Weekly Update: February 27, 2024
Medicaid & MOUD in Corrections: Confronting the Realities of Correctional Dysfunction; JAMA: Public Health & Incarceration

COCHS WEEKLY UPDATE: February 27, 2024


Highlighted Stories

Editor's Note
It is no secret that behind the walls of corrections there is a drug epidemic going on ---the same epidemic occurring in practically every community throughout the nation whether inside or outside of corrections. The traditional correctional perspective is that on incarceration individuals struggling with substance use disorder (SUD) are supposed to go cold turkey and maintain sobriety for the length of their incarceration. This approach ignores what we know about the science of SUD. A chronic brain disease does not suddenly go into remission at the point of incarceration.

As the science of SUD has evolved, there is a growing understanding that an incarcerated person’s need for maintenance is best addressed by Medications for Opioid Use Disorder (MOUD). Before the 1115 waivers (that now permit Medicaid coverage for the last 90 days of incarceration) jurisdictions that allowed for MOUD had to foot the bill for this treatment. But with the advent of 1115 approvals allowing Medicaid to cover incarcerated people, the maintenance of continuous care with integrated treatment protocols is more assured for people dealing with SUD in correctional institutions and their transition into communities.

However, MOUD within corrections has experienced some setbacks. The first highlighted article from California Healthline reports on the surprising increase in overdoses in California’s correctional system after a much-touted introduction of MOUD. Perhaps it is naïve to think that MOUD could be like a magic wand that could solve such a difficult disease as SUD within the many dysfunctions of correctional institutions. As has often been reported, the source of drugs within corrections is often linked to smuggling by deputies or correctional officers. In the second highlighted story from San Diego County, both an oversight board and a grand jury demanded the sheriff scan deputies to prevent contraband from entering that facility. The sheriff has repeatedly vetoed these requests. In the third article from the New Yorker, an incarcerated informant in Georgia state prison has assisted multiple times in the arrest of correctional officers for smuggling.

Just because correctional institutions have structural deficiencies that impede the efficacy of MOUD does not mean MOUD is ineffective. In the fourth highlighted story from Oregon a young woman going cold turkey in a jail took her life during her withdrawal symptoms. MOUD would have most likely saved this young life.

Drug Epidemic In Corrections
California Healthline: California Prison Drug Overdoses Surge Again After Early Treatment Success
Drug overdose deaths in California state prisons rebounded to near record levels last year even as corrections officials touted the state’s intervention methods as a model for prisons and jails across the United States. At least 59 prisoners died of overdoses last year, according to a KFF Health News analysis of deaths in custody data the California Department of Corrections and Rehabilitation is required to report under a new state law. That’s more than double the number who died of overdoses in each of 2020.

San Diego Union Tribune: Citizens’ oversight board again urges sheriff to body-scan deputies entering jails for drugs
For a third time, the Citizens Law Enforcement Review Board (CLERB), has recommended that the Sheriff's Department scan its employees to prevent smuggling into County jails. The Sheriff’s Department has twice rejected the suggestion from the oversight board and has not acted on similar recommendations from the county grand jury and the California state auditor. The issue of scanning deputies on their way into working at jails has become something of a flash point as people have continued to die in custody at alarming rates. According to a state audit released in 2022, 185 people died in San Diego County jails between 2006 and 2020 — the highest rate of any large county in California. State officials said conditions and practices in San Diego County jails were so dangerous that legislation was needed to force improvements.

New Yorker: What Do We Owe a Prison Informant?
his past fall, the Journal-Constitution published a series of articles investigating violence and corruption inside Georgia prisons. Among its findings: since 2018, more than three hundred and eighty cases resulted in state correctional officers being arrested, fired, or both, for smuggling contraband to inmates.

KPTV: Oregon jail faces federal lawsuit after 22-year-old inmate dies during opioid withdrawal
Kendra Sawyer spoke with her dad from the Deschutes County jail and told him she loved him. Six hours later, in the throes of opioid withdrawal, the 22-year-old took her own life. A year later, Sawyer’s father, Kent, is left wondering whether his daughter, troubled as she was, might still be alive if the jail hadn’t failed to provide her with medicine to ease the agony of her withdrawal, as he claimed in a recently filed lawsuit. “Kendra was screaming in pain and crying for hours and hours, and nobody was doing anything,” Sawyer said. “No one truly deserves to die in a painful way.”

News Center Maine: This rural Maine jail is one of two in the US revolutionizing addiction treatment for inmates
One of Governor Janet Mills priorities in the supplemental budget is increasing medication assisted treatment in county jails. The Somerset County Jail partnered with one of the state's leading addiction doctors to give jail residents injections of buprenorphine. Dr. Alane O'Connor is the medical director for Maine Maternal Opioid Misuse Program at the jail in July 2022 with the partnership of Somerset County Sheriff Dale Lancaster.

News From The States: Methadone and other medical assisted treatment programs could be coming to Utah prisons
Despite several county jails expanding medical assisted treatment programs in recent years for people struggling with opioid addiction, if someone is transferred to one of Utah’s two state prisons, that treatment stops. Sen. Jen Plumb, D-Salt Lake City is sponsoring SB212, which would allow anyone receiving medical assisted treatment, whether in their community or in jail, to have access to a program if they’re sent to prison. The bill passed out of the committee with unanimous support, and is headed to the Senate floor for consideration.

Health Affairs: Higher Rates Of Homelessness Are Associated With Increases In Mortality From Accidental Drug And Alcohol Poisonings
For more than a decade, the US has suffered a mortality crisis stemming from opioid and other substance misuse. These trends have been found to be worse in parts of the US with higher rates of poverty and unemployment. As early as the 1990s, the prevalence of alcohol or drug use disorders was observed to be very high among people who were homeless. Although there is evidence that SUD and homelessness are highly correlated, the direction of this relationship remains unclear, as most of the evidence presents associations or is inconclusive.

Public Health & Incarceration
JAMA: Incarceration History and Access to and Receipt of Health Care in the US
Is incarceration history associated with access to and receipt of health care in the US? In a survey study of 7963 individuals with and without an incarceration history, people with an incarceration history were less likely to have a usual source of care and receive preventive services, such as physical examinations, influenza shots, and colorectal and breast cancer screenings.




Medicaid

CMS: 1115 Waiver Demonstration - Pennsylvania Keystones of Health
Under Keystones of Health, DHS will develop a set of services and benefits coordinated through case management in four focus areas including reentry services that would miprove transitions to the community for beneficiaries reentering society from correctional facilities. The available services, which will require a legislative amendment, will focus on improving transitions to community based health care and social services with a particular emphasis on those with significant health care needs such as serious mental illness and substance use disorder.

National Memo: How Private Prison Health Care Rips Off Government (And Why Medicaid Works Better)
Privatization of prison health care started in the 1970s. By 2009, approximately 40 percent of correctional health expenditures were paid to private companies. The number of complaints against the company has risen drastically. In general, these aren’t frivolous claims. Multimillion-dollar judgments aren’t uncommon. But now Medicaid 1115 Waiver Demonstration projects — and ditching private healthcare contracts — have support from sheriffs, which is unusual.

Managed HealthCare: Community Health Centers Pose as Major Stepping Stone in Post-Incarceration Healthcare
Community Health Centers (CHCs) remain a key healthcare access point for people returning to their communities following incarceration. With over 31.6 million patients served in 2022, CHCs play a vital role in maintaining healthcare continuity for folks before, during, and after incarceration. As Medicaid becomes more involved in covering people who are in jail or prison, it's important to note that CHCs serve one out of every six Medicaid beneficiaries. As CHCs already successfully serve lower-income, underserved communities, adopting policies with new healthcare models will be pivotal in reaching the national goal of enhanced reentry care.

NC Health News: Prison system works to combat health care coverage gap by enrolling people in Medicaid before release
People released from incarceration, often fell into a health insurance coverage gap. Historically, most people reentering society after incarceration were either uninsured or uninsurable. But that’s poised to change in North Carolina with Medicaid expansion that took effect. 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.

NC Newsline: Prison reentry council sets ambitious goal for helping people released from prison
The Joint Reentry Council kicked off its ambitious “whole-of-government” approach, which is says will improve the lives of people released from prison. Gov. Roy Cooper created the council via an executive order last month. It directed Ishee’s agency to to coordinate with all Cabinet agencies in expanding housing opportunities for incarcerated people, helping people in prison enroll in Medicaid once they are released, and improving the economic prospects of formerly incarcerated people by expanding access to education, technical training and apprenticeships.




Pregnancy

KFF: Pregnancy Care Was Always Lacking in Jails. It Could Get Worse.
There is limited oversight and absence of federal standards for reproductive care for pregnant women in the criminal justice system. Incarcerated people have a constitutional right to health care, yet only a half-dozen states have passed laws guaranteeing access to prenatal or postpartum medical care for people in custody, according to a review of reproductive health care legislation for incarcerated people by a research group at Johns Hopkins School of Medicine. And now abortion restrictions might be putting care further out of reach.




COVID-19

Medriva: The US Prison System: A Public Health Crisis Exposed by the Pandemic
The ongoing COVID-19 pandemic has not only stressed global healthcare systems but has also shed light on the public health crisis within the US prison system. The conditions in American jails and prisons reveal a dire need for urgent and effective intervention. Within the US prison system, overcrowding is a significant issue that exacerbates health risks. The lack of access to proper healthcare and the increased risk of infectious diseases are pertinent problems that need to be addressed. The COVID-19 pandemic has only intensified these challenges, with the virus spreading rapidly in such confined spaces.




Tuberculosis

University of Cincinnati: UC research links prison time with increase of TB
New research from the University of Cincinnati finds that being in prison or being a former prisoner is responsible for high rates of multidrug resistant (MDR) TB. MDR-TB is tuberculosis that is caused by a strain of bacteria that is resistant to isoniazid and rifampicin, the two core antibiotics of first line TB treatment. An important finding from the research is that it contradicts traditional thought that the MDR-TB epidemic was primarily driven by patients not taking the medications as prescribed. The cases included in the study showed that a main source of transmission was prisons.




Hepatitis

Los Angeles Times: Hepatitis A scare at Men's Central Jail led to more than 1500 vaccinations
More than 1,500 people were vaccinated last year after an ailing inmate worker at Men’s Central Jail unwittingly exposed thousands of detainees to hepatitis A before medical staff discovered what was wrong with him, according to a report released this week by the CDC. At the time, Los Angeles County officials said no one else caught the virus, and the CDC report attributed the successful containment to the county’s quick response. Within 48 hours of detecting the highly contagious virus, officials identified nearly 6,000 people the infected man had potentially come into contact with and offered free vaccinations to more than 2,500 of them.




Solitary Confinement

Orange County Register: The impact of solitary confinement on safety in prison and in the community
Terry A. Kupers, a psychiatrist and Professor at The Wright Institute, writes: In solitary confinement, prisoners, disproportionately prisoners of color, are denied effective mental health treatment as well as rehabilitation programs. Many of those who are eventually released seek to maintain their isolation, staying in a cell, or once released from prison refusing to leave their room or their home. Governor Newsom acknowledges that solitary confinement causes immense psychological damage, but argues that its use is necessary to maintain order in the prisons. He is very wrong about that.




Transgender

Seattle Times: Mississippi might allow incarcerated people to sue prisons over transgender inmates
A bill before Mississippi lawmakers might allow incarcerated people to sue jails and prisons if they encounter inmates from the opposite sex, such as those who are transgender, in restrooms or changing areas. State lawmakers advanced the proposal out of a House committee.

Vera: Advancing Transgender Justice
Transgender people are especially at risk for contact with the criminal legal system and, once in detention, at risk of harassment and violence inside prison. According to a 2022 survey of LGBTQ+ people in the United States, 31 percent had been in some form of incarceration at some point in the last five years. Transgender people who are currently incarcerated have clear suggestions for changes to the content and implementation of policies, and decision-makers should meaningfully include these views. These findings represent common themes across survey participants’ responses.




HIPAA

PublicSource: Amid Allegheny County Jail deaths, board members seek health info — but hit a HIPAA wall
At a meeting of the Jail Oversight Board, new Allegheny County Executive Sara Innamorato’s earlier calls for “productive dialogue” and “an honest answer” to corrections questions ran into a thorny obstacle: HIPAA. That federal law governs the release of protected health information. Board member and County Councilor Bethany Hallam pressed jail officials at the meeting for easier access to information about medical care. “Something as simple as preventing death cannot be done if we cannot get the information about people being injured, about people being hospitalized, about the jail working with the courts to release people from custody so they don’t even have to tell us that somebody died,” stated County Councilor Bethany Hallam.




BOP

Dominion Post: DOJ report sheds light on federal inmate deaths
Following the high-profile deaths of federal inmates the DOJ's OIG initiated an evaluation to assess the circumstances surrounding inmate deaths at Federal Bureau of Prisons (BOP) institutions. The recently published report found that across the country the BOP failed to prevent the deaths of 344 inmates over the course of eight years (2014-21), including 14 at USP Hazelton, the second highest amount of any BOP institution in the country. The majority of the deaths reviewed by the OIG were suicides, accounting for 54% or 187 deaths.




Criminal Justice Reform

Brennan Center For Justice: A Proposal to Reduce Unnecessary Incarceration
Few issues have received more sustained attention from U.S. policymakers over the last decade than the country’s overuse of incarceration. After decades of growth in imprisonment, states have attempted to reduce the number of people behind bars. Yet an astonishing level of incarceration persists. For a half century, the federal government has harnessed its grant-making power to spur states to incarcerate more people. Since assuming office in 2021, the Biden administration now specifically allows grant money to support efforts to reduce incarceration for new crimes or technical violations of community supervision.

Mercury News: Judge weighs rare contempt order against troubled Dublin prison for possible retaliation against inmate
A federal judge is weighing whether to hold the Federal Bureau of Prisons in contempt of court amid allegations that staff at the troubled FCI Dublin women’s prison retaliated against an inmate for testifying about conditions at the scandal-plagued facility. U.S. District Judge Yvonne Gonzalez Rogers on gave the federal prisons bureau until Monday to plead its case after learning that an inmate at the prison appeared to have been placed in a housing unit known to include solitary confinement cells and then transferred to Southern California — all in apparent violation of the judge’s orders. The order comes as Rogers contemplates the appointment of a special master to oversee changes at the federal prison .




State Roundup

Alabama
Alabama Reflector: Alabama death row inmate sues to block future nitrogen executions
An Alabama death row inmate has sued to stop Alabama’s use of nitrogen gas executions, calling it cruel and unusual punishment. In a lawsuit filed in the U.S. District Court for the Middle District of Alabama, David Wilson, sentenced to death for a 2004 murder, argues that nitrogen gas asphyxiation is inherently inhumane and would be particularly painful for Wilson due to pre-existing health conditions, including chronic lung problems and sensory sensitivities. The legal action follows questions about the execution of Kenneth Eugene Smith by nitrogen in January, and criticisms of Alabama’s execution procedures more generally.

Arizona
AZ Central: People are dying in Pima County's overflowing jail. Officials are split on solutions
Officials say they need a new facility for people arrested while in a mental health crisis. But that isn't likely to happen soon. A January report released by the Pima County Adult Detention Center Blue Ribbon Commission, which assessed the need for a new jail, found the jail houses as many as 769 more people than it was originally built for. Much of that overcrowding was in the mental health unit. According to the commission's report, the medical provider at the Pima County Detention Center in 2023 averaged 393 mental health evaluations monthly. An average of 631 people were on "mental health medications" out of an average daily population of 1,799 inmates.

California
Los Angeles Daily News: State orders shutdown of LA County’s two largest juvenile facilities
A state regulatory board has ordered Los Angeles County to shut down its two largest juvenile facilities in the next 60 days over substandard conditions, setting the stage for a potential nightmare scenario where the county will have hundreds of youth in its custody and nowhere locally to hold them. Officials from the Los Angeles County Probation Department pleaded with the Board of State and Community Corrections. But the board, fed up with L.A. County’s repeated appearances before them over the past three years, was not swayed.

San Francisco Chronicle: State watchdog says closing more prisons could help cut budget deficit — but that’s not Newsom’s plan
The California Legislature’s fiscal adviser says the state should close five more state prisons and, by doing so, would reduce its looming budget deficit without compromising public safety. That contradicts the position of Gov. Gavin Newsom, who already has closed two prisons in the state and ordered shutdowns of two others but has not supported any additional closures. In a report to lawmakers on the prison system’s budget, the nonpartisan Legislative Analyst’s Office said that the state could save about $1 billion a year by shutting five more prisons, in addition to the closures already ordered by Newsom, starting in 2028.

Connecticut
CT News Junkie: Formerly Incarcerated, Advocates Call For Expanded Support For Prison Education Programs
Formerly incarcerated people spoke to legislators on Thursday about the need to improve access to higher education for incarcerated people. During a public hearing for the Higher Education and Employment Committee, several people testified regarding HB 5127, a bill that would require the Department of Correction to conduct a needs assessment for the delivery of post-secondary education programs in Connecticut prisons.

Louisiana
Washington Post: Louisiana overhauled its prison system. Now Republicans may undo changes.
Six years after reforming its criminal justice system, Louisiana is no longer the nation’s most incarcerated state. Thousands of nonviolent offenders have been given a second chance. And the state has saved more than $100 million, a windfall for scores of community groups. The reforms, championed by former Democratic governor John Bel Edwards, shortened some prison sentences, recalculated who was eligible for parole, weakened drug laws and made it harder to send someone back to prison for violating parole or probation. Newly-elected Republican Gov. Jeff Landry ran on a “tough on crime” platform and has characterized the measures as some of the state’s “most failed policies.”

NPR: Death and redemption in an American prison
The Angola hospice program has since become a national model. Today at least 75 of the more than 1,200 state and federal penal institutions nationwide have implemented formal hospice programs. The program used medications, including opioids, for the palliative care of patients. Hospice volunteers became the conduit for inmates to get messages to their dying friends.Yet as America's prison population ages, more inmates are dying behind bars of natural causes and few prisons have been able to replicate Angola's approach.

New Jersey
NJ Spotlight News: Is NJ flouting law on prisoner isolation? Recent suicides raise questions
Two recent suicides at the New Jersey State Prison have led to renewed questions over whether the state Department of Corrections is following the three-year old law that limits the time inmates can be held in what used to be called solitary confinement. Academic research indicates that inmates with mental illness should not be kept in isolated confinement for more than the briefest of time because doing so would exacerbate suicidal thoughts. An inmate who died by suicide had been in isolated confinement for almost two years, sources said.

Washington State
New York Times: Officers Charged Her With Drunken Driving. But Her Brain Was Bleeding.
Driving home from work on the day her life changed forever, Nicole McClure could feel her feet tingling and her sense of direction faltering. Then she noticed colorful lights illuminating the early morning landscape. The state trooper who had followed her ran to her door with his gun drawn, shouting at her to get out of the car, according to his dash cam video. The arrest was the beginning of a more than 24-hour ordeal in the criminal justice system at a time when Ms. McClure was in desperate need of medical care. Her lawyers said she was left lying in her own urine on the floor of a cell as jail employees, apparently dismissing her as being drunk, taunted her. When someone finally realized she needed medical attention.




Mental Health Initiatives

KIMA: State Senate Bill Could Provide an Alternative Jail Sentence Based on Mental Health
A Washington senate bill regarding jail sentencing and mental health is now in committee for the state house. Senate Bill 5588 would provide an order of an alternative jail sentence rather than a standard sentence if the courts believe it is appropriate for the individuals. Should they agree, the standard sentence would be waived for community custody and treatment .




Rikers Island

Queens Daily Eagle: Board of Correction issues report on Rikers deaths during second half of last year
Nearly all of the four men who died on Rikers Island in the second half of last year entered the troubled jail complex with mental health and addiction issues, and failed to receive regular medical care or adequate supervision from the Department of Correction, a new report from the Board of Correction found. Three of the deaths led to the suspension of eight DOC staffers, including five officers, an assistant deputy warden and two captains, including one who was later demoted and put on modified duty, barring them from working directly with incarcerated people.




Reentry

Yahoo: Chicago program aids former inmates in rebuilding lives after prison
Every year, approximately 20,000 individuals are released from prison in Illinois, with two out of five of them returning to prison within three years. However, Project H.O.O.D., based out of Chicago’s Woodlawn neighborhood, offers a program aimed at assisting former inmates in rebuilding their lives. The participants spend a week learning essential skills such as resume building, financial literacy, communication, conflict resolution in the workplace, and professional work ethics.

Boston Herald: Gaskin: The prison system needs a theory of change
Ed Gaskin, Executive Director of Greater Grove Hall Main Streets, writes: The prison system needs a “Theory of Change.” Developing a system-wide theory of change for the prison system, with involvement from representatives from all stakeholder groups. Coordinate a fragmented system to reduce wasteful redundancies and identify gaps in existing services. Align programs with existing research that demonstrates effectiveness in reducing recidivism and other more immediate and long-term outcomes.




Technology

Vera: Vera Institute of Justice Issues Report on the Growth of Electronic Monitoring in the United States
Electronic monitoring (EM) coexists with, rather than replace, physical detention. Instead of reducing incarceration rates, EM often expands surveillance and control over people who might otherwise be free. This concerning trend is further exacerbated by the lack of regulation in the EM industry, which has resulted in a decentralized and unaccountable landscape dominated by private companies. EM produces harm in ways comparable to jails and prisons, essentially constituting an alternative form of incarceration. Furthermore, the adverse effects of EM are disproportionately felt by communities of color, deepening existing inequalities.




Correcitonal Health Care Vendors

Corizon/YesCare/Tehum
Bloomberg Law: Warren Nudges DOJ Toward Dismissal of Prison Health Bankruptcy
Sen. Elizabeth Warren (D-Mass.) told the Justice Department’s bankruptcy watchdog it should consider moving to dismiss a prison health-care company’s attempt to use bankruptcy to settle liability. Warren asked the US Trustee, an arm of the Justice Department, to consider joining a motion to dismiss made by tort claimants in Tehum Care Services Inc.'s Chapter 11 case. Tehum, a shell company created by Corizon Health Inc. using a controversial bankruptcy maneuver known as the Texas Two-Step to resolve hundreds of personal injury suits, filed for Chapter 11 in February 2023.

Reuters: DOJ says prison health company's bankruptcy should be dismissed
The U.S. Department of Justice's bankruptcy watchdog on Friday asked a judge to dismiss the bankruptcy of a prison healthcare contractor, saying that the company appeared unable to reach a viable settlement of prisoners' lawsuits accusing it of providing substandard care at detention facilities nationwide. The DOJ's office of the U.S. Trustee said that Tehum Care, a subsidiary of prison health provider Corizon, now known as YesCare, should not remain in bankruptcy if it insists on pursuing a "coercive" and legally flawed settlement that would eliminate prisoners' lawsuits against Corizon and its owners.

PrimeCare Medical
Daily Item: Northumberland County Jail to get new health care program March 1
Northumberland County Commissioners voted to enter into an intergovernmental cooperation agreement to participate in the Prison Inmate Medical Cost Containment program through the County Commissioners Association of Pennsylvania. The new agreement will eliminate the use of PrimeCare Medical, of Harrisburg, which has been with the prison since 2018. PrimeCare was forcing officers to take those individuals to hospitals for evaluations, even for the slightest issues. The new system is designed to provide a quality managed care program which allows the county to choose its own medical cost saving program.

WPDE: W.Va. jail's nurse offered to give inmate insulin overdose to cover up death, lawsuit says
Alarming new allegations have been raised in a lawsuit focused on the death of a Southern Regional Jail inmate, Quantez Burks, who was beaten by guards while restrained and died while in custody. PrimeCare Medical along with three of its employees who worked at the facility at the time of Burks' death, were named in the lawsuit. The lawsuit claims Burks, 37, was beaten while handcuffed by correctional officers in an interview room that does not have any surveillance cameras before a PrimeCare nurse suggested to the officers that she could administer an overdose of insulin to Burks "to coverup his cause of death."

Wellpath
Governing: Georgia’s Prison Medical Provider Incurred $30M in Extra Costs
Wellpath, medical provider for the Georgia prison system, backed out of its contract with the Department of Corrections last year after incurring more than $30 million in unanticipated costs, most due to the rampant violence in the state’s prisons. The company provided no clues for its decision when it sent the state a notice of non-renewal in June, just two years into its contract. Wellpath's trauma costs in Georgia were more than twice as high as those in the other states where it provides prison healthcare. Wellpath was chosen in 2021. Augusta University, Georgia Correctional HealthCare, had been the prison system’s medical provider for the previous 23 years.

Charlotte Observer: NC jail inmate says headache became brain injury. His lawsuit isn’t the only one
Rowan County inmate David Ryan Wood begged for help. Medical staff wouldn’t see him, even after a weeklong headache. The headaches started after he was assaulted. Medical staff downplayed his condition — giving him Tylenol, putting him on a liquid diet and telling him to rest, for example — even as he showed more signs he’d suffered a brain injury. The complaint names the county, its sheriff and health care provider Wellpath as defendants. It’s an example of a “disturbingly common issue of substandard medical care in jails,” according to the North Carolina ACLU. Health care providers working in jails too often put profits over health.

Sequim Gazette: Clallam County to hire jail nurses after service provider ends contract
The Clallam County (Washington State) jail will hire four nurses as county employees after Wellpath submitted its contractually-required termination notice in mid-January. The new staffing arrangement will save the county close to $70,000 next year. Wellpath provided the jail with three nurses (a nursing supervisor and two nurses) for an annual cost of about $611,000.

Wexford
Mississippi Free Press: Dangerous Chemicals and Denied Health Care, Lawsuit Says
Inmates at a Mississippi prison were forced to mix raw cleaning chemicals without protective equipment, with one alleging she later contracted terminal cancer and was denied timely medical care, a federal lawsuit alleges. The companies contracted to provide health care to prisoners at the facility — Wexford Health Sources, Centurion Health and VitalCore — delayed or failed to schedule follow-up cancer screenings for Balfour even though they had been recommended by prison physicians, the lawsuit says.