Steppingstone

The company, of course, wasn’t in business out of the goodness of its heart. Even as it negotiated the South Florida State Hospital contract, it was looking ahead to future business. “We kind of recognized this new business line as very similar in many respects to the corrections business line, in that they were all large state-run facilities, many of which were not running all that well,” says Dale Frick, who oversaw the project’s development. Frick is vice president of project development and client relations for GEO Care, the company descendant of Atlantic Shores. “Of course, we saw a large national market availability of these types of facilities and projects.”

"We kind of recognized this new business line as very similar in many respects to the corrections business line, in that they were all large state-run facilities, many of which were not running all that well,” says Dale Frick, vice president of project development and client relations for GEO Care."

And in fact, the south Florida project has provided a huge springboard for Atlantic’s parent company, which changed its name to GEO Group in 2003 and renamed Atlantic Shores Healthcare as GEO Care in 2005. The original South Florida State Hospital contract of $30.8 million has grown to $35.7 million. And GEO now has several other contracts to run new mental care facilities in Florida, including a $2.7-million-a-year contract to provide mental health services at Palm Beach County jails.

Earlier this year, GEO opened two facilities to help the state deal with a 300-person backlog of mentally incompetent inmates awaiting placement to treatment facilities from county jails. Together, the contracts to operate the two facilities — the 100-bed South Florida Evaluation and Treatment Center Annex in Miami and the 175-bed Treasure Coast Forensic Treatment Center in Indiantown — are worth $34 million.

GEO’s track record in Florida has other states taking notice. At the south Florida hospital, the company regularly hosts visitors from other states curious about the privatization model. Many of the several hundred state mental health facilities around the country don’t reach minimum constitutional standards for care, Frick says. “If the states can’t do it and can’t bring it up to the necessary levels, they might look to a company like ours to come in and do it for them or help them do it. It’s just a nice market.”

But if GEO’s performance at South Florida State Hospital was motivated in part by a desire to create a showcase to attract future business, the results also reflect the provisions of a tough contract insisted on by state negotiators, most particularly Ed Feaver, secretary of the Department of Children and Families when the state negotiated the contract with Atlantic Shores in 1998.

GEO Care has a $18.9-million contract to take over the Florida Civil Commitment Center, a former prison in Arcadia now used as a treatment facility for sexually violent offenders. With 17 states operating similar programs, GEO stands to capitalize if it can turn around the facility. [Photo: Jeffrey Camp]

“I’ll have to give Feaver a lot of credit. Those negotiations were fairly drawn out,” says Bill Marvin, former executive director of the Florida Statewide Advocacy Council, an independent group that protects the constitutional and human rights of people receiving services from state agencies. The state agreed to evaluate Atlantic Shores’ performance based on outcomes and effectiveness rather than on how many workers it employed per patient, but it insisted on a strict set of measurements, standards and goals that Marvin says made a big difference.

Built into the contract, for example, was a provision that Atlantic Shores would be fined if the hospital did not receive accreditation from the Joint Commission on Accreditation of Healthcare Organizations, which the hospital had never been able to attain, within one year. Under Atlantic Shores, the hospital earned its accreditation within 10 months. Another part of the contract involved assigning a member of Marvin’s group, Phil Ketchum, to monitor the facility. Ketchum made sure patients were discharged properly. If patients were discharged prematurely, he’d intervene.

“For the next two or more years, he monitored weekly, if not multiple times a week and became an integral part of making the administration aware of everything that was wrong and making sure they corrected the problems,” recalls Marvin. The council also established a local advocacy committee in the county assigned strictly to South Florida State Hospital. The committee reviewed abuse reports and patient complaints and established a “very strong working relationship” with Atlantic Shores.

The oversight, says Huckshorn, was “kind of uncomfortable for us, but in retrospect, smart.” The state also froze the hospital’s budget for the first four years before it began granting 3% cost-of-living increases. And it mandated clearly defined guidelines and expectations for admissions and discharges of patients.

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