County Budgets, Sheriff Expenses: Differed Healthcare's High Cost

Highlighted Story

Editor's Note

Back from our summer break, this week's Editor's Note turns to a subject we rarely discuss: county budgets, particularly the cost of providing healthcare in county jails.

After Obamacare passed in 2010, COCHS began thinking about how the expansion of Medicaid eligibility could affect people cycling through county jails (see Exploring Health Reform and Criminal Justice: Rethinking the Connection between Jails and Community Health). In that work, we found an important partner in the National Association of Counties (NACo). For years, NACo has called attention to the financial burden counties bear in providing healthcare to people held in their jails, most of whom are awaiting adjudication rather than serving a sentence. This burden is often referred to as an unfunded mandate.

More recently, COCHS and NACo have shared an interest in efforts to connect correctional and community healthcare through 1115 reentry demonstrations and the HRSA PIN allowing health centers, under specified circumstances, to provide transitional services before release. Both initiatives offer ways of connecting healthcare that has traditionally been financed and delivered through county correctional systems with the broader community healthcare system.

This week's three highlighted articles provide very different glimpses of the financial pressures counties face. In Luzerne County, Pennsylvania, officials are scrutinizing rising prison healthcare expenses as they confront a $33 million correctional budget, including a $5.4 million extension of the county's contract with Wellpath. In Deschutes County, Oregon, the Sheriff's Office has averaged approximately $3.8 million annually in medical expenses over the past five years—roughly 5 percent of its current $72.2 million budget.

San Diego County presents the issue on an entirely different scale. Sheriff Kelly Martinez has a budget of approximately $1.3 billion, yet the county faces hundreds of millions of dollars in renovations to its existing jails and potentially close to $1 billion to replace the aging Vista Detention Facility. These are not exclusively healthcare expenditures, of course. But modern detention facilities must accommodate medical and behavioral healthcare along with all the other responsibilities associated with operating a jail.

All the highlighted articles take different perspectives in this relationship between county budget and correctional healthcare cost, but the theme is common that correctional healthcare cost detract from funding for other public safety initiatives and responsibilities of county government and yet correctional healthcare cost are framed as a public safety issue, when in fact, they’re a public health issue. This distinction helps explain why COCHS has spent so much time advocating for Medicaid and, more recently, the HRSA PIN. The objective is not simply to shift costs from one government program to another. It is to connect healthcare delivered in jails with the healthcare system outside their walls.

Addendum: Included in this highlighted section are two articles on Medicaid and reentry. The first, from the National Health Law Program, provides a useful summary of Medicaid eligibility for incarcerated individuals. The second, from the Maryland Association of Counties, focuses on Medicaid coverage for young adults but also links to a manual from the Maryland Department of Health that goes into greater detail about how Medicaid coverage for reentry can be implemented in that state.

Pennsylvania, Luzerne County

Luzerne County prison inmate medical care procedures and costs were discussed at length during last week's County Council work session. County officials have zeroed in on this issue as they attempt to curb rising expenses for the prison system, which has been the top departmental expenditure in the county budget for many years. Total spending is budgeted at $33 million in 2026 — an increase of $1.5 million from 2025. Representatives of Wellpath LLC briefed the council on a range of inmate medical and mental health services provided as part of its contract. The council voted earlier this month on a one-year contract extension with Wellpath totaling $5.4 million for 2027, which includes costs for a medication-assisted treatment program for inmates with opioid use disorder covered by county opioid litigation settlement funds.

Deschutes County, Oregon

The sheriff in Deschutes County, Oregon has a budget of $72.2 million for the 2026 to 2027 fiscal year. That means roughly 5% of that goes to inmates’ medical expenses. The Sheriff’s Office has seen medical expenses average $3.8 million a year over the last five year. The last audit of the jail in 2018 found that estimated jail inmate medical spending grows by about 15% per year. Back in 2018, the audit estimated the average medical cost per inmate per day at $14.40.

San Diego County

Sheriff Kelly Martinez stood before the San Diego County Board requested any additional funding outside her $1.3 billion budget. Jail facility needed renovations that would cost $300 million or more. Replacement for the decades-old Vista Detention Facility would cost almost $1 billion if the work began right away, and tens of millions of dollars more for each year of delay.

Medicaid

As of January 1, 2026, the Consolidated Appropriations Act of 2024 prohibits all states from terminating an individual’s Medicaid eligibility upon becoming incarcerated. This factsheet explains the new legislative mandate and the different suspension approaches states can adopt to comply with it; and explains additional federal Medicaid eligibility and coverage rules that affect adults and youth who are incarcerated.

Maryland is giving local detention centers a new opportunity to recover some of the costs associated with helping incarcerated individuals transition back into the community through the state’s Medicaid Reentry Program for Children and Young Adults. The program allows eligible local jails to bill Medicaid for justice-involved case management provided during the 30 days before release, with reimbursement set at $561.05 per eligible participant per 30-day period. The opportunity comes as Medicaid’s role in correctional health care is changing. Beginning January 1, 2026, federal law requires states to suspend rather than terminate Medicaid enrollment when an individual becomes incarcerated, making it easier to restore coverage upon release. Maryland’s jail manual provides a roadmap for local facilities to establish the data systems, staffing, enrollment procedures and privacy protections necessary to participate.

Follow Ups

Arizona Receiver

Editor's Comment: The on-again, off-again Arizona receivership is back on again—at least for now. The Ninth Circuit Court of Appeals rejected the state's latest attempt to block the appointment of Annette Chambers-Smith as receiver of the Arizona prison system's healthcare. Judge Roslyn Silver has since ordered that the stay be lifted on October 19 *, at which point Chambers-Smith is scheduled to assume control of healthcare delivery. The appellate court did, however, leave open the possibility that the panel hearing the merits of the appeal could reconsider the denial of the stay.

One of the more striking moments in the state's argument before the Ninth Circuit was its acknowledgment that it did not dispute that Judge Silver has spent approximately fourteen years attempting to bring the prison system's healthcare into constitutional compliance.

We were also struck by who was making the state's argument: Andrew Pappas of the private law firm Osborn Maledon. Given the state's repeated concerns about the expense of the receivership, this raises another question: how much is the state spending on outside counsel to prevent it? Why employ outside counsel to resist the receivership rather than rely on the state's own legal resources? This is not the first time we have seen states employing more expensive outside resources while ignoring state resources. If our subscribers will remember in Mississippi, Rep. Becky Currie pointed out that the law firm of Butler Snow charged that state $700,000 for a report that the state’s health department would have done for free.

But back to Arizona, we have mentioned before the state's resistance to the receivership. Fourteen years into this litigation, that resistance continues—and apparently with outside counsel.

* tuscon.com article below reported that the receivership would commence on September 21 but that article was published on September 3 before Judge Silver’s order on September 10 changed to the October date.

Arizona is just weeks away from having a court-appointed receiver run the prisons' health system after a court rebuffed the state's request for a delay. In a brief order late Tuesday, the 9th Circuit Court of Appeals rejected Arizona's last-minute request to delay U.S. District Court Judge Roslyn Silver's order naming Annette Chambers-Smith. The judges did agree to give attorneys for Ryan Thornell, director of the Department of Corrections, Rehabilitation and Reentry, a chance to convince them to overturn their order. But the order installing Chambers-Smith, former Ohio prisons chief, is effective Sept. 21. That means, absent any intervention by the U.S. Supreme Court, Chambers-Smith will be installed to take control of the health system.

Tuberculosis/GEO/ICE

Editor's Comment: Previously, we have highlighted the dispute between Colorado public health officials, ICE, and GEO Group over possible cases of tuberculosis at GEO's immigrant detention facility in Aurora. This week, a commentary in Colorado Newsline provides an interesting Follow Up.

What particularly caught our attention was GEO's explanation for refusing to comply with a state public health order. In a court filing, GEO acknowledged that it had previously worked, with ICE's approval, with Colorado public health officials on disease-control investigations. What has changed, according to GEO, is that the current requests are “different in kind and tone.”

GEO's statement confirms something we could only infer before: cooperation between the detention facility and public health authorities was once possible. We have repeatedly emphasized the importance of connecting healthcare inside correctional and detention facilities with the healthcare and public health systems outside them. Here we appear to be watching that connection move in the opposite direction.

On August 18, wrote that communicable diseases do not recognize the walls of a detention center. Apparently, neither did GEO—until recently.

In a commentary, Quentin Young writes: The state (Colorado) sued GEO and ICE after the company ignored a public health order from the Colorado Department of Public Health and Environment, which sought detailed information about people in federal custody with confirmed or suspected TB. GEO had previously disregarded a public health order from Adams County. The company previously worked with public health officials, but things are different now, as GEO itself admits. In an extraordinary and telling passage, GEO said in a court filing that “while it is true that GEO has in the past, with ICE approval, worked with public health officials in Colorado to conduct disease control investigations, the nature and scope of the requests being made now are different in kind and tone.”

New York

Editor's Comment: New York's prison staffing crisis was a frequent subject of the Weekly Update in 2025, particularly during and after the three-week correction officer strike. Since then, the story has largely disappeared from our coverage. That does not mean the underlying problem has disappeared.

Spectrum News 1 reports that eighteen months after the strike, the number of correction officers employed by the Department of Corrections and Community Supervision remains essentially unchanged. DOCCS points to increased recruitment, greater interest in correction officer positions, and more academy graduates, but those efforts have yet to produce a meaningful increase in the overall number of officers.

This is one reason we created the Follow Ups. News coverage inevitably moves on, while the problems we follow often do not. Staffing shortages, inadequate healthcare, litigation, and failed oversight are interrelated and rarely do they lend themselves to quick solutions.

The news cycle moved on. The staffing numbers didn't.

Eighteen months after the end of a three-week illegal correction officer strike that rocked New York’s prison system and exacerbated a massive staffing crisis, new data shows the number of officers employed by the state Department of Corrections and Community Supervision remains essentially stagnant. DOCCS officials have repeatedly stressed that an aggressive recruitment campaign has resulted in more people graduating from the academy and additional interest in correction officer positions. But new data shows the number of officers employed by DOCCS is essentially stagnant.

ICE

ICE awarded GardaWorld Federal Services $17.3 million on Thursday to renovate an agency-owned building in San Antonio into an immigration processing and detention facilityThe order buys the renovation of an “existing, ICE-owned permanent structure” in San Antonio to serve as a “processing and detention facility,” along with the wraparound services needed to operate it. Wraparound services is ICE's term for the staffing and operations a detention facility requires, including guards, transportation and medical care. That is the same description that ICE used on the orders it issued in in March for warehouses in Williamsport, Md., and Surprise, Ariz.

Facing the prospect of a discrimination lawsuit, the Vermont Department of Corrections has agreed to provide federal immigration detainees in its prisons with better access to language interpretation, legal counsel and court hearings. Immigration lawyers previously said the department restricted their ability to meet with federal detainees and that non-English speakers lacked language interpretation in state prisons.

Transgender immigrants have disproportionately faced a range of difficult conditions while being held in U.S. Immigration and Customs Enforcement detention centers, according to a weekly news recap from Solitary Watch. Furthermore, under the second Trump administration, such conditions have only worsened as protections for transgender people overall have been rolled back, especially for detainees.

Today, the California Legislature approved Senate Bill 420, authored by Senator Steve Padilla (D-San Diego), which would ensure organizations tied to private immigration detention centers cannot claim charitable tax status solely because they are organized as nonprofits. A recent KPBS investigation revealed that the Brawley Community Foundation, a nonprofit organization that owns an ICE detention facility in Imperial County, avoided paying at least $6 million in property taxes through California’s “Welfare Exemption.”

Camp East Montana — the largest immigrant detention facility in the country — has quickly become a symbol of the second Trump administration’s aggressive approach to immigration enforcement. In late July, a federal contract notice showed ICE decided to extend Amentum’s contract, potentially placing the contractor at Camp East Montana through September 2027, without the agency having taken bids from other companies and despite allegations of fraud and wage theft that have followed Amentum over its time as a government contractor.

Laura Berlin watched images of immigration agents rounding up people and flying them to a Latin American prison without due process – and she knew she had to do something. Using her background in nonprofit communications, she built an interactive Google Map titled, “Who is Profiting from ICE?” It plots the contractors across the country who work with Immigration and Customs Enforcement to carry out the Trump administration’s deportation policies. Berlin found that more than 450 candidates across the country had taken campaign contributions from some of the three biggest government contractors working with ICE – GEO, CoreCivic and Management and Training Corporation.The U.S. government found her website, too – and labeled it a tool for domestic terrorism, according to a secret intelligence bulletin obtained by USA TODAY. It’s the latest example of the Trump administration cracking down on dissent it says could veer into political violence.

Election

Oklahoma prison inmates are working in call centers placing political calls and insurance telemarketing on behalf of outside companies, earning $2 an hour while a Virginia super PAC paid nearly $600,000 to the vendor for calls supporting conservative candidates — including calls made during Oklahoma's primary election season. The contracts specify that the call centers may engage in “telemarketing and political polling activity.” HBW Leads agreed to pay the Department of Corrections $10 per inmate hour worked. Prisoners employed at the call centers earn $2 per hour, plus possible bonuses for generating leads or completing surveys. Multiple inmates said they felt uneasy making partisan phone calls. Two indicated that they had been in prison so long that they were not familiar with the names of political candidates. One was unsure what MAGA or a Trump Republican was.

Ending Crime and Disorder on America’s Streets

At the August 25 Alachua County (FL) Commission meeting, the board’s debate about an RFP for street outreach to homeless people highlighted a philosophical disagreement between the County’s approach and the Trump administration’s policies. The meeting’s consent agenda included approval of an agreement between Alachua County and the TaskForce For Ending Homelessness for outreach services and permanent housing services; the TaskForce is the area’s Continuum of Care Lead Agency and is designated by the federal government as the entity that receives federal funds for homelessness.

U.S. Rep. Maxwell Frost was among the chief critics of Alligator Alcatraz before the migrant detention facility shuttered. Now, he wants to make sure similar camps aren’t established for the nation’s homeless. The Orlando Democrat unveiled his No Homeless Detention Centers Act, which would bar the use of any federal funding to gather and house homeless arrested for vagrancy or to force individuals into labor. Frost’s legislation came after President Donald Trump issued an executive order “ending crime and disorder on America’s streets” that shifts away from prior Housing First policies and instead treats vagrancy as a criminal activity.

Incarcerated Women

The rapid growth of incarceration of women in the United States has been accompanied by an increase in the number of pregnant individuals experiencing incarceration. Pregnant individuals in prisons and jails are at a higher risk for poor perinatal health outcomes. Existing data on these outcomes are limited, and research often only reflects single institutions or geographic regions. There is currently no consistent nationwide tracking system, and most existing research focuses solely on maternal health outcomes.

With thousands of women over the age of 50 incarcerated in state and federal prisons, health changes related to menopause should be a significant part of the conversation around prison healthcare. Unfortunately, while advocates and healthcare providers are discussing menopause education, advocacy, and healthcare access, incarcerated women are almost entirely left out of the picture. Their exclusion is particularly troubling because women’s incarceration has grown even more rapidly than men’s, and since 2008, the percentage of women in prison who were 50 or older has more than doubled.

Studies

This report examines trends in homelessness and drug use across California over the past two decades. It analyzes the extent to which local housing and economic factors may have contributed to homelessness within the state, and we assess the impact of California’s major criminal justice reforms. After voters passed Proposition 47, which reclassified some drug and property offenses from felonies to misdemeanors—subsequently reducing incarceration and enforcement for these offenses— unsheltered homelessness increased by roughly 10 percent, according to our estimates.

A team of Indiana University School of Medicine scientists has developed and tested a new intervention for incarcerated people with traumatic brain injuries. The approach has already shown promising results in preventing people from returning to prison or facing repeat arrest. A recent study, published in the Archives of Physical Medicine and Rehabilitation, shared results from the Re-entry Continuum for Brain Injury (RCBI) trial, which included 91 Putnamville Correctional Facility inmates with a history of traumatic brain injury (TBI). About half of the men received education on brain injuries, coping skills training, anger and aggression management, and 12 months of post-release neuro case management.

State Roundup

Alabama

An Alabama lawmaker and outspoken critic of the Alabama Department of Corrections said Thursday the Alabama Attorney General’s Office should have settled an ongoing lawsuit over mental health care in state prisons instead of continuing with litigation. Rep. Chris England, D-Tuscaloosa, said at the Contract Review Committee meeting Thursday that he wanted answers from ADOC about mounting costs in the lawsuit, known as Braggs v. Lovelace. Following a trial, U.S. District Judge Myron Thompson in 2017 ruled that mental health care in Alabama prisons was “horrendously inadequate” and ordered reforms.

California

Eight years after Santa Clara County agreed to overhaul inadequate medical care in its jails, county officials and prisoner advocates have negotiated firmer benchmarks aimed at accelerating reforms that have repeatedly fallen short. Federal Judge Nathanael Cousins last week signed off on a plan that gives short timelines, including as soon as this December, for the county to provide more responsive care at the Main Jail in San Jose and Elmwood jail in Milpitas. This pact comes after the Berkeley-based Prison Law Office — appointed to enforce the 2018 decree that settled class-action litigation over jail conditions — asked a federal court last year to hold the county in contempt and start fining the county for noncompliance.

The U.S. Department of Justice announced Wednesday that it will investigate whether Los Angeles County has failed to provide safe conditions for inmates at the Men’s Central Jail in Downtown Los Angeles. The department said it sent Los Angeles County Sheriff Robert G. Luna and the county notices about the investigation. Officials said the investigation will be conducted under the Civil Rights of Institutionalized Personals Act, “a federal statute intended to protect the rights of people incarcerated in state or local correctional facilities, among other state and locally run institutions.”

Connecticut

Three workers at the New Haven Correctional Center were injured Monday during an incident that began when an inmate attacked a healthcare worker. An inmate ran towards and hit the healthcare worker in the back of the head, knocking them to the ground. Responding correctional officers sustained injuries during the incident, and both were taken to an area health clinic for treatment.

Illinois

Across Illinois prisons peolpe in solitary, or what’s officially known as restrictive housing, are now ineligible to receive audio-visual privileges, unless a mental health professional states otherwise, according to Illinois law. An individual that’s been in restrictive housing for more than 60 consecutive days can seek restoration of those privileges.

Kentucky

The Kentucky Department of Corrections has outlined medical costs that the department will and will not pay for when state inmates at local jails have to be treated. The agency had to better define what “routine care” was after an appellate court ruled its previous definition was too broad. The Department of Corrections has come under fire for not reimbursing local jails for medical costs incurred for state inmates — people who are in the custody of the state agency but are staying at a local jail.

Maine

Franklin County Detention Center launched a new treatment and re-entry program last year. The jail now provides monthly shots to prisoners with an opioid use disorder rather than a daily pill. The injections have been “transformative,” Dr. O’Connor said. Because the medication slowly dissolves under the skin and remains in a person’s system for a month, it protects people from overdosing during the high-risk period immediately after release and buys them time to connect with community resources.

Massachusetts

More than 1 million people in the US correctional population have schizophrenia or another serious mental illness, making prisons de facto mental health asylums. During a psychiatric rotation last year at the Suffolk County Jail, I met countless inmates with psychosis who had little understanding of their own crimes, their illness, or the ramifications for their future. Many of them were veterans; almost all had a history of foster care or abuse. These men languished in behavioral units akin to solitary confinement, and I witnessed their psychosis deepen.

Michigan

The Michigan House voted for a legislative plan (House Bills 5920 and 592) aimed at safety and transparency in the state's prisons after multiple inmate death. It expands expand the authority of the Legislative Corrections Ombudsman, an independent office tasked with investigating complaints and concerns related to the Michigan Department of Corrections. The bills broaden the authority of the ombudsman's office to investigate complaints from corrections employees, family members of prisoners or corrections officers and prisoner advocates. Filing complaints with the ombudsman is limited only to prisoners or legislators under current law.

Minnesota

This year has seen the introduction of more protections for Minnesotans held pretrial, most immediately more accessible healthcare in jails, though its implementation has been delayed. As we look at our current jail system, these bills could mean slow but steady progress in decreasing the large disparity of Black inmates within Minnesota jails. Activist groups such as the MN Justice for All Coalition and Minnesota Freedom Fund have lobbied for reforms in both the pretrial and immigration systems.

Under Minnesota law, the DOC commissioner can grant conditional medical release to an incarcerated person with a severe, terminal or incapacitating medical condition who does not pose a threat to public safety. But advocates and researchers say qualifying for release can be difficult. The Prison Policy Initiative has described medical parole as setting “an extremely high bar for applicants,” with a lengthy and complicated application and hearing process. A 2025 article in the Minnesota Journal of Law argued that compassionate release can serve as both a public safety measure and sound fiscal policy, describing it as “a safe and responsible alternative to the continued incarceration of the elderly and infirm.”

Missouri

Over the past decade, jailers in Missouri have increasingly become caregivers of last resort for vulnerable people, who had a history of untreated schizophrenia. Some are released on bond back into the community for treatment. But the rest are supposed to be held at one of three secure state psychiatric hospitals where they can get therapy and medication until they can better understand the charges against them and assist in their own defense. Instead, with treatment beds unavailable, they are forced to wait in jails that can struggle to meet basic needs like food and hygiene.

For over a decade, families of detainees, helped by jail reform advocates, have sought answers on whether or not their loved ones who died in custody were medically neglected at the St. Louis City Justice Center. A new report from the local NAACP suggests public safety officials and medical providers are not on the same page when it comes to investigating these deaths. The report found that the jail’s medical provider, Physician Correctional USA, conducts an extensive review of processes and procedures at every death.” But that information isn’t shared with everyone involved.

Montana

Legislators in Montana said increased oversight is likely coming to the Department of Corrections, potentially during the next session in 2027. Prison rights advocates have pushed hard for independent oversight of the agency, asking legislators to demand increased transparency and accountability. The Law and Justice Interim Committee voted 5-4 to support legislation that would create a program providing independent oversight of the Department of Corrections housed in the Governor’s Office.

New Jersey

The union that represents New Jersey corrections officers wants lawmakers to expand solitary confinement in state prisons, saying changes are needed to reduce inmates’ assaults on guards. William Sullivan, who heads the officers’ union, is urging lawmakers to introduce a bill this fall that would ease restrictions mandated in a 2019 law (Bill A314) that limits how long prisoners can be in solitary confinement. The union wants prisons to regain the ability to place certain inmates in solitary for disciplinary infractions and isolate others deemed repetitively violent for longer periods of time.

Texas

Newly released videos from inside the Harris County Jail are raising new questions about the treatment of inmates and providing a rare look at incidents that are now evidence in a sweeping federal civil rights lawsuit. Attorneys representing inmates and the families of those who died in custody claim the videos show unnecessary force, delayed or inadequate medical care and detention officers failing to properly check on inmates.

Virginia

During Gov. Abigail Spanberger’s (D) first months in office, Virginia has reported a 56 percent reduction in serious assaults on correctional staff, a 47 percent decline in confirmed overdoses and a 27 percent reduction in facility lockdowns compared with the same period a year earlier. Those numbers represent safer workplaces for correctional officers, safer institutions and a stronger foundation for rehabilitation.

West Virginia

Nearly three years after Nathan Kennedy died at the North Central Regional Jail, the state settled his case for $700,000 last week. Now, the West Virginia Division of Corrections and Rehabilitation and the Attorney General are asking the state’s highest court to disarm families and people who have been harmed in custody of a key legal tool. The West Virginia Supreme Court of Appeals is scheduled to hear arguments in two cases where inmates have died and families are arguing deliberate indifference .

Wisconsin

Local jail reform advocates say they have serious concerns about the death of a 45-year-old man in custody at the Milwaukee County Jail on Aug. 18. The death is at least the 10th death of a person in Milwaukee County Sheriff’s Office custody since June 2022, including six deaths during a 14-month period in 2022 and 2023 and three in 2025.

Technology

The Franklin County (IL) Sheriff’s Office has recently installed a new state-of-the-art health monitoring system for inmates. The Franklin County Jail installed the new device in a medical holding cell. The system utilizes ultra-wideband radar technology to continuously monitor an inmate’s heart rate, respiratory rate, and motion without requiring wearable devices or direct physical contact by staff.

The GTL lawsuit in 2026 could put real money back in your pocket. Families overcharged for prison phone calls may receive up to $1,500 per claim. Global Tel*Link, now called ViaPath, charged families outrageous rates for years. Some paid over $1 per minute just to talk to a loved one behind bars. That adds up fast.

CoreCivic

A former inmate at Bent County Correctional Facility (BCCF) in Colorado, Paul Knuth’s is suing CoreCivic with a highly unusual assertion. His attorney maintains that Bent County has a financial motivation to engage in lax oversight of CoreCivic due to language embedded in their shared contract. Specifically, Bent County allegedly makes an extra $2 per inmate each day because it receives more money from the Colorado Department of Corrections to provide health services in the jail than the county pays CoreCivic.

Correctional Healthcare Vendors

Turn Key/TK Health

It has been almost three years since UT Health began providing medical care at the Smith County Jail, replacing a problematic third-party vendor. County commissioners heard this week about improvements made in the last few years, as well as challenges that remain.“If you don’t know, all of our inmates have access to tablets and at any time they can put a request in to see a medical provider,” said Carol Henson, who oversees medical operations at the Smith County Jail. The jail has used UT Health East Texas since 2024. Background: Turn Key Clinics appears to have be the unnamed medical provider in Smith County. Recently a federal court denied Turn Keys request to be dismissed from a case invovling the death of 24 year old man in Smith County. The young man had not received prescribed medication. Last year a medical tech was arrested for providing drugs to inmates. In addition, Smith County jail has been found non-compliant by the Texas Commission on Jail Standards numerous times.

In a nine minute meeting, the Cleveland County (OK) Board of Commissioners approved a $20 million settlement in the lawsuit regarding Shannon Hanchett's 2022 death in the Cleveland County Detention Center. In a 2-1 vote, the Cleveland County commissioners approved a $20 million settlement for the death of "Cookie Queen" Shannon Hanchett. The settlement applies only to the county and will not include other defendants in the case, meaning claims against former detention center medical provider TK Health — founded by attorney general candidate Jon Echols — and the individual medical staff named in the suit continue separately.

Kosciusko County (IN) Sheriff Jim Smith had hoped to switch the medical services provider for the county jail from Quality Correctional Care (QCC) to TK Health by Jan. 1. He presented an inmate health services contract for Turn Key Health Clinics LLC, doing business as TK Health. The cost for the contract with TK Health is $64,610.60 annually. Smith said they have a medical budget that they’ll be able to use to support the new contract.

Wellpath

A settlement between group of Arkansas inmates and the health care provider for the state prison system will require continued offerings of COVID-19 vaccines and tests and a "sufficient supply" of antiviral medications to treat the illness for at least a year. The agreement, filed in U.S. District Court in Little Rock, also requires Wellpath, the health care company the state contracts with, to offer and administer to any unvaccinated, newly incarcerated person the vaccine upon their arrival in the prison system.

Centurion

Just before Gov. Mike Braun agreed to house up to 1,000 immigration detainees at a troubled Indiana prison, his administration let the state’s for-profit prison health care contractor off the hook for millions of dollars in potential penalties over poor staff­ng. The change allowed Virginia-based Centurion Health to inadequately staff prisons across Indiana without facing penalties that averaged more than $6 million annually in previous years.

PrimeCare Medical

The state Commission of Correction has set no timeline for the Monroe County Legislature to review its jailhouse healthcare provider. Nor is there any penalty for not carrying out the directive at all. The county has not initiated the review, despite the state directive being received eight months ago. Instead, the administration renewed its contract with PrimeCare Medical of New York for another year this past February, at an estimated cost of $13.6 million.

Wexford

Shelby County (TN) commissioners will discuss a resolution to hire Wexford Health Sources. The resolution would pay Wexford nearly $38 million to take over care of inmates and detainees at the Shelby County Jail, Jail East and the Youth Justice Education Center. Wellpath informed the county in August it would not continue offering its services. The company had been named in several lawsuits over the years over inmate deaths. Just City, a nonprofit with the goal of improving the legal system and jail, said it wants the city to pick the best provider, not just the cheapest

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The Next Weekly Update Will Be Published On September 29