Health care behind bars

About the article: Dr. Stephen A. Cullinan, the Peoria physician who has been the target of numerous lawsuits alleging substandard care in jails throughout the Midwest, has retired, according to Correctional Healthcare Companies, the parent company of the Cullinan-founded firm that has contracts to care for inmates in dozens of correctional facilities. Cullinan’s retirement came in January, shortly after he agreed to a $737,500 payout to settle a lawsuit brought by the estate of Maurice Burris, who died in 2007 when a perforated ulcer went untreated in the Sangamon County jail. Illinois Times has written about Cullinan’s practice and accompanying legal woes three times, most recently on June 7, but until now had not received any response from Cullinan or his firm, which took a week to respond to written questions emailed on May 30. Below is a letter we received from the company the night of June 6, after the last article published had already gone to press.

I would like to provide a response to your recent articles and request for information concerning a few isolated cases of inmate care provided by Health Professionals, Ltd (HPL) which was acquired by Correctional Healthcare Companies, Inc. (CHC).

We are a national leader in inmate health care, providing services in 26 states to nearly 70,000 incarcerated patients and over 40,000 probationers. Since 2006, CHC has acquired and assimilated the best industry practices of four regional correctional health care companies and four community service companies with over 135 years of cumulative experience in the correctional health care and community services fields. The incarcerated population is the only population that is guaranteed health care by the U.S. Constitution, making quality inmate health care not just good practice, but a legal requirement that carries with it substantial taxpayer cost and also liability for failing to properly provide necessary services. CHC uses its expertise in the correctional health care field and its leveraged buying power to provide these required services for federal, state and local government agencies at substantial cost savings.

CHC partners with local providers to administer required medical services at correctional facilities and provides employment for over 4,000 employees, over 450 of which are in Illinois, and maintains a regional office in Peoria. Partnering with CHC allows county governments and municipalities to transfer the risk and liability associated with providing these services from local government tax dollars to CHC. Last year, CHC employees cared for the health of over 8,000 inmates in Illinois in county jails, state prisons and juvenile detention centers.

Treating patients in a correctional setting presents a number of challenges not present in the community medical setting. These include patients that typically do not have access to routine medical care, and their visit with correctional health care staff may be the first exposure to proper medical care they have received in a number of years, or ever, in some cases. Inmate patients typically suffer from a higher incidence rate of mental illness, substance abuse, chronic and acute illness and are more likely to malinger symptoms for personal gain such as seeking prescription medication to sell in jail, to manipulate housing assignments or, in the worst cases, to present security threats such as attempting to escape during transport to a hospital or other community provider.

This particular area of health care is extremely litigious compared to community-based treatment and a majority of cases are frivolous and never advance past the initial pleading stages of the lawsuit. Regardless of the quality of care provided, providers may expect to be the recipient of an inmate lawsuit if they provide correctional health care services for any substantive period of time. Despite this challenging legal setting, since CHC‘s acquisition of HPL in 2007, the number of per capita lawsuits filed by inmates has steadily declined. We do, however, always regret the rare situation where treatment doesn’t meet our standards and results in a negative outcome. We constantly strive to improve our treatment models through implementing best in class correctional health care policies and protocols, routine continuing education training of our staff and utilizing quality improvement monitoring of outcomes to identify and correct any deficiencies in care.

Dr. Stephen Cullinan, a co-founder of HPL, is a respectable and compassionate doctor who has treated tens of thousands of inmates in Illinois and other states over 16 years. He and his late wife enjoy a statewide reputation as caring physicians who have contributed millions of dollars to Illinois universities for scholarships and continuing education. Although Dr. Cullinan retired from employment with CHC in January, we still respect his past contribution to the medical community in Illinois as well as his prior dedication to providing needed health care services in area correctional facilities.

Due to pending litigation, we cannot provide further comment on your request concerning state board inquiries about Dr. Cullinan, nor can we provide specific information regarding settled litigation as the terms of all such settlements are subject to confidentiality agreements.

Shelton Frey is vice president and general counsel of Correctional Healthcare Companies, Inc., Greenwood Village, Colo.