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As Connections exits Delaware prisons, lawsuits, unpaid debt loom for treatment provider

Brittany Horn Esteban Parra
Delaware News Journal

As Connections Community Support Programs prepares to depart from its $60 million prison health care contract with Delaware, the organization is staring down a lengthy list of lawsuits and unpaid debts.

The nonprofit owes Bayhealth Medical Center more than $6 million in unpaid medical bills for care to inmates within Delaware prisons over a five year period, according to a lawsuit filed in state court last month.

Connections is also being sued by numerous former employees who filed whistleblower lawsuits about Connections' practices and policies, including lack of treatment to a dying inmate and the firing of two employees when they voiced concerns about over billing. 

Tack on the dozens of federal court cases in which Connections is named as a defendant, most commonly for improper medical treatment inside Delaware's state prisons, and an investigation by the state Department of Justice, and the legal hurdles seem endless.

Standard prison uniform worn by inmates at James T. Vaughn Correctional Center.

On Monday, the Delaware Department of Correction announced it would be ending its contract with Connections three months early after a bid from Centurion of Delaware LLC – for more money than the state is paying now – was secured. 

BACKGROUND:Connections Community Support Programs to exit Delaware prisons amid controversies

Similar to Connections, Centurion has its own history of prison health care lawsuits, what some would consider to be part of the challenge of delivering services in these spaces. 

Though it's common for prison health care providers to come under scrutiny, especially by inmates filing lawsuits on behalf of themselves, Connections has faced a number of cases in which they've lost or settled privately.

Take Steven Sipple, who died in September 2018, a little over a year after he was released from prison with terminal colorectal cancer. His lawsuit, which his family privately settled with Connections, claimed Sipple's condition worsened as he went untreated in Vaughn Correctional Center while cancer spread throughout his body. 

Steven Sipple was an inmate at Vaughn until April 2017, when he was released from prison and diagnosed with colorectal cancer on the same day. He died a little more than a year later, before Connections settled a lawsuit privately with his family.

Or the two separate lawsuits facing Connections regarding the death of inmate Luis Cabrera, who both a former Connections employee and Cabrera's family say could have been prevented had the 49-year-old man been offered better care. 

BACKGROUND:Lawsuits claim agonizing, and preventable, death of inmate in Delaware prison

Yet Connections leaving the prisons is far from the only service provided by this Delaware treatment behemoth, which saw more than $100 million in state contracts before losing the corrections' agreement.

That leaves at least $40 million in state funding on the table for addiction and behavioral health services across Delaware, and hundreds of residents who rely on its services, many in some of the least-resourced areas of the state – all while the organization is searching for a new CEO. 

"After I turned 65, I realized that it had been more than three decades since I was able to devote myself full time to providing therapy services, which is why I got into this line of work and is what I want to do in the remainder of my career," said former CEO and co-founder Cathy McKay in the statement.

But what exactly waits on the horizon for Connections and its clients?

$6M in debt to Bayhealth

Connections, which will be responsible for the prisons' physical and mental health care until April, breached its contract with Bayhealth by failing to pay for services at the hospital when inmates required more care than could be provided at the prison infirmary, the lawsuit says.

The two companies came to an agreement in 2014 over what services Connections would pay for and billing rates, but the agreement ended in 2019 when Bayhealth raised concerns about the mounting unpaid bills, according to court records.

It subsequently renewed the memorandum of understanding upon Connections agreeing to pay for more than $2 million in outstanding bills through an initial $1 million payment and then monthly equal installments, according to the lawsuit. 

A jury concluded that Bayhealth Medical Center Inc. discriminated against a longtime nurse at Kent General Hospital by not allowing her to return to work wearing a back brace after she underwent back surgery. The nurse was awarded $100,000 in punitive damages.

The agreement noted that the contract could be ended by either party if terms were not met or if either company wanted out – which Bayhealth called upon before 2019 came to an end.

The lawsuit says the contracted prison health care provider failed to make the payments laid out in the agreement, and continued not to pay for more services provided in inmates in the months during the extension of the contract. 

Now, Bayhealth has turned to Delaware courts to get its money.

The DOC said Monday that this dispute is between Connections and Bayhealth, and does not involve the prison system. 

Connections did not immediately return a request for comment on this lawsuit, but noted the organization typically does not comment on pending litigation. 

Another whistleblower lawsuit

Two former Connections employees have filed a lawsuit against the nonprofit claiming they were fired after raising and reporting concerns about under-staffing, the number of full-time employees and overbilling.

Theodore Williams and Derick Jackson Jr. were both employees within Connections Department of Intellectual Disability Services, which oversees a number of group homes throughout the state for "intellectually disabled individuals to develop community living and related skills," according to the lawsuit.

When they started, Connections was already on probation for previous overbilling infractions due to staffing mistakes, according to the lawsuit.

This specific program was even at risk of being shut down if "further program infractions" occurred, court documents say.

Despite these concerns, Williams and Jackson describe in the lawsuit an ongoing situation in which complaints were not heard and instead, employees were penalized for the under-staffing and lack of training in which they found themselves.

Even when issues were raised, the men say in the complaint that they were dismissed, not provided meetings with leadership, and eventually terminated.

Williams was told he was fired because he failed to file a report and because another employee wanted their job back, according to the lawsuit. 

Jackson was told he was "nonresponsive" to DDDS and his leadership, the complaint says.

Both were given reasons that their attorney, Stephen Norman, wrote are "unsupported by any articulable facts, are untrue and are a poorly disguised pretext for the actual reasons," according to the lawsuit. 

State investigation

All of this news comes at a tough time for Delaware, a state still battling increasing numbers of drug overdoses – and Connections has, for quite some time, played a leading role in stemming the addiction epidemic here.

Connections in Harrington offers inpatient and outpatient treatment for addiction.

The organization was responsible for opening the first downstate detox facility for Kent and Sussex residents who were otherwise forced to drive north for treatment. And Connections has continued to expand its footprint in southern Delaware with sober living homes, outpatient treatment and its continued presence in Harrington at its detox center.

Yet its addiction treatment services, specifically in Delaware prisons, are what landed the organization under the investigation of the state Department of Justice.

A News Journal investigation in 2019 found that Connections employees at Crest South fabricated notes of therapy sessions that never occurred, made up vague treatment plans to correspond with them and backdated records to appear as if Connections was providing monthly counseling.

INVESTIGATION:Prison contractor falsified records to conceal inadequate addiction treatment, sources say

Shortly after, the DOJ confirmed the agency was investigating. The results of this investigation have not been released to the public. 

Connections denied these allegations.

Contact investigative reporter Brittany Horn at (302) 324-2771 or bhorn@delawareonline.com. Follow her on Twitter at @brittanyhorn.