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Fate of Huge NOLA Jail Health-care Contract Left Undecided

After receiving complaints about the quality of care provided, city officials delayed a decision on whether to replace Wellpath LLC with LSU Health New Orleans. The contract could amount to as much as $93 million.

(TNS) — The fate of a huge health care contract at the New Orleans jail was left up in the air Tuesday when city officials, faced with complaints about the quality of care provided by Wellpath LLC, delayed a decision on whether to replace that company with LSU Health New Orleans.

Wellpath, a titan in the jail and prison health care industry, says it's too risky to switch providers as the Orleans Parish Sheriff's Office tries to complete a nine-year-old reform agreement. The sole other bidder for the city-managed contract, LSU Health, says a local, public institution can do better than a for-profit company based in Nashville, Tennessee.

Both sides faced questions at a City Hall purchasing bureau meeting that drew an unusual level of public input from doctors, community organizations and Sheriff-elect Susan Hutson.

In the end, the committee of city employees overseeing the selection process made no decision. Members said they wanted more public comment and more review of Wellpath's record in the parish jail.

A $93 Million Prize?

The exact size of the contract has yet to be decided, but if the current cost remains steady over the five-year period proposed in City Hall's solicitation it would pencil out to $93 million. Moreover, city officials have asked for new services, such as a plan to treat people with opioid use disorder with drugs such as buprenorphine.

Hutson won't take office until May 2 and doesn't have a vote in the contract selection. But Mayor LaToya Cantrell's administration has appointed her as a non-voting member of the selection committee.

The prospect of losing the contract drew more than a dozen Wellpath officials to the virtual hearing, including company President Kip Hallman.

Yet even before the meeting Wellpath was on the defensive: A coalition of groups, including the Orleans Public Defenders and Orleans Parish Prison Reform Coalition, sent a letter opposing a new contract for the company. So did a group of more than 100 doctors and medical students.

Jennifer Mansour, a Tulane University medical student who did a rotation as a medical advocate for the Orleans Public Defenders, said jailed clients receive "vastly inferior care" to patients she sees elsewhere. Mansour said jailed clients often go a week before receiving medications that are supposed to be delivered in 24 hours.

"I don't believe that we do our communities right by continuing to provide this substandard care," Mansour said. "Y'all have such a big decision to make here, and I really hope you'll consider a community-based provider."

'Proud' of Performance

Hallman and other Wellpath officials said the private equity-owned company does the best job possible in challenging circumstances. They bristled at the idea that critical medications are delayed and chalked up some issues to shortages in the number of sheriff's deputies available to escort medical providers.

They also claimed credit for some of the jail's creeping progress toward fulfilling the 2013 federal reform agreement, known as a consent decree. Since the company began providing services in New Orleans in 2015, full or partial compliance with the consent decree has risen from 18 percent to 98 percent, they said.

Still, Hallman faced direct questioning from Hutson on the more than 1,000 lawsuits that have been filed against Wellpath, including several in New Orleans.

Hallman said 93 percent of lawsuits are dismissed completely, others are settled for small amounts and only one or two a year involve big payouts. Lawsuits are inevitable for a company that employs 15,000 people and serves 300,000 patients a day, he added.

"Are we perfect? Absolutely not," Hallman said. "We continue to work to get better, and I think overall we're very proud of the work that we do."

The Public Option

While many of Wellpath's critics expressed a preference for a local, public institution, LSU Health New Orleans also faced skepticism.

The LSU proposal is led by the health sciences center's psychiatry department. Its department head, Dr. Rahn Bailey, faced multiple questions about whether LSU will be able to provide physical medical care in addition to mental health.

A Wellpath critic said that if New Orleans was concerned about the level of detail in the LSU Health proposal, it should request proposals all over again.

"If the committee sees no alternative to Wellpath, then I think the move here is to delay," said Jared Miller, a supervising attorney for the Orleans Public Defenders. "I understand that LSU's proposals may have its flaws, but Wellpath has proven over the course of the last decade that they cannot provide adequate care."

Bailey said the proposal had full support from other LSU Health New Orleans departments that would be able to provide staffers. He also promised that current Wellpath employees would be invited to continue working in the jail.

He said LSU Health has not previously managed a prison or jail health care contract. But he said he would take full responsibility for ensuring that the handover goes smoothly.

"I think we have a good network, a good footprint of providers that can manage this process, and I think the transition will be seamless," he said.

(c)2022 The Times-Picayune | The New Orleans Advocate. Distributed by Tribune Content Agency, LLC.
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