Weekly Update: March 5, 2024
CMS Approves Montana’s 1115 –Will 1115s Improve Safety & Security In Correctional Institutions?


Highlighted Stories

Editor's Note
This week’s highlighted stories look at the challenges jurisdictions have in providing safe and secure environments to incarcerated or detained people. From these articles, one could reframe the criminal justice assembly line as a gauntlet of threats to health and safety that include: excessive force at arrest, unwarranted administration of dangerous narcotics, knowingly allowing people to drink contaminated water, permitting extreme violence and sexual abuse, not taking steps to prevent contraband that lead to drug overdoses (see last week’s Editor’s Note ), providing minimal or no dental care, and even freezing someone to death. Throughout other sections of the Weekly Update, our subscribers will find articles about how the criminal justice assembly line not only endangers people’s safety but allows companies offering “cost saving systems” like electronic monitoring to financially prey on individuals often leading to modern day debtor prisons. In addition, as always, there are the articles about proprietary correctional health care vendors and the continuous lawsuits accusing these companies of sub-adequate care or no care at all.

As these stories appear to be ongoing and never-ending, we at COCHS have come to wonder whether these ceaseless articles aren’t related to the general lack of consequences for the criminal justice system to provide safe and secure environments. While individuals or bereaved relatives may win lawsuits because correctional institutions failed to protect incarcerated people, these lawsuits are singular events and do not create systemic change. As the repetitive theme of these articles suggest, it is often back to work as normal within a short while after each tragedy.

COCHS has always looked to Medicaid as a way to finally address criminal justice’s inability to ensure basic health care and basic human rights. Over the last year, 1115 waivers to permit Medicaid coverage behind the walls continue to be submitted and approved. Last week, the Weekly Update linked to Pennsylvania’s 1115 submission. On February 26, CMS approved Montana’s 1115. On March 3, in the bipartisan Consolidated Appropriations Act of 2024 (Section 206 (b)), Congress required CMS to issue guidance on Medicaid within corrections. Now as Medicaid standards and regulations begin to permeate through various correctional systems, COCHS will keep a close eye on whether there are real consequences for the criminal justice system's inability to provide for safe and secure environments.

Failure To Provide Safe & Secure Environments
KKTV: Paramedic gets 5 years in prison for Elijah McClain’s death in rare case against medical responders
Colorado paramedic was sentenced Friday to five years in prison in a rare prosecution of medical responders following the death of Elijah McClain, a Black man whose name became part of the rallying cries for social justice that swept the U.S. in 2020. McClain was walking down the street in a Denver suburb in 2019 when police responding to a suspicious person report forcibly restrained him and put him in a neck hold. His final words -- “I can’t breathe” Peter Cichuniec and a fellow paramedic were convicted in December of criminally negligent homicide for injecting McClain with ketamine.

Governing: Florida Knew of Water Risks, Let Prisoners Drink Anyway
It’s no secret that the groundwater around the Florida State Fire College has been highly contaminated for years. But inmates at Lowell Correctional Institution, a 2,400-bed women’s prison across the street from the fire college, say they weren’t told about the potential risks in their tap water, even as state data showed that contamination had spread to the prison.

Miami Herald: Officers broke inmate’s ribs, forced him to crawl to the emergency room, feds say
Instead of taking an injured inmate to an infirmary, an Alabama corrections officer “savagely” beat the man in the hallway of the prison’s health care unit, according to the Justice Department. As he did, another officer joined in the assault, federal prosecutors said. The officers repeatedly kicked and punched the man, who was lying on the ground in a fetal position.

Roll Call: Senate Judiciary panel to hear about federal inmate deaths
The Justice Department’s inspector general reviewed hundreds of inmate deaths and found serious issues at the Bureau of Prisons that created unsafe conditions. The report criticized the agency’s emergency response to inmate deaths, raised doubts about its ability to properly assess inmate mental health and detailed failures in the agency’s efforts to root out contraband drugs and weapons. Chronic problems within the bureau also were contributing factors to inmate deaths, the report stated, as it pointed to staffing shortages, an ineffective staff disciplinary process and an out-of-date security camera system.

Politico: Justice Department finds problems with violence, gangs and poor conditions in 3 Mississippi prisons
Gangs, violence and sexual assaults are a problem in three Mississippi prisons because the facilities are short-staffed and inmates are sometimes left unsupervised, the Department of Justice said in a report. The department said the state failed to protect inmates’ safety, control contraband or investigate harm and misconduct.

Mendocino Voice: 5 incarcerated people overdose in their cells at Mendocino County Jail — 1 dies at hospital
Five incarcerated people overdosed at the Mendocino County Jail in Ukiah today, and one of them died at the hospital. Jail employees were notified about the first overdose around noon. A deputy responded to the call and found that person’s cellmate unconscious. The deputy summoned other deputies and medical personnel and administered multiple doses of Narcan.

Alaska Beacon: Alaska prison failed to provide adequate dental care to inmates, state investigator finds
One inmate with an abscess was not treated for two months. Another went toothless for more than two years while he waited for dentures. He filed paperwork to get them 18 times and experienced mouth pain, swelling of mouth tissue known as mucositis and digestive issues while on a soft food diet. Another said the dental team at Goose Creek Correctional Center would do no dental work except to pull teeth.

Sun News: Detainee held in jail ‘freezer’ died of hypothermia, suit says. Death ruled homicide
A 33-year-old man was detained — and neglected — inside a frigid, isolated jail cell referred to as the “freezer” by corrections officers, according to a federal lawsuit, which says he died of hypothermia. Officers are accused of purposely exposing Anthony “Tony” Mitchell, a pretrial detainee who was arrested during a welfare check, to freezing temperatures overnight from Jan. 25 to Jan. 26, the day of his death, at Walker County Jail in Alabama. They directed “extremely cold” air into his cell using the facility’s climate control system, according to an amended complaint filed in the U.S. District Court.

CMS: CMS Approves Montana'a 1115 Waiver
Expenditure authority is also being provided to Montana to provide limited coverage for a targeted set of services furnished to certain incarcerated individuals for up to 30 days immediately prior to the beneficiary’s expected date of release. The state’s proposed approach closely aligns with CMS’s “Reentry Demonstration Opportunity” as described in the State Medicaid Director Letter (SMDL) released April 17, 2023.

US House of Representatives: Cosolidated Appropriations Ace of 2024 (Section 206 (b))
The legislation requires that the Centers for Medicare and Medicaid Services (CMS) issue guidance within 18 months to states laying out strategies and best practices states can use to overcome common implementation and operational challenges to ensuring access to timely, accessible care before, during and after incarceration for Medicaid and CHIP beneficiaries. The guidance will focus on strategies including: eligibility and enrollment process modifications; screening, application assistance and coordination of reinstatement of coverage; data sharing and exchange; ensuring the timely provision of services; establishing community-based provider networks. It will also clarify the circumstances under which states can use Medicaid administrative and other funding sources to help people enroll and obtain services.

WUNC: Prison system works to combat health care coverage gap by enrolling people in Medicaid before release
In North Carolina with Medicaid expansion that took effect on Dec. 1.. The expanded eligibility rules allow people ages 19 to 64 whose incomes are up to 138 percent of the federal poverty level. This criteria allows substantially more justice-involved individuals — people who often work in low-paying jobs or struggle to find work because of their criminal history — to enroll in Medicaid. The program can cover a variety of services, including doctor visits, behavioral health treatments and prescription drug.

National Memo: For Prisoners, Medicaid Waivers Permit Off-Site Care -- And Better Outcomes
Jails are filled with low-income people who can’t afford to post bond. Two-thirds of people detained in jails report annual incomes under $12,000 prior to arrest. Despite the thoroughness of the indigency of an incarcerated population, in Washington State, jails are required to gather information about the person’s ability to pay for medical care as part of the intake process, including whether the person has insurance. Additionally, at sentencing, courts are authorized to require an individual to repay their medical costs based on their ability to pay. That complete lack of insurance coverage shows where correctional healthcare intersects with “legal financial obligations” or LFO’s, the aspects of prosecution and incarceration that prisoners have to pay for themselves.


MedCity News: Lower Health Care Costs, Help Inmates. Why Aren’t There PrEP Programs in Prison?
Prisons should offer abundant opportunities for HIV screening and comprehensive pre-exposure prophylaxis (PrEP) adherence programs to benefit incarcerated individuals and carceral systems as a whole. Justice-impacted individuals are at greater risk than the general population for contracting HIV outside of prison from high-risk activities like injection drug use, while activities like unprotected sex inside prison also risk transmission.


National Council for Mental Wellbeing: Provider Clinical Support System-Medications for Opioid Use Disorder (PCSS-MOUD) — Improving Continuity of Care for Justice-involved Individuals
On March 19 from 3-4 p.m. ET, the National Council for Mental Wellbeing is hosting a webinar: Provider Clinical Support System-Medications for Opioid Use Disorder (PCSS-MOUD) — Improving Continuity of Care for Justice-involved Individuals: Lessons from the Field.

FORE: State Policy Landscape to Address the Opioid and Overdose Crisis in 2024
On Mar 13, 2024 12:00 PM FORE is hostin a webinar to examine how state policymakers are navigating changes on multiple fronts in substance use policy, such as 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.


Military Times: More VA health care, GI Bill eligiblity could keep vets out of jail
A pair of former defense secretaries are backing plans to enroll all separating servicemembers in Veterans Affairs health care and extend veterans education benefits to troops with other than honorable discharges in an effort to curb homelessness and incarceration among young veterans. The recommendations are included in a new report released Thursday by the Council on Criminal Justice’s Veterans Justice Commission, which also calls for an overhaul of post-military transition classes to better prepare departing troops for civilian life.


Roll Call: Federal prison director tells senators about staffing ‘crisis’
Senators zeroed in on chronic staffing problems in the federal Bureau of Prisons on Wednesday, as the head of the agency said the system faces a “crisis” in recruiting and retaining employees. Long-standing staffing shortages were among the problems cited in a scathing watchdog report this month that found systemic and operational failures contributed to scores of prisoner deaths over the years. At a Senate Judiciary Committee hearing, Bureau of Prisons Director Colette Peters said they have thrown every incentive they can at the problem — such as raising the base salary for correctional officers by $2,000 — but are still not able to compete with the private sector and other law enforcement agencies.

Data & Statistics

BJS: Heroin, Fentanyl, and Other Opioid Offenses in Federal Courts, 2021
This report presents data from the Drug Enforcement Administration (DEA) and the U.S. Sentencing Commission (USSC) describing the federal criminal justice response to opioids. It focuses on heroin, fentanyl, and other opioids, including how they are classified under the Controlled Substances Act, the number of deaths due to overdose, and the number of persons arrested and sentenced for federal offenses involving these substances.

State Roundup

Equal Justice Initiative: EJI’s Health Clinic Receives Recognition
Since opening in 2023, EJI Health has provided free health services to hundreds of people across Alabama. Many patients are formerly incarcerated and did not receive any personalized medical care while they were in jail or prison. Formerly incarcerated people are particularly vulnerable, and many people coming out of jails and prisons suffer from undiagnosed illnesses that can seriously compromise their health and successful re-entry. While EJI’s Health Clinic prioritizes care for people who have been incarcerated, it is open to anyone unable to access healthcare in other ways.

Tallahassee Democrat: Florida lawmakers won't hear bills to improve state prison conditions this session
Appalled by the lack of air-conditioning and numerous other problems in the state prison system for years, state lawmakers were hoping to kickstart change by backing bills that reinforce the rights inmates are to have — things they say should already be considered basic human rights. But those bills, filed by Democrats in a Republican-dominated Legislature, never received a hearing this legislative session.

The Guardian: Louisiana prisons have experienced 50% spike in deaths, report says
A class-action lawsuit in 2023 resulted in federal oversight for Angola prison, where healthcare has been deemed deathly inadequate and unconstitutional. While Louisiana appeals the ruling, arguing that Angola’s healthcare has improved, the state’s prison population is expected to continue ageing and dying under the state’s far-right governor, Jeff Landry, who took office in January after running on a tough-on-crime platform. He convened a special legislative session on 19 February aimed at enacting a swath of criminal justice measures that reform advocates worry could send the state’s incarceration rate soaring again.

New York Times: Ferguson, Mo., Agrees to Pay $4.5 Million to Settle ‘Debtors’ Prison’ Suit
The City of Ferguson, Mo., has agreed to pay $4.5 million to settle a federal lawsuit that accused it of violating the constitutional rights of thousands of people who said they were jailed without due process because they could not pay fines. The lawsuit was filed in 2015 amid protests over the killing of Michael Brown, an unarmed Black teenager, by a white Ferguson police officer. It accused the city of jailing the plaintiffs in “deplorable” conditions simply because they could not pay debts owed for traffic tickets or other minor offenses.

ProPublica: Lawmakers Could Limit When County Officials in Mississippi Can Jail People Awaiting Psychiatric Treatment
Key Mississippi lawmakers have introduced several bills that would drastically limit when people can be jailed without criminal charges as they await court-ordered psychiatric treatment. The proposals follow an investigation that found that hundreds of people in the state are jailed without charges every year as they go through the civil commitment process, in which a judge can force people to undergo treatment if they’re deemed dangerous to themselves or others. People who were jailed said they were treated like criminal defendants and received no mental health care.

This Is Reno: Advocates, lawmakers laud progress on implementation of prison reforms
New laws limiting solitary confinement and ending medical copays have taken effect, but efforts to set up an independent prison ombudsman and expand medical services to women who are incarcerated are still ongoing. Senate Bill 307 went into effect Jan. 1 and requires the department to implement the “least restrictive manner” when separating inmates from the general population, and doing so for the “shortest period of time safely as possible.” The bill requires a multidisciplinary treatment team, which includes a mental health clinician, to conduct a review after a person has been in solitary for 15 consecutive days.

News From The States: Legislature passes bill allowing methadone and other medical assisted treatment programs in Utah prisons
Inmates struggling with opioid addiction in either of Utah’s two prisons may soon have a reprieve after a bill allowing them to continue medical assisted treatment while incarcerated passed the Utah Senate and House Wednesday evening. SB212, sponsored by longtime recovery advocate and Salt Lake Democratic Sen. Jen Plumb, passed both the House and Senate with unanimous support.

Mental Health Initiatives

Texas Tribune: Travis County to launch $23 million project to keep mentally ill from jail
For years, veteran Texas sheriffs like Travis County’s Sally Hernandez have watched how countless tax dollars are spent to break the endless cycle of taking mentally ill or intoxicated individuals who commit minor crimes, only to see them released within hours. Now, Travis County, in partnership with county mental health provider Integral Care, will launch the first phase of its own version of a jail diversion initiative with a $23 million three-year pilot program. Once launched, law enforcement officers and paramedics will be able to quickly drop off someone in crisis and stabilize them at a former walk-in crisis clinic .

MSU Today: 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.


WVLT: Recidivism programs helping former inmates re-enter the workforce
For many, re-entering everyday life after incarceration is not simple. Recidivism programs such as Men of Valor in Knoxville help former inmates rejoin the workforce and live an everyday life after prison. According to a 2023 study conducted by the Tennessee Department of Correction, recidivism rates for the state dropped below 30%, the lowest mark in over a decade. Programs such as Men of Valor and numerous others are dedicated to life after prison, but the choice to join these initiatives starts while they are still incarcerated.


Vera: Electronic Monitoring Is an Extension of Mass Incarceration
The number of people on electronic monitoring has increased exponentially in recent years. Vera’s report shows that electronic monitoring is often costly for those subjected to it, who might be required to pay “user fees.” Companies may push electronic monitoring as a cost-saving measure, but those costs are often passed on to people on electronic monitoring—or their loved ones. People have paid hundreds of dollars per week

Correctional Health Care Vendors

Corizon/YesCare/Tehum Care
Baltimore Banner: Maryland’s prison health care provider could be in big trouble
The state of Maryland has about a month to decide whether it will continue to do business with YesCare. Meanwhile, a cascading series of events over the last week in a related Texas bankruptcy case has thrown the viability of YesCare into question. An atypical coalition including civil rights organizations, formerly incarcerated people, a progressive bloc of U.S. senators, the Arizona prison system and now the U.S. Department of Justice is pushing a judge in Houston to toss out the bankruptcy case of Tehum Care Services — an offshoot of the correctional health care giant formerly known as Corizon Health.

Bloomberg Law: Prison Health-Care Bankruptcy Tests ‘Texas Two-Step’ Strategy
Tehum Care Services Inc. is a shell company created to absorb the medical malpractice suits and other legal liabilities of what used to be the nation’s largest prison healthcare provider: Corizon Health Inc. Tehum is pushing for court approval of a settlement that would remove the rights of prisoners and others to sue parties that took over Corizon and engineered its bankruptcy filing. The move thwarted prosecution of hundreds of cases alleging substandard medical care in prisons, including ones that led to wrongful deaths. Driven by Corizon’s record of purportedly shoddy care of inmates, several local and state governments in New York, California, Indiana and elsewhere have canceled contracts with the provider.

Tributary: In 2 months, Jacksonville Sheriff’s Office has already reported 4 inmate deaths
A 24-year-old who was incarcerated at the Duval County jail died on Tuesday evening at a local hospital after experiencing a medical episode, according to a news release from the Jacksonville Sheriff’s Office. He is the fourth person to die in jail custody this year, and the sixth death since NaphCare took over the jail’s medical care in September. The Tributary previously found that deaths in the Duval County jail tripled after 2017 when the Sheriff’s Office privatized medical care at the facility. The sheriff then severed its $98-million contract with Armor Correctional Health Services, replacing it with a $110-million contract with NaphCare for the next five years.

PrimeCare Medical
News-Item: PrimeCare Medical named as third-party defendant involving suicide of inmate
PrimeCare Medical, which had provided health care services at the Northumberland County Jail, has been named as a defendant in a third-party complaint filed by Northumberland County involving litigation over the suicide of inmate Megan McAndrew. Timothy McAndrew, as administrator of his daughter’s estate, sued Northumberland County in federal court on claims that correctional officers lacked training and did not follow procedures for inmates on suicide watch. The suit contends jail staff was aware of his daughter’s history of drug use and mental illness, but placed her in a cell with a top bunk and failed to conduct suicide checks every 15 minutes.

WCSC: Healthcare provider answers questions about Charleston Co. jail services
It’s been about six months since a new medical provider, VitalCore took over healthcare operations at the Al Canon Detention Center in Charleston County. VitalCore introduced a behavioral health clinic a few weeks into its operations, highlighting it as something the jail and inmates did not have before that provides onsite mental health services. Right now, the behavioral health unit has four employees who all see patients. Since VitalCore took the healthcare at the jail, there has been one death at the Al Cannon Detention Center. The coroner ruled the cause of death an overdose and a report states the inmate was not responsive but healthcare workers were not called before they had died in custody.

VC Star: Ventura County faces federal lawsuits over jail deaths
Three federal civil rights lawsuits were filed in 2023 by the relatives of people who died in one of Ventura County’s two jails. Three other lawsuits over jail deaths in Ventura County in the past five years were settled for a combined $5.7 million, with Wellpath picking up most of the tab, according to information from the county. Wellpath has provided health care to Ventura County jail inmates since 1987, Sheriff's Capt. Dean Worthy said in an email interview.