A year after the city-parish privatized health care at the East Baton Rouge Parish Prison, a private company has the operation fully staffed and outfitted with new medical equipment that past nurses repeatedly and unsuccessfully requested from City Hall.

CorrectHealth officials said they have spent the past year changing the way inmates go through health screenings when they enter the prison, converting paper files into electronic medical records, increasing the number of nurses staffing the prison and more. The Atlanta-based company will receive nearly $5.7 million from the city-parish to pay for its continued services in 2018.

Prison health care costs have been escalating for years while the amount of medical attention inmates need has also been on the rise. East Baton Rouge Prison Warden Dennis Grimes said the population of sick inmates is the highest it has ever been, and the high rates of people coming to prison as they detox from heroin or need treatment for HIV put even more strain on the prison's health care providers.

The prison has also seen more inmates who need mental health treatment and more lawsuits alleging a lack of proper mental health care.

When former Mayor-President Kip Holden's administration privatized prison medical care last year, top officials said City Hall was not equipped to run a health care clinic. But going private led to ire from some Metro Council members who remembered pleas from prison nurses in 2015 about being dangerously understaffed, overworked and in need of basic medical supplies. The nurses also alleged they were at risk of losing their jobs because they spoke out.

Some of those nurses have remained working under CorrectHealth while others have moved on. But Grimes said inmates are now complaining less about their medical care.

On a recent tour of the prison's health care unit, one inmate with a cut on his face stopped and thanked Natasha Jones, a nurse practitioner, for cleaning him up the night before. Jones runs the prison medical unit on a daily basis as its health services administrator. 

Within the next year, CorrectHealth hopes its Baton Rouge operation can go through an audit and become accredited by the National Commission on Correctional Healthcare.

Jones and CorrectHealth's Susan Hatfield also revamped the way inmates go through health screenings when they first arrive at the prison. On the recent tour, Hatfield and Jones showed how they transformed a small room near the prison's entrance into a "medical intake" area with nurses sitting at desks and computers.

Before someone is booked into prison, he or she now goes through a quick examination with a licensed practical nurse. The nurse asks a series of questions designed to ensure an inmate does not need to be diverted to an emergency room or higher level of care than the prison can provide. Nurses then ask about medical history, incarceration history, drug use, alcohol use, pregnancies and more, and they check vital signs and administer tuberculosis tests.

"Sometimes, inmates overexaggerate because they don't think anyone will listen otherwise," said Hatfield, the Atlanta-based executive director of clinical services for CorrectHealth. "Other times, they won't tell you at all."

Still, having initial contact with an inmate has been crucial to helping medical staff anticipate when an inmate might need more care, Jones said. The medical intake also determines whether an inmate can be placed in the prison's general population, or whether he or she needs to be placed on suicide watch, mental health watch or another special assignment.

The volume of inmates at the parish prison exceeds 1,500 and is one particular challenge in Baton Rouge, Hatfield said. The staff frequently works with patients who have not properly managed chronic conditions like HIV, diabetes and high blood pressure because many people who land in prison had not previously accessed health care on the outside.

Yet most inmates in parish prison are also released back into the public, Grimes said. Thus, the CorrectHealth officials said they try to make the best of their one potential chance to convince someone to take care of his or her health.

"That may be the first conversation that person has about their addiction," Jones said.

CorrectHealth has also been able to replace equipment that was a chief complaint of past prison nurses. Those nurses said faulty EKG machines, wheelchairs that were falling apart and a lack of other supplies were putting prisoners at risk.

One of those who spoke up in 2015 and who returned many times to the Metro Council was Beatrice Stines, the former prison director of nursing. She and others said in 2015 the prison only had about 25 nurses and a few doctors on contract, and that multiple nurses were out on stress leave.

CorrectHealth has around 50 people now staffing the prison operation.

Stines said in a recent interview that after prison health care was privatized, she switched to working in the city-parish's call center. She had three years left until retirement and hoped to hang onto her city-parish benefits. But the call center work meant a pay cut of $7 per hour, and she missed nursing, so she went to work at a dialysis clinic.

"All of my benefits and all of my tenure is just gone," Stines said. "Now I'm starting over."

She said she misses the array of medical problems to treat at the prison, but her new job is far less stressful.

As CorrectHealth has tried to improve medical operations, prison officials and the warden agreed one hurdle will continue to stand in the way: The prison is outdated and undersized.

The prison does not have wards in its medical unit for female inmates, as the male population is so large that men take up the two wards they do have. Medical staffers have to separately visit the female section of the prison to treat people there. Jones, Hatfield and Grimes said they wish they had a separate female ward.

Recent attempts to pass taxes to pay for a new jail have been unsuccessful.

Also, the improvements under the CorrectHealth contract have not stopped lawsuits from people who allege medical care at the parish prison is deficient. 

The family of 27-year-old Jonathan Fano filed a lawsuit in September against the city-parish and prison medical services. Fano, who struggled with mental illness, hanged himself inside his prison cell in February, according to the family's lawsuit.

They allege medical staff thought Fano was faking his condition and started weaning him off medication before he died. Prisoner deaths are all too common in Baton Rouge because the prison lacks a dedicated and safe mental health unit, according to the family's lawsuit. 

Follow Andrea Gallo on Twitter, @aegallo.​