by Michael Thompson

President Donald Trump (R) signed the One Big Beautiful Bill Act in July 2025. The tax spending bill was passed along party lines and is so massive, that it is likely only a few lawmakers read it through before voting. Resting within the bill were massive cuts to Medicaid, which will force rural hospitals to reduce services or even shut down entirely. A consequence of these cuts is that access to lifesaving health care will be even more remote for 60% of people incarcerated in American prisons and 25% of those in jails.

Carceral-impacted people tend to have shorter life expectancies and experience health problems at higher rates than the general public. Beyond higher substance abuse rates, they struggle with higher rates of Hepatitis B and C, HIV, mental health issues, and asthma as well. Nevertheless, 19% of state prisoners never see a doctor when they are incarcerated, while many have passed years without seeing a doctor before incarceration. In addition, two percent (2%) of women enter incarceration while pregnant.

Prison healthcare is terrible in most cases. While the U.S. Supreme Court identified healthcare as a right for prisoners, providers are given immense …

by Matt Clarke

On December 1, 2025, the United States Court of Appeals for the Eleventh Circuit held that jailers could not be held liable for the death of a Georgia pretrial detainee caused by lack of medical care. The Court’s rationale was that the jailers followed the advice of medical personnel and it was not obvious that the symptoms were that of a perforated ulcer rather than drug withdrawal.

When Kevil Wingo was booked into the Cobb County Jail for possession of 0.2 grams of cocaine, “he was complaining of nausea, vomiting, and abdominal discomfort. He was also heard pleading with God, saying that he would never touch drugs again should he survive.” This caused nurse Yvette Burton (who worked for Wellstar Health Systems, the jail’s contracted provider of health care) to believe he was suffering from opiate withdrawal when she saw him at 12:45 a.m. on September 29, 2019.

Wingo was placed on a 5-day period of “withdrawal checks” every 12 minutes, admitted into the infirmary, and scheduled to see a physician in the morning. His very loud complaining of being unable to breathe and needing hospitalization disturbed other detainees. Deputy Lynda Marshall “relayed …

by Chuck Sharman

In a filing with the U.S. District Court for the Northern District of Alabama on January 26, 2026, state prisoner Joseph Allen Renney said that he had reached agreements with the state Department of Corrections (DOC) and its contracted medical provider, Wexford Health Services, settling claims he filed against them over amputation of his toes and part of his foot. The partial amputation allegedly resulted from inadequate medical care that Renney received for an infection. While a victory for Renney, the settlement and its payout amounts remain shielded from PLN.

Renney, now 60, is diabetic. He was incarcerated at Limestone Correctional Facility in March 2021 when he broke his left big toe and it “quickly became infected,” according to the complaint he later filed. He was sent to an outside podiatrist in early April, who recommended partial amputation of the tip of the toe “the sooner the better” to stop the infection’s spread. Instead, Renney got oral antibiotics that failed to quell the infection and gauze to clean his festering wound himself. He waited until July 2021 to see an outside podiatrist again for what was supposed to be the surgery.

However, an …

by Matt Clarke

On November 20, 2025, the United States Court of Appeals for the Eleventh Circuit held that an Alabama law making sheriffs responsible for jail prisoners’ health care did not excuse a county from liability for having a policy resulting in inadequate prisoner health care. The summary dismissal of a claim against the county in a lawsuit over the death of a jail prisoner was reversed and the case was remanded.

Mitchell Wayne Smothers, Jr. was convicted of fourth-degree possession of a forged instrument. He was booked into Alabama’s Walker County Jail in February 2019. At that time, he had several serious health issues, including liver cirrhosis secondary to hepatitis C, alcoholism, chronic obstructive pulmonary disease, recurrent cellulitis, and nonhealing pressure wounds. Just one month earlier, he was discharged from a hospital after being treated for antibiotic-resistant infections in large, open, nonhealing wounds on his leg.

The County contracted for prisoner health care with Preemptive Forensic Health Solutions (“Preemptive”) which is owned and operated by Roger Childers, a registered nurse with a Ph.D. in Business Administration. He referred to himself and signed communications as “Dr. Childers.” Court documents show the healthcare company was aware …

by Chuck Sharman

On January 16, 2025, a grand jury in Georgia’s Richmond County reported that its inspection of the County jail revealed serious overcrowding, with mattresses on the floor pressing many cells into double-occupancy. As if to underscore the problem’s seriousness, a detainee was violently assaulted and stabbed on January 23, sending him to the hospital with nine stab wounds. Five fellow detainees have been charged in that attack.

GA Code § 15-12-71 (2024) requires grand juries in each of the state’s 159 counties to physically inspect its jail every year. The grand jury seated in state Superior Court for Richmond County for its November 2025 term conducted the inspection on January 6, 2026, presenting its report to Judge R. Ashley Wright on the term’s last day. Though jailers quibbled about the exact number, the Grand Jury reported that the Charles B. Webster Detention Center in Augusta was operating at more than 126% of its designed capacity.

That “inadequate ability to house its jail population,” the report noted, was reflected in the fact that the jail was “set up to house 1,065” detainees and prisoners, but there were 1,346 confined there on the date of …

On December 30, 2025, Pennsylvania’s Centre County renewed its contract with PrimeCare Medical—a prison and jail healthcare profiteer—despite the dozens of lawsuits over substandard care that have been filed against it. The five-year contract will cost the County $8 million in total, or about $1.6 million per year, amounting to a 27% increase from the previous year. PrimeCare has been the contractor for the Centre County Correctional Facility since 2005.

Just in 2023, PrimeCare paid out at least $1.2 million to settle lawsuits from prisoners and detainees in Pennsylvania over the company’s failure to provide adequate healthcare. And that’s just what PLN has reported on from the handful of settlements that were unsealed; the actual figure is likely much higher, as the company has managed to keep their litigation payments confidential in many cases. [See: PLN, Mar. 2025, p. 51]. In one of the unsealed settlements, PrimeCare paid $1 million to the estate of Brittany Ann Harbaugh, 26, a detainee who died from an opiate withdrawal after being booked at the Bucks County Jail in 2018. Harbaugh did not see a doctor and did not receive detox medications, despite telling a PrimeCare nurse she was experience withdrawal …

by Chuck Sharman

On June 5, 2025, the U.S. Court of Appeals for the Ninth Circuit vacated a $24 million punitive damages award against NaphCare for a Washington jail death, remanding the case to the U.S. District Court for the Eastern District of Washington to make a new punitive damages award that was not more than four times the $2.75 million in compensatory damages awarded to the Estate of Cindy Lou Hill. But the firm was not off the hook entirely; only weeks earlier, another massive jury verdict was returned against NaphCare for costing another Washington jail prisoner his leg, as reported elsewhere in this issue. [See: PLN, Jan. 2026, p.25.]

In Hill’s case, the firm was hit with a July 2022 verdict awarding $26.75 million to the surviving daughter of Cindy Lou Hill, 55, for NaphCare’s denial of medical care to her for a ruptured intestine. As PLN also reported, that led to her death in 2018 at the Spokane County Jail. [See: PLN, Oct. 2023, p.27.]

NaphCare appealed that verdict, and the Ninth Circuit provided considerable relief. However, the Court found sufficient evidence to uphold the jury’s finding that NaphCare was liable for maintaining …

by Chuck Sharman

For letting a detainee’s infected leg go untreated so long that it had to be amputated, a federal jury assigned liability to NaphCare, Inc., the contracted healthcare provider at Washington’s Pierce County Jail in Tacoma, returning a massive $25 million verdict on Javier Tapia’s civil rights claim on April 4, 2025. That was on top of a $1 million settlement reached with the County the prior month, as PLN reported. [See: PLN, Apr. 2025, p.20.] The U.S. District Court for the Western District of Washington then awarded $2,271,906.70 in costs and attorney’s fees on November 26, 2025, pushing the total recovery for Tapia, 43, to $28,271,906.70.

Tapia said that he was struggling with opioid addiction in June 2018 when he was arrested for driving a stolen vehicle and booked into the jail. Three months later, when guards noticed his disordered thinking, he submitted a sick call for insomnia. But he wasn’t seen by a doctor for another month, and only after a guard noticed his toes were turning black. By then, his foot and leg had developed bleeding sores and blisters, and his weight was rapidly plummeting. Taken to a hospital, he was diagnosed …

by Chuck Sharman

A $2.75 million settlement will help the surviving children of a detainee left to decompensate from her mental illness for seven and a half months before she died in Washington’s Clark County Jail in Vancouver. That was the result of an agreement reached in July 2025 between the Estate of Shelly Ann Monahan and officials with the County and its contracted jail healthcare provider, NaphCare, Inc.

Monahan was days away from her 28th birthday when she was booked into the lockup on felony charges on December 3, 2020. She had a history of drug use and repeatedly spent time in the jail after related arrests. During those incarcerations, jailers also became aware of her mental health struggles, placing Monahan on suicide watch the first time in 2014 and again the following year.

So it should have come as no surprise when she arrived at the jail the last time and was found to be under the influence of drugs. However, she was placed in the general population after a medical evaluation by NaphCare staff—without undergoing a mental health screening. Three weeks later, a nurse noted that Monahan “appeared disheveled, her room was a …

by Chuck Sharman

Meeting at the courthouse in Wilkes-­Barre, Pennsylvania, the Luzerne County Council approved three settlements in November 2024, totaling $645,330 in payouts on behalf of three former detainees at the Luzerne County Prison—two of whom committed suicides that jailers allegedly failed to prevent. That was on top of a $780,000 settlement approved the year before for another detainee’a unprevented suicide, pushing total payouts to $1,425,330.

Under terms of the first agreement, approved on November 12, 2025, the County paid $45,330 to Joshua S. Miller, whose federal civil rights suit claimed that he was subjected to a highly invasive strip search in April 2016, when tipped-­off guards found him and five other detainees with suspected contraband drugs after seeing visitors.

Miller, then 28, admitted that guards found and confiscated contraband from his pants. But they then took him to a conference room and strip-­searched him to look for more, leaving him naked and shackled while the door repeatedly opened and closed, exposing him to male and female workers in the office. Finding no more contraband at that point, he said that they ordered him on all fours atop a table and forced him to place …