And primary care managers — doctors, physicians' assistants or nurse practitioners — oversee care and prescribe medicines.
One involved hiring eight "recovery coordinators" to oversee care for 46 people.
Nine mental-health nurses have joined the staff under the new programme, and their only job is to oversee care for suicidal passengers on the transport system.
Dr. Parks, the medical director overseeing care at Rikers Island and the Manhattan Detention Center, worked for Prison Health Services, a Nashville company that holds a $123 million contract with the city's health department for comprehensive jail medical care.
The Obama administration, as part of its ambitious health care reform, has proposed that Medicare use incentives and penalties to encourage hospitals and doctors to cooperate in overseeing care from hospitalization through the first 30 days after discharge.
Paul Burstow, the care services minister, said he welcomed the report and wanted to make sure there were sufficient safeguards in place to oversee care providers to protect people who relied on these services.
The scandal came to light in 2007, when the Healthcare Commission, the body then charged with overseeing care at the National Health Service, became concerned about unusually high mortality rates at Stafford Hospital.
"All the hospitals here provide some uncompensated care, and they are eating it and passing the costs along to the payers," said Patricia A. Young Brown, president of the Travis County Healthcare District, which was set up last year to oversee care of the indigent through public clinics, drawing on property taxes to pay.
Most of the larger EDs are staffed with medically or surgically trained physicians, with board-certified emergency medicine physicians serving as consultants overseeing care.
