Weekly Update: May 21, 2024
After Medicaid Who Will Be The Mental Health Providers In Corrections? JAMA Study: Suicide & Reentry


Highlighted Stories

Editor's Note
In last week’s update, the editor’s note focused on the treatment of people with behavioral health challenges within correctional environments. This week's highlighted stories approach these challenges from a different angle, emphasizing the availability of mental health services within corrections.

The first story comes from Mississippi, where the legislature has changed the rules on civil commitment due to previous journalistic exposés revealing how many mentally ill individuals were detained in jail solely because alternative placements were unavailable. The legislature has limited incarceration to 24 hours, except when a mental health professional extends that period. In the next story from Baltimore, a judge slapped the Maryland Department of Health with sanctions over continuing delays in creating bed space in its psychiatric hospitals for incarcerated individuals. The third story focuses on Oregon, where the Oregon Health Sciences University has terminated its relationship with the Multnomah County Jail due to issues faced by that facility (see Editor’s Note of April 30, 2024). Following that story, is an article from Riverside County in California, where a man who was detained in that jail while experiencing a mental health crisis, died on account of a violent extraction from his cell. It was noted that there was no mental health professional, or a deputy trained in crisis intervention present during this extraction.

And this lack of mental health services does not only affect adults involved in the criminal justice system. In the fifth article, a study from Northwestern University showed that most justice-involved youth with mental health disorders did not receive needed services. This lack of services was greatest among juveniles who were Black, male, or had a substance abuse disorder.

Despite COCHS and many of its legislative, regulatory, and organizational partners working hard to bring Medicaid into corrections through 1115 waivers and statutory changes, we need to recognize that the demand for mental health professionals will be significant when Medicaid is brought within correctional environments. It must be obvious to our subscribers from the many articles highlighted over the years that correctional institutions have become our nation’s mental health hospitals of last resort. While structural roadblocks to Medicaid within corrections are slowly being removed, the availability of providers will be critical. Just how critical this need is, can be seen in the last highlighted article, a study published in JAMA, about the high suicide rate among the previously incarcerated. It points out that behavioral health treatment should not be siloed and effective treatment will require continuity of care between corrections and community providers.

Mental Health Shortages
ProPublica: Mississippi Lawmakers Move to Limit the Jail Detentions of People Awaiting Mental Health Treatment
Mississippi lawmakers have overhauled the state’s civil commitment laws as hundreds of people in the state are jailed without criminal charges as they wait for court-ordered mental health treatment. Right now, anyone going through the civil commitment process can be jailed if county officials decide they have no other place to hold them. House Bill 1640, which Gov. Tate Reeves signed, would limit the practice. It says people can be jailed as they go through the civil commitment process only if they are “actively violent” and for a maximum of 48 hours.

Baltimore Banner: People with severe mental illness are stuck in jail. Montgomery County is the epicenter of the problem.
Severely mentally ill criminal defendants are supposed to be moved to a psychiatric facility within 10 days of a judge’s order, according to state law. Many people on the waitlist for psychiatric beds are serving sentences of 90 days or less. Montgomery County is contributing more than any other place in Maryland to a worsening bottleneck of severely mentally ill criminal defendants waiting in jail for months on end. The revelation came in a court hearing last week as a Baltimore County judge slapped the Maryland Department of Health with $608,000 in sanctions over continuing delays in creating enough bed space in its psychiatric hospitals.

Willamette Weekly: OHSU Pulls Psychiatry Fellows From County’s Troubled Jails
On April 30, Multnomah County corrections medical director Eleazor Lawson announced to employees that Oregon Health & Science University was pulling its forensic psychiatry fellows out of the county’s jails. OHSU’s Forensic Psychiatry Fellowship program has played an integral role in providing badly needed mental health care in the county’s jail. The psychiatry students would rotate between various correctional facilities, spending one day a week doing rounds at Multnomah County’s downtown jail. The county got rid of its staff correctional psychiatrist years ago.

New York Times: Jail Death Lawsuit Is Settled for $7.5 Million Amid California Inquiry
Video from inside a Southern California jail shows a violent confrontation in October 2020 in which 10 sheriff’s deputies burst into the cell of a man who was having delusions and resisting medical care, restrained him and repeatedly shocked him, leading to his death days later. Officials in Riverside County did not bring charges against any of the deputies involved in the encounter with the man, Christopher Zumwalt, 39, but quietly agreed in December 2023 to pay $7.5 million to settle a lawsuit filed by his family. Ron McAndrew, a jail consultant and former Florida prison warden, said that Mr. Zumwalt’s actions warranted mental health treatment, not violent extraction.

Northwestern University: Northwestern study reveals inequities in mental health services for justice-involved youth as they age
A new Northwestern University study found that most justice-involved youth with a mental health disorder did not receive needed services during the 16 years after detention. The lack of services was greatest among persons who were Black, male, or had substance use or disruptive behavior disorders. Northwestern University Feinberg School of Medicine researchers used data from the Northwestern Juvenile Project, which included13 follow-up interviews across 16 years after detention. Researchers investigated whether youth who needed mental health services received them as they aged, up to median age 32 years.

Suicide & Reentry
JAMA: Share of Adult Suicides After Recent Jail Release
Inmates released from jail have a ninefold increased risk of suicide within the following year, compared to people who’ve never been incarcerated, new research shows. This study suggests that better integration of suicide risk detection and prevention across health and criminal justice systems is critical to advancing population-level suicide prevention efforts. However, high volumes of jail admissions and discharges, short jail stays, and understaffing mean that the 3119 local jails in the US generally have limited capacity to coordinate care with outside health agencies. In addition, broader use of 1115 Medicaid waivers to keep short incarcerations from disrupting Medicaid coverage could help to ensure that released individuals are insured, reducing barriers to health system reengagement.


Wichita Eagle: It’s time for Kelly to consider the nuclear option to expand Medicaid
In testimony to the Kansas Legislature, Sedgwick County Sheriff Jeff Easter projected similar substantial savings for the jail he manages and jails across the state. He cited cases in which only two inmates had required treatment exceeding $1.6 million. Medicaid paid most of that, but the county still was on the hook for more than $270,000.” If (Medicaid expansion) were to pass, the money spent on these two inmates would have a substantial impact on local taxpayers,” Easter testified. But the Legislature has adjourned for the year — its seventh year in a row — without a straight up or down vote on Medicaid expansion. The time has come for Gov. Laura Kelly to seriously consider defying the Legislature, inform the federal government she’s accepting expanded Medicaid on behalf of the people of Kansas, and fight it out in court.

Opioid Epidemic

Office of Senator Jon Ossof: Sen. Ossoff Pushing to Expand Substance Abuse Treatment
Sen. Ossoff recently joined a bipartisan group of Senators introducing the bipartisan STRONGER Act to reduce recidivism by providing treatment for inmates with substance use disorders. The bipartisan bill would reauthorize the Residential Substance Abuse Treatment for State Prisoners (RSAT) program and allow state and Federal correctional facilities to use grant funding for medication-assisted drug treatment. It would also require staff to be trained on the science of addiction and promote strategies for continuing care during and after incarceration.

NC Health News: Many NC jails violate legal requirements by skipping meds for opioid use disorder
Jails have a legal responsibility to provide those medications because people with opioid use disorder are protected under the Americans with Disabilities Act. Guidance from the U.S. Department of Justice issued in April 2022 states that it is a violation of the ADA if correctional facilities do not continue an individual on the medications to treat their addiction that they were receiving in the community before incarceration. Many North Carolina jails have yet to meet these legal requirements. Only about one-third of 92 jails provide medications for opioid use disorder in their facilities.

Star Tribune: 'Longer we wait, the more people will die'
The jail administrator in Minnesota's Cass County, Chris Thompson, has seen firsthand how many people now under his responsibility struggle with substance abuse disorder, upwards of 65% at his facility, which was built to house 60 inmates. He is a supporter of the 1115 Re-Entry Medicaid Waiver proposed by Gov. Tim Walz's administration to improve substance abuse treatment for inmates nearing release.


KSBY: Closure of California federal prison was poorly planned, judge says in ordering further monitoring
The plan to close a troubled prison in California where female inmates suffered sexual abuse by guards was “ill-conceived,” a judge said while ordering close monitoring and care of the incarcerated women who were moved to other federal facilities across the country. U.S. District Court Judge Yvonne Gonzalez Rogers said in Wednesday's order that last month's decision by the Bureau of Prisons, or BOP, to shut down FCI Dublin “created serious concerns” for the well-being of more than 600 women who were transferred out.

Incarcerated Labor

CLASP: The Unethical Use of Captive Labor in U.S. Prisons
On average, incarcerated laborers earn between 15 cents and 52 cents per hour nationwide, although seven states do not pay for the majority of prison work performed in their states. The 13th Amendment was designed to abolish slavery and other forms of involuntary servitude, but contains an exception allowing involuntary servitude as a punishment for a “crime whereof the party shall have been duly convicted.” Corporations including McDonald’s and Costco use goods produced by incarcerated individuals, enabling these corporations to amass substantial profits through the remuneration of low wages.

ABC: US prisoners are being assigned dangerous jobs. But what happens if they are hurt or killed?
Nationwide, hundreds of thousands of prisoners are put to work every year, some of whom are seriously injured or killed after being given dangerous jobs with little or no training. They include prisoners fighting wildfires, operating heavy machinery or working on industrial-sized farms and meat-processing plants tied to the supply chains of leading brands. These men and women are part of a labor system that – often by design – largely denies them basic rights and protections guaranteed to other American workers.

Webinars & Other Announcements

Mental Health Colorado: Register for our Care Not Cuffs ‘Monthly Dispatch’ Webinar (May 23, 5:00 PM MT)
Historian Anne Parsons will speak about the new traveling exhibit Care and Custody, produced by the National Library of Medicine. The exhibit explores how we have worked to move away from custodial responses to mental health conditions and sought a more inclusive society. Anne E. Parsons is Associate Professor of History at UNC Greensboro and the author of From Asylum to Prison.

BJA: FY24 Second Chance Act Improving Reentry Education and Employment Outcomes
The Bureau of Justice Assistance seeks to fund reentry services and programs focused on strengthening education and employment outcomes for individuals returning to their communities after a period of incarceration. The purpose of this program is to support fair chance opportunities to improve education and employment outcomes for individuals currently incarcerated with 2 years or less before release into the community.

State Roundup

Los Angeles Times: Supreme Court denies California’s plea for immunity for COVID-19 deaths at San Quentin
The Supreme Court on Monday turned down an appeal from California prison officials who sought immunity from lawsuits for having transferred inmates with COVID-19 to San Quentin in May 2020, setting off an outbreak that killed 26 prisoners and one guard. The justices denied the appeals with no comment or dissent. The transfer decision was later lambasted by state lawmakers as a “fiasco,” “abhorrent” and “the worst prison health screw-up in state history.” The California Institution for Men in Chino had been hit hard by COVID-19. Nine of its inmates had died and about 600 were infected in May 2020.

KQED: California Could Save Millions by Closing More Prisons. So Why Is Newsom Holding Back?
Gov. Gavin Newsom faces a huge deficit this spring, and he has one especially big money-saving option that he’s not using. California’s rapidly falling inmate population could allow Newsom to close as many as five more prisons, analysts say, saving $1 billion a year at a moment when he’s pulling from reserves to bring the state budget into the black. Labor unions representing prison employees intend to slow or stop the closure and may have forced Newsom to take smaller steps than shuttering entire facilities while he crafted his plan to close a projected $27.6 billion deficit.

WILX: Ingham County Jail highlights importance of providing mental health services to inmates
The Ingham County Jail has become a statewide leader in helping people on the inside deal with mental health issues. The jail has one of the largest programs in the state, helping people cope behind bars. 15 staff members from the Community Mental Health Authority of Clinton, Eaton, and Ingham Counties work from an office located right inside the jail.

KTSM: Missouri inmate facing execution next month is hospitalized with heart problem
A Missouri inmate who is due to be executed next month has been hospitalized because of a “medical emergency,” a spokeswoman for the Missouri Department of Corrections said. David Hosier, 69, is scheduled to be put to death June 11. His attorney, Jeremy Weis, said a prison doctor diagnosed Hosier with heart failure this week. Hosier’s sister, Barbara Morrill, said he has atrial fibrillation, which causes an irregular heartbeat.

Kera: Tarrant County inmate died of fentanyl, trazodone toxicity in custody last month
One of two people who died in Tarrant County Jail custody last month died of fentanyl and trazodone poisoning, according to the Tarrant County Medical Examiner’s Office. Use of fentanyl, a synthetic opioid, has been on the rise in North Texas in recent years as law enforcement and public health officials respond to a sharp increase in overdoses.

NPR: Texas inmates are being 'cooked to death' in summer heat, lawsuit alleges
As summer arrives, many inmates in prison brace for high temperatures, which can be dangerous to their health. Texas prisoners filed more than 4,000 heat-related complaints last year, according to the watchdog group American Oversight. Only about a third of Texas prisoners today have air conditioning where they sleep.

ABC: ‘How do you get hypothermia in a prison?’ Records show hospitalizations among Virginia inmates
The Virginia State Police investigator seemed puzzled about what the inmate was describing: “unbearable” conditions at a prison so cold that toilet water would freeze over and inmates were repeatedly treated for hypothermia. “How do you get hypothermia in a prison?” the investigator asked. “You shouldn’t.” The exchange, captured on video took place during an investigation into the death of Charles Givens, a developmentally disabled inmate at the Marion Correctional Treatment Center, who records show was among those repeatedly hospitalized for hypothermia.

Correctional Contractors

New Yorker: Do Children Have a “Right to Hug” Their Parents
County sheriffs across the country are making similar deals with Securus and GTL (now known as ViaPath), which resulted in millions of dollars in commissions. The Yale Investigative Reporting Lab identified more than a hundred jails in thirty-six states which have replaced in-person visits with video calls. The costs of these calls were passed along to incarcerated “customers” and their families, who lacked consumer choice.

Private Prisons

USA Today: Two killed, more than 30 injured at Oklahoma prison after 'group disturbance'
Two inmates are dead and several others are injured after a “group disturbance” at Lawton Correctional and Rehabilitation Facility in southern Oklahoma. A spokesperson for The GEO Group, a security company that operates prisons and detention facilities under contract with governments, reported that injuries resulted from “an inmate-on-inmate assault.” The incident took place after an “operational error” allowed “the disturbance to happen.”Emily Barnes, founder of criminal justice advocacy group Hooked on Justice, said the incident involved two gangs who were supposed to have been kept separate. Homicide is the fourth-leading cause of inmate death in Oklahoma prisons, excluding executions.

Correctional Health Care Providers

New Hampshire Bulletin: Dartmouth takes over psychiatric treatment for children at Hampstead Hospital
Over the objections of mental health advocates and others two years ago, the state chose a private company that primarily works with incarcerated adults to provide psychiatric treatment to children at Hampstead Hospital. With that $52.5 million contract up, the Department of Health and Human Services is replacing Wellpath Recovery Services with Dartmouth Health, which has provided behavioral health treatment at New Hampshire Hospital and the Glencliff Home, a residential facility for people with developmental disabilities, for nearly 30 years.

CommonWealth Beacon: It’s past time to move Bridgewater State Hospital out of the Department of Correction
A report release in March by the Disability Law Center condemns Bridgewater State Hospital —Massachusetts’s state psychiatric facility. The Disability Law Center, has been advocating for better conditions at Bridgewater for over a decade. The organization observes the facility and continuously calls for action to address the dubious practices perpetuated by the Department of Correction, which maintains oversight of the hospital, and its private health care contractor, Wellpath Recovery Solutions. Wellpath has a notorious reputation, including being sued over 1,000 times in federal court for poor or wrongful patient care across the country. The state announced that Wellpath’s contract will not be renewed and it will be replaced by another private health care provider at 10 state correctional facilities. However, Bridgewater was excluded from the shift, and instead remains under contract with Wellpath until at least mid-2025

Charlotte Observer: Mecklenburg sheriff faces another lawsuit over inmate’s death, supervision at jail
A new lawsuit against Mecklenburg County Sheriff Garry McFadden and health care provider Wellpath alleges negligence in a man’s death in the jail in 2021. Karon Golightly, 20, was found pulseless and not breathing in a pool of his own urine on May 14, 2021, according to the federal complaint. His death happened during a “blind spot” of about 90 minutes in which Mecklenburg County jail staff did not check on him, the lawsuit alleges. Wellpath ended its contract with the sheriff’s office effective immediately. It, too, is a defendant in the lawsuit.

YesCare/Corizon/Tehum Care
Baltimore Banner: Maryland set to oust problematic prison and jail health care provider. It’ll be costly.
After a lengthy bidding process, Maryland is ready to part ways with its prison and jail health care provider, YesCare. Two massive mental and medical care contracts totaling billions of dollars for state prisons and the state-run Baltimore jails have been in the works. The contract for state prisons was approved by the Maryland Board of Public Works, while a vote on the jail complex contract was postponed until early June. Centurion of Maryland was selected for both contracts: $1.7 billion for the state prisons and $723 million for the pretrial complex. Both contracts are for five years with an option for a two-year extension.

In Observation Of Memorial Day
COCHS Weekly Update Will Not Be Published Next Week