Document:

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                                                                   Exhibit 10.28

                    CONTRACT MODIFICATION AGREEMENT NO. 1 TO
                           MEDICAL SERVICES AGREEMENT
                      BETWEEN COMMONWEALTH OF PENNSYLVANIA,
                            DEPARTMENT OF CORRECTIONS
                        AND PRISON HEALTH SERVICES, INC.

     This Modification No. 1 ("Modification") to the Medical Services Agreement
Between Commonwealth of Pennsylvania, Department of Corrections and Prison
Health Services, Inc. ("Contract") is made this 12th day of August, 2004, by and
between the Commonwealth of Pennsylvania, Department of Corrections
("Department") and Prison Health Services, Inc. ("PHS").

     WHEREAS, the Department and PHS are parties to the Contract; and

     WHEREAS, under the Contract PHS delivers general health care and
specialized medical services to inmates in the custody of the Department; and

     WHEREAS, the Request for Proposal for Health Care Services, RFP #101-100
("RFP") is part of the Contract; and

     WHEREAS, Section II-39.B.1 of the RFP has a provision concerning Hourly
Penalties if PHS fails to furnish adequate staffing hours, and

     WHEREAS, Section II-39.B.1 of the RFP provides in pertinent part that:
"Hourly Penalties First, if the vendor fails to furnish 90% to 100% of the
number of Physician (including Psychiatrist), Physician Assistant, Dentist or
Nurse staffing hours required in the Pricing Proposal, the DOC may impose a
penalty equal to one hundred percent (100%) of the hourly rate provided for that
position respectively, for each hour which the vendor fails to provide. Should
these hours drop below 90%, the penalty shall increase to 150% for those hours
less than 90%. For instance, if nursing hours are provided at 85% of the monthly
requirement, the DOC may impose a penalty of 150% for the 5% of hours below 90%
and 100% for those between 90 and 100%."; and

     WHEREAS, the Contract also includes Attachment Four Supplemental Provisions
("Attachment Four") that was agreed to by the Department and PHS after the
issuance of the RFP; and

     WHEREAS, the Attachment Four contains language in Article 15 that revises
the hourly Penalties provision in Section II-39.B.1 of the RFP; and

     WHEREAS, Article 15 of Attachment Four provides in pertinent part that:
"Hourly Penalties for Staff. Penalties for staffing may be assessed as follows:
-Staffing 100-95% of staffing plan - no penalties -Staffing less than 95% to 90%
of staffing plan - 100% -Clinical staffing at less than 90% of staffing plan -
150%."; and

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     WHEREAS, the rates for these Hourly Penalties for Staff are, under the
Contract, assessed using an institutional basis; and

     WHEREAS, the Contract between the Department and PHS went into effect on
September 1, 2003; and

     WHEREAS, the Department and PHS believe, based upon their experience under
the contract, that Hourly Penalties for Staff are more appropriately assessed
using a consolidated basis; and

     WHEREAS, since the Contract took effect a dispute has arisen between the
Department and PHS over the meaning of the Hourly Penalties provisions of the
RFP and Attachment Four referred to above; and

     WHEREAS, the Department and PHS recognize that there are ambiguities int eh
meaning of the Hourly Penalties provisions of the RFP and Attachment Four
referred to above; and

     WHEREAS, the Department and PHS have different interpretations of the
application of the terms of Article 15 of Attachment Four concerning Hourly
Penalties; and

     WHEREAS, this dispute could result in litigation between the Department and
PHS over the meaning of the Hourly Penalties provisions of the RFP and
Attachment Four referred to above and whether penalties should be imposed; and

     WHEREAS, the Department and PHS prefer and intend to resolve their dispute
over the meaning of the Hourly Penalties provisions of the RFP and Attachment
Four referred to above through an agreement rather than litigation; and

     WHEREAS, the Department and PHS through a modification of the Contract seek
an interpretation of the RFP and Attachment Four that is acceptable to both
parties and provides a clarification of the ambiguities.

     NOW THEREFORE, in consideration of the mutual covenants herein contained,
and the considerations identified herein, and intending to be legally bound, the
Department and PHS agree as follows:

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     1. This Modification serves as a clarification of the Hourly Penalties
provisions of the contract, in particular Section II-39.B.1 of the RFP and
Article 15 of Attachment Four.

     2. The assessment of penalties will be based on statewide aggregate totals
per position type. No penalties shall be assessed should the total number of
on-site hours provided for each position category (e.g. MD, PA, RN, LPN, etc.)
be at or above 95% of the total PHS statewide hours of each position category
hours as reflected in the current staffing plan across all sites.

     3. For unfilled hours in the 90%-95% range, a penalty of 100% of the hourly
rate by position category may be assessed by the Department. For any unfilled
hours that fall below 90% in the MD, PA, or nursing categories, a penalty of
150% of the hourly rate by position may be assessed by the Department.

     4. For purposes of calculating the 95%, PHS shall receive 'credit' for up
to a maximum of 110% of hours provided by position at each site unless a request
for additional hours (e.g., to provide additional services or address special
needs) has been submitted to and approved by the Department.

     5. Should PHS provide more than 100% of the hours for a specific position
on a statewide aggregate basis, the additional hours can be used to offset a
shortage of another position hours provided the work of the first position can
be considered equal to greater to the specific work of the latter position. For
instance, additional hours of the RN classification could be used to offset a
shortage of LPN or nursing assistant hours.

     6. The Department and PHS will use the consolidated position penalty rates
set forth in Attachment Five, that is attached to this Modification and is made
part of it, for hourly Penalties for Staff assessed pursuant to the Contract.
During the life of the Contract, these rates will be increased in accordance
with the annual increase provisions of Section I or Attachment Three of the
Contract.

     7. On an individual site basis, PHS shall provide at least 80% of the
staffing plan hours by position category or be subject to the following
progressive penalty structure for each successive period where hours provided
are less than the 80% by positions:

     -    1st - 150%

     -    2cd - 175%

     -    3rd - 200%

     8. Except as specifically modified herein, all other terms and conditions
of the Contract shall remain unchanged and in full force and effect.

                                        3

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IN WITNESS WHEREOF, and intending to be legally bound, the parties hereto
subscribe their names to this instrument.

PRISON HEALTH SERVICES, INC.            COMMONWEALTH OF PENNSYLVANIA DEPARTMENT
                                        OF CORRECTIONS

/s/ Richard D. Wright                   /s/ Jeffrey A. Beard
-------------------------------------   ----------------------------------------
By: Richard D. Wright                   By: Jeffrey A. Beard, PhD.
    President/Vice President                Secretary

Date: June 28, 2004                     Date: June 30, 2004

/s/ Jean L. Byassee
-------------------------------------
By: Jean L/ Byassee
    Secretary/ Treasurer

Date: June 28, 2004

                                        4<PAGE>

                                                                   Exhibit 10.29

                    CONTRACT MODIFICATION AGREEMENT NO. 2 TO
                           MEDICAL SERVICES AGREEMENT
                      BETWEEN COMMONWEALTH OF PENNSYLVANIA,
                            DEPARTMENT OF CORRECTIONS
                        AND PRISON HEALTH SERVICES, INC.

     This Modification No. 2 ("Modification") to the Medical Services Agreement
Between Commonwealth of Pennsylvania, Department of Corrections and Prison
Health Services, Inc. ("Contract") is made this 28th day of October, 2005, by
and between the Commonwealth of Pennsylvania, Department of Corrections
("Department") and Prison Health Services, Inc. ("PHS").

     WHEREAS, the Department and PHS are parties to the Contract which went into
effect on September 1, 2003; and

     WHEREAS, under the Contract PHS delivers general health care and
specialized medical services to inmates in the custody of the Department; and

     WHEREAS, the Attachment Four, Supplemental Provisions, is part of the
Contract; and

     WHEREAS, Section 10 of Attachment Four has a provision concerning Outside
Medical Service Cap settlements, and

     WHEREAS, since the Contract took effect a dispute has arisen between the
Department and PHS over the meaning and timing of the Outside Medical Services
Cap settlements; and

     WHEREAS, the Department and PHS recognize that there are ambiguities in the
meaning and timing of the Outside Medical Services Cap settlements language in
Attachment Four referred to above; and

     WHEREAS, this dispute could result in litigation between the Department and
PHS over the meaning of the timing of Outside Medical Services Cap settlements
in Attachment Four; and

     WHEREAS, the Department and PHS prefer and intend to resolve their dispute
over the meaning and timing of Outside Medical Services Cap settlements in
Attachment Four referred to above through an agreement rather than litigation;
and

     WHEREAS, the Department and PHS through a modification of the Contract seek
an interpretation of Attachment Four that is acceptable to both parties and
provides a clarification of the ambiguities; and

     WHEREAS, the PHS Pricing Proposal, Attachment #3, is part of the Contract;
and

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     WHEREAS, the Department also seeks a change in the annual increase
provisions of Section I of Attachment #3 as part of the Commonwealth effort to
reduce costs; and

     WHEREAS, PHS is agreeable to a change in Section I of Attachment #3 to
assist in the Commonwealth's cost control efforts;

     NOW THEREFORE, in consideration of the mutual covenants herein contained,
and the considerations identified herein, and intending to be legally bound, the
Department and PHS agree as follows:

     1. This Modification serves as a clarification of the Outside Medical
Services Cap settlement provisions of the Contract, in particular Section 10 of
Attachment Four.

     2. Contract year-to-date cost settlements of the Outside Medical Services
Cap will be made on an accrual basis at the conclusion of each contract quarter.
The first quarterly pro rated cap will be one fourth of PHS' full yearly
responsibility for Outside Medical Services expenses. Additional expenses above
this amount will be pro rated between the parties on a 50/50 cost sharing basis
up to one fourth of the shared cost amount stated in the Contract. Corrections
will be responsible for 100% of the quarterly Outside Medical Services expenses
in excess of the sum of both maximums stated above. Corrections will reimburse
PHS within 45 days of receipt of quarterly documentation supporting expenditures
for Outside Medical Services. For each subsequent quarter, PHS will consider the
sum of all previous quarters in the then current contract year plus the current
quarter's maximum PHS Outside Medical Services liability total for all quarterly
expenses actually incurred less the amount previously paid by the Commonwealth
to determine the amount due PHS for that quarter or the amount to be returned to
the Commonwealth. A final settlement using the actual amounts paid by PHS for
Outside Medical Services that takes into account the impact of all 4 quarterly
settlements will occur within 180 days of the end of each contract year.

     3. PHS will include dialysis treatment costs for services previously
provided at SCI Graterford and transferred to SCI Laurel Highlands as eligible
costs toward the Outside Medical Services Cap. This includes one-time equipment
purchases and ongoing operational costs to operate the program. It does not
include staffing costs, which are covered in the PHS base monthly fees. Costs
will be reported in the months incurred in the same manner as other costs are
reported for Outside Medical Services.

     4. This Modification also serves to change the future year annual cost
adjustments to the Contract. For contract year 3 (September 1, 2005 to August
31, 2006), the scheduled annual increase will be applied, effective September 1,
2005, as per the existing Contract terms. Beginning January 1, 2006 and
continuing through August 31, 2006, PHS will reduce its monthly base fees to the
Department by $62,500, resulting in a total base fee reduction of $500,000 for
the contract year.

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     5. In calculating the new base fees for contract year 4 (September 1, 2006
to August 31, 2007), the annual increase will be applied to the contract year 3
base fees net of the $500,000 discussed in Item #4.

     6. The annual increase to base fees and respective aggregate cap specified
in the Contract for contract years beginning September 1, 2006 and September 1,
2007 would be modified to refer to the trailing twelve month percentage change
in the Health Services component of the Employment Cost Index for Total
Compensation for Private Industry Workers, by Industry and Occupational Group,
for the most recent quarter prior to the start of the contract years, as
published by the United States Department of Labor - Bureau of Labor Statistics.

     7. Except as specifically modified herein, all other terms and conditions
of the Contract shall remain unchanged and in full force and effect.

                                        3

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         IN WITNESS WHEREOF, and intending to be legally bound, the parties
hereto subscribe their names to this instrument.

PRISON HEALTH SERVICES, INC.            COMMONWEALTH OF PENNSYLVANIA
                                        DEPARTMENT OF CORRECTIONS

/s/ Trey Hartman                        /s/ Jeffrey A. Beard
-------------------------------------   ----------------------------------------
By: Trey Hartman                        By: Jeffrey A. Beard, PhD.
    President                               Secretary

Date: September 13, 2005                Date: September 15, 2005

/s/ Andrew L. Schwarcz
-------------------------------------
By: Andrew L. Schwarcz
    Secretary

Date: September 13, 2005

/s/ Joan R. McIntosh                    Date: October 26, 2005
-------------------------------------
Comptroller's Office

Approved for Form and Legality:

/s/ Illegible                           Date: September 22, 2005
-------------------------------------
Office of Chief Counsel
Pennsylvania Department of
Corrections

/s/ Illegible                           Date: October 4, 2005
-------------------------------------
Office of General Counsel

/s/ Illegible                           Date: ___________________
-------------------------------------
Office of Attorney General

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