Weekly Update: April 30, 2024
Frontline Correctional Health Care Workers Struggle With Funding Constraints: 1115s & State/County Budgets; Asst. AG Amy Solomon’s Remarks


Highlighted Stories

Editor's Note
This week's highlighted stories focus on the tension frontline correctional workers experience because there is often inadequate funding to support their work. The letter to the editor from a dentist in Connecticut at that state’s women’s prison speaks loudly to the challenges that frontline workers face. In delivering care that is their professional responsibility, frontline health care providers struggle when there is not sufficient funding to provide the necessary services. The articles from Multnomah County (Portland, Oregon) point to the tension between frontline nurses and administrative staff. There have been requests by nurses for higher pay and because of recent deaths there is a need for funding to “de-silo” health care from corrections.

Keeping states and counties as solely responsible for providing health care to the individuals under their care and custody has been the policy of the United States since the landmark Supreme Court case, Estelle v. Gamble. With the possibility of 1115 waivers and the ability of federally qualified health centers to provide care behind the wall (see last week’s Editor’s Note), federal dollars are now becoming available to states and counties. These highlighted stories simply underscore how we cannot expect frontline workers to meet their obligation to people under the care and custody because of state and county budgetary constraints.

While 1115 waivers may help those states that have expanded Medicaid, there are states where there is still considerable resistance to expansion. Non-expansion of Medicaid would greatly lessen the impact of an 1115 waiver. Governor Laura Kelly of Kansas has been hosting roundtables with public safety to emphasize the importance of Medicaid expansion for her state. The Director of the Shawnee County Department of Corrections, said it best: “The cost to provide quality health care for those who are incarcerated is becoming one of the biggest challenges our community faces today.”

Recognizing the work of public safety is also an important component within corrections. In a speech given in Chicago, Assistant Attorney General, Amy L. Solomon emphasized the other frontline workers, correctional officers. She noted the extremely difficult conditions under which these professionals work and also their need for higher pay. Continuing on, she stated, "The transformative power of safe environments, of respectful climates, of conditions that are conducive to sound physical and mental health, cannot be overstated."

Dental Care & Funding
CT Examiner: Without Funding, Connecticut Cannot Live Up to its Legal Obligations for Prison Care
Connecticut is reaching a crisis point where the most vulnerable members of the population are experiencing worsening health conditions. Despite being one of the wealthiest states in the U.S., we are failing to adequately support healthcare, dental, and mental health services for marginalized communities. My name is Leslie Bumpus, DDS, and I am a dentist at the York Correctional Institution, the state’s sole women’s facility. As the only dentist responsible for over 800 incarcerated women, and with no option for overtime, I witness individuals suffering from dental pain daily. Those incarcerated have a constitutional right to receive timely healthcare. Public Act 22-133 mandated dental screenings and care plans upon intake and annually thereafter. We have the resources to do whatever it takes to recruit quality healthcare staff with proper compensation, but this is simply not being done. To address years of systemic understaffing there must be adequate funding.

Multnomah County (Portland, Oregon)
KOIN: Multnomah County nurses call for termination of Corrections Health leaders
In a letter sent to Multnomah County Sheriff Nicole Morrisey O’Donnell, Nurses at Multnomah County jails (Portland) are demanding the ouster of the administrators leading the Corrections Health Department. According to the letter, 95% of corrections nurses who were surveyed in February said their workplace conditions hadn’t improved within the past four years. About 97% of respondents also returned a vote of no confidence in the current leaders. The letter also called for higher pay for nurses, and insisted they be included in the hiring process.

Willamette Weekly: Multnomah County Weighs Spending $200,000 to “De-Silo” Jail Health System
Multnomah County officials propose to spend $200,000 of contingency funds on initiatives to improve relations between the two organizations responsible for the well-being of jail inmates: the sheriff’s office and the county’s health department. The County Board of Commissioners plans to consider the proposal which would “immediately begin efforts to de-silo the sheriff’s office and Corrections Health.” The plan comes after an unprecedented string of seven inmate deaths last year and a subsequent report by a National Institute of Corrections consultant that found “serious health care and operations issues in the Multnomah jail system.”

Multnomah County: Sheriff’s Office, Corrections Health provide update to Board addressing reports and recommendations in response to jail deaths
The Multnomah County Board of Commissioners on April 23 received updates from the Sheriff’s Office and Corrections Health on several reports and policy recommendations responding to a sharp increase in deaths in custody. One recommendation was to improve communication with the Sheriff’s Office. One of the biggest initiatives taken to meet that recommendation was creating a multi-agency release of information form that allows for more efficient communication between Corrections Health and the Sheriff’s Office while also maintaining patient confidentiality.

KOIN: Multnomah County addresses ‘unprecedented’ spike in inmate deaths in 2023
The Multnomah County Sheriff’s Office and Corrections Health briefed the Board of Commissioners on recent steps taken to prevent in-jail deaths on April 23, after seven inmates died in Multnomah County jails between May and October of 2023. Accidental fentanyl overdoses and suicides accounted for five of the seven deaths. The county ordered an independent audit and performed internal evaluations to address the spike in inmate deaths.

Kansas & Medicaid Expansion
Office of Governor: Governor Kelly and Law Enforcement Leaders Hold Roundtable Discussion on Medicaid Expansion
Governor Laura Kelly hosted a roundtable with law enforcement and local community leaders at the Shawnee County Adult Correctional Facility to discuss Medicaid expansion and its impacts to counties and local taxpayers. This event marks Governor Kelly’s second stop on her relaunched “Healthy Workers, Healthy Economy” tour, ahead of the Kansas Legislature’s vote on a motion to debate Medicaid expansion on the Senate floor on April 26. “The cost to provide quality health care for those who are incarcerated is becoming one of the biggest challenges our community faces today,” said Director Brian Cole, Shawnee County Department of Corrections.

Assistant Attorney General's Remarks
Department of Justice Office of Public Affairs: Assistant Attorney General Amy L. Solomon Delivers Remarks at the Elevating Our Profession Corrections Conference and Medal Of Honor Ceremony
[Excerpt 1] The job of the corrections officer is one of the most difficult and demanding jobs in public safety, and we know the corrections field is facing some serious challenges right now.
[Excerpt 2] Corrections officers are being burdened with more responsibilities and longer hours. High job vacancy rates are making it difficult to run safe and secure facilities, and that contributes heavily to the extended hours and responsibilities.
[Excerpt 3] Recruiting qualified people to reach appropriate staffing levels takes time, and improving retention rates is a long-term strategy that encompasses everything from higher pay to better professional development opportunities to fundamental issues around personal security.
[Excerpt 4] The transformative power of safe environments, of respectful climates, of conditions that are conducive to sound physical and mental health, cannot be overstated.

KFF: Section 1115 Waiver Watch: Medicaid Pre-Release Services for People Who Are Incarcerated
This Waiver Watch reviews CMS guidance and summarizes key features of the three approved 1115 reentry waivers. The site includes a map of approved and pending 1115 waivers.

Environmental Safety

Office of Senator Ed Markey: Senator Markey and Rep. Pressley Introduce Declaration of Environmental Rights for Incarcerated People
Senator Markey and Congresswoman Ayanna Pressley introduced the Declaration of Environmental Rights for Incarcerated People. This resolution affirms the human right of nearly two million people currently incarcerated in the United States to a healthy and safe environment and to advocate for protecting and improving their environmental health. The Resolution text was developed in partnership with the African American Coalition Committee and other incarcerated leaders at MCI-Norfolk. During Senator Markey’s and Congresswoman Pressley’s March 29 visit to the facility, incarcerated individuals shared testimonials of living through a water quality crisis that has gripped the facility since 2011.

Time: The Unbearable Heat of Prisons in Summer
With its rising number of deaths, Texas prisons have received a specific censure from the U.N. Convention Against Torture. The U.N. called the prisons “unbearably hot” and pressed for “urgent measures.” Very few have yet been taken. Nor is this issue confined to Southern states: many Northeastern prisons lack air conditioning, and a 2023 study of their state prisons by the Prison Policy Initiative found that deaths increased around 21% from two-day heat waves. Over the past few years, we have decried the suffering of Palestinian and Ukrainian citizens. But at the same time, we have ignored the hundreds of thousands who suffer from heat torture in our prisons.

University of Southern Florida (College of Behavioral and Community Sciences): Students experience Florida's unforgiving heat in model prison cell
According to the Florida Department of Corrections Secretary Ricky Dixon, 75% of prisons in Florida don't have air conditioning. Department of Criminology Assistant Professor of Instruction Colby Valentine, PhD, in her efforts to go above and beyond for her students, decided to give an immersive lesson about the plight of Florida's incarcerated individuals – without sending her students to prison. As temperatures inside the model prison cell climbed to 97 degrees with no airflow, students who visited the exhibit described it as "eye-opening" and "overwhelming."


Oxford Academic: Allocating health care resources in jails and prisons during COVID-19: a qualitative study of carceral decision-makers
COVID-19 created acute demands on health resources in jails and prisons. Little is known about how carceral decision-makers balanced the allocation of scarce resources to optimize access to and quality of care for incarcerated individuals. This study analyzes a national sample of semi-structured interviews with health care and custody officials. The rapid onset of COVID-19 confronted decision-makers with unprecedented resource allocation decisions, often with life-or-death consequences. Planning for future resource allocation decisions now may promote more equitable decisions.

Axios: California's prison death rates rose amid COVID
Death rates among incarcerated people in California, as well as in many other states, significantly increased during the worst phase of the coronavirus pandemic. In California, the 2020 death rate for those incarcerated was 40.2 for every 10,000 people — a 27% rise in death rate compared to 2019. Bay Area correctional facility San Quentin State Prison was fined more than $400,000 and faced general scrutiny over its safety practices related to COVID-19. A federal appeals court has ruled that California can be held responsible for the incarcerated people's deaths.


NIJ: Five Things to Know About Women and Reentry
Each year, nearly two million women are released from prison or jail. These women experience unique challenges during their reentry - the period of transition from correctional confinement to the community - but correctional programming to support successful reintegration has largely focused on men. Despite evidence that findings from men’s reentry programs may not be generalizable to women, there has not been a commensurate investment in research, development, implementation, or evaluation of programs that integrate gender-specific factors in their designs. This study discusse five things that are known about women and reentry based on available data and research.


John Jay Research: Mass Incarceration and the Need for Sentencing Reform (May 2nd from 1pm to 3pm Eastern)
The Center for Community Alternatives and Data Collaborative for Justice invites you to a special event for formerly incarcerated individuals, families with incarcerated loved ones, policymakers, researchers, and experts. The event will reflect on legislative opportunities to advance justice and safety and address decades of draconian sentencing laws. Speakers will explore strategies such as the repeal of mandatory minimums, “second look” policies, and earned time programs that prioritize in-prison transformation.

State Roundup

AL.com: Alabama parole board would be forced to consider an inmate’s health under new bill
A divided House Judiciary Committee Wednesday approved legislation allowing the Alabama Board of Pardons and Paroles to consider an applicant’s medical condition when reviewing a parole application. The legislation defines a serious health condition as “any non-terminal physical or medical condition rendering an individual permanently and irreversibly incapacitated as determined by reasonable medical judgment.”

WHNT: Lawsuits claim UAB took inmate organs without permission
Lawsuits filed on behalf of five families of deceased Alabama prison inmates claim UAB Medical Center took and retained inmates’ organs without the consent of their family members. The lawsuits outline an agreement between the Alabama Department of Corrections and UAB. Explaining that UAB is an independent contractor for inmate autopsies. None of the lawsuits say what was done with the organs taken from the bodies of those inmates, but they do cite a 2018 incident in which UAB medical students grew curious about the number of ADOC specimens they were studying.

Corrections 1: Ala. sheriff calls for 24/7 jail medical services following inmate’s death
Walker County Sheriff Nick Smith said he has consistently advocated for 24/7 medical serves at the county jail, but the issue has yet to be adequately addressed by the county commission. “Given the current drug crisis facing our nation and county, the need for round-the-clock medical attention is more critical than ever,’’ Smith said. As early as October 2023, the sheriff’s office submitted its first request for life-saving monitors in the book area, he said, and they still aren’t in place, despite being approved in two months ago.

Arkansas Times: Prison suicide report critical of correction system’s mental health treatment
A study of 49 suicides that happened in Arkansas prisons from 2017-2022 found that many of the suicide victims met with a mental health staff member only days before taking their lives. According to the report, 85% of the individuals died within six days of their last encounter with a mental health professional, while 65.3% died within two days and 12.2% died the same day. The study also found that nearly 20% of the individuals were not properly classified as suicidal when their mental health history was examined at intake.

Huffpost: Paramedic Who Injected Elijah McClain With Ketamine Before His Death Avoids Prison
A former paramedic who injected Elijah McClain with a powerful sedative avoided prison and was sentenced to probation Friday after his homicide conviction in the Black man’s death, which helped fuel the 2020 racial injustice protests. Jeremy Cooper had faced up to three years in prison after being found guilty in a jury trial last year of criminally negligent homicide. He administered a dose of ketamine to McClain, 23, who had been forcibly restrained after police stopped him as the massage therapist was walking home in a Denver suburb in 2019.

Washington Post: Georgia prison officials in 'flagrant' violation of solitary confinement reforms, judge says
Georgia prison officials have flagrantly violated a court order to reform conditions for prisoners in the state’s most restrictive holding facility, showing “no desire or intention” to make the required changes to solitary confinement practices, a federal judge said. In a damning ruling, U.S. District Judge Marc Treadwell on Friday held officials at the Georgia Department of Corrections in contempt, threatening them with fines and ordering an independent monitor to ensure compliance with a settlement agreement,

Corrections 1: Minn. DOC reinstates county jail, implements new oversight measures
The Otter Tail County Detention Center has been reinstated with a Class III Facility License, essentially being able to operate somewhat normally (see April 2, 2024 Editor's Note). The surprise development transpired on April 19, following a Minnesota Department of Corrections (DOC) follow up visit that occurred on April 10. As previously reported, in the DOC’s review of the incident that occurred in February, an inmate had smeared feces on their cell door and threw it under their door. Based on video from inside the jail collected during a preliminary investigation, beginning on Feb. 10, at 6:53 a.m., correctional staff refused to give the inmate food until the inmate cleaned up the feces. No medical providers or mental health experts were notified and 50 hours passed until Feb. 12

Minnesota Department of Health: Innovative jail program to support children of incarcerated parents expands
The Minnesota Department of Health (MDH) and the University of Minnesota (UMN) have worked to more than double the number of Minnesota counties offering a program that helps children keep family ties to incarcerated parents. The program focuses on improving the health of children and their incarcerated parents by facilitating visits as well as having parents complete parenting education programs in and outside of jail. In Minnesota, one in six children are impacted by parental incarceration. Researchers found that about two-thirds of adults in Minnesota jails were parents with children younger than age 18.

Missouri Independent: Missouri prison agency to pay $60K for Sunshine Law violations over inmate death records
The Missouri Department of Corrections must pay more than $60,000 for refusing to give records to a mother trying to find out how her son died in 2021 while in state custody. And that amount could grow, both because the department lost an appeal of an order finding it violated the Sunshine Law and because the mother is now suing the state for wrongful death in her son’s death by suicide. In a decision, the Western District Court of Appeals upheld a trial court judgment that the prison agency committed a “knowing and purposeful violation of the Sunshine Law” to prevent Willa Hynes of St. Louis from learning her son hanged himself with a bedsheet while in solitary confinement.

North Carolina
NC Health News: “We can make more success stories”: State leaders mobilize to strengthen reentry support
A report released this month by the North Carolina Sentencing and Policy Advisory Commission found a 44 percent re-arrest rate within two years from a sample of 12,889 people released from North Carolina state prisons. State leaders are increasingly focused on improving reentry support for formerly incarcerated people so that their transition back to the community is more successful. A driving force behind improving reentry is Gov. Roy Cooper’s Executive Order No. 303. The directive calls for a “whole-of-government” approach to boosting reentry services for formerly incarcerated people.

KGW: Washington County touts 'rapid' process that gets defendants in jail quicker mental health evaluations
Washington County's rapid fitness program provides mental health evaluations to defendants within two or three weeks, on average. Under Oregon's statewide system, a mental fitness examination can take months — roughly 62 days on average — which can be harmful to defendants and delay the judicial process. Washington County leaders say its "rapid fitness to proceed" program, intended to arrange quicker mental health evaluations for jailed defendants, is improving parts of Oregon's flawed mental healthcare system and deserving of statewide expansion.

South Carolina
Post & Courier: DOJ investigators visited Al Cannon Detention Center day after jail suicide
Less than a day after a homeless man attempted suicide in Charleston County's jail, U.S. Department of Justice officials toured the facility amid an ongoing civil rights investigation into possible patterns of abuse against inmates. The DOJ launched its investigation into civil rights abuses in Charleston County's jail and Richland County's Alvin S. Glenn Detention Center in November. On April 22, the Sheriff's Office reached a $300,000 settlement agreement, which is the most state insurers can pay out, on behalf of another inmate who died after she jumped headfirst from a second-story balcony area in the jail.

East Bay Times: Rural jails turn to community health workers to help the newly released succeed
Cheryl Swapp was hired as Sanpete County Jail's community health worker last year. In the 18 months before she began her work, 599 of the people booked into Sanpete County Jail had been there before. In the 18 months after she started, that number dropped to 237. Swapp meets with every person booked into the county jail soon after they arrive and helps them create a plan for the day they get out. She makes sure everyone has a state ID card, a birth certificate, and a Social Security card so they can qualify for government benefits, apply to jobs, and get to treatment and probation appointments. She helps nearly everyone enroll in Medicaid and apply for housing benefits and food stamps.

Rikers Island

New York Post: NYC Council grills DOC on rising unresolved inmate complaints — including claims about sexual assault
Fewer than one in five inmate complaints on Rikers Island over the last four years ever saw any resolution, including shocking claims of sexual assault, according to a review of jail data. The revelation emerged during the City Council’s Committee on Criminal Justice hearing where Department of Correction officials were grilled over the agency’s poor track record with inmate complaints. The analysis, conducted by the committee, found fewer than 15% of grievances filed by inmates or third parties through the DOC find a formal resolution.

Los Angeles County

Los Angeles Times: Carson sheriff’s deputies shot homeless man in the back, lawsuit alleges
Attorneys for the family of a 34-year-old homeless man who they say was fatally shot by Los Angeles County sheriff’s deputies while on his knees have filed a wrongful death lawsuit against the county. Lawyers allege in the lawsuit that deputies used excessive force when they shot Arturo Cernas four times in the back outside a gas station in Carson. The lawsuit also says the deputies failed to render aid immediately and failed to use proper tactics to de-escalate the situation.

San Diego County

CalMatters: He swore to fix some of California’s deadliest jails. He gave up.
Paul Parker set out to fix some of California’s deadliest jails. San Diego County was paying out millions of dollars to families whose relatives died in jail, two jail medical staffers were facing criminal charges, and the sheriff in charge insisted nothing needed to change. Last month, Parker quit. San Diego County is one of the few counties in the state that grants civilians a review process for their sheriff’s department. Yet the San Diego County review board doesn’t have the power to force the sheriff’s department to make changes. Parker’s resignation underscores both the limits of civilian oversight and the power of sheriffs to ignore them.

Correctional Health Care Vendors

Miami Herald: Family begs jail to give man life-saving medicine — but get ignored, suit says. He died
Brad Hensley was born with a potentially life-threatening condition and died after spending four days in a Virginia jail, where he wasn’t given his daily medications until it was too late, according to a new federal lawsuit. Hensley had congenital adrenal hyperplasia, which can send a person’s kidneys into a crisis if untreated. He needed two doses of two different prescription steroids everyday as prescribed. His family pleaded with officers and jail nurses to give him his medicine and warned he would die without it. Hensley’s parents are suing the jail’s medical provider Wellpath LLC. The suit also names several Wellpath employees, a Henry County Sheriff’s Office deputy lieutenant and former county sheriff.

Santa Barbara Independent: Grand Jury Gently Blisters Medical Care Oversight at Santa Barbara County Jail
The Santa Barbara County Grand Jury took further exception to the dispensation of medical care in the Santa Barbara County Jail this past week, especially for people suffering from mental health challenges. The Grand Jury found that Wellpath, the private company paid to provide such care since 2017, experienced so many vacancies for so many days running that the quality of inmate care was called into question. The Sheriff’s Office — charged with ensuring the contract is adhered to — was contractually entitled to as much as $135,000 in rebates because of Wellpath’s failure to maintain minimum staffing levels, but the Sheriff’s Office failed to take advantage of this.