Avoiding Transparency: County Contracts & Correctional Healthcare Vendors

Highlighted Stories

Editor's Note

This week’s two highlighted stories focus on Hudson County, New Jersey. The first article, from WHYY, reports on at least seven deaths that occurred over a 12-month period at the Hudson County jail. It also details how the jail has cycled through correctional healthcare providers twice—CFG was the provider, then replaced by Wellpath, and has now returned. As longtime subscribers know, COCHS often views multiple deaths in a short time frame as a warning sign that serious problems may exist with medical care. The WHYY article points to a lack of medical resources, but what also caught our attention was the familiar pattern of recycling healthcare vendors with little or no apparent improvement in care for incarcerated people.

The Hudson County story becomes even more complicated in the second highlighted article, which concerns actions taken by the New Jersey Office of the State Comptroller (OSC). The county’s attempt to contract with Wellpath drew the OSC’s scrutiny. In 2024, the OSC directed Hudson County not to proceed with a proposed $13.5 million contract with Wellpath, finding that the county had circumvented transparency and public bidding requirements. According to the OSC, the county failed to publicly advertise the opportunity, invited only a small group of hand-picked firms to apply, and entered into private negotiations with a preferred vendor. Under state law, any contract valued at $12.5 million or more must be submitted to the OSC for review and approval at least 30 days before the procurement process begins.

After repeated warnings, the OSC sued Hudson County in August 2024 for failing to follow a fair bidding process. The county appealed to the Superior Court of New Jersey, which ultimately affirmed the OSC’s findings. The court also noted that Hudson County failed to submit required compliance forms and associated contract documents—including the contract itself—for more than 45 days, and it denied the county’s motion to stay the ruling.

Why was the county so intent on bringing in Wellpath under what was effectively a no-bid process? Who knows. Recently counties' and sheriffs' relationships with correctional healthcare vendors has attracted some noteworthy attention. In 2022, Gerard Boyle, former CEO of Correct Care Solutions (now Wellpath), and Bob McCabe, sheriff of Norfolk County, Virginia, were convicted on felony bribery charges related to jail medical services. Former Dauphin County Commissioner Jeff Haste accepted $325,000 from the founder of PrimeCare while overseeing jail operations. And NJTODAY reports that Wellpath made a $500 campaign contribution to Monmouth County Sheriff Shaun Golden, who announced a three-year contract with the company in January 2024.

COCHS is glad to see that the OSC was successful in blocking the no-bid contract. But the return of CFG to Hudson County is hardly a cause for celebration. CFG previously lost the contract following multiple suicides at the jail, and Wellpath, as our readers know, does not have a perceived stellar record in correctional healthcare either. In the end, we can only hope that after this confrontation between Hudson County and the OSC, the people incarcerated at the jail see some real improvement in care—something that too often fails to materialize when the same vendors simply rotate back into place.

Hudson County

In the Hudson County jail there have been at least seven known deaths over the course of 12 months. Regardless of the causes behind the deaths, critics have pointed at the lack of medical resources for those being held in jail as one of the reasons the deaths have been occurring at an alarming rate. They say that there has been inadequate medical staff on site to properly screen inmates for potential physical issues. Between 2018 and this year, the Hudson County jail was served by Wellpath. In 2024, the New Jersey Comptroller’s Office sued the county for violating public bidding requirements. As a result, the county was forced to change medical providers and went with CFG. However, CFG is not only Wellpath’s successor at the Hudson County prison, but also its predecessor. CFG lost its contract t after a series of suicides at the facility.

In a ruling the Appellate Division affirmed the Office of the State Comptroller’s findings that Hudson County violated the law in awarding a $13.5 million prison services contract. The three-judge panel unanimously ruled that Hudson County repeatedly improperly bypassed public bidding and competitive contracting rules when it awarded the multimillion-dollar prison services contract for the Hudson County Correctional Center without public notice or open competition, as required by law. After the County defied OSC’s directive and awarded the contract in 2024, OSC sued to enforce its directives to the County. The County appealed. The Appellate Division affirmed that Hudson County had repeatedly failed to provide adequate notice to OSC, restricted competition to select vendors, and illegally relied on a narrow “professional services” exception that did not apply in order to avoid a competitive, public process.

Follow Ups

Ending Crime and Disorder on America's Streets

Editor's Comment: Continuing from last week’s Editor’s Note, which discussed the anticipated impact of the Ending Crime and Disorder on America’s Streets executive order (EO), this week we include an op-ed from MedPage Today by a psychiatrist who in response to the EO outlines protocols designed to better match the diverse needs of people experiencing homelessness.

This is an op-ed by Kenneth Minkoff, MD, a a board-certified community and addiction psychiatrist: America is once again debating whether to expand involuntary treatment for people with serious mental illness and/or addiction who are experiencing homelessness. The recent executive order, “Ending Crime and Disorder on America’s Streets,” has reignited that debate by naming a real and visible crisis: people with severe mental illness—often with co-occurring substance use disorders—are left to deteriorate in public, cycling endlessly between emergency departments, jail cells, and sidewalks without ever receiving meaningful care. At the same time, the order raises serious concerns about overreach, and the erosion of civil liberties. Advocates now face both a challenge and an opportunity: can we build a system in which involuntary interventions for the most vulnerable are not an expression of control or punishment, but a pathway toward recovery? We believe the answer can be yes.

Mississippi

Editor's Comment: Investigations into medical neglect in Mississippi’s prison system continue, once again underscoring that VitalCore is receiving hundreds of millions of dollars to provide care that remains under serious scrutiny.

In the wake of Mississippi Today reports of an amputation from a neglected broken bone, untreated hepatitis C and delayed cancer diagnoses in state prisons, Rep. Becky Currie will try again in the coming legislative session to advance Mississippi prison health care reforms. A similar effort by the Republican chairwoman of the House Corrections Committee fizzled and died in in last year’s session. In an interview outlining her plans, Currie said she will introduce legislation based on findings gleaned from numerous tours of Mississippi’s prisons as well as instances of alleged denial of medical care documented by Mississippi Today. The findings have come to light as the state continues to direct hundreds of millions a year to a private medical contractor, VitalCore Health Strategies.

San Diego

Editor's Comment: This week’s San Diego Follow Up feels almost like a repeat of last week’s. Once again, a lawsuit has been filed over the death of a mentally ill man who was placed in solitary confinement. A second San Diego story reports that guards allegedly responded to a woman’s repeated pleas for help by calling her a liar; those pleas ended only when she was found dead.

At COCHS, we often note that jurisdictions that contract with correctional healthcare providers may assume they are insulated from liability. As the second story from San Diego County illustrates, medical care in correctional settings is complex, and when correctional officers are alleged to have been indifferent to serious medical needs, jurisdictions can—and often do—find themselves named in lawsuits. A similar story appears at the end of this Weekly Update from Jefferson County, Missouri, where a lawsuit claims that a correctional officer, along with VitalCore medical staff, ignored the pleas of an incarcerated person who later died.

The parents of a man, Corey Michael Dean, who died while in custody at the Vista jail filed a lawsuit this week alleging he should have been placed in housing designated for mentally ill detainees, but was instead placed in solitary confinement for the final two weeks of his life. The lawsuit filed in San Diego federal court alleges Mr. Dean’s mental health issues were known to jail medical staff, yet he was not provided adequate medication or psychiatric care while housed at the Vista Detention Facility.

Following Callen Lines' death at Las Colinas Women's Detention Center, her family filed a federal lawsuit against the San Diego Sheriff's Office. Ms. Lines the lawsuit claims sat slumped over in a chair in front of her cell door, hoping to get guards to notice her pleas for help. Those pleas for help were ignored, and guards allegedly responded by calling Ms. Lines a liar. The pleas for help ended after she was found, according to the lawsuit, "purple and blue" following her death.

New York

Editor's Comment: Another overview of the crisis in New York’s prison system, viewed through a legislative lens. For those subscribers who have not been closely following this story, here are some links from past Weekly Updates to fill in the gaps: January 6, 2026 and December 9, 2025.

Two high-profile deaths in custody and an unauthorized strike by correctional officers over the past year underscored a broader crisis in New York State’s prison system. In response, the legislature passed a package of reforms aimed at improving accountability and transparency. Gov. Kathy Hochul signed the legislation after negotiating modifications to the original bills. Among the changes, lawmakers sought to strengthen oversight by expanding the State Commission of Correction. The governor, however, limited that expansion to five commissioners and removed provisions that would have reduced her appointment authority. The legislation also addressed transparency around in-custody deaths, where the absence of surveillance cameras was identified as a contributing factor. The new law mandates full-time surveillance cameras in most prison areas and establishes a body-worn camera pilot program for staff. The reforms unfolded against the backdrop of a correctional officers’ strike, during which staff cited the HALT Act’s restrictions on solitary confinement as contributing to staffing shortages, increased violence, and operational strain.

Medicaid

The Kansas Department of Health and Environment announced on Wednesday that the state received a $4.6 million grant from the Centers for Medicare and Medicaid Services for its Medicaid program, KanCare. The funding will be used over the next four years to develop Continuity of Care strategies for people eligible for Medicaid and Children’s Health Insurance Program coverage after they leave custody.

BOP

Nicolás Maduro, the Venezuelan president captured by the United States on Saturday, is being held in a notorious Brooklyn jail complex that has been plagued by scandal and accusations of mismanagement. It is also deeply troubled. In recent years, it has been the scene of stabbings and killings. It became New York City’s only federal jail center, when the Justice Department shut down the Metropolitan Correction Center in Manhattan, at least temporarily, because of deteriorating conditions. Others who have been detained at the M.D.C. include Ghislaine Maxwell, the partner of the convicted sex offender and financier Jeffrey Epstein; the music mogul Sean Combs, known as Diddy; and the singer R. Kelly.

Opioid Epidemic

The Clark County (OH) Jail received a $220,000 grant to support addiction treatment for inmates. Attorney General Dave Yost has awarded $5.3 million in a fourth round of grants to 17 jails, which extended the program’s reach to 49 jails in 54 counties, and 13 community-based correctional facilities (CBCF), which are residential prison diversion programs for nonviolent offenders. The Opioid Remediation Grant Program is awarding the county jails and CBCFs up to $200,000 per year to hire a full-time addiction services coordinator or contract with a company that provides those services to treat opioid and other addictions and help inmates through detox and recovery.

Food

Eating while incarcerated at Ashland County Jail is getting more expensive. Ashland County (OH) commissioners approved a three-year deal with a Florida-based jail food service firm, Trinity Services Group, with meal prices increasing an average of 35 percent. Food has historically been the jail’s second-highest expense behind employee wages. But it’s the fastest-growing line item, having increased 52 percent since 2021, according to county budget data. Meal prices, according to the contract, are determined by an “inmate population sliding scale.” Trinity reserved the right to adjust those prices annually.

The Butler County Jail faces scrutiny from Ohio lawmakers who claim the facility violates state standards for inmate meals, housing and conditions. all inmates placed in disciplinary isolation are served a ‘warden burger.’ In response to the letter, Butler County Sheriff Richard Jones disputed that the jail is overcrowded and defended the “warden burger.” A warden burger is made of tomato paste, flour, dry milk, oats, beans, ground turkey, cabbage, carrots, potatoes, onion, celery, and “a pinch of salt.”

Studies

A new study, Estimating Health Condition Prevalence Among a Statewide Cohort with Recent Homelessness or Incarceration calls attention to the health-care needs of people who are unhoused or formerly incarcerated. A North Dakota lawmaker says the results resonate around the region. Researchers aligned with the Minnesota Electronic Health Record Consortium looked at data covering more than four million people in that state. They found significant disparities when comparing various health conditions of people recently incarcerated or unhoused to the total statewide population. In Minnesota, researchers say people who’ve recently been in prison also have higher rates of asthma, COPD and other illnesses.

In new data from 562 jails, we find that more than 1 in 8 jail bookings (13%) are related to a failure to appear (FTA), and more than half of those are FTA only. That may not sound like many, but because so many people cycle through jails annually, these numbers add up quickly: Across the United States each year, there are around 1,033,000 jail bookings involving people facing FTA charges (either alone or alongside other criminal charges). Roughly 546,000 — or over half — of those jail bookings are due only to a failure to make it to a court appearance.

A significant proportion of individuals with hepatitis C virus (HCV) experience incarceration. Jails house individuals who are pre-trial or for short sentences and represent a critical setting to expand HCV treatment access. Low-barrier treatment models may help overcome implementation barriers to initiating treatment in jail settings. In 2021, the Rhode Island Department of Corrections began implementing low-barrier HCV treatment including take-home medications for those released before completing therapy in both a jail (pre-trial) and prison (sentenced) setting.

State Roundup

California

The ACLU of Southern California released a report that examines more than a decade of in-custody deaths in the Orange County jail system, relying on stories of individuals who suffered from medical neglect and endemic lack of care in the jails. Between 2010 and 2021—the timeframe of the report—at least 119 people died while incarcerated in the O.C. jails. The death rate in O.C. jails has remained high in recent years, with at least eight people dying in custody in 2025.

Job vacancies in prison and state hospital health care have grown even as California has invested hundreds of millions of dollars to fill medical and mental health positions, according to a new state audit. The audit reviewed staffing at Atascadero State Hospital, Porterville Developmental Center, and Salinas Valley State Prison. These facilities house individuals who are incarcerated or institutionalized after being deemed dangerous to themselves or others or incompetent to stand trial.

Colorado

A federal judge declined last month to dismiss the claims against numerous prison employees for Victor Esquivel's in-custody death following several seizures and his repeated ingestion of liquified pain-numbing medication. The individual defendants invoked qualified immunity, which is a judicially created doctrine to shield government employees from civil lawsuits unless they violate someone’s rights as clearly established through court decisions. But in a Dec. 19 order, U.S. District Court Judge Charlotte N. Sweeney rejected defense counsel’s argument as so brief as to be almost “lazy.”

Missouri

A southeast Missouri judge on Tuesday threw out all of the Missouri Department of Corrections’ defenses in a mother’s wrongful death case over her son’s suicide because the department “repeatedly violated” court orders to produce records. The judge wrote that the Missouri attorney general’s office “repeatedly offered excuses ranging from secretarial blame to Dropbox malfunctions and staffing issues" and failed to meet multiple court deadlines. The lawsuit was filed by the mother of 27-year-old Jahi Hynes, who died by suicide in a Missouri prison.

New York

Juvenile detention centers in New York are keeping children and young adults in solitary confinement for days or weeks at a time, a federal lawsuit filed alleges. The facilities lock the youth in small cells without sinks or toilets, often for upwards of 23 hours a day, forcing them to urinate and defecate in bottles, food containers, and garbage bins, according to the lawsuit. The detention centers routinely use isolation both as punishment and when they’re understaffed, the youth allege.

North Carolina

Speaking before the state's Joint Reentry Council on Wednesday, Gov. Josh Stein called for a boost to the state's mental and behavioral health system to help those struggling with mental health conditions and keep the broader community safe. Stein said he would like to see additional funding for behavior health urgent care centers that can help people in crisis, adding to the five that are currently clustered around the Triangle. Stein also called for enhanced outpatient treatment and involuntary commitment options.

North Carolina has become the first state in the country to launch an online dashboard that tracks progress for people leaving prison, as part of a national initiative called Reentry 2030. The dashboard tracks four major goals: boosting economic mobility, improving healthcare, expanding housing, and removing barriers for formerly incarcerated individuals. Frankie Roberts, co-director of Leading into New Communities in Wilmington, a nonprofit that works with formerly incarcerated people, said the tool helps his organization by strengthening coordination between prisons, probation and service providers while highlighting gaps in treatment and housing.

With the recent purchase of the former Wayne Correctional Center in Goldsboro, Kerwin Pittman is laying claim to an unusual title — he says he’s the first formerly incarcerated person in the U.S. to purchase a prison. Pittman is the founder and executive director of Recidivism Reduction Educational Program Services, Inc. (RREPS). Pittman’s purchase of the abandoned, 400-bed prison is an extension of the work he started soon after he left prison. He plans to create re-entry housing and a workforce campus where formerly incarcerated people can attain job skills or industry certifications.

Oklahoma

The department in a review of 2025 that has obtained a $4.6M grant that will go towards creating a new Electronic Health Record (EHR) system in 2026. Improvements in the inmate health database documentation system could help provide regular and preventative healthcare to inmates across the state of Oklahoma. Editors Note: According to a slide deck published by the Oklahoma Senate, the state has made a statewide selection of Epic for multiple health services, including apparently corrections. In the same announcement, the Oklahoma Department of Corrections reported that it has entered into an agreement to purchase the Lawton Correctional and Rehabilitation Facility from GEO Group. The $312 million purchase—including the buildings, equipment, and surrounding acreage—was approved by the Legislature.

Texas

Twenty people died in 2025 in the Harris County Jail, the state’s largest pretrial detention system, which has faced years of understaffing, overcrowding, and wrongful death lawsuits. One of those deaths occurred at the Natchitoches Parish Detention Center in Louisiana, a private jail, operated by LaSalle Corrections,where Harris County has contracted to outsource the housing of inmates.

Hays County Commissioners Court took final action to approve a Jail-Based Competency Restoration (JBCR) Program aimed to address the growing mental health crisis in the criminal justice system while reducing lengthy jail stays for individuals deemed incompetent to stand trial. Currently, individuals who are found incompetent often face long delays awaiting placement in a state hospital for treatment. In the Hays County Jail, delays can stretch to nearly 300 days. The newly approved program enables Hays County to collaborate with its local mental health authority to offer competency restoration services directly within the Hays County Jail.

Wisconsin

Jared Hoy, Secretary of the Department of Corrections (DOC), appeared before the Assembly Committee on Corrections to discuss a Falcon Correctional and Community Services report on DOC facilities and practices. Falcon noted several positive steps, including restructuring the Bureau of Health Services in 2024, reforms to restrictive housing through enhanced training and increased security rounds, and improvements in medication distribution and documentation. The report also highlighted ongoing challenges, particularly in mental health classification, appropriate placement of individuals, and broader cultural changes needed to improve interactions with incarcerated people.

Legislation aimed at improving health and dignity in Wisconsin’s correctional facilities received a public hearing. Assembly Bill 741 and Assembly Bill 736. The legislation is about setting a clear and statewide standard. Providing access to basic hygiene and menstrual products reduces preventable infections, improves living conditions, and supports safer, more stable facilities for staff and incarcerated people alike.

Rikers Island

New York City Mayor Zohran Mamdani signed an emergency executive order directing his administration to come up with a plan limiting the use of solitary confinement on Rikers Island. The union for correction officers pushed back, saying the move puts the lives of everyone at Rikers at risk. The mayor says the city's Law Department and the Department of Correction must develop a plan within 45 days that implements Local Law 42, which bans prolonged solitary confinement in city jails.

Mayor Zohran Mamdani signed two emergency executive orders on, including one that would give the city 45 days to create a plan to either close or renovate the city’s emergency migrant shelters Mayor Zohran Mamdani signed two emergency executive orders on Tuesday, including one that would give the city 45 days to create a plan to either close or renovate the city’s emergency migrant shelters

CoreCivic

Harris County announced the termination of a CoreCivic contract sending inmates to a northwest Mississippi facility, with roughly 300 people scheduled to be returned to county custody at the end of the month. The move, announced at a Texas Commission on Jail Standards meeting, follows months of pressure from county officials and advocates over out-of-state outsourcing amid jail deaths, overcrowding and staffing challenges, and comes as the county manages state remedial orders tied to jail compliance.

Correctional Healthcare Vendors

PrimeCare

Centre County’s (PA) governing body re-upped with its longtime partner, PrimeCart that provides medical care to people incarcerated at its jail. The county will pay about $1.6 million annually, a more than 27% increase from what it paid this year. PrimeCare has faced dozens of lawsuits over allegations of substandard care, including in Centre County. A Bellefonte man who alleged that ham-handed treatment at the county jail left him paralyzed from the upper torso down settled his lawsuit with Centre County for $2.75 million. His settlement with PrimeCare was confidential, though his attorney said in April 2024 that the payment was “sufficient enough to take care of his financial and medical needs for the rest of his life.”

VitalCore

The family of William Zinselmeier who died at a Missouri jail is suing the agency, claiming in a lawsuit that corrections officers and VitalCore medical staff ignored his deteriorating health in the days and hours leading up to his death. William Zinselmeier died on Jan. 7, 2023, in the Jefferson County Jail at the age of 58. He told jail staff that he suffered from diabetes and hypertension and required medication. Zinselmeier became "too sick" to get out of bed or eat. A fellow inmate requested the guards bring Zinselmeier his medicine and a guard allegedly responded that "if he wants his medicine he can get up and come get his medicine."

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