A California newspaper’s investigation of deaths in county jails is shining a light on the issue of both for-profit prisons and outsourced prison healthcare. An investigation by the Redding Record-Searchlight found that “from 2005 to 2019, about 1,960 people died in the custody of California county jails.” Even granted the state’s immense size this is a shocking figure, one that highlights the importance of civil rights laws protecting even an unpopular group such as prisoners.
The figures compiled by the Record-Searchlight work out to roughly 130 jail deaths per year. Last year an investigation by Oregon Public Broadcasting put the 2018 figure for Oregon and Washington combined at 39, and noted that jail deaths have been trending upwards over the last decade. When you adjust for population (about 12 million for our two states versus just under 40 million for California) the overall mortality rate is similar.
I have written about jail deaths here in Oregon before. Both here and in the Record-Searchlight’s reporting one name keeps turning up. Wellpath is a Tennessee-based company which describes itself as “the premier provider of localized, high-quality, compassionate care to vulnerable patients in challenging clinical environments.” In ordinary English that means they are a private, for-profit, health-care company that specializes in offering care for prisoners. The newspaper quotes a psychologist who consults on prison staff training and prison conditions saying that for-profit companies like Wellpath do “an absolutely awful job.”
“There is a built-in tension between profit level and quality of care… and if the quality of care is sacrificed, usually, then you can quickly get into situations where inmate lives are at risk.”
The newspaper notes that one of the companies involved in the merger that formed Wellpath has, since 2003, “been sued at least 1,395 times in federal court including wrongful death suits, according to the Project on Government Oversight.”
The law in cases like these is very clear: both companies like Wellpath and the local governments which hire them have a legal duty to offer adequate healthcare to the people whose lives they control. This can be as basic as ignoring the detox protocols that are supposed to govern the treatment of people under the influence of alcohol or drugs when they are brought in. It also extends to other medical needs and, indeed, many lawsuits in this area focus on care that was denied or doctors who did not take the sort of care with prisoners that we would consider routine in other settings. When it comes to healthcare in jail, deliberate indifference on the part of the people in charge is a civil rights violation.
Municipal and county governments may think they are saving money by outsourcing medical care to a private company, but doing so does not absolve them of a constitutional duty to take care of the people in their custody. The Supreme Court ruled on this more than 40 years ago in a case known as Estelle v Gamble. That case was decided 8-1.
As a Portland attorney practicing in both Oregon and Washington, one of my top priorities is helping families who believe that a loved one has not received the care or urgent treatment they need while in jail or prison. It is especially important to note that when a city or county hires an outside company to run part or all of its jail services that government entity has a legal obligation to ensure that the contract is being carried out properly. It is far too easy to find examples from here, and elsewhere in the country, of medical needs being ignored, potentially deadly allergies overlooked and care that, when it comes, is both late and inadequate. The accountability offered by our civil court system when someone dies or suffers an injury while in custody plays an important role in preserving the rights we all value.
Redding Record Searchlight: Analysis reveals disparities among death rates in California county jails
Oregon Public Broadcasting: Booked and Buried (April 2019)
Oregon Department of Statistics: Research and Statistics
Cornell University Legal Information Institute: 42 USC 1983
Justia.com: Estelle v Gamble (429 US 97 (1976))