COCHS Weekly Update: May 16, 2023
Highlighted Stories
Editor's Note
Last week, the Editor’s Note discussed the important role public safety will need to play if the 1115 demonstration projects are to be successful. COCHS would now like to draw our subscribers' attention to this week’s articles about correctional health care vendors. To be honest these articles are in no way exceptional –in fact they are pretty run of the mill. At a macro level, one could summarize most of these articles in the following way: a vendor receives a multimillion-dollar contract to provide medical services in a correctional institution and within a few years because of inadequate medical treatment or possibly a total lack of care, someone ends up in a coma, is paralyzed, dies or experiences some other debilitating condition. The lawsuits then commence. The jurisdiction is left paying multimillion-dollar settlements and it’s time once again to contract with a new vendor.
Looking at this week’s selection of highlighted articles, we see that many of the stories neatly fit into this paradigm. Delaware’s Department of Corrections is replacing Centurion with VitalCore. That story points out that Centurion is facing multiple lawsuits in Delaware for its performance in that prison system. But that article does go on to report that VitalCore has its own legal problems but in different jurisdictions. And in Charleston County, South Carolina, that county is finalizing its contract with VitalCore which is replacing Wellpath after the death of an inmate at that facility during Wellpath's tenure. (The Weekly Update has recently included stories about how Charleston County’s sheriff has vociferously protested the result of that selection process.) It should be noted that in all these stories one should not assume that once a vendor leaves a jurisdiction it will never come back --far from it! In a previous Weekly Update, our subscribers saw how Vermont has this year replaced VitalCore with Wellpath which provided health care in the Green Mountain state under the name of Correct Care Solutions between 2010 - 2015. (Not to single out VitalCore, Wellpath or Centurion, the Weekly Update has included articles that mention YesCare! --formerly Corizon Health--, Wexford, Southern Health Partners, Correctional Behavioral Health, Correctional Care and Turn Key.)
Often the people who cycle through the criminal justice system are dismissively referred to as "frequent flyers" --their frequent incarceration often being blamed on behavioral health issues, or some form of substance use disorder. But could not this appellation, "frequent flyer", be just as well applied to the correctional health care vendors? And what is to blame for their cycling through correctional facilities? These companies receive multimillion dollar contracts with the promise of improving care, but they very often leave in disgrace within a few years, only to return perhaps later. Some correctional institutions insist that their vendors receive some form of accreditation to guarantee quality. Yet these accreditations are about processes not outcome measures and the lawsuits persist. As Dan Mistak’s "Dear Colleague Letter" two weeks ago asked: “Will correctional health providers elevate their quality of care and step into the future?” Meaning, will these companies be able to meet the scrutiny that Medicaid demands? As COCHS likes to remind its subscribers, our public safety partners are firmly behind the push to bring Medicaid behind the walls. The question remains to be seen if the correctional health care vendors will follow public safety's lead?
Looking at this week’s selection of highlighted articles, we see that many of the stories neatly fit into this paradigm. Delaware’s Department of Corrections is replacing Centurion with VitalCore. That story points out that Centurion is facing multiple lawsuits in Delaware for its performance in that prison system. But that article does go on to report that VitalCore has its own legal problems but in different jurisdictions. And in Charleston County, South Carolina, that county is finalizing its contract with VitalCore which is replacing Wellpath after the death of an inmate at that facility during Wellpath's tenure. (The Weekly Update has recently included stories about how Charleston County’s sheriff has vociferously protested the result of that selection process.) It should be noted that in all these stories one should not assume that once a vendor leaves a jurisdiction it will never come back --far from it! In a previous Weekly Update, our subscribers saw how Vermont has this year replaced VitalCore with Wellpath which provided health care in the Green Mountain state under the name of Correct Care Solutions between 2010 - 2015. (Not to single out VitalCore, Wellpath or Centurion, the Weekly Update has included articles that mention YesCare! --formerly Corizon Health--, Wexford, Southern Health Partners, Correctional Behavioral Health, Correctional Care and Turn Key.)
Often the people who cycle through the criminal justice system are dismissively referred to as "frequent flyers" --their frequent incarceration often being blamed on behavioral health issues, or some form of substance use disorder. But could not this appellation, "frequent flyer", be just as well applied to the correctional health care vendors? And what is to blame for their cycling through correctional facilities? These companies receive multimillion dollar contracts with the promise of improving care, but they very often leave in disgrace within a few years, only to return perhaps later. Some correctional institutions insist that their vendors receive some form of accreditation to guarantee quality. Yet these accreditations are about processes not outcome measures and the lawsuits persist. As Dan Mistak’s "Dear Colleague Letter" two weeks ago asked: “Will correctional health providers elevate their quality of care and step into the future?” Meaning, will these companies be able to meet the scrutiny that Medicaid demands? As COCHS likes to remind its subscribers, our public safety partners are firmly behind the push to bring Medicaid behind the walls. The question remains to be seen if the correctional health care vendors will follow public safety's lead?
Correctional Health Care Vendors
DPM: Dept. of Correction awards health care contract to new provider
Delaware’s Department of Correction chose a new medical care and behavioral health care provider last week — the second provider since 2020. VitalCore Health Strategies will over health care services — including behavioral health care — for Delaware’s incarcerated population in July, replacing Centurion Health, which has held the contract for the past three years. The three-year contract will cost the state just over $49 million per year: $2 million higher than Centurion’s current contract. Centurion is currently navigating multiple lawsuits by current and former Delaware prisoners, while VitalCore faced a lawsuit by a disability rights group stemming from its role as the health care provider in several Mississippi prisons in 2021.
WCSC: County finalizes $7.4M contract for new jail medical provider
VitalCore Health Strategies is now officially scheduled to take over for Wellpath, despite vocal objections from Charleston County Sheriff Kristin Graziano. When compared to the former contract, VitalCore’s services will cost taxpayers around $78,745.94 more each month. The individual cost per inmate per day is estimated to be $18.45, based on a population size of 1,100 inmates. Though lower in clinical costs than Wellpath, its rate for staffing will cost $103,747.05 more a month, for an annual cost of $5.26 million. A new provision in the contract also requires VitalCore to carry medical professional liability insurance of $4 million per occurrence and $12 million overall.
Mohave Valley Daily News: Former health contractor at jail faces lawsuit from former inmate
An inmate was led into custody at the Mohave County Jail (AZ) in 2018, charged with theft of a credit card. By the time his case was dismissed five months later, he was paralyzed from the shoulders down. Brian R. Rodrigues, 46, is now suing former Mohave County Jail health contractor Wellpath (formerly Correct Care Solutions) for medical malpractice in the case, after Wellpath doctors allegedly failed to treat Rodrigues for acute osteomyelitis.
Casper Star Tribune: Attorneys question prison grievance system
There are many reasons that inmates file grievances. One of the most common in Wyoming is the denial of adequate medical care. Currently, The Wyoming Department of Corrections is contracted with YesCare! for prisoner health services. The grievance system “is a farce,” Doug Bailey, a Cheyenne-based attorney said. YesCare “gets paid tens of millions of dollars a year by Wyoming taxpayers,” but refuses to provide elective surgeries such as hernias, even though “any surgeon will tell you that the standard of care is to repair a symptomatic hernia.”
Times Leader: Luzerne County keeps inmate medical provider on monthly agreement
Luzerne County Council unanimously voted last week to keep its prison inmate medical provider (Wellpath) on a monthly contract until the county has time seek proposals in case other entities are interested in the work (see Family demands change at Luzerne County prison after daughter's death). The administration proposed a one-year renewal of WellPath’s contract last month, but council members said they want to explore all options to determine if the county is receiving maximum services at the best price. Three other outside entities had submitted proposals when the county publicly sought them in 2019 — Wexford, Correctional Behavioral Health and Correctional Care.
News 9: Family Of Woman Who Died In Oklahoma Co. Jail Suing Facility, Health Care Provider
The family of a woman who died at the Oklahoma County Jail in 2021 is suing the facility and the facility's healthcare provider, Turn Key. Lawyers for Christa Sullivan said both entities provided inadequate healthcare to Sullivan, who they said suffered from severe mental illness and attempted suicide several times before dying in custody more than two years ago. The federal lawsuit filed last month also claims Turn Key is liable, due to what Sullivan's family calls systemic failure of its policies and procedures.
Yahoo News: Nurse at Cumberland County jail accused of engaging in sex acts with inmate
A contract worker at the Cumberland County (NC) jail was arrested Thursday for allegedly "engaging in sexual acts" with an inmate. Jean Rodriguez, 32, is charged with five counts of sexual acts by a custodian, according to a news release. Rodriguez was contracted by Southern Health Partners Inc., as a licensed practical nurse at the jail.
Recommendations: 1115 Demonstration Projects
California Health Care Foundation/SHADAC: Opportunities to Learn More About Serving Justice-Involved Individuals Through 1115 Demonstration Evaluations
High level recommendations for the recent 1115 demonstration projects.
OUD Treatment
NEJM: Racial Inequality in Receipt of Medications for Opioid Use Disorder
Since 2010, Black persons in the United States have had a greater increase in opioid overdose–related mortality than other groups. Differences in the receipt of medications to treat OUD were substantial and did not change over time. Disparities persisted despite frequent health care contact.
Conversations On Health Care: COVID Emergency Ends but Mental Health Issues Remain
Miriam Delphin-Rittmon, Ph.D., serves as Assistant Secretary for Mental Health and Substance Use for the U.S. Department of Health and Human Services explains plans for dealing with the fact there are more Americans dying of drug overdoses now than at any time in modern history. Research also shows over 5 million Americans are struggling with an opioid addiction.
Fore Webinar (Today, May 16): Impact of the End of the COVID-19 Public Health Emergency on Opioid Use Disorder Treatment
This webinar will discuss the ending of the COVID-19 Public Health Emergency and its impact on OUD treatment.
COVID & Solitary Confinement
Slate: Dear Prison Officials: Stop Searching My Nose for Your Contraband
Prisoners attempt to hide COVID from prison administrators as long as there is a punitive response attached to COVID-positive cases. COVID is not treated as an illness in prison. Nasal cavity searches are conducted under force as prisoners are individually made to shove cotton swabs into their noses and place the swab in a plastic tube. Those who test positive are dragged off to medical isolation. It is, for all intents and purposes, solitary confinement.
BOP
KSTP: Surprise inspection of Waseca prison uncovers ‘many significant issues,’ DOJ says
A surprise inspection of the federal women’s prison in Waseca uncovered “many significant issues,” according to a Department of Justice report. According to the report, the prison is running with only 67% of its correctional service positions filled, leading to the temporary assignment of non-correctional officer personnel into correctional officer positions, a practice known as augmentation.
Title 42 Ending
Seeking Alpha: CoreCivic and GEO Group in the spotlight as Title 42 expires
Title 42 is part of the Public Health Service Act, which was enacted by FDR in 1942. The measure was intended to suspend entries and imports from designated places to prevent the spread of communicable diseases, like tuberculosis, which was a big health concern at the time. It was later invoked in 2020 during the coronavirus pandemic, and essentially suspended immigration at U.S. land borders. Title 42 comes to an end on Thursday. Publicly-traded operators of illegal immigration detention centers, CoreCivic and GEO Group, are now in the spotlight as Title 42 comes to an end, climbing 2.5% and 1%, respectively, in the premarket session. The Title 42 reversal is expected to result in more migrants entering the U.S.
Marketplace: Private prisons anticipate business opportunity after Title 42
The pandemic-era rule that allowed for the rapid expulsion of migrants at the border, called Title 42, expired late Thursday. And private prison companies with lucrative immigrant detention contracts with the U.S. government are paying close attention since there’s a chance the end of Title 42 could lead to more people crossing the border — and in immigrant detention centers. “The scheduled expiration of Title 42 restrictions at the southwest border could provide upside to our current forecast,” said George Zoley, CEO of GEO Group. “It’s an unpredictable situation, I think for all of us.”
State Roundup
California
California Healthline: California Confronts Overdose Epidemic Among Former Prison Inmates
More than 80% of inmates released in California between April 2020 and June 2022 departed with antidote kits and the training that goes with them, according to a study by corrections officials. Now corrections officials are trying to determine whether the kits actually save lives by examining overdose rates among formerly incarcerated people. They are still gathering data and have no timeline for results, though their report calls the evaluation effort “a critical priority.”
Los Angeles Times: 18-year-old dies of overdose in L.A. County juvenile hall, as state suggests shutdown
A state oversight agency issued a report calling for Los Angeles County’s juvenile halls to be shuttered in the wake of a staffing crisis and reports of increased violence and drug use, just hours after an 18-year-old was found dead of an apparent overdose in one of the deteriorating facilities. Staff deployed Narcan, a nasal spray that can reverse an opioid overdose, but he could not be revived and was pronounced dead a short time later. According to a nine-page report, the Probation Department continues to fail to adequately staff the halls while holding youth in isolation.
District Of Columbia
DCist: Lawsuit Alleges Life-Threatening, ‘Deliberate’ Medical Neglect At D.C. Jail
A lawsuit alleges that DOC is “deliberately indifferent” to its constitutional obligation to provide people with adequate medical care, arguing that medical care at the jail is “systematically dysfunctional.” The suit alos alleges that people with serious medical conditions routinely miss doses of life-saving medication and are forced to wait months or years for urgent medical care. In multiple cases, the suit says, medical staff at the jail failed to schedule necessary follow-up appointments until they were months past due, or canceled appointments last minute without explanation.
Nebraska
WOWT: Mental health policy changes recommended after inmate hurt at Tecumseh prison
The Office of Inspector General of the Nebraska Correctional System released a report Tuesday on an incident that happened nearly two years ago at the Tecumseh State Correctional Institution. The June 2021 incident involved an inmate with a serious mental illness and history of disruptive behavior. According to the report, the inmate caused a disturbance and threatened staff. That person was then shot by about 200 projectiles, leaving him wounded all over his body.
Oklahoma
The Oklahoman: The Oklahoma County Jail under the Jail Trust. A timeline of trouble
After control of the Oklahoma County jail was stripped from the sheriff's office in 2020, the facility became one of the deadliest jails in America under the leadership of the Jail Trust. But problems in the Oklahoma County jail can be traced back decades. By 2008, the U.S. Justice Department released a report chronicling more than 60 civil rights violations. Two former Oklahoma County jailers pleaded no contest to a misdemeanor cruelty charge for forcing inmates to listen to "Baby Shark" as punishment.
Pennsylvania
Leader Vindicator: Inmate mental health tops prison board discussion
Despite the temporary absence of a facility counselor, the mental health of inmates continues to be a top priority of Clarion County Jail officials. Jail Warden Jeff Hornberger told prison board members that the jail’s full-time counselor has been out with a medical issue. In April, according to Hornberger, 21 inmates were seen by the jail’s contracted psychiatrist, while eight individuals were placed on suicide watch. Pointing out that the statistics were higher than normal.
Texas
LMTonline: $1.3 million settlement reached in wrongful death of Webb County Jail inmate
On April 25, the county agreed to a $1.325 million settlement in the wrongful death of Luis Alberto “Albert” Barrientos Jr., who died of a treatable infection while in pre-trial detention at the jail after his medical needs were ignored. His mother told a correctional officer that Barrientos had heart valve and kidney problems and that her son needed to be taken to the hospital immediately. But her plea got a “Yeah, whatever” from the correctional officer.
Vermont
VT Digger: Franklin County sheriff loses access to national, state police databases due to assault charge
The troubles of Franklin County Sheriff John Grismore appear to be stacking up. On Wednesday, the Vermont House took a key step in its plans to impeach him. That same day, the sheriff was also barred from access to Valcour, the computer-aided dispatch and records management system used by police throughout the state.
VT Digger: Corrections commissioner denies records appeal, keeps ID of out-of-state prison bidder secret
The commissioner of the state Department of Corrections has denied a public records appeal from VTDigger seeking the name of the lone bidder on a state contract to house incarcerated Vermonters out of state. CoreCivic, a giant in the private prison industry, has held the contract since October 2018. CoreCivic has declined to say if it is the bidder for the new contract.
Rikers Island
New Yorker: The Diary of a Rikers Island Library Worker
A library assistant for the Brooklyn Public Library working on Rikers Island recounts lending books throughout the multiple housing units.
San Diego County
KPBS: Grand jury recommends more mental health staff, resources at SD County jails
More mental health clinicians and services are needed in San Diego County jails, particularly to assist a growing number of criminal defendants who are considered mentally incompetent to stand trial, according to a report released this week by the San Diego County Grand Jury
Domestic Violence & Criminal Justice
Now This (YouTube): Here’s How Domestic Violence Survivors Are Criminalized
Survivors of intimate partner violence share how they ended up in prison. This is how the criminal legal system is punishing those impacted by domestic abuse.
Capital Punishment
CNN: Supreme Court sides with Alabama inmate who seeks to die by nitrogen gas
The Supreme Court on Monday sided with a death row inmate in Alabama – whose scheduled execution by lethal injection was called off at the last minute by the state – who seeks to die by nitrogen gas when he is ultimately executed. Alabama had asked the high court to intervene – arguing that a lower court that contravened Supreme Court precedent that requires an inmate to demonstrate that a proposed alternative method is not just “feasible” but able to be “readily implemented.” Monday, the court declined.
Mental Health Initiatives In Criminal Justice
Fresno Bee: A humane path to keeping the mentally ill from homelessness or prison
Despite decades of effort, California is still far from creating an effective approach to treating severely mentally ill citizens. The debated CARE Court program isunder development. CARE Court works this way: All 58 California counties must create new court systems to serve people suffering from severe mental illness. Another solution is reforming conservatorships to make treatment more widely available. That is the primary goal of Senate Bills 43 and 363. SB 43 would expand the “gravely disabled” standard for compelling treatment. SB 363, would create a real-time dashboard that providers could check for open beds in often overcrowded psychiatric and substance abuse facilities throughout California.
WHYY: N.J. advocates ‘encouraged’ by recent analysis of program that pairs cops with mental health specialists during emergency responses
When cops in New Jersey are paired with mental health specialists, people in mental distress are far less likely to be arrested and are instead referred to health care services, a recent report found. According to a Brookings Institution analysis of New Jersey’s ARRIVE Together program, people in mental distress are also less likely to become victims of force.
WDET: Macomb County addressing mental health with jail improvements
Macomb County (Detroit, MI) officials hope to improve the way they handle people in mental health crisis or dealing with addiction by creating space at the county jail. The $228 million dollar proposed addition to the facility has been in the planning stages for years. Officials are looking to use $128 million in American Rescue Plan federal money and another $50 million from the county’s general fund.
Southeast Missourian: 'Jail navigator' addressing inmate mental health issues
Her title is "jail navigator", but the work Heather Ressel does is a little more complicated and innovative than her title implies. The first of her kind in Missouri, Ressel is a full-time staff member who provides mental health services to inmates at Cape Girardeau County Jail. Her job is funded by Missouri Department of Mental Health. She provides mental health support and connects inmates to services before they leave the judicial system's confines to rejoin society.
WVLT: Alternative to jail coming to Knox County for people with mental health issues
Knox County (TN) leaders have set up an alternative to jail: a court for people with mental health issues. Experts believe it could reduce incarceration rates. Knox County Mayor Glenn Jacobs made the announcement during his budget proposal on Monday that a mental health court would be coming to the county.
ABC: How a proposed program could help inmates with mental health before release
According to Shelby County Mayor Lee Harris (Memphis TN), The Bailey Justice Center has one of the highest volumes of inmates in the country. Harris adds a lot of them are repeat offenders who face substance abuse and mental strain. The mayor is trying to curb this strain many people face. Harris is trying to put together a program to help treat inmate PTSD, anxiety and substance abuse. The proposed program will take inspiration from the Behavioral Care Center from the Nashville area, and unite inmates with critical resources while they are in jail.
Technology
Arlington Virginia: Sheriff's Office Announces High Tech Approach to Inmate Safety
Sheriff Jose Quiroz announces the launch of a pilot program with Silicon Valley Company 4Sight Labs to track the vital signs of individuals in custody, becoming the first sheriff’s office in the area to use the technology as an additional tool, adding a layer of protection and safety in the Arlington County Detention Facility (ACDF).
Correctional Contractors
Dallas Moring News: Carrollton technology firm cutting 272 jobs
Aventiv Technologies, which operates corrections contractors Securus and JPay, notified 272 employees that their positions would end May 12. Aventiv and its correctional arms have often drawn criticism for their relationship with people being held in the jails they contract with. Its JPay division was fined $6 million by the Consumer Financial Protection Bureau in 2021 for allegedly siphoning off money from people being released from jail by requiring them to sign up for prepaid credit cards with fees to access their own money.