Guest Commentary: Wellpath’s Flawed and Deadly Cost Containment Program

Part 1 – Who will protect the unborn babies?

by Malik Washington, Destination Freedom Media Group

Wellpath LLC, formerly known as California Forensic Medical Group (CFMG), is the largest for-profit jail health care provider in the United States.  Wellpath is the health care provider for Santa Rita Jail in Dublin, California (SRJ), as well as for numerous other jail/prison/detention center facilities in California and throughout the United States.

To say that Wellpath has a bad reputation in the realm of health care for the incarcerated is a gross understatement.  Here are just a few links to news articles which describe the deliberate indifference, medical neglect, and reckless disregard for human life by management and employees of Wellpath:

.25 million settlement reached in Fremont inmate’s death


Clark County signs up correctional health care provider facing litigation for wrongful deaths

By Conrad Wilson

County sued over another suicide at Santa Rita Jail

By Joe Dworetzky/BCN Foundation

El Paso County jail’s medical provider failed to give inmate critical care before second suicide attempt, lawsuit alleges

By Shelly Bradbury, Denver Post

SRJ is located literally across the street from the newly-closed Federal women’s facility known as FCI Dublin.  The entire country is aware of the horrible abuses and indignities visited upon the former inmates of FCI Dublin but very few are aware of the disgraceful treatment of pregnant mothers trapped inside Alameda County’s infamous SRJ.

Between the years of 2017 through 2022, approximately 600 pregnant women have been housed at SRJ.  Candace Steel is just one of these women and her story serves as a cautionary tale for women who find themselves in the clutches of Alameda County Sheriff’s Office (ACSO) deputies.

Candace was booked into SRJ shortly after midnight on July 21, 2017.  She was pregnant and it was noted in a medical report that she had a history of pregnancy-related seizures, recent substance use, and a urinary tract infection diagnosis.  (These conditions are known to lead to premature births).  At SRJ, Candace reported to Wellpath medical staff that she was experiencing severe cramping and pain.  She could not stand or walk…only crawl.

Many female inmates who observed Candace’s condition alerted the Sheriff’s deputies. A Wellpath nurse said Candace was “exaggerating her distress.”  Sheriff deputies placed Candace into an isolation cell and left her there in order to fend for herself.  Candace went into labor inside that nasty isolation cell.  Although she screamed in pain for hours, no help came.  Alone and unattended, Candace gave birth to her baby on the floor of that filthy jail cell.  Candace’s baby was born with her umbilical cord wrapped around her neck.  Candace noticed her baby girl wasn’t breathing, so she stuck her fingers in her baby’s mouth in order to open the baby’s airway.  Finally, when the deputies heard Candace’s baby crying, they entered the cell to provide assistance.


I gathered this information from a civil case I studied for this article.  See, Steel vs. Alameda County Sheriff’s Office, 428 F.Supp. 3d 235.  There was another relevant piece of information that I gleaned from my review and analysis of the Steel case which I will quote:

“The FAC states that Alameda County had outsourced medical care of detainees at Santa Rita Jail to CFMG (now known as Wellpath).  Plaintiffs allege that the contract with CFMG made it liable for all costs associated with hospital stays and services, without any compensation from Alameda County.  They contend this arrangement created ‘a financial incentive and imperative for CFMG to refuse and withhold inpatient hospitalization services to all inmates, including inmates in active labor.’” (Emphasis Added.)

Ladies and gentlemen, this custom, policy, and pattern of practice described in the Steel case has a name….it’s called Wellpath’s COST CONTAINMENT PROGRAM!

As you may surmise, there is a bidding process that takes place when local, county, state, or federal jails, prisons, and detention centers wish to outsource their medical care.  Wellpath uses their Cost Containment Program in a manner that lures county administrators and policy makers with the promise of low budget medical services.

The Cost Containment Program is designed to decrease costs by optimizing onsite medical care which, in turn, is supposed to reduce offsite transport to hospitals which are known to be expensive.

In theory, the Cost Containment Program sounds great, but Wellpath’s practical application of the policy has created a trail of misery and in-custody deaths that spans the entire country.

Wellpath pressures their employees (which include nurse practitioners, doctors, physician assistants, and nurses) not to seek emergency hospital services for detainees who experience serious medical problems inside a jail setting.

This program and policy are interwoven into the Health Service Agreement which is approved by county policymakers and jail administrators in California and beyond.


I have studied lawsuits against Wellpath all over the United States and it’s as if some U.S. District Court judges presiding over these cases have preferred the strategy of shielding Wellpath from accountability.  However, there are a few important lessons that I’ve learned:

Constitutional health care non-delegable.  Allow me to explain.

The “non-delegable duty doctrine” holds that the government cannot avoid liability in a section 1983 civil lawsuit by contracting out its constitutional duties to a third party like Wellpath.

Left to right: Susan Muranishi, Nate Miley, Donna Ziegler, and Yesenia Sanchez

It is my allegation that all four of these public servants from Alameda County are well aware of Wellpath’s Cost Containment Program and, as a result, they have blood on their hands.  What makes them liable?

The ACSO (Sanchez), the County Administrator (Muranishi), the County Attorney (Ziegler), and Board of Supervisors (Miley and possibly others on the Board) are all “municipalities” of the County of Alameda.  Municipal liability requires proof of three (3) elements:

  1. An official policy (or custom);
  2. A policy maker can be charged with actual or constructive knowledge; and
  3. A constitutional violation whose “moving force” is that policy or custom.

This is known as a “Monell claim” and the case which illustrates this is, Monell v. New York City Dept. of Social Services, 436 U.S. 658, 690,; 98 S.Ct. 2018, 56 L.Ed. 2d 611 (1978).

Just reflect for a moment on all the lost lives at SRJ to date.  Do you think for one second that Alameda County Counsel Donna Ziegler, Nate Miley and some or all of the other Alameda County Board of Supervisors, and Alameda County Sheriff Yesenia Sanchez have a vested interest in the lives of detainees held inside SRJ?  Of course not!  If they did, they would have canceled the Wellpath contract.

Ladies and gentlemen, it’s all about the money.  When Alameda County signed the contract with Wellpath, they all knew what the provisions were.

Although the focus of this piece has been on Alameda County, I would like to introduce our readers to a similar struggle that is happening right now with the State of Massachusetts.  Many months ago, my partner and colleague, Gale Washington, was conducting her own research into Wellpath.  Gale shared with me an op-ed that appeared in the Boston Globe.  The piece was authored by U.S. Senators Elizabeth Warren and Edward Markey.  These highly respected U.S. Senators want Wellpath kicked out of their state prison system!

Warren, Markey shine a much-needed light on prison health care

By Editorial Board, Boston Globe

Instead of pondering over this remarkable opinion piece, my partner Gale penned a letter of her own to both Senators Warren and Markey.  We share this letter with the public.

For the first time and we strongly encourage all who are willing to write a similar letter to their U.S. Congressperson, here’s the link to our letter:  Ltr to Senators Warren & Markey 2024 01 19 re Wellpath.pdf

We also recently came across letters sent to Wellpath from Warren and Markey and other U.S. Senators.  Here are the links to both of these letters:  (letter from Senators Markey and Warren)  (letter from 10 other Senators)

I think it’s time that as a community and nation, we get “political.”  In California, we must let newly appointed U.S. Senator Laphonza Butler (she signed the letter) and U.S. Representative Lydney Kamlager-Dove know that we, too, are dissatisfied with the actions of Wellpath.  With enough support from the communities’ citizens, like you, Gale, I, and all of you may be able to save at least one human life.

Editor’s Note:  Gale Washington

Both Malik and I have been relentless in pursuing the harm that Wellpath has caused to so many families.  Malik has tirelessly researched the lawsuits against Wellpath….which over the past several years have been hundreds.  A recent EINwire article stated that “Nationally, more than 1,000 federal lawsuits have been filed against Wellpath by prisoners, their families, and civil rights groups. The Nashville, Tenn. company is also the target of three U.S. Department of Justice quality of care investigations, and four FBI investigations.”  


About The Author

Disclaimer: the views expressed by guest writers are strictly those of the author and may not reflect the views of the Vanguard, its editor, or its editorial board.

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