COCHS Weekly Update: May 09, 2023
Highlighted Story
Editor’s Note
COCHS has been excited about the 1115 waiver in California and the new CMS guidance for other states seeking a similar waiver. But being excited does not mean being blind to the challenges that need to be addressed to bring Medicaid coverage behind the walls. As Dan Mistak’s "Dear Colleague Letter" last week pointed out "translating federal guidance to local practice is particularly challenging." The subscribers to COCHS Weekly Update should not be completely surprised about how challenging it will be to translate this guidance to the day-to-day operations of correctional facilities especially given the multiple articles included in each week’s Weekly Update detailing the state of health care delivered within these facilities. This week’s update is highlighting the recent editorial of the Los Angeles Times as possibly indicative of some of the challenges that might face any jurisdiction trying to provide Medicaid coverage prior to release and how these challenges may exist because there is a lack of understanding on how the criminal justice system works.
The Los Angeles Times editorial board wrote that conditions in the county's jail have gone from "horrific" to "outrageous" and this occurred even while the jail has been under court supervision for decades. Trying to alleviate some of these issues, two members of the Board of Supervisors introduced proposals "to transfer thousands of jail occupants to community mental health clinics”. But this proposal was shot down as an example of “catch and release” or in other words soft on crime. However, the proposal was meaningless even if passed. Supervisors do not control who is released and who remains in jails; that is solely the bailiwick of the sheriff --the board of supervisors can only "encourage alternatives."
The new waiver that California has received from CMS in many ways can be seen to be similar to the “encourage alternatives” power of the Los Angeles Board of Supervisors –it could be meaningless but it could also be transformative. In the end, it is the sheriff who decides what can be implemented in the facility that the sheriff has been elected to oversee, not a change in regulations. Even after decades of court supervision, outraged editorials and proposals from politicians, the conditions at the Los Angeles jail remain pretty much the same. In order to meet the conditions for participation of Medicaid, the official in charge of the correctional facility will need to be a full and willing participant. Many of our subscribers may not fully understand that even though a jail is the baliwick of the sheriff, a sheriff does not control who enters a correctional facility. In most jurisdictions, a sheriff does not control the timing of release of any specific individual. Nevertheless, COCHS is encouraged that strong support exists among sheriffs and other officials in control of correctional facilities. Such organizations as the National Sheriffs Association among others of our public safety partners have been vociferous proponents of bringing Medicaid behind the walls of corrections.
The Los Angeles Times editorial board wrote that conditions in the county's jail have gone from "horrific" to "outrageous" and this occurred even while the jail has been under court supervision for decades. Trying to alleviate some of these issues, two members of the Board of Supervisors introduced proposals "to transfer thousands of jail occupants to community mental health clinics”. But this proposal was shot down as an example of “catch and release” or in other words soft on crime. However, the proposal was meaningless even if passed. Supervisors do not control who is released and who remains in jails; that is solely the bailiwick of the sheriff --the board of supervisors can only "encourage alternatives."
The new waiver that California has received from CMS in many ways can be seen to be similar to the “encourage alternatives” power of the Los Angeles Board of Supervisors –it could be meaningless but it could also be transformative. In the end, it is the sheriff who decides what can be implemented in the facility that the sheriff has been elected to oversee, not a change in regulations. Even after decades of court supervision, outraged editorials and proposals from politicians, the conditions at the Los Angeles jail remain pretty much the same. In order to meet the conditions for participation of Medicaid, the official in charge of the correctional facility will need to be a full and willing participant. Many of our subscribers may not fully understand that even though a jail is the baliwick of the sheriff, a sheriff does not control who enters a correctional facility. In most jurisdictions, a sheriff does not control the timing of release of any specific individual. Nevertheless, COCHS is encouraged that strong support exists among sheriffs and other officials in control of correctional facilities. Such organizations as the National Sheriffs Association among others of our public safety partners have been vociferous proponents of bringing Medicaid behind the walls of corrections.
Los Angeles Times: Editorial: Unconscionable abuse and shameful inaction at L.A. County jails
Practices in the Los Angeles County jail would would spark international outrage if they were perpetrated by enemies in wartime: chaining or handcuffing mentally ill people to chairs for days without access to drinking water, toilets, showers, adequate ventilation or medication, and leaving them to sleep on concrete floors at the Inmate Reception Center with no mattresses or blankets, amid one another’s excrement. Yet the court’s ongoing supervision over nearly a half-century has somehow permitted conditions to slide from bad to horrific to utterly unconscionable.
Health Issues
Aging In Corrections
The Appeal: Dying Behind Bars: Another Form of Capital Punishment
Hundreds of thousands of prisoners who are growing old in U.S. prisons and might die there. The country’s overall prison population peaked at roughly 1.6 million people in 2009. Though the overall number of incarcerated people has been decreasing ever since, the number of older people in prison has been increasing. There were only 48,000 people aged 55 and older incarcerated in 2001, according to the federal Bureau of Justice Statistics. That number jumped to 154,000 by 2019.
Asthma
Healio: Asthma care faces unique challenges in incarcerated populations
Individuals with asthma and other chronic illnesses who are incarcerated do not receive the same levels of treatment as individuals outside of the correctional system, according to a study published in JAMA Health Forum. Incarcerated patients account for 0.85% of the total population with asthma, but they only receive 0.15% of distributed asthma prescriptions, indicating a 5.45-fold relative difference between diagnosis and care.
PTSD
The Appeal: Post-Traumatic Prison Disorder Could Impact Millions. Congress Wants to Learn More.
Members of Congress are calling on the leading federal mental health research agency to study post-traumatic prison disorder, a condition potentially impacting millions of people who have been incarcerated. Democratic Reps. Ayanna Pressley and Grace F. Napolitano sent a letter to National Institute of Mental Health (NIMH) director Joshua A. Gordon, requesting that the institute “research post-traumatic prison disorder and share findings related to prevention and treatment.”
BOP
Reason: Newly Released Government Records Reveal Horrible Neglect of Terminally Ill Woman in Federal Prison
A woman who died in federal prison suffered in pain for eight months while waiting for a routine CT scan. Doris Nelson was one of three inmates who have died since 2018 from alleged medical neglect at Federal Correctional Institution (FCI) Aliceville, a federal women's prison in Alabama. Interviews with current and formerly incarcerated women inside the prison described months-long waits for doctor appointments and routine procedures, retaliation from staff, and terrible pain and fear.
NY Times: Short on Staff, Prisons Enlist Teachers and Case Managers as Guards
Federal, state and local law enforcement agencies around the country, especially corrections departments, are struggling to hire and retain employees at all levels, as higher-paying, less demanding jobs draw away people facing rising housing, food and transportation costs. Nowhere has that been more of a problem than at the chronically troubled Bureau of Prisons, with about 160,000 inmates at 122 prisons and camps
State Roundup
California
NBC: California prisoner who swallowed a staple ends hunger strike to protest jail conditions
A prisoner at an infamous California jail led a hunger strike to protest poor food quality, lacking medical care and retaliation from jail staff. Jazz Svarda, 34, was among several prisoners taking part in a hunger strike for about two weeks at Santa Rita Jail, an Alameda County facility with a history of health and safety violations. He ended his protest Monday, he said, for fear that jail staff would not help him if he were to face a health emergency as a result of the strike.
Florida
News4Jax: Family of man found dead in Clay County jail claim he was abused and neglected
The family of Joshua Swann say his death was the result of neglect and abuse while inside the Clay County jail. Swann died March 6 which was 39 days after his arrest. In January, Joshua Swann voluntarily checked himself into the Orange Park Medical Center Behavioral Health floor. For most of his adult life, he’s been on medication for schizophrenia. According to his arrest report, Swann punched another patient in the head. Instead of keeping him in the hospital and treating him, he was arrested, and the report says he should be placed on suicide watch at the jail.
Illinois
Chicago Sun Times: Illinois has a law to release seriously ill and disabled prisoners. It’s time to use it.
A cancer patient lying in his own feces in the days leading up to his death. Another with ALS, slowly dying of starvation because no one has the time or inclination to feed him. Patients with dementia who are not fed, not changed, not supervised. An elderly person who died after suffering nearly two dozen falls. These horrific acts of negligence are commonplace in prison health care units across Illinois, according to a devastating report released last month by a federal monitor.
New Hampshire
Vermont Public Radio: Recent death renews concerns about conditions at NH Secure Psychiatric Unit: 'This is a prison. This is not a hospital.'
Officials have shared little about what happened leading up to Jason Rothe’s death at New Hampshire’s Secure Psychiatric Unit on April 29, except that he died after a “physical altercation” with six correctional officers, who remain on leave pending further investigation. Rothe is one of at least three people who have died at a Department of Corrections psychiatric facility in the last decade.
New Jersey
New Jersey Monitor: Shifting policy on prison placement of transgender people sparks scrutiny
New Jersey prisons were held up as a role model nearly two years ago when corrections officials agreed to house transgender people by their gender identity instead of genitalia, a protection recognizing the harassment and assaults they often endure behind bars. But last fall, the Department of Corrections reversed course after a scandalous headlines about a transgender woman who impregnated two cisgender women at the female state prison.
North Carolina
WBUR: Investigation looks at mental health care for incarcerated people in North Carolina
A new investigation looks at the long wait times that inmates with mental illness face when they're too sick to stand trial in North Carolina. Half end up waiting longer than 300 days in custody so they can receive treatment so they can go to trial.
Oregon
Willamette Week: Oregon Department of Corrections Accused of Lax Safety Practices and Whistleblower Retaliation
A Salem prison employee is accusing the Oregon Department of Corrections of retaliating after she reported a series of safety lapses. Kristine Gates, a manager in the Oregon State Correctional Institution’s mental health unit, filed a whistleblower lawsuit in Marion County Circuit Court yesterday. It accuses ODOC, and her union of failing to heed complaints—and then putting her under investigation. Gates has safety concerns at the prison, including the use of “black box” practices in its solitary confinement unit, which involved locking inmates behind a second layer of security doors without an intercom to communicate with guards. These practices were found to be unconstitutional by the 9th U.S. Circuit Court of Appeals.
Vermont
VT Digger: Advocates rally at Statehouse to demand better prison health care
About two dozen people gathered in front of the Statehouse on Thursday to demand better health care for incarcerated people in Vermont. The rally, led by organizers with Vermont Just Justice, a nonprofit and blog advocating for criminal justice reform, was spurred by the death of David Mitchell, 46, who died April 17 at Southern State Correctional Facility in Springfield after complaining he couldn’t breathe.
VT Digger: Sheriff reform bill clears House with changes related to compensation, transparency
The House Government Operations and Military Affairs Committee had hammered out the latest version of S.17 with stakeholders, including the Vermont Sheriffs’ Association. The bill comes in the wake of multiple scandals in Vermont sheriffs' departments. Some legislators have described these as symptoms of a lack of oversight and accountability in an elected law enforcement office that can bring in hundreds of thousands of dollars from contracts with public and private organizations.
VT Digger: Department of Corrections keeps identity of lone bidder for out-of-state prison contract secret
The state has received one bid to house incarcerated people in another state, but top corrections officials are not saying who submitted it. Vermont has contracted with a CoreCivic facility in Mississippi to house incarcerated people out of state since October 2018. The department extended what was originally a two-year contract, but it has now expired. Civil rights organizations have long opposed sending incarcerated people to an out-of-state prison run by a for-profit entity, especially one so far away from Vermont.
Virginia
VPM: Irvo Otieno’s family questions his jail transfer amid mental health crisis
The family of Irvo Otieno has more questions about why law enforcement took the 28-year-old to jail when he was experiencing a mental health crisis. They’re also questioning why officers prevented Otieno’s mother from seeing him at the hospital, as she has alleged. Ten individuals, so far, have been charged with his March 6 death, including seven Henrico, VA, sheriff’s deputies and three Central State Hospital employees.
Mental Health Initiatives In Corrections
Fox59: New Indiana law aims to send people to mental health facilities instead of jail
Gov. Eric Holcomb, Indiana, has signed a bill into law that aims to get more offenders into mental health facilities instead of jail. House Enrolled Act 1006 creates a system for law enforcement officers to refer someone in crisis to mental health treatment. It also sets up a process for some people currently in jail to be transferred to a mental health facility.
ABC: How a proposed program could help inmates with mental health before release
Shelby County Mayor Lee Harris is trying to put together a program to help treat inmate PTSD, anxiety and substance abuse among other issues related to reentry. 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. The Shelby County Mayor says he hopes this program will help quickly treat inmates, stabilize them, help them meet their court dates and help lessen the likelihood the inmate will reoffend once they are released.
Technology
Baltimore Banner: Crises in confinement, bugs in medical records: Health care in Baltimore jails is still broken
In Baltimore’s sprawling jail system, bugs in the medical recordssoftware make records hard to interpret and error-prone, with recurring oddities such as detainees having multiple medical records and a “widespread problem” of people being falsely marked as deceased when they are in fact alive. Not only does this complicate care for the medical staff, it’s also rendered the records increasingly difficult for the court monitors to decipher.
Economic Conditions
Marshall Project: Why Inflation Price Hikes Are Even Worse Behind Bars
The Marshall Project requested commissary prices from all 50 state departments of correction to understand the scope of inflation behind bars. Twenty-six departments responded. Incarcerated people across the country are paying more now for staple items such as peanut butter, soap, coffee and toothpaste than they did a year ago. Price increases for some items are higher in prison than on the outside.
Core Civic
San Diego Union Tribune: Judge dismisses early COVID-19-era lawsuits over workplace safety at Otay Mesa Detention Center
A San Diego federal judge has dismissed a trio of related lawsuits filed in the early stages of the COVID-19 pandemic in which guards at the Otay Mesa Detention Center accused the facility’s operator, CoreCivic, of failing to take reasonable steps to protect their health. The lawsuits alleged the former detention officers were effectively forced to resign because of CoreCivic’s insufficient safety protocols at the facility.
Montana Free Press: Legislature approves new version of funding for CoreCivic prison transfer
The House Tuesday voted to concur with Senate amendments to House Bill 817, keeping alive a roughly $8 million biennial appropriation for the Department of Corrections to contract for 120 out-of-state prison beds. Previous language in the bill specifically set aside the money to contract with private prison company CoreCivic for 120 beds at one of its Arizona facilities. Last week, the Senate Finance and Claims Committee took the CoreCivic name out of the bill through a unanimous voice vote with little explanation. Critics had previously questioned whether the Legislature could write the name of a private company in statute. CoreCivic has spent more than $25,000 lobbying in the Montana Capitol this session.
Correctional Health Care Vendors
Delaware Online: Centurion out as Delaware prison health care provider; state officials select replacement
The Delaware Department of Correction has selected a new organization for the state's seven-figure contract to provide health care services to those imprisoned by the state. On Friday, state correction officials announced they had signed a three-year contract with VitalCore Health Strategies, a Kansas-based company that conducts similar services in 100 lockup facilities across 15 states. The prior health care provider, Centurion of Delaware, was paid $47.8 million annually for health care services at $21.1 million for behavioral care, according to the organization's 2020 agreement with the state.
Aspen Daily News: Jail provider denies liability in inmate attack
An inmate’s attack on a deputy cannot be blamed on a physicians-owned company that provided medical treatment to detainees of Pitkin County Jail, lawyers for Correctional Health Partners argued in a recent court pleading. Correctional Health Partners is a defendant in a lawsuit filed by a former longtime deputy, who sued the Denver-based company for negligence over an assault that happened Jan. 27, 2021. Turn Key Health Clinics acquired CHP in July 2022 and currently provides behavioral and medical service at the jail.
Chattanooga Times Free Press: Family blames Hamilton County for death of Silverdale inmate, sues for $20 million
A new federal lawsuit details alleged medical neglect and claims it led to the death of a Chattanooga woman, Carol Rene, five days into a 45-day sentence at the Silverdale Detention Center (TN). The suit names Hamilton County, former Hamilton County Sheriff Jim Hammond and Quality Correctional Health Care as defendants The court had ordered specific medications that Silverdale was supposed to give to Mrs. White, which Silverdale did not follow. In addition, Mrs. White was given a lethal dose of medication she was never prscribed.
AP: Mom gets $2M for jail death of intellectually disabled son
When Tomas Beauford was arrested after getting into a fight at a group home for intellectually disabled people, a device he wore around his wrist to help regulate his seizures was confiscated as if it were jewelry when he got to jail, according to a lawsuit filed by his mother. When he refused to take an array of medications there for his epilepsy and mental illness, he was allowed to skip them even though he had the mental capacity of a 5-year-old. Tomas' mother has now announced that she won a $2 million settlement with Mesa County and the health care company (Correctional Health Care Companies, Inc., which is now part of Wellpath) which the county had hired to provide medical care for people housed at its jail.