COCHS Weekly Update: May 23, 2023
Highlighted Stories
Editor’s Note
The two previous editor’s notes have explored California 1115 Medicaid Waiver and the 1115 demonstration projects from different perspectives. One highlighted the crucial role public safety will have in implementing these regulatory changes. The other raised questions on how correctional health care vendors might possibly fit into this new ecosystem. This week’s note will be a bit different. It will not be about Medicaid waivers and the impact that they will have on the adults that cycle through criminal justice system; rather, this note will focus attention on certain sections of last year’s the appropriation bill (Consolidated Appropriations Act of 2023) that will require Medicaid-eligible juveniles to begin certain benefits before release (Section 5121) and allow states to maintain benefits for juveniles who are pending disposition of charges (Section 5122).
Section 5122 of the recent law is particularly germane to the Weekly Update’s first highlighted article from Petits County, MO. A teenage hemophiliac was transferred from a juvenile detention facility to an adult facility. The young man while in the juvenile facility had his health needs covered by Medicaid but once transferred his treatment and medications became the burden of the county. The medication for hemophilia came to $62,000 a month. Under Sec 5122 this gap in coverage might not have occurred. This section amends the Social Security Act to allow states the choice of allowing incarcerated eligible juveniles to maintain their Medicaid benefits as they await disposition of their charges (see Dan Mistak’s “Dear Colleague Letter” on January 3, 2032).
The second highlighted article points to the significance of Section 5121 in providing services to young adults. In Youth Today, two authors from Columbia University’s Emerging Adult Justice Project, emphasize the difference between the brain development of a young person and a mature person in their 40’s or 50’s. To better serve the young population involved in the criminal justice system, they have initiated projects in several states that allow for a variety of services with the aim of lessening involvement in the criminal justice system. These services might include special education services, employment assistance, diversion programs, reentry support to name a few. In the future such projects might reframe these services through the lens of Section 5121. Section 5121 not only allows for eligible sentenced beneficiaries to receive screenings, diagnostic services, and referrals thirty days before release, but also allows for 30 days of targeted case management (TCM) after release. Probation, parole, and other public safety entities may be able to qualify for TCM participation. But who can receive such services hinges on many factors. One of the most important factors is who is an “Eligible Juvenile”. Broadly speaking that is someone under the age of 21 and might even include someone under the age 25 if involved in the foster care system.
It should be noted that these modifications heralded by Sections 5121 & 5122 will take effect two years from the enactment of the appropriation bill signed into law on December 29, 2022. For us at COCHS, who have firsthand experience working behind the walls of corrections, the reason we have started to link these Editor’s Notes with articles is to give our subscribers a better idea of the complex conditions in corrections. Through this juxtaposition our readers will hopefully understand that there might be many twists and turns in the road ahead. We hope you share our excitement from these glimpses of the arena in which these new laws and changes in regulations may make a significant impact.
Section 5122 of the recent law is particularly germane to the Weekly Update’s first highlighted article from Petits County, MO. A teenage hemophiliac was transferred from a juvenile detention facility to an adult facility. The young man while in the juvenile facility had his health needs covered by Medicaid but once transferred his treatment and medications became the burden of the county. The medication for hemophilia came to $62,000 a month. Under Sec 5122 this gap in coverage might not have occurred. This section amends the Social Security Act to allow states the choice of allowing incarcerated eligible juveniles to maintain their Medicaid benefits as they await disposition of their charges (see Dan Mistak’s “Dear Colleague Letter” on January 3, 2032).
The second highlighted article points to the significance of Section 5121 in providing services to young adults. In Youth Today, two authors from Columbia University’s Emerging Adult Justice Project, emphasize the difference between the brain development of a young person and a mature person in their 40’s or 50’s. To better serve the young population involved in the criminal justice system, they have initiated projects in several states that allow for a variety of services with the aim of lessening involvement in the criminal justice system. These services might include special education services, employment assistance, diversion programs, reentry support to name a few. In the future such projects might reframe these services through the lens of Section 5121. Section 5121 not only allows for eligible sentenced beneficiaries to receive screenings, diagnostic services, and referrals thirty days before release, but also allows for 30 days of targeted case management (TCM) after release. Probation, parole, and other public safety entities may be able to qualify for TCM participation. But who can receive such services hinges on many factors. One of the most important factors is who is an “Eligible Juvenile”. Broadly speaking that is someone under the age of 21 and might even include someone under the age 25 if involved in the foster care system.
It should be noted that these modifications heralded by Sections 5121 & 5122 will take effect two years from the enactment of the appropriation bill signed into law on December 29, 2022. For us at COCHS, who have firsthand experience working behind the walls of corrections, the reason we have started to link these Editor’s Notes with articles is to give our subscribers a better idea of the complex conditions in corrections. Through this juxtaposition our readers will hopefully understand that there might be many twists and turns in the road ahead. We hope you share our excitement from these glimpses of the arena in which these new laws and changes in regulations may make a significant impact.
KRCG: Inmates not eligible for Medicaid, falls to county, taxpayers to cover medical costs
A juvenile went to juvenile detention at 16 years old. Eventually, he was transferred to the Pettis County Jail (MO) as he awaited trial. While in juvenile detention, he was covered under Medicaid. Now he is not. This is detrimental to both the inmate’s health and the Pettis County budget. The inmate needed a $ 62,000-per-month medication because he has hemophilia. The inmate was in the Pettis County Jail for months. Pettis County paid over $200,000 for his medicine.
Youth Today: To end the age of incarceration, three communities pioneer a developmental approach
People ages 18 to 25 are over-represented at every stage of the criminal legal system and have the highest recidivism rate of any age group. A growing body of science tells us that brain development continues into the mid-20s. It is obvious that we are responding badly to the developmental needs of these emerging adults. The Emerging Adult Justice Project at the Columbia Justice Lab, recently created a developmental framework for the healthy maturing of emerging adults. Instead of treating older youth in almost exactly the same way as 40- or 50-year olds.
Journal of Addiction Medicine: “No Excuses Anymore”: Substance Use Screening and Treatment for Justice-involved Youth
This study had 14 participants from 12 institutions and 9 states. The facilities mainly catered to male and minoritized populations, with substance use. The analysis of the study revealed the follwing themes: substance use training for all team members, integrating medical and behavioral health care, addressing staff reticence, establishing a supportive environment, allocating sufficient resources, formalizing screening and treatment protocols, engaging youth with trauma-informed approaches, and collaborating with multidisciplinary teams.
Addiction Policy Forum: Study Shows Naloxone expansion not associated with increased heroin use among teens
Increased availability of naloxone, a drug that reverses the effects of opioid overdose, does not result in a rise in heroin use among teens, a new study has found. Researchers examined naloxone access and distribution against teen lifetime heroin and injection drug use (IDU) rates in 44 states over a period of 12 years starting in 2007. The study found that adoption of laws to increase naloxone access was not associated with a meaningful change in drug use rates.
The City: NYC Schools Handcuff and Haul Away Kids in Emotional Crisis
New York City officials have promised for years to stop relying on police to respond to students in emotional crisis. Under the terms of a 2014 legal settlement, schools are only supposed to call 911 in the most extreme situations, when kids pose an “imminent and substantial risk of serious injury” to themselves or others. And yet city schools continue to call on safety agents and other police officers to manage students in distress thousands of times each year.
Incarcerated Natives
BJS: Jails in Indian Country, 2022
A new BJS report, Jails in Indian Country, 2022, provides statistics from BJS’s Annual Survey of Jails in Indian Country on the demographic characteristics, most serious offense, and conviction status of persons held in Indian country jails. It also describes facility characteristics.
Alaska Public Radio: Inmates continue to die in tribal jails despite promises of reform
Despite promises of reform by the Bureau of Indian Affairs, inmates at tribal jails overseen by the federal agency continue to die, according to a new report. At least four inmates died and 46 others attempted suicide from July 2021 through June 2022, according to the report by the Justice Department’s Bureau of Justice Statistics. Three of the four deaths were from suicide.
Data & Statistics
BJS/NACJD: Mortality in Correctional Institutions: ICD-10 Diagnosis Codes for Natural Deaths Occurring in State Prison or Local Jail Custody, 2000-2019
BJS has released new data from the Mortality in Correctional Institutions (MCI) data collection through the National Archive of Criminal Justice Data (NACJD). The new data are archived at the restricted-use level, meaning they will be more widely available to researchers for use in public health and criminal justice studies.
Opioid Epidemic
Medical Xpress: Physicians push for standard-of-care opioid treatment for incarcerated patients
In a recently published commentary, UK HealthCare physicians call for standard-of-care treatment for opioid use disorder (OUD) among patients who are incarcerated. For patients with opioid use disorder, medications such as buprenorphine and methadone are considered by the medical community as standard of care treatments. However, the use of these medications is often restricted in U.S. prisons and jails, with only a few states mandating their use in the carceral system.
MedPage Today: The Opioid Treatment Dilemma in Jails
Jeffrey E. Keller, MD, a correctional physician, expresses his excitement about the Biden administration's call on state Medicaid programs to fund opioid treatment programs in jails and prisons. He goes on to explain the pressing need for this treatment considering the current opioid epidemic. However, he does detail some reasons why this change will have implementation challenges: training in MOUD, staff shortages, continuity of care in the community, diversion of drugs like buprenorphine as well as other impediments.
US News & World Report: 7 People Treated for Fentanyl Overdoses in Washington Jail
A man in custody in a jail north of Seattle is facing additional charges after officials say seven incarcerated people were treated for overdosing on fentanyl. A deputy noticed a person in custody showing signs of an opiate overdose. At the same time, another person in the same area of the jail began showing similar signs. A total of seven inmates began displaying signs of an overdose. Detectives found fentanyl inside the cell of a 37-year-old man, who they believe brought the substance into the facility.
Post & Courier: Life-saving drug now offered to recently released inmates at Lexington Detention Center
Inmates being released from the Lexington County Detention Center (SC) can now access Narcan, an opioid overdose reversal drug, at no cost. Modeled after a similar program in Charleston County, free vending machines filled with Narcan have been installed in the release hallway at the detention center. Between 2020 and 2021, fatal drug overdoses in South Carolina increased by 25 percent.
Local 10: Correctional Health Services employee accused of planning to smuggle drugs, other contraband into Miami-Dade jail
A Correctional Health Services employee has been arrested by the Miami-Dade Police Department after they discovered that she was planning to smuggle drugs and other contraband into the Metro-West Detention Facility, authorities said. The employee in question, Junell Raquel Bess, 39, was arrested Saturday night after arriving to the facility. The report states that she arrived to work just after 6:45 p.m. Saturday and police could smell a strong odor of marijuana emitting from Bess as they approached her. Ten pills of suspected oxycodone were found in a prescription bottle inside her purse.
Health Care Providers In Corrections
BMC: Motivation and training needs of prison healthcare professionals: findings from a qualitative study
Providing health care in prison is challenging. The conditions of imprisonment create distinct difficulties for those providing health care in this setting. Due to the coercive environment and the frequent lack of resources, it is often difficult to respect the principle of equivalence of care. Health care professionals trained in hospitals may not be appropriately prepared for working in prison. This is because in the prison context, these professionals face not only medical problems, but also distinct social and legal issues.
State Roundup
California
LAO: May Revision Proposals Related to the California Model and San Quentin State Prison
On March 17, 2023, Governor Newsom announced his intention to establish an advisory council to recommend changes to San Quentin in order to help develop the California Model. The scope of the projects will be determined by an advisory council. Funding for the project includes funds to demolish an existing building and construct a new educational and vocational center. The May Revision proposes to transfer these funds to CDCR’s capital outlay budget. Statutory changes include language toexempt the proposed projects from historic preservation requirements and the California Environmental Quality Act.
Georgia
WMAZ: Father of schizophrenic inmate killed in Monroe County jail wants change in handling mental health
The father of a man who died in Monroe County’s custody in January 2020 says he wants to see change after his son's death. A GBI autopsy lists 40-year-old Josh Marshall's death as homicide. They say the cause of death was neck compression and prone position constraint caused by his fight with deputies. Monroe County settled a lawsuit with Marshall’s family last month. The county settled for $1 million plus more than $10,000 in funeral expenses.
Illinois
Corrections 1: 3 Ill. state prison COs indicted, accused of beating restrained inmate
A federal grand jury indicted three correctional officers, accusing two of them of beating an inmate who was handcuffed and trying to cover it up in written reports. The indictment alleges the incident happened on April 24, 2022. Williams and Pyles are accused of beating "an inmate who was fully restrained with his hands cuffed behind his back and secured in leg irons," the release states.
New Mexico
Source NM: Medical care at largest jail in N.M. to go public
New Mexico’s flagship hospital is expected this summer to begin sending its staff to treat people incarcerated while awaiting trial in the state’s largest jail. An advisory panel for the Metropolitan Detention Center in Bernalillo County on Wednesday night endorsed a proposal to no longer rely on private companies to provide health care, and instead partner with the University of New Mexico Hospital as part of an effort to provide adequate medical treatment to people held inside.
New Jersey
Department of Justice: Justice Department Secures Agreement with Cumberland County Addressing Mental Health Care, Suicide Prevention and Medication-Assisted Treatment for Opiate Withdrawal at the Cumberland County Jail
Cumberland County will provide adequate mental health treatment and access to medication for incarcerated people struggling with opioid withdrawal under a proposed consent decree after the Department of Justice investigated the jail following the suicides of seven inmates. The agreement stems from allegations that between 2014 and 2020, jail officials treated inmates experiencing withdrawal and at risk of self-harm or suicide with “deliberate indifference,” federal prosecutors said.
New York
NY Times: Guards Brutally Beat Prisoners and Lied About It. They Weren’t Fired.
Shattered teeth. Punctured lungs. Broken bones. Over a dozen years, New York State officials have documented the results of attacks by hundreds of prison guards on the people in their custody. But when the state corrections department has tried to use this evidence to fire guards, it has failed 90 percent of the time. The review of prison disciplinary records dating to 2010 found more than 290 cases in which the New York State Department of Corrections and Community Supervision tried to fire officers.
NY Times: How a ‘Blue Wall’ Inside N.Y. State Prisons Protects Abusive Guards
The Marshall Project, a nonprofit news organization, obtained disciplinary data on more than 290 cases in which the corrections department tried to fire guards or supervisors accused of abusing prisoners. After analyzing lawsuits involving excessive-force incidents the Marshall Project found that the Department of Corrections did not try to discipline officers in 88 percent of the lawsuits, including some in which prisoners were permanently injured or even killed.
Spectrum News: How more mental health professionals could provide support in prisons
Mental health professionals who provide services in New York prisons would be eligible for thousands of dollars in student loan forgiveness under legislation proposed this week by a state lawmaker. The bill, backed by Assemblyman Jake Blumencranz, would provide annual grant awards of up to $2,000 in student loan forgiveness that would be awarded to people who provide mental health services to incarcerated people.
Ohio
Journal Record: Jailers neglected safety checks before inmate deaths
Cleveland County detention officers failed to perform required safety checks on detainees in critical care the same month two women died waiting for mental health evaluations in the jail, a health inspector found. Jailers failed to follow a policy that requires them to observe detainees who are violent, suicidal or struggling with mental health problems at least every 15 minutes.
Pennsylvania
Truthout: Profiteers of Holmesburg Prison’s Medical Experiments Have Yet to Redress Harm
Dr. Kligman may not be a household name today, but the products he developed are staples in the skincare and pharmaceutical industries, Retin-A. But Kligman’s discoveries came on the backs of scores of incarcerated men — an overwhelming number of whom were Black — detained in Philadelphia’s now-shuttered Holmesburg Prison. Retin-A was directly made possible by the tests conducted on men imprisoned. Many other products and chemicals were tested on incarcerated men at the facility through contracts with pharmaceutical companies and even the U.S. military.
Texas
Click 2 Houston: Family of sixth HCSO inmate to die this year seeks details, says he was healthy
The Harris County Sheriff’s Office said a sixth inmate, Robert Terry has died while in custody at the Harris County Jail this year. Ongoing questions are swirling about how this keeps happening again, and again, and again. According to officials, Mr Terry asked officers to be taken to the jail clinic just moments before he was said to have collapsed around 6:20 a.m. Tuesday morning. He was taken to the hospital where he died.
Vermont
VT Digger: ‘They’re helping me save the rest of my life’: Rutland organization helps incarcerated people find sobriety and rebuild their lives
The Turning Point Center of Rutland offers the only community-based recovery coaching program within Vermont’s corrections system — a service that several formerly incarcerated people told VTDigger has helped them find sobriety and rebuild their lives. The center’s prison programs has provided participants with a guiding hand in re-entering society. Once released, they can continue receiving coaching and attending group meetings, whether in the Rutland area or elsewhere. Rutland Turning Point can also link them with social services, such as transitional housing, job search assistance and food pantries.
Rikers Island
NY Times: Tracking the Deaths in New York City’s Jail System
A Rikers Island detainee died late Tuesday night while being held at the jail complex, marking the second death in 2023 following what had been the deadliest year in nearly a decade. This article goes on to list all deaths between 2022-2023 providing known details about each death.
Los Angeles County
Los Angeles Daily News: LA County to treat severely mentally ill inmates in the Twin Towers jail
Part of the Twin Towers jail in Los Angeles will be used to treat inmates with severe mental illness, a way to provide emergency care and evaluate those who may be a danger to themselves or others, according to an action approved Tuesday, May 16, by the Los Angeles County Board of Supervisors. The board’s action sets up a Jail Inpatient Unit, also known as the Acute Intervention Module, at the county jail at 450 Bauchet St., in Chinatown in Los Angeles.
RLN: County and State Assist on Mental Health Front For Inmates and Students
The Los Angeles County Board of Supervisors May 16 unanimously approved a motion that will create a special unit at the Twin Towers Correctional Facility to care for acutely mentally ill inmates. Data provided by Correctional Health Services reports there are about 6,800 inmates housed in L.A. County’s correctional facilities participating in jail mental health programs. Approximately 12% of those individuals are acutely mentally ill. On average, 40 or more acutely mentally ill inmates are booked on a daily basis.
San Diego County
San Diego Union-Tribune: Despite known medical problems, 67-year-old was ignored for hours before he died in Vista jail, lawsuit argues
Despite orders from a doctor that he be closely monitored, Gilbert Gil was placed in a holding cell at a Vista jail and ignored for 14 hours, argues a lawsuit filed this week in federal court. It is the second lawsuit filed in less than a month alleging wrongful death in a San Diego County jail. Gil, 67, whose family says he suffered from diabetes and showed early signs of dementia, died on Valentine’s Day last year.
Mental Health Initiatives In Corrections
Altoona Mirror: Prison adds mental health counseling program
The Blair County Prison (PA) has added mental health counseling to its voluntary programs for inmates. Representatives from the National Alliance on Mental Illness of Blair County started this month to provide group counseling at the prison. Commissioner Bruce Erb said he expects NAMI’s involvement at the prison will be helpful to the county’s Re-Entry Coalition, a group that works with local agencies to identify housing, job and educational resources for inmates getting close to release dates.
WKOW: New, emotional mental health program provides Rock County inmates with a path to change
Verenice Sandoval is the Rock County Sheriff's Office's treatment coordinator— she leads a six-week rehabilitation class called "Houses of Healing." Class begins with a guided meditation. After the 13-session class, inmates receive certificates and participate in a graduation ceremony with coffee and doughnuts. Every inmate in the program said they'd learned something by the end of their six-week course.
ABC: Genesee County Jail holds mental health event for inmates and corrections staff
In honor of Mental Health Action Day, the Genesee County Jail held a pop-up workshop for jail participants and corrections staff. The event provided nutritional resources, breakout yoga meditation sessions, raffles and more. Law enforcement and community partners like the Genesee Health System, IGNITE, Michigan State University Extension and Mindful Flint came together to streamline the activities.
Title 42 Termination.
NY Times: 8-Year-Old Migrant Died After a Week in U.S. Detention
An 8-year-old girl who died while in U.S. border custody on Wednesday had been detained for a week — more than twice the amount of time the government holds migrants. The girl and her family were being held in a facility in Harlingen, Texas, where they were waiting to be deported on a flight to Honduras. In the past week the authorities have struggled with overcrowding at border facilities after a spike in illegal migration ahead of last week’s lifting of the pandemic-era public health rule, known as Title 42.
CoreCivic
Kansas City Star: Guards at Kansas detention center used racist slurs against Hispanic people
A corrections officer at the now-closed Leavenworth Detention Center was subjected to racist slurs and other demeaning language by other employees, according to a federal lawsuit filed this week. Wilfredo Carrasquillo, who is Hispanic, started working for CoreCivic at the federal jail in Leavenworth in May 2021. He had over a decade of security experience. During a training class, a co-worker said “that Hispanic people cannot comprehend things,” the lawsuit said. Guards used a racist slur against Hispanic people many times,
Nashville Scene: Failing Prison Leaves Inmates Dead, Families Grieving
There have been multiple deaths at Trousdale Turner Correctional Center, the Hartsville prison opened by CoreCivic in 2016. It’s the state’s largest facility, housing around 2,500 inmates, and has been the target of a nearly constant string of lawsuits. A case filed in March against specific CoreCivic employees, including former warden Martin Frink, alleges negligence and “deliberate indifference” in the death of Jose Torres at the hands of another inmate last year.
Yahoo Finance: CoreCivic, Inc. (NYSE:CXW) is a favorite amongst institutional investors who own 81%
To get a sense of who is truly in control of CoreCivic, Inc. (NYSE:CXW), it is important to understand the ownership structure of the business. With 81% stake, institutions possess the maximum shares in the company. Because institutional owners have a huge pool of resources and liquidity, their investing decisions tend to carry a great deal of weight, especially with individual investors.
Correcrtional Health Care Vendors
Reader: ’Inmates are extremely manipulative‘
Hundreds of lawsuits against Wexford allege substandard care. Wexford controls the medical systems of at least 120 prisons and jails in states including New Mexico, Arizona, Alabama, Virginia, West Virginia, and New Hampshire. When states turn their obligation to provide health care over to private for-profit correctional health care vendors like Wexford, there is far less transparency about how that health care gets delivered. Wexford often argues against the disclosure of its training manuals and other policy documents. But recenlty obtained manuals advise clinicians to be skeptical of their incarcerated patients. The manual describes the people inside as “patient-inmates” and bluntly writes “inmates are extremely manipulative” and “inmates may exaggerate their conditions.”
Republic: Medical contractor responds to Jackson County Jail lawsuit filed over inmate’s death
Advanced Correctional Health which provides medical care for inmates at the Jackson County Jail has denied allegations against it and an employee in a lawsuit that claims they violated the constitutional rights of an inmate suffering from an acute mental health crisis who died last year. The lawsuit filed is not the first time that the company has been sued over the death of an inmate at the Jackson County Jail. The lawsuit claims that the county’s use of Advanced Correctional Healthcare to reduce the costs of caring for inmates contributed to the inmates death by limiting access to doctor care and treatment.
Denver Post: Dying man denied medical care in El Paso County jail, lawsuit alleges
A 48-year-old man died in the El Paso County jail after the facility’s medical staff ignored his deteriorating health and obvious extreme pain for hours, according to a federal civil rights lawsuit filed by the man’s sister. Cristo Canett died in the jail after he suffered a perforated duodenal ulcer. It’s a treatable condition, but jail medical staff refused to give Canett any help beyond mild painkillers even as he moaned in pain, could not walk and complained about nausea and abdominal pain for hours, the complaint alleges. The lawsuit names as defendants the jail’s medical provider, Wellpath.
WWNO: Orleans jail monitors find falsified records, understaffing at facility
Monitors tasked with overseeing the New Orleans jail and tracking its compliance with the long-running federal consent decree said staff falsified suicide-watch documentation, rubber-stamped investigations to justify uses of force, and that the facility is dangerously understaffed. Mental health monitor Dr. Nicole Johnson said that she was concerned that WellPath staff tasked with doing check ins on detainees on suicide watch were falsifying time sheets to suggest they were making in-cell observations when in fact they hadn’t.
FOX 25: Oklahoma City-based company that provides medical services to inmates facing lawsuits
Many lawsuits have accused Turn Key staff of failing to provide medical care. According to contracts the Cleveland County Jail just upped what they pay Turn Key, to now $1.4 million a year. Oklahoma County pays Turn Key $7.6 million a year. And what's also grown, is the number of lawsuits filed against them. There have been 32 in the past three years filed in Oklahoma, more than a dozen are still active in federal court, and several others are in district court.
In Observation Of Memorial Day
COCHS Weekly Update Will Not Be Published Next Week
COCHS Weekly Update Will Not Be Published Next Week