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Activists are urging the Alameda County Board of Supervisors to take over medical care services or find another provider for Santa Rita Jail as the current health care company contracted with the county faces heavy scrutiny amid a bankruptcy declaration and other legal challenges, including criminal charges for their alleged role in the 2021 death of a man incarcerated at the Dublin facility.
Representatives from Interfaith Justice in our Jails gathered at the board’s public protection committee meeting March 27, during which a report from third-party auditor Forvis Mazars was the sole agenda item, and which organizers said pointed to an almost total failure rate by current medical provider Wellpath on a majority of key compliance indicators.
“We implore the Board of Supervisors to start now exploring alternatives to the current unacceptable healthcare in the jail,” ICJJ Chair Richard Spiegelman said in a press release ahead of the meeting. “We must provide decent levels of healthcare in the jail.”
The county is currently locked into a $252,112,035, five-year contract with California Forensic Medical Group – one of the companies that merged in 2018 to form Wellpath – through September 2027, which was recommended by former sheriff Greg Ahern during his last months in office in 2022 and went into effect that October.
The current contract was awarded following the 2021 death of Maurice Monk at Santa Rita Jail, which led to a $7 million settlement paid by the county in a civil case filed by his family and the announcement of charges against multiple sheriff’s deputies and a nurse from Wellpath in late 2024.
Months before Monk’s death, the U.S. Department of Justice completed an investigation in April 2021 that found “reasonable cause to believe” the county and the sheriff’s office were in violation of the Americans with Disabilities Act and culpable for a “pattern or practice of constitutional violations in the conditions at Santa Rita Jail”.
These conditions were among the factors that paved the way for voters to unseat Ahern in the 2022 primary election, favoring current first-term Sheriff Yesenia Sanchez’s reform platform over the incumbent’s by more than 20% in the final tally. But the death toll has continued to rise at Santa Rita Jail, most recently last month with the death of 37-year-old Elias Rivera, who was found injured and unresponsive in his cell late March 17 and succumbed to his injuries after being hospitalized March 18 — a case being investigated as a homicide.
While there have been varied reasons for the dozens of inmate deaths at Santa Rita over the past decade, advocates for improved conditions at the jail and county officials alike have centered much of their discussions on health care at the facility, particularly behavioral health and suicide prevention, which were major points highlighted in the public protection committee’s recent meeting.
“Suicide watch compliance was only 50% in 2023,” John Lindsay-Poland said in ICJJ’s press release. “One hopes for mercy for the other 50% for whom Wellpath did not adequately document the risks of suicide.”
Ahead of public comments from ICJJ organizers and others calling for Wellpath to be replaced by county behavioral health services, District 4 Supervisor Nate Miley said that he was “not pleased” with Wellpath, and had sought to find out if they were in breach of contract in order to allow for an early termination of the contract.
Regardless, Miley said he did not want to see the contract extended, and that the pieces were now in place for the county to consider taking over health care at Santa Rita — an option he said had been explored before awarding the current contract to Wellpath in 2022, but was not feasible at the time.
If a request-for-proposals (RFP) process for a new health care provider were to be necessary rather than a direct shift to the county taking over for Wellpath, Miley said the time to begin that process is now, with only two years left in the current contract.
Regardless, the sheriff pointed to the importance of the county’s relationship with Wellpath under the current contract.
“I want to make sure we’re not bashing our Wellpath partners,” Sanchez said. “I do want to say that we’ve been meeting, and it’s clear that there are different expectations from the last two years than there may have been before, and I think it’s only right to give people an opportunity to correct or improve after set expectations have been made very clear, and so there have been conversations with the NAHW and follow-up conversations with our Wellpath managers team. They have been receptive and they have responded.”
ICJJ and its offshoot group Stop Deaths and Harm provided analyses ahead of the recent meeting of neighboring counties healthcare services in their jails, pointing to Marin County and Contra Costa County as prime examples of the success of providing health services to inmates through their county health services rather than contracting out to companies like Wellpath.
“Even though these counties have different demographics, if they can manage to provide healthcare in their jails, so can Alameda County,” said Stop Deaths and Harm chair Micky Duxbury in a public comment. “It will take immense political will and leadership and we hope we can count on both of you (Miley and District 2 Supervisor Elisa Márquez) to bring a full motion to the board.”
“I want to end by bringing up Maurice Monk’s name, because it was with his horrific death that we began looking into Wellpath and their pattern across the country, and Wellpath’s allegiance to their shareholders,” she continued. “I know Alameda County can do better than this.”
Katie Dixon echoed Duxbury’s points and emphasized Wellpath’s alleged role in Monk’s death according to a video that was publicized before criminal charges were brought forth last year.
“These deaths are on someone’s hands, and I’m blaming it on Wellpath,” Dixon said.
Monk’s death wasn’t an isolated incident according to others in the public comment portion of the meeting, who pointed to the 1,000-plus lawsuits against the company and its current bankruptcy filing in addition to the local troubles highlighted in the audit on the table for discussion at the March 27 meeting.
“I think we know we’ve got a problem,” said former state senator Loni Hancock. “We have an underperforming health care contractor, it turns out the largest in the country, currently filing for bankruptcy in Texas – which is known for sympathy to corporate bankruptcies – because there are over 1,000 lawsuits brought against them for low performance. And the cost in human tragedy and financial settlements has been quite large here in Alameda County. The good news is that there are options.”
Rabbi Allan Berkowitz told Márquez and Miley that the results of the audit painted a clear picture and provided a clear choice for the county.
“It is very rare that life gives you, as supervisors managing a county, a complex issue that I think has a really simple way forward,” Berkowitz said. “The ‘if’ question about Wellpath should be the simplest one that you as supervisors confront. Of course what to do after that is where the complexity lies. I encourage you not to fight your way through an open door.”
Although the audit report at the March 27 meeting was informational only, Miley and Márquez concluded by agreeing to pursue a joint meeting with the public protection committee and the health committee for an as of yet undetermined date within five weeks, and to call for an update on Wellpath’s compliance with directives from county officials within three months.
“By then we should have more concrete information based on the many questions raised with respect to the timeline of an RFP or potentially other options,” Márquez said. “Before we get to that point, I want to make sure we have another follow-up conversation.”
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