COVID Outbreaks Highlight the Many Problems with Private Healthcare in Prisons

I have used this space more than once to focus on healthcare and prisons, with a particular emphasis on Wellpath. The Tennessee-based company touts itself as “the premier provider of localized, high-quality compassionate care to vulnerable patients in challenging clinical environments.” In plain English, that means they are a for-profit company that provides medical care in jails and prisons nationwide.

As I noted in a post last October, Wellpath is frequently sued for being deliberately indifferent to their patient/inmate’s constitutional right to adequate medical care. A California newspaper reported last year that since 2003 Wellpath has been sued “at least 1,395 times in federal court.” Wrongful death actions figured prominently in this tally.

Recent news from both the east and west coasts has highlighted WellPath’s approach to the COVID-19 pandemic. That news also raises, yet again, questions about whether the company does everything it should to care for the people placed in its charge.

In California, The Davis Vanguard reports “a massive outbreak” of COVID at the Santa Rita jail “during December, reporting over 100 positive cases in custody” as the month ended. The paper reports that the outbreak among inmates can clearly be traced to “a massive surge in staff/contractor cases. Between July and November, only two staff cases were reported.” In the last six weeks of the year, however, that number jumped to 45. The paper quotes a WellPath spokesman saying that based on contact tracing by the area’s health authorities “there was an assumption that it (the inmate outbreak) could have been related to the staff positives.”

Across the country in North Carolina a COVID outbreak at the jail in Forsyth County now includes “186 inmates and 38 staffers”, according to the Winston-Salem Journal. Forsyth County, centered on the city of Winston-Salem, is one of the most heavily-populated areas of the state. The jail outbreak is the second-largest in the state, eclipsed only by one in the area around Charlotte. As noted by Charlotte TV station WBTV, WellPath runs the healthcare system in that county’s jails too.

As the outbreak spread in Forsyth County a spokeswoman told the newspaper “that sheriff’s officials would no longer answer specific questions about the numbers there and that, from now on, all media enquiries about specific numbers of COVID-19 cases at the jail would be referred to the state health department.

One might ask why they are not being referred to WellPath.

A disease like COVID spreads particularly easily in Jails and prisons. The inmates are locked up most of the day, often in overcrowded cells. Sanitary conditions are far from ideal, and the ventilation is frequently poor. Yet though prisoners may not be a popular or sympathetic population, Supreme Court rulings stretching back to the 1970s have made it clear that when the government takes away someone’s freedom it also assumes responsibility for their well-being. As the media has documented time and again when that responsibility is turned over to for-profit companies corners are cut.

As an attorney practicing in both Oregon and Washington I keep close tabs on WellPath and the consistent legal problems it has fallen into. Cases like the ones in both California and North Carolina are best thought of as civil rights issues, because by failing to provide care (or, in some cases, failing to supervise a company like WellPath properly) state, county and municipal governments are denying inmates equal treatment under our laws. When a public entity like a county jail or state prison contracts with a private company like WellPath the law requires that company to be held to the same standards and responsibility as its government client when it comes to protecting the Civil Rights of inmates.

We should all be concerned about this health crisis behind bars. It is an affront to the freedoms we all enjoy as Americans and it also represents a threat to public health. Because outbreaks of disease inside a jail rarely stay there, they also pose a wider public health risk, meaning that if a prison contractor can’t contain COVID outbreaks among its own staff we should ask what responsibility the company bears when the disease it failed to contain escapes into the wider community.


Winston-Salem Journal: Forsyth jail outbreak jumps to 224 COVID-19 cases, including 186 inmates and 38 staffers, state health agency reports

WBTV Charlotte: Mecklenburg jail on lockdown after recent spike in COVID-19 cases

The Davis Vanguard: Santa Rita Jail’s COVID-19 Outbreak Triggered by Surge in Staff Cases says Wellpath Representative

Cornell University Legal Information Institute: 42 USC 1983 Estelle v Gamble (429 US 97 (1976))

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