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Mass. state prison health care scrutinized

Avery Bleichfeld

The Massachusetts Department of Corrections last month announced a new contractor to provide health care services in state prisons, as care and mortality in prisons has received increased scrutiny in recent years.

The contract, with Kansas-based VitalCore Health Strategies, comes as the DOC’s agreement with Wellpath, a Tennessee-based company, is set to expire this summer.

Wellpath, whose agreement goes to the end of this month, has faced concerns that it was failing to provide adequate care to individuals incarcerated in the state, with delayed or denied care, inadequate staffing and failure to following physician treatment plans.

Wellpath and YesCare, another company bidding for the new state contract, were the subject of a letter in February from U.S. Sens. Elizabeth Warren and Ed Markey to the DOC. The politicians raised concerns about the two companies having been subject to congressional oversight and criticism because of record handling health care needs in jails and prisons across the country.

Limited access to care can have a distinct impact, especially on a prison population that trends older, said Ada Lin, a staff attorney at Prisoners’ Legal Services of Massachusetts.

“Our clients are unable to access the medical care they need, even sometimes in emergent circumstances,” Lin said in a written statement. “They experience long delays in care, have little access to their own medical records or other health information and are often blocked from seeing specialists.”

She said that poor care can have downstream impacts, for example an increased burden of chronic illnesses, which can impact the community as a whole.

Massachusetts prisons have not been immune to concerns around their treatment of health care needs.

In 2020, the U.S. Department of Justice found that it had reason to believe conditions at Massachusetts DOC facilities — especially around access to mental health care — were lacking to the point that they could violate the Eighth Amendment to the U.S. Constitution, which prohibits cruel and unusual punishment.

That investigation found that Massachusetts prisons failed to provide appropriate supervision and care to individuals in mental health crises, leading to incarcerated individuals dying or experiencing serious injury after engaging in self-harm.

At the end of 2022, the Department of Justice reached a settlement with the state’s corrections department to more thoroughly train staff on mental health care for incarcerated individuals and provide increased supervision and more contact with mental health staff.

According to statistics from the Department of Justice published in 2021, there were 656 deaths recorded in state and federal prisons in Massachusetts between 2001 and 2019. Heart disease and cancer were the most common causes of death, making up over half of the carceral deaths in that time.

Organizers are also seeking legislative action on the issue. The Medical Civil Rights Initiative, formed in 2019 by a group of Boston-based physicians, has proposed the Medical Civil Rights Act as a step to improving access to care across the system of interactions with law enforcement.

That bill, which passed in Connecticut in June 2023 but has yet to make it through the Massachusetts legislature, would create a legal right to immediate medical services for an individual interacting with law enforcement officers — something that currently not exist.

Advocates for the legislation point to examples like the case of Al Copeland, a Black man who had a stroke while driving down Massachusetts Avenue. He pulled over and put on his hazard lights, but when police found him, they assumed he was intoxicated. It took five hours for police officers to call an ambulance.

While much of the conversation around the legislation has focused on how it would relate to police officers and their interactions with civilians, Frederick Brown, a retired appellate court justice who has worked with the legislation, said the bill would also apply to carceral settings.

“They have medical problems when they get arrested, and they have the same problems when they get incarcerated,” Brown said.

health care, health care services in state prisons, Massachusetts Department of Corrections, Medical Civil Rights Act, WellPath