Miami Herald - December 3, 2004
Carol Marbin Miller and Wanda J. Demarzo, wdemarzo@herald.com

The jail's new healthcare provider, Correctional Health Services (CHS), apparently has not submitted necessary paperwork that would allow the firm to legally stockpile medications for inmates, according to the Florida Board of Pharmacy, which processes applications for pharmacy licenses.

"I haven't issued them a [pharmacy] license and they can't dispense any medications until they receive one," Dinah Skrnich, of the state board, said Thursday.

"That's a little scary," said Howard Finkelstein, Broward's public defender-elect. "Our clients are in jail, and they have a constitutional right to appropriate treatment. If that treatment includes medication, it is their right to have it."

In any given month, about 200 inmates suffer from hypertension. Another 88 suffer from seizures, 55 are on medication for diabetes, 135 are asthmatic, 40 are being treated for tuberculosis and 86 receive medication for HIV, the virus that causes AIDS, according to internal records of the Broward Sheriff's Office.

In addition, the jail, which has become the warehouse for thousands of South Floridians with chronic and severe mental illness, dispenses psychotropic drugs to, on average, 1,100 inmates each day, or nearly one-fifth of the jail's population.

CHS has applied for a pharmacy license and contracted with Medistat Pharmacy Services to operate the jail's pharmacy, said Col. James Wimberly, executive director of BSO's Department of Detention and Community Control.

Medistat, based in Fort Lauderdale, provides pharmaceutical services to local nursing homes and correctional institutions. "We're good to go," Wimberly said Thursday. "We are not having problems with the medications at the jail."

But late Thursday sources said nurses at the jail got a phone call from Angela Goehring, a CHS administrator, ordering them to pack up all medications and remove them from the jail.

Nurses took out about 15 boxes packed with over-the-counter drugs, injections, narcotics and stock medication. In one case, a nurse stuffed eight boxes in her car.

The nurses may have been preparing for an inspection today, said BSO spokeswoman Cheryl Stopnick.

"I'm not sure what is going on over there, but I think they're just getting things ready for the inspection," Stopnick said. "The inspection is to make sure the jail is 100 percent in compliance."

The company's move to take over healthcare at the jail has not gone as smoothly as officials had hoped, according to Doyle Moore, CHS's chief executive officer.

"I was under the impression we had 60 days for the transition, not 28 as we later learned," Moore said.

Healthcare workers are dispensing drugs to specific patients -- not through the jail pharmacy but through Medistat Pharmacy services, Moore said.

The company brings in the medication in the morning and again in the afternoon.

"They're making deliveries twice a day," Moore said. "We're not able to stock drugs yet, though."

If an emergency arises, inmates will be taken to the hospital for treatment, Stopnick said.

"No one is going without medication," Stopnick said.

Broward County operates the 12th-largest county jail system in the nation, with more than 5,000 inmates, according to a U.S. Bureau of Justice Statistics May 2004 report. Miami-Dade County's jail system is ranked sixth, with some 6,800 inmates during the same time period.

CHS filed papers with Florida's Secretary of State on July 19 to become a corporation, state records show.

Three weeks later, BSO formally sought bids to manage healthcare at the jail.

In October, BSO awarded the contract to CHS.

Following a recent jail inspection by the American Correctional Association, the previous healthcare provider, Wexford Health Sources, expected high marks.

In a Nov. 5 letter to Sheriff Ken Jenne, the company's vice president, Jimmy Webster, said he anticipated the company would get a "100 percent compliance report" for medical care from the accrediting agency. Instead, the firm was dropped.

Wexford, based in Harrisburg, Pa., formally left the jail after managing healthcare there for the last three years. CHS took over Wednesday.

Wexford's license to operate a pharmacy at the jail remained active until late Thursday, said Skrnich, of the state pharmacy board.

If drugs were being dispensed at the jail, the healthcare provider was probably using Wexford's license, said Skrnich. But that's not allowed under state law, Skrnich said.

"CHS has to have their own facility license to dispense or fill any medications."

Processing the applications could take up to a month, Skrnich said. An inspector has to visit the facilities before any licenses can be processed.

The firm also has to have a Drug Enforcement Administration license to dispense narcotics, including drugs used to treat mental illness or sedate people with behavioral or emotional problems.

"I don't want to hear about licensing snafus," said Finkelstein, whose office represents up to 90 percent of the jail's inmates. "That's not our problem."

The mix-up over obtaining a pharmacy license could lead scores of county residents with chronic mental illness to become more gravely ill if locked up, said Mark Moening, a Broward activist who serves on the Broward Alcohol, Drug Abuse and Mental Health Planning Council.

"People get worse while in jail, even if they are medicated," said Moening, who has been incarcerated himself a dozen or so times during the last decade. "Now, they will end up having an even worse crisis."

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