COCHS WEEKLY UPDATE: June 09, 2026
Medicaid & Reentry Update Part II: Medicaid Suspension & Work Requirements
Highlighted Stories
Editor's Note
When we wrote last week's Editor's Note, we did not anticipate there would be a Part II to our Medicaid & Reentry Update. However, given the stories that crossed our desk this week, it seemed appropriate to continue the theme. The first highlighted article, from Health Affairs, explains the complexity of the Medicaid suspension provisions included in the 2024 Consolidated Appropriations Act (CAA) and what is known as the "coverage gap."
For subscribers who are unfamiliar with Medicaid suspension, the following is a very abbreviated history. The legislation that created Medicaid in 1965 prohibited federal Medicaid matching funds for services provided to "inmates of a public institution." This prohibition is known as the Medicaid Inmate Exclusion Policy (MIEP). For people enrolled in Medicaid who became "inmates of a public institution"—for our purposes, individuals in jails or prisons—states terminated Medicaid coverage. One method to identify incarcerated individuals covered by Medicaid (or receiving Supplemental Security Income) was a bounty system whereby correctional facilities received incentive payments for sending a list of their detainees to the Social Security Administration. Upon release, individuals had to go through the reenrollment process, creating a coverage gap for those who had previously been covered.
In 2004, CMS issued a State Medicaid Director's Letter (SMD) encouraging states to suspend Medicaid rather than terminate it during incarceration. The letter emphasized the need for a "continuum of care" that would avoid costly and inappropriate service utilization later—a concept we would now describe as addressing the coverage gap. States did not immediately change their policies to allow for suspension. In fact, there was considerable pushback. The National Association of State Medicaid Directors warned of the complexities involved: statutes might need to be amended, and system upgrades could require significant expenditures.
It must be remembered that at the time CMS encouraged suspension, Medicaid eligibility was tied to specific categorical groups such as pregnant women, the aged, the blind, and people with disabilities. These populations did not constitute a significant portion of the incarcerated population. States were slow to change their policies—or did not change them at all. One explanation may be that only a small percentage of incarcerated individuals were eligible for Medicaid. However, as the Health Affairs article explains, the Affordable Care Act created a new expansion population based on income rather than categorical eligibility. In states that expanded Medicaid, this meant that as many as 80 percent of incarcerated individuals could potentially be eligible. As a result, the consequences of the coverage gap became much more significant.
The CAA of 2024 attempts to address this problem by requiring states to suspend rather than terminate Medicaid coverage for incarcerated individuals. Recognizing that implementation would require substantial system changes—a concern identified by the National Association of State Medicaid Directors more than twenty years ago—Congress appropriated $113.5 million to support system upgrades. Yet this amount appears modest compared with the costs some states have reported. California, for example, reported spending approximately $410 million on infrastructure changes associated with implementation.
Why is it so expensive? The answer lies in the history of Medicaid itself. The system was binary: Eligible/Not Eligible. Enrolled/Not Enrolled. The computer systems were built accordingly. There was no use case for suspension. State Medicaid systems are often legacy systems, and adapting them to accommodate suspension may require far more than adding a new line of code or another field in a database. In many cases, suspension introduces an entirely new business process into systems whose underlying architecture was designed decades ago. These implementation hurdles may help explain why, as the Health Affairs article notes, only six states have fully modified their systems to support suspension. In addition, although Congress provided funding for upgrades, CMS did not establish specific penalties for states that fail to comply.
Adding further uncertainty is the One Big Beautiful Bill Act's (OBBBA) restructuring of Medicaid eligibility. If work requirements significantly reduce Medicaid enrollment among justice-involved populations, the practical importance of suspension could diminish simply because fewer people will have Medicaid coverage to suspend.
The articles from the Center on Budget and Policy Priorities, Politico, Roll Call, and the Autistic Self Advocacy Network highlight another aspect of the challenges facing Medicaid beneficiaries and states attempting to comply with OBBBA requirements. On June 1, the Trump Administration released its final rule implementing Medicaid work requirements and made several significant last-minute policy changes, including revisions to how states determine whether an individual qualifies as medically frail and is therefore exempt from the work requirement. Again, as with the changes required for Medicaid suspension, this final rule will require states to revisit and modify eligibility systems. As Politico notes, many states will be forced to make these changes using aging technology platforms that already struggle to keep pace with federal policy shifts—a challenge that sounds remarkably similar to the difficulties surrounding Medicaid suspension.
Despite these complicated developments, the Legal Action Center (LAC) welcomed the New York Legislature's passage of the Transitional Reentry Health Act, which now awaits Governor Hochul's signature. The legislation would require state prisons and local jails to assist eligible incarcerated individuals with Medicaid enrollment prior to release and ensure that previously enrolled individuals have their coverage reinstated when they return to the community. But, as LAC makes clear, the need for this legislation has considerably increased in light of how the OBBBA's work requirements will affect Medicaid eligibility among justice-involved populations.
For subscribers who are unfamiliar with Medicaid suspension, the following is a very abbreviated history. The legislation that created Medicaid in 1965 prohibited federal Medicaid matching funds for services provided to "inmates of a public institution." This prohibition is known as the Medicaid Inmate Exclusion Policy (MIEP). For people enrolled in Medicaid who became "inmates of a public institution"—for our purposes, individuals in jails or prisons—states terminated Medicaid coverage. One method to identify incarcerated individuals covered by Medicaid (or receiving Supplemental Security Income) was a bounty system whereby correctional facilities received incentive payments for sending a list of their detainees to the Social Security Administration. Upon release, individuals had to go through the reenrollment process, creating a coverage gap for those who had previously been covered.
In 2004, CMS issued a State Medicaid Director's Letter (SMD) encouraging states to suspend Medicaid rather than terminate it during incarceration. The letter emphasized the need for a "continuum of care" that would avoid costly and inappropriate service utilization later—a concept we would now describe as addressing the coverage gap. States did not immediately change their policies to allow for suspension. In fact, there was considerable pushback. The National Association of State Medicaid Directors warned of the complexities involved: statutes might need to be amended, and system upgrades could require significant expenditures.
It must be remembered that at the time CMS encouraged suspension, Medicaid eligibility was tied to specific categorical groups such as pregnant women, the aged, the blind, and people with disabilities. These populations did not constitute a significant portion of the incarcerated population. States were slow to change their policies—or did not change them at all. One explanation may be that only a small percentage of incarcerated individuals were eligible for Medicaid. However, as the Health Affairs article explains, the Affordable Care Act created a new expansion population based on income rather than categorical eligibility. In states that expanded Medicaid, this meant that as many as 80 percent of incarcerated individuals could potentially be eligible. As a result, the consequences of the coverage gap became much more significant.
The CAA of 2024 attempts to address this problem by requiring states to suspend rather than terminate Medicaid coverage for incarcerated individuals. Recognizing that implementation would require substantial system changes—a concern identified by the National Association of State Medicaid Directors more than twenty years ago—Congress appropriated $113.5 million to support system upgrades. Yet this amount appears modest compared with the costs some states have reported. California, for example, reported spending approximately $410 million on infrastructure changes associated with implementation.
Why is it so expensive? The answer lies in the history of Medicaid itself. The system was binary: Eligible/Not Eligible. Enrolled/Not Enrolled. The computer systems were built accordingly. There was no use case for suspension. State Medicaid systems are often legacy systems, and adapting them to accommodate suspension may require far more than adding a new line of code or another field in a database. In many cases, suspension introduces an entirely new business process into systems whose underlying architecture was designed decades ago. These implementation hurdles may help explain why, as the Health Affairs article notes, only six states have fully modified their systems to support suspension. In addition, although Congress provided funding for upgrades, CMS did not establish specific penalties for states that fail to comply.
Adding further uncertainty is the One Big Beautiful Bill Act's (OBBBA) restructuring of Medicaid eligibility. If work requirements significantly reduce Medicaid enrollment among justice-involved populations, the practical importance of suspension could diminish simply because fewer people will have Medicaid coverage to suspend.
The articles from the Center on Budget and Policy Priorities, Politico, Roll Call, and the Autistic Self Advocacy Network highlight another aspect of the challenges facing Medicaid beneficiaries and states attempting to comply with OBBBA requirements. On June 1, the Trump Administration released its final rule implementing Medicaid work requirements and made several significant last-minute policy changes, including revisions to how states determine whether an individual qualifies as medically frail and is therefore exempt from the work requirement. Again, as with the changes required for Medicaid suspension, this final rule will require states to revisit and modify eligibility systems. As Politico notes, many states will be forced to make these changes using aging technology platforms that already struggle to keep pace with federal policy shifts—a challenge that sounds remarkably similar to the difficulties surrounding Medicaid suspension.
Despite these complicated developments, the Legal Action Center (LAC) welcomed the New York Legislature's passage of the Transitional Reentry Health Act, which now awaits Governor Hochul's signature. The legislation would require state prisons and local jails to assist eligible incarcerated individuals with Medicaid enrollment prior to release and ensure that previously enrolled individuals have their coverage reinstated when they return to the community. But, as LAC makes clear, the need for this legislation has considerably increased in light of how the OBBBA's work requirements will affect Medicaid eligibility among justice-involved populations.
Suspension
Health Affairs: Navigating Medicaid Suspension For Incarcerated Adults
This year marked a major shift in carceral health care policy with the activation of a nationwide Medicaid suspension provision, originally stipulated by the 2024 Consolidated Appropriations Act (CAA). The provision sets a new federal floor, where states are now required to suspend Medicaid benefits for incarcerated adults instead of terminating. Enactment within and among states is inconsistent, while enforcement mechanisms are absent, and funding for the data infrastructure necessary for compliance is insufficient. As of January 2026, only six states had fully automated Medicaid suspension processes in either their jails or prisons. Meanwhile, the 2025 One Big Beautiful Bill Act’s (OBBBA) Medicaid reforms threaten to undermine the Medicaid eligibility base itself, putting the entire suspension mandate at risk of becoming an empty promise.
Work Requirements
Center on Budget and Policy Priorities: Administration’s Last-Minute Restrictions Likely to Worsen Impact of Medicaid Work Requirement
The Trump Administration’s final rule implementing the new Medicaid work requirement makes major, last-minute policy shifts that will likely increase the number of people who are denied or lose health coverage due to the requirement, while stymieing states’ ability to implement it on time. The work requirement as established by the 2025 reconciliation bill (H.R. 1) was harmful enough. The new interim final rule, published June 1, compounds these problems and will make the coverage loss even higher. One example — it adds new requirements to the medically frailty exemption from the work requirement, requiring that the medical condition significantly impair a person’s ability to comply with the work requirement in order to qualify them for the exemption. The final rule departs significantly from what the Centers for Medicare & Medicaid Services (CMS) has been telling states for months. The changes in the rule will force states to make time-consuming and costly changes to their eligibility system, redo notices, rescind prior communications, and prepare for eligibility workers to take on significantly more burden than anticipated.
Politico: States balk at the high price of Medicaid work requirements amid budget crunch
The Trump administration is counting on Medicaid work requirements to save the government billions of dollars. But well before the rules formally go into effect Jan. 1, they’re costing already-strapped states millions or tens of millions to implement. State health departments are having to funnel resources into hiring more staff, paying for overtime, and upgrading their aging technology systems so they can determine which low-income residents are working, volunteering, caregiving, or studying enough hours to keep their Medicaid coverage. The only states to run pilot versions of work requirements in recent years — Arkansas, an expansion state, and Georgia, a partial expansion state — saw many working residents become uninsured because they couldn’t navigate the bureaucracy. Both states also spent a lot to implement the rules and saw no rise in employment as a result.
Roll Call: Administration sticks with Congress on Medicaid work mandate exemptions
The Centers for Medicare and Medicaid Services on June 1 outlined states’ obligations to implement upcoming Medicaid work requirements, issuing a rule that closely adheres to a list of exemptions already found in federal law. States have sought clarification about how much flexibility they will have to determine whether someone is frail enough to be exempt from the work requirements. In particular, state officials have wondered whether homeless people could be exempt. Medicaid coverage under Arkansas’ short-lived work requirement program in 2019. Many of those people met the requirements but didn’t fill out paperwork. The changes made by Congress are significant changes to Medicaid, with the Congressional Budget Office projecting that work requirements will increase the number of people without health insurance by 4.8 million in 2034.
Autistic Self Advocacy Network: New Medicaid Expansion Changes Hurt People with Disabilities
On June 1st, The Centers for Medicare and Medicaid Services (CMS) came out with a bad rule. This rule will hurt people with disabilities and many other people. CMS is the part of the U.S. government that makes rules that all state Medicaid programs have to follow. The rule tells states how to limit who can get health care from Medicaid expansion, or programs like Medicaid expansion. This would make it harder for many people to get the health care they need. If your state thinks you can work, you will have to work to get health care from Medicaid expansion or programs like Medicaid expansion. We still don’t know how people will be able to prove they can’t work.
Transitional Reentry Health Act
Legal Action Center: LAC Applauds NYS' Passage of Lifesaving Transitional Reentry Health Act
The New York Legislature passed the Transitional Reentry Health Act (S.614 / A.1008) in the closing days of the 2026 legislative session. The bill requires both state prisons and local jails to take steps to enroll eligible incarcerated individuals in Medicaid (or other health coverage programs for which they qualify) before release. It also requires reinstatement of Medicaid coverage when appropriate. LAC urges the Governor to swiftly sign the bill into law so every New Yorker leaving incarceration can access the care and support they need.
Follow Ups
Market Failure?
Editor's Comment: It is difficult to know how to categorize this first Follow Up from Alabama's AL.com. It could easily be connected to several stories we have covered in the Weekly Update. It could be viewed as another chapter in the continuing repercussions of YesCare's bankruptcy, particularly in Alabama. Or perhaps it belongs in one of COCHS' favorite recurring themes: the revolving door of proprietary correctional healthcare vendors. As the article explains, NaphCare is replacing YesCare in the Alabama Department of Corrections.
Then again, perhaps the story is really about NaphCare's own challenges. There is its recent history of being barred from doing business in New York State. There is also the growing attention being paid to its role in Arizona, where some observers have pointed to deficiencies in correctional healthcare as a contributing factor in Federal Judge Roslyn Silver's decision to move the Arizona Department of Corrections' healthcare system into receivership.
Phew. There are a lot of ways to categorize this story, and there are probably several more.
Rather than choosing one, perhaps all of these interlocking stories point to something we mentioned in last week's YesCare Follow Up: the proprietary healthcare model often leaves jurisdictions wondering whom they can turn to for correctional medical services. In other words, are we witnessing a form of market failure discussed previously in which jurisdictions continually search for solutions that never quite arrive?
In other areas of healthcare, proprietary providers have achieved considerable success. Specialty hospitals, imaging centers, ambulatory surgery centers, and dialysis services are obvious examples. Yet all of these sectors share one characteristic: a relatively narrow and well-defined scope of services.
Correctional healthcare is different. The patient population presents complex medical and behavioral health needs. Utilization is difficult to predict. Staffing shortages are chronic. Contracts are often fixed-price arrangements that shift substantial financial risk to the vendor and leads to what many see as negligent healthcare. Put all of these factors into a blender and it almost seems inevitable that we end up with a succession of familiar names—YesCare, Wellpath, NaphCare, Centurion, and whatever proprietary provider emerges next.
And then, as we so often see in the Weekly Update, the cycle repeats itself: tragedy followed by litigation, litigation followed by financial distress, and financial distress followed by bankruptcy, contract termination, or, in the most extreme cases, a complete breakdown that results in federal receivership.
Then again, perhaps the story is really about NaphCare's own challenges. There is its recent history of being barred from doing business in New York State. There is also the growing attention being paid to its role in Arizona, where some observers have pointed to deficiencies in correctional healthcare as a contributing factor in Federal Judge Roslyn Silver's decision to move the Arizona Department of Corrections' healthcare system into receivership.
Phew. There are a lot of ways to categorize this story, and there are probably several more.
Rather than choosing one, perhaps all of these interlocking stories point to something we mentioned in last week's YesCare Follow Up: the proprietary healthcare model often leaves jurisdictions wondering whom they can turn to for correctional medical services. In other words, are we witnessing a form of market failure discussed previously in which jurisdictions continually search for solutions that never quite arrive?
In other areas of healthcare, proprietary providers have achieved considerable success. Specialty hospitals, imaging centers, ambulatory surgery centers, and dialysis services are obvious examples. Yet all of these sectors share one characteristic: a relatively narrow and well-defined scope of services.
Correctional healthcare is different. The patient population presents complex medical and behavioral health needs. Utilization is difficult to predict. Staffing shortages are chronic. Contracts are often fixed-price arrangements that shift substantial financial risk to the vendor and leads to what many see as negligent healthcare. Put all of these factors into a blender and it almost seems inevitable that we end up with a succession of familiar names—YesCare, Wellpath, NaphCare, Centurion, and whatever proprietary provider emerges next.
And then, as we so often see in the Weekly Update, the cycle repeats itself: tragedy followed by litigation, litigation followed by financial distress, and financial distress followed by bankruptcy, contract termination, or, in the most extreme cases, a complete breakdown that results in federal receivership.
AL.com: Prison health care company awarded $500 million Alabama contract faces complaints across country
Alabama Department of Corrections has entered a contract a $500 million contract with NaphCare after abruptly terminating a $1 billion agreement with Tennessee-based YesCare due to ongoing financial problems in the company. NaphCare was banned from operating in New York earlier this year and has been blamed by the Arizona Department of Corrections for negligence that led to nine prisons in that state being placed in receivership. NaphCare is alleged to have not provided adequate medical and mental health services after being granted contracts originally held by three other private firms, including Corizon, the company formerly known as YesCare.
Ending Crime and Disorder on America's Streets
Editor's Comment: The Executive Order, Ending Crime and Disorder on America's Streets, was issued on July 24, 2025, and over the last several months we have begun to see how significant its impact may be.
In the New York Times article, one can see the Administration's shift away from the Housing First model and toward time-limited housing programs. This issue first appeared in the March 17, 2026 Weekly Update, when HUD Secretary Scott Turner had been too hasty in the administration shift away from the long-standing Housing First policy. The changes were announced at the last minute, prompting a federal judge to issue an injunction. Congress subsequently passed legislation requiring the Department of Housing and Urban Development to direct at least 60 percent of its homelessness assistance funding to long-term housing programs, while allowing the remaining 40 percent to be used for transitional housing.
The Executive Order's influence can also be seen in substance use policy. In that same March 17 Weekly Update, we reported that the CDC had informed grant recipients that they could no longer promote the "Never Use Alone" slogan. Now, Think Global Health reports that SAMHSA is encouraging practitioners to taper individuals off buprenorphine and methadone. In addition, drug czar Sara Carter is promoting faith-based organizations as part of the nation's substance use treatment strategy.
Finally, WOSU reports that health agencies have lost funding for fentanyl test strips. The article notes that Ohio has experienced a significant decline in fentanyl-related deaths in recent years, a trend that some public health advocates fear could be reversed if harm-reduction resources are discontinued.
In the New York Times article, one can see the Administration's shift away from the Housing First model and toward time-limited housing programs. This issue first appeared in the March 17, 2026 Weekly Update, when HUD Secretary Scott Turner had been too hasty in the administration shift away from the long-standing Housing First policy. The changes were announced at the last minute, prompting a federal judge to issue an injunction. Congress subsequently passed legislation requiring the Department of Housing and Urban Development to direct at least 60 percent of its homelessness assistance funding to long-term housing programs, while allowing the remaining 40 percent to be used for transitional housing.
The Executive Order's influence can also be seen in substance use policy. In that same March 17 Weekly Update, we reported that the CDC had informed grant recipients that they could no longer promote the "Never Use Alone" slogan. Now, Think Global Health reports that SAMHSA is encouraging practitioners to taper individuals off buprenorphine and methadone. In addition, drug czar Sara Carter is promoting faith-based organizations as part of the nation's substance use treatment strategy.
Finally, WOSU reports that health agencies have lost funding for fentanyl test strips. The article notes that Ohio has experienced a significant decline in fentanyl-related deaths in recent years, a trend that some public health advocates fear could be reversed if harm-reduction resources are discontinued.
New York Times: Pushing Treatment, Trump Administration Limits Housing Aid for Homeless
The Trump administration has issued a revised plan to address homelessness that shifts large sums of federal aid from long-term housing to time-limited programs that emphasize treatment for mental illness and addiction. The administration’s revised plan is a frontal assault on the longstanding model of homelessness aid known as Housing First. The move is likely to shift about $1.2 billion away from housing programs, with the risk of displacing current tenants. It constitutes the sharpest change in homelessness policy in a generation. The change involves the Department of Housing and Urban Development’s Continuum of Care program, which disburses about $4 billion a year to more than 400 local grant-making groups to finance aid to the homeless.
Think Global Health: Trump's Faith-Based Push Threatens Standard Addiction Treatment
Last July, Donald Trump signed an executive order Ending Crime and Disorder on America's Streets. However, broader harm reduction initiatives—specifically medications for opioid use disorder like buprenorphine and methadone—have continued receiving federal support to expand access. However, Christopher Carroll, principal deputy assistant secretary at SAMHSA, encouraged practitioners to consider tapering patients off these medications, despite clinical research supporting their long-term use. Meanwhile, the National Drug Control Strategy under drug czar Sara Carter is promoting faith-based organizations into addiction treatment efforts.
WOSU: Federal funding ends for fentanyl test strips as Ohio public health agency supplies run low
Many Ohio public health agencies have lost a key funding stream from the Trump administration to stock test strips for illegal drugs containing fentanyl or other dangerous substances. These test strips are considered a vital harm reduction tool that helps prevent overdose deaths. Agencies like Columbus Public Health warn they might run out of test strips, risking a jump in overdoses after the Buckeye State saw a reduction in deaths in the last several years.
Texas Commission on Jail Standards
Editor's Comment: Following up on last week's Texas Follow Up, it appears that Dallas County Sheriff Marian Brown has neither reported Julie Buelna's death at Parkland Hospital to the Texas Attorney General nor provided an explanation for the failure to do so. According to the executive director of the Texas Commission on Jail Standards, Buelna's death should be classified as an in-custody death and should have been reported to the Commission within 24 hours
Dallas Morning News: Why won’t Dallas County sheriff answer questions about jail death?
Three months after Julie Buelna was fatally injured in the Dallas County jail, the Sheriff’s Department has yet to notify the Texas attorney general’s office about her death. State law requires notification within 30 days. Sheriff Marian Brown hasn’t explained why her agency neglected that duty. The jail standards commission reaffirmed in February that all in-custody deaths, even if they happen outside of the jail, must be reported to the commission within 24 hours. They also must be investigated by an outside agency. The commission’s director confirmed to McManus that Buelna’s death should be considered an in-custody death.
Food Poisoning
Editor's Comment: Last week we included an article from Broome County, New York, reporting a salmonella outbreak at the county jail. The following articles continue that story as the investigation unfolds. A lawyer has now filed a class-action lawsuit against Sheriff Fred Akshar and Broome County. Testing of food samples from the jail identified chicken salad recently served to detainees as the source of the outbreak. Investigators determined that frozen chicken had been handled improperly.
This was not the first such incident involving Trinity Services Group. It is hardly surprising that the final article in this series reports that the "frozen chicken that was used in the salad was left in the middle of the kitchen for more than three hours."
As a point of interest, in 2024, we highlighted a CDC report finding that foodborne illnesses occur in correctional facilities at a rate six times higher than in the general public. The report identified inadequate temperature control as one of the leading causes of foodborne outbreaks in correctional settings.
This was not the first such incident involving Trinity Services Group. It is hardly surprising that the final article in this series reports that the "frozen chicken that was used in the salad was left in the middle of the kitchen for more than three hours."
As a point of interest, in 2024, we highlighted a CDC report finding that foodborne illnesses occur in correctional facilities at a rate six times higher than in the general public. The report identified inadequate temperature control as one of the leading causes of foodborne outbreaks in correctional settings.
PressConnect: Inmates allege neglect during Broome County Jail's salmonella outbreak
Former and current inmates suing the Broome County sheriff over a salmonella outbreak that spread to more than 300 inmates are speaking out, alleging dereliction of duty and systemic failures that led to mistreatment in the Broome County jail. After filing a class action lawsuit against Broome County Sheriff Fred Akshar and Broome County, attorney Ronald Benjamin announced on that he had also contacted New York Gov. Kathy Hochul and the Broome County Legislature, calling for their intervention. Food from the prison was sent to the Wadsworth Center lab in Albany for testing to find the source of the bacteria, and test results for chicken salad that was served to the inmates came back positive for salmonella. The Broome County Health Department said it is working with the jail's food vendor, Trinity Services Group, and the jail itself to "enhance food handling."
BinghamptonHomePage: Health Department found six violations at BC jail following salmonella outbreak
An update on the salmonella outbreak in the Broome County Jail, the Health Department cited six critical violations in the meal preparation of the chicken salad that tested positive. Food was improperly refrigerated in numerous instances, with frozen and refrigerated foods being left on the loading dock for over five hours. The frozen chicken that was used in the salad was left in the middle of the kitchen for more than three hours. The chicken was placed in a skillet and workers picked pieces off of it while it was cooking. Many of these are repeat violations that food provider Trinity Service Group has made in the past.
New York
Editor's Comment: It has been a while since we talked about New York State. Once again, we are seeing complaints from public safety officials about the Humane Alternatives to Long-Term Solitary Confinement (HALT) Act. This time, however, the concerns are coming from county sheriffs rather than statewide organizations like the New York State Correctional Officers.
Local sheriffs are chafing under the Act's mental health requirements. They point to staffing shortages and budget constraints, now compounded by the need to hire additional mental health professionals. In addition, as is often the case in public safety, sheriffs express concern about the potential for manipulation by detained individuals, particularly because people with certain mental health diagnoses cannot be placed in segregated confinement.
At a broader level, however, what seems to be occurring is captured by a comment from Essex County Sheriff David Reynolds: "It seems like the only place New York State can figure out where to put people with mental health issues is in jail, and it's not the place for them."
Here at COCHS, we would say amen to that.
Many of the conflicts surrounding the HALT Act reflect a larger problem: jails have increasingly become the de facto mental health institutions. If meaningful solutions to the mental health crisis were developed and jails were no longer expected to serve in that role, some of the continuing clashes over the HALT Act—and similar legislation elsewhere—might be reduced.
Unfortunately, that outcome does not appear imminent. If it does not occur, corrections may remain trapped in another bleak cycle, like the one with proprietary correctional healthcare vendors discussed in our first Follow Up this week.
Local sheriffs are chafing under the Act's mental health requirements. They point to staffing shortages and budget constraints, now compounded by the need to hire additional mental health professionals. In addition, as is often the case in public safety, sheriffs express concern about the potential for manipulation by detained individuals, particularly because people with certain mental health diagnoses cannot be placed in segregated confinement.
At a broader level, however, what seems to be occurring is captured by a comment from Essex County Sheriff David Reynolds: "It seems like the only place New York State can figure out where to put people with mental health issues is in jail, and it's not the place for them."
Here at COCHS, we would say amen to that.
Many of the conflicts surrounding the HALT Act reflect a larger problem: jails have increasingly become the de facto mental health institutions. If meaningful solutions to the mental health crisis were developed and jails were no longer expected to serve in that role, some of the continuing clashes over the HALT Act—and similar legislation elsewhere—might be reduced.
Unfortunately, that outcome does not appear imminent. If it does not occur, corrections may remain trapped in another bleak cycle, like the one with proprietary correctional healthcare vendors discussed in our first Follow Up this week.
NBC: HALT Act requirements for mental health support in jails continues to overwhelm resources
More than two thousand officers were fired after the unsanctioned, illegal walkout more than a year ago across New York State prisons. A major point of contention is still the implementation of the HALT Act. The state law restricts solitary confinement and mandates specific mental health protections within prisons and jails. The language in the HALT Act describes incarcerated people living with mental illnesses as "vulnerable populations." Sheriff David Reynolds at Essex County Jail said addressing mental illness is more complicated than the state realizes, particularly when it comes to the wide range of individuals who could be held at the county jail at any given time. Clinton County Sheriff David Favro along with Sheriff Reynolds say that because of budget restraints, they're faced with hiring mental health professionals while struggling with an officer shortage.
ICE
Reprisals
The Sun: 3 detainees who recently spoke to congressional visitors at Adelanto ICE facility reportedly sent to solitary confinement
Three detained men who met this week with members of Congress at the Adelanto ICE Processing Center to discuss conditions inside the detention facility and offer details about an ongoing hunger strike have been transferred to solitary confinement, several detainees told the Southern California News Group, a move some believe was retaliatory. U.S. Rep. Judy Chu (D-Pasadena) said she was “horrified” to hear about the alleged retaliation faced by the three men she and Reps. Pete Aguilar and Jimmy Gomez visited.
ABC: ICE detainee who spoke out about conditions in Moshannon was punished, transferred
An ICE detainee was put in solitary confinement, then transferred out of state after the private contractor that runs a Pennsylvania detention center claimed he encouraged others to refuse meals to protest conditions. The Department of Homeland Security said at the time that claims of a hunger strike were “false.”
Suicide
Solitary Watch: The Deadly Abuses Within ICE Facilities Are Amplifications of Our Own Prison System
On April 30, the U.S. House of Representatives passed legislation to end a record-long government shutdown that shuttered annual discretionary funding for the Department of Homeland Security for 76 days, though it notably omitted funding for U.S. Immigration and Customs Enforcement and U.S. Customs and Border Protection. The next day, ICE announced the apparent suicide of Cuban migrant Denny Adan Gonzalez, who had been held in solitary confinement in its custody — the 18th death and the fifth suicide of a person in ICE custody so far in 2026. Since President Trump retook office in January 2025, medical neglect, abuse, and solitary confinement within ICE detention facilities have led to over 40 individual deaths, with a person now dying every six days in the agency's custody.
Food
NJ: Trump border czar says he ate the food at Delaney Hall. Detainees say it’s not even fit for animals.
White House border czar Tom Homan said he made a “surprise visit” last weekend to Newark’s Delaney Hall ICE detention center amid an ongoing hunger and labor strike by detainees. Detainees have reported receiving spoiled or rotten food and having no access to toilet paper, menstrual products or toothpaste. Bryan Carchipulla, a detainee who helped organize the strike and has since been released, told NJ.com that the food is “disgusting” and “so bad, not even animals would eat it.” Homan disputed the allegations calling reports of harsh conditions inside the facility a “false premise.”
California
California State Senator Padilla: Senator Padilla Introduces Legislation Closing A Loophole Allowing Nonprofits to Avoid Millions in Taxes by Claiming ICE Detention Centers as Charities
Senator Steve Padilla (D-San Diego) introduced language to amend Senate Bill 420, ensuring organizations tied to private immigration detention centers cannot claim charitable tax status solely because they are organized as nonprofits. The California Welfare Exemption serves as a property tax relief program for nonprofit organizations that conduct charitable activity and benefit the public. For years, nonprofits have been supported through this exemption for the valuable work they do in local communities.
New Jersey
New York Times: Governor Says Immigration Officials Won’t Let Her Visit Delaney Hall
Gov. Mikie Sherrill of New Jersey said Wednesday that federal immigration officials were continuing to bar her from entering a detention center in Newark, raising “serious questions about what is happening behind its walls.” Ms. Sherrill noted that she had met Tuesday evening with relatives of migrants being held at the Delaney Hall detention center, which has become a focal point of protest against President Trump’s immigration crackdown.
New Jersey Monitor: NJ sues Newark migrant jail owners over blocked health inspections
New Jersey sued the owners of Newark migrant jail Delaney Hall to force the company to allow state health inspectors inside the detention center that has been at the center of claims that detainees are living in inhumane conditions. The complaint, filed in state Superior Court in Essex County, asks a judge to order the company, Geo Group, to allow state inspectors access to the jail’s medical unit, sleeping quarters, shower and toilet facilities, and HVAC systems. Gov. Mikie Sherrill said when state inspectors visited the jail last week, Geo Group staff allowed them access to food service areas only.
NBC: N.J. targets prison company running immigration detention center in lawsuits over conditions
The mayor of Newark is doubling down on his efforts to shut down Delaney Hall, the New Jersey immigration detention facility that has been at the center of protests for nearly two weeks, drawing demonstrators over allegations of poor conditions and counterprotesters voicing support for ICE. Mayor Ras Baraka announced Tuesday that the city will continue focusing its efforts on going after GEO Group, the major private prison company that operates the facility, instead of federal immigration agencies.
Texas
Center Square: ICE sued over ‘inhumane’ conditions at Texas detention camp
The ACLU has sued Immigration and Customs Enforcement over alleged inhumane conditions at Camp East Montana, a massive immigration detention tent camp at the Fort Bliss military base in El Paso. The lawsuit and motion for class certification were filed on behalf of four people detained at Camp East Montana and is the first lawsuit against the nation’s largest immigration detention center.
Technology
NC Health News: New app aims to make it easier for people leaving incarceration to identify resources
An app released last week seeks to fill a gap in guidance for the recently incarcerated. Next Steps by RREPS uses artificial intelligence to create personalized reentry plans in just a few minutes by pulling from a verified database of resources maintained by RREPS. The app was developed by the nonprofit Recidivism Reduction Educational Program Services led by Kerwin Pittman.
Correctional Healthcare Vendors
PrimeCare Medical
phillyburbs.com: Inmate alleges Bucks County Jail stay led to sepsis, surgery in lawsuit
A former Bucks County jail inmate is alleging he was hospitalized twice with a life-threatening infection from a deep bedsore after he was denied a special mattress that prevents the condition. The lawsuit, which alleges negligence, names as defendants, Bucks County, its corrections department, the jail’s health care provider PrimeCare Medical and multiple employees. In addition, Lansdale resident Joseph Walsh sued the county and PrimeCare Medical last year alleging he was repeatedly denied a pressure-relieving mattress, catheters, incontinence supplies, wound care and skin integrity checks during a five week incarceration in 2024.
FirstClass Healthcare
WALB: Dougherty County approves renewal of multimillion-dollar jail medical contract
Dougherty County (GA) commissioners have approved renewing a multimillion-dollar contract to provide medical care for inmates at the county jail. Officials said this year’s cost is higher than expected. The county’s agreement with First Class Health Care covers everything from inmate intake screenings and ongoing medical treatment to outside appointments and mental health care. The three-year contract is now in its second year. Commissioners approve renewing it for just over $8.4 million more than last year, because of a deferred payment from year one.