The Monterey County Jail has been under scrutiny for nearly a decade related to the lack of medical and mental health services provided to inmates resulting in serious harm and at times death. Monterey County contracts with Wellpath, a for profit private company that provides medical services to jails and prisons throughout the United States. Wellpath, as a company, has also been under scrutiny for the lack of care it has provided at the Monterey County Jail.
In 2015, a settlement agreement in the Hernandez class action lawsuit required an implementation plan be put in place for the County and Wellpath. Each plan outlined certain requirements to ensure proper medical and mental health care, as well as other obligations. Since the plans were implemented in 2016, neutral monitors have visited the Jail on numerous occasions to evaluate whether the County and Wellpath are complying with the settlement agreement conditions. For years, these reports remained sealed, keeping the devasting conditions at the Jail hidden from the public, including the Monterey community.
In August 2023, a motion was granted unsealing numerous documents, including the neutral monitors’ reports. The lack of compliance with the implementation plans was stunning. The reports confirmed that Wellpath was repeatedly non-compliant throughout many categories, often reflecting a compliance score of under 50% and sometimes under 40%. Further, the reports detailed horrific care and deaths of multiple inmates. The review of the deaths found numerous points of non-compliance and repeated findings that there were steps that could have been taken to avoid these deaths.
The following month, September 2023, the judge in the Hernandez matter found that Wellpath was out of compliance in 43 of 44 categories brough to the Court’s attention. Previously, counsel for the Hernandez plaintiffs provided notice on three occasions to Wellpath of its deficiencies. After the third attempt, the Court confirmed that there was clear and convincing evidence of Wellpath’s non-compliance, a standard not easily met. Some of the categories where Wellpath was non-compliant included:
- Medical Intake Screening
- Chronic Care
- Treatment of Intoxicated Patients
- Medical Quality Assurance
- Initial Mental Health Screenings
- Hospital Transfers
- Treatment Planning
Prior to the Court making its ruling, Wellpath had an opportunity to respond, however, it provided zero evidence that it was in substantial compliance after any of the jail evaluations that were performed.
After reviewing the evidence, the Court found:
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“Wellpath’s continued failure to comply with its obligations under the Settlement Agreement and Wellpath Implementation Plan creates a serious risk of harm to the health and well-being of the entire inmate population of the Jail….Wellpath’s ongoing refusal to comply with this Court’s orders, coupled with the continued harms to incarcerated people, shows that only the threat of monetary sanctions will force private-equity owned Wellpath to take its obligations seriously.”
The Court order Wellpath to pay $25,000 for each of the 43 areas of non-compliance, if it was not in compliance within six months. The six-month deadline expires on March 25, 2024. It is unclear if Wellpath has or will do anything ahead of the deadline to comply.
Despite years of the County knowing Wellpath was out of compliance resulting in harm and death to inmates, during which time the monitoring reports were sealed and hidden from the public, the County opted to continue to allow Wellpath to provide medical and mental health care to its inmates. The County is ultimately responsible for the health and wellbeing of inmates and cannot avoid responsibility through the outsourcing of care. Knowing all of this, in 2022 the County chose to renew its contract with Wellpath for $44.3 million. The contract runs for a three-year period. Importantly, the contract creates a conflict of interest as the money is not only used to pay Wellpath for services, but it is also used to pay for Wellpath employees and certain medical care for inmates. In other words, the more money Wellpath spends to hire staff and provide care, the less it sees in its bottom line. It is important to note that Wellpath has notoriously had understaffing issues at the Jail.
In December 2023, 12 U.S. senators sent a detailed letter to Wellpath outlining serious concerns related to its lack of care provided to inmates at jails and prisons throughout the country. The letter notes that Wellpath is the largest private prison health care contractor in the country serving approximately 300,000 patients across 34 states. The letter touches on many of the issues that are occurring in Monterey as well as the inherent conflict in the Wellpath contracts that incentivize less care for more profit. The senators laid out 24 categories with numerous questions for Wellpath to respond to no later than January 8, 2024. It appears Wellpath has responded to some degree disputing the claims in the initial letter, despite the senators’ citing multiple sources for their concerns.
All of this information has been hidden from the public and the Monterey community for years. The result is that many people enter prison and never return home to their families. People with charges related to petty crimes often due to mental illness or addiction are dying in Monterey County Jail due to lack of basic care. While inmates are required to serve time for wrongdoing, their sentences are not and should never be a death sentence. Unfortunately, Wellpath and the County’s negligence have turned many inmates time sentences into death sentences. The public has a right to know what is going on in the Jail so the County and Wellpath can be held accountable and so that people are protected from serious harm and death.
