August 09, 2024

Warren, Trone, Scanlon, Lawmakers, Call for Key Improvements to Quality of Health Care in Jails, Prisons, Detention Centers

“Jails, prisons, and immigration and juvenile detention facilities hold people with some of the most serious unmet health needs in the United States today… [but], detained individuals face routine delays or outright denials of care and rampant structural barriers to accessing care.”

Text of Letter (PDF) 

Boston, MA – U.S. Senators Elizabeth Warren (D-Mass.) and Representatives David Trone (D-Md.), and Mary Gay Scanlon (D-Pa.) led a letter to federal health agencies urging key investments to improve the quality of care in prisons, jails, and detention centers. The lawmakers lay out three important recommendations for HHS agencies to: improve critical health data gathering, increase technical support to help facilities manage urgent health challenges, including the outbreak of infectious diseases and mental illness and substance use disorders; and maximize the benefit of new Medicaid coverage for individuals before their release from custody.

Millions of people spend time imprisoned in jails, prisons, and juvenile and immigration detention facilities. These populations have disproportionately high rates of mental illness, chronic medical conditions, substance use disorders, and other health needs. Ensuring that these people return home with a fair chance at health and productivity is a public safety and moral imperative. In recent years, the COVID-19 pandemic and opioid epidemic have helped reveal just how poorly equipped detention facilities are to respond to urgent health needs.

The letter makes three key asks of federal officials:

  • First, HHS should work with state and local public health authorities to facilitate the collection of health data from facilities, and work with the Department of Justice and Department of Homeland Security on health data collection from federal facilities. This data is critical for monitoring health needs, tracking emerging health trends, prioritizing support to facilities with health emergencies, and identifying best practices.

  • Second, HHS should develop stronger health guidelines for detention facilities and provide more technical assistance for the implementation of those guidelines. The lawmakers urge the CDC and other HHS agencies to provide more intensive support with responding to a broader range of health challenges, like substance withdrawal and substance-related deaths. The lawmakers recommend HHS develop toolkits for jails and support with implementation.

  • Finally, HHS should maximize the impact of Medicaid to improve health in jails, prisons, and juvenile detention. Historically, Medicaid funding could not be used to treat incarcerated individuals, but CMS has begun approving waivers that allow states to use Medicaid funding for health care of individuals who will soon be released from custody. CMS can use Medicaid funding as an incentive to require that jails and prisons meet minimum care standards and to report sufficient data on the specific health services provided and on the prevalence of particular health conditions in order to track unmet health needs.

“The Department of Health and Human Services (HHS) can play a key role in increasing detained individuals’ access to care, ensuring that care in custody meets minimum standards to protect patient safety, and expanding the range of critical health data that facilities report,” wrote the lawmakers. 

The lawmakers requested details of HHS’s plan to address the current state of health care in prisons by August 21, 2024. 

The letter was sent by Sen. Warren (D-Mass.) and Sens. Ed Markey (D-Mass.), Jon Ossoff (D-Ga.), Reverend Raphael Warnock (D-Ga.), and Representatives Nanette Barragan (D-Calif.), Sydney Kamlager-Dove (D-Calif.), Eleanor Holmes Norton (D-D.C.), Mary Gay Scanlon (D-Pa.), Shri Thanedar (D-Mich.), Paul Tonko (D-N.Y.), and David Trone (D-Md.). The members of Congress sent the letter to the Department of Health and Human Services (HHS), Centers for Disease Control and Prevention (CDC), Centers for Medicare and Medicaid Services (CMS), the Agency for Healthcare Research and Quality (AHRQ), the Health Resources & Services Administration (HRSA), and the Substance Abuse and Mental Health Services Administration (SAMHSA),

Senator Warren has fought to improve the quality of health care for individuals in custody: 

  • In February 2024, Senators Warren (D-Mass.) and Ed Markey (D-Mass.) sent a letter to Massachusetts DoC Commissioner Carol Mici, urging her to carefully review the track records of Wellpath and YesCare (“Corizon”), which are possible bidders to become the next healthcare provider for Massachusetts prisons. The senators also pushed the DoC to impose strong monitoring and accountability measures on any contractor selected.

  • In December 2023, Senators Elizabeth Warren (D-Mass.), Dick Durbin (D-Ill.), Jon Ossoff (D-Ga.), Ed Markey (D-Mass.), Raphael Warnock (D-Ga.), Jeff Merkley (D-Ore.), Laphonza Butler (D-Calif.), Richard Blumenthal (D-Conn.), Bernie Sanders (D-Vt.), Mazie Hirono (D-Hawaii), Cory Booker (D-N.J.) and Peter Welch (D-Vt.) sent a letter to Wellpath — the nation’s largest private provider of prison healthcare — raising concern over reports of inadequate care at federal, state, and local prisons and jails. 

  • In October 2023, Senator Warren and other lawmakers sent a letter to Corizon Health expressing concern about poor-quality health services provided to incarcerated people in jails and prisons around the country.

  • In May 2021, Senators Warren, and other lawmakers wrote to Secretary of Health and Human Services Xavier Becerra, asking him to use new funding authorized by Congress in the American Rescue Plan Act of 2021 and his authority under the Public Health Service Act to take immediate and aggressive action to help manage COVID-19 outbreaks in federal, state, and local correctional facilities.

  • In March 2021, Senator Warren and lawmakers sent a letter to the U.S. Department of Justice Office of the Inspector General (OIG) urging it to conduct a comprehensive review of all COVID-19-related deaths of incarcerated individuals in the custody of the Federal Bureau of Prisons (BOP) and BOP staff since the beginning of the pandemic.

  • In March 2021, Senators Warren, Booker, and Durbin sent a letter to the U.S. Department of Justice Office of the Inspector General urging it to conduct a comprehensive review of all COVID-19-related deaths of incarcerated individuals in the custody of the Federal Bureau of Prisons (BOP) and BOP staff since the beginning of the pandemic.

  • In February 2021, Senator Warren and Congressional Democrats reintroduced the COVID-19 in Corrections Data Transparency Act, which would require the BOP, the United States Marshals Service (USMS), and state governments to collect and publicly report detailed data about COVID-19 cases, hospitalizations, deaths, and vaccinations in federal, state, and local correctional facilities.

  • In February 2021, Senators Warren, Booker, and Congresswoman Nannette Diaz Barragán (D-Calif.) reintroduced the Federal Correctional Facilities COVID-19 Response Act, legislation to require weekly testing for incarcerated people and employees, fund vaccine distribution and administration, promote contact tracing, expand data collection, and increase accountability.

  • In December 2020, Senator Warren released the findings of the May 2019 investigation she opened into the American Correctional Association (ACA) — the nation's largest accreditor of prisons and immigration detention Facilities — and its relationship with the three largest private prison companies that receive ACA accreditation: CoreCivic, GEO Group, and Management & Training Corporation.

  • In December 2020, Senator Warren (D-Mass.), Congressman Joaquin Castro (D-Texas.), and Senator Cory Booker (D-N.J.) introduced the bicameral COVID-19 in Immigration Detention Data Transparency Act, which would require immigration-detention facilities to collect and publicly report data about COVID-19 cases and the preventative measures in place in these facilities.

  • In November 2020, Senator Warren and lawmakers sent a letter to the Department of Justice (DOJ) and the Federal Bureau of Prisons (BOP) seeking information about the status of medical copays in correctional facilities during the COVID-19 pandemic.

  • In October 2020, Senators Warren, and Durbin urged the Department of Justice (DOJ) and BOP to act promptly to reduce the spread of COVID-19 in federal facilities by adopting a public health-driven approach to managing COVID-19, including releasing eligible individuals to home confinement and adopting procedures to medically isolate or quarantine individuals infected with COVID-19. 

  • In September 2020, Senators Warren, Booker, and Congressman Ted Deutch (D-Fla.) requested information from USMS and private prisoner transport firm, Prisoner Transportation Services (PTS), about the steps USMS and PTS are taking to manage coronavirus spread. 

  • In August 2020, Senator Warren (D-Mass.) and Congresswoman Ayanna Pressley (D-Mass.) led the introduction of the COVID-19 in Corrections Data Transparency Act, legislation that would require the Federal Bureau of Prisons (BOP), the United States Marshals Service (USMS), and state governments to collect and publicly report detailed data about the coronavirus disease 2019 (COVID-19) in federal, state, and local correctional facilities.

  • Last May 2020, Senators Warren, Markey, and Congresswoman Lori Trahan (D-Mass.) wrote to BOP urging them to implement widespread COVID-19 testing of all incarcerated individuals and staff at Federal Medical Center Devens (FMC Devens) and release to home confinement vulnerable individuals who do not pose specific and substantial safety threats.

  • In March 2020, Senator Warren and her colleagues sent letters to BOP and the three largest private prison operators asking about the policies and procedures they have to prepare for and manage a potential spread of COVID-19 in federal prisons. 

  • In March 2020, Senator Warren joined Congresswoman Ayanna Pressley (D-Mass.) in calling on then-President Trump to adopt and release decarceral guidelines to reduce the population of people in federal custody during the pandemic.

  • In September 2019, Senator Warren led colleagues in sending a letter to the Department of Homeland Security (DHS) and HHS regarding the decision not to vaccinate families in Customs and Border Protection (CBP) detention ahead of flu season and argued that the decision threatens the health of detainees, CBP personnel, and others.

  • In May 2019, following reports that two additional children had died in the custody of CBP, Senator Warren sent a letter demanding answers about conditions that lead to the deaths of five children in the span of six months. 

  • In April 2018, Senator Warren and other lawmakers sent a letter to Deputy Director of Immigration and Customs Enforcement (ICE) Thomas Homan, requesting information on a recent policy change allowing for the increased detention of pregnant women in ICE detention facilities. 

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