Weekly Update: October 31, 2023
Correctional Health Care Enriching Private Equity

COCHS Weekly Update: October 31, 2023

Highlighted Stories

Editor's Note
Our subscribers are well aware that COCHS’ Weekly Update has published many Editor’s Notes about the merry go round which is the Corizon-YesCare-Tehum-Care bankruptcy strategy (also known as the Texas two-step). Briefly stated that strategy uses bankruptcy to decrease financial settlements from the multiple lawsuits brought by incarcerated patients. This tactic has grown so egregious that it has even drawn the attention of US Senators Waren, Booker, Sanders, and Wyden (see the first highlighted article).

The story has now entered its tawdry phase (see second highlighted article). It was recently revealed that the Texas judge overseeing Corizon’s bankruptcy was having an “alleged affair” with a former assistant who was representing Corizon. Once exposed, that judge resigned, and a new judge was assigned to the case. The current judge halted the bankruptcy's settlement which had been expedited (see the third highlighted article).

Bankruptcy, multiple lawsuits --why would any company bother? The reason any of the many manifestations of Corizon (and the other correctional health care vendors for that matter) enters the correctional health care market is because of the big bucks involved. As the Baltimore Banner article reports (the fourth highlighted story), Corizon received $680 million for its contract in Maryland. That same article also detailed how Corizon has been owned by various private equity firms for more than 16 years. One of those firms in 2009 marked the outsourcing of correctional health care as an especially strong market given the negatively impacted budgets of many jurisdictions due to the great recession. Furthermore, a conference held by Washington University on correctional health care (the fifth highlighted story) advances the hypothesis that the privatization of correctional health care has an economic incentive to minimize care.

Nor does it seem that private equity firms have the added benefit of assuring their subsidiary correctional health care companies perform thorough background checking on the health providers hired. In a rather disturbing article out of Vermont (see the sixth highlighted story), a nurse in that states Springfield facility alerted Wellpath (owned by HIG Capital) that its health service administrator (HSA) had a history of diverting opioids. The nurse was fired three weeks later after alerting Wellpath’s human resource department about the HSA’s history.

Diverging substantially from the previous articles, the last highlighted story from Vera has a broader theme, discussing the poor conditions within corrections and how harsher treatment (such as denying air conditioning) is not conducive to reform but rather more conducive to recidivism. But what caught the editorial eye which ties into the preceding article is this sentence: “In many cases, people are sent to jails and prisons due to behavior rooted in poverty, homelessness, mental illness, and substance use—the outcomes of woefully insufficient investments in community health.” A person with a cynical perspective might consider that the 2009 analysis by private equity to invest in correctional health care created a very profitable cycle. Communities that are cash strapped turn to outsourcing which drains community health, feeding the profitability of private equity but at the same time might also increase crime requiring more outsourcing to private health care vendors. If one were to add up all the public funds that states and local jurisdictions spend on enriching private equity, one might begin to consider the idea that those funds might possibly be better spent on community health instead of financing a system that harms public health and safety but is a good investment for a thin slice of the population.

Correctional Health Care & Private Equity
Office Of Senator Elizabeth Warren: Senators Warren, Durbin, Lawmakers Call on Corizon Health, Inc. to Answer for Abuse of Bankruptcy System, Evasion of Liability after Years of Corporate Wrongdoing
Nine senators including Elizabeth Warren, Bernie Sanders, Cory Booker, Judiciary Committee chair Dick Durbin, and Finance Committee chair Ron Wyden, sent a letter to executives of Corizon's successor companies — YesCare and Tehum Care Services — the lawmakers say Corizon employed an "abusive" bankruptcy strategy to avoid paying not just medical-malpractice lawsuits but also "bills for tens of millions of dollars' worth of goods and services provided to Corizon by hospitals, small businesses, and your own former employees."

Business Insider: Top US bankruptcy judge resigns following revelation of undisclosed romantic relationship
David Jones has resigned his post as chief bankruptcy judge for the Southern District of Texas– a stunning turn of events for one of the country's most powerful bankruptcy judges who has overseen a series of high-profile cases during his tenure. The resignation follows a week of controversy surrounding Jones: Less than two weeks ago Insider first reported that Jones was in a previously undisclosed romantic relationship with attorney Elizabeth Freema. Both Jones and Freeman were also involved with the bankruptcy case that centered around Corizon Health, once one of the nation's largest prison healthcare providers.

Business Insider: Federal judge hits the brakes on Corizon bankruptcy deal
A $37 million settlement in the bankruptcy of a prison health care company accused of responsibility in prisoner deaths is now in doubt. A federal judge has declined to consider expedited approval of the plan's disclosures, saying far too many questions remained unanswered. "We're not going forward today," Judge Christopher Lopez said. The bankrupt company, Tehum, formerly known as Corizon Health, was once the nation's leading prison health provider. During the hearing, Lopez obliquely referenced the sudden resignation of the bankruptcy court's chief justice, David Jones, on Sunday, saying, "A lot has come out" about the mediation process.

Baltimore Banner: The legal gymnastics and thorny history of Maryland’s correctional health care provider
Earlier this month, a prisoner at medium-security state-run facility on the Eastern Shore filed a lawsuit against YesCare, the company responsible for providing medical care in state prisons and Baltimore jails. Maryland hired what was then known as Corizon Health as its medical provider for prisons and Baltimore jails in 2018 to a five-year, $680 million contract. Between Corizon Health and YesCare, the related entities have changed hands between four different private equity firms since 2017

Washington University: Prison Education Project holds panel discussion on mass incarceration and public health
The Washington University Prison Education Project (PEP) held a panel discussion on the public health crisis posed by mass incarceration in Missouri and the United States. The event focused on the growing public health crisis in prisons. It was noted that the privatization of prison healthcare has further reduced access for inmates to expensive and potentially life saving treatments. The majority of jails and prisons now have privately provided health care services, which means that someone has an economic incentive to reduce the number of expensive procedures that are happening.

VTDigger: Top health care contractor at Springfield prison has long history of diverting opioids
The top-ranking health care employee at Southern State Correctional Facility in Springfield has faced disciplinary action in three states for diverting or wasting opioids. Robert Stevenson has worked as the health services administrator for Vermont Department of Corrections’s private health care contractor, Wellpath. Louise Walker, who worked under Stevenson as Springfield’s director of nursing, uncovered Stevenson’s disciplinary history last month through a search of public records. She flagged her findings to Wellpath’s human resources and demanded the company’s leaders take action. Three weeks later they fired her.

Vera: Why Punishing People in Jail and Prison Isn’t Working
When politicians sought to convince voters in Jefferson Davis Parish, Louisiana, to fund a new jail, they touted the fact that the facility would not have air conditioning. This strategy—used in a climate where incarcerated people suffer and even die each summer due to extreme heat—reflects a pervasive notion in the United States that jails and prisons shouldn’t be “country clubs” and that punishment is productive. It isn’t. In many cases, people are sent to jails and prisons due to behavior rooted in poverty, homelessness, mental illness, and substance use—the outcomes of woefully insufficient investments in community health.

Sexual Abuse

The Guardian: One prison guard, 96 abuse charges: women say ‘serial rapist’ targeted them over a decade
Abuse of incarcerated women is a systemic problem across the United States – government surveys have estimated that more than 3,500 women are sexually abused by prison and jail staff each year, and that federal employees have abused women in at least two-thirds of federal women’s prisons. Prosecution is rare: since 2014, people incarcerated in California’s women’s prisons have filed hundreds of complaints of sexual abuse by staff, but one of only four officers from those institutions confirmed by the state to have faced charges.

Seattle Times: Ex-Oregon prison nurse convicted of sexually assaulting women in custody gets 30 years
A former nurse convicted of sexually abusing women in custody at an Oregon prison has been sentenced to 30 years in federal prison. Tony Klein’s sentence handed down Tuesday also includes five years of supervised release after prison, according to a statement from the U.S. Attorney’s Office.

Opioid Epidemic

New York Times: To Combat the Opioid Epidemic, Cities Ponder Facilities for Drug Use
Public health experts have long endorsed a controversial strategy to blunt the opioid epidemic that has been sweeping cities like Philadelphia: supervised drug consumption sites, in which people are allowed to take illicit drugs under professional supervision. Safe drug consumption facilities have reversed thousands of overdoses in the United States and abroad, helping people who use potent synthetic opioids like fentanyl avoid the worst consequences of a volatile drug supply.

Camden County: First of its Kind Evaluation Done on Jail-Based Opioid Treatment Program
In 2018, the Camden County Correctional Facility’s Medication for Opioid Use Disorder (MOUD) Program was initiated. A new study found that the MOUD Program has reduced overdoses among participants after they have left the facility. The study, which is the first of its kind in the state, found that non-participants had a higher chance of overdosing post release than participants. Comparing both groups at 30 days, 180 days, and up to 365 days post-release, participants of the program had a lower percent overdose rate than nonparticipants. The analysis was completed on a subset of the jail population with a history of opioid use disorder in their medical records.

SciTechDaily: Prisons: The Unexpected Answer to the Opioid Epidemic?
With opioid overdose deaths surging in the United States, many communities are urgently seeking effective solutions. A recent Rutgers-led study has identified strengthening prison reentry programs for the highest-risk users as one of the most promising interventions.


KGET: The most frequently banned book in prison is about ramen
Tens of thousands of books have been banned or restricted in U.S. prisons, according to a new report by PEN America, a free speech organization that has been tracking book bans in the country. PEN based its report on freedom of information (FOIA) requests for all the prison systems in the country, as well as interviews with prison staff. The organization says its analysis is likely an underestimation due to the poor tracking of the information by states. Florida was the top in book banning in prison among the 28 states that track that information, banning 22,825 titles. Texas is in second at 10,265 and Kansas third at 7,699.

State Roundup

Sacramento Bee: California faces $50 million in fines for failing to meet prisoners’ mental health needs
California faces more than $50 million in fines for failing to correct a chronic shortage of mental health providers in its state prisons. The fines, which could be imposed by Chief U.S. District Judge Kimberly Mueller, are part of a decades-long, federal class action lawsuit regarding the treatment of mentally ill California inmates.Gov. Gavin Newsom has made overhauling the state’s mental health system a major focus of his second term, but his office declined to comment on the staffing deficits, citing ongoing litigation.

Sacramento Bee: Sacramento Sheriff Jim Cooper is mismanaging the jail and impairing care for inmates
In an op-ed, Dr. Phillip Summers writes: I have had a front-row seat to the crisis in our jail [Sacramento County]. As a physician, I have received critically ill and injured ER patients from jail who tell me how they are routinely mistreated and denied medications when they are incarcerated. The recent wave of opioid overdoses in the jails is particularly heartbreaking and infuriating, especially because it is so preventable. The sheriff [Jim Cooper] openly disregarded formal requests to implement screening procedures for his staff, frustrating efforts to interrupt smuggling networks.

Sacramento Bee: Sacramento Sheriff: Don’t blame my officers for the inmate deaths at the Main Jail
In an op-ed Sacramento County's Sheriff, Jim Cooper writes: While inmate-on-inmate assaults have been responsible for two significant cases this year, the spotlight needs to be placed on the sheer ineptitude of the county department providing the jail health services, Adult Correctional Health (ACH). It is not a coincidence that most of the deaths at the jail have been medically related. In the past, the sheriff had control of medical care in the facility, but that control was removed before I got here and transferred to ACH, a separate county agency that I have no control over. ACH provides all health care within the jail to the entire inmate population 24/7.

East Bay Times: Marin County to expand involuntary medication of jail inmates
Marin County plans to expand a program that allows medications to be administered to jail inmates against their will. Last fall, the Board of Supervisors allowed court-ordered medications to be given to inmates who have been deemed incompetent to stand trial — without their consent, if necessary. Prior to the authorization, inmates had to remain in jail for months until a bed became available at a state hospital.

Florida Phoenix: FL Supreme Court weighing prison guard’s dismissal for using medical marijuana
A case filed with the Florida Supreme Court tests whether the Department of Corrections properly fired a corrections officer because of his use of medical marijuana while off work. Florida’s First District Court of Appeal upheld the firing, but Samuel Velez Ortiz now argues before the state Supreme Court that the action violates both the Florida Constitution’s sanction of medical marijuana and the U.S. Supreme Court’s recent rulings establishing a broad right to bear firearms.

NPR: Kansas prison fires 2 employees, disciplines 6 for mocking injured inmate and refusing to help
The Kansas prison system has fired two employees and disciplined six others for mistreating an injured inmate last month. According to inmates at the Topeka Correctional Facility, Elizabeth Wince spent two hours crawling back to her cell after hurting herself. Wince fell and tried to seek medical treatment, but was denied.

Willamette Week: Multnomah County Jails Also Lost Their Psychiatrist
In 2017, Multnomah County hired a psychiatrist to staff its downtown jail—a move applauded by disability rights advocates who said it would improve mental health care. Five years later, that psychiatrist is gone. Five years later, that psychiatrist is gone. The county has admitted it has had difficulty hiring and retaining health care workers during the pandemic, citing the lack of telework opportunities in the jail.

Washington State
KUOW: Transgender prisoners in Washington state deserve gender affirming care, judge decrees
A federal judge in Seattle has signed off on a settlement in a lawsuit over the treatment of transgender people in Washington state prisons. The suit was brought by the advocacy group Disability Rights Washington against the state's Department of Corrections

Rikers Island

New York Times: As Conditions Worsen at Rikers, New Commission Revives Push to Close It
Calls for the federal government to take control of Rikers Island have intensified in recent months. Damian Williams, the U.S. attorney for the Southern District of New York, in July called the jail a “collective failure” and urged for it to be placed into receivership to address the “ongoing risk of harm” to detainees and correction officers. The Lippman Commission wants to “take a renewed and realistic look at current on-the-ground conditions” and find a clear path to “swiftly” close Rikers

The City: More than 15,000 Rikers Jail Video Visits Canceled Since 2020
The city Department of Correction has canceled 15,129 jail detainee video visits since its online system launched department-wide in 2020. The visitation records — reluctantly provided via a Freedom of Information Law (FOIL) request — comes as a federal judge overseeing the department in June agreed to hear arguments next month in favor of an outside takeover of the city jails system. The department did everything possible to block the release of the data.

Gothamist: Hundreds of beds for NYC detainees with serious physical, mental illnesses delayed by years
A plan to move more than 360 detainees with serious mental and physical health conditions off Rikers Island and into state-of-the-art therapeutic beds in borough-based hospitals has been delayed by years with no clear date of completion in sight, city jails officials told the New York City Council.

San Diego County

San Diego Union Tribune: State medical board seeks to revoke or suspend license of second doctor in Elisa Serna’s death in jail
State regulators are seeking to discipline a second physician who treated Elisa Serna in the days before her 2019 death in the Las Colinas women’s jail in Santee. According to what’s called an accusation, Dr. Carol Ann Gilmore should have her license revoked, or at least suspended, for what regulators call her negligent treatment of Serna


Los Angeles Daily News: Using ex-inmates to help people who were just released from county jails cuts recidivism
L.A. County partners with 29 Community Based Organizations (CBOs) who help those being released from county jails and also state prisons to find shelter, jobs. And if necessary they provide food and clothing as well as mental health and substance abuse treatment. Community Health Workers hired by the CBOs are people who’ve been incarcerated and have found a way out of the cycle of arrest, incarceration, release and rearrest.

Mental Health Initiatives in Criminal Justice

12News: Law enforcement in Jefferson County put together $8M to help fund mental health center for inmates
Jefferson County Sheriff Zena Stephens tells 12News too many inmates are being taken to the county jail when what they really need is mental health services. Stephens is spearheading the new diversion center. The funding is coming from a contract agreement that we had from Port Arthur police and Beaumont police and Jefferson County. All together, the three departments are putting down $8 million to make this facility happen.


Atlanta Journal Constitution: Immigrant detainees’ forced labor case ends in settlement
A group of former detainees said Georgia’s largest immigrant jail broke federal anti-slavery laws by forcing them to work against their will. Their 2018 lawsuit against CoreCivic, the private prison company that operates South Georgia’s Stewart Detention Center, ended with a settlement last week.

Correectional Health Care Vendors

Idaho Statesman: Diabetic incarcerated man in Idaho sues medical provider, says staff withheld insulin
A diabetic prisoner has sued Idaho Department of Correction’s medical provider and alleged the company has “bungled, mismanaged, and ignored” his constant requests for medical care, even refusing him insulin on one occasion. Jacob Frey, 41, who resides at the Idaho State Correctional Institution in Kuna, filed a civil rights lawsuit against Centurion Health, which provides health care for those incarcerated at IDOC’s facilities.