Santa Rita Jail health care provider should be dumped, activists urge

Several groups advocating on behalf of people incarcerated at Santa Rita Jail are calling on the Alameda County Sheriff’s Office to end its contract with Wellpath, the private company that provides health care services in the jail.

In October 2022, the Alameda County Sheriff’s Office entered into a $252 million, five-year contract with Wellpath, one of the nation’s largest for-profit health care providers for incarcerated people.

But at Thursday’s meeting of the Alameda County Board of Supervisors Public Protection Committee, members of the American Friends Service Committee, Interfaith Coalition for Justice in our Jails, and Families Advocating for the Seriously Mentally Ill urged the committee to replace Wellpath with the county’s public health care system before the contract expires in September 2027.

Micky Duxbury, chair of Stop Deaths and Harm, an offshoot group of the Interfaith Coalition for Justice in our Jails, told Supervisors Elisa Márquez and Nate Miley that Contra Costa, Marin and Santa Clara counties provide their own health care in their prisons and jails.

“Even though these counties have different demographics if they can manage to provide health care in their jails, so can Alameda County,” Duxbury said. “Wellpath’s allegiance is to their shareholders. I know Alameda County can do better than this.”

Supervisor Miley agreed with Duxbury, adding that he believes Alameda Health System, the county’s medical services agency, would be better suited to serve patients in Santa Rita Jail.

“I have not been pleased,” he said. “In fact, I’ve wanted to have the county move ahead and see if Wellpath was in breach of contract.”

Wellpath did not immediately respond to an email and phone call seeking an interview for this story.

The push to replace Wellpath in the jail follows a series of audits that were critical of Wellpath’s performance.

In 2020, the county and sheriff’s office commissioned Forvis Mazars, an auditing and consulting firm, to conduct audits on Wellpath’s performance at Santa Rita Jail. Every month from March 2023 through June 2024, Forvis Mazars reviewed the files of 15 incarcerated people to measure Wellpath’s compliance with 39 standards set by the National Commission on Correctional Healthcare. The commission considers a 90% to 95% compliance rate “Satisfactory”; anything below that warrants a corrective action plan. Forvis Mazars, however, deemed anything below 95% “unsatisfactory.”

“Evaluations by [Forvis Mazars] … shows an almost total failure rate by Wellpath of 70% to 100% of ‘important’ and ‘essential’ compliance indicators,” read a press release from the Stop Deaths and Harm group.

Wellpath and the jail scored lowest for language translation (0% compliance), access to care (6.8%), and problems after intake, or whether their medical records were consistently updated with new conditions (10.6%).

Forvis Mazars found that only two categories — whether patients were well-informed and consented to care, and specialty referrals — had an average compliance rate exceeding 90%.

Of the 39 standards the auditors examined, 24 had an average of less than 50% compliance. One of those standards was “suicide watch alert” — whether Wellpath documented patients who’d previously attempted suicide or had suicidal ideation — which averaged a 46% compliance rate, according to the press release.

“One hopes for mercy for the other 50% for whom Wellpath did not adequately document the risks of suicide,” John Lindsay-Poland, co-director of the American Friends Service Committee’s California Healing Justice program, stated in the press release.

While we were unable to independently review every audit between March 2023 and June 2024, publicly available records on the sheriff’s office’s website reveal low rates of compliance for almost every metric.

According to Forvis Mazars’ June 2024 report, the most recent audit available, there were no metrics for which Wellpath exceeded the “satisfactory” rate of 90% to 95%. Ten metrics showed compliance rates of less than 90%, with access to care and informed consent scoring 0% compliance.

Forvis Mazars’ May 2024 audit also shows poor evaluations. While Wellpath exceeded 90% to 95% compliance for two standards (discharge planning and grievance process for health care complaints), it scored 0% compliance for “restraining, secluding, and segregating inmates” and informed consent. And eight metrics showed compliance rates of less than 90%.

Failure to comply with these standards can result in severe health repercussions or even death for incarcerated people, especially since medical staffing at Santa Rita is not consistent and staff must rely on records submitted by others to provide adequate care.

Noncompliance also comes with steep penalties for Wellpath. Lieutenant Joseph Atienza with the Alameda County Sheriff’s Office told the supervisors that in 2024 alone, Wellpath paid the sheriff’s office over $2 million for “staffing reimbursements and penalties.”

Dr. Eric Lee of Forvis Mazar told the supervisors that caring for people in a correctional facility is “extremely challenging.” Understaffing, patients’ complex behavioral health needs, lack of communication between medical staff, and poor training have all played a role in Wellpath’s failure to comply with certain standards, according to Lee.

“This is an uphill battle that our clinicians have to face every day,” he said.

Lee estimated that the technology Wellpath staff use at the jail to keep track of patients’ medical files is “15 to 20 years” behind, making record-keeping cumbersome and leaving nurses and doctors with less time to complete other tasks.

Sheriff Yesenia Sanchez said she believes Wellpath deserves more credit, and that the supervisors should give Wellpath more time to course-correct before seeking a replacement provider.

“I think it is only right to give people an opportunity to correct or improve after set expectations have been made very clear,” she said.

Still, advocates at the meeting said Wellpath’s inability to improve on multiple metrics is unacceptable.

“If they’re selling us parachutes, and the parachutes are killing people, why are we going to keep buying parachutes from these people?” said Brian K. Woodson Sr. with Bay Area Christian Connection. 

“We live in one of the wealthiest regions in America, home to world-class hospitals and medical innovation, but we can’t seem to provide the basic care for those in our county jail,” Laurie Manning, pastor at Skyline United Church of Christ in Oakland, told the committee Thursday.

Based in Nashville, Tennessee, and owned by the private equity group H.I.G. Capital, Wellpath has made headlines in recent years for being the target of more than 1,500 lawsuits from multiple states.

One of those lawsuits was filed by the family of Maurice Monk, a 45-year-old Oakland resident who was detained in Santa Rita Jail. On Nov. 15, 2021, jail staff found Monk in his cell after he had been dead for at least three days, according to KTVU. Monk’s family sued Alameda County and Wellpath the following year, accusing them of criminal negligence and wrongful death, among other allegations.

Elvira Monk, Maurice’s sister, implored supervisors on Thursday to drop Wellpath.

“There was no reason for my brother to die,” she said through tears.

In November 2024, former Alameda County District Attorney Pamela Price filed criminal charges against nine deputies and two Wellpath staff for Monk’s death. The defendants pleaded not guilty. That same month, Wellpath filed for Chapter 11 bankruptcy after being unable to pay off $644 million in debt.

Alameda County paid Monk’s family $7 million. The family has yet to receive any money from Wellpath.

Hector Hernandez Jr. also died while incarcerated at Santa Rita Jail in May 2019. His father sued the county in 2023, alleging his 39-year-old son died of pneumonia due to having been denied proper medical treatment.

Wellpath employs medical professionals at more than 600 facilities nationwide, including prisons, jails, and state hospitals, according to its website.

This isn’t the first private health care provider at Santa Rita Jail to come under fire.

Before Wellpath, the Alameda County Sheriff’s Office contracted with Corizon Health — a for-profit medical services provider headquartered in Brentwood, Tennessee — to provide health care in both Santa Rita Jail and Oakland’s Glenn E. Dyer Detention Facility.

In 2016, the county Board of Supervisors voted 4-0, with former Supervisor Keith Carson abstaining, to terminate its contract with Corizon after several people at Santa Rita Jail died in custody.