What should happen when a proprietary correctional healthcare vendor fails to mitigate financial risk for a jurisdiction?

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Editor's Note

Last week we included an Alabama story in which State Representative Chris England criticized YesCare for failing to fulfill its contractual obligations. The Alabama Department of Corrections (ADOC) terminated YesCare's contract in April while the company's bankruptcy was creating turmoil in correctional systems across the country. This week we return to Alabama, where Representative England is calling for a criminal investigation into whether the company defrauded the state.

Correctional healthcare providers often leave jurisdictions under a cloud, but it is highly unusual for a legislator to call for a criminal investigation. How did matters reach this point?

The process for selecting a correctional healthcare provider is fairly straightforward. A jurisdiction issues a request for proposals (RFP), vendors submit bids, and a contract is awarded—often to the lowest responsible bidder. In exchange, the selected company agrees to provide a specified level of healthcare services at an agreed-upon price. As we discussed in a previous week's Follow Ups on correctional food services, competition based primarily on price may not always promote quality, but that is generally how the procurement process operates. Occasionally, investigations reveal improper relationships between public officials and vendors. Those cases can result in ethical questions and sometimes criminal charges and imprisonment. Alabama, however, presents what seems to be a unique scenario.

By now, our subscribers know the broad outlines of YesCare's bankruptcy. As the company struggled financially, it reportedly became unable to meet payroll in Alabama and elsewhere. In response, Alabama advanced YesCare $12 million so the company could pay its employees—a remarkable step considering the state had already awarded the company a contract worth approximately $1 billion.

According to Representative England, however, the $12 million never reached the employees. Instead, these employees might have to join the growing list of creditors seeking payment through the bankruptcy proceedings. If those allegations are accurate, the issue extends well beyond poor contract performance and raises questions about what happened to the $12 million dollars meant for the employees.

Last week we launched our new Your Turn experiment. Many thanks to those subscribers who responded. This week's questions are below:

An Alabama state representative said a former Department of Corrections contractor has committed millions of dollars worth of fraud. State Rep. Chris England, D-Tuscsloosa, made that claim Monday about YesCare, a prison healthcare provider that recently was terminated by the ADOC. England said he is calling for a criminal investigation into YesCare. Specifically, he wants to know what happened to $12 million the state gave the company in April for it to make payroll. England said he has not been able to get a clear answer on what happened to the $12 million. “Now, those employees still haven’t been paid. For those folks to get the money that they earned, they have to essentially become a creditor behind a whole bunch of people,” England said.

Follow Ups

Medicaid & OBBBA

Editor's Comment: We return once again to Medicaid behind the walls and the impact of the One Big Beautiful Bill Act (OBBBA, H.R. 1) on states that have received approval for justice-involved Section 1115 demonstrations. The Tradeoffs' article revisits familiar ground, examining both states that are moving forward with implementation and those that have chosen not to proceed despite receiving CMS approval. It also points to Louisiana's implementation of its demonstration as an indication of what the Trump administration appears willing to support.

The Hawaiʻi article below explores one of the OBBBA's less obvious consequences. A persistent challenge in compassionate release is finding a long-term care facility willing to accept someone leaving incarceration. Many nursing homes are already reluctant to admit these individuals. The OBBBA may make that challenge even greater. In most states—unlike those operating justice-involved 1115 demonstrations—a person granted compassionate release must wait until release to enroll in Medicaid before long-term care can be covered. As the article explains, the OBBBA shortens the period during which long-term care facilities can receive retroactive Medicaid reimbursement for newly enrolled patients. That change increases the financial risk of accepting newly released individuals whose Medicaid eligibility has not yet been established.

As the OBBBA is implemented, it will be interesting to see what other “challenges” come out of the woodwork.

In the four states — California, Washington, Montana and New Hampshire — that have started providing Medicaid coverage to people inside correctional facilities. Now, some Medicaid agencies say federal changes are making it impossible for them to replicate those efforts in their states. Advocates and policy experts who are assisting states with implementing this experiment say most are still moving forward with their plans for now. But at least three states — Oregon, Rhode Island and Michigan — have paused their work as a result of H.R. 1. For Louisiana t get a thumbs up from the Trump administration, Louisiana limited the services it would pay for to mental health care, medications for addiction treatment, infectious disease screening and medical equipment like wheelchairs.

Hawaiʻi's parole board granted compassionate release to a 52-year-old man who had suffered a stroke that left the left side of his body paralyzed. However, he was not released because no long-term care facility was willing to accept him. A study found that nursing home admissions dropped sharply once facilities learned that prospective residents were being released from prison. The One Big Beautiful Bill Act (OBBBA) may further complicate the situation. Because incarcerated people generally are not eligible for Medicaid, many must apply only after being granted release. The OBBBA shortens the period during which long-term care facilities can receive retroactive Medicaid reimbursement for newly enrolled patients. As a result, facilities face greater financial risk if Medicaid applications are delayed, potentially making them even more reluctant to accept individuals released from incarceration.

San Diego

Editor's Comment: Once again we return to San Diego. The county has agreed to pay $3 million to the widow of a man who died in the county jail after failing to receive insulin for his diabetes. It is difficult to read the account of someone dying from such a readily treatable condition.

What may be of particular interest to our subscribers is that the Citizen's Law Enforcement Review Board (CLERB) issued a report examining the actions—and inactions—that contributed to the man's preventable death. The report also raises the broader issue of continuity of care between correctional facilities and community healthcare providers. According to CLERB, Mr. Bach was initially deemed medically unsafe to detain and transported to a hospital emergency department. After being medically cleared, he was returned to the jail, where he appears to have received little meaningful medical attention.

Subscribers may recall that the Sheriff's Office opposed expanding CLERB's authority to review correctional healthcare matters until those expanded powers were approved at the end of last year.

San Diego County has paid $3 million to the widow of a man who died at the San Diego Central Jail three days after he was arrested because he was not administered the insulin he needed to survive. Keith Bach died on Sept 28, 2023, from a lack of insulin in his body, after it was reported that he had notified a deputy of his need for insulin and had repeatedly hit an intercom button to request it. The medical examiner’s office ruled his death a homicide by neglect. The Citizen Law Enforcement Review Board’s (CLERB) reported that Bach fainted during the booking process, which led him to be taken to the hospital. He was cleared and taken back to Central Jail. CLERB reports found that medical staff never directly interacted with Bach. The current medical provider at the jaiil is NaphCare.

ICE

Delaney Hall, New Jersey

According to Republicans on a House panel “False Narratives Surrounding Conditions at the Delaney Hall ICE Detention Center,”, the site of several clashes between police and demonstrators, is a model detention center. Democrats accused ICE and GEO Group of shielding Delaney Hall from scrutiny despite a 2024 law allowing members of Congress to visit detention facilities.

Rivers Correctional Institution, North Carolina

U.S. Immigration and Customs Enforcement will be reopening a for-profit prison in Winton, North Carolina, as one of the largest immigrant detention facilities on the East Coast. The report cited internal ICE documents showing plans for a mass detention center in the former Rivers Correctional Institution with 1,400 beds. .

Juveniles

Shelby County leaders are considering changes to how juveniles are disciplined while in detention, with a proposed ordinance that would further limit the use of seclusion and expand rehabilitation-focused practices at the Youth Justice and Education Center (YJEC). Under Tennessee law, juvenile detention facilities are already prohibited from using solitary confinement for punishment and discipline.

Studies

Lawmakers frequently propose bills named after victims of tragic events to rally public support and memorialize those who died. A recent study evaluates whether reading these personal stories causes voters to support legislation they might otherwise question.

State Roundup

Florida

The Florida Department of Corrections (FDC) broke ground July 22 on a new modular medical facility at Lowell Correctional Institution in Ocala, marking the beginning of a healthcare initiative that will expand surgical capabilities inside the state’s prison system while reducing the need to transport incarcerated individuals to outside hospital.

Illinois

Recently, the Joliet Treatment Center has experienced more than 70 fires over the past three years. These include a dozen incidents in which incarcerated men set themselves on fire.

Maryland

Maryland Gov. Wes Moore on Thursday acknowledged that the state’s high rate of prison killings is a problem, but was light on specifics of how to address the problem. “This is a tragedy and tragic issues that we’ve seen within some of our correctional facilities,” Moore, a Democrat, said.

North Carolina

In North Carolina’s largest jail, hundreds of people sleep on the floor on portable bed platforms. As of July 16, 2,146 people were in custody in Mecklenburg County’s uptown Charlotte jail — 242 people above the jail’s capacity of 1,904.

New York

A man incarcerated at Coxsackie Correctional Facility (New York) reportedly has been experiencing gastrointestinal symptoms that have caused him to lose consciousness twice. He has submitted 20 requests to see a physician but was not examined by one until this month.

Oregon

The Oregon State Penitentiary’s aging facility is contributing to potentially life-threatening conditions, an audit by the Oregon Secretary of State found. The audit investigated failing facilities, staffing shortages and obsolete information technology systems that are working to undermine reform efforts in Oregon’s prison system.

Technology

FYI

CSG Government Solutions announced that it is a sponsor of the 2026 Corrections Technology Association (CTA) Annual Technology Summit held July 26-29 in Aurora, Colorado. CTA is a public, non-profit network of professionals actively involved in leveraging technology in the field of Corrections.

Correctional Healthcare Vendors

PrimeCare

A pair of Philadelphia attorneys blame Lehigh County Jail and its health care provider, PrimeCare, for failing to prevent the jail’s fifth inmate suicide in the past four years.