COCHS Weekly Update: August 29, 2023

Highlighted Stories

Editor's Note
Since a high percentage of health care within corrections is provided by proprietary health care vendors, COCHS will often highlight articles about these providers. This week’s lead stories offer many insights into the operations of these companies. The Business Insider details the ability of Corizon/YesCare to limit its liability through transferring assets from one entity to another through a loophole in Texas law known as the Texas Two Step. This asset reassignment often leads people seeking damages for health care provided by Corizon/YesCare to accept lower settlements. Another article reports on a $12.75 million settlement that Wellpath will pay for a death in the jail in Shasta County, California. Wellpath providers ignored the obvious medical conditions of a seriously ill person, who subsequently died on the floor of the jail. In Duval County, Florida, local legislators are requesting the Department of Justice investigate its jail after a string of deaths. In a scenario familiar to our subscribers, the sheriff has replaced one proprietary, Armor Health Care, with another proprietary, NaphCare --both with long histories of lawsuits for the quality of health care they deliver. Six of one, half dozen of the other.

What all these stories speak to is the fact that these proprietary correctional health care providers operate in a deregulated environment. If there are state regulations, they tend to be weakly enforced (see Most Oklahoma jails failed health department inspections in 2022). As Medicaid enters correctional environments, it is time to ask whether Corizon/YesCare, Wellpath, Armor, NaphCare and the host of other proprietaries can really re-invent themselves as Medicaid providers? The challenges are evident in the Shasta County story, where Wellpath had licensed vocational nurses operating outside their scope of practice --something that would draw the attention of state and federal Medicaid regulators. Perhaps what would also draw the attention of regulators is the quote from a former CEO of Corizon describing the current practices of that company as "engaging in what can only be described as a bankruptcy fraud scheme."

The drumbeat for Medicaid behind the walls of corrections is growing both through changes of policy and legislation. Yet, by their actions or inactions, correctional health care proprietaries seem to be deaf to this change or possibly think, because of their overwhelming market penetration, their quality of care will just somehow have to be permitted as if the unregulated environment had been maintained.

Correctional Health Care Proprietaries
Business Insider: Hidden investors took over Corizon Health, a leading prison healthcare company. Then they deployed the Texas Two-Step.
In a lawsuit, a former Corizon CEO describes the company's maneuver as "an old-fashioned bankruptcy fraud scheme." Hundreds of malpractice cases have now been stayed --a tactic dubbed the Texas Two-Step. A group of investors bought out Corizon in 2021 and within months created a new company called YesCare, home to most of Corizon's valuable assets — including hundreds of millions of dollars in taxpayer-funded contracts with prisons and jails. The liability-laden Corizon was renamed Tehum and, in February of this year, filed for bankruptcy. The goal of Corizon's Two-Step may have been laid bare in a recent civil complaint. It describes an alleged meeting in which a Tehum director, a man named Isaac Lefkowitz, says the Texas Two-Step can be used to "force plaintiffs into accepting lower settlements."

The Young Turks (YouTube): Prison Healthcare Provider Gets Accused Of SHOCKING Inhumanity
This YouTube posted by the Young Turks is a summarization of the Business Insider article above. The video as in the aforementioned article also quotes the former CEO of Corizon describing that companty as "engaging in what can only be described as a bankruptcy fraud scheme."

GlobeNewswire: Haddad & Sherwin LLP Reaches $12.75 Million Settlement for Death of Shasta County Jail Inmate Under the Care of Wellpath
Civil rights law firm Haddad & Sherwin LLP announced today that it has reached the largest settlement ever against Wellpath, $12.75 million . Randall Johnson, a 56-year-old painter attempted suicide by injecting methamphetamine. He was arrested and booked into Shasta County jail (CA). During intake, a video recording shows he was speaking incoherently, screaming in pain, and vomiting. A Wellpath nurse falsified Randall’s medical intake form, checking boxes for “no” in response to important medical questions she never asked. Despite the obvious need for emergency medical attention, jail staff admitted Randall into the jail rather than allow him to go to a hospital. With the deliberate indifference of jail staff, several Wellpath nurses and L.V.N.s, and a social worker, Randall’s attempted suicide by overdose was allowed to succeed, in slow-motion. In addition, Wellpath often provided Licensed Vocational Nurses (L.V.N.’s) to work Registered Nurse shifts, outside their legal scope of practice. The Wellpath L.V.N.’s were not legally qualified to clear Randall Johnson to stay in the jail, but did so anyway.

News4Jax: Jacksonville lawmakers call on DOJ to investigate possible medical negligence at Duval County jail
Local lawmakers and civil rights activists are calling on the U.S. Department of Justice to investigate possible medical negligence at the Duval County jail. Since July, three people have died in the Duval County jail, including a woman believed to have had a brain aneurism and two other inmates who had unspecified medical episodes. Sheriff T.K. Waters recently announced the healthcare contractor at the jail will be replaced by another company starting next week. The sheriff has terminated the multi-million dollar inmate healthcare contract with Armor Health and signed on with NaphCare, an inmate healthcare provider that’s already under scrutiny by the DOJ.

MDLinx: Florida jury rules against Armor Correctional Health Services in $16 million medical malpractice case
A Santa Rosa County, FL, jury ruled in favor of the plaintiff in a medical malpractice case against Correctional Health Services. The suit was brought by the family of Misty Williamson, who was incarcerated at the Santa Rosa County Jail when she contracted pneumonia and died in 2016. This $16 million verdict against Armor Correctional Health Services is just one of many malpractice suits filed against the provider in its nearly 20 years of operating.


New York Times: Settlement Would Award $10 Million to Those Jailed Without Heat or Power
People who endured a week without heat or electricity while incarcerated at a Brooklyn federal jail during a polar vortex in 2019 could share as much as $10 million in compensation under a proposed settlement deal. Many of the approximately 1,600 people held at the Metropolitan Detention Center, on the waterfront in Sunset Park, had described harrowing conditions during the outage, which followed a fire at the facility. The lawsuit accused the warden at the time of “a shocking dereliction” of his duties to maintain the facility. A subsequent report by the Justice Department’s strongly criticized how officials handled the crisis.

CCJ: First Step Act --An Early Analysis of Recidivism
Passed in 2018, the First Step Act (FSA) was designed to reduce reoffending among people leaving federal prisons. This analysis estimates recidivism rates among individuals released from federal prison prior to the FSA who had similar risk profiles and were tracked for similar periods of time as those released under the Act.


Yale School of Public Health: High levels of exposure to the COVID-19 virus may reduce protection provided by vaccination and prior infection, study finds
High levels of exposure to the virus that causes COVID-19 may reduce or overcome the protection that vaccination and prior infection provides, according to a new study by researchers from Yale University, the University of Florida, and the Connecticut Department of Correction. The study found that during the Delta and Omicron epidemic waves, immunity acquired after a vaccination, prior infection, and both vaccination and infection (“hybrid immunity”) was weaker when residents were residing with an infected inmate.


BMC: Relational security: conceptualization and operationalization in small-scale, strengths-based, community-embedded youth justice facilities
Justice-involved youth can be remanded or sentenced to a secure facility as a last resort. Both from a child rights as well as scientific perspective these residential settings should be safe places where youth’s developmental needs are met, strengths and protective factors are built upon, and positive community connections are forged. Relational security is grounded in three distinct, but interrelated, elements – staff’s basic attitude, a constructive alliance between staff and youth, staff presence – and promotes a safe and therapeutic environment through several mechanisms.

State Roundup

Equal Justice Initiative: Report Spotlights Horrific Conditions in Solitary Confinement in Alabama Prisons
People incarcerated in Alabama endure horrific conditions in solitary confinement and the neglect and mistreatment they suffer too often ends in tragedy. That was the case for Antonio Bell, a 29-year-old man who died in 2020 after spending 18 months in solitary confinement. An autopsy showed he’d previously had a stroke and his heart was enlarged, but his father stated thag Antonio received no medical care.

WSFA: Mental health worker accused of bringing drugs into Alabama prison
The Alabama Department of Corrections arrested a mental health worker at Donaldson Correctional Facility. Jasmonique Ware was charged with trafficking methamphetamine, unlawful possession of marijuana and promoting prison contraband.

The Tributary: Jacksonville jail’s review of deaths deemed inadequate by accrediting agency
The National Commission on Correctional Health Care’s accreditation report criticized the Sheriff’s Office’s review of jail deaths. The position responsible for coordinating those reviews was vacant for 11 months in 2022, the report notes, and when reviews were done, they weren’t always shared with staff. In some cases, the Sheriff’s Office took longer than the 30-day deadline to conduct a review of deaths. In one case, the Sheriff’s Office didn’t do the required psychological review after an inmate’s suicide.

The Guardian: ‘Daily horrors are happening there’: dark side of jail where Trump surrendered
Millions of people watched on as former president Donald Trump surrendered to the Fulton County jail, and then promptly left the building on $200,000 bond. Local activists say it’s a starkly different experience from what the more than 1,500 inmates who are booked into the facility each month typically face in the overcrowded jail, which has been the subject of ongoing reports of horrific conditions and has seen a spate of recent deaths.

Civil Beat: Inmate Found Dead In Apparent Suicide At Hilo Jail Was Due A Mental Evaluation
A prisoner with a longstanding mental disability apparently killed himself in his cell in the Hilo jail last week in what is believed to be the eighth suicide in a state correctional facility in the last three years. Drake Terlep, 55, was housed in a cell with two other inmates, and staff at the jail told family members Terlep had been a target of harassment by other inmates in the overcrowded Hawaii Community Correctional Center, according to his brother Jason Terlep.

Boston Globe: Graying of Massachusetts prisons cries out for a dose of compassion
Of the 6,000 or so men and women currently incarcerated in Massachusetts state prisons, 933 are over the age of 60, according to Department of Correction data. Of the more than 1,000 inmates serving life without parole, nearly a third are over age 60. Since the state’s medical parole law went into effect as part of the landmark Criminal Justice Reform Act in 2018, only 69 inmates have been granted medical parole. The department includes in that tally those who never got to actually leave prison before their deaths.

The Lund Report: A prison pipeline that could help meet Oregon’s behavioral health workforce needs
The state corrections department is expanding a program that certifies prisoners to be drug and alcohol counselors and mentors. Study after study has shown huge gaps in the state’s behavioral health system, but for years there’s been a stubborn shortage of trained workers to fill those gaps. Currently, the Oregon Department of Corrections offers training programs for drug and alcohol counselors and recovery mentors at three of Oregon’s prisons. But officials at the department say they plan to establish large training and treatment programs at all 12 of Oregon’s prisons.

South Carolina
WACH: Woman found dead in Sumter County jail raises questions over mental health procedures
A woman died after she was found unresponsive in a Sumter County jail. She wasn't being held on criminal charges. In fact, it was an order from a probate court judge that kept her there until she could be transferred to a mental health facility. Sumter County officials say in these kinds of transfer procedures, it could sometimes take months, or even years.

Corrections 1: Over 300 inmates evacuated during Texas prison fire
Fire broke out Friday morning at a state prison in Texas, forcing more than 650 inmates to evacuate but injuring no one. The inmates had initially been moved to other areas of the prison in Huntsville, about 65 miles (105 kilometers) north of Houston. But about 400 of the displaced inmates will be moved to other facilities across the state. A report by the State Fire Marshal’s Office in 2021 noted that “most of the units’ fire alarm systems aren’t functioning properly in Huntsville.”

KJZZ: Mosquitoes test positive for West Nile virus at Utah State Correctional Facility
West Nile virus has been detected in mosquitoes collected in a "mosquito pool" at the Utah State Correctional Facility in Salt Lake City. Staff and inmates were encouraged to wear long-sleeve shirts, long pants, and closed-toe shoes to reduce mosquito bite risks.

VT Digger: Man kept in prison for dismissed shoplifting charge now eligible for release
Matthew Morgan, who was serving four years in prison after a dismissed shoplifting charge, will be released. While out on furlough last fall, Morgan was charged with shoplifting a $129 speaker from Walmart. That charge was later dismissed by the state with prejudice, which means the case cannot be brought up again, but not before the department of corrections decided Morgan should spend four years in prison following the alleged violation.

Rikers Island

Spectrum News: A Rikers Island inmate died early Tuesday morning, officials said, marking the year's eighth in-custody death.
A Rikers Island inmate died early Tuesday morning, officials said, marking the year's eighth in-custody death. This death came weeks after a string of deaths in custody in July.

The City: Thousands of Former Rikers Detainees are Eligible to Claim Millions in Commissary Deposits Left in Their Accounts
Former detainees at Rikers Island and other city lockups have left a total of $4.2 million in commissary accounts waiting to be claimed — a figure on the rise despite new legislation requiring jail officials to do more to refund the money. Advocates for incarcerated people have long urged jail officials to do more to give the money back to a mostly low-income population, where every dollar can make a difference.

The City: Demand Grows to Make Rikers Island Death Reports Public
Anytime someone dies inside a city jail, the agency in charge of medical care launches a comprehensive review of what happened, with an eye toward preventing future detainee deaths. But the morbidity and mortality reports conducted by Correctional Health Services are never made public, and their “corrective action” recommendations are rarely shared with anyone outside of city government. City Councilmember Carlina Rivera (D-Manhattan), who chairs the council’s Criminal Justice Committee, wants to force Correctional Health Services to make basic parts of the reviews public and require jail officials to put the word out within hours of any death behind bars.


Daily Beast: The Government Makes It Harder for the Formerly Incarcerated to Be Good Citizens
The United States Department of Agriculture (USDA) permanently bans anyone with drug, alcohol, tobacco, or firearms convictions from participating in the Supplemental Nutrition Assistance Program (SNAP) a harsher punishment than the agency dishes out to those who have actually defrauded the program. Unfortunately, the USDA’s permanent punishment scheme isn’t unique. Throughout the country face arbitrary hurdles to employment that various government agencies create for people returning from incarceration.

University of Colorado, Anschutz Medical Campus: New Program Aims to Improve Health Outcomes for the Incarcerated
The new Wellness, Opportunity, Resiliency Through Health (WORTH) program at the University of Colorado School of Medicine aims to help with that transition, and to empower people to better manage their health care needs after release and while they are still incarcerated. The WORTH program facilitates access to community-based medical care and social support for individuals detained in or recently released from a county jail.

Providers In Corrections Moral Distress in Correctional Nursing
Nurses are often faced with ethical dilemmas in their day-to-day practice, that, left unaddressed, may result in moral distress. Moral distress in correctional nursing may be knowing that a patient should be able to make a health decision autonomously, but seeing that they are limited in the choices offered. Nurses are often confronted with an ethical dilemma where the course of action best for the patient is in conflict with what would be best for others; whether it is the organization, other providers, other patients, or society.


NJ Insider: Rep. Watson Coleman Leads New Jersey Delegation Letter Calling on Department of Justice to Rescind its Support for CoreCivic Lawsuit
Congresswoman Bonnie Watson Coleman (NJ-12) along with 9 other members of the New Jersey delegation sent a letter to Attorney General Merrick Garland calling on the Department of Justice to rescind its support for CoreCivic, a private prison company, in its lawsuit against the State of New Jersey to overturn a 2021 law which prohibits state and local entities from entering into agreements with private detention facilities to detain noncitizens.

Immigration Impact: Biden Keeps Ties with Billion-Dollar Business of Immigration Detention, Despite Reports of Serious Abuse
The expansion of for-profit immigration prisons marks an about-face for President Biden, who promised during his presidential campaign to end private immigration detention. Instead, DHS rejected the recommendation of its own Office of Inspector General to remove all detainees from CoreCivic’s Torrance County Detention Facility.

In Observation Of Labor Day
COCHS Weekly Update Will Not Be Published Next Week