Expansion/Non-Expansion States, Medicaid 1115 Waivers, Section 5121 & Oversight Organizations: What does it all mean in a Trump Administration?

Highlighted Stories

Editor's Note

This week's Editor's Note, along with the highlighted articles, explores the effectiveness of oversight bodies responsible for ensuring adequate healthcare in local jails. It focuses on San Diego County, California; Bexar County, Texas (San Antonio); and Oklahoma County, Oklahoma (Oklahoma City). The articles often reveal that oversight organizations often fall short in preventing negative health outcomes. As our subscribers probably suspect, we will also discuss what role Medicaid could play in these jurisdictions: whether that jurisdiction is in an expansion or non-expansion state and whether that state has obtained an 1115 waiver for providing pre-release coverage during the last 30 or 90 days of incarceration. Important for this discussion is how Section 5121 of the Consolidated Appropriations Act of 2023 is even more of a game changer given the uncertainties about Medicaid with Republicans in control of Congress and the Presidency in 2025.

The first highlighted article focuses on proposed stricter oversight at the jail in San Diego County. As the article notes, a state audit revealed that the county’s jails have the highest mortality rate in California. In response, newly elected Supervisor Monica Montgomery Steppe has proposed expanding the authority of the Citizens’ Law Enforcement Review Board (CLERB) to include oversight of jail medical staff and contractors. However, the article also states that CLERB’s role is purely advisory, and its recommendations are frequently rejected by the sheriff.

The next highlighted article is about the jail in Bexar County, The Texas Commission on Jail Standards (TCJS) recently found the county jail out of compliance with state health and safety standards. In 2024 alone, there have been 13 deaths in the jail. Healthcare in the facility is provided by University Health System, a public hospital system owned and operated by Bexar County and serving as the teaching facility for the University of Texas. Unlike CLERB in San Diego, the TCJS appears to wield more influence. Both the jail and University Health System are implementing plans to address the deficiencies, though their efforts could be seen as reactive as opposed to proactive, given the alarming number of deaths that occurred before TCJS found the jail out of compliance.

Now looking to Oklahoma County, in the neighboring state, the next set of articles detail what can only best be described as a rather uncollegial relationship between jail and oversight organization. The Oklahoma County Criminal Justice Authority (OCCJA), which is the governing body in control of operations at the jail had this summer refused the State Department of Health to exercise its right to carry out unannounced inspections. The OCCJA sued the State Health Department to prevent unannounced inspections but a judge ruled in favor of the State Health Department, a decision that dismayed the OCCJA. Additionally, the State Health Department has taken the issue to the Oklahoma Supreme Court addressing the same issue. Unlike San Diego or Bexar County, the OCCJA responded to oversight, in a novel way, by simply not permitting oversight of the State Health Department. (For more context on this Oklahoma County story see the Editor’s Note of September 17.)

From all these articles, our subscribers might understand why COCHS has a pessimistic view of oversight organizations and their effectiveness. Sheriffs like the one in San Diego County don’t pay attention to them. State organizations like the one in Texas seem to exert its influence only after a number of deaths have occurred and Oklahoma County…well that state of affairs speaks for itself.

Looking at these articles now from a Medicaid lens let’s parse the different jurisdictions and the impact Medicaid might or might not have.

California is the first state to have its 1115 waiver approved. It is currently being rolled out in Inyo, Yuba and Santa Clara Counties. All counties will have to implement it by Oct 1, 2026. Will this impact the healthcare delivery in San Diego County? Medicaid requirements are not advisory, which might be to the chagrin of the sheriff.

The hope that 1115 waivers might improve healthcare in corrections, is probably not germane for either Texas or Oklahoma. Texas is a non-expansion state. Texas therefore would probably never submit an 1115, as coverage is not likely to apply to the bulk of single males that are incarcerated in Bexar County or any other county in Texas for that matter. Oklahoma, on the other hand, is an expansion state but chose not to submit a waiver. COCHS usual refrain of pinning hopes on 1115 waivers to bring about change is therefore not applicable to these jurisdictions.

Now it’s time to speak frankly. The issue of Medicaid expansion and 1115 waivers could become more complex under the incoming Trump administration, as highlighted in the next two articles from the Kaiser Family Foundation. That article notes that some Republican proposals aim to reduce the federal match rate for the expansion population from 90% to the standard Medicaid match rate. In certain expansion states, trigger laws could take effect if the rate drops below 90%, potentially ending or modifying expansion. As of this writing, a few states with 1115 waivers appear to fall into this category (Arizona, Arkansas, Illinois, Montana, New Hampshire, North Carolina, and Utah), perhaps raising questions about the viability of those 1115 waivers.

Until changes to Medicaid are enacted, it may be more productive to focus on the statutory requirements of Section 5121 of the Consolidated Appropriations Act of 2023. This particular section ensures juveniles have access to case management and other healthcare services. The last highlighted article from the CDC and a COCHS’ FAQ from last year highlight how Medicaid and the criminal justice system define "juvenile" differently—sometimes extending coverage to individuals up to 26 years of age. Translated that means many individuals might be covered by Medicaid regardless of a state’s expansion status or 1115 waiver.

Section 5121 takes effect on January 1, 2025, a little over three weeks from today. Do not expect the dynamics that exist between jail and oversight organizations to be any less fraught with this statutory change. But do expect that these Editor’s Notes will have a lot to say about what might transpire in the coming year.

San Diego County, California

A February 2022 audit reported 185 jail deaths statewide from 2006 to 2020, with San Diego County having the highest mortality rate among California counties. Nearly three years later, Supervisor Monica Montgomery Steppe proposed expanding the jurisdiction and authority of the Citizens’ Law Enforcement Review Board (CLERB) to improve oversight of the Sheriff’s Office and Probation Department The proposed expansion of CLERB’s jurisdiction would include jail medical staff and contractors. The CLERB has been historically understaffed and underfunded, and its policy recommendations and disciplinary findings are strictly advisory. In the past the sheriff has rejected almost two-thirds of the 91 separate recommendations of the CLERB.

Bexar County, Texas

The Texas Commission on Jail Standards (TCJS) has deemed the Bexar County Jail noncompliant, prompting the Bexar County Sheriff's Office (BCSO) to submit a plan of action to regain compliance. So far in 2024, the jail has recorded 13 deaths. The TCJS identified two critical issues requiring corrective action: an inmate held in holding for too long and another not receiving prescribed medication. University Health, the jail's healthcare provider, has introduced measures to ensure accurate medication distribution. Meanwhile, the BCSO plans to implement 48-hour reports to monitor prisoners awaiting housing assignments. Additionally, they intend to introduce radar technology capable of detecting inmate motion, heart rate, respiration, and occupancy, enhancing overall safety and monitoring.

Oklahoma County, Oklahoma

The Oklahoma County Criminal Justice Authority, which operates the Oklahoma County Jail, has filed a lawsuit against the State Department of Health, claiming it does not have the power to conduct unannounced jail inspections. The petition was filed after the jail failed two unannounced health inspections by the State Department of Health this summer.

State health inspectors "shall" be allowed to conduct unannounced inspections of the Oklahoma County jail, even if it disrupts operations, following District Judge C. Brent Dishman's dismissal of the jail trust's lawsuit to restrict such access. Inspectors were denied entry during surprise visits on June 25 and July 9. The trust's attorneys argued that statutes granting inspectors access didn’t explicitly allow unannounced visits. However, a yearlong investigation by The Oklahoman revealed the jail as one of the deadliest in the country. Jail CEO Brandy Garner, present in court, appeared visibly shocked by the ruling.

The Oklahoma State Department of Health wants the Oklahoma Supreme Court to order the Oklahoma County jail trust to let its inspectors in without notice, although District Attorney Vicki Behenna argues that the department has no such authority and that surprise inspections are disruptive to operations. The department went to the high court after the jail trust sued in district court, asking a judge to permanently block surprise inspections.

When the Oklahoma County jail lost its health care provider in October, it also lost medical malpractice insurance coverage, leaving it — and county taxpayers — exposed. Turn Key Health, the former jail health care provider, had malpractice insurance that is not available to the jail as an institution, but is obtainable by individual physicians and other medical practitioners working for it. The county is self-insuring, meaning it has to pay out of pocket for any problems.

Trump Administration & Medicaid

With President-elect Trump returning to the White House and Republicans controlling Congress, significant changes to Medicaid are expected. One potential target for federal spending reductions is the Affordable Care Act’s (ACA) Medicaid expansion. Rather than repealing the ACA outright, some conservative and Republican proposals would instead lower the federal match rate for the expansion population from 90% to the standard Medicaid match rate, which is calculated based on a state’s per capita income and ranges from 50% to 83%. Twelve states have “trigger” laws in place that would automatically end expansion or require other changes if the federal match rate were to drop below 90%.

With Donald Trump’s return to the White House and Republican control of Congress in 2025, the Affordable Care Act’s Medicaid expansion faces renewed threats. Over 3 million adults in nine states could lose coverage if the GOP cuts extra federal Medicaid funding, as these states have trigger laws that would end expansions if funding decreases.

Section 5121

Effective January 1, 2025, Medicaid and Children’s Health Insurance Program (CHIP) are required to provide select services to certain eligible youth, including some youth under 21 years of age or under 26 years of age with a history of foster care, who are incarcerated and within 30 days of their scheduled release date following adjudication. The new coverage requirements include screening, diagnostic, and case management services, as outlined in CMS guidance. In addition to this mandatory coverage, states will have the option to provide Medicaid coverage to eligible youth who are incarcerated pending disposition of charges and/or to consider children who are pending disposition of charges as eligible for CHIP during that time

Opioid Epidemic

Opioid overdoses have claimed the lives of some 2,000 people in Massachusetts for eight years, a trend continuing in 2024. One population is particularly vulnerable are people who have recently left prison or jail. But medications approved for treating opioid use disorder — Suboxone, naltrexone and methadone — has helped prevent overdoses. People in the jail also have access to the medication as they wait for trial or serve out their sentences. Adam DeYoung, who was incarcerated at the Middlesex jail, said knowing he could get access to methadone in jail was a deciding factor in his decision to turn himself in.

Drafted in collaboration with the O’Neill Institute for National and Global Health Law at the Georgetown University Law Center, the purpose of the Model Building the Substance Use Disorder Workforce of the Future Act is to address the current and projected shortage of professions for the substance use disorder workforce. This legislation guides states in adopting a strategy that supports and advances immediate, intermediate, and long-term measures to build and sustain an SUD workforce.

Traumatic Brain Injury

Experts are only now beginning to recognize the connection between brain injury and incarceration. It’s estimated that nearly 45 percent of people who have been involved with the American criminal justice system have a history of brain injury. Some research suggests rates of brain injury among incarcerated women are 5 to 7 percentage points higher than for incarcerated men. Brain injuries often result in overwhelming feelings of disinhibition, mood swings, overreaction and even acts of rage, which can lead to criminalized behaviors. Colorado requires the state to create a pilot program to offer screenings for brain injury to individuals in the criminal justice system who are about to be sentenced.

Mental Health

Deputy Attorney General Lisa Monaco today announced over 50 new actions the Justice Department will take to reduce the risk of death by suicide of adults who are detained or incarcerated in the custody of the U.S. Marshals Service (USMS) or Federal Bureau of Prisons (FBOP). These actions follow from recommendations developed by a working group of experts, from across the Department, tasked by the Deputy Attorney General with creating a multifaceted approach to reducing the risk of suicide and self-directed violence among those in the Department’s care and custody.

Two more Hawaii inmates have died in prison this fall in what corrections officials believe were suicides, bringing the number of confirmed or suspected suicides in the system this year to four. That would be the largest number of known suicides in the state correctional system in a single year since at least 2020. The recent deaths come at a time when the state prison system is the target of a class-action federal lawsuit demanding improvements in the mental health services provided for Hawaii prisoners. That lawsuit was filed by Honolulu lawyer Eric Seitz, who has described mental health services in the state system as “absolutely atrocious.” The lawsuit seeks appointment of a special master to oversee mental health treatment for Hawaii prison inmates.

The Ninth Circuit held two hearings Friday in Coleman v. Newsom, a decadeslong class action focused on mental health care for California inmates who claim the state isn’t doing enough to address serious mental disorders in the corrections system. In its appeal of two court orders from the Eastern District of California, the state argued the lower court overstepped its authority by levying a $6.7 million fine for every month the state is out of compliance with previous court orders. The bill has topped $130 million. Today, the case covers all prisoners with serious mental disorders housed in California state prisons — around 34,000 people known as the “Coleman class.”

Mad Moms began in Colorado, inspired by Angry Moms, an Arizona group advocating for mental health reforms. Both groups aim to push for changes to clozapine regulations, a drug for schizophrenia and anosognosia, a condition where the brain can't recognize illness. Current rules require frequent blood draws and strict communication between doctors and pharmacists, which Mad Moms say makes it hard for patients to stay on the drug or find prescribing doctors.

BOP

The federal Bureau of Prisons is permanently closing the notorious "rape club" women's prison in Dublin, California, and will idle six facilities in a sweeping realignment after years of abuse, decay and mismanagement. After repeatedly promising to reform FCI Dublin and other troubled facilities, Bureau of Prisons Director Colette Peters is pivoting to closures and consolidation, citing inadequate staffing and staggering costs to repair aging infrastructure. Since 2021, at least eight employees, including a former warden, have been charged with sexually abusing inmates.

Issues in Corrections

Across the United States, state prison systems are grappling with chronic understaffing and overcrowding — dual crises that are keeping incarcerated people confined to their cells for far longer periods than in recent decades. Lockdowns are common in jails and prisons nationwide, but most usually last only a few hours or days. Recently, lockdowns have been extended for weeks or even months at many facilities suffering staff shortages. In some cases they have intensified tensions within prison walls, at times contributing to violence between incarcerated people and staff, increased drug use and deaths by suicide.

Rutgers is one of several universities forming "academic-correctional health partnerships" to provide healthcare for inmates and detainees. These partnerships began in Texas in the 1990s and have since spread to states like New Jersey, Georgia, and Connecticut. While most programs are small, some universities, like Rutgers, have taken over healthcare delivery for entire state correctional systems, replacing government agencies. Academic medical centers are now the second most common source of inmate healthcare nationwide. Advocates claim these partnerships bring the expertise of scholars and university-affiliated doctors to prisons, but evidence of improved health outcomes is scarce. In some cases, these programs have been canceled for being as ineffective—or worse—than the systems they replaced.

State Roundup

Alabama

A security guard at an Alabama prison was arrested on drug trafficking charges. Law enforcement agents arrested Alesia Jarrett on Tuesday, the Alabama Department of Corrections said. Jarrett is a prison guard at Elmore Correctional Facility. Jarrett was found in possession of about 250 grams of methamphetamine, the prison system said in a news release. She had been under investigation for suspected drug smuggling into the facility, the agency said.

A contract employee for Bullock Correctional Facility and an alleged accomplice were arrested. The Alabama Department of Corrections says the pair tried to evade a vehicle checkpoint, prompting a traffic stop. According to ADOC, a search of their vehicle revealed 1 gram of methamphetamine, 30 grams of marijuana and 5 grams of cocaine.

California

L.A. County’s chief probation officer said he plans to depart the troubled agency as a deadline to evacuate Los Padrinos Juvenile Hall approaches, sources said, potentially leaving more than 200 incarcerated youths with no place to go. Viera Rosa’s unexpected departure would cap a 20-month stint during which he failed to reform an agency whose juvenile halls again face the threat of closure under mounting scrutiny from oversight agencies and the California attorney general’s office.

Florida

Dionne Alexander was waiting in a Jacksonville courtroom for the hearing of her husband, Maurdrik when a bailiff told her that her husband’s hearing would be postponed: He had collapsed on his way to court from the Duval County jail and was rushed to UF Health Jacksonville. Maurdrik lay in a hospital bed for days while his wife was denied the chance to speak with him or learn about his condition. “I’m his wife,” she said. “Don’t I have the right to know what’s happening?” According to experts and those taking care of Maurdrik, the answer is no.

Maryland

Maryland’s Department of Public Safety and Correctional Services has failed to properly manage and oversee contracts with private companies that provide medical and mental health care to prisoners in state-run detention facilities, according to a newly released audit. Outsourcing prison medical care is becoming increasingly common across the country, but the practice often draws criticism and lawsuit. In Maryland, the system has recently resulted in “consistent failure to provide the minimum staffing and properly complete key health examinations of incarcerated individuals.”

Missouri

Dean Butterfield, was a 59-year-old Nevada, Missouri, auto mechanic who died in October in the Vernon County Jail, where he was being held without bond. His family and those incarcerated with him told me that not only was he denied the medical care he begged for every day of the nearly six weeks he was in custody, but that he was punished for even asking. “It’s really bad,” City Councilwoman Melissa Robinson said of the Vernon County facility. “I went out there last Christmas to bring them some books, and the way they had them housed, it is really bad.”

Nevada

Jeremy Bean, the warden of High Desert State Prison, said that there had been instances of failures to provide medical care. “As medical providers, it is our duty to ensure that all individuals, including offenders, receive adequate medical care to address their health needs,” Bean wrote in the memo, which was distributed on Aug. 16 and addressed to all medical providers. “Failure to do so not only put the health of offenders at risk but also jeopardizes your professional integrity.”

A court order has requested 20 Nevada State Prison inmates to receive tuberculosis testing. According to court documents, these High Desert State Prison inmates have refused their annual tuberculosis tests since October, 22, 2024. Officials have filed the immediate petition to ensure Nevada Department of Corrections is in compliance with medical laws and regulations.

North Carolina

Teenagers in North Carolina’s juvenile justice system are routinely being locked alone in their rooms for as much as 23 to 24 hours a day, according to an ongoing federal lawsuit and advocates for young people in custody, despite state officials’ own acknowledgment of research showing that prolonged isolation causes mental and physical harm. The lawsuit is seeking class-action status to represent the thousands of youths.

Ohio

The MetroHealth System is hiring an overnight physician to address nighttime medical calls in the jail and avoid millions of dollars in transportation costs for inmates who would otherwise have to be sent to the hospital. The nocturnist, as the overnight physician is called, will be providing care in the jail starting this month. Prior to MetroHealth taking over medical care in the jail in 2019, the county was “not providing nearly enough medical care to the inmates, and it created a lot of health problems, and it was a very bad situation,” he said, referring to an 11-month span when nine inmates died.

Oregon

"The Multnomah County jail system is in crisis ... And at risk of jeopardizing public health and safety." That's a direct quote from a new report on Multnomah County's correctional facilities. Some of the key findings include staffing shortages, deteriorating buildings, and not adequately addressing inmate-mental health, and substance abuse needs.

Oklahoma

The Oklahoma County Board of Commissioners today approved a memorandum of understanding to use nearly $40 million in American Rescue Plan Act funds to construct a new behavioral health center despite objections from local activists over the project’s uncertain future. Slated to be built alongside the new $700 million Oklahoma County Jail. The behavioral health center would be constructed entirely with ARPA funds. That means those funds had to be encumbered by the last day of this year under ARPA rules.

Oregon

The Oregon Department of Corrections placed its chief of medicine and the assistant director for health services on paid administrative leave pending a human resources investigation. The department declined to give any details about the investigation into Dr. Warren Roberts, its chief of medicine, and Joe Bugher, the agency’s assistant director of health services. Oregon Medical Board public records show that Roberts, a trained neurosurgeon licensed since 2001, was placed on a corrective plan to avoid formal disciplinary action in 2020.

Pennsylvania

The editorial staff for the Pittsburgh Post-Gazette write: Allegheny County Jail Oversight Board meeting was marked by a rare sentiment: optimism. The biggest strides were made in hiring new staff — for years one of the largest issues facing the facility. The jail’s new court-mandated medication assisted treatment options for opioid use disorder, inmates can finally receive proper treatment for withdrawal. Roughly 65% of inmates suffer from some sort of substance abuse.

Virginia

At least six inmates at a Virginia prison burned themselves using “improvised devices” in recent months, prompting renewed concerns about conditions for incarcerated people there and a call by some state lawmakers for an independent investigation. Reports about the burnings prompted the Virginia Legislative Black Caucus to issue a statement that said that since Sept. 15 at least 12 Black men incarcerated at Red Onion had set themselves on fire “in response to the degrading and inhumane conditions” at the prison.

Wisconsin

An outside review of day-to-day operations at the Milwaukee County Jail found several major safety concerns, including a failure to properly monitor occupants on suicide watch and inconsistent communication with medical staff when corrections staff believe an inmate is at risk of harming themselves. The report found inmates placed on suicide watch often times were either not safely restrained or medical staff was not alerted to someone going on suicide watch. Auditors noted instances where they observed jail occupants handcuffed to a bench for longer than eight hours

Rikers Island

In 1976, Alabama's prisons were so dire that a federal judge appointed an outside authority, the state governor, to reform them. By 1989, the system saw notable improvements, but the progress unraveled, prompting federal intervention again. This history is now being examined as a federal judge, Laura Taylor Swain, considers appointing a receiver to oversee New York City’s failing jails, a rare step taken when all other remedies have failed. Judge Swain has already held the city in contempt.

Telecommunications

The CFPB has taken action against Global Tel Link Corporation (GTL) over allegations that the company took millions of dollars from a half-million accounts and blocked money transfers to consumers who are incarcerated. Those prisoners relied on those funds for food, medicine and clothing. The CFPB is ordering GTL and its subsidiaries to stop the allegedly illegal activity, pay at least $2 million in redress to victims and pay $1 million civil monetary penalty. GT business as ViaPath Technologies; its subsidiaries include limited liability companies Telmate, LLC, based in California, and TouchPay Holdings, LLC, based in Texas.

Correctional Health Care Providers

Wellpath

Bankrupt prison health-care service provider Wellpath Holdings Inc. is attempting to improperly convert secured debt through a loan that would benefit some lenders at the expense of other creditors, the Department of Justice’s bankruptcy watchdog said. Private equity-backed Wellpath filed Chapter 11 in November, citing escalating labor and legal costs. The company lined up a $522 million bankruptcy financing loan, which includes a $417 million roll-up of existing debt to a higher tier of payment priority, the US Trustee told the US Bankruptcy Court for the Southern District of Texas in an objection (see Editor’s Note of November 12, 2024).

Wellpath, one of the nation’s largest providers of prison-based and outsourced behavioral health care, is seeking the sale of its behavioral health division, according to bankruptcy documents. Wellpath hopes its Recovery Services division will net at least more than $375 million. Throughout much of 2024, Wellpath has tried to sell the Recovery Solutions division to pay down a major portion of its debt.

Michigan Emergency Medical Service (EMS) providers are grappling with financial fallout after Wellpath Holdings, Inc., the former healthcare provider for the Michigan Department of Corrections (MDOC), declared bankruptcy in November. The move leaves nearly $6 million in unpaid claims to at least 15 EMS agencies in Michigan’s eastern Upper Peninsula, The Center Square reports (see Editor’s Note of September 24, 2024).

Nashville-based Wellpath has declared bankruptcy after reporting it fell into more than $600 million in debt because of legal bills and COVID-19 driving up the cost of healthcare labor and supplies. The company collected more than $2 billion revenue in 2022 but went into bankruptcy Nov. 11 with $70 million cash on hand, according to bankruptcy filings. All other lawsuits against the company in Charleston and across the nation have been paused. A Texas bankruptcy judge could allow cases to proceed on a case-by-case basis.

The Santa Barbara County Jail was fully staffed with correctional officers and medical professionals on November 8 when Cecilia Michelle Covarrubias, 41, died in an apparent suicide by hanging herself in an observational isolation holding cell located within the Inmate Reception Area. Wellpath had filled 12 of the 16 positions newly authorized by the Board of Supervisors this past summer to get the company’s jail staffing levels up to where they were needed.

New Hampshire’s Department of Health and Human Services is proposing a public-private partnership with Mary Hitchcock Memorial Hospital to take over the state’s Hampstead Hospital and Residential Treatment Facility. The state bought the hospital in 2022 with the aim of providing mental health treatment for children and adults, but state officials faced controversy over the company contracted to run it, Wellpath Recovery Solutions. In May, after reported ongoing issues with waitlists for beds, the state dropped Wellpath Recovery Solutions and awarded a contract to Dartmouth Health to provide behavioral health services.

YesCare/Corizon/Tehum Care & Centurion

Maryland’s state government failed to provide sufficient oversight of for-profit companies that provide medical and mental health care to thousands of individuals incarcerated in state facilities, according to an audit. The report paints a picture of state officials turning over the responsibility of maintaining the health of more than 17,000 individuals to private companies and then rarely checking in. The audit primarily examined the last five years of services offered by a company now known as YesCare, formerly Corizon Health, which held the medical care contract, as well as Centurion of Maryland, which held the mental health care contract during that time period. Combined, the two companies were paid more than $1 billion over five years. The state dumped YesCare at the end of its contract, with one official calling the company “uniquely terrible and irresponsible” for its long record of complaints.

Prime Care Medical

Former Dauphin County Commissioner Jeff Haste received $10,000 in campaign contributions from PrimeCare Medical and Herbert, Rowland & Grubic after leaving office in 2021. Haste’s connections to the two companies have been called into question following an unfolding corruption scandal. Haste, who is believed to be at the center of an ongoing FBI investigation, received two $5,000 contributions in 2023 totaling $10,000 from PrimeCare Medical, the health care provider for Dauphin County’s jail, and Herbert, Rowland & Grubic, Dauphin County’s long-time engineering firm and Haste’s former employer.

Naphcare

The Pima County Board of Supervisors unanimously approved spending an additional $2 million for the controversial healthcare provider at the county jail. Naphcare has been the contracted healthcare provider at the county jail since 2021. This brings the total contract amount to about $64.8 million. But the company has struggled to meet their expected staffing requirements in the past. Pima County’s Chief Medical Officer Dr. Francisco Garcia says Medically Assisted Treatment (MAT) is one of those areas, and one that is helping with a dramatic decrease in overdose deaths compared to just two years ago.