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Private prisons turn a profit caring for sick inmates

WOODLAND, Pa. (AP) -- For the county jails, state lockups and federal prisons within a short drive of this central Pennsylvania nowhere, Norm Cox has a pitch: Send me your sick, and I'll save you millions.

His Corrections National Corp. is building a 700-inmate medical prison here. It's the nation's second private lockup designed to deal with the ever-increasing ranks of sick inmates and those over age 55 in this era of three-strikes-and-you're-out sentencing.CNC is one of several private corrections companies venturing into medical care with promises of big savings for cash-strapped public jails and prisons.

CNC and Just Care Inc., which opened the first private medical prison in Columbia, S.C., in October, are following the lead of many state governments.

From Ohio to Louisiana to California, states are investing in wards and entire hospitals to treat prisoners. About 100 miles south of the CNC site, Pennsylvania already houses about 400 inmates, most sick, at its Laurel Highlands State Prison.

These public efforts please budget watchdogs and advocates for elderly inmates. But the same groups are wary of the private firms' foray into medical care.

Their concern is oversight: When states deliver their sick to private wardens hundreds of miles away, how will they make sure their prisoners are getting good health care?

"I have mixed feelings, frankly, about private geriatric units," said Jonathan Turley, founder of the Project for Older Prisoners. "There is the added need to generate profit, and that could potentially interfere with care and security."

Like Just Care's Columbia Care Center, CNC's $45 million prison would not handle emergencies or surgery. Instead, both companies target prisoners who need nursing attention, but not hospitalization. Inmates recovering from surgery, AIDS patients, hepatitis sufferers, paraplegics, mental patients -- all would be candidates.

These are prisons' costliest burdens, and more are on the way.

The federal and most state governments don't have an exact number of prisoners over 55, but the generally accepted figure is about 50,000. Pennsylvania now houses 1,586 of them and expects the number to triple by 2005.

At 55 years old, inmates are more likely than the general population to have chronic illnesses, experts say, because of the ravages of doing time and, in many cases, drugs.

Sick inmates, on average, cost three times more to house than those in the general prison population. At Laurel Highlands, the annual cost-per-inmate is $77,649, compared to $23,776 at Pennsylvania's other prisons.

That cost can be much higher. If a prison system has no medical center, it must send inmates to hospitals.

South Carolina has a contract with Richland Memorial Hospital, which charges $1,048 per day for a bed, plus $288 per day for a respirator and $880 per day for intensive care. Add wages for 24-hour security, and the cost tops $2,000 per day. Just Care will provide the same services for $460 per day.

For a state that spends $35.5 million a year -- 15 percent of its corrections budget -- on health care, that's too good to pass up. Gail Fricks, a deputy corrections director, was enthusiastic about the center after a 30-day trial, and South Carolina plans to send more prisoners there.

"It was wonderful," Ms. Fricks said. "Security loved it, and I loved it."

While large states are building their own medical prisons, Tull Gearreald, Just Care president and a former Merrill Lynch investment banker, thinks county jails and prison systems in small states will be just as eager as South Carolina to contract out.

States facing prison crowding can get more beds for their buck by putting up a general population prison and leaving it to the private companies to build the more expensive health care jails.

It's a bad trade-off, one critic says.

"I'm troubled about it because our secretary of corrections has absolutely no authority, no oversight, was not consulted," said Julia Glover Hall, president of Pennsylvania Prison Society, which monitors prisons and jails.

Recent scandals do not help CNC. A private prison in Youngstown, Ohio -- the Northeast Ohio Correctional Center, owned by the Corrections Corp. of America -- drew the most attention after at least 13 inmate stabbings and two inmate deaths in its first year of operation, 1997-98. A year ago, six inmates, four of them killers, escaped briefly from the center.

Pennsylvania's Department of Correction admits it will have no control over CNC's facility, unless it signs a contract to send some of its sick prisoners there. But the Department of Health would certify the facility annually, and Cox said he will apply for accreditation.

"Because we don't have long-term medical contracts, if they don't think we're doing a good job, they'll take 'em back," Gearreald said.