals.”

Brandes, who vice-chairs the Senate Committee on Criminal Justice, said not having enough nurses doesn’t just lead to a sicker population of prisoners.

“Ultimately it ends in massive lawsuits. And that’s the thing that the state has now been fighting for years, are the lawsuits on negligent care that they received within the Department of Corrections by some health care providers. We know that’s existed,” Brandes said.

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State Senator Jeff Brandes, R-St. Petersburg

That litigation forced the Department of Corrections to spend an additional $146 million between the fiscal year 2016 and 2019, to fund hundreds of new staff positions related to mental health and care for inmates with disabilities, as well as hernia and Hepatitis C treatments.

REPORT: Florida Department of Corrections: 2020-2021 Strategic Plan & Annual Report

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Bar graph from the report posted above

“We have to have a better system. And that’s where we have to allocate our resources more efficiently,” Brandes said.

In 2018, the state contracted prison health care services to Centurion, a Virginia-based company and the only bidder for the $375 million contract.

“It’s one of the biggest challenges we have in the State of Florida is finding a good medical contractor. In fact, we went into emergency bid a couple of years ago and now we operate on what they call a 'cost-plus' contract. So we pay all of the costs, plus a profit for our vendor to do that. That was the only way we could get somebody to come into the State of Florida and provide health care to the entire system,” Brandes said. “We have looked at other models, there are other models out there. Sometimes the universities take on that inmate healthcare, we’ve seen that work in other states. The simple truth is, in Florida, it’s all hands on deck to just keep the Department of Corrections and healthcare facilities running appropriately today.”

RELATED STORY: Florida prisoners 'inches away' from emergency release

Greg Krolikowski, a registered nurse with 20 years of experience, recently retired after working for four years at the state prison in Zephyrhills.

Most of his years were spent working in hospitals.

“That was my first contact with prison,” he said. “Everyone who passes those gates and barbed wire, kind of — I believe chills go through the spine. What am I going to find out on the other side?”

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Zephyrhills Correctional Institution

Krolikowski worked in the psychiatric unit.

“On the psych unit in the prison, it’s highly unpredictable,” he told the I-Team. “It might be violence, it might be cutting, it might be open wounds, it might be an attempt of suicide, you don’t know. And for that reason, the staffing should be higher up, should be better than what it was. I had roughly 40 inmates and I was by myself. 12-hour shift at night.”

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Greg Krolikowski, a registered nurse with 20 years of experience, recently retired after working for four years at the state prison in Zephyrhills

Krolikowski told the I-Team he saw more than a dozen people accept a position show up for their first day of work, and never come back.

“People were calling in sick because they didn’t want to work there with that kind of staffing,” Krolikowski said. “The revolving door, it costs money.”

The Department of Corrections was supposed to save money outsourcing healthcare for prisoners in 2011.

REPORT: Health Care Study: Florida Department of Corrections

Problems keeping health care staff positions filled was a “significant factor” in turning to privatized care in the first place, according to an independent audit of the Department of Corrections inmate health care from November 2019. The report said, “vendor performance in filling positions has been similar to that experienced by the state and it still has difficulty in recruiting and retaining nursing and mental health staff.”

In the report, the I-Team found the Department of Corrections does not track Centurion’s staffing levels as a part of its contract, something the auditors called “unique.”

While most contracts include detailed staffing plans to monitor vacancies, the state’s contract with Centurion does not.

The audit states that the impact of staffing levels on services is so significant that “it arguably should be tracked, and the vendor held accountable for providing agreed levels” and pointed to lawsuit settlements that have cost Florida taxpayers millions.

Democratic State Representative Dianne Hart, of Tampa, told the I-Team Centurion has to go.

“Going into these facilities and speaking to the wardens and to the correctional officers, everybody says the same thing. We have no real medical provider. They’re not providing people medication as they should, they’re not sending people on sick calls as they should,” Hart said. “I mean they did a study. So it’s not like it’s me who’s saying it because I’m visiting and they’re telling me, it’s in writing. And we’re still allowing them to be responsible for our inmates.”

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State Rep. Dianne Hart, D-Tampa

RELATED STORY: Florida inmate dies weeks after breast cancer diagnosis; family wants change in prisons' health care

According to that study from 2019, the state could save an estimated $46 million if it did not outsource prison health care, but it would continue to be difficult to recruit and retain staff.

A Centurion spokesperson told the I-Team:

“Quality correctional medical services hinges on the ability to both attract and retain dedicated healthcare professionals to join a challenging industry, as well as support from security officers who serve as partners in providing care, ensuring safe escort, and maintaining safety in medical service areas.

Centurion uses incentives to attract top talent, provides continual training and development programs for current employees, and partners with educational programs to teach students about the benefits of a correctional health career path. Centurion employs over 30 recruiting staff members working diligently to attract staff so that we can continue to ensure that high-quality health care services are delivered to the residents of the FDC.”

Centurion has not answered questions about how many open positions it has in Florida prisons.

RELATED STORY: Florida prison staff, inmates wait on word for vaccine eligibility

Krolikowski retired six months ago.

“It takes a toll on everybody. The level of anxiety, insomnia, even PTSD, depression,” he said. “This was the first time when I had to take medical help.”

Still, he said, it’s important to share what’s happening on the inside.

“If something is wrong, you should not just ignore it. And this interview proves that if I believe that something is wrong, I want to talk about it. Hoping that things will change.”

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Greg Krolikowski, a registered nurse with 20 years of experience, recently retired after working for four years at the state prison in Zephyrhills

Centurion’s contract with the state ends in June.

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In the ABC Action News series, Crisis in Corrections, the I-Team reveals the factors building to what state leaders call a breaking point in the Florida Department of Corrections. What’s at stake in the state’s largest agency and the third-largest prison system in the country and the impact beyond prison gates.