COCHS Weekly Update: July 18, 2023
Highlighted Stories
JD Supra: CMS Approves WA’s 1115 Waiver with Health-Related Social Needs & Justice-Involved Initiatives
The Centers for Medicare & Medicaid Services (CMS) approved Washington’s five-year Section 1115 demonstration renewal, the Medicaid Transformation Project 2.0 (MTP 2.0 or Demonstration). Washington is the second state to receive CMS approval to operate a justice-involved initiative, which will provide a targeted set of Medicaid services to youth and adults in state prisons, county and city jails and youth correctional facilities up to 90 days before release.
Daily News : N.Y. should move quickly on inmate Medicaid enrollment
We’ll rarely object to taking federal dollars to pay for something that would otherwise fall on the state’s shoulders, and medical care for inmates is no exception. So we commend the state’s efforts to enroll detainees in a Medicaid program 90 days out from their scheduled release dates. From a purely fiscal perspective, taxpayers end up covering their care behind bars anyway. If we can defray these costs while also creating a softer landing pad for the people in custody as they leave, there’s no reason not to.
Editor's Note
As can be seen from the approval of Washington State’s 1115, the drumbeat for Medicaid behind the walls grows louder (as is also evident from the Daily News editorial in support of New York's 1115). The news about Washington State’s 1115 and the approval earlier this year of California’s 1115 is heartening. The changes that Medicaid might bring behind the walls could be dramatic. But at the same time, it must be realized that these 1115s will be operating in very challenging environments. The story directly below about jails in Oklahoma drives home that point. That story details how those jails continuously fail to meet minimum health standards set by that state, yet face minor negative repercussions if those standards are not met. From COCHS’ firsthand experience such stories are sometimes more the rule than the exception. In a previous Editor’s Note, we at COCHS pointed out that providers in corrections will need to meet minimum health and safety standards to participate in Medicaid. That note also went on to explain: “These requirements, the conditions of participation, will need to be closely attended to when incarcerated people’s health care is covered by Medicaid.” For further reference see these CMS documents: Certification Process and Quality, Safety & Oversight - Enforcement.
Ponca City News: Most Oklahoma jails failed health department inspections in 2022
A state health department inspector found a man lying in soiled clothing during an unannounced examination of the Kiowa County Jail in early September. Months earlier, in February 2022, an inspector cited the Bryan County Detention Center for failing to have working intercoms in every cell, raising the odds that detainees in distress would not be able to reach staff. Oklahoma’s jails are bound by a series of minimum health and safety requirements codified in state law. The Oklahoma State Department of Health enforces those standards through annual unannounced inspections. But unless their facilities are continually cited for the same repeated deficiencies, jail administrators face no formal repercussions for housing detainees in substandard conditions.
State Of Reform: Utah launches new agency for correctional health services
The Utah Department of Health and Human Services (DHHS) launched the first phase of transitioning health services for incarcerated individuals from the Utah Department of Corrections (UDC) to DHHS by announcing a new sub-agency this month, the Division of Correctional Health Services (DCHS). The transition is aligned with the guidance CMS issued in April around using Medicaid 1115 demonstration waivers to increase healthcare access for those departing prisons.
Dakota Free Press: Medicaid Expansion Will Reduce Counties’ Costs for Indigent and Jail Health Care
Medicaid expansion may indirectly reduce those county jail medical costs by keeping people out of jail. In states with Medicaid expansion (i.e., where eligibility is based solely on income), there have been correlated reductions in crime rates and arrests. Compared to counties in states that had not implemented expanded Medicaid coverage, counties in states with Medicaid expansion saw a 25% decrease in drug arrests, a 19% decrease in “violent offense” arrests, and a 24% decrease in “low-level” offense arrests.
Opioid Epidemic
Kaiser Family Foundation: A Look at the Evolving Landscape of Federal OUD Treatment Policies
Opioid overdose deaths, primarily driven by fentanyl, have surged during the pandemic, exposing significant gaps in access to availability of treatment. From 2016 to 2021, opioid overdose deaths nearly doubled. SUD-focused section 1115 waivers can allow states to facilitate the provision of OUD services prior to release from incarceration. Yet, the recent resumption of Medicaid renewals following a three-year pandemic halt—termed ‘Medicaid unwinding’— has already led to many individuals losing coverage, primarily due to procedural rather than eligibility reasons.
BJA: Leveraging Telehealth for Justice-involved Populations With Substance Use Disorders: Lessons Learned and Considerations for Governors
This report from the Bureau of Justice Assistance (BJA) describes the various state-level efforts to expand access to telehealth that benefit justice-involved and incarcerated patients with substance use disorders (SUDs) throughout the pandemic, along with the lessons to guide future use.
Corrections 1: Justice Department releases new tool to manage substance withdrawals in jails
This tool supports the department’s commitment to increasing access to evidence-based treatment for individuals with substance use disorders (SUD) and those at risk for overdose, including individuals who are incarcerated or reentering their communities. The number of those in jail who died from drug or alcohol intoxication increased nearly 400% from 2000 to 2019. Less often recognized, but also potentially fatal, is the risk of substance withdrawal complications, such as profound dehydration and aspiration pneumonia due to severe vomiting.
West Virginia Record: Class action accuses prison health provider of denying inmates opioid addiction medication
A potential federal class action lawsuit has been filed accusing Wexford, a prison health care provider, of routinely denying thousands of people medication to treat Opioid Use Disorder. The complaint claims Wexford “intentionally subjects patients entrusted to its care to significant pain and suffering and an elevated risk of drug relapse and overdose death.” The complaint also states that Wexford has no medical justification to deny medications for OUD (or MOUD), but it says Wexford does so purely for profit.
Spectrum: Adams County Jail evacuates inmates after fentanyl scare
Inmates at the Adams County Jail had to be evacuated Friday after officials said a female inmate smuggled in fentanyl and distributed it to others behind bars. Several inmates and corrections officers were rushed to the hospital Friday after being exposed to the drug. They were all treated and released.
BOP
WBUR: Former Mass. federal prison guard sent to prison for violating civil rights of injured inmate
A former guard at a federal prison in Massachusetts who prosecutors say caused serious head injuries to a handcuffed inmate with severe mental health disorders has been sentenced to a year in prison. The officer was also sentenced in federal court in Boston to two years of probation. He was convicted by a jury in December of deprivation of civil rights under color of law.
State Roundup
California
Press Democrat: California spent $600 million to house and rehab former prisoners — but can’t say whether it helped
As Gov. Gavin Newsom retools the state’s prison system to emphasize rehabilitation, his administration has little evidence that a privately run program for parolees costing taxpayers $100 million a year works to prevent future crime. The state does not collect data on whether parolees who participate in the program have found jobs or whether they are returned to prison for another crime. What state data does show is that only 40% of participants completed at least one of the services they were offered.
Desert Sun: Coachella Valley woman dies of illness after months in Riverside County jail, sheriff says
A Coachella Valley woman who'd been an inmate in a Riverside County jail died in a hospital this week of an "ongoing illness" that doctors had deemed terminal. Riverside County Sheriff Chad Bianco's department, which operates the county's five jails, last year reported the deadliest year behind bars, with what was later determined to be 19 deaths. California Attorney General Rob Bonta opened an investigation of the sheriff's department due to the number of deaths last year. The department illegally failed to report them to the California Department of Justice within the required 10 day deadline.
Los Angeles Daily News: LA County moves first 88 youth detainees to Los Padrinos ahead of state shutdown
Los Angeles County quietly moved a third of its juvenile detainees to Los Padrinos Juvenile Hall, marking the first time the facility has housed youth prisoners since 2019. The Probation Department must move the rest of the nearly 200 children in its custody to the renovated detention center within the next 10 days to meet a state mandate to empty its juvenile halls by July 23. The county has struggled to appropriately staff the juvenile halls for more than a year.
Georgia
New York Times: Justice Dept. to Investigate Georgia Jail Where Inmate Died Covered in Lice
The Justice Department said on Thursday that it was investigating the conditions at a jail in Fulton County, Ga., citing reports of violence, deteriorating surroundings and the death last year of an inmate who was covered in lice and feces. The civil investigation, part of a broader effort by the department to scrutinize conditions at jails and prisons across the country, will also examine whether officers used excessive force, the availability of medical care and the treatment of mentally ill prisoners.
Pennsylvania
Reporters Committee: Pennsylvania appeals court orders Allegheny County to disclose inmate autopsy records
The Commonwealth Court of Pennsylvania has ordered Allegheny County to provide journalist Brittany Hailer with autopsy records concerning a 63-year-old man who died in custody in 2020. In a 6-1 decision, the Commonwealth Court reversed the trial court’s earlier ruling in favor of Allegheny County’s decision to withhold the records. The appeals court held that the lower court erred in concluding that the disclosure of autopsy records were restricted to “nongovernmental agencies”. It also rejected as “absurd” the argument that the autopsy records could be kept secret in Allegheny County because it is classified as a second-class county.
Texas
PBS (YouTube): Prison inmates struggle to survive unrelenting heat without air conditioning
The extreme heat scorching much of the country is particularly brutal for incarcerated Americans. In Texas, more than two-thirds of prisoner living areas lack air conditioning. Earlier in 2023, an effort to include funding for prison air conditioning in the state’s budget failed in the Texas Senate.
Rikers Island
New York Times: Federal Prosecutor Urges Takeover of Rikers Island
Manhattan’s top federal prosecutor, Damian Williams, is calling for an outside authority to take control of New York City’s troubled jails, a major shift that could help persuade a judge to strip Mayor Eric Adams of his power over Rikers Island. "Aafter eight years of trying every tool in the tool kit,” Mr. Williams said, “we cannot wait any longer for substantial progress to materialize. That is why my office will seek a court-appointed receiver to address the conditions on Rikers Island.” Mr. Williams’s office said it would also seek to have the city held in contempt of court “to address the ongoing risk of harm” to detainees and jails staff.
Spectrum News: Rikers inmate dies after being found unresponsive in cell: DOC
A Rikers Island inmate died Saturday afternoon, the Department of Correction said. William Johnstone, 47, was found unresponsive in his cell unresponsive in the George R. Vierno Center at approximately 1:50 p.m., DOC officials said in a statement. Johnstone is the sixth person to die who spent time in city custody this year, and the third one this month. Last year, 19 incarcerated people died in Rikers Island jails.
The City: City Hall Set to Supply Free Phones to People Newly Released from Rikers
Rikers Island detainees fresh out of lockup — including some with serious mental illnesses — will soon receive free smartphones to better connect them with health care and other community services. The plan to distribute phones comes after a 2003 court settlement in which a state judge appointed a monitor to ensure the city would provide a discharge plan for the newly released that included continued mental health treatment and assistance with public benefits and housing.
Los Angeles County
Los Angeles Times: After jail deaths, supervisors ask LASD to give more warm clothes to inmates
Weeks after a watchdog report raised concerns about two inmate deaths last winter linked to suspected hypothermia, the Los Angeles County Board of Supervisors unanimously passed a motion asking jail officials to give out warmer clothes to people in custody who are cold. The county’s seven jails have long struggled to maintain consistent indoor temperatures during freezes and heat waves.
Correctional Health Care Vendors
Wellpath
Voice Of Monterey Bay: Pain, death and secrets in Monterey County Jail
As inmate deaths continued piling up in the Monterey County Jail, investigators for reform-minded lawyers kept finding evidence that the jail’s health care provider, Wellpath, had violated provisions of its contract in death after death after death — at least 11 in a row through April of this year. Tennessee-based Wellpath is possibly the largest provider of health care in U.S. jails and prisons. Including litigation involving sister companies, such as its predecessor, Monterey-based California Forensic Medical Group.
Voice Of Monterey Bay: Secrecy In Court
In other counties and states where federal courts monitor health care in jails and prisons, most of the information that goes into the court files is considered public record. Open to the press. Open to everyone. Lawyers for the inmates have filed a motion to open the reports to the public, a move opposed by Wellpath and the Monterey County Counsel’s Office.