The Ugly Record of Armor Health

Armor Correctional Health Services will soon be replaced as the contractor handling the Milwaukee County Jail and House of Corrections, but it leaves behind a sorry record that is still being litigated. The Milwaukee County District Attorney has charged the Florida-based company with a felony complaint of abusing an inmate, and a county audit found a laundry list of problems, including negligent care and falsifying records.

“I think what we’ve learned what we don’t want to do,” County Supervisor Sheldon Wasserman said of Armor’s performance.“We’ve learned that staffing has to be complete” and “that we need psychiatrists available.”

Those were some of the 18 recommendations made by an audit by the county Comptroller conducted in August 2018. The 115-page investigation found that over a 22 month period — November 2015 to August 2017 — Armor never met the required 95 percent staffing level needed to earn its County payment. The company provided an average of only 89 percent of its staffing requirements over that period, with only 83 percent of registered nurse hours and 85 percent of mental health staff hours covered, according to the audit.

Staff also neglected “perform checks on inmates to ensure they swallowed their medications.” This was during a period where several people died while in custody at the jail.

The audit was prompted in part by the shock wave which followed the death of 38-year-old Terrill Thomas In April 2016, after flooding occurred in his cell, Thomas was moved to a solitary cell where his water was shut off. A week later Thomas was found fatally dehydrated.

Armor Correctional staff were found to have falsified Thomas’ medical records to include checks on him which were absent on surveillance footage. Footage viewed by then-Captain George Gold, who claims he reported what he saw to Major Nancy Evans, was later lost. A list of seven staffers recommended for charges, besides medical personnel, eventually shrank to three, two of whom were given short sentences (30 to 60 days) in the House of Corrections.

Evans was later sentenced to nine months in HOC, charged with felony misconduct in office and obstructing an officer. Neither Gold (who resigned) nor former Sheriff David Clarke, who oversaw the county jail, were charged. By contrast, under laws allowing corporations to be charged as people, Armor Correctional itself was charged.

Initially, Armor faced seven counts of intentionally falsifying medical records. Each misdemeanor carried a fine of no more than $25,000 to the company itself. Falsification of medical records was called an intentional “pattern and practice” in the criminal complaint.

Chief Deputy District Attorney Kent Lovern declined to comment on the still pending court case, but his revised criminal complaint, amended in December 2018, states Armor is now charged with one count of felony abusing an inmate. It carries a fine of not more than $10,000.

Milwaukee County Corporation Council Margaret Daun, in an email to Urban Milwaukee, said it’s “not common, particularly at the federal level,” to charge a corporation in this way. “It is unclear from the charging document whether the DA’s office will argue that Armor knowingly permitted the abuse of Mr. Thomas, or directly committed the abuse.” At least one employee “fabricated blood pressure and pulse readings that the employee never performed on Mr. Thomas,” the criminal complaint reads.

Armor also was assessed fines related to the low staffing levels uncovered by the audit, but these paled compared to the company’ earnings. Armor’s contract was worth over $16 million, and its CEO Bruce Teal referenced its “billion dollar sister company” MCCI Holdings at a county meeting in 2013.

“I thought the penalties were a little low,” Supervisor Wassernman said in an interview with Urban Milwaukee. “They [Armor] still made so much money that the fines didn’t hurt. It was like a kind of slap on the wrist for them. Armor defiantly didn’t get the message.”

Candice Owley, president of the Wisconsin Federation of Nurses and Health Professionals (WFNHP), says the company itself should be targeted. “It’s kind of easy to attack the front line staff,” she told Urban Milwaukee. “If you can link the company to having a climate or policy which causes this behavior, that is far more important.” Still, she noted that  employees directly involved in misconduct “should have their license removed.”

Urban Milwaukee contacted the Wisconsin Department of Safety and Professional Services, which handles that very process. Assistant Deputy Secretary Dan Hereth said via an email that convictions do not “come about” from misconduct cases, but rather, “convictions may be a basis for a misconduct case if substantially related.” He added that, “when some violation is both a practice violation and a criminal conviction, a referral from DSPS to criminal authorities may occur.”

Owley and her organization went before the county board multiple times in 2011 and 2012 opposing privatizing inmate healthcare. State and county budget cuts, however, made outsourcing increasingly attractive. WFNHP dug into Armors reputation and presented its findings in an article presented to the board entitled “Bribery And Bad Medicine,” which detailed Armors lawsuits, inmate deaths, and a pattern of winning favor with sheriffs through campaign donations and gifts. This may have helped the board decide against using Armor, and the board voted repeatedly against hiring the company.

But Sheriff Clarke, who oversaw the jail, sued the board in 2013, and a judge ruled in favor of Clarke, declaring that Milwaukee County must contract with Armor. The reasoning behind the ruling was that the county was having trouble filling vacant staff positions that were mandated by the Christensen Decree, an earlier court order to improve the services at the jail.

Since Armor nurses aren’t unionized through WFNHP, the organization was shut out of subsequent discussions about Armor’s performance. Owley says it wouldn’t surprise her “if Armor went out of business or re-organized itself.” The company was banned from New York State after similar inmate deaths in 2016, and a Florida jail recently had its own death. The company’s website states it still has 27 other clients besides Milwaukee, including immigration detention facilities. How current that list is, however, not clear. Armor Correctional didn’t respond to requests for comment from Urban Milwaukee.

For the time being another company, Wellpath, will inherit Armor’s job. It was formed through the merger of Correct Care Solutions, and Correctional Medical Group. The company beat out NaphCare, VitalCore Health Strategies, and Centurion Detention Health Services for the Armor contract. Like Armor, the two merging companies that created Wellpath had numerous malpractice lawsuits of their own.

Daun noted numerous improvements have been made to the new contract with Wellpath, including; “increased emphasis on accountability, auditability, and reporting, the requirement of a third party contract monitor to ensure contract compliance,” and a focus on filling nursing positions.

Wasserman agrees, stating he feels the improved regulations “are for the better.” He says Wellpath is facing requirements “that no one else had to deal with before.”

As Urban Milwaukee reported yesterday, the county board has voted to replace Wellpath by 2021 with an in-house operation of county paid employees providing medical care for the jail and House of Correction, but that is likely to be a far more expensive way to go.

“The question is what we can afford” said Wasserman. “I just got briefed on the budget short fall for next year. We’re already looking at a $23 million structural deficit.”

But he also noted the “legal, constitutional requirement for healthcare that meets community standards” for “our prisoners,” not to mention “a moral and ethical responsibility” to provide better care. The county must do better, he stressed.

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