FEATURED |
By Royal Calkins
The seemingly bankrupt company that provides health services to inmates at the Monterey County Jail has admitted failing to meet 43 requirements imposed on the company after special monitors found a long pattern of dangerously inadequate care.
Wellpath, one of the incarceration industry’s largest providers of health care, was ordered in 2023 to meet federal standards after years of non-compliance. It appealed, however, in hopes of avoiding $1 million in fines by showing that its work was improving.
Attorneys for the inmates, however, were then allowed to formally question the company’s own medical, mental health and dental experts. That led to Wellpath admitting late last month that U.S. District Court Judge Beth Labson Freeman was correct when she ruled the company had failed to satisfy all but one of 44 requirements.
Examples of poor performance included failing to refer sick inmates to physicians, failing to perform proper intake procedures, failing to provide proper medications and assistive devices like wheelchairs, failing to provide prenatal care to pregnant inmates, failure to assist inmates with cognitive issues, and more. Suicide protocols were sometimes ignored by Wellpath and the jail staff, to deadly effect. The death rate among Monterey County inmates was among the highest in the state, although fatalities slowed fairly dramatically in the last half of this year. Sheriff Tina Nieto attributes that to increased staffing and closer monitoring of Wellpath’s performance.
The 43 deficiencies were found by court-appointed medical specialists who regularly inspect the facility in Salinas. Wellpath then hired its own specialists to claim it was in full compliance. But when questioned by lawyers for the inmates, court records show, the company acknowledged that its consultants never visited the jail.
The judge can fine the Tennessee-based company up to $1 million. The ACLU and others involved in the class-action litigation will recommend that money be funneled through a local foundation to organizations that assist inmates and former inmates, said Van Swearingen, one of the attorneys for the inmates. The plaintiffs are represented by Swearingen, Ernest Galvan, Caroline Jackson, Maya Campbell, and Ben Hattem of the Rosen Bien Galvan & Grunfeld firm in San Francisco, as well as David Fathi, Corene Kendrick, Kyle Virgien, and Alyssa Gordon of the ACLU National Prison Project.
When questioned by lawyers for the inmates, court records show, the company acknowledged that its consultants never visited the jail.
Possibly complicating matters, however, Wellpath filed for bankruptcy protection in Texas on Tuesday, listing both its assets and liabilities as between $1 billion and $10 billion. Swearingen said it was too soon to comment on how that might affect the fine. Wellpath representatives told the bankruptcy court that the company plans to sell some assets and restructure a heavy debt load, some of which it attributed to legal settlements.
Nieto said company officials told California law enforcement representatives this week that they didn’t expect the bankruptcy to affect inmate care. At the moment, Nieto said, she is more concerned about the county’s hiring freeze, brought on by budget troubles, which will make it harder to keep the jail properly staffed. Many deputies and others have complained that keeping the jail staffed well enough to satisfy the federal court has resulted in inadequate staffing in patrol and the investigative units.
Even without enough correctional officers to always meet the federal court’s mandates, the sheriff said Wellpath’s contract compliance has significantly improved since she took over two years ago. The company operates under an annual $15 million county contract.
The legal proceedings are known as the Hernandez Settlement. It was the result of a lawsuit detailing years of shoddy care at the jail, which is operated by the Monterey County Sheriff’s Office and funded by the county. Lawyers representing past and present inmates demonstrated that inmates with life-threatening afflictions were routinely denied basic standard treatment by Wellpath doctors and nurses assigned to the 900-inmate jail.
The federal court has jurisdiction in the matter because inmates, unlike the rest of the population, have a Constitutional right to adequate health care because they are essentially wards of the government.
Wellpath has contracts with most California counties and other jurisdictions nationwide and is operating under court-ordered monitoring in several locations. Records in the Hernandez Settlement and other cases provide graphic evidence that jails across the land are struggling with overpopulation in general and a growing percentage of inmates suffering from mental illness, addiction or both. Aggravating the problem, Wellpath and many of its competitors are owned by hedge funds believed by their critics to be consumed by profitability.
In bankruptcy court papers, Wellpath’s chief financial officer, Timothy Dragelen, said the company’s finances had withered because of legal settlements stemming from its health care services as well as the pandemic, inflation and increases in the minimum wage.
“This is an important victory for the people of Monterey County,” said Caroline Jackson, senior counsel for the San Francisco law firm. “Individuals incarcerated at the jail have faced shocking levels of healthcare neglect since this case was first filed in 2012, leading to preventable harm and even deaths. We hope this stipulated order requiring Wellpath to pay monetary fines for its non-compliance will coerce the company to provide high-quality care to incarcerated individuals.”
Wellpath initially opposed the imposition of contempt fines, claiming in a brief filed on Aug. 16, 2024, that it was in compliance with nearly all of the 43 requirements. Wellpath supported its position with declarations from four experts retained by the company to conduct an audit of the medical, mental health, and dental care at the jail, who consistently found much higher levels of compliance than did the court-appointed neutral monitors in their most recent reports.
By deposing Wellpath’s hired experts and consultants, the plaintiff’s lawyers found that the company’s lawyers, not the experts, had created the auditing tools used to assess conditions in the jail.
“The list of audit questions omitted numerous court-ordered requirements, preventing Wellpath’s medical, mental health and dental experts from assessing compliance in those areas,” the plaintiffs’ attorneys said in a news release Wednesday.
Supposedly random patient records provided to the experts were instead specially selected to artificially boost compliance scores, the attorney said.
After scrutiny by the other side, Wellpath stipulated that “it cannot meet its burden of proof to establish that it was in substantial compliance” with Judge Freeman’s rulings.
“This settlement recognizes that … Wellpath cannot hide behind hired ‘experts’ to mask the deficiencies in their healthcare services,” said Corene Kendrick, deputy director of the ACLU-National Prison Project added. “The people of Monterey (County) deserve better.”
Have something to say about this story? Send us a letter.
SUPPORT NONPROFIT JOURNALISM 
GET OUR FREE NEWSLETTER
