STATE OF CONNECTICUT AUDITORS OF PUBLIC ACCOUNTS STATE CAPITOL 2.10 CAPITOL AVENUE JOHN C. GERAGOSIAN HARTFORD, CONNECTICUT 06106-1550 ROBERT J. KANE April 6, 2018 The Honorable George C. Jepsen Attorney General 55 Elm Street Hartford, CT 06106 Subject: Request for a Formal Opinion on the Auditors of Public Accounts Access to a Department of Correction Contractor?s Report Related to Inmate Medical Care Dear Attorney General epsen: In May of 2017, our of?ce released an audit report on the Department of Correction (DOC) for the ?scal years 2012 and 2013. In that report, we found several issues surrounding the agreement between the Department of Correction and the University of Connecticut Health Center for inmate medical care through Correctional Managed Health Care The audit highlighted several problem areas related to the implementation and oversight of the contract and the medical care of inmates. Among them are: 0 Lack of clear performance standards 0 Lack of evidence of oversight over contractual terms by the Executive and Management committees 0 Critical Incident Case Reviews lacked independent review 0 The Department of Correction does not have adequate, systemized documentation of the quality of review performed over the UConn Health Center Correctional I Managed Health Care delivery of care - Allowing UConn Health Center Correctional Managed Health Care to conduct reviews of critical inCident cases risks impairing, in appearance if not in fact, the integrity of the resulting findings 0 Insufficient independent Department of Correction monitoring of quality and quantity of care by denies DOC the assurance that inmate health needs are being met ef?ciently, economically, and effectively to prevent worsening and more costly complications. This also poses a risk to the general health and well-being of the inmate community, undermines the assurance that DOC releases inmates to the general population in a sustainable condition, and undermines the mitigation of risk of litigation from allegations of medical malfeasance. During the course of our audit work, we became aware that the Department of Correction contracted with the Criminal Justice Institute, Inc. in 2016 through a personal services agreement. The intent of the personal services agreement was to review the care of approximately 20 inmate medical cases, include recommendations for improvements to the memorandum of understanding between DOC and UConn Health, and include a comparison of the DOC-UCHC service model to successful models in other jurisdictions. On July 18, 2017, we requested a copy of the contractor?s report, per our authority under 2-90 and of the Connecticut General Statutes. On July 20, 2017, the Department of Correction?s Acting Director of Legal Affairs denied our request, citing the attorney-client and attorney work product privileges. She also denied our access to the report because it contained con?dential information and was in draft form. On September 12, 2017, we again requested a c0py of the contractor?s report from DOC and included your of?ce?s informal opinion that we were entitled to that information. Once again, the Department of Correction refused. We reiterated our request in an in?person meeting on January 10, 2018, and have still not received a copy of the report. The Department of Correction has consistently cited the attorney/client and attorney work product privileges in denying our request for the report. Our understanding is that your of?ce concurs that the report is cloaked in attorney/ client and/or attorney work product privilege. We understand further that the Freedom of Information Commission has concluded that the document is privileged. While we need to review the contractor?slreport in relation to the ?ndings of our Department of Correction audit, our duties also include oversight of the contracting process. In that role, we have a duty to determine whether a state agency received the product it paid for. In this case, DOC paid $63,000 to the contractor. The agreement between the contractor and DOC states: he Contractor shall make all of its and the Contractor Parties? Records available at all reasonable hours for audit and inspection by the State, including, but not limited to, the Agency, the ConnecticutAuditors of Public Accounts, Attorney General and State ?s Attorney and their respective agents. Requests for any audit or inspection shall be in writing, at least ten (10) days prior to the requested date. We believe this language also clearly indicates that the Department of Correction and/or the contractor should provide us access to the contractor?s report and the underlying documentation supporting it. Lastly, our role of ?nancial oversight necessitates that we opine on the state?s ?nancial statements to determine whether the state has presented them fairly in all material respect. The potential of large claims against the state could have a material impact on the state?s ?nancial statements. The contractor?s report is pertinent to that determination. We have attempted to resolve this issue in an informal manner. However, after eight months, we have not received the contractor?s report or a de?nitive answer on whether the Governor?s Of?ce and the Department of Correction are denying our access to it. Therefore, we feel we have no other choice but to request a formal opinion from your office. Speci?cally, we would ask: ?Does the attorney/client, attorney work product or other privilege constitute a permissible basis upon which the Department of Correction may withhold the report from the Auditors of Public Accounts? If not, would providing a copy of the report to the Auditors of Public Accounts breach any such privilege?? We are available to answer any questions you have related to this matter or any work our office performs. Sincerely, Ro rt . ane John C. Geragos1an State Auditor State Auditor cc: Governor Dannel P. Malloy Commissioner Scott Semple Senator Martin M. Looney, President Pro Tempore Senator Leonard A. Fasano, President Pro Tempore Senator Bob Duff, Majority Leader Representative Joseph Aresimowicz, Speaker of the House Representative Matthew Ritter, Majority Leader Representative Themis Klarides, Minority Leader