Weekly Update: January 30, 2024
The Proprietary Correctional Health Care Vendors Merry-Go-Round

COCHS WEEKLY UPDATE: January 30, 2024

Highlighted Stories

Editor's Note
One of the insights that we at COCHS provide to our subscribers in the Weekly Update is our real-world experience in correctional environments. The stories in this week’s news cycle make our experience particularly germane. COCHS has been involved in the past with several jurisdictions in developing request for proposals (RFPs) for the selection of correctional health care providers. This editor recalls during one of these RFPs, an official wearily commenting after a slick presentation by a proprietary: "This whole process is like a merry-go-round. We select a horse to ride, something goes wrong, we get off and select another horse. In a few years we might even select the same horse that we rode before. Nothing really changes."

In the highlighted stories below we see how this merry-go-round plays out in multiple jurisdictions. Vermont just last year went through the selection process for a new correctional health care provider. Because of a series of deaths , Vermont was looking to replace VitalCore (which had replaced Centurion a few years before). In the end, the Green Mountain state decided to go with Wellpath. However, as many people pointed out, Wellpath was the provider before VitalCore and Centurion when it was known as CCS. When Wellpath/CCS previously left Vermont, many assumed it would never return but it did.

Do these companies learn from past mistakes and are there dramatic improvements? The answer to these questions would seem to be in the negative. Vermont’s Defender General Matt Valerio says in the first article from VT Digger, “It doesn’t matter what contractor it is. Fundamentally, they end up hiring the same people to do the work." Lest anyone think that Vermont’s decision would have much of an impact on VitalCore and there would be a drop in business, look at the second article from El Paso. There VitalCore is replacing Wellpath. In the third story from West Virgina, Wexford is taking the place of PrimeCare. In Jacksonville, Florida, Naphcare steps in for Armor. In Illinois, the last article, that state didn't even bother with the merry-go-round around and stuck with Wexford for $4 billon dollars (although VitalCore did submit a competing bid).

OK so why does this keep happening? How come the merry-go-round continues unabated? From a private equity point of view there is a lot of money to be made despite the negative publicity. Even though there is bad publicity most people do not want to know about what goes on behind the walls of corrections. This editor once described to someone what COCHS does and that person’s immediate response was, "Why do those people get care?" With such an attitude, providing apparently substandard care behind the walls comes with few negatives and a lot of profit (Wexford is getting $4 billion in Illinois!). Of course, something always goes wrong (i.e. someone dies, or most likely many people die) and the proprietary has gotta-go! But another proprietary is always waiting in the wings to step in and get a shot at the gold pot. As we see in the articles below, a proprietary that is leaving town might be like Arnold Schwarzenegger in one of those Terminator movies, when he whispers under his breath, "I'll be back."

VT Digger: Defender general's investigation finds medical staff failures, ‘boy who cried wolf’ culture in Springfield prison death case
The Defender General’s Office’s investigation into the death of David Mitchell, who died in the Springfield prison last April, revealed that medical staff did not recognize the seriousness of his condition. In fact, the Medical staff didn’t seem to know what to do with CPR, they didn’t seem to know how to attach the defibrillator. The LPNs and RNs did not appear to be trained to the same standard as like local EMS. At the time of Mitchell’s death, Vermont contracted with VitalCore for health services in its prisons. Last summer, the state switched the contract to the private-equity-owned firm Wellpath. “It doesn’t matter what contractor it is.Fundamentally, they end up hiring the same people to do the work”, Matt Valerio, Vermont’s defender general said. “Fundamentally, they end up hiring the same people to do the work.”

KRDO: El Paso County changes jail healthcare provider amid lawsuits, deaths
The El Paso County Sheriff's Office recently announced a new health care provider inside the El Paso County Jail, after the former provider Wellpath faced numerous lawsuits and dozens of jail deaths, sparking protests from the community. The county’s contract with VitalCore, the new provider, began Jan. 1 and totals $11,047,188.68 for 2024.

Yahoo: Former prison medical provider, named in SRJ civil rights lawsuit, files for bankruptcy
A private healthcare company named in a civil rights violation lawsuit files for bankruptcy in federal court. The company, PrimeCare Medical of West Virginia, is based in Pennsylvania. The State of West Virginia previously paid the company on a contract basis to give medical care to state inmates and prisoners. West Virginians who were serving sentences at Southern Regional Jail alleged in a federal lawsuit filed in 2022 in U.S. District Court of the Southern District of West Virginia that they were denied adequate medical care by PrimeCare providers. The state no longer contracts with PrimeCare West Virginia but now contracts with Wexford Health. Both companies are named in the federal lawsuit filed on behalf of inmates.

Tributary: Rising costs and in-custody deaths: Jacksonville’s struggle with jail health care
Jacksonville, FL, paid $6.1 million to pay for transportation and security at the hospital. And then the city is billed for the inmates’ care at the hospital — a cost of $13.9 million last year. That cost comes on top of the $20 million allocated this year toward a private contract with the jail’s medical providers. The city hired NaphCare in September After Armor left.

WTTW: Despite ‘Lack of Progress' Toward Consent Decree, IDOC Awards New $4B Contract to Same Private Health Care Provider
Incarcerated people in Illinois are still not getting access to quality health care, even with the Illinois Department of Corrections being under a consent decree since 2019. According to the health care monitor’s report, “the lack of progress towards compliance with the Consent Decree can be summarized as a failure by the State to establish the foundations of an adequate medical program in the IDOC.” And despite appalling accounts of what’s provided as care, the Illinois Department of Corrections has awarded a new contract to the controversial Wexford Health Sources

Family Voices

Washington Post: My dad was ill. Could he survive the prison health-care system?
At the time of his sentencing, my dad was not a healthy man — he had a manageable but serious blood cancer that increased his risk of stroke and heart attack, and an autoimmune disorder that weakened one side of his body What we didn’t know as he entered prison was that navigating the maddening world of corrections health care might not be enough to keep him healthy, and that even a short prison term can easily turn into a death sentence — a reality the more than 1.2 million people in U.S. correctional facilities face every day.


AZ Mirror: Proposed bill would outlaw forcing pregnant inmates to give birth before due dates
A fundamental respect for the dignity of all people is the driving force behind legislation ensuring that pregnant prisoners are not forced to schedule an induction of labor before their due dates, and that strip searches are only performed by correctional officers of the same gender as the prisoners being searched. The bill’s sponsor is Rep. Stephanie Stahl Hamilton, D-Tucson. “When it comes to labor, birth and delivery, the person who gets to make that choice is the person who is pregnant,” Stahl Hamilton told the Arizona Mirror.

Data & Statistics

NACJD: December 2023 Data Releases
In this study newly released data cover topics such as crime rates, forensic sciences, law enforcement, and more. Often matters that could be resolved outside of the courtroom are clogging dockets. Establishing modern systems would enable judicial and court staff to focus on the cases that require their expertise and attention, allowing them to better serve communities.


Pew: Courts & Communities
Many state and local cases that would benefit from a judge's decision never reach the bench. Conversely, matters that could be resolved outside the courtroom are clogging dockets. Many of these cases—including those involving debt collection, eviction, traffic, and child guardianship—can have profound, life-changing implications, and communities of color are disproportionately affected by the outcomes.

NASHP: Engaging with People with Lived Experience in Opioid Settlement Decision-Making
A key strategy emphasized by state leaders is the need to engage individuals at every point in the policy process, from ideation to implementation and evaluation. Input and engagement processes perceived as a one-time endeavor without further feedback or policy action can result in degradation of trust. To help foster ongoing dialogue, officials can institute processes for bi-directional feedback and transparency throughout the policy process, including evaluation of outcomes. Continuing to invest and build long-term relationships with organizations that represent or serve people with lived experience can better meet the unique needs of communities.

State Roundup

Press Democrat: As California closes prisons, state spending per inmate hits a new record
The cost of imprisoning one person in California has increased by more than 90% in the past decade, reaching a record-breaking $132,860 annually, according to state finance documents. That’s nearly twice as expensive as the annual undergraduate tuition — $66,640 — at the University of Southern California, the most costly private university in the state. It’s propelled by lucrative employee compensation deals and costly mandates to improve health care behind bars, according to the Legislative Analyst’s Office. The recent budget proposal includes $18.1 billion for the Department of Corrections and Rehabilitation, up from $15.7 billion.

Willamette Week: Newly Released Documents Contain New Ways to Measure the Dysfunction at Multnomah County’s Jails
Investigations into the underlying causes of 10 deaths over two years at Multnomah County’s jails are beginning to bear fruit. Two deputies have been criminally charged for failing to adequately monitor two of the inmates who died. And a federal evaluator recently submitted a report outlining dozens of recommendations to improve conditions inside the jails.

New York Post: Inmate seen crawling on the floor, begging for help was given antacid and put back in cell day before death: suit
A man crawled on the floor and begged for medical help inside a troubled Minnesota prison — only to be given an antacid and to die the next day, according to a lawsuit filed by his family. A video shows the moment Hennepin County Jail inmate Lucas Bellamy, 41, crawls out of his cell on his hands and knees and appears to be hunched over in pain on July 20, 2022.

San Diego County

San Diego Union Tribune: They died in San Diego County jails. They shouldn’t have been there at all, an outside review found.
Two people who died in San Diego County jails in 2021 and 2022 should not even have been in Sheriff’s Department custody, an independent investigation has found. In another case, deputies stood by for months as a man lost more than one-third of his body weight while repeatedly refusing meals, showers and day room visits. He was later found unresponsive in his feces-covered cell. San Diego Sheriff’s Department practices have come under growing scrutiny over the hundreds of deaths inside county jails over the past two decades.

Criminal Justice's Detrimental Impact On Mental Health

Mississippi Today: 'Depriving people of their liberty': Lawmakers question jail without criminal charges
Restricting the use of jail to detain people who haven’t been charged with a crime – a practice that is extremely rare in the vast majority of the country but common in Mississippi – is a top priority of the Department of Mental Health this session, director Wendy Bailey told lawmakers at a Senate Public Health Committee meeting. Sen. Brice Wiggins, R-Pascagoula, said that having a mental illness is not a crime, and he suggested jailing people while they wait for treatment is against the law (though Mississippi commitment statutes permits it when there is “no reasonable alternative”).

noozhawk: Report Reveals 60% of People in County Jail Custody Have Mental Health Conditions
A new jail report supports what advocates have been saying for years: Hundreds of people in the Santa Barbara County jails have significant mental health issues and need treatment the jail doesn’t provide. More than 13% — about 92 people — are seriously mentally ill and require specialty health care, she said. With a shortage of local inpatient beds, people experiencing a mental health crisis can end up in jail.

Private Prisons

Houston Public Media: State inspection finds medical neglect, other violations at private facility housing hundreds of Harris County inmates
The Giles W. Dalby Correctional Facility owned by Management & Training Corporation in northwest Texas that houses hundreds of Harris County detainees has been violating statewide safety standards due to a lack of medical care and safety training. This comes as the Harris County Jail remains in hot water for a handful of additional safety violations. For years now, the Harris County Jail has suffered from severe understaffing and overcrowding within the facility, leading county officials to approve several multi-million dollar contracts to outsource more than 1,000 people.