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Why has Skagit County contracted out health services at its new jail to a for-profit company with a terrible track record?

Reporting and Commentary by Tony Harrah

Skagit County Community Justice Center
Skagit County Community Justice Center photo by Eric Hall

In January 2018 Skagit County Commissioners signed an agreement with an outfit called Naphcare. Naphcare’s job, as laid out in a thirty-four page contract, is to provide comprehensive health care at the new jail. However, in a field known for bad actors – companies who provide for-profit medical care to correctional facilities – Naphcare stands out as one of the worst. Since 2004 they have been named as defendants – along with the government agencies with which they hold contracts – in two hundred and seventy-two federal lawsuits, including five filed in August 2019 alone (Justia Dockets and Filings, Justia.com). Most of these suits allege serious violations of inmates’ civil rights. Those are just the federal lawsuits – because every state has its own system of recording civil suits, information about lawsuits in state courts is difficult to obtain in a systematic fashion.

Naphcare was founded in 1989 by Birmingham Alabama pharmacist James McLane, and its first comprehensive contract was signed with the state of Alabama’s prison system in 2001. Ironically, even though Naphcare’s corporate headquarters are in Alabama, that state, with arguably the worst prison system in the U.S., actually cancelled Naphcares’ contracts in 2003 after a series of state and federal lawsuits which alleged substandard – and worse – conditions in the facilities which Naphcare oversaw. (Prison Legal News – The Deadly Health Services of Naphcare in Alabama, prisonlegalnews.org)

As mentioned above, Naphcare’s egregious failings are not old news. In 2018 a federal judge in Virginia, in her ruling on a suit against Naphcare and the Hampton Roads Correctional Institute, had this to say: “This settlement brings a monetary conclusion to a lawsuit involving some of the most appalling, inhumane conditions to which the undersigned judge has been privy to in over thirty years on the federal bench”. According to the record, the man died, ignored, “among his own feces and bodily fluids”. Space constraints keep me from recounting more of the long list of horrific stories in the legal archives featuring Naphcare and the jails and prisons in which they allegedly provide health care.

According to the Skagit County Sheriff’s Department, at any one time there are somewhere between two hundred and sixty and two hundred and seventy-five inmates in the new jail. Of these, approximately one hundred and ten have chronic illnesses, one hundred and eighty need regular medications, one hundred or so are mentally ill, and from one to three are usually on suicide watch. No doubt many inmates are listed in at least two of these categories, but the Sheriff’s figures underline the fact that most inmates suffer from some kind of mental or physical problem. These citizens, whatever their failings, deserve to be treated as human beings, not neglected, abused, and thrown away in the interests of a for-profit corporation.

I believe that three major issues stand out regarding the County’s contract with Naphcare. The first, documented above and certainly the most important, is that the company has a history of neglecting the health of prisoners under their care in the pursuit of profit. From the point of view of simple human decency, the County has no business contracting with a company with Naphcare’s track record. A few keystrokes on my computer led me to reams of damaging information about Naphcare. I find it hard to believe that the County’s staff conducted due diligence before the Commissioners awarded a contract to a company with such a sordid history.

Second, any competent plaintiff attorney goes after the deep pockets of government whenever possible, be it local, state or federal. Although the contract states that Naphcare will shield the County from liability “to the fullest extent of the law”, it’s simply a fact that in almost every complaint filed against Naphcare in the federal court system, the governmental entity in partnership with them – in our case it would of course be Skagit County – was named as a co-defendant in the lawsuit. County Commissioners maintain that they tried to find competent staff for the jail’s health system and couldn’t, so they reached out to Naphcare. This certainly raises an important question: if the County couldn’t find competent staff, who has Naphcare hired? What are their hiring standards? The actions of Skagit County’s Commissioners have definitely exposed the County’s citizens and taxpayers to liability for the actions of an irresponsible company over whose employees it exercises no day-to-day control.

Third, the County’s contract guarantees Naphcare 7.4 million taxpayer dollars over the course of three years. However, that’s just the “base” amount; there are other provisions which make the County responsible for other health care costs – lots of them. If anyone is interested in looking at the contract in detail, it can be obtained in PDF format from the Commissioners’ office. And, after expenses, Naphcare’s profits (read taxpayer dollars) go to corporate headquarters in Alabama instead of staying at home and supporting the local economy – surely a lose/lose proposition for Skagit citizens.

Naphcare’s contract with Skagit County ends in early 2021. Preliminary planning for that year’s budget has already begun. It is important that the Commissioners hear from citizens about this issue, and their contact information is listed below. In addition, the Jail Finance Committee, which makes budget recommendations to the Commissioners, will be holding its last meeting of 2019 on October 24th at 9:00 AM. Though there is no public comment permitted at these meetings, a robust presence of concerned citizens would send a strong signal to Committee members, and most are available for informal conversations after their meeting concludes.

Commissioners Ron Wesen, Lisa Janicki and Ken Dahlstedt can be contacted at commissioners@co.skagit.wa.us

Tony Harrah is a long-time activist who works on issues of social justice. He is also a forty-year member of Service Employees International Union, and an active leader in SEIU Local 925’s retiree chapter.

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