Arizona Correctional Healthcare in Receivership: What It Means? Why It Took So Long?

Highlighted Stories

Editor's Note

This week’s highlighted story centers on Federal Judge Roslyn Silver’s decision to place healthcare in the Arizona Department of Corrections, Rehabilitation and Reentry under a court-appointed receiver. The decision follows more than a decade of litigation dating back to 2012, when incarcerated people alleged that the state’s healthcare system violated the Eighth Amendment’s prohibition against cruel and unusual punishment. In 2014, Arizona agreed to a detailed 103-point performance plan, but the department repeatedly failed to comply. The court twice found the agency in contempt and imposed more than $2.5 million in fines.

For longtime readers of the Weekly Update, this ruling will not come as a surprise. As reflected in years of Editor’s Notes, Follow Ups and articles, healthcare receivership has been threatened for some time (October 28, 2025, September 16, 2025, March 19, 2024, April 11, 2023, January 17, 2023, August 9, 2022). Still, many may ask what healthcare receivership actually mean and why it takes so long. When a court imposes receivership, it transfers operational, financial, and legal control from the state or local jurisdiction to an independent, court-appointed official. Judges do not take this step lightly. Correctional systems are typically given multiple opportunities to remedy deficiencies, often over many years, before such intervention is ordered.

Receivership is strongly resisted. California’s prison healthcare system has been under federal receivership since 2005, a fact cited by Arizona officials in criticizing Judge Silver’s ruling, particularly in light of the costs involved. Yet the court’s reasoning was unequivocal: allowing the department to retain control would expose incarcerated people to “an intolerable, grave, and immediate threat of continuing harm.” Notably, Arizona’s healthcare is currently provided by NaphCare, which has faced scrutiny over the handling of sensitive patient information.

What was once rare is becoming less so. California’s prison mental health system was placed into receivership in 2025 after persistent staffing failures, and Rikers Island is under federal oversight following repeated findings of noncompliance. These cases reinforce a recurring COCHS theme: correctional systems struggle to correct themselves. Whether due to the opacity of corrections or close relationships with private vendors (see recent stories from Arkansas), meaningful reform often requires outside intervention.

The Arizona story also highlights the long history of proprietary correctional healthcare vendors in the state. As documented in a 2021 Marshall Project article, Arizona has cycled through multiple companies—Wexford, Corizon (rebranded as YesCare), Centurion, and NaphCare. That same history traces how proprietary vendors became embedded across correctional systems nationwide. A related article from the Arizona Public Health Association responding to Judge Silver’s ruling notes that Arizona’s move toward privatization began in 2012, when the state disbanded its correctional healthcare system and shifted to contracted providers, a path that appears to have coincided with persistent concerns about care (as COCHS recently highlighted, Iowa tried to privatize correctional healthcare but failed after considerable union push back).

Taken together—the department’s repeated noncompliance with court orders and the mixed record of proprietary vendors—these developments return us to a familiar conclusion. Bringing Medicaid into corrections may be one of the few viable mechanisms for aligning correctional healthcare with the standards, accountability, and outcomes expected in healthcare more broadly. In other words, removing the word correctional from “correctional healthcare” and just providing healthcare.

Receivership

After nearly a decade and a half of litigation, Federal Judge Roslyn Silver has cleared the way for a court-ordered takeover of medical and mental health care at the Arizona Department of Corrections, Rehabilitation and Reentry, citing chronic, persistent constitutional violations. “Plainly, only the imposition of the extraordinary can bring an end to this litigation and the reasons it was brought,” Judge Roslyn Silver wrote. “An end to unconstitutional preventable suicides. An end to unconstitutional preventable deaths. An end to unconstitutional failures to treat those in severe pain. The Motion for a Receiver will be granted.” The class-action lawsuit came to the court in 2012, claiming inadequate medical, dental and mental health care, excessive isolation and insufficient conditions. Two years later, the parties reached a settlement agreement detailing 103 required health care and maximum custody improvements, approved by the court in 2015. The Arizona Department of Corrections did not respond to a request for comment. Gov. Katie Hobbs said she was “disappointed” in this decision, which fails to recognize the immense strides” of the department and that her office had “inherited a decade of neglect and mismanagement.”

The American Civil Liberties Union (ACLU) of Arizona, the Arizona Center for Disability Law, and the law firm Perkins Coie LLP, filed a federal class-action suit in 2012 alleging grossly inadequate medical care inside the ADCR. The ADCRR agreed to settle the suit in 2015 by taking steps to improve medical care inside its prisons. But since then, the ACLU and other law firms have repeatedly accused the ADCRR of failing to abide by the settlement agreement, and federal judges have agreed. A federal magistrate judge fined the ADCRR $1.4 million in 2018. Silver held the department in contempt in 2021 and fined it another $1.1 million for failing to meet the benchmarks for proper medical care. In 2022, Silver ruled that Arizona prison officials were deliberately indifferent to "grossly inadequate" medical and mental health care, violating inmates' Eighth Amendment rights. The ruling came after an expert witness report filed in the case described appalling and fatal delays in medical care for incarcerated people inside the ADCRR: A paraplegic man was left to physically deteriorate until his penis had to be amputated

The U.S District Court yesterday ordered the appointment of a receiver to oversee all health care services in the 9 state prisons run by the Arizona Department of Corrections, Rehabilitation and Reentry (ADCRR). The Department strongly disagrees with the Court’s decision, as it disregards the immense progress that has been made. We will aggressively pursue an appeal of this order. Under the Court’s receivership order, the State of Arizona (and hardworking Arizona taxpayers) will be responsible for paying all costs of the Court-appointed receiver, including any new requirements the receiver may impose on the Department. Plaintiffs have previously advised the Court that the Court-appointed receiver in California’s prisons costs the state approximately $3 million annually, in addition to the cost of requirements imposed by the receiver, but provided no estimate for the cost to Arizona. California’s receiver has been in place for twenty years, and Arizona’s receiver would likewise have no specified end date.

Arizona is one of around two dozen states that use a private, for-profit contractor to provide prison medical care, and almost all have been sued. In 1976, the Supreme Court in Estelle v. Gamble found that “deliberate indifference by prison personnel to a prisoner's serious illness or injury” was cruel and unusual punishment, forbidden by the Eighth Amendment. These court decisions forced prisons to hire hundreds of medical personnel and pay for hospital stays and expensive procedures. Just as health care in broader society began relying on “managed care” to limit costs, some states started privatizing prison medical care, using small contractors to provide hard-to-hire staff. The newly merged and fast-growing companies were an attractive investment for private equity, says Dan Mistak of Community Oriented Correctional Health Service (COCHS). Arizona has employed three prison health care contractors over the past decade: Pittsburgh-based Wexford Health, then Corizon (rebranded as YesCare), and now Centurion (Editor’s Note: NaphCare is the current provider —this article was published in 2021.). Allegations of subpar care and chronic understaffing have dogged all three companies.

n 2012, the Arizona Legislature made a major change in how health care was delivered in our state prisons. In a party-line vote, lawmakers decided to privatize prison health services. Governor Brewer signed the law in 2012. What followed? The AZ Department of Corrections fired the state-employed doctors, nurses, and health staff, contracting the work out to private companies. Then-ADOC Director Chuck Ryan was tasked with dismantling a decades-old, state-run system and replacing it with a contract model. Instead of directly providing care, the ADOC would write requests for proposals (RFPs), select vendors, and manage contracts. That transition — from running health care to managing contracts — didn’t go well. Over the next several years, complaints increased. Inmates and their families experienced and documented delayed treatment, missed medications, and preventable suffering. Lawsuits followed.

Follow Ups

Ending Crime and Disorder on America’s Streets

Editor's Comment: These first two Follow Up articles respond to the initial policy changes of the executive order Ending Crime and Disorder on America’s Streets. In Health Affairs Forefront, Carlos A. Larrauri, Michael Ashley Stein, and Vikram Patel critique SAMHSA’s new policy favoring court-ordered psychiatric hospitalization, arguing that it rests on unsupported claims. A related article in KevinMD examines why forced treatment often fails to address underlying issues, including the lack of housing and the fragmentation of mental health services from primary care.

In Health Affairs Forefront, Carlos A. Larrauri, Michael Ashley Stein, & Vikram Patel write: On September 10, 2025, the Substance Abuse and Mental Health Services Administration (SAMHSA) released strategic priorities that represent a significant shift in federal mental health policy. The agency’s plan emphasizes “lasting [] recovery” through “gold-standard science” and promotes the expanded use of court-ordered psychiatric hospitalization (civil commitment) and court-ordered community treatment (assisted outpatient treatment or AOT) as mechanisms for “ending crime and disorder on America’s streets. SAMHSA’s approach relies on unsupported claims to expand coercive measures at the expense of interventions with established evidence bases, such as voluntary community-based services. It also risks reductively attributing complex social problems like homelessness, crime, and violence to serious mental illness (SMI)—a subset of diagnosable mental disorders such as schizophrenia, bipolar disorder, and major depressive disorder—thereby oversimplifying their multifaceted causes.

In his recent executive order, Ending Crime and Disorder on America’s Streets, President Trump directed federal agencies to utilize forced institutionalization of unhoused individuals under the guise of public safety, lambasting evidence-based harm reduction programs in the process. Rather than addressing the root issues, this executive order scapegoats the unhoused. Many people are unhoused due to skyrocketing rent prices and the absence of low-barrier housing, in addition to mental health and substance use treatment largely being siloed from primary care services. Programs that attempt to bridge this gap, such as syringe service programs, are largely underfunded and have tenuous legal status at best in many states. This funding issue will only be exacerbated by the significant federal disinvestment from Medicare and Medicaid, including $345 million in substance use treatment and overdose-prevention funding cuts as of July 16, 2025. Substance use, mental health struggles, and addiction are not the cause of homelessness; not having homes is.

Bankruptcy & Proprietary Correctional Healthcare Vendors

Editor's Comment: In the last Weekly Update, the Editor’s Note examined in detail the Tehum Care/YesCare/Corizon bankruptcy saga. This week, we return to another bankruptcy, Wellpath’s. The death of a woman at the Norfolk, Virginia jail has resulted in a settlement with jail officials, but the claim against Wellpath continues separately in bankruptcy court. We have included a link to the debtor’s reply to its creditors in the Texas bankruptcy proceedings. Our astute subscribers might recall that in 2022, Gerard Boyle, former CEO of Correct Care Solutions (now Wellpath), and Bob McCabe, sheriff of Norfolk County, Virginia, were convicted on felony bribery charges related to jail medical services.

Nearly three years after a 24-year-old man died by suicide inside the Norfolk City Jail (VI), his family has reached a $950,000 settlement with jail officials, bringing closure to a case that raised questions about inmate mental health care and jail procedures. Philemon died Aug. 18, 2022, four days after he was booked into the Norfolk City Jail on a misdemeanor charge for failing to appear in court. His mother, Jamie Vinson, later filed a wrongful-death lawsuit alleging jail staff failed to follow procedures meant to protect inmates experiencing mental health crises. The settlement, reached earlier this year, resolves claims against jail officials, though litigation involving the jail’s former medical contractor (Wellpath) continues separately in bankruptcy court. (See this related filing in the Bankruptcy Court for the Southern District Of Texas.)

Restoration to Competency

Editor's Comment: As we have previously noted, Missouri faces a shortage of psychiatric beds, leaving many individuals waiting in jail before they can access treatment. This shortage has now drawn the attention of the state legislature, which is beginning to recognize it as a growing crisis. As the next article from Vermont makes clear, this lack of psychiatric capacity is part of a broader national trend and states are struggling on how to address this shortage. Vermont is investigating restoration to competency in a lock facility under the department of corrections.

Missouri has just eight outpatient beds for people charged with crimes who have been ordered to undergo mental health treatment so their cases can move forward.

If someone charged with a violent crime is deemed a threat to public safety, they might be held without bail. And if that person is also incompetent to stand trial, they could remain in prison for years until they pass a competency evaluation. But the state currently lacks a process to restore their competency — sometimes leaving people to languish in jail even though they haven’t been convicted of a crime. Lawmakers in the Senate Judiciary Committee are grappling with a bill, S.193, that would allow defendants found incompetent to stand trial or not guilty of a crime by reason of insanity to be committed to a locked facility under the purview of the Vermont Department of Corrections.

Los Angeles County

Editor's Comment: In the September 16, 2025, Editor’s Note, we wrote about California Attorney General Rob Bonta suing Los Angeles County over conditions in its jails. Today’s first Los Angeles County story underscores those concerns, reporting nine in-custody deaths so far this year. Perhaps, a more positive development appears in the second story, which describes the opening of a new mental health assessment area within the jail.

Nine people have died inside L.A. County jails so far this year, an alarming number for the Sheriff’s Department as it continues to face a lawsuit from the state over the conditions in local lockups. Sheriff’s Department officials said they are continuing to make changes, hoping to reduce the number of in-custody deaths and care for an inmate population that is increasingly struggling with medical and mental health issues. Seven inmates died in January. The Sheriff Civilian Oversight Commission will probe the county’s Correctional Health Services during its next meeting, specifically eight suicides and 10 drug-related deaths that occurred in 2025. The concerning number of inmate deaths also comes as the Sheriff’s Department faces questions about whether inmates are receiving timely and proper care.

A new Mental Health Assessment Area has been added to the Los Angeles County Sheriff’s Department‘s Inmate Reception Center downtown, part of an effort to strengthen care and improve efficiency for incoming jail detainees, officials said Tuesday. The unveiling marks “a significant advancement in the department’s ongoing commitment to care, dignity and operational excellence within the jail system,” according to a Sheriff’s Department statement. In June 2022, the Los Angeles County Board of Supervisors directed the Jail Closure Implementation Team and the Alternatives to Incarceration Initiative to explore the use of AB 109 funding to alleviate overcrowding.

San Diego County

Editor's Comment: South of Los Angeles County, San Diego County has, as our subscribers know, had its share of problems in its jails (January 13, 2026, January 6, 2026, January 16, 2025, September 16, 2025, September 9, 2025,December 10, 2025 ). Today’s stories begin with a settlement of a class action lawsuit requiring the sheriff to hire additional mental health staff, with the federal court retaining jurisdiction to ensure the reforms are implemented, oversight that is especially germane given the experience in Arizona discussed in this week’s Editor’s Note.

In the next article, a federal judge denied San Diego County’s attempt to dismiss a lawsuit over the death of a developmentally disabled woman in jail. The judge found that the complaint sufficiently alleged that sheriff’s deputies, jail medical staff, and private healthcare contractors failed to respond appropriately. Sharing another connection with the Arizona story, both Arizona and San Diego contract with same healthcare provider: NaphCare.

Lawyers representing people in San Diego County jails have reached a settlement in a long-running class-action lawsuit that will require Sheriff Kelly Martinez to improve the level of mental health care. The agreement, which was filed in San Diego federal court calls for the Sheriff’s Office to do more to treat mentally ill people who are booked into county custody. It also requires San Diego County to hire more mental health providers to serve in its jails, and it calls for the federal court to retain jurisdiction over the case to make sure that reforms are implemented. The deal requires an intake nurse to review the outside medical records of people who have been arrested when they are booked into custody, and it calls for county health care staff to examine their medication history and ensure continuity of care.

A federal judge has denied motions to dismiss a lawsuit over the death of a developmentally disabled woman in San Diego County jail custody, allowing her family’s claims of unconstitutional medical neglect, violations of federal disabilities law and other systemic failures to move forward. In a 70-page order, U.S. District Judge William Hayes ruled that the lawsuit sufficiently argued that sheriff’s deputies, jail medical staff and private healthcare contractors had failed to respond appropriately as Roselee Bartolacci’s mental and physical health deteriorated during her nearly two months in the Las Colinas jail. The ruling clears the way for the case to proceed into discovery and a potential trial. Hayes denied motions to dismiss filed by San Diego County, Sheriff Kelly Martinez and jail medical contractors NaphCare and Correctional Healthcare Partners.

Idaho

Editor's Comment: Turning to Idaho, NAMI officials warn that cuts to Medicaid and other safety-net programs will lead to more people cycling through jails. This echoes our Editor’s Note from January 6, 2026, where Idaho sheriffs similarly warned that Medicaid cuts would harm public safety and drive more people into the jail system.

NAMI's Beth Markley and Dona Brundage in an op-ed write: Idaho’s steady dismantling of the systems that prevent people with mental illness from cycling from crisis to crisis and then often into prison is the predictable outcome of policy choices that are pushing Idaho to the brink of catastrophe. Now comes the news that Idaho’s Mental Health Court programs are at risk. One of Idaho’s most effective tools for interrupting the cycle of incarcerating those with mental illness is mental health court. Recent cuts to Medicaid in December (specifically peer support specialists and ACT teams that support people with serious mental illness) to address Idaho’s budget shortfall have already cost lives. Prisons are already under significant strain. Recent reports show they are over capacity and struggling with increasing costs.

New York

Editor's Comment: In New York, there are continued reflections on the events of last year following the murder of Robert Brooks. The Department of Corrections and Community Supervision’s commissioner, Daniel Martuscello, stands by the decision to fire 2,000 correctional officers who participated in the wildcat strike. From an incarcerated person’s perspective, Cliff Ryan describes his experience during the strike, including periods of constant food shortages while in solitary confinement due to staffing shortages.

When the state Department of Corrections and Community Supervision fired 2,000 correction officers to end a three-week-long strike in 2025, it exacerbated a staffing crisis. At a state budget hearing, state Sen. Tom O’Mara asked DOCCS Commissioner Daniel Martuscello III if he regrets firing the correction officers, especially as the state is spending more than $1 billion to deploy the National Guard to state prisons and the agency has 4,600 vacant correction officer positions. Martuscello did not hesitate. “No,” he responded.

It’s been one year since New York state correction officers went on a 22-day illegal strike over unsafe working conditions, forced overtime and the HALT Act, which limits the use of solitary confinement. The three-week period aimed for change for the striking COs who lit fires, shared food and deepened their sense of brotherhood, but for the incarcerated individuals inside the facilities, it was a different story. Incarcerated people were confined to their cells for days at a time, relying on the staff that remained for food and medication. For 14 days, Cliff Ryan, who was in solitary confinement, said he wasn’t just alone, but starved. Of the 42 meals he was supposed to receive, he says he only received 12.

Medicaid

Lawmakers in the Wisconsin Assembly voted in favor of a bill seeking Medicaid coverage for people in Wisconsin prisons and jails. Supporters hope it will help recently incarcerated people avoid addiction and overdoses. Rep. Shelia Stubbs (D-Madison) said her experience working for the Wisconsin Department of Corrections has given her firsthand knowledge about the impact AB 604 will have. She said it will improve access to treatment and case management and ease the financial burden on justice-involved Wisconsinites.

ICE

Cases of measles — a highly contagious virus that spreads in close quarters — cropped up in two centers for unauthorized immigrants in Arizona and Texas last month. The centers are almost 1,000 miles apart, yet they have one thing in common: They are operated by CoreCivic. The publicly traded detention company has secured contracts worth hundreds of millions of dollars since President Trump took office last year, but it has a checkered track record of providing medical care to the people in its facilities.

Immigration and Customs Enforcement is now holding immigrants in two different cell blocks inside of the Metropolitan Detention Center, a hulking federal jail in Sunset Park, Brooklyn. That news came from Rep. Dan Goldman, whose district encompasses the prison and who toured the facility for the first time speaking to several detainees who had been held there for months. Members of the U.S. House of Representatives, who are supposed to be able to conduct unannounced inspections of any place ICE detainees are being held, had been repeatedly denied entry.

U.S. Representative Adelita S. Grijalva (AZ-07) sent a letter to Department of Homeland Security Secretary Kristi Noem demanding answers regarding reports that the closed Arizona state prison facility in Marana, Arizona, may be converted into an immigration detention center.

A new report from the Center for Reproductive Rights provides horrific details on how Immigration and Customs Enforcement (ICE) has departed from its own protocols by detaining pregnant, postpartum, and nursing women, forcing them to endure inhumane conditions. One pregnant woman, Marie, was placed in solitary confinement for three days, where she suffered from psychological trauma and developed eclampsia, a life-threatening pregnancy complication. Other women report being shackled, separated from their breastfeeding children, denied prenatal care, and withheld basic necessities like food, causing them to be too malnourished to breastfeed.

Detainees and advocates across the country say conditions inside U.S. immigration detention centers are deteriorating, with detained people taking extraordinary risks to be heard, organizing hunger strikes, writing public declarations, and even attempting to get messages out through improvised channels. Detainees from New Jersey to Washington state have described inadequate medical care, prolonged isolation, poor nutrition, and limited communication alongside a rising national advocacy response demanding accountability.

Dauphin County Prison employees turned over Chaofeng Ge to ICE agents at the end of July with medical paperwork that contained potentially lifesaving information. What happened to those records in the roughly 100-mile drive to Moshannon Valley Processing Center in Clearfield County, Pennsylvania, remains a mystery. They never made it to the medical staff, and Ge died by suicide in federal custody five days later.

A federal judge ordered the Trump administration to provide constitutionally adequate health care to people detained in the largest immigration jail in California. In her preliminary injunction, District Judge Maxine Chesney also called for an independent third-party monitor to ensure U.S. Immigration and Customs Enforcement meets constitutional requirements for care. And she ordered ICE to allow the monitor to access the facility for at least 120 days, inspect conditions, review medical records and interview staff and patients. The ruling followed a lawsuit on behalf of seven detained individuals alleging brutal conditions at the California City Detention Facility, a privately operated center by CoreCivic.

Juveniles

In late January, Judge Peter A. Hernandez briefly interrupted testimony in his Los Angeles County courtroom, sounding genuinely baffled. In the case before him, the state of California was arguing that the Los Angeles County Probation Department, which runs the county’s juvenile detention halls, had done such a poor job, and for so long, that the court should authorize a leadership takeover — called a receivership. The lawsuit over detention conditions, first filed in 2021, was assigned to Hernandez in the summer of 2024. And despite dozens of hours of prior testimony in his court on the minutiae of daily operations, Hernandez said it was the first time he’d been briefed about how the department had failed to master the most basic of workplace functions.

A new report from Congress has raised the alarm about children with mental health conditions being held in juvenile detention, rather than getting treatment. "Prolonged Incarceration of Children Due to Mental Health Care Shortages," released by the staff of Democratic Sen. Jon Ossoff and Republican Rep. Jen Kiggans, is based on a survey sent to administrators of public juvenile detention facilities around the country. About half of those who responded to the survey reported they had, at some point, kept children incarcerated when they could have been released into offsite mental health care. "This should shock America's conscience," Ossoff says. "Children with special needs, locked up for extended time instead of getting the mental health care that they need."

Reports of a bare room with a grated drain in the center, called “the Hole,” used as a disciplinary tactic in one facility. Emotional stories of being left in a cell in solitary confinement for hours on end in another. Those are just some of the stories Disability Rights North Carolina’s 13-month monitoring project uncovered inside the state’s juvenile detention centers. The watchdog group found that the care and treatment of young people navigating this system varies significantly from facility to facility, where the vast majority of residents locked inside in 2024 were between the ages of 13 and 17.

Last summer, Fabian Quintana spent 22 days isolated in a cell, often for 23 hours a day, at Spring Creek Youth Corrections Facility in Colorado Springs. He was 14 years old. The punishment – carried out under a secretive program that violated state law – was common practice at all 10 state-run youth corrections facilities in Colorado. “It was really shocking to find out that DYC by its own policies sanctioned this practice of putting kids in solitary confinement for days, weeks and in some cases months at a time even when there was no emergency,” said Rebecca Wallace, staff attorney with the ACLU.

Aging

New Jersey taxpayers pay more than half a million dollars a day to cover the health care costs of people incarcerated in state prisons, a price tag that’s expected to climb soon with corrections officials now negotiating a new contract with the system’s medical provider. Rutgers University Correctional Health Care has done that job since 2005 at a cost that has soared 44% over two decades, even though the number of people in state prisons fell by half during that period. A potential response would be to release elderly people who have languished behind bars for decades. An effort to pass a geriatric release law for imprisoned people 60 or older failed. The full Assembly passed it, but it stalled in the Senate.

State Roundup

California

California’s parole board is using unreliable drug test results in decisions about releasing incarcerated people despite flaws that were exposed in a rash of false positives two years ago, more than a dozen state prison doctors and state-appointed attorneys say. As a result of the practice, which conflicts with policies governing prison health care, more and more incarcerated people are walking away from life-saving addiction treatment over fears that a false positive could cost them their freedom.

Colorado

A Denver judge on Friday ruled that the Colorado Department of Corrections has been violating a 2018 amendment to the state constitution by requiring people in state prisons to work under the threat of solitary confinement and other punishments. The ruling comes as part of a class action lawsuit filed four years ago.

Georgia

Workers and inmates at Coastal State Prison are reporting what they call a human rights crisis, echoing findings from a federal investigation into Georgia’s prison system. A 2024 U.S. Department of Justice investigation found Georgia prisons, including Coastal State, are failing to protect inmates from violence, neglect, and unconstitutional conditions. T

Hawai'i

Confirmed or suspected suicides accounted for more than half of all deaths in the state’s largest prison in the past two years, and amounted to one-third of all deaths in Hawaiʻi's correctional system during 2024 and 2025. Data detailing the death toll from suicides in Hawaiʻi prisons and jails was drawn from autopsies and other public documents, and shows prisoners in the state system continue to have an abnormally high fatality rate from suicide. Of particular concern is Hālawa Correctional Facility where confirmed or suspected suicides accounted for eight out of the 15 deaths in the past two years.

New Mexico

The Metropolitan Detention Center continues to provide unconstitutionally poor medical care, according to a recently released medical audit. The report details poor staffing, long waits for detox, unreliable responses to medical emergencies and no framework to track patients' chronic conditions, medical history, medications and preventative care. Officials with the University of New Mexico Hospital, which took over health care at the jail more than two years ago, said that their providers are meeting “nationally recognized health care standards” and that the settlement agreement “exceeds typical community standards of care used in detention facilities.”

Ohio

A state inspector found that a Cuyahoga County jail officer showed a “complete lack of urgency or concern” in the death of Michael Papp. County officials released body-worn camera footage of the incident last week, about three days after we published what we knew of the egregious case findings and how they reflect a pattern of repeated failures at the jail. Delays like this, which a county spokesperson said were not intentional, are common when asking for footage from the Cuyahoga County Sheriff’s Department. There were more violations of state standards in Papp’s case than in any of the 20 deaths at the jail since 2020, records showed.

Texas

When a person dies in any jail in Texas, it falls to an outside agency to handle the investigation. That is a simple standard meant to avoid a conflict of interest. Nevertheless, it’s a standard the Bexar County Adult Detention Center failed to meet eight times between 2020 and 2022. In 2023, the Texas Commission on Jail Standards put the Bexar County Sheriff’s Office on notice for handling eight death investigations on behalf of the Bexar County Precinct 2 Constable’s Office. “This practice does not meet the intent of the law,” Texas Commission on Jail Standards Executive Director Brandon Wood wrote Sheriff Javier Salazar.

In an effort to reduce incarceration rates and increase rehabilitation for low-level offenders who have mental health conditions, substance abuse issues or are experiencing homelessness, the San Antonio City Council voted to fund $30,000 of a $100,000 study to create the Bexar Jail Diversion Center. The creation of the diversion center will be based upon a study by Alexander Testa, the research and consultant leading study, which will collect operational standards and workflows from diversion centers in other counties, such as Harris, Tarrant and Dallas counties.

The 2017 Sandra Bland Act stands as a marvel of bipartisan Texas lawmaking. The bill passed without opposition in both chambers of the Legislature. The law also requires the Texas Commission on Jail Standards to appoint an outside law enforcement agency to independently investigate any “death of a prisoner in a county jail.” Texas Attorney General Ken Paxton has interpreted the law applies only to detainees who die within a jail’s walls — not, for instance, in an ambulance or at the hospital. That would have been a terrible outcome. Among the 653 Texas county jail detainees who died in the past five years, nearly three-quarters took their last breath in a hospital, according to the jail commission.

Vermont

A 28-year old woman held at the Chittenden County Regional Correction Facility died from complications stemming from a MRSA infection, according to her death certificate. Alexis Poulin, who’d been incarcerated since December 2022, was transferred from prison to the University of Vermont Medical Center in mid-January after experiencing a “medical event,” state police said in a press release last month. Her condition worsened and she died a few days later at the hospital. The medical examiner’s officer determined Poulin’ cause of death was a cardiac arrest following air entering her chest cavity due to a separate condition that was caused by “necrotizing MRSA pneumonia."

Virginia

Virginia Democrats passed a bill expanding the state parole board as lawmakers scramble to address the rising medical costs of an aging inmate population. On a 67-29 vote, the House of Delegates passed a bill from Democratic Delegate Patrick Hope that expands the parole board from five to at least 10 members, with the General Assembly and the governor splitting appointments.

Wisconsin

Bar soap, toilet paper, a toothbrush and toothpaste. These were the necessities that Stanley Correctional Institution regularly provided to Eddie Brooks during the two and a half years that he was incarcerated. Everything else — including medicine, lotion, shampoo, deodorant, phone calls, entertainment and even health care — he had to pay for. And many were only available at a large mark-up. For people who don’t have much coming into prison, those extra costs are a massive burden.

Rikers Island

Mayor Zohran Mamdani released a plan to end nearly five years of emergency orders that have suspended basic jail rules at Rikers Island. But some reforms — including limits on solitary confinement — won’t take effect for nearly a year, and others require court approval. The action plan lays out how the city will phase out emergency suspensions that have allowed 12-hour officer shifts, weakened discipline procedures and permitted the mixing of young adults with the general jail population since September 2021.

Four people with correction expertise were asked for their suggestions to improve Rikers Island: Martin Horn, DOC commissioner from 2002 to 2009; Sidney Schwartzbaum, Assistant Deputy Wardens/Deputy Wardens Association president, from 1991 to 2016; Zachary Katznelson, executive director of the Independent Rikers Commission; Michael Jacobson, DOC commissioner from 1995 to 1998.

Correctional Nursing

Grievances are a standard mechanism for patients in a correctional facility to request changes and express discontent with a variety of conditions of confinement such as housing, officer treatment, and inadequate healthcare. Although many in correctional health care see the grievance process as a tedious necessity, medical grievances can be a rich source of information for uncovering system flaws.

Correctional Healthcare Vendors

Armor

The DeKalb County Sheriff’s Office (GA) is investigating the death of an inmate found unresponsive in his cell Sunday. It is the first reported inmate death of 2026. Last year, the sheriff reported eight inmate deaths at the jail.In 2023, the sheriff hired a new medical services provider for the jail, Armor Health of Miami, replacing Wellpath and Centurion, contractors named in a lawsuit filed by the family of Anthony Walker, an inmate who froze to death in the jail.

CFG Health Systems

A federal judge has denied motions to dismiss a civil rights lawsuit filed by Christie Figuracion, a pretrial detainee who claims she was catastrophically injured after officials at Salem County Correctional Facility failed to protect her from self-harm despite knowing of her long history of mental illness and suicide attempts. In a detailed opinion, the U.S. District Court for the District of New Jersey found that Figuracion’s complaint plausibly alleged constitutional violations under 42 U.S.C. § 1983 and the Americans with Disabilities Act, rejecting efforts by Salem County, CFG Health Systems, and several individual defendants to have the case thrown out.

Mediko

In 2025, a man died in the J. Reuben Long Detention center before he reached his trial. Now, his brother is suing based on claims that the prison’s medical care failed his sibling. James Carroll, 48, was detained in March 2025. Upon his detainment, he informed the prison that he was under the influence of opiates, according to the lawsuit, and medical orders were signed prescribing detoxification medications and observation protocols. The lawsuit names Horry County (Myrtle Beach, SC), the Horry County Sheriff’s Office, and Mediko, Inc. as defendants in the medical malpractice case, as well as a John Doe to represent responsible physicians.

After a rash of lawsuits regarding detainee deaths at the J. Reuben Long Detention Center, Horry County may seek a new correctional healthcare provider. Mediko, Inc., a Virginia-based correctional healthcare provider, has been contracted with the detention center in Horry County since 2017. In the years that followed, court records show that in Horry County over a dozen lawsuits were filed against the company for medical malpractice and wrongful deaths at the prison

NaphCare

Contracted medical providers at the Washington County jail shrugged off the bulging tumors on an inmate’s jawline, leading to a four-month delay in his cancer diagnosis, a new lawsuit alleges. Civil attorneys for Jason S. Zong seek $5 million in damages from the county and NaphCare, an Alabama-based correctional health care company that operates in the Washington County Jail and other secure facilities across the U.S. “The conduct at issue was not the result of isolated mistakes, but of systemic failures in jail medical care, where known medical emergencies were met with bureaucratic delay, misplaced responsibility and inaction.” attorney John Burgess wrote in the complaint.

Wellpath

A worker at a state-contracted psychiatric hospital in Columbia was arrested and charged with Abuse of a Vulnerable Adult, the State Law Enforcement Division announced Feb. 19. Gregory Marcel Higgins was booked into Richland County’s detention center. Higgins worked at Wellpath Recovery Solutions, a Columbia psychiatric hospital contracted with the state Department of Behavioral Health and Developmental Disabilities’ Office. Higgins is charged for allegedly placing psychiatric patient in a chokehold. Wellpath’s South Carolina contract included providing care to people under involuntary commitments.