Forbes Dives Into The Economics of Correctional Healthcare Vendors, Past DOJ Investigations and Current Strategies

Highlighted Stories

Editor's Note

This week’s highlighted story may not at first seem unusual to our subscribers. It centers on Centurion, a correctional healthcare provider, and begins with the tragic account of a woman, Sheqweetta Vaughan, in Georgia’s Lee Arrendale State Prison who had recently given birth and was found dead in her cell—her body already decomposing. What makes this piece striking, from COCHS’ perspective, is not only the tragedy itself but that it appeared in a business magazine like Forbes. Beyond the human story, the article examines the economics of correctional healthcare and the federal government’s role in responding to failures in care delivery.

What immediately stood out was the discussion of cost control—utilization management and prior authorization—familiar concepts to anyone working in healthcare generally. But in correctional contracts, the stakes are heightened. Providers like Centurion are paid per capita based on an assumed census. As populations rise, profits fall. That structure creates an incentive, or at least the appearance of one, to delay or deny care. Which raises the central question: does this model risk violating the constitutional prohibition against deliberate indifference to incarcerated people’s medical needs under the Eighth Amendment—the basis of Estelle v. Gamble, the Supreme Court ruling that established healthcare as a constitutional right in correctional institutions?

It was precisely such violations that led the U.S. Department of Justice (DOJ) to investigate facilities where Centurion operated, most notably Mississippi’s Parchman Prison. The DOJ found serious constitutional deficiencies—suicides, staff shortages, delayed responses. Yet, as the article notes, whether today’s DOJ would pursue such investigations remains uncertain. Interestingly, because Centurion was once owned by Centene, a publicly traded company, shareholders were seen as a potential lever for reform. A Delaware complaint argued that correctional healthcare failures in Mississippi posed not just humanitarian crises but also breaches of fiduciary duty. Readers may recall that the Weekly Update raised this very point more than five years ago, when a July 28, 2020 article highlighted how even unlikely actors—reportedly including Jay-Z—were considering Delaware courts as a venue for pushing correctional healthcare reforms. At the time, some questioned why COCHS spotlighted such a “diverse initiative,” but that skepticism likely reflected a naïveté about the necessity of using different levers to effect change.

If there is a weakness in the Forbes article, it is the suggestion that shareholder activism could still meaningfully drive reform. That may be true for publicly held firms like Centene, but the reality is that most correctional healthcare vendors—Wellpath, Corizon/YesCare, NaphCare, Armor, Wexford, VitalCore, TKHealth, and now even Centurion—operate as private companies. As our subscribers know, these firms cycle in and out of contracts, often leaving under a cloud, only to be replaced by competitors who often also depart under a cloud. Without shareholders, accountability usually comes only through lawsuits. Yet even here, bankruptcies like those of Corizon/YesCare/Tehum Care and Wellpath show how corporate restructuring can shield vendors from liability, limiting the very settlements that are supposed to provide redress.

Addendum: We decided to include one more article in this week’s highlighted section that just came across our desk from Law.com — “Prison Medical Neglect Should Outrage Us All” — because it so closely aligns with the themes of this Editor’s Note. It underscores two issues central to COCHS’ mission: the ongoing violations of Eighth Amendment guarantees, and the high cost communities pay for ignoring these failures. As our subscribers have often seen in the Weekly Update, neglect in correctional healthcare exacts its price not only in lives harmed, but also in the tax dollars that ultimately fund this neglect.

The death of 32-year-old Sheqweetta Vaughan at Georgia’s Lee Arrendale State Prison in July 2025 has renewed scrutiny of prison healthcare contracts. Reports suggest she recently gave birth, sought medical help, and was ignored; her body was already decomposing when found. Her case highlights systemic issues in how states contract with private providers and the constitutional obligations tied to those arrangements. Georgia relies on Centurion Health to deliver medical, dental, and mental health services across its prisons. Most facilities maintain 24-hour healthcare units, but the system is built around “utilization management.” Prison-based providers act as gatekeepers, requiring prior authorization before referring patients to hospitals or specialists. Centurion was formerly a subsidiary of Centene Corporation, under whose ownership the U.S. Department of Justice investigated Mississippi’s Parchman Prison. The 2022 DOJ report concluded Parchman failed to meet constitutional standards for medical and mental health care, citing suicides, staff shortages, and delayed responses. The parallels between those findings and Vaughan’s death in Georgia raise questions about whether problems are systemic to the correctional healthcare model.

In this article, Laurie Jubelirer, an attorney from Montgomery County, Pennsylvania, recounts multiple cases in which incarcerated people were denied proper medical care, often with deadly consequences.. She writes: [These cases] represent only a small window into the thousands of men and women across Pennsylvania—and the country—who suffer from preventable pain, illness, and even death because of medical neglect and abuse at the hands of jail and prison medical staff. This treatment is a blatant violation of the Eighth Amendment’s prohibition against cruel and unusual punishment. The system continues to operate in ways that deny incarcerated people the basic medical care that every human being deserves. As taxpayers, every dollar spent on neglectful or abusive prison medical systems is a dollar that pays for suffering, for avoidable trauma. The people enduring this neglect are not statistics or faceless offenders; they are sons, daughters, parents, veterans, neighbors, and community members. They are human beings. Their incarceration does not strip them of their right to dignity, health, and humane treatment. I continue to ask: why do we accept a system that inflicts harm instead of providing care? Why is it tolerable for the state to turn its back on medical ethics when the people in need happen to be behind prison walls? Until we collectively confront these questions, the cycle of neglect and abuse will continue.

Follow Ups

San Diego

Editor's Comment: The first Follow Up article comes from San Diego. As noted in the September 9, 2025 Follow Up, Supervisor Monica Montgomery Steppe had proposed strengthening the Citizens’ Law Enforcement Review Board (CLERB). The San Diego Union-Tribune now reports that the proposal has passed, despite Sheriff Kelly Martinez’s warning that jail healthcare providers NaphCare and Correctional Healthcare Partners might terminate their contracts if subjected to such oversight.

Irony of ironies: in the very next Union-Tribune article, San Diego County is reported to be suing NaphCare and its subcontractor, Liberty Healthcare, for the anticipated costs the county may owe to the family of a mentally ill man who was tortured to death in his cell by another detainee. The county argues that its contract holds NaphCare and Liberty liable for injuries or deaths.

For COCHS, the irony here is striking. Correctional health vendors often claim they bear liability for the quality of care they deliver, but this lawsuit suggests that such claims may be overstated—or at least far more complicated—than the vendors would like counties to believe.

The San Diego County Board of Supervisors voted to finalize an ordinance that gives the Citizens’ Law Enforcement Review Board, or CLERB, authority to investigate the role of medical and mental health providers in jail deaths — making San Diego the first in the nation to adopt such oversight. The push to expand oversight gained momentum after a series of high-profile jail deaths, including that of Elisa Serna, whose family won a $15 million settlement from the county and a jail medical contractor in July 2024. Sheriff Kelly Martinez repeatedly objected to the proposal to expand CLERB’s oversight to health providers, warning it could destabilize jail healthcare. In a March memo to the Board of Supervisors, she said the county’s private healthcare contractors — NaphCare and Correctional Healthcare Partners — might cancel their contracts or raise their rates if subjected to civilian oversight.

The county of San Diego is suing two of its jail health care providers, alleging that failures by their employees led to the brutal killing of 24-year-old Brandon Yates inside a cell at the San Diego Central Jail. Filed last week in federal court, the claim argues that NaphCare and its subcontractor, Liberty Healthcare, violated their contracts by failing to provide adequate mental health care to Alvin Ruis — a man with a known history of psychosis, violence and self-harm. Ruis was placed in a cell with Yates and ultimately tortured and killed him. The county, a named defendant in a wrongful death lawsuit filed by Yates’ family earlier this year, is seeking a ruling that would hold NaphCare and Liberty financially responsible for any damages awarded to the family — and allow the county to recover legal costs. The county’s claim does not say the Yates’ allegations are true but rather argues that the providers’ contracts hold them liable for any injuries or deaths resulting from “any act, error, omission or negligence” by employees.

New York

Editor's Comment: Again this week, we have multiple articles from New York. Four correctional officers have pleaded guilty to manslaughter in the beating death of Robert Brooks at the end of last year. In the second article, as a follow-up to the Weekly Update of September 16, 2025, a federal judge has ruled in favor of a lawsuit brought by Disability Rights New York and Prisoners’ Legal Services of New York, requiring more out-of-cell time for mentally ill patients. The Times Union, in the third article, provides an overview of conditions in the state prison system that contributed both to Brooks’ death and the subsequent wildcat strike.

Two additional pieces focus on efforts to limit or amend the HALT Act. The second of these is essentially a jeremiad by a state senator, not only targeting the HALT Act but Democrats more broadly. On the other side of the issue advocates opposed to weakening the law are calling on the United Nations to investigate New York’s use of solitary confinement as a violation of international human rights. The final article in this series highlights advocates criticizing the lack of HALT Act enforcement on Rikers Island.

Notably, New York is not alone. In the section that follows, we include numerous articles from other jurisdictions, underscoring the nationwide debate around solitary confinement.

Four corrections officers pleaded guilty Monday for their roles in the brutal beating of Robert Brooks, a New York State inmate who was punched and kicked while handcuffed and bleeding in a prison infirmary last year. Two of the officers, Nicholas Anzalone and Anthony Farina, pleaded guilty to first-degree manslaughter and agreed to a sentence of 22 years in prison for the killing of Mr. Brooks at the Marcy Correctional Facility in upstate New York in December. They had originally been charged with second-degree murder.

A federal judge has ordered New York State to provide significantly more out-of-cell time and therapeutic programming for mentally ill inmates at the Mid-State Correctional Facility. The ruling stems from a lawsuit filed on behalf of nine prisoners who alleged they were kept in near-solitary confinement—sometimes 24 hours a day—without the treatment required by state and federal law. Judge Mae D'Agostino's preliminary injunction mandates expanded therapeutic programming and out-of-cell time for inmates.

Months before New York’s prison guards staged a weeks-long strike, tensions were already visible. Officers warned prisons were unsafe for staff, while incarcerated people said they were often punished over false accusations. The HALT Act, implemented two years earlier to ease such conflicts, had been only partially enforced due to a staffing crisis. Officers claimed it forced them to handle incarcerated people with “kid gloves,” even after violent acts. Tensions escalated when Robert L. Brooks, Sr., was killed after a severe beating at Marcy Correctional Facility, followed by the strike. Afterward, the corrections department suspended parts of the law for three months, only to be sued soon after.

The state Department of Corrections and Community Supervision’s Humane Alternatives to Long-Term Solitary Confinement Act Committee released recommendations to amend the law to make it easier to make use of solitary confinement in an attempt to increase the safety of corrections officers and incarcerated peoples. The committee recommended clarifying that the law allows incarcerated people to be sent to segregated confinement for behaviors including sexual harassment, extortion and lewd conduct, and It also recommended more objective standards for sending people to segregated confinement in response to riots, escapes and participation in attempted escapes.

In an op-ed, New York State Senator, Tom O'Mara writes: Ever since, New York’s approach to a rising tide of unrest and violence within the state’s prisons has been rife with questionable strategies, shortcomings, and outright failures that led to the breaking point and resulted in correctional officers striking earlier this year. Specifically, the “Humane Alternatives to Solitary Confinement (HALT) Act,” better known as the HALT Act, was approved in 2021 by the Legislature’s Democrat-led majorities and signed into law by then-Governor Cuomo to fundamentally restrict the ability of prison officials to discipline the state’s most violent inmates by separating them from the general population.

The HALT Solitary Campaign is turning to the United Nations over what it calls international human rights violations happening in New York state prisons. The campaign filed a complaint with both the U.N. special rapporteur on torture and other cruel, inhuman, or degrading treatment or punishment and special rapporteur on extrajudicial, summary or arbitrary executions. In the complaint, the campaign alleges that the state, as well as localities including New York City, have engaged in “egregious practices” that violate local, state and international human rights laws. The complaint specifically cites prison and jail use of solitary confinement, staff abuse, long sentences and deaths while incarcerated

The Legal Aid Society and a private law firm have filed a lawsuit which will seek class action status, names New York City and Lynelle Maginley-Liddie, the jail commissioner, as defendants. According to the lawsuit, two housing areas in Rikers are designed so that detainees are automatically in segregated confinement. The law upon which the suit depends is the Humane Alternatives to Long-Term Solitary Confinement Act, or HALT, signed by Andrew M. Cuomo in 2021 when he was governor. It prohibits prisons and jails from keeping people in solitary for more than 15 consecutive days. It also bans the practice for some people, including minors and those with certain disabilities.

Solitary Confinement

State Rep. Strom Peterson has introduced bills to prohibit solitary confinement, pointed to an ethical contradiction. “[In the United States,] it is unethical to use mice or lab rats to study the effects of isolation,” Peterson said. “We treat people in our prisons worse than we are allowed to treat lab rats.” A 2024 report by the state Office of the Corrections Ombuds found that more than 3,000 incarcerated people in Washington had spent over 120 days in solitary or other forms of restrictive housing during fiscal year 2023. The report also documented more than 170 suicide attempts and 14 deaths by suicide in solitary confinement over the past decade.

An increasing number of solitary confinement placements in the U.S. drag on for 15 days or longer, which the United Nations says constitutes psychological torture, according to the report by Harvard University researchers and Physicians for Human Rights. Massachusetts jails that have held immigrant detainees have isolated people for weeks at a time, a new report states. Researchers found that nearly 14,000 people were placed in solitary confinement in immigrant detention centers nationwide between April 2024 and August 2025. (This article provides a nationwide map of the number ICE detainees held in solitary confinement).

A federal district court in Springfield has blocked officials at the Mary Davis Detention Home (“MDH”) in Galesburg, Illinois from continuing to subject the young people confined at the facility from being held in abusive, extended solitary confinement, and to quickly develop a plan for emergency mental health intervention for youth after they are identified as being at risk for suicide or self-harm.

Suicide

Suicide is a leading cause of death in American jails.  According to federal data analyzed by the Marshall Project, nearly 900 people died by suicide in jails across the country during a recent four-year period. Brown University’s Lauren Weinstock studies suicide risk for people who have been incarcerated. Weinstock said that jails and prisons have a responsibility to keep incarcerated people safe in their care. But that doesn’t always happen, as jails are understaffed and underresourced. And, she said, jails and prisons may not know about detainees’ risk factors.

Aging

America’s prison population is growing older at a pace that some experts say is unsustainable. As of 2022, the latest year with available data, people 55 and over made up nearly 1 in 6 prisoners — a fourfold increase since 2000 — and their numbers are projected to keep rising. A new report from the American Civil Liberties Union and the Prison and Jail Innovation Lab at the University of Texas at Austin warns that this trend is straining correctional systems that were not designed to care for older adults. (This article includes a nationwide map of incarcerated people over 55).

The number of older people in prison has surged over the past three decades, making them one of the fastest-growing groups behind bars. Many were sentenced under extreme laws as teenagers or young adults and have now spent decades incarcerated. Yet research shows they are the least likely to reoffend: recidivism rates for people over 50 are a fraction of younger groups, as low as 6% in Florida. Prisons, however, are ill-equipped to meet their needs. Older adults face far greater medical and mental health challenges, but private providers often cut costs by delaying or denying care. Access to mental health services is limited, and few facilities are prepared for dementia or cognitive decline.

Infectious Diseases

Infectious diseases remain one of the most pressing health concerns in correctional facilities. Overcrowding, limited resources, and the high prevalence of communicable diseases among incarcerated individuals create a perfect environment for rapid transmission. For correctional nurses, prevention and management are not just clinical duties—they are essential public health responsibilities. Incarcerated populations often enter the system with higher rates of tuberculosis (TB), hepatitis B and C, HIV, and other infections due, in part, to social and health disparities in the community. Inside the walls, close quarters, shared facilities, and frequent population movement can accelerate disease spread. Emerging diseases, such as COVID-19, mpox, and novel influenza strains, present an added layer of complexity.

Opioid Epidemic

HARP developed this toolkit to help state Medicaid agencies (SMAs) and their state and local correctional partners as they implement Medicaid reentry waivers to effectively expand access to OUD treatment for Medicaid beneficiaries returning to the community from incarceration. This new toolkit highlights this powerful pathway to expand access to treatment services and delves into the information, tips, and examples states need to expand opioid use disorder (OUD) treatment for Medicaid beneficiaries returning to the community.

ICE

Behind the walls of California City Detention Facility, more than a hundred men staged hunger strikes during several days this month and refused to go back to their cells, protesting poor conditions. Men with diabetes or psychiatric conditions who arrived late last month complained they couldn’t get their medication. Others, who had never committed crimes or been in jails, found themselves locked behind metal doors in cold cells for most of the day. The complaints about poor conditions in the CoreCivic-run operation are echoed at other detention facilities across the country as concerns grow about the administration’s plans to expand. The Trump administration, with a $45-billion immigration detention budget, is quickly converting old prisons and jails for the job, including a section of the notorious Angola Prison, now dubbed Lockup Louisiana.

The deadliest six-month period for immigration detention since 2018 has occurred this year, according to a letter Georgia Sens. Jon Ossoff and Raphael Warnock sent to the Department of Homeland Security this week. Less than 24 hours after that letter was published, the year became deadlier still. A detainee was killed, and two others were seriously injured by a sniper who fired rounds at an Immigration and Customs Enforcement office in Dallas. Increasingly, federal agents are making arrests at state courthouses as well. In California, state law bans immigration enforcement at courthouses, but ICE has done so anyway, often by waiting just outside the building.

The planning commission for California City, a town of 15,000 people, was out of its depth. Made up of volunteer residents tasked with advising the City Council on zoning permits and land use, it has no jurisdiction over what happens inside the newly reopened detention facility or access to information about who is housed inside the center, which sits 7 miles from City Hall on the edge of what locals call “second city” — or the town’s acres of undeveloped desert. The private prison, which previously held state inmates, began housing detained migrants at the end of August and is operated by Tennessee-based CoreCivic. The city said it got no notice the center would begin housing detainees. When rumblings of the center opening began, anti-ICE protesters started showing up. They gained numbers throughout the summer. Now, once sparsely attended City Council meetings have become packed five-hour marathons brimming with public commenters — many of them come from Bakersfield, other corners of Kern County and Los Angeles.

BOP

The Federal Bureau of Prisons said that it was canceling a collective bargaining agreement with the union representing more than 30,000 prison workers, making it the latest group to be targeted by the Trump administration’s effort to assert more control over the government work force William K. Marshall III, the bureau’s director, told employees that he was terminating the contract with the union, the Council of Prison Locals, saying that it had become an obstacle to making changes intended to improve safety and morale.

Studies

A recent study by Penn researchers found that one-third of deaths among incarcerated individuals in the United States were caused by cardiovascular disease. The study, which was published in The Journal of the American Heart Association, examined how incarceration affects cardiovascular outcomes using health records from state prison systems over a 19-year period. Looking at more than 18,000 cardiac deaths, the researchers found that cardiovascular mortality rates, when age-adjusted, have increased since 2012 for those incarcerated in U.S. state prison systems.

State Roundup

California

Billed as the “Homelessness, Drug Addiction and Theft Reduction Act,” Proposition 36 passed in November 2024 with more than two-thirds support. Backed by retailers and law enforcement, it reclassified certain drug and theft crimes as felonies, imposing steeper penalties for repeat offenders but also offering treatment for long-term addictions. The measure had no dedicated funding, leaving state and counties to absorb costs. Gov. Gavin Newsom initially refused to fund it, warning that more incarceration would drain community treatment budgets, but later allocated $110 million to courts, behavioral health programs, and public defenders. Jails, however, were excluded. San Diego County Sheriff Kelly Martinez said her office has already spent nearly $32 million housing Proposition 36 arrestees, diverting funds from infrastructure.

A scathing report, released by California State Auditor Grant Parks, stated that the Alameda County Department of Children and Family Services often failed to investigate allegations of child abuse and neglect with the urgency legally required. The agency also did not ensure foster youth received timely access to critical physical and mental health services and did not adequately report serious incidents that occurred at its transitional shelter for foster youths awaiting placement, the audit revealed. The audit was requested last year by state Sen. Aisha Wahab, D-Hayward, due to problems within the county’s child welfare system, including “clear systemic failures and a lack of administrative planning to support foster youth with emerging and complex needs.”

Thanks to a new state grant, Berkeley is launching an ambitious "post-arrest diversion pathway" to serve unhoused individuals and others with mental health and substance use needs. The bulk of the grant, more than $6 million, will be set aside for "transitional housing, case management, and peer navigation services," with the balance paying for project management, program evaluation, daily meals and other costs. The new CareBridge program, conceived through a collaboration between the Berkeley city manager's office and Health, Housing, and Community Services, along with Berkeley police and others, is expected to launch in the new year and serve 60-80 people annually.

Georgia

In an op-ed, Dr. Mark Spencer, the executive director of Stop Criminalization Of Our Patients (SCOOP), writes: $1.2 billion is to be split between renovations at Fulton’s main jail—currently at the center of a Department of Justice consent decree—and a new “special purpose facility” designed to treat “mental health and medical needs.” This new facility is simply a jail by another name. It is to be built with the explicit purpose of incarcerating those with mental health conditions. Over the past 15 years, Fulton County has dedicated upwards of $186 million to behavioral health initiatives. In that time, the sheriff’s department alone received over $1.5 billion, eight times the funding for mental health. If courts, the district attorney’s office and additional carceral investments are accounted for, the number is well north of $3 billion, or 16 times the amount committed to mental health in that time.

South Carolina

Disability Rights South Carolina filed in April 2022 case for inmates with serious mental illness, a federal judge has upheld two of their civil rights complaints against Richland County. Specifically, under the due process clause of the U.S. Constitution’s 14th Amendment, the complainants claim the jail is failing to protect inmates with serious mental illness from substantial risk of serious harm and the jail’s physical conditions continue to be unsafe and unsanitary. U.S. District Judge Mary Geiger Lewis also granted the 11 inmate-complainants’ request to bring a class-action lawsuit against the county on those allegations. These issues will go before a jury if the parties don’t reach a settlement.

Texas

The Harris County Sheriff’s Office has reduced the number of jail inmates housed outside of the county since June, a Sept. 18 quarterly jail data report shows. However, outsourcing inmates at other facilities was still a top expense in the fiscal year 2025-26 county general fund budget approved Sept. 24. HCSO oversees four different facilities in downtown Houston, with two jail facilities outsourced in Louisiana and Mississippi. Outsourcing inmates to jails outside of Harris County’s overcrowded jails is the single most expensive budgeted item. Overcrowding and understaffing at the Harris County jail have led to failed state safety inspections, as previously reported. The Texas Commission on Jail Standards has cited the Harris County jail as noncompliant since May.

Rikers Island

While a 29-year-old detainee with severe mental illness was on the brink of death in his Rikers Island cell last month, a medical staffer stood outside his door spraying air freshener. The striking detail appears in the Board of Correction’s initial review of Ardit Billa’s August 23 death inside the George R. Vierno Center. The case has already led to the suspension of two correction officers for four weeks for failing to conduct mandated routine checks and allegedly falsifying an internal logbook entry.

Telecommunication

Over the nine months that Dominic “Kobeany” Deere was incarcerated at the Kalamazoo County Jail in 2023 and 2024, he estimates he and his family spent $3,100 in phone calls and $4,600 in video calls. The telecommunications services are provided by a private corporation under a 2020 contract. As part of the deal, the majority of the fees, paid by jailed people, go to the county’s coffers – not to pay the service provider. The winning contract bidder, ViaPath, previously called Global Tel*Link, or GTL, paid the county a $325,000 signing bonus as well. Similar contracts are being scrutinized in St. Claire and Genesee county lawsuits that allege a “quid pro quo kickback scheme” overseen by the same prison phone company that Kalamazoo County signed with.

Correctional Healthcare Vendors

Editor's Comment: They Flew the Coop! That’s what this Editor’s Comment could well be entitled. NaphCare is pulling out of Spokane, Washington, after costly settlements. The county didn’t even need to threaten an oversight board to scrutinize healthcare delivery (see the San Diego Follow Up above). Perhaps NaphCare realized its record spoke loudly enough for itself?

In Cleveland County, Oklahoma, after the abrupt departure of Turn Key Clinics (as noted in the May 13, 2025 Follow Up), the county has replaced Turn Key with Redemption Correctional Healthcare Solutions—founded by providers who had watched the controversies and multiple deaths under Turn Key’s watch. Not to be outdone, Turn Key has now rebranded as TK Health, following the well-worn path of other correctional healthcare vendors: Corizon becoming YesCare, CCS becoming Wellpath.

Southern Health Partners, meanwhile, appears to be withdrawing from Aiken County, South Carolina, and from a number of other counties in the state.

And while the last story isn’t exactly a “cut and run,” we once again find ourselves back at Wellpath. In Jackson County, Oregon, both the county and Wellpath are being sued over the suicide of a man with schizophrenia.

It bears repeating—as noted above in the San Diego story—that correctional health vendors often claim they shoulder liability for the quality of care they deliver. But cases like these show that such claims are, at best, overstated—and at worst, far more complicated than the vendors want counties (or taxpayers) to believe.

NaphCare

Facing a $20 million deficit, Spokane County is preparing to replace the health care provider overseeing the two local jails, which could impact the general fund by as much as $16 million. Michael Sparber, senior director of the Law and Justice division, and his team presented their options to the Board of County Commissioners. The upcoming transition follows a letter from NaphCare in June, signaling its intent to leave Spokane under a “without cause” provision by January 1, 2026. Spokane has contracted with NaphCare to provide services at the local jails since 2017, and extended that agreement through 2028 in January. Project Manager Ken Mohr said the letter wasn’t a surprise, and mentioned hearing “rumblings” that NaphCare wanted to leave the state amid costly settlements. He recommended that the board select Mediko, Inc. as the replacement and requested permission to enter negotiations with the health care provider next month.

TK Health/Turn Key Health

The Cleveland County Detention Center chief said the center’s new health care company is doing well amid process changes and new protocols following the departure of previous controversial provider TK Health. Detention center Chief Ted Woodhead said Redemption Correctional Healthcare Solutions is better than the center’s former provider. The detention center has seen 11 deaths in three years under TK Health. The most recent death happened at the end of June, just two days before Redemption was set to take over. Cynthia Smith, former registered nurse for Norman Regional Health System and co-founder of Redemption, said she and her business partners, Patrick Cody and Sean Lauderdale, decided to found the company after seeing the controversy surrounding the detention center’s health care.

Southern Health Partners

Southern Health Partners left Aiken County in 2023; now it’s pulling out of another county. The company told Bamberg County leaders it is pulling out of the Bamberg County Detention Center. That is the same company that was in charge of Alan Thibodeau’s treatment when he was there. He lost almost 80 pounds and essentially starved to death in the Bamberg County Detention Center. Thibodeau wasn’t supposed to be in jail. He was initially arrested on burglary charges, but a judge ordered that he be moved to a mental health facility. That never happened. The County is now negotiating with the Medical University of South Carolina for inmate care. Bamberg leaders say Southern Health Partners told them they are pulling out of other South Carolina counties, too.

Wellpath

A wrongful death lawsuit filed Aug. 28 in U.S. District Court alleges Jackson County (OR) and its healthcare provider, Wellpath, violated the constitutional rights of 58-year-old Leonard Kirklin, who died in custody. The suit claims Kirklin told a Wellpath mental health worker he was considering suicides. His schizophrenia and suicidal tendencies were known to staff, yet he was placed in a standard cell rather than on suicide watch. A Wellpath employee reportedly cited the “unhealthy” environment of the suicide watch cells. The case adds to Wellpath’s growing legal troubles. In 2023, the company paid $11 million to settle the in-custody death of a Redding man. A federal judge later found Wellpath had destroyed emails tied to a woman’s death in Josephine County Jail, and in a separate 2023 case, another judge ruled the company was deceptive in withholding evidence related to a Coos County death.

COCHS Weekly Update will not be published next week
in honor of the federal holiday