The Private Option

WINSTON-SALEM, N.C.—In the span of 24 days in May 2017, two men died in Forsyth County’s jail. Both were fathers. Both were black. The first man, Deshawn Lamont Coley, had written request after request begging for his asthma inhaler—accurately predicting that his sporadic access to it was putting his life at risk. The second, Stephen Antwan Patterson, was found without a pulse about a week after he was booked with a blood-pressure reading that would likely have led any free person to the emergency room. The deaths came at an uncomfortable time for Forsyth County: Patterson died just four weeks before the Board of Commissioners sat down to decide whether to renew a contract with the private health-care company that had cared for the two men, then called Correct Care Solutions and now Wellpath, or sign with someone else.

What might have been a routine board meeting turned tense. “Correct Care Solutions makes the sheriff’s office look bad, makes the county look bad, makes the Department of Health look bad, and makes us commissioners look bad,” Everette Witherspoon, then a commissioner, declared. “So many people have blown up my phone about some of these incidents that it doesn’t even make any sense.” The following week, a regional vice president from Correct Care Solutions, Bill Kissel, showed up to try to massage the situation. It didn’t go well. Commissioners posed a series of questions. Had the company lost any lawsuits? “I am not aware, Commissioner,” Kissel replied, adding that legal claims are often settled before a trial. When would the county see the company’s plan for resolving issues that may have contributed to the deaths? “[That] would not be made public,” Kissel said. “In those eight years [that Correct Care Solutions had the contract for Forsyth County], how many deaths have we had in the jail? Do you know?” Witherspoon asked. “I don’t know offhand, sir,” Kissel said.

In my review of Forsyth County’s videotaped meetings and in interviews with several commissioners, sheriff’s-office staff, and community members, it was clear that few seemed totally comfortable continuing to work with Correct Care Solutions. People entering jails are not necessarily society’s healthiest, often detoxing from substances or dealing with mental illness; a death in custody may not imply wrongdoing. But Patterson’s and Coley’s deaths were not a first in the jail under the care of the contractor. Two legal settlements were reached—one for $180,000, and the other for an undisclosed amount, about six months earlier, according to the Triad City Beat—in the deaths of two other inmates, Dino Vann Nixon in 2013 and Jennifer McCormack Schuler in 2014. But Forsyth’s commissioners had exactly zero alternatives. After an exhaustive search for a contractor, starting almost an entire year earlier, the only entity that formally offered its services was Correct Care Solutions. So the board voted to award it an estimated $13.2 million contract for three more years. Only Witherspoon and one other commissioner voted against it.

When I asked Patterson’s mother, Deborah Miles, whether she thought the jail’s health care should be privately run, her reaction was immediate: “No! No! No, no, no. ’Cause it just becomes a meat market, just a moneymaking thing.” Her son was in jail over a couple of hundred dollars in unpaid child support, she added. “The horrible reason people are there is because they don’t have money to bail themself out for simple stuff! And so you get stuck there,” she said. Patterson’s eldest son and Coley’s mother are separately suing the contractor. (The company declined to comment on ongoing litigation.) Most people held in jails haven’t been convicted, and as of the end of 2017, black people were jailed at a rate of more than three times that of white people. Their charges, too, are often minor: traffic offenses, marijuana possession, petty theft. Put another way, every day, thousands of legally innocent people are stopped, searched, cuffed, booked, examined, locked up, and upended from their routines, families, homes, and jobs—all without their own medical supplies and prescriptions—to endure a few days, or more, in a jail. Many will eventually see their charges dismissed or pleaded down, if they are charged at all.