Weekly Update: March 12, 2024
Correctional Officials’ Resistance To Improving Healthcare & Medicaid’s Ability To Rectify Conditions Through Regulations & Health Outcomes


Highlighted Stories

Editor's Note
In this week’s highlighted stories, the Weekly Update returns again to the health and safety of incarcerated people. In Louisiana, a district court ruled that healthcare being provided to incarcerated people was a violation of the Eighth Amendment’s prohibition against cruel and unusual punishment and therefore ordered that the prison’s medical wards be overseen by court-appointed special masters. Instead of following the court’s order, the Louisiana Department of Public Safety and Corrections has decided to appeal this decision. In New Mexico, it took a suit from the ACLU for a court to determine that individuals have the right to receive MOUD rather than having their lives, put in danger. Turning to California, that state is facing $40 million dollars in fines for failing to improve suicide prevention measures.

These articles highlight the challenge that advocates for health and safety of people behind the wall face. Without a program like Medicaid, creating required standards of care, jurisdictions are left to their own devices, usually by their department of corrections if they are a state or by sheriffs, if they are a county, to determine what they consider to be adequate care. COCHS has stressed that this unregulated environment, without any central authority to protect life and health safety, creates a clear and present danger to incarcerated people. The fact that Louisiana is appealing the district judge’s order to appoint special masters again highlights the need for Medicaid to be permeated throughout the criminal justice system to improve standards of quality and access.

On another note, highlighted this week are various webinars. NAMI has asked COCHS’ Dan Mistak to discuss issues of integration between behavioral health care and corrections. The Institute for Innovation in Prosecution and the Vera Institute are hosting a panel on diversion strategies implemented in Vermont. And FORE is presenting a webinar that dives into state policies that address the opioid epidemic.

Conditions In Corrections
Louisiana Illuminator: Louisiana seeks to overturn court ruling of ‘abhorrent’ prison health care
A federal district court’s November ruling that medical care provided at the Louisiana State Penitentiary at Angola amounted to “abhorrent cruel and unusual punishment” and ordering that the prison’s medical wards be overseen by court-appointed “special masters” now hangs in the balance after a federal appeals court considered a challenge by the Louisiana Department of Public Safety and Corrections, among other defendants.

ACLU: New Mexico Corrections Department Must Provide Life-Saving Medication to Incarcerated People
As a result of a settlement approved by a federal district court Monday, incarcerated people with opioid use disorder (OUD) in the custody of the New Mexico Corrections Department (NMCD) will now be able to continue taking buprenorphine, a medication for opioid use disorder, when they enter NMCD custody. In 2023, the New Mexico Legislature passed Senate Bill 425, which requires NMCD to provide medications for opioid use disorder (MOUD) to those in their custody. However, under the statute, NMCD is not required to start continuing medication for people entering custody until the end of 2025. Waiting until then means many people would have been forced off life-saving medication and exposed to heightened risk of overdose and death.

California Healthline: California May Face More Than $40M in Fines for Lapses in Prison Suicide Prevention
California could face more than $40 million in fines after it failed to improve suicide prevention measures in state prisons despite a federal judge’s warning that she would impose financial penalties for each violation. Chief U.S. District Judge Kimberly Mueller told state officials over a year ago that she would start imposing fines unless they implemented 15 suicide prevention protocols that had been lacking for nearly a decade.

NAMI: Criminal Justice and Mental Illness: A Webinar on The State of The Issue (March 20, 4 PM Eastern)
COCHS' Dan Mistak will explore the history of mental health care and how policy choices have led to the development of parallel health care systems at the intersection of health care and the criminal justice. Now at this historic moment there are opportunities to implement best practices that promote integration between behavioral health care and corrections, and policy solutions that improve access to quality care for people who are incarcerated.

Institute for Innovation in Prosecution: Diversion in Action – Understanding Successful Diversion Strategies: A Case Study from Vermont (March 14, 1:30 PM Eastern)
You’re invited to join the Institute for Innovation in Prosecution and Vera Institute of Justice on Thursday, March 14th at 1:30 PM ET for a virtual panel on innovative diversion strategies being implemented in Vermont. Diversion programs can serve as an “off-ramp” from the harmful effects of the traditional criminal justice process and can offer benefits to both individuals accused of crime as well as to the broader public.

FORE: State Policy Landscape to Address the Opioid and Overdose Crisis in 2024 (March 13, 3 PM Eastern)
States have an array of policy options and levers to improve access to prevention, treatment, harm reduction, and recovery services. These options include: new federal rules and expansions in service delivery and harm reduction, increases in federal grants and Medicaid options, and new funding resulting from legal settlements.

Opioid Epidemic

NIDA: Nora' Blog
Nora Volkow, Director of NIDA: write: Substance use prevention interventions that are effective as well as cost-effective are not widely implemented. Evidence-based addiction treatment remains unevenly distributed and, for some, hard to come by. Racial inequities make it much harder for Black people and other underrepresented groups to access effective medications. A large percentage of people in jails and prisons have an untreated substance use disorder, often an opioid use disorder, and a shocking percentage fatally overdose upon their release due to lowered tolerance, coupled with the dangers of fentanyl in the drug supply.

Stat: The War On Recovery
Although the opioid overdose epidemic has burned through the U.S. for nearly 30 years, the country has had tools that are highly effective at preventing overdose deaths: methadone and buprenorphine. But virtually every sector of American society is obstructing the use of medications. Increasingly, public health experts and even government officials cast the country’s singular failure to prevent overdose deaths not as an unavoidable tragedy but as a conscious choice. Narcotics Anonymous, a nationwide organization that promotes the 12-step model of addiction recovery, actively opposes the use of medication. Roughly 40% of Walmart, Rite Aid, and CVS pharmacy locations decline to stock it.

Stat: Why fentanyl withdrawal is agony and how medication can prevent it
Over 2 million Americans have opioid use disorder, according to some estimates. Illicit opioids such as heroin and fentanyl were responsible for over 80,000 U.S. overdose deaths in 2023. Despite the known risks, these drugs are notoriously hard to stop using — due in large part to how debilitating withdrawal can be. Medications such as methadone and buprenorphine are very effective at treating opioid dependence, but despite sky-high overdose death rate, these treatments are unnecessarily hard to access in the United States.

Fierce Health Care: Opioid use disorder treatment retention improves with insurance coverage: study
Insurance network coverage dramatically impacts whether a person remains in treatment for opioid use disorder, according to results shared by treatment provider Ophelia. A new study finds that nearly three-quarters (72.3%) of patients receiving opioid treatment through network insurance stayed in treatment for at least six months. For a 12-month period ending in April 2023, more than 111,000 people died due to drug overdoses. Fentanyl and other opioids accounted for nearly 70% of these deaths.

CBS News: Medical examiner says two Wisconsin inmates died of fentanyl overdose, stroke
Two of the four inmates found dead at Waupun Correctional Institution since June died of a drug overdose and a stroke. Dodge County Sheriff Dale Schmidt said in telephone interviews that those deaths remain under investigation. He declined to comment on how they obtained the fentanyl. The Department of Corrections instituted lockdowns at Waupun as well as at prisons in Green Bay and Stanley last year due to a shortage of guards.

WISN: Waupun inmate deaths: Fentanyl overdose, stroke in separate cases
Two of the four inmates found dead at Waupun Correctional Institution since June died of a drug overdose and a stroke. Dodge County Medical Examiner PJ Schoebel said in a telephone interview that Lemons overdosed on acetyl fentanyl, a potent opioid painkiller. He has ruled Lemons’ death accidental.


Flathead Beacon: Montana Expands Medicaid Coverage for Housing Assistance and Transition from Prison
The state Department of Public Health and Human Services announced the green light from the Centers for Medicare and Medicaid for three distinct expansions of what the public insurance program can fund. Those expansions include housing support services for people with a serious mental illness or substance use disorder; 30 days of pre-release health care for people exiting state prisons; and therapeutic “contingency management,” an incentive-based treatment for people addicted to stimulants such as methamphetamine.

KU News: Medicaid’s impact on inmate health and recidivism rates explored in new research
“Accessing the Safety Net: How Medicaid Affects Health and Recidivism” addresses this by estimating the causal impact of access to means-tested public health insurance coverage on health outcomes and recidivism for those recently released from incarceration. It finds that reducing barriers in access to Medicaid for vulnerable populations increases enrollment and utilization of health care services, but it does not reduce 1-year or 3-year recidivism. This suggests the effectiveness of such policies is context-dependent.

Michigan Public: MSU study links lack of mental health services to higher incarceration rates
A recent study found that recommended mental health practices are only present in 21.9% - 43.0% of U.S. counties, highlighting significant gaps in mental health care for this population. One notable issue highlighted in the study was the suspension of Medicaid for individuals in jail, leading to challenges in reactivating coverage upon release. Johnson emphasized the importance of timely reactivation of Medicaid to ensure access to necessary healthcare services post-release.


Orlando Sentinel: Amid rising cases, Orange County jail screens inmates for syphilis
Faced with rising syphilis cases, health care providers are testing some of the people who may need screening the most: inmates. In April, the Orange County jail began testing inmates for syphilis upon admission hoping to reach people who might otherwise go undiagnosed. So far, the program has tested more than 1,400 people for syphilis – 981 male, 473 female – and diagnosed 17 new cases.


Cancer Health: People With Incarceration History Less Likely to Receive Health Care, Including Cancer Screening
A new study led by researchers at the American Cancer Society (ACS) shows people with an incarceration history had worse access to and receipt of health care, including physical exams, blood pressure, blood sugar and cholesterol tests, as well as dental check-ups and breast and colorectal cancer screenings compared with people without incarceration history in the United States.


Click Orlando: Prisoners with developmental disabilities face unique challenges. One facility is offering solutions
There is no comprehensive count of how many prisoners in the U.S. have autism or intellectual disabilities, though some studies estimate more than 4% are autistic and almost 25% reported having cognitive impairments, according to the U.S. Bureau of Justice Statistics — nearly twice the rate of each in the overall population. Many advocates believe the number could be much higher because of underdiagnosis before prison or because of ineffectual or nonexistent screening at some corrections departments.


Vera: Cheap Jail and Prison Food Is Making People Sick. It Doesn’t Have To.
In correctional institutions, to artificially meet health requirements, especially calorie minimums, meals are packed with refined carbohydrates. For key nutrients, powdered drinks stand in for whole foods. A study conducted in a rural Southwest jail found that daily meals had 156 percent more sodium than is recommended. Even seemingly healthy options, like oatmeal, are over-sweetened and low in fiber. People in prison were 150 percent more likely than the general population to report histories of diabetes, asthma, or high blood pressure. Nearly one in four incarcerated people have hypertension. They, too, have higher rates of hearing, vision, cognitive, and ambulatory disabilities than the general public, which the abysmal nutrition in corrections doesn’t help.


BU School of Public Health: Formerly Incarcerated Students Work More Hours, Have More Severe Substance Use Disorder
Findings show that students who are formerly incarcerated are more likely to work more hours than students who have not been incarcerated. Students who have had some level of involvement with the criminal justice system, but not incarcerated, were more likely to experience more severe substance use disorder (SUD) than students who did not engage with this system.

Criminal Justice's Detrimental Impact On Mental Health

US News & World Report: Mental Health Concerns Prompt Lawsuit to End Indefinite Solitary Confinement in Pennsylvania
Arguing that solitary confinement worsens mental health crises and violates Constitutional rights, six people incarcerated at prisons throughout Pennsylvania filed a federal class action lawsuit seeking to end indefinite use of the practice. A number of lawsuits nationally have targeted the conditions of solitary confinement, saying the treatment of incarcerated people there has led to psychiatric episodes of self-mutilation and death due to lack of adequate care. The federal suit filed in the Eastern District of Pennsylvania against the state Department of Corrections argues that people incarcerated have suffered from increased mental health struggles. Some have been in solitary confinement for up to 12 years consecutively.

Pittsburg Post-Gazette: Matthew Rosing: Because of a misdiagnosis, I went to prison and lived in hell
During my time in prison, I lived in hell. I witnessed horrific abuse, suffered from a critical lack of mental health care, and was treated as less than human. Guards even taunted inmates that we couldn’t change the system because our right to vote would be stripped away when we got out. My story isn’t uncommon. The National Alliance on Mental Illness reports that in 2020, nearly 53 million adults — 21% of the U.S. adult population — reported mental health issues. For incarcerated people, the numbers are even higher.

State Roundup

Los Angeles Daily News: LA County psychologist settles retaliation lawsuit for $1.65 million
A psychologist who said she was retaliated against for reporting civil rights violations at the Twin Towers jail has settled her lawsuit against the county’s Department of Mental Health for $1.65 million. Hough reported that she and some of her colleagues noticed civil rights violations against inmates, but the complaints went ignored. Hough reported to her supervisor that deputies were refusing to provide inmates with basic necessities such as food and clothing. She also said in the suit that an inmate at Twin Towers died after they were placed in handcuffs for ten hours. Los Angeles County spent more than $80 million in litigation costs in 2023. Twin Towers jail has long been at the center of allegations of abuse and misconduct against inmates.

San Francisco Chronicle: Lawmaker wants longer state hospital stays for violent offenders following Chinatown stabbing
Fook Poy Lai, who was on parole when he allegedly stabbed an employee at AA Bakery, stayed at the Potter Hotel before the incident. A San Francisco lawmaker has proposed a bill that would allow people with severe mental illness who commit violent crimes to be kept in state mental hospitals longer. A decade ago, lawmakers rejected a similar effort to give the state more time to plan before people held in state mental hospitals after committing a violent crime are released. That bill would have required that people were held for 30 days before their release, but died in committee. The advocacy group Legal Services for Prisoners with Children called the proposed 30-day holding period “excessively long."

WCGU: ‘This is Torture:’ State of healthcare in U.S. prisons leads to brutal inmate deaths
On Sept 8, 2017, Craig Ridley, an inmate at Florida Department of Corrections’ Reception and Medical Center (RMC) in Lake Butler for nine years, called his sister. He told her he was afraid for his life after filing a complaint against a prison guard who threatened him. Hours later, around 3:20 a.m., two corrections officers hurt 62-year-old Ridley so badly he was left paralyzed from the neck down. He remained in solitary confinement for five days, unable to move or eat, until he developed sepsis and was rushed to the hospital, where he died a month later.

WCTV: Families want to see changes in Florida prisons before legislative session ends
With just hours left in this year’s legislative session, families urged lawmakers Thursday to consider changes in the prison system. Several bills were filed this session addressing inmate conditions, but most didn’t go anywhere. More than 250 inmates died while locked up in Florida’s prisons since July 1, according to the Florida Department of Corrections. Families said Thursday many of them could have been prevented.

Florida Policy Institute: Florida Budget Proposals in Brief: Criminal Justice and Corrections
Both chambers’ budget proposals provide an overall increase for the Department of Corrections (DOC) over current-year funding levels. The Senate, though, recommends $223 million more than the House in total allocations. Despite the difference between the two budgets, the recommendations are commendable and would go a long way in expanding educational opportunities for incarcerated people. The Senate includes $93 million for basic education whereas the House proposes $89 million.

Maui News: Breaking Cycles Symposium updates community on plans to improve correctional system in Hawaiʻi
The Department of Corrections and Rehabilitation (DCR) is working on is the implementation of more rehabilitation services and programs. Currently, the DCR is in discussions with the Men of Pa‘a for a mentoring program for inmates at the Kulani Correctional Facility. At the symposium, Iopa Maunakea of Men of Pa‘a (Positive Action Alliance) said, it is “our kuleana” to take care of each other.

Mississippi Today: Lawmakers advance bills to restrict jailing people awaiting mental health treatment
Two bills imposing strict limits on when people can be jailed without criminal charges while they await mental health treatment are headed to the House and Senate floors. Both measures would allow counties to jail people during civil commitment proceedings only if alternatives such as local hospitals and crisis stabilization units are unavailable, and would restrict such jail detentions to no more than 24 hours.

North Dakota
Dakota Scout: Gov. Noem sympathetic to men's prison site opponents, defends plan
Gov. Kristi Noem says she's still open to meeting with Lincoln County residents who want to stop a new prison from being built there. But if that's going to happen, it won't be until a lawsuit brought against the governor's administration related to the project is resolved. Neighbors Opposed to Prison Expansion (NOPE) sued the state, contending the DOC cannot place the planned men's prison on a 320-acre site near Worthing without the consent of local government planners, while also asking for a ruling on whether the process used to select the planned location was legal.

Washington Post: Feds investigating suspected smuggling at Wisconsin prison, 11 workers suspended in probe
Federal authorities have been investigating an apparent smuggling operation involving employees at a troubled Wisconsin prison. The probe has resulted in the suspension of nearly a dozen Waupun Correctional Institution employees to date, according to the state Department of Corrections. Multiple sweeps of Waupun housing units revealed people in the prison were obtaining prohibited items such as cellphones and illegal drugs.

WBAY: Community leaders, advocacy groups speak out about correctional institution conditions
Dozens of people attended a panel at St. Norbert College night to hear from advocates from groups like JOSHUA and community leaders like Representative David Steffen speak on the inmate conditions at correctional facilities. Some key points of conversation included the lack of medical care, including mental health care, rodent infestations, and the limited options offered for rehabilitation, like the option to work or try masonry. Organizers say it’s the same as it was in the 1950s.

Rikers Island

amNewYork: How will NYC care for incarcerated people in need of medical care after Rikers Island closes?
Rikers Island is still on track to shut down in 2027, meaning that New York City not only needs to figure out how to detain alleged criminals but also how to care for sick and mentally ill inmates. Mayor Eric Adams, the Correction Department (DOC) and NYC Health + Hospitals revealed how the city plans to do just that while also mulling over the proposed use for its space when its facilities are emptied. According to DOC and NYC Health + Hospitals, people in custody who require serious medical treatment are transported from the island to a medical facility for treatment, putting a great strain on them — especially for those with terminal illnesses. The Adams administration is looking to avoid that in the future by green-lighting the construction of more than 350 therapeutic beds as part of a comprehensive ward inside several NYC hospitals.

New York Times: Rikers Island Not Likely to Close by 2027 Deadline, N.Y.C. Official Says
A senior New York City official acknowledged that Rikers Island, one of the nation’s most notorious jails, would most likely not be closed by the legally mandated deadline of August 2027. The candid admission from Jacques Jiha, the city’s budget director, reflected Mayor Eric Adams’s resistance to closing the Rikers jail complex and the city’s nearly invisible progress in building the four smaller borough facilities that are supposed to replace it.

Parole & Recidivism

New York Times: Living Slow Deaths Behind Bars
Barbara Hanson Treen, New York State parole commissioner from 1984 to 1996, writes: The number of aging long-termers warehoused in prisons has only increased in recent years. Many long-termers languish in cells or in substandard prison infirmaries or even in so-called long-term care units. With labored breathing, they limp to the mess hall and miss their chance to eat, sink deeper into dementia. At the same time, they are under the supervision of guards who lack the training and often the empathy to properly manage the diminished capacity of many older people to follow often senseless prison rules. There are now more than 7,500 incarcerated people age 50 or older in New York, or about 25 percent of the state prison population. Why? Because of the unwillingness of my former colleagues on the parole board to release people who have served their minimum sentences and often years and decades more.

World Population Review: Recidivism Rates by State 2024
The United States justice system places its efforts on getting criminals off of the streets by locking them up but fails to fix the issue of preventing these people from reoffending afterward. This is why many believe that the U.S. prison system is greatly flawed. Recidivism affects everyone: the offender, their family, the victim of the crime, law enforcement, and the community overall. According to the National Institute of Justice, almost 44% of criminals released return before the first year out of prison. In 2005, about 68% of 405,000 released prisoners were arrested for a new crime within three years, and 77% were arrested within five years.


NIJ: March 2024 — Drone-Delivered Contraband in Correctional Facilities
The use of drones, or unmanned aircraft systems, to deposit contraband, such as drugs, weapons, and cellphones, into correctional facilities poses a significant and growing threat to the safety and security of prisons and jails. Advances in drone technology have enabled remotely piloted aircraft to carry larger payloads, fly faster and longer distances, and operate at lower costs. Most drones suited to prison incursions are fast, quiet, and small enough to be difficult to detect with the human eye.

Private Prison

Sentencing Project: Private Prisons in the United States
Harmful crime policies of the 1980s and beyond fueled a rapid expansion in the nation’s prison population. The resulting burden on the public sector led to the modern emergence of for-profit prison. Of the 1.2 million people in federal and state prisons, 8%, or 90,873 people, were in private prisons. States show significant variation in the use of private prisons. At one end of the spectrum, Montana incarcerates almost half of its prison population in private prisons, but in another 23 states, private prisons are not used at all. A total of 27 states and the federal government use private corporations like GEO Group, Core Civic, LaSalle Corrections, and Management and Training Corporation. Political influences have been instrumental in securing the growth of for-profit private prisons.

Correctional Health Care Vendors

Corizon/YesCare/Tehum Care
Business Insider: Inside a prison healthcare company's ownership shell game
Newly obtained documents show YesCare agreed to send millions of dollars to companies controlled by insiders. Experts say the "unusual" corporate structure appears designed to divert profits and evade accountability. One of the nation's largest providers of healthcare to prisoners was set up as an elaborate corporate shell game, according to newly unsealed and previously unreported court records. Experts said the highly unusual structure appears to have been designed to siphon off profits to opaque investors and evade accountability over allegations of substandard healthcare. Many of those records, part of a lawsuit filed by a Missouri hospital system that had sued Corizon Health over $12 million in unpaid hospital bills, were unsealed after a months-long legal battle by Business Insider. They show that YesCorp, a Corizon successor company that took over Corizon's active contracts with jails and prison systems, was secretly controlled by an obscure management company linked to insiders. Documents show that the management company, in turn, was owned as of late 2022 by a troubled nursing home chain.

Wellpath/Correct Care Solutions
The Intercept: George Latimer Awarded County Jail Contracts to Private Firms That Donated to His Campaign
George Latimer is now running for Congress in the Democratic primary against Rep. Jamaal Bowman. Latimer has billed himself as a progressive, and throughout his tenure as county executive — including just last month — he has cited the quality of the county jail as proof of his administration’s humanity. But after taking office in 2018, Latimer repeatedly ignored complaints from guards and detainees about the quality of the food and medical services in the county jail. Correct Care (now Wellpath) would become an issue for Latimer. The medical care provided by Correct Care, the report said, “was grossly uncoordinated and mismanaged.” In 2021, Latimer received another donation from Wellpath, for $2,500. The following year, he again renewed the firm’s contract.

Boston Globe: All eyes on the state's next move on prison health care
The Department of Correction remains under a four-year settlement agreement with the DOJ to provide “adequate mental health care and supervision” to those in “mental health crisis." An aging prison population poses new challenges for addressing both the physical frailties of the incarcerated and the cognitive issues the system has not adequately planned for. Complaints about the existing levels of care and staffing of prison medical facilities by Wellpath have been all too common. A contract worth well over $100 million a year to provide health care services to all of the state’s prison facilities is out to bid. Adding to the drama has been the recent involvement of Massachusetts Senators Elizabeth Warren and Ed Markey, who zeroed in on the current contractor, Wellpath, and YesCare (previously known as Corizon), both of which are among seven vendors known to have filed bid intent forms.

Turn Key Health
KOSU: Federal lawsuit: subpar care led to Cleveland County detainee's death in jail
Cleveland County (OK) Detention Center staff recklessly disregarded Shannon Hanchett’s constitutional rights and contributed to her in-custody death amid a mental health crisis, a federal lawsuit filed on Jan. 25 claimed. The Cleveland County Sheriff’s Office, Turn Key Health Clinics and three medical professionals who cared for Shannon Hanchett in the days leading up to her death are named as defendants in the lawsuit. While medical staff reported that Hanchett displayed suicidal ideation and was severely dehydrated, jailers routinely missed 15-minute sight checks required under state law.