Weekly Update: November 21, 2023
Does Privatized Correctional Health Care Really Save Money?

COCHS Weekly Update: November 21, 2023

Highlighted Stories

Editor's Note
Over the last several months, the Editor’s Note has consistently included stories that focus attention on proprietary correctional health care vendors. Recently the Weekly Update has commented on what many might consider to be the unsavory business practices of YesCare /Corizon/Tehum Care as well as lawsuits due to this company’s health care delivery (not to cast stones only at YesCare /Corizon/Tehum Care see the stories at the end of this Weekly Update concerning Armor and Wellpath).

This week we turn our attention to PrimeCare Medical. In 2022 a federal lawsuit was filed against the state of West Virginia and PrimeCare Medical over conditions at the Southern Regional Jail of West Virginia’s Division of Corrections. Now a year later, as the first highlighted story below reports, the Mountain State will settle that suit for $4 million dollars. The second highlighted story from York County (PA) reports that that jurisdiction and PrimeCare Medical have settled a lawsuit for $1.5 million to a family of an incarcerated person who died in York County’s jail. However, in the third highlighted story, the sheriff in Jefferson County (NY), boasts how privatizing health care delivery at the jail with PrimeCare Medical will be a cost saver for the taxpayer. Not to second guess the sheriff’s logic but he could be, as the old saying goes, “counting pennies on the floor while dollars fly out the window.” The “dollars flying out the window” being possible lawsuits that that county and PrimeCare Medical could face for similar reasons as those that occurred in West Virginia, York County and other jurisdictions.

Also included in our highlighted section is an update on Medicaid Coverage In Corrections. COCH’s Dan Mistak writes for the Center For Community Solutions on how Medicaid coverage in Ohio's correctional facilities could improve the health of the incarcerated population and reduce the strain on criminal justice and health systems created by the lack of health care continuity.

Privatized Correctional Health Care
Mountain State Spotlight: West Virginia to pay $4 million to settle lawsuit over conditions in Southern Regional Jail
West Virginia has agreed to pay $4 million to settle a class action lawsuit alleging inhuman conditions and improper treatment at Southern Regional Jail. The settlement was agreed only with the state, not with the counties, Wexford Health Sources or PrimeCare Medical of West Virginia, the medical care providers at the jail.

York Dispatch: Everett Palmer's family to receive $1.5M settlement following jail death
York County (PA) and its prison healthcare contractor will pay a combined $1.5 million to the family of Everett Palmer Jr., who died after being restrained at the jail in 2018. PrimeCare Medical Inc., the prison’s health care provider, will pay the Palmer family $500,000 to settle the portion of the suit that involved the company and staff, the settlement shows.

WWNYTV: Privatizing inmate medical care is ‘huge accomplishment,’ says sheriff
The most expensive new cost for Jefferson County (NY) in 2024 will be privatizing medical care for inmates at the county jail. “The biggest thing that could have happened. I consider this a huge accomplishment for the taxpayers, the incarcerated individuals, and the staff down at the correctional facility,” said Sheriff Peter Barnett. Shifting the responsibility and liability of the care from correctional officers to medical professionals. The jail currently outsources the services to a private company, PrimeCare.

Medicaid Coverage In Corrections
Center for Community Solutions: New Opportunities to Improve Linkages between Health and Justice Systems
COCHS’ Dan Mistak was asked to contribute his expertise concerning Medicaid 1115 waivers that would allow for Medicaid coverage of incarcerated people in Ohio. Ohio has been a Medicaid innovator, having launched the Medicaid Pre-Release Enrollment Program in 2014 in cooperation with the Ohio Department of Rehabilitation and Correction.

Healthcare Innovation: Medicaid Waivers Should Be Leveraged to Improve Care for the Incarcerated
Waivers provided under Section 1115 of the Social Security Act could offer the opportunity for state governments to modernize carceral healthcare. Ensuring that carceral health care is independently financed and operated would be one step toward modernizing care delivery. Health care contracts and budgets are generally overseen by security officials, many of whom have limited expertise in and experience with health care provision.

Jail/Prison Conditions

Department of Justice: Associate Attorney General Vanita Gupta Delivers Remarks at Jails and Justice Support Center Event
I don’t have to tell anyone here that managing jails is a challenging endeavor. People often enter jails with a range of untreated needs — trauma, substance use disorders, mental and behavioral health challenges — and society has for too long put a lot of these issues at the feet of jail administrators without adequate support or investments in community-based treatment and solutions.

Carolina News: We can do better on prisons
Homicides in jail happen at double the rate as in the United States in general, as do suicides. Staff shortages and negligence can provide the means and opportunity for prisoners to kill themselves or others. In addition to staffing issues, part of the overcrowding and inhumane conditions can be blamed on the sheer number of prisoners we are attempting to hold. Looking at the annual cost of keeping a prisoner ($52,880 in NC) and the cost of behavioral health treatment like rehab (also about $50,000), it doesn’t appear to save money.

The Conversation: We studied jail conditions and jail deaths − here’s what we found
Relatively high turnover rates in jail are associated with higher death rates overall, as well as due to suicide, drugs and alcohol, and homicide. In addition to revealing a relationship between turnover rate and mortality, research shows that the presence of greater proportions of non-Hispanic Black people in populations of relatively large jails was associated with more deaths due to illness.

JHND: Nudging food choice in a prison setting: an investigation using food choice data
Diet has a clear role in prisoner health, and the prison food environment within which food choices are made is relatively under–researched. The aim of this study was to examine whether food choices in a women's prison changed after the introduction of a new menu design by the catering team.

Solitary Confinement

WTTW: US Supreme Court Rejects Appeal of Illinois Prisoner Kept in Solitary Confinement for 3 Years
The Supreme Court declined to take up the appeal of an Illinois inmate whose lawyers argued his rights were violated when he was kept in solitary confinement for some three years and denied virtually all access to exercise. Illinois Attorney General Kwame Raoul told the justices in court papers that as a result of “persistent misconduct,” he was “on yard restrictions” from January 2014 to August 2016 but that he regularly met with doctors and mental health professionals supplied by the prison healthcare provider.

Racial Disparities

Vera: Elections are Warped by Prison Gerrymandering Year After Year
In the vast majority of states, voters will be casting their ballots in legislative maps misshapen—sometimes dramatically—by prison gerrymandering, the practice of counting incarcerated people where they are detained, rather than in their actual homes. This method has been used since the first U.S. census in 1790. While this practice has always been unjust, the explosion of racialized mass incarceration over the past decades has exacerbated its impact.

Press Democrat: Bay Area doctor claims no evidence of harm from allegedly racist experiments on inmates
A San Francisco Bay Area dermatologist and university professor accused last year of using state prisoners in decades-old experiments that included pesticide injections has denied in a legal filing that his accusers had any evidence he caused harm. Dr. Howard Maibach filed a court petition challenging a University of California at San Francisco report accusing him of using “questionable research methods” in experiments in the ’60s and ’70s on at least 2,600 male inmates at the California Medical Facility.

Urban Institute: Exploring Racial Disparities in Arrests among Native Americans in Flagstaff, Arizona
A recently released study by the Southwest Center for Equal Justice examining racial disparities in policing practices in Flagstaff, Arizona, found that Native Americans were arrested at nearly 12 times the rate of white people, most often for misdemeanor “quality-of-life crimes,” minor infractions that, according to police, disrupt the quality of life among neighborhood residents and may lead to more serious future crimes.

New York Times: They Wanted to Get Sober. They Got a Nightmare Instead.
Prosecutors and tribal leaders call it one of the largest, most exploitative frauds in Arizona’s history — a scheme in which hundreds of rehab centers provided shoddy or nonexistent addiction treatment to thousands of vulnerable Native Americans that cost Arizona as much as $1 billion. Navajo activists in Phoenix, who first alerted authorities more than a year ago to problems inside the sober-living homes, say they have tracked the deaths of at least 40 Native Americans who had been at these homes.

Women's Health Issues

Medscape: Menopause Behind Bars Challenges Patients, Clinicians
Research on menopause care in prisons and jails indicates that incarcerated women do not receive the treatment that they need. Meanwhile, from 1980 to 2021, the number of incarcerated women rose to 168,449, an increase of 525%. A report from the United States Commission on Civil Rights found that correctional facilities neglect the needs of incarcerated women and girls. Clinicians do not ask their patients about possible menopause symptoms, patients feel too ashamed to bring up symptoms.

Opioid Epidemic

JAMA: Recent Incarceration, Substance Use, Overdose, and Service Use Among People Who Use Drugs in Rural Communities
Results from a survey of almost 3,000 people in eight rural areas nationwide who report using illicit drugs show that 42% had been incarcerated, either in prison or local jails, in the preceding six months. The findings suggest a prime opportunity to tackle the nation’s opioid crisis by expanding addiction treatment to people while they’re incarcerated. Currently, access to proven therapies such as medication to treat addiction is limited or unavailable in many jails.

NH Business Review: NH aims to reimburse jails’ drug treatment costs with latest opioid settlement money
The commission deciding how New Hampshire will spend millions of dollars received from a settlements with opioid manufacturers and distributors plans to use $9.4 million to reimburse six county corrections departments and one local police department for past expenses related to the drug crisis.

Data & Statistics

BJS: Federal Deaths in Custody and During Arrest, 2021 – Statistical Tables
This report presents statistics on deaths that occur during federal arrest, detention, and incarceration in the United States. It describes decedent, incident, and facility characteristics of deaths in federal custody and during arrest by federal law enforcement agencies during fiscal year 2021.

NACJD: New Criminal Justice Dataset Releases
The National Archive of Criminal Justice Data (NACJD) is publishing 13 new studies, including new data from the National Crime Victimization Series (NVCS). Other newly released data cover topics such as intimate partner violence (IPV), recidivism, juvenile crime, and more. Please click on the study titles linked below for more information about a particular study.

State Roundup

KTAR: Arizona prisons reach deal with DOJ to remedy visual impairment support
The U.S. Justice Department announced last week the Arizona Department of Corrections, Rehabilitation, and Reentry has agreed to adopt systemwide reforms to correct and prevent discrimination against incarcerated people with vision disabilities.

White Mountain Central: Cost of prison healthcare, tax cuts and Medicaid adds pressure to state budge
Arizona’s prison system will boost spending and medical staffing for prison health care by more than a third as it works to meet a federal judge's orders that it vastly improve treatment of the prisoners in state-run prisons, but the move puts added pressure on a state budget. Much of that pressure is blamed on a massive income tax cut enacted in by the Republican-controlled Legislature and former Gov. Doug Ducey that got rid of graduated tax rates and replaced them with a flat rate.

Legislative Analyst's Office: Overview and Update on the Prison Receivership
California’s prison medical system has been under direct management of a Receiver appointed by a federal court since 2006 because the state was found to be providing unconstitutional levels of care in a case now referred to as Plata v. Newsom. This brief provides an overview of the establishment of the Receivership and the key changes to prison medical care made by the Receiver to date.

Sacramento Bee: One-third of California prisons provide ‘inadequate’ medical care, watchdog report says
A third of California’s adult prisons provide an “inadequate” level of medical care to their inmate patients, according to the most recent inspections from the state’s prison watchdog. Of the 34 facilities 11 provided “inadequate” care to their patients. Twenty-three institutions earned “adequate” rankings, and no facilities earned the top designation of “proficient.”

New York Times: Justice Dept. Watchdog Describes Unsanitary Conditions at Florida Prison
When inspectors with the Justice Department’s internal watchdog appeared unannounced at a federal women’s prison in Tallahassee, Fla., they expected to find serious problems but what they encountered shocked them: Moldy bread, rotting vegetables, breakfast cereal and other foods crawling with insects or rodents, cracked or missing bathroom and ceiling tiles, mold and rot, leaky roofs stoppered with plastic bags, windows blocked with feminine hygiene products.

Reason: Florida's Bloated Prison System Will Cost Billions To Maintain
Florida's crumbling prison system and aging prison population will cost the state billions to maintain, according to a newly released report commissioned by the state. A report presented to Florida state lawmakers says that Florida will have to pay somewhere between $6 billion and $12 billion over the next 20 years to keep its troubled Department of Corrections afloat.

The Advocate: Judge orders federal oversight of Angola, calls inmate medical care 'abhorrent,' 'cruel'
A judge has ordered federal oversight of the Louisiana State Penitentiary at Angola, saying the prison has continued to violate inmates' constitutional rights by systematically ignoring their medical needs — despite the court's ruling officials must fix the problem. U.S. District Judge Shelly Dick blasted prison officials for "the callous and wanton disregard for the medical care of inmates at Angola." The Department of Corrections released a statement saying it will be appealing the decision.

WGBH: Massachusetts becomes fifth state in nation to make prison calls free
Massachusetts this week became the first state in New England and the fifth in the nation to make prison and jail calls free. The move is a victory for advocates and legislators who have sought to lessen the burden on prisoners communicating for years — and through many legislative sessions.

Second Wave: Lack of data raises questions about quality and cost effectiveness of Michigan's prison health care
The Citizens Research Council of Michigan (CRC) recently reported that Michigan prisons spend approximately $300 million per year to provide health care for more than 30,000 prisoners. Even after adjusting for inflation, the average per-prisoner health care cost has increased 34% over the last two decades. According to Michigan advocates for incarcerated people, health care in prison is far less than adequate.

New York
New York Times: New York Will Give a ‘Clean Slate’ to Formerly Incarcerated People
Roughly two million people convicted of crimes in New York may be eligible to have their records sealed as part of a broad criminal justice initiative that was signed into law by Gov. Kathy Hochul. Under the so-called Clean Slate Act, people who complete their sentences and remain out of trouble for a set period — three years for misdemeanors, eight for eligible felonies — will have their convictions sealed.

WIVB: Former correctional health director pleads guilty to falsifying timecard
A former Erie County correctional health director accused of lying on her timecard to collect fraudulent pay pleaded guilty to a misdemeanor charge, Erie County District Attorney John J. Flynn announced. Former Director of Correctional Health for the Erie County Sheriff’s Office Christa M. Cutrona, 46, admitted to one count of falsifying business records in the second degree.

Yahoo News: Lawton inmate was denied medical care for four days before he died, lawsuit says
After an X-ray revealed a life-threatening injury, nurses, a doctor and prison guards locked Justin Barrientos in a cell where he suffered for hours without care and lay dead for more than 90 minutes before anyone noticed. Almost 10 months after his death, no charges have been filed, spurring Barrientos’ mother to seek justice in court. Linda Gray is suing The GEO Group, the publicly traded company that operates Oklahoma’s lone private prison.

Oregon Capital Chronicle: After critical report, Oregon Department of Corrections plans changes at women’s prison
A state-ordered report on conditions at the women's prison, Coffee Creek Correctional Facility, found an unsafe, harsh environment and retaliatory culture that punishes women who report wrongdoing, including sexual misconduct. A former nurse was recently sentenced to 30 years in prison for sexually assaulting incarcerated women, and a corrections sergeant currently faces charges of sexual misconduct. Gov. Tina Kotek has ordered the Oregon Department of Corrections to make immediate changes within 60 day.

NPR: The severe beating of a Texas inmate underscores staffing and training crisis
Thirteen guards from a North Texas prison were fired or resigned after a brutal beating in September left an inmate in a coma, likely for the rest of his life. Some inmates and former staffers say an acute shortage of guards is leading to more violence in some Texas prisons, and they warn it may only get worse.

Rikers Island

New York Times: Federal Prosecutor Asks Judge to Strip New York of Control Over Rikers
The federal government on Friday formally joined an effort to strip Mayor Eric Adams’s administration of control over Rikers Island, asking a judge to hand oversight of the troubled jail complex to an outside authority. Joining lawyers who represent people detained in New York City jails, Manhattan’s top federal prosecutor, Damian Williams, wrote in a court filing that the appointment of an outside authority, known as a receiver, was the only solution to the persistent violence and chaos at Rikers.

Los Angeles County

Los Angeles Daily News: How LA County is fighting drug smuggling into juvenile halls
Six months after the fentanyl-related death of an 18-year-old detainee, the Los Angeles County Probation Department plans to create an investigative team to trace the flow of drugs into the county’s juvenile facilities. At least six youth in custody have been hospitalized. Searches at Barry J. Nidorf recovered more than 120 pills “resembling fentanyl” in the first three months of this year

Los Angeles Daily News: Second youth escapes from Los Padrinos in four months, prompting call for security overhaul
Los Angeles County Supervisor Janice Hahn plans to call for an investigation and a security overhaul at Los Padrinos Juvenile Hall following a weekend escape, the second in just four months since the facility reopened.

Los Angeles Times: Four L.A. sheriff's employees died of suicide in 24 hours
The suicide deaths of four current and former Los Angeles Sheriff’s Department employees over a 24-hour span have prompted a plea from Sheriff Robert Luna urging deputies to check on the well-being of their colleagues and friends.

San Diego County

San Diego Union Tribune: As deaths and lawsuits pile up, sheriff releases a 10-year plan to modernize aging San Diego jails. Here’s what’s in it.
Faced with multiple lawsuits, a brutal state audit and a growing number of deaths inside San Diego County jails, Sheriff Kelly Martinez has introduced an ambitious — and costly — 10-year plan to upgrade the region’s aging detention centers. The Sheriff’s Department introduced what it calls a strategic framework for renovating and replacing the county’s seven-facility jail system. The planning, design and construction of county jails will cost almost $500 million over the next decade.

San Diego Union Tribune: Federal lawsuit over conditions and treatment in San Diego County jails wins class-action status
What began as a federal lawsuit accusing the San Diego Sheriff’s Department of discriminating against a dozen or more people in county jail with various disabilities has expanded into a case that now involves thousands of current and future detainees. Judge Anthony Battaglia has granted a motion to certify the complaint initially filed in early 2022 as a class-action lawsuit.

Criminal Justice's Detrimental Impact On Mental Health

KevinMD: From mental health facilities to prisons: a concerning shift
At the same time mental health institutes were being defunded, prisons were being built at a record rate, especially for-profit ones. Contracts were signed guaranteeing that a certain number of citizens would be delivered to the incarceration system, and no one designs a better industrial system than the good old US of A. Very quickly, the number of incarcerated Americans per capita came to closely match the number of previously institutionalized, and by 2001.

ProPublica: Mississippi Jailed More Than 800 People Awaiting Psychiatric Treatment in a Year. Just One Jail Meets State Standards.
Fourteen years ago, Mississippi legislators passed a law requiring county jails to be certified by the state if they held people awaiting court-ordered psychiatric treatment. Today, just one jail in the state is certified.

Correctional Health Care Vendors

KRIS: Medical Service Provider for Nueces County Jail in "Substantial Debt"
The company that provides medical services for the Nueces County Jail is running out of money. Armor Health Management was first hired by the county in 2020. Court documents show the company has substantial debt equating to over 150 million dollars, and eighty pending lawsuits. Armor has asked a Florida judge to transfer that contract to another company... headquartered at the same address.

Corizon/YesCare/Tehum Care Services
Reuters: Prison healthcare company restarts mediation after bankruptcy judge Jones quits
Prison healthcare company Tehum Care Services received court approval to proceed with a new mediator who will replace former bankruptcy judge David Jones, who resigned from the bench over his romantic relationship with an attorney involved in the negotiations. Tehum Care, which filed for bankruptcy in February to address prisoners' medical malpractice lawsuits against its corporate predecessor Corizon Health, had reached a mediated bankruptcy settlement which would have allocated roughly $8.5 million to settle prisoners' and former prisoners' claims.

Baltimore Banner: He was owed $770K for botched treatment of a wrist fracture in jail. Then a bankruptcy got in the way.
In 2021, Dennis Hall won a $3 million jury award that was capped at nearly $800,000 by state law. But the forces behind Corizon Health, the company that owed Hall the money, had other plans. Days after he won his case, in February 2023, Corizon declared bankruptcy. The correctional health care giant has drawn scrutiny from watchdogs and the media for its maneuvers. It converted into a Texas company before splitting into two entities Tehum Care Services, which was saddled with debt and is now bankrupt, and the other entity, now known as YesCare, that is retaining contracts worth hundreds of millions.

WRDW: Augusta fast-tracks change in jail medical provider
After years of complaints about the current Richmond County jail medical provider, Augusta leaders aren’t wasting any time in changing things. The Augusta Commission had already decided to drop WellPath and move forward with VitalCore Health Strategies as the new provider starting Jan. 1. But on Tuesday, commissioners decided to make the change sooner. Instead, the new contract will take effect Dec. 1.

PR Newswire: Multiple Wrongful Death Lawsuits Filed Against Monterey County Jail Amid The Jail And Wellpath's Continued Failures
Attorneys for 6 families filed lawsuits and claims alleging negligence and civil rights violations leading to the wrongful death of inmates at Monterey County Jail. Monterey County Jail and Wellpath routinely failed to meet basic compliance standards, putting inmates in danger both in terms of their physical and mental health. Wellpath has continually failed to comply with the agreement. As a result, Monterey County Jail's death rate is more than twice the national average, and the suicide rate is more than three times the average for California jails.

Happy Thanksgiving!
COCHS Weekly Update Will Not Be Published Next Week