St. Mary's Hospital discontinues treating inmates of state prison

Dale Quinn

Nov. 7, 2009 (McClatchy-Tribune Regional News delivered by Newstex) -- State prisoners will no longer get treated in a detention unit at Carondelet St. Mary's Hospital, as the health network says it would lose money caring for the sick inmates during the state's budget crisis.

The hospital at 1601 W. St. Mary's Road has cared for the bulk of the state's inmates who required treatment outside a prison facility. But the reimbursement rates put in place by Arizona make continuing to provide that care cost-prohibitive, said Andrew Guarni, chief financial officer for Carondelet Health Network.

"We cannot provide the level of care that this patient population requires at the reimbursement rate the state is requiring," Guarni said.

The contract between St. Mary's Hospital and the Arizona Department of Corrections expired Sept. 30, but the health network extended it as negotiations over reimbursement rates lingered. Carondelet Health Network decided to terminate the contract last Saturday, but a transition plan will remain in place until Nov. 23.

Carondelet operates three hospitals in Tucson and one in Nogales.

The Department of Corrections will negotiate with other Southern Arizona hospitals to provide out-of-prison care for inmates, said DOC spokesman Barrett Marson. Inmates with minor illnesses are treated at prison infirmaries, Marson said.

The state has contacted University Physicians Healthcare Hospital at Kino Campus on Tucson's south side, said UPH spokeswoman Sarah Frost. She provided no details about any contract negotiations.

So far this fiscal year, 319 of 610 inmates -- or roughly 52 percent -- requiring hospitalization have been sent to St. Mary's, Marson said. In the previous fiscal year, of 1,781 total admissions, 61 percent went to St Mary's, he said.

Prisoners are also treated at Maricopa Medical Center in Phoenix, Marson said.

The St. Mary's program treated inmates with acute illnesses, such as a heart attack, as well as those with chronic ailments like cancer, or injuries that require orthopedic surgery.

The hospital also treats patients who require blood cleansing dialysis treatment because of kidney failure.

Carondelet had received the same reimbursement rate for the previous six years, but with the state's budget crisis, officials opted to lower the rate to one equal to payouts through the state's Medicaid program, the Arizona Health Care Cost Containment System, or AHCCCS.

Diana McBroom, chief nursing officer for St. Mary's, said the rate was too low because of the specialized care and equipment required by inmates -- including locked units, cameras, additional outpatient care and security training for physicians and nurses.

Carondelet offered a reimbursement rate lower than previous years that would have covered the cost of inmate care with a small profit margin, but that rate wasn't accepted, Guarni said. If providing care at AHCCCS rates, Carondelet would have been operating the program at a loss, he said.

"We operate at a very slim margin as it is," Guarni said. "So in order to reduce that margin we'd have to make it up someplace else."

The St. Mary's program -- which had 40 beds in secured detention areas isolated from other patient-care units -- has been in existence about 20 years, McBroom said. About 40 employees staff it, but there are several openings throughout the health network so no job losses are expected, McBroom said.

To cut the state's transportation costs, Carondelet developed a "telemedicine" program where inmates could talk to and see a physician on a monitor, McBroom said. The monitor also had medical equipment, such as stethoscopes and otoscopes, that could help the physician diagnose and treat inmates, McBroom said.

The telemedicine program will also end with the termination of the contract. The equipment will likely be used to improve rural health care, McBroom said.

The secured prison unit will be converted for other use, the Carondelet officials said.

With the closure of the program, St. Mary's will only treat inmates who are admitted through the emergency department.

Losing the program is difficult for the health network because inmates are a "vulnerable population" with limited access to health care, McBroom said. Caring for such individuals falls into Carondelet's mission as a nonprofit Catholic health-care provider, but continuing the program at a loss wouldn't benefit the community at large, she said.

"When we start looking at cuts that are going to impact the level of care we're going to provide, we have to make a decision," McBroom said.

Contact reporter Dale Quinn at 573-4197 or dquinn@azstarnet.com

Newstex ID: KRTB-0014-39521762