DOC looking to privatize state's offender health care

FORT MADISON – A move by the Iowa Dept of Corrections is creating some preliminary angst locally with employees engaged in offender health care.
The state DOC announced on Tuesday that they are seeking out requests for proposals to privatize health care delivery in state institutions under DOC control as well as electronic health document programming.
Paul Cornelius, Chief of Staff for DOC Director Beth Skinner, told Pen City Current in an email Tuesday morning that this is a very preliminary step and no plans have been changed to date.
“At this time, the Iowa Department of Corrections is issuing a Request for Proposal (RFP) to explore future options for healthcare delivery and to replace our current electronic health record system,” Cornelius wrote in the email.
“This is an exploratory step—no final decisions have been made, and no immediate changes are planned for staff or services. The goal is to evaluate how we can best meet long-term healthcare needs while continuing to provide high-quality care.”
Additional questions were sent to Cornelius as follow-ups. Those questions were not addressed or returned.
Todd Copley, President of AFSCME 61, said this is a reaction to the state’s inability to manage their own money.
“The Governor brags about a $1.8 billion surplus. Cornelius told me this has to do with rising costs of pharmaceuticals, which comes out of a totally different budget, and the upgrading of a new software system. That may cost $50 million, but that’s a drop in the bucket when you have $1.8 large sitting in a fund.”
According to an FAQ sent to healthcare staff from the DOC earlier this week, the RFP is being released to explore medical services, care coordination, identify cost efficiencies, and meet ongoing healthcare demands to see if a provider will assume responsibility for delivering medical, dental, mental health, and pharmaceutical services; will be the employer for all DOC healthcare staff to ensure consistency and continuity; and maintain compliance with contractual and regulatory requirements.
The current health recording system has been in use for more than 20 years and has been difficult to navigate and find data in a timely manner. The new system will help healthcare staff access records more quickly and coordinate better care. Additionally, a newer system will assist with quality assurance and compliance.
The FAQ also addressed several challenges, including staffing shortages.

“IDOC Health Services have ongoing challenges such as staff shortages, rising pharmaceutical and transport costs, demands on staff time, and a growing need to expand mental health and substance abuse treatment. The RFP seeks to explore the evolving demands and needs, enhance cost efficiency, and enhance service delivery for Iowa’s incarcerated population.”
Copley said the staff shortage isn’t because people don’t want to work for the state. He said the wages aren’t sufficient for this type of work and are not competitive.
“They cannot fill these positions because the wages aren’t there. A hospital nurse can make $15 more per hour than in the prison system. It’s the IPERS,” he said.
“Per the FAQ, a new vendor would be willing to interview the current staff to give them first looks at open positions. These people are underpaid where they’re at, and then they apply for a job where they may make less money and lose IPERS? I may be dumb, but I’m not stupid. The pot at the end of the rainbow is IPERS and they are taking that away. It’s like a bad dream. It really is.”
The state said the change is needed now as the DOC has a responsibility to explore sustainable solutions for offenders.
“Healthcare is one aspect of our operations. Additionally, rising healthcare and pharmaceutical costs requires us to explore a different approach. Partnering with a qualified healthcare vendor offers an opportunity to strengthen service delivery, improve health outcomes, and ensure long-term financial sustainability,” the email indicated.
Copley said he’s hearing the DOC wants to have numbers and some answers by September. He said that makes him think they already have the answer and are just waiting for the “ink to dry.”
“I hope I’m wrong and I pray to God I’m wrong. This affects too many people," he said.
"The state plays the blame game and, for the past 10 years or longer, the employees of the state of Iowa, have carried the burden of fixing the state's problem with short staffing, and by working egregious amounts of overtime. We never used to have that problem. I’m all for being fiscally minded, but you have to quit stealing from Peter to pay Paul,” he said.
Copley said numbers out of an October survey show that close to 200 employees could be affected statewide. He didn't have a southeast Iowa count at hand.
State Rep. Blaine Watiins (R-Donnellson)  said  he wants to see the process unfold a little, but said private engagement isn't necessarily harmful.
"Based on what I've heard, the Department of Corrections has said, it sounds like this is still in the exploratory phase. No decisions have been made, and I want to give the process time to unfold. That said, any move that could affect local jobs, IPERS eligibility, or public safety deserves close attention," he said.