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NaphCare in the Spotlight

At the October 26 Mendocino County Board of Supervisors (BOS) meeting, the consent calendar contained an item to approve an extension of a contract with NaphCare in the amount of $3,484,847.76. How does almost three and a half million dollars of county funding go through the BOS as a “consent” item?

Fortunately, it did not. Fifth District Supervisor Ted Williams pulled the item “for further consideration.” Williams added that the supporting material for the contract extension with NaphCare to provide physical and medical health services at the county jail was “a bit thin.”

Supervisor Glenn McGourty concurred as did Supervisor John Haschak. Board Chair Dan Gjerde requested the contract come back for potential approval as a regular agenda item after a motion by Williams that additional background material including performance records be brought to the BOS by the contractor with input from the sheriff’s office and county behavioral health services.

This takes us to the November 16 BOS meeting. The item rolled around on the regular agenda. Undersheriff Brewster was present, but seemed reluctant to provide any introduction on the contract, so officials from NaphCare (Bradford McLane, Susanne Moore, and Amber Simpler) jumped in with a Powerpoint show. Supervisor Williams remarked later that this presentation had the appearance of a glossy brochure.

Williams questioned why the NaphCare officials failed to bring more quantifiable data. At one point Williams asked pointedly, “Why didn’t you bring it or attach it [as supporting material to the November 16 agenda]?”

At another juncture in the discussion, after Williams made a specific point about things lacking in NaphCare’s presentation, McLane sounding a bit childish said, “That’s not very fair.”

McLane zooming

A couple of times McLane touted NaphCare’s electronic records, which just served to underline the questions that Williams and other supervisors asked. Indeed, why is a company that is supposed to be expert in computerized record keeping bringing such lightweight facts to a hearing involving a $3.5 million contract.

NaphCare provides healthcare services in prisons and jails. It does this in thirty states. Mr. McLane stated that it currently is working ninety separate contracts with law enforcement institutions. Originally founded in 1989 by Jim McLane under the company name Correctional Pharmacy Systems, the moniker softened to the current title. The company created a first of its kind corrections specific electronic health record (EHR) called TechCare (which is a registered trademark) and implemented it in Las Vegas during 2003.

After Ms. Simpler (who holds a PHD in psychology) touted the number of inmates who had intake mental health evaluations done as they entered Mendocino County’s jail, it came to light that these intake assessments were not performed by clinicians trained in mental health but simply by a NaphCare hired nurse.

Supervisor Williams talked about constituents who had been placed in solitary confinement for lengthy periods of time, allowed out only at night, not seeing the light of day for months, and not receiving medications. He said, “I don’t know if that falls on us as a county or NaphCare.”

This, of course, begs questions about competent mental health assessment. As Williams alluded to, if this is no longer a practice, proof of that requires more thorough data. Simpler noted that medications are available in the county jail, but except in rare circumstances an inmate cannot be physically forced to take those medications.

Amber Simpler is a forensic psychologist with her doctorate from Sam Houston State University. She has testified at murder trials in Texas in which the mental capacity of a defendant is in question. Readers interested in such matters can check out reports on the case of Gregory Lawton. Part of Simpler’s testimony in that case reflected her belief that intelligence test numbers could be manipulated to avoid punishment or to gain Social Security disability benefits.

That case is now several years in the rearview and serves up only an anecdotal look at the person who heads NaphCare’s mental health services for the Mendocino County jail. Put NaphCare itself in your computer’s search engine and you can find a site titled “NaphCare Rap Sheet.” This includes a 2004 Gainesville Sun article about a lawsuit settlement claiming HIV-positive inmates were not given adequate health care treatment by NaphCare. An end result of the lawsuit, as reported in the Sun: the state department of corrections changed medical providers.

The NaphCare officials present at the November 16 BOS meeting noted that there had been no deaths in the county jail under their healthcare services, which began in 2017. Perhaps they have learned a thing or two. A 2016 inspector general report concerning conditions at the Hampton Roads Regional Jail in Virginia cited the death of a twenty-four-year-old mentally ill man due to “wasting syndrome.” The inspector general’s report stated that records kept by NaphCare, the facility’s healthcare and mental health services provider, were “incomplete and inconsistent.”

In May, 2021, a family in Fulton County, Georgia sued the jail and NaphCare, along with individual medical providers after the death of a high school student in custody. Allegedly, in April an eighteen-year-old inmate complained of chest tightness. Though he said the pain was constant and intense, rating it ten out of ten on a scale of severity to a doctor, the medical providers prescribed only ice packs, Ibuprofen, and antacids.

Undersheriff Brewster stated, “The Sheriff was extremely pleased with NaphCare.” Placing the statement in the past tense may have simply been a slip of the tongue. Brewster also said, “The lack of lawsuits, [no] deaths at the jail, it’s extremely impressive.”

At one point Supervisor Williams put Dr. Jenine Miller, head of Mendocino County’s behavioral health services, on the spot by asking her if she could endorse the $3.4 million contract as presented. Miller maneuvered her way around a direct answer. The lack of a straightforward, yes, without any hesitation may be telling in and of itself.

Other questions from supervisors elicited the current lack of independent oversight as to NaphCare’s work in the jail. At the end of the BOS questioning, a motion passed unanimously for the sheriff and behavioral health to assist NaphCare to come back to the Supervisors with a more thorough and data-based report.

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