Weekly Update: May 7, 2024
Medicaid’s Potential of Limiting Abuse of Juveniles in Corrections Starting on January, 1, 2025


Highlighted Stories

Editor's Note
This week's first highlighted story focuses on a lawsuit against the Department of Correction and the Administration for Children’s Services in New York City for abuse that 150 juveniles suffered at the hands of New York's correctional system. These types of stories about inmate abuse, be they juveniles or adults, are not unusual. We are highlighting this story to draw our subscribers' attention again to sections 5121 and 5122 of Consolidated Appropriations Act of 2023 (see COCHS FAQ). Under section 5121 states are required to offer Medicaid's screening and diagnostic benefits to sentenced Medicaid-eligible juveniles up to thirty days prior to their release from a jail, prison, juvenile justice facility, or any other "public institution." Section 5122 gives states the option to maintain juvenile Medicaid benefits for the entire duration that an eligible juvenile is held in a "public institution" during the pre-trial period. We want to remind the reader that "juvenile" is defined by Medicaid and not the justice systems. Under the Medicaid definition, an individual can be considered a juvenile up to the age of 21, or in some instances, up to the age of 26. These provisions, which go into effect on January 1, 2025, will bring Medicaid into any so-called "public institution" where a Medicaid-eligible juvenile is held --whether that be a juvenile facility or an adult jail or prison.

Along with providing Medicaid services, these changes create a legal right to these services that cannot be taken away without due process. Most correctional facilities have not had to grapple with the larger body of legal rights that exist within the Medicaid system, which would require redress outside the scope of the typical grievance processes within a correctional institution. For those who become eligible for these services in 2025, they will find they have new avenues for redress and opportunities to ensure the type of abuse that these stories describe are likely to be far more limited.

To provide our subscribers with an idea of what might happen to a correctional institution that does not adequately protect incarcerated juveniles who are Medicaid enrollees, the second story about the Oregon State Hospital in Salem might be instructive. That hospital did not investigate sexual assaults. CMS investigated and demanded a plan of action to address deficiencies. The Oregon State Hospital now needs to respond with a plan of action that CMS approves. Furthermore, once CMS approves the plan it will conduct unannounced survey to review implementation. Taking this type of scenario into account, come January 1st, 2025, corrections might find itself in an entirely new world.

Sexual Abuse of Juveniles In Corrections
New York Times: 150 People Sue, Saying They Were Abused as Minors in N.Y.C. Custody
After an altercation with a police officer, Mary Soto, who was 14, found herself in custody at Horizon Juvenile Center in the Bronx where another detained girl told her that a particular staff member would bring her anything she wanted from the outside world if Ms. Soto was “really nice to him.” What that meant, Ms. Soto said she soon found out, was enduring repeated sexual assaults over the next four months of her detention. What happened to Ms. Soto, now 30, did not happen in a vacuum, said her lawyer, Jerome Block. She is one of about 150 people who filed lawsuits on Monday against New York City — including the Administration for Children’s Services and the Department of Correction — for the abuse they said they endured while in the city’s custody as minors. In 2019, the city settled a lawsuit with a 22-year-old man who said that a supervisor at Horizon repeatedly sexually assaulted him during his detention when he was a minor.

CMS Investigation
OPB: Oregon State Hospital failed to keep patients safe from assault, federal report finds
The Oregon State Hospital, the state’s most secure inpatient psychiatric facility, has only a limited ability to keep its patients safe from each other. The safety lapses contributed to a serious choking attack, injuries and sexual assaults. The hospital also didn’t adequately investigate the incidents after they happened. Those are the conclusions of an unannounced, onsite federal investigation conducted at the Salem hospital earlier this year by the Centers for Medicare and Medicaid Services, or CMS. Investigators also found the state hospital had inadequately investigated sexual contact and sexual assault, and had been handing out condoms to patients without a clear policy to prevent abuse. The Oregon State Hospital received the investigators’ report, known as a statement of deficiencies, on May 1. It has 10 calendar days to respond with a plan of correction. Once CMS approves the plan, it will conduct another unannounced survey to review its implementation.

1115 Waivers

Stateline: Many states are eager to extend Medicaid to people soon to be released from prison
Under federal guidance released a year ago, states can connect prisoners with case managers 30-90 days before they are released to develop plans based on their health needs. Jack Rollins, director of federal policy at the National Association of Medicaid Directors, said states that want to participate are focusing on different incarcerated populations and medical conditions. Some would start with jails, others with state prisons or youth detention facilities. Some states would provide coverage to all inmates, others just to those with a substance use disorder.

Opioid Epidemic

News From The States: Number of incarcerated pregnant women increases amid opioid epidemic
The number of jailed pregnant women fighting addiction has increased amid the skyrocketing opioid use in the past decade that led Virginia to declare a public health emergency in 2016. While the state has started to fund more recovery and treatment efforts, incarcerated mothers have fewer resources. Women in jail say facing motherhood and addiction is a specific struggle that needs more attention, in addition to more uniform prenatal care.

StarTribune: Overdose deaths spike after incarceration, but Minnesota jails lack treatment
Minnesota's jails are filled with people who have substance use disorder, but a state survey found less than half of county jails provide medication for opioid addiction. Corrections officials, people in recovery and state researchers say there would be fewer overdoses and less recidivism if facilities provided the medications and ensured people leaving lockup had health insurance and access to treatment. But they say the cost and staffing shortages prevent many jails from providing the help.

WTVR: Why are so few former Virginia inmates receiving treatment for substance abuse disorders?
National data suggests about 85% of people in the incarceration system struggle with substance use disorder. According to a new research study released by VCU, over 4,600 adults were released from county jails and state prisons in 2022. About 85% of that population were enrolled in Medicaid. However, only about 17% had received a diagnosis or treatment for substance use disorder while on Medicaid, including opioid use. The research was done as part of a study with the Virginia Medicaid Agency and Department of Medical Assistance Services (DMAS), using data from the Department of Corrections and Medicaid.

State of Reform: MOUD program helping Michigan jails provide SUD treatment to inmates
Law enforcement officers are using medications for opioid use disorder (MOUD) program in Michigan correctional facilities to help inmates get the substance use disorder (SUD) care they need to reintegrate into society. They discussed their progress at the 2024 Michigan State of Reform Health Policy Conference. The MOUD project is funded through opioid settlement dollars and is designed to address significant overdose risks in incarcerated populations during and following incarceration by increasing access to MOUD programs. Participating counties will receive grants up to $25,000 to cover associated costs.

Tributary: JSO correctional officer, city employee charged with bringing drugs into Duval County jail
The Jacksonville Sheriff’s Office arrested its own correctional officer and 16 other people and charged them with bringing drugs into the Duval County jail. Back in January, City of Jacksonville Public Works another correctional officer was accused of dealing drugs to inmates who were on the work crews he supervised, the sheriff said. He was charged with three counts of selling drugs, two counts of possessing drugs and one count of introducing or possessing contraband in a county detention facility. At least six people since 2022 have died with fentanyl in their system while incarcerated there, according to JSO and medical examiner’s records.

Mental Health

News Medical Life Sciences: MHFA training for correctional officers may boost mental health support in prisons
According to Rutgers Health researchers, training correctional officers in Mental Health First Aid (MHFA) for adults, a 7.5-hour national education program from the National Council of Mental Wellbeing, may help provide them with the necessary skills to effectively identify signs and symptoms of mental distress and advocate for incarcerated individuals facing mental health crises.

County of San Mateo: One year later – how the San Mateo County Sheriff’s Office is going beyond the call to help incarcerated persons overcome addiction, mental illness
San Mateo County Sheriff Christina Corpus sought out long-term solutions to address how addiction and mental illness were severely impacting the lives of those in San Mateo's correctional facilities. The Sheriff’s Office and Correctional Health Services first set out to find a holistic approach to providing wrap around services for incarcerated persons with mental illness. The initial step was to expand the existing Behavioral Health Unit. The immediate goal is to reduce violent and self-harm behaviors within the correctional facility, improving the safety and quality of life of incarcerated persons.

FlaglerLive: At Brendan Depa Sentencing, Prisons’ Mental Health Chief Draws Bizarrely Rosy Picture of Services Awaiting Him
To hear Suzonne Kline, chief of mental health at the Florida Department of Corrections, mental health services in Florida prisons are so extensive, so thorough, so attentive, you’d want to get imprisoned just to get a piece of them. That’s not exactly the case. Six years ago the Department of Corrections was sued in federal court by Disability Rights Florida for failing to comply with a 2017 settlement that was to address systemic failures regarding the treatment of people with disabilities. Though she appeared ready to produce numbers, Kline at no point was challenged to document generalities with specifics.

Oklahoman: Cleveland County jail inmate dies after 'medical episode' Saturday; second death in weeks
A Cleveland County jail inmate died Saturday after a medical episode. Thomas Sanchez Pesina was booked into the jail on May 21, 2023. He was found incompetent to stand trial during an August 2023 hearing and has been waiting since then for transfer to the Oklahoma Forensic Center. The center has a long history of issues with capacity and wait times. In February, a judge found the Oklahoma Department of Mental Health and Substance Abuse Services in contempt of court and fined the department $500 for each day a criminal defendant who needs treatment is left in jail.

Pittsburgh Post-Gazette: Allegheny County jail is operating with no therapists
Currently there are no therapists working at the Allegheny County Jail. That was but one of the details illustrating an ongoing health care staff shortage at the facility presented to the Allegheny County Jail Oversight Board. Part of the issue is that many health care staff currently working in the jail are hired through contract work and are not county staff. Health care staff vacancies are not a new issue. Across full-time union, part-time union and nonunion health care positions at the facility, there were more than 80 vacancies as of the end of 2022.

WFAE: How the mental health system affects North Carolina’s jails and the people that work there
If you ask your sheriff about North Carolina’s mental health system, they might tell you their jail is evidence it’s broken. The state’s jails are on the frontlines of the mental health crisis. Jail staff have to tend to inmates with mental health issues, even though they’re not fully equipped to do so. That can take a high toll on those jails — and the people who work there. Locking up inmates living with mental illness can make deputies’ work more dangerous. And it increases the likelihood that officers will use force.

The Virgin Islands Daily News: Monitor says jail still understaffed for mental health care
The St. Thomas jail is still failing to provide mental health counseling, according to a court-appointed independent monitor, who testified that more staff are needed to adequately treat detainees awaiting trial. The monitor, Dr. Kahlil Johnson, said the jail is providing psychiatric medication and medical care, but group counseling and individual therapy are not available. “The jail is insufficiently staffed for mental health care,” Johnson said.

Events & Webinars

Overdose Prevention Initiative: The Overdose Crisis & Black Americans (May 17, 2024, 10:10-11:30AM ET)
Please join the Overdose Prevention Initiative at the Global Health Advocacy Incubator, in collaboration with the Congressional Black Caucus and the Addiction, Treatment, and Recovery Caucus for a briefing on this urgent issue - "Addressing Inequities: The Overdose Crisis and Black Americans.”

BJS: BJS webinar on interactive data dashboards
BJS has released a recording of a past webinar describing interactive data visualization tools that make criminal justice data more accessible to the public.

State & Territory Roundup

CalMatters: California officials won’t say why it would cost ‘billions’ to protect prison workers from heat
More than a month after Gov. Gavin Newsom’s administration delayed a workplace indoor heat rule because it might be too expensive for the state prison system, state officials are refusing to release records showing how they made that decision. The Department of Finance said today it’s withholding records of any cost estimates it has conducted over the proposed workplace rule or received from other state agencies, plus communications between prison and finance officials over those costs.

EMS1: Calif. prison firefighters help save 10-year-old in cardiac arrest
Two incarcerated firefighters are being credited with helping save the life of a 10-year-old boy, according to the California Department of Corrections and Rehabilitation. The Chuckawalla Valley State Prison/Ironwood State Prison Fire Station, which assists surrounding areas, responded to an emergency, a child in cardiac arrest. Fire Chief Richard Selph, along with incarcerated firefighters Antonio Alonso and Leopoldo Leon arrived to find a 10-year-old in severe distress. Their timely intervention helped the child regain a pulse.

11 Alive: 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. He accused prison officials of falsifying documents and said they routinely placed new arrivals at the facility in “strip cells,” where one inmate said he was not given clothes or a mattress and could not use the toilet because it was broken and filled with human waste.

Chicago Sun Times: Solitary confinement in Illinois prisons violates human rights, Chicago lawyers group says
The use of solitary confinement — also called segregation or restrictive housing — in Illinois violates international human rights laws, according to a report from the Chicago Lawyers’ Committee for Civil Rights detailing cases similar to Moore’s. The report calls for reducing or restricting its use, saying that would improve prison safety and inmates’ health, limit costs and help cut down on recidivism.

Michigan Department of Attorney General: Former Corrections Officer Pleads to Assault of Inmate
Today, a former corrections officer, Christopher Cluley, of Mount Pleasant, pled to one count each of Aggravated Assault and Willful Neglect of Duty, for the in-custody jailhouse assault of an Isabella County man. In April 2020, Cluley was working in the Isabella County Jail as the administrator in charge when he interacted with an inmate during a cell transfer. Video evidence shows Cluley grabbed the inmate, spun him around and pushed him into the cell door before then pushing him into the wall next to the cell door.

KSTP: At Stillwater prison, tattoo program seeks to improve health, career outcomes for inmates
The Minnesota Department of Corrections is launching a tattoo parlor in a prison to reduce the spread of bloodborne diseases and set prisoners up for success when they get out. It’s one of very few such programs that exist nationwide. The DOC explained “do-it-yourself” tattoos and needle-sharing run rampant in prisons, which could lead to the spread of bloodborne diseases. The state sees about 100 cases of hepatitis C in prisons per year.

Spectrum News: Mo. 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.

Oklahoma Watch: Prisoner Advocates Ramp Up Lobbying Efforts
Dozens of family members of Oklahoma prisoners descended on the State Capitol, urging lawmakers to improve conditions for the incarcerated. Advocacy days at the Capitol are a commonplace during the legislative session. But last week’s gathering was the first time family members of the incarcerated have formally lobbied lawmakers on prison issues.

North Carolina
NC Newsline: Three thousand people were released from NC prisons to homelessness last year
About one in six people released from North Carolina prisons in 2023 were homeless, according to figures provided to NC Newsline — a rate the state hopes to cut in half by 2030. That goal is one part of an executive order issued by Gov. Roy Cooper in January to improve reentry supports for people getting out of prison. In issuing that mandate, Cooper set a series of ambitious goals, enrolling North Carolina in a national initiative known as Reentry 2030.

Daily Tar Heal: Organizations file lawsuit against NCDHHS about prolonged jailing of people with disabilities
Disability Rights North Carolina and the American Civil Liberties Union of North Carolina Legal Foundation are suing the NC Department of Health and Human Services for alleged violations against pre-trial detainees with disabilities. The lawsuit, which was filed on April 18, claims that the NCDHHS is violating the 14th Amendment, Americans with Disabilities Act and the Rehabilitation Act by failing to provide timely competency assessments.

The Hill: DOJ files lawsuit against Texas prison agency for denying religious accomodation
The Department of Justice (DOJ) filed a lawsuit against a Texas prison agency for allegedly denying religious accommodation to an employee over wearing a head covering. Franches Spears was first put on leave with pay and later terminated after wearing a head covering “as an expression of her Ifa faith.” “Employers cannot require employees to forfeit their religious beliefs or improperly question the sincerity of those beliefs,” Assistant Attorney General Kristen Clarke said.

Voices From Corrections

The Appeal: After 20 Years in Prison, Jail is Still a Different Kind of Hell
Jails are filled with people experiencing the worst days of their lives. Some are forced to forgo medication for physical and mental illnesses, while others are withdrawing from drugs without proper treatment. Unable to afford price-gouged necessities, many are hungry and lacking basic hygiene items. A recent report by the Washington State Attorney General’s Office found that in 2022 there were at least 1,270 assaults between detained people in state jails. That same year, there were at least 3,720 instances of use of force by jail staff against detainees. Both statistics are likely an undercount as there is limited data available.


Philly Voice: People leaving prison face many hurdles. Temple is running a reentry simulation to help health care providers relate
A recent patient of Dr. Valerie Armstead, an anesthesiologist at Temple Health, made a request before he underwent a colonoscopy, a procedure that requires sedation. As Armstead recalls, he said, "I don't want to have anything that's going to show up on my drug test, because I've been out of prison for a week, and I have to see my parole officer in five days – and if my urine comes up dirty, they're going to act first and ask questions later." Armstead's patient was harder to anesthetize because he could not have the drugs she normally would administer for a colonoscopy. "But we got it done. We just worked with him to give him what he needed in order to have this very important procedure," Armstead said.


Filter: CoreCivic Manages Our Prison, and Tries Not to Manage Our Medical Care
Tony Vick writes from Tennessee's South Central Correctional Facility: CoreCivic is responsible for our medical care, but it isn’t always clear whether CoreCivic is the company providing it. Currently the registered nurses who perform emergency procedures and make referrals to outside hospitals—are hired through CoreCivic. Anyone who performs mid-level procedures is hired through Corrections Professional Corporation—a private prisons health care company that is not CoreCivic, but works for no one else but CoreCivic and is headquartered at the same address. CoreCivic is responsible for hospital-trips costs up to $4,000, but past that, the bill is supposed to go to the private medical contractor for the state-run facilities, Centurion Health. Centurion won a messy bidding war in 2020, before that TDOC’s medical contractor was the company formerly known as Corizon Health.

Correctional Health Care Vendors

NHPR: State weighs shakeup at Hampstead Hospital
The state may be considering a change at Hampstead Hospital, two years after buying the youth mental health facility and tapping a private company to run it. That company, Wellpath Recovery Solutions, has faced criticism over its handling of safety issues and the continued waitlists for youth mental health care. Now, with the contract out to bid, state officials have indicated they prefer another vendor – Dartmouth Health – to Wellpath by most measures.

KOAA: Mother of inmate who died by suicide at El Paso County Jail hopes federal lawsuit will hold medics accountable
A federal lawsuit filed by the family of 18-year-old Dezaree Archuleta claims mental health providers at the El Paso County Jail repeatedly ignored her cries for help before she took her own life two years ago while in custody. The lawsuit was filed in April of 2024 against Wellpath, the jail's medical provider at the time, its parent company H.I.G. Capital and several Wellpath medical providers. The El Paso County Sheriff's Office (EPSO) switched healthcare providers at the jail starting Jan. 1 of this year, signing a new contract with VitalCore Health Strategies

WCSC: Man suing Charleston County sheriff, detention over insulin treatment
A man is suing the Charleston County sheriff and jail staff who were working at the time alleging they wouldn’t give him insulin for his diabetes, and after more than a week without his treatment, he had to go to the hospital. The lawsuit also states that staff failed to take basic steps to verify Washington’s condition and help since they could have asked his outside doctor or done a variety of blood tests. At the time, the jail healthcare was managed by Wellpath, also named in the lawsuit. VitalCore Healthcare has since taken over the service, after multiple complaints and complications with treatment under Wellpath.

Baltimore Banner: How a Maryland prisoner’s 15-month quest for eye surgery ended in blindness
Incarcerated in a Western Maryland prison, Nathaniel Appleby-El knew he was going blind in his right eye. Appleby-El told a nurse that his retina was detached, and he needed to be seen by an ophthalmologist. It was a medical emergency but prison medical staff did not immediately treat it like one. It would be nearly a year until Appleby-El was finally seen by an ophthalmologist. Fifteen months later, Appleby-El finally underwent laser surgery. Appleby-El languished in prison without post-surgery care. His medication was withheld. The pressure in his right eye became critically high. The optic nerve was destroyed. Appleby-El is now permanently blind in his right eye. Appleby-El will receive a $200,000 settlement payment, most of which will be paid by Wexford Health Sources, a former medical contractor for state prison