Weekly Update: March 19, 2024
Court Orders & Correctional Intransigence: Will Medicaid Funding Break The Resistance?


Highlighted Stories

Editor's Note
This week’s highlighted stories emphasize the bias of correctional officials to maintain an unregulated environment. The California article details the machinations of the CDCR to get out of court mandated supervision of a receiver and how it took a judge to create boundaries around these efforts. In a woman’s federal correctional institution in Dublin, California, a judge has taken the step of ordering a special master ---the first time a BOP institution has been subjected to such an action. The Utah story talks about how the DOJ is having to intervene to protect incarcerated individual’s ADA rights (it should be noted that DOJ will be more involved with ADA rights in corrections as it has issued guidance on protecting people with opioid use disorder). In the ongoing saga of healthcare delivery in the Arizona correctional system, the Arizona Department of Corrections has failed to comply with court ordered changes for improving conditions in its facilities. U.S. District Judge Roslyn Silver is considering a third contempt-of-court proceeding against the state for failing to follow her orders. Looking to Illinois, there is the familiar story of courts ordering people to treatment in mental health facilities but because of a lack of space in such facilities, people with mental illness find themselves incarcerated in local jails.

All these examples and others that we have reviewed over the weeks point to the challenges to the opportunity of bringing Medicaid into the correctional environment. One of the complaints local jurisdictions have about federal mandates such as the requirement to provide healthcare to incarcerated people (Estelle v. Gamble) is that they come with financial burden that falls on local budgets. Because the regulatory framework of Medicaid comes with additional dollars, one can only hope that the ongoing resistance to regulatory structures may diminish in the wake of a funded mandate.

Courts & Corrections
California Healthline: A secret contract aims to upend landmark California prison litigation on inmate mental health
California commissioned an exhaustive study of whether its prisons are providing sufficient mental health care, an effort officials said they could use to try to end a 34-year-old federal lawsuit over how the state treats inmates with mental illness. But corrections officials won’t disclose basic details of the now-stalled study — even the cost to taxpayers for two consulting firms and more than two dozen national experts retained to examine the issue in 2023. California officials set out nearly four years ago to show that care has improved beyond the constitutional threshold. But Chief U.S. District Judge Kimberly Mueller temporarily halted tours for the study while she considered their scope. Mueller rejected the state’s request to resume the tours in a March 6 order. “The record is devoid of several pieces of threshold evidence necessary to support the costly and time-consuming prison tours,” she wrote. Those include evidence backing the initial study’s finding that California’s standards exceed national standards or that those national standards themselves are sufficient. Moreover, the tours would distract from the state’s ongoing and, so far, deficient efforts to bring mental health care to constitutionally adequate levels, she wrote.

Guardian: Judge orders special master for California prison known for rampant sexual abuse
US district judge Yvonne Gonzalez Rogers called a California federal women’s prison known for rampant sexual abuse against inmates “a dysfunctional mess” on Friday as she ordered a special master to oversee the facility, marking the first time the Federal Bureau of Prisons has been subject to such an action. “The situation can no longer be tolerated. The facility is in dire need of immediate change,” wrote the judge, adding that the Bureau of Prisons has “proceeded sluggishly with intentional disregard of the inmates’ constitutional rights despite being fully apprised of the situation for years. The repeated installation of BOP leadership who fail to grasp and address the situation strains credulity.”

Desert News: Justice Department finds Utah Department of Corrections discriminated against transgender woman
The United States Department of Justice found that the Utah Prison System violated the Americans with Disabilities Act by discriminating against an incarcerated person on the basis of gender dysphoria. The Justice Department opened up its investigation after a transgender women filed a complaint saying that the Utah Department of Corrections denied her requests for reasonable modifications and health care related to gender dysphoria.

12News: Arizona's prison health care system deemed 'complete failure' for not complying with judge's orders
The Arizona Department of Corrections, Rehabilitation and Re-entry, or ADCRR, is not complying with a majority of court-ordered changes to its health care system, according to an order filed in federal court. Last year, a federal judge outlined a series of changes ADCRR needed to make to its health care system, including overhauls in staffing and mental health care. Judge Roslyn Silver found in 2022 that ADCRR was violating inmates' rights with the current health care system. This is all part of a lawsuit over prison health care filed by the ACLU in 2012. Previously, a judge has found ADCRR in contempt of court twice for missing the marks over the past few years. The first time was in 2018 and the state was fined $1.4 million. The second time was in February 2021 and the state was fined $1.1 million.

PBS: Judge mulls third contempt case against Arizona for failing to improve prison health care
U.S. District Judge Roslyn Silver presiding over a nearly 12-year-old lawsuit challenging the quality of health care in Arizona’s prisons is considering whether to launch a third contempt-of-court proceeding against the state for failing to improve prisoner care. Experts who monitor prison health care operations on behalf of Silver said at a court hearing Friday that Naphcare, the private company hired by the state to provide those services, doesn’t have enough workers and needs to increase salaries for new and existing employees.

WCIA: IL inmates stuck in jail despite mental health court orders
Dozens of inmates in Illinois are stuck in jails, despite court orders that they instead be treated in mental health hospitals. The holdup is from state facilities reporting that they have no room. The Madison County Sheriff reports six inmates with court orders for transfer to hospitals who are also stuck in jail. One of the inmates in custody was determined to have the mind of a five-year-old.

Opioid Epidemic

Scientific American: Medicaid Expansion Alone Isn’t Enough to Stop the Opioid Overdose Crisis
Why might Medicaid not be enough to effectively link people to treatment? First, the U.S. has long suffered a marked shortage of treatment slots, so insured individuals who want treatment may still not be able to get it. For example, residential treatment programs operated at 90 percent capacity in 2022, but about three quarters of the people needing treatment that year did not receive it. Second, even with enhanced capacity, Medicaid expansion can only substantially impact overdoses among individuals facing poverty if treatment providers accept its insurance. Unfortunately, in 2020 only 71 percent of treatment facilities nationwide accepted Medicaid. Low reimbursement rates are a longstanding barrier to provider acceptance of Medicaid.

CNN: Biden administration announces focus on ‘flooding the zone’ with life-saving overdose reversal medicine
The Biden administration launched an initiative Wednesday that it describes as a nationwide call to increase training on and access to life-saving opioid overdose reversal medications, dubbed the Challenge to Save Lives from Overdose. To expand access, the US Food and Drug Administration approved an over-the-counter Narcan spray in March 2023, and it approved the first generic nonprescription nasal spray in July. Without the need for a prescription, anyone can buy the sprays at pharmacies, in grocery stores and even in vending machines.


PRISIM: COVID-19 is far from over for the incarcerated
Despite the false and damaging narrative from the Centers for Disease Control and Prevention (CDC) and many news outlets that COVID is over, it continues to infect life in corrections. Throughout the pandemic and my multiple infections, I’ve watched my Georgia state prison utterly transform. Every aspect of institutional life has been altered, making an already difficult situation even worse. The existing staff shortage has intensified. The COVID-era “social distancing” from loved ones has persisted. Enrichment programs have been completely removed.


New York Times: Warden Ousted From Federal Women’s Prison Plagued by Sex Abuse
The warden of a federal women’s prison in Northern California that has long been plagued by rampant sexual abuse was ousted from his job after a raid on the facility by F.B.I. agents. The scandal has resulted in an avalanche of litigation and allegations that sexual abuse has continued despite past leadership shake-ups. A spokesman for the Bureau of Prisons, in a statement, said the firings and the appointments of new leaders were meant to “create a positive change in culture” at the minimum-security prison. The changes came hours after F.B.I. agents raided the prison, carried away documents and computers, and sought to interview prison employees.


Prison Policy Initiative: New report, Women’s Mass Incarceration: The Whole Pie 2024, shows the size and scope of women’s incarceration in America
190,600 women and girls are locked up in the United States on any given day. The number tells only part of the story of women’s incarceration in America. Women in the U.S. experience a dramatically different criminal legal system than men do, but data on their experiences is difficult to find and put into context. 58% of women in state prisons are parents to minor children, and of those, most are single mothers who were living with their children prior to imprisonment — making it likely that incarceration uprooted their children and led to termination of parental rights, permanently breaking up their families.


NPR: The U.S. prison population is rapidly graying. Prisons aren't built for what's coming
The proportion of state and federal prisoners who are 55 or older is about five times what it was three decades ago. In 2022, that was more than 186,000 people. In Oklahoma, the geriatric population has quadrupled in the past two decades. In Virginia, a quarter of the state's prisoners will be geriatric by 2030. And in Texas, geriatric inmates are the fastest-growing demographic in the entire system. Some states have opted to build entirely new facilities to house elderly or sick prisoners. Others have retrofitted existing units.

Mental Health

Newswise: Key mental health services could reduce jail time
Counties could save money and keep more people out of jail by improving access to community-based mental health and substance use disorder services, according to a study led by a Michigan State University College of Human Medicine professor. The study published by Psychiatric Services, a journal of the American Psychiatric Association, identified 59 recommended mental health practices, but found that United States counties, on average, offered only a few of them. Most counties offered very few of the recommended mental health and substance use disorder services.

Corrections 1: Case law: Jail staff liability for inmate suicide
Today, officers can face liability even if they did not actually know of a risk of harm to a pretrial detainee. The court noted, “Pretrial detainees need only prove that the officers recklessly disregarded a risk so obvious that they either knew or should have known of it.” That is a change from the standard of “consciously (not recklessly)” disregarding that risk.

State Roundup

Washington Post: Former Phoenix jail officer is sentenced for smuggling drugs into facility
A former jail officer in Phoenix has been sentenced to two years in prison for smuggling drugs into the detention facility where he worked. Andres Salazar, 28, was arrested in November 2022 as he arrived for work. According to prosecutors, Salazar was part of a narcotics ring and had been expecting “payments from outside sources” for bringing the drugs into the jail. Three others also were indicted in connection with the operation, including two inmates and a man who authorities say provided the drugs.

South Carolina
The State: Man with mental health issues brutally beaten while in handcuffs by SC officer, lawsuit says
A homeless man suffering from bipolar disorder and schizophrenia is suing the Marlboro County Sheriff’s Office and a former detention officer, alleging he was severely beaten while in handcuffs in custody. The lawsuit says officers “began brutalizing” the man. The lawsuit alleges the officer pinned him to the floor with his foot, stood on, stomped and struck his head then punched him in the face.

Mississippi Today: Senate passes measure restricting jailing of people with mental illness
SB 2744 would allow a person to be jailed only if they are violent, all alternatives have been exhausted, and a judge has ordered the jail detention. The person could be jailed no longer than 24 hours. The bill passed with little opposition. The limits on jail that it proposes are similar to language in a House bill that also passed.

KERA: Tarrant County jail chief addresses deaths, understaffing and mental health care behind bars
There have been more than 60 deaths at the Tarrant County jail since Sheriff Bill Waybourn took office in 2017. Conditions at the jail are a constant topic of conversation at county meetings, and jail lawsuit settlements have cost Tarrant at least $1.6 million – with more cases pending. Two former jailers face criminal charges for allegedly lying about checking on an inmate who who died of a seizure disorder in his cell in 2020.

Los Angeles County

Los Angeles Times: Some who are mentally ill remain in L.A. County jails after charges are dropped, report says
People with mental illnesses who are in conservatorships are being held in Los Angeles County jails even after their criminal charges are dropped. Similarly, they are staying months in county psychiatric hospitals after doctors have agreed that it’s safe for them to leave. The issue is partly one of capacity. Facilities where they could be sent after being released from jail or hospitals are often full and have months-long waiting lists. But Disability Rights California, a nonprofit that advocates for people with disabilities, criticized L.A. County for transferring them only to locked facilities, when they could be safely treated in unlocked community settings such as group homes or supportive housing.

Correctional Health Care Vendors

Corizon/YesCare/Tehum Care
Baltimore Banner: Maryland extends contract with ‘uniquely terrible’ prison health provider
Maryland extended its contract with a troubled, for-profit prison medical care provider, though top officials expressed reservations about the deal. Comptroller Brooke Lierman called the company, currently known as YesCare, a “uniquely terrible and irresponsible” company that has provided poor quality care and dodged responsibility in Maryland and across the country through bankruptcy protections. Despite a protest vote, YesCare’s contract extension was approved Wednesday, with Gov. Wes Moore and Treasurer Dereck Davis voting in favor. The company will be paid $125 million for the next nine months. During a tense meeting, Board of Public Works members heard about YesCare’s unpaid bills to local health care providers and an unusually long process by state corrections officials to solicit new contractors to provide care to an estimated 20,000 people in custody in state-run prisons and jails.

Boston.com: Bridgewater State Hospital is overly violent with patients, watchdog says
Bridgewater State Hospital — a Massachusetts Department of Correction facility in Bridgewater — continues to illegally restrain patients and inadequately provide medical care during a mold infestation. The report accuses Wellpath, a private organization based in Tennessee which is contracted for medical care of the facility, of dehumanizing and disrespecting patients through medicative restraint. The report describes multiple incidents where unaggressive patients were sedated involuntarily by the hospital’s security staff, who wear riot gear. One man was in his room reading before receiving the psychotropic medication, and another was laying on his bed when the team injected the medicine into his buttocks.

Boston Globe: Profiting off prisons
Thanks to the Steward Health Care disaster, we need no further proof around here that private equity should have no place in the healthcare business – especially when it comes to vulnerable patients. But we got that proof anyway this week, with a report laying bare the appalling conditions at Bridgewater State Hospital, where care is provided – or not – by Wellpath, owned by yet another equity firm looking to make massive profits off medical care for the unluckiest among us. And, like Steward, Wellpath should be booted from Massachusetts.

NOLA: New Orleans jail to ditch longtime medical care provider in pending deal
A new company is poised to take over medical care at the Orleans Parish jail under a pending deal backed by Sheriff Susan Hutson to replace Wellpath, a national outfit that has held the contract for a decade while facing heavy criticism. Wexford Health Sources, a healthcare company based in Pennsylvania, will take over jail medical care on June 1 under a deal that Mayor LaToya Cantrell is expected to sign next week, said sheriff’s office spokesperson Casey McGee. Hutson, who took office in 2022, declared it a top priority to transition the jail to a “public health” model where incarcerated people make seamless transitions to medical providers upon release. Hutson was still sheriff-elect when the city agreed to reup with Wellpath over a rival bid from LSU Health.