Alameda County Indicts Correctional & Medical Staff; Election Impact: Medicaid As Block Grant? Continuing Story: Wellpath Bankruptcy

Highlighted Stories

Editor's Note

This week's first highlighted story comes from Alameda County, California, and it discusses the indictment of correctional officials, and healthcare personnel, in reference to the death of Maurice Monk. Mr. Monk was reported to have been face down on the floor of his cell surrounded by his bodily fluids for 72 hours in sight of correctional officers and medical staff, apparently without any of them taking action.

We highlight this story in the context of last week's stories from Kansas, Minnesota, and Colorado. All those articles explored this complicated and perhaps dysfunctional relationship between correctional staff and healthcare staff and the appropriate care for incarcerated individuals.

As COCHS has previously emphasized, neither regulatory nor prosecutorial efforts appear to be sufficient to assure that the needs of incarcerated individuals are met. From our perspective, it will take the granting of individual rights under Medicaid to assure that appropriate care for incarcerated individuals can be provided by the jurisdictions responsible for their care and safety.

In COCHS attempt to understand the outcome of the election, the second highlighted article from the Center on Budget and Policy Priorities broaches the subject of what the next Trump Administration might mean for Medicaid. There is some speculation that Medicaid funding might be turned into block grants. How the block grant paradigm would impact Medicaid in corrections is unclear.

Continuing the theme of last week’s Editor’s Note concerning the rumors that Wellpath was about to declare bankruptcy, the third highlighted story from Yahoo Finances confirms that this was indeed the case. H.I.G. Capital the private equity firm that owns Wellpath filed for chapter 11 in Texas on November 12. The next four highlighted stories are just some of the articles that have been published in reaction to this news. We at COCHS are fairly certain that this bankruptcy will elicit other Editor’s Notes in the coming weeks and months ahead…stay tuned.

Correctional & Medical Staff Indicted

Seven active Alameda County sheriff's deputies charged in the death of Santa Rita Jail inmate Maurice Monk have been placed on administrative leave, according to Sheriff Yesenia Sanchez. Besides the deputies, charges have also been filed against Alameda County Behavioral Health Dr. Neal Edwards and Wellpath nurse David Everett Donoho. Monk was found in his cell after apparently being dead for at least 72 hours. Monk's family lawyers said multiple jail guards and Wellpath medical staff saw him lying face-down in a puddle of bodily fluids for days. His family settled a wrongful death lawsuit with Alameda County for $7 million and their lawsuit against Wellpath is still pending.

Block Grants

The Republican Study Committee 2025 budget plan calls for eliminating premium tax credits as part of its proposal to convert federal funding for existing health programs into block grants. Limiting and cutting Medicaid funding by implementing either block grants or caps on per-enrollee spending in a way that will not only drive deep cuts over time but change the fundamental federal-state partnership for funding Medicaid.

Wellpath Bankruptcy

Wellpath Holdings Inc., one of the largest providers of health-care services to prisons and jails, has filed bankruptcy. The H.I.G. Capital-backed firm, which has about $644 million of funded debt, filed for Chapter 11 in the US Bankruptcy Court for the Southern District of Texas. Wellpath is among a number of private equity-owned companies in the prison-services industry that have struggled under heavy debt loads. Also prison-phone provider Aventiv Technologies, backed by Platinum equity, was looking to sell itself to avoid a potential bankruptcy filing. H.I.G. is a former owner of Securus Technologies, now known as Aventiv.

For years, Wellpath has been embroiled in a series of wrongful death lawsuits over allegations it delivered low-quality medical care. Since 2020, three federal judges in Oregon and Washington have ruled against Wellpath after company leaders intentionally destroyed emails they were ordered to preserve for trial. At least one case in Oregon could be affected by the bankruptcy. Earlier this year, Wellpath settled a wrongful death lawsuit with the family of Janelle Marie Butterfield, who died in the Josephine County Jail in 2018.

The former Mecklenburg County jail healthcare provider, Wellpath, routinely accused of contributing to deaths has filed for bankruptcy, halting all lawsuits against it and leaving families and attorneys stunned. Wellpath worked inside Mecklenburg County jails for 15 years — first in 2008 as Correct Care Solutions, then as Wellpath after a private equity firm bought Correct Care Solutions in 2018. Wellpath abruptly ended its contract in Mecklenburg this year.

The seemingly bankrupt company that provides health services to inmates at the Monterey County Jail has admitted failing to meet 43 requirements imposed on the company after special monitors found a long pattern of dangerously inadequate care. Wellpath, one of the incarceration industry’s largest providers of health care, was ordered in 2023 to meet federal standards after years of non-compliance. Examples of poor performance included failing to refer sick inmates to physicians, to perform proper intake procedures, to provide proper medications and assistive devices like wheelchairs, to provide prenatal care to pregnant inmates, failure to assist inmates with cognitive issues, and more.

Why are Vermont’s prisons contracting with Wellpath owned by private equity firm to provide health care to the state’s incarcerated population? Wellpath is owned by multibillion-dollar private equity firm, H.I.G Capital. Private equity firms have a playbook; they buy up companies, load them with debt, consolidate them and strip them down, and then leave them hollowed out or bankrupt within 5 to 10 years. The prison services sector has historically attracted interest from private equity because it has a consistent stream of government funding and is fragmented, which creates opportunities for consolidation.

Medicaid 1115 Waiver

This brief dives into what correctional leaders need to know about the Medicaid Section 1115 Reentry Demonstration Opportunity, which empowers states to enhance pre- and post-release care for people returning from incarceration.

State legislatures are creating new opportunities to leverage Medicaid for those in the criminal justice system. Lawmakers are also focusing on corrections oversight, including women in prisons and jails. Similarly, immigration continues to receive attention at the state and federal levels, and behavioral health and its interplay with the justice system remains hot.

Other Election News

A progressive prison reform that was on the ballot in California and Nevada this month met drastically different outcomes after the votes were counted: In California, voters chose to keep the status quo, allowing “involuntary servitude” to remain legal in prisons. On the other side of the state line, Nevada voters overwhelmingly passed a measure to ban “slavery and involuntary servitude.” The distinction came down to the word “slavery”: Nevada’s measure included the word, while California’s did not.

Juveniles

The rate of juveniles running into issues with the law has declined by 76% since 1997, according to the federal Office of Juvenile Justice and Delinquency Prevention—which was created to help make that happen. Naomi Smoot, a senior policy specialist at the office, says it has two principles: addressing racial and ethnic disparities in the justice system and supporting young people and families who have had direct contact with the system. Smoot told an NCSL Base Camp session that 85% of the 437,300 delinquency cases referred to juvenile court in 2021 came from law enforcement. Of those cases, 244,100 were addressed through a formal process, while the remaining 193,300 cases were handled informally, thereby keeping young people out of the justice system.

HIV

Being doubly marginalized as incarcerated people and as people living with HIV, we would have been lost without outside interventions. Back in the mid to late 1990s, an HIV organization called the Cascade AIDS Project was the sole organization that worked to improve treatment access among incarcerated people in Oregon. They did so by sending advocates inside state prisons to learn about how we were being treated.

Nutrition

A recent analysis from CDC identified that incarcerated and detained people were six times more likely to have an illness associated with a foodborne outbreak compared to the public. Many of the outbreak investigations in correctional settings identified recurring issues, like lack of time and temperature control, which speak to lapses in basic food safety operational control. The FDA Food Code is a model code that provides state, tribal, local, and territorial governmental bodies with a technical and legal basis for the regulation of restaurants and retail food establishments.

Fulton County, Georgia

The Justice Department announced today its findings that conditions of confinement at the Fulton County Jail (the Jail) in Georgia violate the 8th and 14th Amendments to the U.S. Constitution, the Americans with Disabilities Act, and Individuals with Disabilities Education Act. The department found that the Jail: 1) Fails to protect people from the substantial risk of serious harm from violence by other incarcerated people, including homicides, stabbings, and sexual abuse; 2) Houses incarcerated people in unconstitutional living conditions that are unsanitary and dangerous; 3) Fails to provide adequate medical and mental health services to incarcerated people; 4) Uses solitary confinement in discriminatory and unconstitutional ways that exposes incarcerated people, including 17-year-old children and those with mental health disabilities, to substantial harm; 5) Fails to provide special education services to 17-year-old boys and girls who are entitled to those services while they are incarcerated at the Jail.

The jail in Georgia's largest county, Fulton County, leaves its inmates vulnerable to "substantial risk of serious harm from violence" and violates their constitutional and statutory rights, according to a new Justice Department report. The Justice Department launched its civil investigation into Fulton County's jail in July 2023, after at least four Black inmates died in the mental health unit in a matter of weeks, including two who were killed by their cellmates. Crumbling infrastructure, failing security, abusive staff and insufficient medical and mental health treatment contributed to the overall unconstitutional conditions.

Prison Telecommunications

The Consumer Financial Protection Bureau announced it has instructed one of the largest prison service providers to pay $3 million to settle claims tied to the company's money transfer and telecommunications businesses, including a claim alleging it froze and drained incarcerated individuals' accounts. In a consent order, Global Tel Link Corp. and two of its subsidiaries agreed to pay a $1 million fine to the CFPB and refund at least $2 million to consumers affected by money transfer practices that the agency described as variously unfair and abusive. GTL does business under the ViaPath Technologies brand.

Proprietary Correctional Healthcare Vendors

Wexford

The family of an Illinois inmate who died during a summer heatwave at a prison in Crest Hill is taking legal action. An attorney representing the family says Stateville Prison officials handled the man’s medical emergency poorly. The day the plaintiff died it was 100 degrees outside and the temperature on the prison floor ranged as high as 120 degrees. In addition to the Illinois Department of Corrections, the defendants in the case include health contractor Wexford Health Sources, the warden, and a dozen other staff members.

PrimeCare Medical

An explosive and wide-ranging Dauphin County meeting Wednesday revealed accusations of an unfair bidding process for the county’s multimillion-dollar health care contract and a failed attempt to oust former county Commissioner Jeff Haste, who has recently been the subject of intense public scrutiny, from his county leadership roles. Questions have recently emerged about several contracts and agreements involving Haste, who retired from his commissioner post in 2021, including his ongoing role as a paid liaison to the NRA’s annual outdoor show and his paid consulting role with PrimeCare Medical, the county jail’s health care provider, while he was in office.