Weekly Update: September 12, 2023
Statutory Medicaid Changes For Justice Involved Juveniles: A COCHS FAQ

COCHS Weekly Update: September 12, 2023

Highlighted Stories

Editor's Note
As our subscribers know, since the passage of the Affordable Care Act, COCHS has been advocating ways in which eligible Medicaid beneficiaries can receive care when they are in a correctional institution. A provision in the Consolidated Appropriations Act of 2023 created a statutory vehicle through which juveniles will be able to receive this care.

COCHS has prepared a frequently asked questions document (FAQs About the New Statutory Changes to Medicaid –see below) that discusses these changes This document was prepared as a part of COCHS’ Beyond The Inmate Exclusion Project which was supported through a grant from the Robert Wood Johnson Foundation.

This FAQ is not exhaustive, and it cannot answer all of the significant questions that lay ahead regarding how these statutory changes will be implemented. However, it may provide an overview of what these modifications might mean.

The COCHS' perspective has always been that health care is a right and not a privilege and individuals behind the wall should have the same entitlement to healthcare as all other Americans. The provisions in Consolidated Appropriations Act of 2023 represent the first step on what we hope will be a very long road of statutory modification to the Medicaid Inmate Exclusion Policy creating equal access to care for all Americans, juveniles and adults alike.

COCHS: FAQs About the New Statutory Changes to Medicaid
This FAQ details how the statutory changes to Medicaid in the Consolidated Appropriations Act of 2023 will impact the health care of juveniles in the justice system. Beginning January 1, 2025, states will be required to implement a plan that offers screening, diagnosis, and case management services to sentenced juveniles up to 30 days before a release from a "public institution". Importantly, this FAQ explains that who is classified as a juvenile is how Medicaid defines a juvenile not how criminal justice systems may define a juvenile. Under Medicaid, a juvenile is someone who is under the age of 18 and qualifies for Medicaid coverage. However, in some cases, individuals who have aged out of foster care may still be considered "juveniles" until the age of 24.

Webinar Registrations

BJA: From Corrections to Community: Navigating the New Medicaid Section 1115 Demonstration Opportunity
The Bureau of Justice Assistance and the CSG Justice Center are offering this webinar for state and local corrections agencies and their state and community partners to hear directly from leaders in two states that have developed Medicaid Reentry Section 1115 demonstration proposals. Presenters will include state leaders from New Hampshire who have submitted a proposal to CMS to apply for an extension to the current 1115 demonstration and from Washington whose proposal was recently approved by CMS.

Legislative Analysis And Public Policy Association: Overdose Prevention and Treatment in Correctional Settings
This webinar is the third installment of the Legislative Analysis and Public Policy Association’s (LAPPA’s) Model Law Virtual Knowledge Lab series sponsored in partnership with the White House Office of National Drug Control Policy. The Knowledge Labs are a virtual learning series that provide stakeholders with an opportunity to deepen their awareness and understanding of how model laws can assist jurisdictions in addressing substance use disorders.

Data Collaborative for Justice: Showing Up: Strategies to Increase Court Attendance and Limit Pretrial Detention
Missed court appearances are a leading cause of warrants, unnecessary pretrial detention, and racial disparities in arrests. Join ideas42's (Un)warranted team and the Data Collaborative for Justice (DCJ) at John Jay College as we host a webinar featuring practitioners from across the country discussing effective strategies to ensure court attendance, reduce pretrial incarceration, and deliver accountability, justice, and fairness.


NC Health News: Medicaid expansion unlikely in NC in 2023 with lawmakers’ stalemate over budget
Kody Kinsley, head of the N.C. Department of Health and Human Services, announced Monday that uncertainty over the state budget may push the launch of Medicaid expansion into next year. In March, when North Carolina became the 40th state to pass legislation expanding access to Medicaid, the law’s implementation was tied to the passage of a state budget. But once negotiators from the state Senate and House of Representatives sat down to hammer out the differences between the two chambers’ priorities, the process ground to a halt.

Big Country News: Washington State to Extend Medicaid to People Close to Release from Prisons, Jails
Washington will allow people nearing release from state prisons and jails to qualify for Medicaid health coverage. The expansion starts in July 2025. Incarcerated Washingtonians, including those in juvenile facilities, can apply for Medicaid up to 90 days before their release.

Opioid Epidemic

Philadelphia Inquirer: Cory Booker is holding up a Camden jail as a national model for addiction treatment
U.S. Sen. Cory Booker is so impressed by the Camden County Correctional Facility’s programs to treat addiction among incarcerated people that he wants the nation to follow its example. In 2019, Camden became the first jail in the state to offer all three federally approved medication options to treat opioid addiction: methadone and buprenorphine, both opioid-based medications, and naltrexone, which blocks opioids from latching onto receptors in the brain.

Emergent: Nasal Spray Launches Over the Counter Making it Possible for Everyone to Help Save a Life from an Opioid Overdose Emergency
Emergent BioSolutions Inc. announced NARCAN® Naloxone HCl Nasal Spray 4 mg will be available on shelves nationwide and online beginning in September.


CUREUS: COVID-19 Infection Rates in Vaccinated and Unvaccinated Inmates: A Retrospective Cohort Study
This study analyzed COVID-19 surveillance data from January to July 2023 across 33 California state prisons, primarily a male population of 96,201 individuals. Low infection rates were noted in both the vaccinated and unvaccinated groups, with a small absolute difference between the two across age groups. A combination of monovalent and bivalent vaccines and natural infections likely contributed to immunity and a lower level of infection rates compared to the height of the pandemic.

Solitary Confinement

San Diego Union Tribune: Opinion: Solitary confinement is needlessly cruel and inhumane. We must explore alternatives.
During more than 24 years of incarceration in Central California Women’s Facility and Valley State Prison for Women, I spent over three years in solitary confinement. This experience was by far the worst part of my imprisonment. Life in solitary can also be uniquely uncomfortable for women. They often are watched by male prison staff, many of whom engage in harassment or inappropriate treatment of women. Some women are even forced to shower in front of male guards.

DCist: D.C. Councilmember Renews Push To Ban Solitary Confinement At D.C. Jail
Ward 1 D.C. Councilmember Brianne Nadeau is re-upping a years-long effort to ban solitary confinement at the D.C. Jail and other facilities operated by the city’s Department of Corrections. In a press release, Nadeau announced her intent to introduce the ERASE (Eliminating Restrictive and Segregated Enclosures) Solitary Confinement Act of 2023, which would ban all forms of solitary confinement for any reason — including for long-term suicide prevention or discipline.

Collateral Health Effects of Imprisonment

US News & World Report: When Parent Is in Prison, Kids' Heart Risks Rise
Along with having to deal with the social stigma of having a parent who is incarcerated, young adults in that situation may be more likely to develop signs of heart trouble, a new study finds. The study analyzed data from over 9,600 young adults between the ages of 33 and 44 in the National Longitudinal Study of Adolescent to Adult Health. They found that 14.1% of all participants, but 21.4% of Black participants, reported having been exposed to a parent or parental figure in jail during childhood. These participants were more likely than their peers to develop high blood pressure in adulthood.

BMC: Health decline in prison and the effects of sporting activity: results of the Hessian prison sports study
Previous studies about health in prisons conclude that incarceration has detrimental consequences for physical and mental health. It is associated with weight gain, decreased fitness, increased cardiovascular risks, and increased risks for mental illnesses, like depression and anxiety. Some qualitative studies highlight that sporting activity is beneficial for psychosocial health, as it seems to buffer stress, frustration, and loneliness and is a temporary escape from monotony. After taking part in a nine months long, supervised exercise program, male Italian prisoners showed a better mental well-being

State Roundup

AZPM: Pima County Jail Transition Center Opens
Pima County officially opened its new Transition Center at the Pima County Adult Detention Center on Thursday, Sept. 7. The facility is part of the county’s effort to reduce rearrests and individuals failing to appear in court. According to a county fact sheet , the most common charge for booking in the Pima County Jail is failure to appear in court. The Transition Center is aiming to solve this by giving new releases a free cell phone with three months of service.

Press Democrat: As California closes prisons, correctional officers land a $1 billion contract with raises and more
Thousands of California correctional officers are in line to get $10,000 bonuses through a new contract their union negotiated with Gov. Gavin Newsom’s administration as the state prepares to close several prisons. The tentative deal for the California Correctional Peace Officers Association is loaded with other incentives that collectively increase compensation for about 26,000 prison guards through a combination of raises, retirement perks and pay differentials for working overnight.

Sacramento Bee: Six Sacramento jail inmates have died this year. They won’t be independently investigated
Three inmates have died at the Sacramento jail so far this year of suspected drug overdoses — deaths that could have been prevented with adequate monitoring and detoxification, according to a new report by two medical professionals tasked with independently monitoring medical care of Sacramento inmates under a federal settlement. Lawyers at the San Quentin-based Prison Law Office suspect some of the drugs could be coming in from the staff, not the inmates.

Bakersfield.com: Dead inmates' families 'hope for change' after filing legal action against local jails
Families of former Kern County inmates are seeking justice through legal action after alleging deputies’ failure to ensure inmates' safety led to their loved ones dying, according to documents released afternoon as part of the Board of Supervisors' agenda.

WSB-TV: ‘No one should die in custody;’ NAACP, ACLU calls for change at Fulton jail after 10th inmate death
Two national organizations are calling on the Fulton County Jail to make improvements after officials confirm the deaths of 10 inmates so far in 2023. American Civil Liberties Union and the National Association for the Advancement of Colored People have said that the jail needs to make the necessary changes to housing inmates to prevent further deaths. The DOJ announced they will be doing a comprehensive investigation of the living conditions at the jail, access to medical care and mental healthcare, use of force and conditions that may give rise to violence against inmates.

AP: Dying and disabled Illinois prisoners kept behind bars, despite new medical release law
The Joe Coleman Medical Release Act is a pivotal criminal justice reform bill touted by Gov. J.B. Pritzker as an effective way to alleviate the state’s decrepit prison health care system, reduce the “staggering” costs of caring for ailing people in prison, and reunite families with frail loved ones. But a year-and-a-half since the Coleman Act went into effect, an investigation by Injustice Watch and WBEZ found far fewer prisoners have been released under the law than expected, as the medical release process has become mired in the charged politics of criminal justice reform.

Washington Post: Minn. prison emergency ends after 100 inmates had refused to return to cells
Officials placed a Minnesota prison on an emergency lockdown Sunday after about 100 inmates in one living unit refused to return to their cells, according to the Minnesota Department of Corrections (DOC). Inmates are now back in their cells, but union representatives for correctional officers said the situation highlights staffing problems that have degraded the quality of life for inmates and security for prison personnel.

Missouri Independent: Missouri prison officials restrict inmate access to books from friends or family
Missouri inmates will no longer be able to receive books from friends or family under a new policy adopted by the state Department of Corrections. These new restrictions arose after a decision last year to ban all physical mail from entering DOC facilities. The DOC cites contraband and illicit substances arriving through these channels as the reason for the new policy.

WESA: Allegheny County Jail ‘grossly understaffed,’ new audit reveals
Allegheny County Jail is “grossly understaffed,” according to a new audit from the county controller’s office. A report released found that the jail is short-staffed by more than 100 corrections officers and more than half of the facility’s budgeted healthcare positions are vacant

Bradford Era: Diversion programs combat crime, drugs, mental illness
As states deal with the mentally ill and drug users in the criminal justice system, many use diversion programs to steer people into help. Some reforms have been in the works in Pennsylvania, where recidivism rates have stayed high, albeit flat. If the programs work, they could keep more residents out of prison. Pennsylvania’s Department of Corrections’ Recidivism Risk Reduction Initiative has shown some progress since it began in 2008. Still, the commonwealth’s recidivism rate has slightly increased to 65%.

New York Times: Woman Gives Birth Alone in a Tennessee Jail Cell
A woman gave birth alone in a jail cell in Tennessee on Tuesday after seeking medical attention for more than an hour, the authorities said, raising questions about the care provided to the woman and her baby. The episode highlights issues about the incarceration of women and drew criticism from prison reform advocates who have raised concerns about pregnant women in prisons or jails being ignored and put at risk.

VT Digger: State officials argue Vermont’s fentanyl laws need updating. Changes look likely.
As opioid overdoses in Vermont continue to set records year after year, politicians appear likely to update the state’s laws around fentanyl, the drug responsible for the vast majority of deaths. Legislators in both chambers proposed the same suggestions earlier this year. H.312, introduced last session by three Republican lawmakers, would have changed the definition of “knowingly” possessing or distributing to “consciously ignoring a substantial risk that one or more preparations, compounds, mixtures, or substances contains” a regulated substance in question.

VT Digger: Corrections department chips away at staff vacancies in Vermont’s prisons
Despite the inherent challenges of the job, the Vermont Department of Corrections has cut staff vacancy rates within the state’s prisons by almost half in the last year. Last summer, Vermont’s prisons experienced acute staffing shortages, with union leadership highlighting an exhausting and untenable situation for rank-and-file staff.

State Safety Standards

FOX 25: 'Not in substantial compliance': Health inspection highlights ongoing issues with OCDC
State leaders say the Oklahoma County Jail is "not in substantial compliance." It's what the Oklahoma State Department of Health (OSDH) determined in their newest inspection of the facility. The nine-page report looks into things like sight checks and bed bugs. One of the issues, the OSDH mentions, is sight checks. According to the OSDH, "the facility failed to conduct and document at least one visual sight check every hour."

Houston Public Media: Another person dies in the Harris County Jail as pressure mounts from the state’s jail commission
Another man died while in custody at the Harris County Jail on Thursday, marking the 12th reported death from within the facility this year. This comes after a federal lawsuit was filed last month accusing the county of creating a "culture of death" inside the Harris County Jail. As of now, at least 12 people have died while in custody this year. For over a year now, the Harris County Jail has been noncompliant with state safety standards for a lack of timely medical care, keeping people in holding cells for longer than the legal limit and insufficient staffing levels within the facility.

Rikers Island

Gothamist: What a federal receiver can — and can’t — do for NYC’s troubled jail system
A federal judge recently agreed to hear arguments for and against appointing a receiver to oversee New York’s troubled jail system. Those are expected to start this fall, but questions around who, what, how and how long – are questions that will dominate the city’s criminal justice community throughout the proceedings. In crafting a potential consent decree and receivership, U.S. District Judge Laura Taylor Swain, who is handling New York’s case, must navigate what justice reform advocates say is a winnowing appetite in courts and localities for judicial control over local authority.

The City: Legal Aid Sues to See Canceled Jail Medical Visits Info
The city agency in charge of medical care for incarcerated people routinely cancels sick-call appointments when correction officers fail to bring a patient to jail clinics on three consecutive days, according to a lawsuit filed by the city’s largest public defender organization. The Legal Aid Society also contends that Correctional Health Services — a division of NYC Health + Hospitals — refuses to disclose more about the official missed-appointments policy and its impact on people who are locked up.

Gothamist: ‘We will close Rikers’ — Elected officials blast back at Mayor Adams
Elected officials and advocates stood in front of City Hall on Thursday with clocks made of posterboard and started a countdown for when the city jail on Rikers Island will close: four years from today. On Tuesday, Adams suggested that Rikers can’t be closed because there are too many people detained there. Adams spokesperson Charles Lutvak responded on Thursday, saying the administration will always follow the law, but that “ the plan passed by the City Council during the previous administration leaves open serious questions about the city’s ability to keep New Yorkers safe.”

Data Tools

Anne E Casey Foundation: Pro-DATA
Pro-DATA is an application for jurisdictions to gather and visualize their youth justice data on more than 100 measures, with the option to add unlimited additional measures to address local priorities. The application’s chartmaking capability helps users identify opportunities for improvement and track what interventions work — and don’t work, and for which groups of youth.

Staffing Shortages

Corrections 1: The shock factor of correctional officer training
With the majority of newly hired officers never having been exposed to prison-related work, correctional training academies are positioned to leave a significant imprint on those who will soon work in our nation’s prisons. Beyond preparing officers to carry out their correctional officer roles, training academies also can create a positive correctional culture and climate that could result in greater longevity on the job. However, a recent study found that training academies are failing in this aspect, with fewer rather than more officers expressing they intend to remain on the job long-term after undergoing training.


Politico: Federal judge says New Jersey law banning immigrant detention contract with private operator unconstitutional
A federal judge on Tuesday declared a New Jersey law that would ban a private immigration detention contract with federal authorities from being renewed “unconstitutional” — paving the way to keep the state’s last detention center open. The opinion by U.S. District Court Judge Robert Kirsch, sitting in Trenton, could allow the center in Elizabeth run by private corrections company CoreCivic to remain open just days before its contract was set to expire.

Press Reader: Sinema among top takers of private prison donations
U.S. Sen. Kyrsten Sinema, who left the Democratic Party last year to become an independent, is among the top recipients in recent years of political donations from private prison operator CoreCivic Inc., a departure from the norms of her former party. Arizona Democrats largely are critical of the private prison industry. Sinema herself, when she was serving in the state Legislature as a Democrat, was critical of private prisons on social media in 2010 and 2011, once calling them a “disaster.”

Correctional Health Care Vendors

Armor Correctional Health Services
The Tributary: Former Duval County jail medical provider failed to pay settlement on time, lawyer says
The Duval County jail’s former medical provider has landed itself back in court — this time for failing to pay the first sum in a wrongful-death settlement. Lina Odom, 28, died in 2018 after her extreme alcohol withdrawal symptoms were ignored, according to her family’s settled lawsuit. At the time, Armor Correctional Health Services handled care at the John E. Goode Pre-Trial Detention Facility.

Star Tribune: Minnesota inmate died from COVID-19 because prison doctors didn't act
Doctors and a prison health care agency are being sued for failing to prevent the COVID-19 death of a chronically ill inmate. If doctors had been looking out, they wouldn't have sent a senior citizen into a COVID hotbed and would have advocated for his early release. The state's contractor, Centurion Health, did not reply to a request for comment.

Business Insider: Prison healthcare giant Corizon reaches tentative bankruptcy deal that could shortchange prisoners; Sen. Elizabeth Warren pledges oversight
Corizon Health, once the nation's largest prison healthcare provider, reached a tentative bankruptcy deal last week that could leave hundreds of prisoners with pennies on the dollar for their medical malpractice claims. If the settlement is approved, it would mean that Corizon's owners succeeded in their use of a controversial financial maneuver called the Texas Two-Step. In a recent civil complaint, Isaac Lefkowitz, a company representative, said the Two-Step is used to "force plaintiffs into accepting lower payments."

Prime Care Medical
Altoona Mirror: Inmate medical care cost increasing
Blair County’s cost of medical care for inmates is increasing to $2.19 million annually — about $41,000 more a month than the county has paid since February when it extended PrimeCare Medical’s contract by six months. “We knew this was coming,” Commissioners Chairman Bruce Erb said Tuesday about the Harrisburg-based company’s new rate that equates to about 6% of the county’s annual revenue of $35 million in real estate taxes.

Yahoo: Whistleblower claims Westmoreland prison inmates lack sufficient mental health treatment
A former behavioral health clinician claims inmates at Westmoreland County Prison received substandard mental health care and that she was fired when she reported her allegations to the facility's private medical provider.Carla Rhodes claims her employer, PrimeCare Medical Inc. of Harrisburg, relied upon an unlicensed mental health professional to diagnose and prescribe treatments for inmates as part of what she described as sporadic remote meetings with patients, resulting in insufficient and improper care.

FOX 13: Inmates' health care at 201 Poplar questioned as Shelby County leaders to vote on new contract
$8 million. That’s the difference between two health care providers for the inmates at Shelby County Jail. With the current contract up within months, county leaders have issued denials to two companies and are looking to extend the contract of current provider, Wellpath. For one Memphis mom, she says she’s watched her son’s mental health deteriorate since he’s been awaiting trial in the jail.