COCHS Weekly Update: April 11, 2023
Health Affairs: Medicaid Episode-Based Bundled Payments Can Improve Health Equity For Justice-Involved Individuals
There is growing concern that many existing value-based payment models do little to address health inequity and, if anything, are structurally regressive. Instead another alternative is to create bundled payments around episodes of care—not defined by a health episode, such as an acute myocardial infarction or surgical joint replacement, as with traditional bundled payment models, but instead defined by an episode of social disruption, such as release from incarceration or housing instability after eviction, which are associated with increased health care use and poor health outcomes.
NACJD: Evaluating Medicaid Access for Halfway House Residents: A Research Partnership with the Connecticut Department of Correction, 2013-2017
This study examines how providing Medicaid coverage for halfway house residents may affect care seeking, improve health care usage, and decrease criminal recidivism relative to providing health care through prison or jail medical facilities. A researcher-practitioner partnership with the Connecticut Department of Correction (DOC) was developed to implement a mixed-methods research design.
Overdose Prevention Initiative: Sign On Letter Supporting Reentry Act
This letter supporting the Reentry Act is for organizaions (individuals will not be listed). The text of the letter is available here. Also the Overdose Prevention Inititiative has distributed a PDF detailing how essential the Reentry Act is for preventing overdose deaths.
Data & Statistics
Sentencing Project: Incarcerated Women and Girls
The result of more expansive law enforcement efforts, stiffer drug sentencing laws, and post-conviction barriers to reentry that uniquely affect women. The female incarcerated population stands over six times higher than in 1980. Over half (58%) of imprisoned women in state prisons have a child under the age of 18. Between 1980 and 2021, the number of incarcerated women increased by more than 525%, rising from a total of 26,326 in 1980 to 168,449 in 2021.
CancerCancer Health: How Prison Affects Cancer Risk, Diagnosis and Death
A recent study found that individuals with a history of incarceration are not only more likely to be diagnosed with cancer but are less likely to survive the disease. The study compared the cancer incidence in incarcerated and post-incarcerated people with that of the general population in Connecticut. Findings showed that cancer was detected at a significantly lower rate among incarcerated people but at a significantly higher rate among those recently released from prison.
COVID-19BJA: An Innovative Approach to Detect and Mitigate COVID-19 in New York State Local Jails
The Bureau of Justice Assistance’s (BJA) COVID-19 Detection is hosting a webinar featuring the New York State Sheriffs’ Association (NYSSA) which is implementing a comprehensive approach to the detection and mitigation of COVID-19. The mitigation strategy includes clean air, clean surfaces, cleaning management standards, building occupancy/limitations, and a technology infrastructure to enable customized, automatic, and regular alerts based on real-time data.
Hepatitis CManaged Health Care Executive: Look to Prison-Based Programs to Stop HCV Transmission
Prison-based prevention and treatment intervention for people who inject drugs may be especially important for reducing the transmission of the hepatitis C virus because incarceration is itself a risk factor in transmission, according to recently published study.
ArizonaUS News & World Report: US Judge Issues Order in Arizona Prison Health Care Case
A U.S. District Court judge, Judge Roslyn Silver, has made permanent an order that aims to improve the way Arizona delivers health care to incarcerated people in state-run prisons. The injunction gives the Arizona Department of Corrections, Rehabilitation & Reentry three months to hire more people to support the health care staff. The state’s compliance with the injunction will be monitored by court-appointed experts and attorneys representing incarcerated people.
ConnecticutCT Mirror: CT lawmakers curtail push to end routine strip searches in prisons
An effort to end routine strip searches in Connecticut’s correctional facilities is unlikely to succeed this year as lawmakers have instead opted to gather information on what it would take to implement body scanning technology in the jails and prisons.
CT Mirror: New Haven tests giving $500 monthly to formerly incarcerated
A new program in New Haven, Connecticut will provide recently released inmates with a $500 stipend to help them cover basic expenses as they transition back into the community. The program, funded through private donations, aims to reduce recidivism by addressing some of the financial barriers that often make it difficult for people leaving prison to succeed.
GeorgiaFOX 5 (You Tube): Fulton County Jail inmate gives order to officer on security breach
At the Fulton County Jail (Atlanta) inmates attacked another inmate while a correctional officer watched. The attacked inmate was stabbed, punched and kicked. Apparently one of the attacking inmates had instructed a correctional to open where the beating took place. After the incident the correctional officer tampered with evidence cleaning the blood on the floor resulting from the attack.
IllinoisWBEZ: Illinois officials obtained do-not-resuscitate orders from prisoners who were not of sound mind
In 2016, a man incarcerated at an Illinois prison signed a living will, stating he was of sound mind and did not want certain medical interventions to extend his life. But there was a problem. When he signed the do-not-resuscitate (DNR) order, he had a diagnosis of dementia and his signature was disorganized and illegible.
VermontVT Digger: The capital bill — and renewed debate about Vermont’s women’s prison — lands in the Senate
Gov. Phil Scott’s administration, lawmakers and criminal justice reform advocates have for years debated what to do about the Chittenden Regional Correctional Facility, Vermont’s only women’s prison. The state hasn’t selected a site for a new prison, which officials have estimated would cost at least $70 million, and construction is not expected to begin within the two-year cycle of this capital bill. A $15.5 million proposal from Scott to use the legislation to start saving money for a women’s prison and re-entry facility has reignited a long-running debate about whether to build one as soon as possible or prioritize more aggressive strategies for decarceration.
VT Digger: Incarcerated person at Springfield prison charged in assault against corrections officer
The Vermont Senate is currently discussing a capital bill that includes funding for the construction of a new women's prison. However, this proposal has sparked renewed debate about the state's approach to criminal justice and whether building a new facility is the best way to address the needs of incarcerated women. Some argue that the focus should be on alternatives to incarceration and addressing the root causes of crime.
WashingtonKIRO: State’s mask requirements for healthcare, adult correctional facilities lifted Monday
Washington’s mask requirements inside healthcare and other facilities ended. The state Department of Health announced it was ending the universal masking requirement on March 3. The policy had been in effect since the early days of the COVID-19 pandemic, but health experts said that after months of declining cases, hospitalizations and deaths, now is the time to end it.
Gothamist: Detainees spend an average of 115 days at Rikers – 4 times the national average
Detainees at Rikers Island spent an average of 115 days locked up at the jail last year – four times the national average, according to a federal monitor report published on Monday. The report found the average length of stay for detainees at Rikers has nearly doubled from 61 days in 2016, when a federal court installed a monitor to oversee reforms at the troubled jail.
NIJ: Specialty Mental Health Probation Rated Promising
The program targeted individuals on probation with a mental illness. The goal was to reduce rates of community supervision failures. Individuals on specialty probation had both statistically significant lower rates of technical violations and rearrest, and higher receipt of mental health services and dual-diagnosis treatment, compared with individuals on traditional probation. There was no statistically significant impact on substance use treatment and violence.
Prison Policy Initiative: Mortality, health, and poverty: the unmet needs of people on probation and parole
Research shows that people on probation and parole have high mortality rates: two and three times higher than the public at large. That certainly suggests that community supervision systems are failing at their most important — and basic — function: ensuring people on probation and parole succeed in the community.
Reuters: US rule to allow some inmates to stay home after COVID emergency lifts
The U.S. Department of Justice announced a new rule that would allow some non-violent inmates to serve the remainder of their sentences at home once the COVID-19 emergency declaration is lifted. The rule is intended to help reduce overcrowding in federal prisons and increase opportunities for reentry into society. However, the rule is limited in scope and will only apply to a small number of inmates who meet certain eligibility criteria.
NIJ: NIJ Director Nancy La Vigne Discusses Evidence-Based Strategies for Successful Reentry
In a new video message, NIJ Director Nancy La Vigne highlights the importance of evidence-based strategies for successful reentry. She emphasizes the need for tailored and holistic support that starts during confinement and continues after release, with a focus on family involvement, cognitive-behavioral therapy, and community supervision.
BallotPedia: Voting rights for convicted felons
As of April 2023, individuals convicted of a felony in Maine, Vermont, and Washington, D.C. retained the right to vote while incarcerated. In 38 other states, individuals convicted of a felony could not vote while incarcerated but automatically regained the right to vote upon their release or at some point thereafter. Ten states did not automatically restore voting rights for individuals convicted of a felony.
NY Times: Virginia Rolls Back Voting Rights for Ex-Felons, Bucking Shaky Bipartisan Trend
For more than a decade, states around the country have steadily chipped away at one of the biggest roadblocks to voting in the United States — laws on the books that bar former felons from casting a ballot. Last month, Gov. Glenn Youngkin of Virginia, a Republican who took office a year ago, revealed that he had rescinded a policy of automatically restoring voting rights to residents who have completed felony sentences.
Mental Health Initiatives In Corrections
KCLU: New jail unit in Ventura County takes on issue of inmates with mental health, or medical care issues
Ventura County Jail in California has opened a new unit to provide specialized care for inmates with mental health needs. The unit includes a medical clinic and a mental health unit, staffed with nurses, therapists, and other healthcare professionals. The goal is to provide more appropriate and effective care for individuals with complex health needs and to reduce the use of solitary confinement.
Prison Policy Initiative: The rapid & unregulated growth of e-messaging in prisons
This report details the growing trend of electronic messaging in correctional facilities and its impact on incarcerated individuals and their families. The report examines the high costs associated with electronic messaging services and the ways in which these services can be exploitative and harmful to vulnerable populations. The dominant companies in this space are Global Tel*Link (GTL), which recently rebranded to ViaPath, provides e-messaging for fifteen prison systems and Securus, under its JPay brand.
Correctional Health Care Vendors
The articles below taken together will give our subscribers both a better idea of why the selection of correctional health care vendors is frequently compared to a revolving door and how this selection process can be the source of tension between corrections and other jurisdictional entities who are often financially responsible for correctional operations (see last week’s Editor's Note).
The revolving door of correctional health care is writ particulary large this week: Charleston County, SC, has decided to replace Wellpath with Vital Core, while the Department of Corrections in Vermont has gone in the opposite direction and decided to replace Vital Core with Wellpath, which it had already contracted with between 2010 - 2015 when it was known as Correct Care Solutions (Rebranding through renaming is not unusual in the industry. See PE Firms Rebrand Prison Healthcare Companies, But Care Issues Continue).
Vermont Department of Corrections decision to go back with Wellpath can be framed within the context of quality of care and the extent to which this revolving door of correctional health care vendors represents a jurisdictional search for improvements. And yet, at about the same time of this decision, Wellpath's former Vice President of Clinical Operations testified against Wellpath in the death of an inmate in Charleston County's jail.
As mentioned, these selection issues in turn can bring about tension between corrections and other jurisdictional entities and might be resolved quite differently. The sheriff of Charleston County, Kristin Graziano, in the end needed to bow to the will of the county commission’s decision to select Vital Core. Meanwhile, in the last article of the Weekly Update, the supreme court in Indiana has ruled that county sheriffs have the authority to sign contracts on behalf of their jails without obtaining approval from other county officials. This decision in Indiana, removing a check on sheriffs, might be problematic. Last year, the former CEO of Correct Care Solutions, Gerard Boyle and the sheriff of Norfolk County, VA, Bob McCabe were convicted on felony bribery charges connected to medical services at that jail.
ABC: Charleston County Sheriff expresses concern over new medical service for Al Cannon
The Charleston County Council voted to award a new medical provider for Al Cannon Detention Center on April 4. The new medical provider is Vital Core Health Strategies, which will replace the current service, Wellpath. However, Charleston County Sheriff Kristin Graziano isn't fully on board with the new replacement. "I find myself in this unfortunate position of having to advocate for people in my care when I don't really have the ability to impact the contract that somebody else is signing," Graziano said.
Vermont Public Radio: Vt. prisons will have a new medical contractor July 1. The company is accused of providing inadequate care
The Vermont Department of Corrections announced Tuesday that Wellpath, the country’s largest prison health care provider, will soon take over medical services in the state's prisons. The Nashville-based company was formerly called Correct Care Solutions; the name changed in 2018 after it was acquired by H.I.G Capital, a private equity firm. Vermont previously contracted with Wellpath, when it was called Correct Care Solutions, from 2010 to 2015, according to DOC. But Wellpath has faced numerous accusations of providing inadequate health care, including instances in other New England states. Vermont DOC released a Request for Proposals (RFP) in May 2022 for a new comprehensive health services contract upon the completion of the current contract with VitalCore Health Strategies. “We are thrilled to once again partner with the Vermont DOC to provide comprehensive medical and mental healthcare to the roughly 1,300 incarcerated individuals across the state,” said Ben Slocum, CEO of Wellpath.
WCSC: Lawyers file intent to sue jail medical provider in inmate’s death
In a new court filing, lawyers for D’Angelo Brown’s family formally announced their intent to hold Wellpath accountable for its employees’ inactions that they say led to the death of the 28-year-old. Dr. Edward C. O’Bryan, a former Vice President Clinical Operations for Wellpath, found that Wellpath staff failed to conduct a thorough health assessment of Brown, failed to administer medications for mental health issues and failed “to intervene whatsoever to provide any reasonable treatment for Mr. Brown’s declining health” among several conclusions.
ABC 4: Charleston County sheriff talks deaths at detention center, new medical provider
The Charleston County Sheriff’s Office released nearly 200 pages of emails and reports between senior staff and Wellpath, which included 57 non-compliance reports ranging from inmates not receiving medicine or medical care to Wellpath staff leaving 600 unanswered grievances.
Longview News Journal: Top Indiana court won't limit sheriff's authority to ink jail contracts
The Indiana Supreme Court has ruled that county sheriffs have the authority to sign contracts on behalf of their jails without obtaining approval from other county officials. The ruling comes after a dispute over a jail contract that was signed by a sheriff without the approval of the county board of commissioners, and is seen as a victory for sheriffs who argue that they should have greater autonomy in managing their jails.