(*This story was updated at 10:39 a.m. on Tuesday, Dec. 19, 2023, to include comment from Wellpath.)
Long waits for care, service denials, and staffing gaps — those are just a few of the complaints lodged against the company that manages healthcare across Massachusetts’ state prison system. And now, two federal lawmakers are pressing for answers.
In a letter exclusively obtained by MassLive, Democratic U.S. Sens. Elizabeth Warren and Ed Markey fired off a series of questions about the quality of care that Nashville, Tenn.-based Wellpath provides to incarcerated people as the firm’s contract with the state comes up for renewal in 2024.
Those queries include whether Wellpath, which took over healthcare services in 2018, plans to cut its healthcare operational costs even as the state’s prison population grows older and sicker; the percentage of required staffing it’s provided to meet those needs, and even whether — and how much — the company has donated to county sheriff races across the state.
“Wellpath’s healthcare services have caused alarm in jails and prison across the country,” Warren and Markey wrote in a 7-page letter, dated Dec. 15, to Wellpath CEO Ben Slocum and two officials from Miami, Fla.-based H.I.G. Capital, the private equity firm that owns the healthcare company.
“In addition to the issues surrounding Wellpath’s healthcare nationally, we are also deeply concerned about Wellpath’s operations in the Commonwealth of Massachusetts in particular,” the lawmakers continued. “We write to raise concerns about the inadequacy of Wellpath’s healthcare provided to individuals incarcerated in Massachusetts state prisons and to seek answers to questions about these problems.
National Scrutiny
Wellpath found itself the center of national scrutiny earlier this year when The Appeal, a website that covers criminal justice reform issues, revealed that incarcerated people in the state’s prison system “had to wait years” for Wellpath to provide them with dentures or other basic dental care.
In their letter to Wellpath, Warren and Markey raised similar concerns, noting that some of the most serious complaints against the company include allegations that time-sensitive care was delayed; that some requests for care were denied outright, and that staff failed to follow physicians’ treatment plans or the company’s own policies, as well as claims that the company inappropriately used restraints and solitary confinement to deal with people with mental health needs.
*In a statement, a Wellpath spokesperson said the company was “proud of the work it does in Massachusetts and around the country to provide high-quality care to hundreds of thousands of patients every year.
“We put patients at the center of everything we do and our clients count on us for our professionalism, our innovative approach and our world-class health care providers,” the spokesperson said.
While the state’s contract with Wellpath remains in place, at least one county has already ditched the healthcare provider, telling a local news outlet that it had been unable to meet its staffing obligations since 2020.
In October, Barnstable Sheriff Donna Buckley ended the company’s contract two months ahead of schedule, moving to in-house medical care in August, according to the local Provincetown Independent.
“We had no other choice,” Buckley told the newspaper. “We cannot afford to have all our cards with Wellpath and have them not show up.”
The sheriff told the newspaper that the company had been operating at a 20% staffing capacity, leading to what Buckley described as a “death spiral,” with clinicians pulling up to 16-hour shifts.
An aging population
The letter from the two lawmakers also comes as data show that the U.S. prison population, including Massachusetts, is aging, and requiring more care as a result.
Between 1991 and 2021, the percentage of those in state and federal prison populations aged 55 and older increased from 3% to 15%, according to a report released earlier this year by the Northampton-based Prison Policy Initiative, which tracks trends across the corrections system.
In Massachusetts, the average age of an incarcerated man was 44, while the average age of an incarcerated woman was 42, according to a May 2022 report by the state Department of Correction. The nation’s median age, meanwhile, is 38.9, according to U.S. Census data.
As of January 2022, incarcerated individuals aged 40 and older accounted for 58% of the commonwealth’s prison population, state data show. There were 195 inmates who were aged 60 and older at the time of their incarceration and 554 who were aged 50-59 at the time of their incarceration, state data show.
The new research highlights the public health risks of incarceration for older adults, noting that a “robust body of research shows that incarceration itself accelerates aging: people face more chronic and life-threatening illnesses earlier than we would expect outside of prison, and physiological signs of aging occur in people younger than expected.”
Individual Stories
In their letter to Wellpath, which included nearly two-dozen queries, sometimes in multiple parts, Warren and Markey relayed individual testimony from incarcerated people about the quality of care, including one who said that “[e]ver since [Wellpath has] taken over medical, it’s been a nightmare.”
Indeed, at the state prison in Norfolk County, where about a fifth of the total population is aged 60 and older, “critical healthcare positions have remained unfilled,” the two lawmakers wrote.
“At various points in 2022, Wellpath failed to staff a Medical Director, Director of Nursing, or certain nurse practitioner and mental health clinician roles, Warren and Markey continued. “As a result, MCI-Norfolk providers often cancel medical appointments. From July 2021 until June 2022, 470 medical appointments were cancelled by Norfolk medical providers.”
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