COCHS Weekly Update: October 04, 2022

Highlighted Stories

Health Payer Intelligence: States Plan Medicaid 1115 Demonstration Waivers for Incarcerated People
States across the country are working with the US Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) to obtain Section 1115 demonstration waivers to innovate healthcare for incarcerated patients. These waivers come four years after the passage of the Substance Use-Disorder Prevention That Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act. Arizona, California, Kentucky, Massachusetts, Montana, New Jersey New York, Oregon, Utah, Vermont, and Washington recently submitted their Section 1115 demonstration requests with CMS. The submitted requests vary in terms of eligibility standards. Oregon, Washington, and Vermont plan to support all who are eligible for Medicaid. Arizona, California, Massachusetts, New Jersey, New York, and Utah all aim to include those with one or more chronic conditions and behavioral health conditions.

JDSupra: States Push for Innovative Ways to Improve Health Outcomes for Justice-Involved Individuals
There is growing momentum among states to develop innovative models to help people involved with the justice system (i.e., justice-involved individuals) receive health care services covered by Medicaid while they are incarcerated. By providing services before people are released, including care management to plan for reentry, states are hoping they can improve health outcomes when individuals return to their communities.

NACo: Medicaid Inmate Exclusion Policy (MIEP) Advocacy Toolkit
Letter campaign to help county officials educate Congress, the administration and the public on the importance providing access to federal health benefits for those awaiting trial and verdict decisions. Across America, the double standard created by the Medicaid Inmate Exclusion Policy (MIEP) is putting undue strain on our local judicial, law enforcement, public safety and human services systems.

New York Times: Justice Dept. to Seek Stiffer Sentences in Prisoner Abuse Cases
The Justice Department is finalizing long-awaited plans to overhaul the troubled Federal Bureau of Prisons, which include a recommendation to increase sentences for prison employees found guilty of sexual abuse against inmates, according to people familiar with the situation. For the past year, several working groups in the department, under the supervision of Deputy Attorney General Lisa O. Monaco, have been hammering out potential fixes in a sprawling system long plagued by sexual abuse that has disproportionately targeted female inmates and prison workers.

New York Times: 14 Guards at New Jersey Women’s Prison Are Indicted Over Beatings in 2021 Raid
Fourteen guards at New Jersey’s only prison for women were indicted Tuesday in connection with a violent 2021 midnight raid that left two women with serious injuries. The officers charged include a former top supervisor at the prison, Edna Mahan Correctional Facility, a troubled institution the Justice Department found two years ago was plagued by sexual violence.

New York Times: Alabama Inmates Strike, Denouncing Prison Conditions
Thousands of Alabama inmate workers began a labor strike this week to protest poor prison conditions across the state, where facilities are overcrowded, understaffed and notoriously dangerous. The Alabama corrections system has drawn the scrutiny of the Justice Department, which released a report in 2019 that outlined “severe, systemic” conditions across the state’s prisons that violated constitutional protection from cruel and unusual punishment because they were in danger of being raped or murdered.

Washington Post: Jail warden and brother charged in roadside shooting of Mexican migrants
Near sundown one night this week in West Texas, a white-bearded jail warden and his twin brother allegedly drove past a group of migrants trekking through the desert. Migrants scrambled to hide in the brush. The warden, Michael Sheppard, allegedly fired a pair of shotgun blasts in their direction.A man in the group was killed, and a woman was shot in the abdomen. Michael Sheppard worked at the West Texas Detention Center, according to Salgado. The jail, which holds federal detainees awaiting trial or sentencing, is operated by LaSalle Corrections.

CCJ: Racial Disparities in State Imprisonment Declined Substantially from 2000 to 2020
While troubling racial and ethnic disparities persist within the U.S. criminal justice system, new research released by the Council on Criminal Justice (CCJ) today shows that the gap between Black and White state imprisonment rates narrowed significantly over the first two decades of the 21st century. In 2020, Black adults were imprisoned at 4.9 times the rate of White adults, down from 8.2 times in 2000-a 40% drop. Black-White disparities in state imprisonment rates fell across all major crime categories—violent, property, drug, and public order—with the steepest decline occurring for drug offenses.

Scientific American: Dementia in Prison Is Turning into an Epidemic: The U.S. Penal System Is Badly Unprepared
A survey by the Pew Charitable Trusts found that the number of inmates age 55 or older increased by 280 percent from 1999 to 2016. Three-strikes laws and mandatory life sentences without the possibility of parole expanded during the 1980s and 1990s, and many of these laws are still on the books today. As the number of aging prisoners balloons, so, too, do instances of dementia.

Health Day: U.S. Prisoners Face Higher Odds of Dying From Cancer
New research shows the risk of dying from cancer is sharply higher among those who are behind bars or have been recently released. In Connecticut prisons, where the data for this study were gathered, the average age for a cancer diagnosis was 50. For those who were never behind bars, it was 66. Other benchmarks showed similar differences. Cancer is the leading cause of death in prison.

Cost of Corrections

USA Facts: How much do states spend on prisons?
State governments spent a combined $55 billion on corrections in 2020, with most of the spending going toward operating state-run prisons. There were more than 1.2 million people in prison. Spending per prisoner varies widely across states, from about $18,000 per prisoner in Mississippi to $135,978 per prisoner in Wyoming in 2020. States spent an average of $45,771 per prisoner for the year.

The Guardian: What’s Prison For? Concise diagnosis of a huge American problem
America’s incarceration rate per 100,000 is “roughly twice that of Russia’s and Iran’s, four times that of Mexico’s, five times of England’s, six times Canada’s” and nine times that of Germany. America’s exceptionalism is actually a recent development. Liberals and conservatives were equally responsible. Democratic Senate judiciary committee chairman, Joseph Biden of Delaware, made it much worse by championing the Violent Crime Control and Law Enforcement Act of 1994. President Reagan inserted the profit motive into the prison business, allowing the Corrections Corporation of America to pioneer “the idea of privately run, for-profit prisons”

Rikers Island

New York Times: Jails Boss Urged Man’s Release in Apparent Bid to Limit Rikers Death Toll
After learning that a man held at the Rikers Island jail complex had suffered cardiac arrest and was on the brink of death, Louis A. Molina, the commissioner of the New York City Department of Correction, issued a directive to his subordinates. “Make sure we do what we can,” Mr. Molina wrote on Thursday in an email to ensure the man was “off the Department’s count.”

City & State New York: Mental health care on Rikers: New York’s largest psychiatric provider
Around this time last fall, a delegation of state and local lawmakers visited Rikers Island. Some of them ended up seeing something unimaginable: an attempted suicide. Just over a year later, with a new mayor and a new commissioner leading the Department of Correction, New York City is still dealing with this crisis. Sixteen people have died in custody.


Washington Post: Behind Newsom’s move on California’s chronic problem with the mentally ill
In 1967, Ronald Reagan, California’s Republican governor, signed legislation that would have far-reaching impact on people with severe mental illness. The 1967 legislation was a bipartisan undertaking that proponents hailed as the Magna Carta for people in state hospitals. The legislation’s flaws were that it did not compel counties to spend money to help former patients. Governor Newsom last month signed into law CARE Court, short for Community Assistance, Recovery and Empowerment. It’s aimed at compelling those with severe mental illness to obtain help.

San Diego Union Tribune: With San Diego jail deaths at record pace, Newsom vetoes bill to improve safety standards
Gov. Gavin Newsom has vetoed legislation that would have mandated improvements to mental health care, medical services and safety standards in California jails, disappointing advocates who have pushed for reforms as people continue to die in San Diego jails at a record pace.

CalMatters: A veto for the ‘Mandela’ bill that sought to limit solitary confinement in California
Assembly Bill 2632, named the “California Mandela Act” after former political prisoner Nelson Mandela, would have been the most wide-ranging change to solitary confinement of any state, limiting the practice in all California prisons, jails and immigration detention facilities. Its contentious passage through the Legislature ended largely on party-line votes, with Republicans continuing to raise an alarm about the bill’s potential costs. Gov. Gavin Newsom vetoed the bill last Thursday.


Arnold Ventures: In Oklahoma, a Red State Model of Criminal Justice Reform
In the last half-decade, Oklahoma has enacted a series of landmark legislation that has reclassified drug offenses, removed barriers to reintegration, and reappropriated funding to social services — all with stunningly positive outcomes. More than a one-off effort, these policies span two different governorships and demonstrate how justice reform can earn bipartisan support and a warm public reception.

Local Jails

WECT: Sheriff: “I’m sick of these Black bastards.... Every Black that I know, you need to fire him...”
On one end of the phone was Columbus County Sheriff Jody Greene. On the other was then-Captain Jason Soles, who had just been tapped to lead the Sheriff’s Office while elections officials investigated a complaint questioning whether Greene was eligible to serve as sheriff. Greene wanted to know who in the department had communicated with Lewis Hatcher, the former sheriff whom Greene had narrowly defeated in the election. “I’m sick of it. I’m sick of these Black bastards,” said Greene said to Soles. “I’m going to clean house and be done with it. And we’ll start from there.”

East Bay Times: 47 Alameda County sheriff’s deputies removed from active duty after poor psychological exams
Nearly four dozen Alameda County sheriff’s deputies were wrongfully hired over the last six years despite unsatisfactory scores on their psychological exams — a revelation that forced the deputies, about 10% of the force, off active duty, and could put an untold number of criminal cases in legal limbo, the department confirmed Monday. The moves followed the arrest of a sheriff’s deputy earlier this month in the execution-style killings of Benison Tran, 57, and his wife, Maria Tran, 42, in their Dublin home.

Opioid Epidemic

NACo: Supporting People with Opioid Use Disorders Involved in the Justice System
County and justice leaders play a key role in implementing strategies and local programs to reduce the impact of opioid and other substance misuse within the community and criminal legal system. The 2022 NACo Annual Conference featured a workshop on Supporting People with Opioid Use Disorders that featured speakers from Memorial Regional Health in Northwest Colorado, Pitt County, N.C. and the U.S. Department of Justice. Speakers shared evidence-based strategies to prevent substance misuse and support community members living with opioid use disorders who are involved in the criminal legal system.

PEW: Overview of Opioid Treatment Program Regulations by State
Opioid treatment programs (OTPs) are the only health care facilities that can offer patients all three forms of FDA-approved medication for opioid use disorder (OUD): methadone, buprenorphine, and injectable extended-release naltrexone. But Pew found that nearly all states have rules governing OTPs that are not based in evidence and in turn limit access to care or worsen patient experience.

Corrections 1: SoCal jails fight fentanyl smuggling with K9s, body scanners
Jails in Southern California are taking steps to guard against fentanyl-related deaths among inmates, but some are still dying and now deputies and nurses at the institutions are facing the threat of exposure. Riverside County Sheriff Chad Bianco recently announced that fentanyl has been confirmed in the deaths of three inmates and suspected in two other deaths so far in 2022. That total, matching the deaths attributed to fentanyl in 2021 and 2020, constitutes more than 38% of the 13 in-custody deaths this year.

NC Health News: Opioid use disorder treatment in jails making strides in North Carolina
Establishing programs that provide medications for opioid use disorder in jails is part of that paradigm shift, he said. Momentum is building for this type of treatment in jails due to recent guidance from the U.S. Department of Justice that states it is a violation of the Americans with Disabilities Act if correctional facilities do not continue an individual on the medications they were receiving to treat their addiction in the community prior to incarceration.

Spectrum News: Most Mainers want to move away from criminal punishment for low-level drug offenses
A survey of Maine voters shows 74% support a move away from criminal punishment for low-level, non-violent drug offenders and toward rehabilitation programs. The results come at a time when Maine is once again experiencing a high number of drug overdose deaths largely fueled by fentanyl.

Hartford HealthCare: Program Celebrates Success in Putting People in Treatment, Not Prison
Pride was in the air Tuesday at the “Celebration of Success” reception for the Meriden Opioid Referral for Recovery (MORR) program, a partnership between first responders and Rushford that has helped put people in treatment instead of behind bars. The most effective tactic has been the enhancement of community policing efforts by embedding Rushford clinicians to provide immediate mobile crisis services to guide individuals on a path to recovery.

Prison Labor

Washington Post: Why are prisoners paid a pittance to make glasses I prescribe for poor kids?
Near the beginning of the pandemic, I performed eye surgery for an infant born with cataracts. To prevent irreversible blindness, it is necessary for children to start wearing eyeglasses immediately after surgery. For this child, I was told that the glasses would take at least six weeks to arrive — a serious and vision-threatening delay. The reason for the delay? Coronavirus-related shutdowns of an optical shop in a nearby prison, staffed by incarcerated people, who in California are generally paid between 8 cents and 37 cents per hour.

The Guardian: ‘Slavery by any name is wrong’: the push to end forced labor in prisons
The 13th amendment of the US constitution abolished slavery and involuntary servitude. But it contained an exception for “a punishment for crime whereof the party shall have been duly convicted”. This exception clause has been used to exploit prisoners in the US as workers, paying them nothing to a few dollars a day.


Ohio Capital Journal: Health Policy Institute of Ohio argues cash bail bad for community health
Issue 1 would direct judges in Ohio to weigh public safety when setting the dollar amount for bail. They already take that into account for non-monetary conditions. Opponents argue the effort punishes the poor and gives unfair advantages to the rich. They also note state law already carries provisions to hold truly dangerous defendants without bail.

Crime Report: No Bail for Pretrial Detainees Means No Vote
Every election, thousands of eligible voters fail to turn out ballots because they reside in a jail cell, not convicted of a crime, simply because they can’t raise bail money. The Supreme Court has upheld protections for presumed innocent pretrial detainees to access ballots and register to vote, but several obstacles restrict these individuals of that right.

Mental Health Initiatives In Corrections

NBC News: Mental health crisis teams aren't just for cities anymore
For years, many cities have sent social workers, medics, trained outreach workers, or mental health professionals to calls that previously were handled by police officers. But crisis response teams have been slower to catch on in rural areas even though mental illness is just as prevalent there. But small police departments and sheriffs’ offices seem increasingly open to finding alternatives to a standard law enforcement response.

Los Angeles Daily News: Move 7,000 mentally ill inmates from jail to treatment centers, say LA County Supervisors
The increase in inmates with mental illnesses, which rose from 3,500 in 2015, makes any depopulation of the overcrowded jails, called for by the courts, that much more difficult. The mentally ill make up about 50% of the entire inmate population of roughly 15,000 people in county jails. The Los Angeles board of supervisors plans to build new facilities, or contract out, to treat those designated as having a mental illness.

West Hawaii Today: ‘We can get much better outcomes’
A possible solution to decrease the revolving door of incarceration for people suffering serious mental illness and substance use disorder. Miami-Dade County Associate Administrative Judge Steven Leifman presented the model his Florida community has used to effectively address the needs of those with mental illness and substance abuse issues to dozens of Hawaii County stakeholders, including members of the Judiciary, law enforcement, health care and more.

Corrections 1: Program aims to address staff, inmate mental health in Idaho prisons
The Idaho Department of Correction recently received $500,000 to launch a pilot program aimed at helping staff members and prison residents deal with trauma, burnout and stress. The money was approved during the 2022 legislative session and was included in the department's budget. It was part of Gov. Brad Little's Leading Idaho plan that expanded mental health resources in the state by $50 million.

Missoula Current: Missoula’s efforts on jail diversion, behavioral health moving the dial
Efforts to reduce crowding at the Missoula County Detention Center and divert offenders to other resources have shown progress in recent years, saving taxpayer's money while getting low-level offenders help, the county said. The Jail Diversion Master Plan was written and adopted in 2016 and included roughly 40 recommendations across a number of categories, such as pre-sentencing and behavioral health.

Spokane City: Healing Those Hurt by Addiction
When police and sheriff’s deputies arrest someone for eligible offenses, they can be taken to jail or diverted to Spokane’s new Regional Stabilization Center. “Usually, when they want to go to treatment, we are able to provide them this resource. Then, we’re able to take them there and get them in either a withdrawal program, mental health program, or a co-occurring disorder,” explained Spokane police officer Richie Plunkett.

Criminal Justice's Detrimental Impact On Mental Health

New York Focus: Prisons Are Illegally Throwing People With Disabilities Into Solitary Confinement
Solitary confinement can take a heavy mental toll on anyone; international bodies have deemed prolonged solitary a form of torture. But people with disabilities, particularly mental illnesses, can be especially affected. The American Psychiatric Association has said that, with rare exceptions, prisons and jails shouldn’t place anyone with a serious mental illness in solitary, and that those who end up there “generally face bleak prospects of any medical improvement.”

Elko Free Press: Mental health issues increase at jail
Mental health issues are common in any jail, but their frequency and severity have been getting much worse than normal in Elko County. “As of this year so far we’ve had 10 suicide [attempts],” including two this month, Sheriff Aitor Narvaiza told county commissioners on Sept. 21. Solutions are hard to find, partly because of the ongoing labor shortage that has broadly impacted the U.S. economy.

Staffing Shortages

PEW: Prison Staff Shortages Take Toll on Guards, Incarcerated People
Amid a nationwide worker shortage in various industries, prison systems across the country are desperate to reverse an exodus of corrections officers that administrators and prison experts describe as the worst ever. To attract more officers, states are raising salaries, offering hiring bonuses, reducing the minimum age to 18 and ratcheting up recruiting efforts with advertisements on billboards and social media.

Politico: Why Nevada wants to use drones inside prisons
Corrections officers have become so difficult to hire and retain that robots may end up doing the job. In Nevada, prison officials imagine a security system with a central command center where one person can monitor live video feeds and the decibel levels. This all-seeing staff member can then dispatch officers available to an emergency situation. In the event of an escape, drones could be utilized, along with tracking bracelets.

WHEC: Nevada prison escape, resignation raises political stakes
The head of Nevada’s Department of Corrections resigned Friday at the request of Gov. Steve Sisolak in the wake of a prison escape by a convicted bombmaker that went unnoticed for four days. The embarrassing chain of events has put a spotlight on chronic staffing shortages at prisons throughout Nevada against a high-stakes political backdrop in the western battleground state a month before the November elections. The report found that major prisons were at 182 percent of capacity, and that prisoners in the Alabama system endured some of the highest rates of homicide and rape in the country.

Nebraska Examiner: Prison system touts drop in staff turnover, while lack of medical workers remains a concern
The Nebraska Department of Corrections, long plagued by high turnover among protective services staff, is now projecting that the turnover rate among guards will be cut nearly in half. In a press release, Corrections said it expects the turnover rate among custody staff to be around 18% by the end of the year. That would compare with a 34% turnover rate in 2018. Worries remain about a shortage of medical and mental health providers at state prisons, and whether the hiring gains can be sustained.

Private Prisons

Tennessee Lookout: Lawmaker raises specter of federal takeover of Tennessee prison system
Lawmakers blasted the Department of Correction Monday for making a weak response to a 2020 audit, with one legislator questioning whether the federal courts need to take over Tennessee’s prison system again. Prison system officials contended they had solved nearly every problem but finally admitted that CoreCivic, the state’s private prison operator, paid more than $10.6 million in liquidated damages over the last two years compared to $7.3 million from 2018 to 2020 for failing to meet staffing requirements.

Bloomberg: US Detention-Center Owners Reject Claims of Human Rights Violations
Two of the biggest operators of detention centers in the US rejected allegations of human rights breaches that Norway’s biggest pension fund said drove its decision to unload shares of the companies. GEO Group Inc said in a statement that it follows standards set by US authorities, which also decide who is detained and released at the facilities. CoreCivic Inc said it has clear commitments “regarding resident rights and treatment.”

Reuters: GEO Group wins legal challenge to California ban on private immigrant prisons
A U.S. appeals court on Monday struck down California's ban on privately-run immigrant detention centers in a challenge brought by private prison operator GEO Group Inc and the Biden administration. The San Francisco-based 9th U.S. Circuit Court of Appeals said California's 2019 ban gave the state too much control over how the federal government handles immigrant detainees.

Correctional Health Care Vendors

Herald Mail: Lawsuit claims Boonsboro woman forced to give birth in Washington County jail alone
A Boonsboro woman who claims she was forced to give birth in the Washington County Detention Center last summer with no medical assistance is suing Washington County government, the sheriff and a Pennsylvania company that provides medical care to inmates. Sheriff Doug Mullendore and PrimeCare Medical Inc., of Harrisburg, Pa., which is contracted to provide medical services to inmates.