Market Failure: States and Counties Search for Reliable Correctional Healthcare Partners

Editor's Note

Over the years, COCHS has examined correctional healthcare through many different lenses: the incarcerated individual, the vendor, litigation, environmental conditions, politicians, law firms, regulators, grand juries, judges, and prosecutors. There are no single highlighted stories this week, but scattered throughout the Weekly Update one can see many of these perspectives — the ongoing YesCare/Tehum Care/Corizon bankruptcy saga, the air-conditioning trial in Texas, legislation from Congresswoman Sydney Kamlager-Dove establishing care standards for pregnant and postpartum women in federal custody, a Sacramento grand jury investigating jail conditions, and a Chicago law firm highlighting pro bono representation of a detainee allegedly retaliated against for raising concerns about COVID-19 policies.

This week, however, we shift our focus to another lens: states and counties as purchasers of correctional healthcare.

The most immediate challenge is resources. Healthcare in corrections is expensive. As our subscribers know, COCHS has long supported bringing Medicaid behind the walls through 1115 waivers, as well as the HRSA PIN that allows Federally Qualified Health Centers to include pretrial detainees within their scope of services. These initiatives provide resources previously unavailable to corrections — namely Medicaid reimbursements for incarcerated people who are eligible beneficiaries within a defined period before release. They also import another valuable resource: community standards of care. What they do not resolve is a more basic question: from whom will states and counties purchase healthcare?

Again and again, we see the same cycle. Jurisdictions move from one provider to another — and sometimes back again. VitalCore and Wellpath are familiar examples. Providers fail to pay subcontractors, fail to maintain required insurance, or face mounting litigation. Some, like Armor and NaphCare, have been barred from certain jurisdictions. Others, like YesCare, appear to be unraveling — yet are most likely replaced by firms that carry their own histories of controversy.

Some states and counties have turned to universities and academic medical centers as an alternative. The results have not always been more encouraging. The University of Connecticut Health Center's tenure providing care to that state's Department of Corrections was shadowed by lawsuits and settlements. In Bexar County, where 12 deaths occurred in 2024, healthcare is provided by University Health. In a May 2025 Follow Up, we noted significant dissatisfaction in New Jersey with University Correctional Health Care, a nonprofit operated by Rutgers University. Perhaps most strikingly, advocates fought for years to end the reliance on proprietary care at the Metropolitan Detention Center in Albuquerque, New Mexico. After the University of New Mexico Hospital was given the contract, a court found after two years the care being delivered by the university was unconstitutional.

The uncomfortable conclusion is that states and counties appear to have few reliably adequate partners — proprietary or academic. The proprietaries operate in a high-risk environment and must generate profit, a structural tension that shapes clinical decisions in ways we have documented repeatedly. Universities and nonprofits, despite their different incentives, have struggled no less with the basic demands of correctional care delivery.

This is market failure operating on two levels. First, staffing healthcare in correctional settings remains persistently difficult. Second, the available options seem functionally interchangeable in their outcomes — one company replaces another, or care shifts to an academic institution, and the litigation seems to follow either way. For states and counties, choosing a healthcare provider has come to resemble pulling the lever on a slot machine — and the odds, for the jurisdiction and the incarcerated alike, are not great.

Follow Ups

YesCare/Tehum Care/Corizon

Editor's Comment: Last week we joked that our Follow Ups about YesCare/Tehum Care/Corizon seemed to resemble a serialized drama. The Texas bankruptcy — filed employing the Texas Two-Step strategy — is no longer protecting the company, which has failed to meet the requirements of both the original settlement and a revised one, apparently losing its bankruptcy protection in the process. With this week's stories, it almost feels as though we are closing in on the final chapters. YesCare has now filed for bankruptcy protection in Florida. Meanwhile, it is reported that the Alabaman law firm representing YesCare/Tehum Care/Corizon has not been paid and is seeking to withdraw from all cases in which it represented the company. Louisville Metro Corrections has also announced it is dropping YesCare/Tehum Care/Corizon in the wake of this second bankruptcy filing.

If this is indeed the beginning of the end, it marks the close of an era. Our subscribers may not be aware that this company has operated under many names beyond the YesCare/Tehum Care/Corizon trinity. It began as Correctional Medical Services (CMS), founded in 1978 — two years after Estelle v. Gamble, in which the Supreme Court ruled that withholding medical care from incarcerated people violated the Eighth Amendment's prohibition against cruel and unusual punishment. It later merged in 2011 with Prison Health Services (PHS) — its largest competitor, also founded in 1978 — emerging under the new name Corizon. Both companies carried long histories of litigation into that merger. Taken together across all its incarnations, this enterprise has been a presence in correctional healthcare for nearly half a century.

Prison healthcare company YesCare filed for bankruptcy in Florida on Friday, after the earlier bankruptcy of a YesCare subsidiary failed to fully shield the ‌parent company from lawsuits alleging that prisoners were harmed by substandard medical care. YesCare's Chapter 11 petition, filed in Fort Meyers, Florida, said that the company has between $100 million and $500 million in total liabilities, and between $50 million and $100 million in assets. YesCare is ⁠the successor to Corizon Health, which used a legal strategy known as the "Texas two-step" to split into two companies after being hit with about 200 lawsuits alleging that it provided substandard medical care that led to injuries and deaths at 50 detention facilities in 27 states. YesCare inherited Corizon's contracts and business assets, while a new shell company Tehum Care Services filed for bankruptcy after being saddled ‌with ⁠responsibility for the lawsuits. After a contested bankruptcy case, Tehum ultimately reached a bankruptcy settlement with its creditors, including people who had filed personal injury lawsuits against Corizon and YesCare. But those creditors sued YesCare in Texas last month, alleging that ⁠YesCare had failed to make a required $50 million contribution to the Tehum bankruptcy settlement.

A Birmingham law firm representing a Tennessee-based healthcare company that recently lost a $1 billion contract with the Alabama Department of Corrections has requested to withdraw from two lawsuits involving the company. Philip Paggott, a shareholder with Rushton, Stakely, Johnston & Garrett, P.A., wrote in a filing with the U.S. Middle District of Alabama that YesCare, doing business as Corizon Health Care (CHS) had not paid the firm since the beginning of the year. “The below-signed counsel has been informed by the general counsel for CHS AL, LLC, Scott King, that CHS AL, LLC does not have the resources to pay any legal invoices currently owed nor does it have any financial resources at this juncture to pay any legal expenses going forward,” Paggott said in a filing with the court.

The Louisville Metro Department of Corrections will soon transition to a new medical provider for inmates after its current provider filed for bankruptcy.This comes after YesCare filed for Chapter 11 protection Friday in the United States Bankruptcy Court in the Middle District of Florida. According to the bankruptcy filing, YesCare has between 1,000 and 5,000 creditors, 18 of which are Louisville-based. This includes Norton Healthcare, Baptist Health, Louisville Metro EMS, and the University of Louisville School of Dentistry.

Climate Change

Editor's Comment: See our April 12, 2026 Editor's Note on climate change: Crazy Weather: Climate Change & Death In Corrections.

In Texas, an ongoing federal trial will determine whether prisoners have a right to air-conditioning in prisons. The suing inmates argue that in Texas, where summer temperatures can surpass 110 degrees, a lack of air-conditioning constitutes cruel and unusual punishment. Five prisoners in the state have allegedly died from heat-related illness since 2023. Five prisoners in the state have allegedly died from heat-related illness since 2023. Meanwhile, the Texas Department of Criminal Justice has reportedly argued that, although it wishes to install air-conditioning in more prisons, doing so would cost too much—over $1 billion.

ICE

Florida is in talks with the Trump administration to shut down a high-profile immigration detention center that opened last summer in the Everglades and has cost the state hundreds of millions of dollars to operate. The shutdown talks are preliminary, the people said. But officials at the Department of Homeland Security have concluded that it is too expensive to keep operating the center, known as Alligator Alcatraz.

The U.S. Department of Homeland Security is on track to spend 75%, "if not more," of the $45 billion it was allocated for immigration detention by September 2026. Jaclyn Rubio, executive director of the Homeland Security One Big Beautiful Bill Principal Executive Office, said Wednesday in downtown Phoenix that the funding originally meant to be executed over a number of years has been "front-loaded" and the department is on track to obligate the majority of the funds by the end of this fiscal year that ends on Sep. 30.

The Tucson City Council unanimously passed a resolution opposing a proposed federal immigration detention center in Marana. The council voted 7-0 to adopt Resolution 24116, which declares opposition to the U.S. Immigration and Customs Enforcement detention facility. The resolution also declares an emergency regarding the matter. The Utah based Management and Training Corporation owns the former prison on Silverbell Road.

Pregnancy

Rep. Sydney Kamlager-Dove (CA-37) reintroduced the Pregnant Women in Custody Act, that establishes care standards for pregnant and postpartum women in federal custody. This updated version builds upon the bipartisan bill passed by the House in the 117th Congress by expanding coverage across agencies, elevating healthcare and safety standards, and creating enforceable mechanisms to ensure accountability. Following recent reports of pregnant women being shackled, denied medical care, and miscarrying in immigration detention centers, the updated Pregnant Women in Custody Act extends protections beyond the Bureau of Prisons and U.S. Marshals Service to include pregnant and postpartum women in the custody of U.S. Customs and Border Protection (CBP), U.S. Immigration and Customs Enforcement (ICE), and the Office of Refugee Resettlement (ORR).

Sexual Abuse & Rape

Allegations of sexual abuse and rape of incarcerated people is, unfortunately, a persistent problem in the federal prison system. The Federal Bureau of Prisons, which manages federal prison facilities, received about 8,500 allegations of sexual abuse of incarcerated people from 2014-2022. About half of these allegations were filed against Bureau employees, such as corrections officers. In two well known examples, a prison warden responsible for inmate welfare and a chaplain meant to provide spiritual care were convicted of sexual abuse at a women’s prison, the Federal Correctional Institution Dublin, along with seven of their colleagues.

Survivors of alleged sexual and physical abuse by state employees at the former Youth Development Center are staging a protest outside the River Road facility in a show of support for children being held there now. “More than 1,500–2,000 individuals have come forward with allegations of physical and sexual abuse inside this state-run facility, making it one of the largest institutional abuse scandals in the country,” said Michaela Jancsy, 38, of Rochester. “Despite this, the facility remains open—and recent reports indicate that children inside continue to be harmed.”

HIV

When people leave prison, they enter one of the highest-risk periods for acquiring HIV—often with the least support, the fewest resources, and the greatest uncertainty about where to turn for care. It’s this critical gap that Lina Rosengren, MD, MPH, an infectious diseases physician and researcher with the Institute for Global Health and Infectious Diseases is determined to close. “There has been very little investment in understanding how justice-involved populations can access biomedical interventions to prevent HIV,” said Dr. Rosengren, associate professor of medicine.

Nutrition

A new report released today by the Center for Science in the Public Interest and the Carceral Nutrition Project finds that privatized food service in US prisons and jails raises serious concerns about nutrition, food safety, and oversight. The report, Private Food, Public Harm: Privatized Food Service in Prisons and Jails, draws on a review of more than 130 reports and articles, interviews with key informants, and an analysis of litigation to assess how outsourcing food service affects the health and well-being of incarcerated people, focusing on Aramark.

State Roundup

California

The Sacramento County Grand Jury has released a seven-page report after touring five detention facilities within the county. “The Grand Jury found that each facility has its own unique challenges from aging physical infrastructure to higher demand for medical and mental care,” the report says. The grand jury said the Sacramento Main facility had “outdated infrastructure of the jail is a significant issue.”

Los Angeles County is on the final step of a court-approved plan designed to save Los Padrinos Juvenile Hall from closure, but critics argue the effort is failing to live up to its promises and instead has created turmoil throughout the probation system. Advocates and two unions representing probation officers say the plan has destabilized the county’s other juvenile facilities and left a skeleton crew to monitor tens of thousands of probationers on community supervision.

Georgia

The Georgia Bureau of Investigation says it is looking into claims from a former Fulton County inmate that severe medical neglect at the county's jail led to the amputation of his fingers and lower legs. In a statement, the GBI confirmed that it has been requested by the Fulton County Sheriff's Office to review Rashaad Muhammad's allegations.

Idaho

Idaho's prison system grapples with a severe overcrowding crisis that forces women demonstrating good behavior into solitary confinement, spotlighting profound human rights concerns within rigid state policy frameworks. This analysis examines the drivers of this punitive approach, its impacts on female inmates, and the tension between reform efforts and entrenched practices, rooted in investigative findings. Idaho leads the nation in female incarceration rates, imprisoning women at three times the national average with approximately 1,300 held, predominantly for nonviolent drug offenses lacking good-time credits.

Texas

The governing board for Texas’ jail watchdog agency confirmed its interim executive director. Ricky Armstrong heads an agency that inspects and sets minimum standards for around 240 county lockups that mainly hold people awaiting trial. Armstrong is stepping in amid increasing public attention on in-custody deaths, including Texans sent to await trial in out-of-state jails. Shortly after Armstrong stepped in, he affirmed in a public memo to all sheriffs and jail administrators that the agency will continue requiring an independent law enforcement agency to investigate all in-custody deaths. The move followed Attorney General Ken Paxton’s opinion agreeing that the phrase “death of a prisoner in a county jail” in the state’s Government Code requires investigations of deaths that occur only in a jail. Paxton’s written opinion also said this interpretation does not limit the commission’s authority to enforce a broader rule regarding all deaths.

Washington State

A new report from Washington’s prison watchdog lays out policy changes the Department of Corrections should make to improve and reduce solitary confinement in its prisons. The agency says it agrees with many of those recommendations. Still, advocates are frustrated by what they see as slow progress. Corrections pledged in 2023 to reduce solitary confinement by 90% in five years, but whether it’s on track to meet that goal is in doubt.

Rikers Island

City lawyers have agreed to pay nearly $5.2 million to settle lawsuits brought by the families of two men who died from methadone overdoses while jail staff ignored them on Rikers Island. The settlements come amid a sharp rise in claims and a dramatic spike in taxpayer-funded payouts by the Department of Correction. In fiscal year 2024, the city logged 7,254 claims, up from 4,580 the previous year and eclipsing prior highs, according to data from the city comptroller’s office.

Correctional Healthcare Vendors

Cermak Health Service

The US District Court for the Northern District of Illinois (NDIL) and the Chicago Chapter of the Federal Bar Association honored a Jenner & Block team with its 2026 Pro Bono and Public Interest Award for Excellence at a ceremony on May 1. The Jenner team was appointed to represent Dwayne Cummings, a pretrial detainee at Cook County Jail who had not been convicted of a crime. Mr. Cummings alleged that after he vocally raised concerns about the jail's COVID-19 policies, Cermak Health Services, the medical provider for Cook County Jail, retaliated by denying him adequate medical care for worsening vision problems.