Higher Ed’s Dubious Deal With Prison Health Care

By January 2018, Tremayne Durham had been in New Jersey State Prison in Trenton for nearly a decade. Being locked up corrodes a person’s health, and Durham was no exception. He was diagnosed with lumbar stenosis — a narrowing of the spinal canal — and received steroid injections. His doctor prescribed him a walking cane in November 2019.

When Covid hit in March 2020, Durham was quarantined but allegedly told he couldn’t bring his cane. Soon after, he says he told a nurse he was suffering horrible back pain, needed his cane, and wanted to see a doctor. When a nurse dismissed his appeal, Durham lobbied a prison guard, who said he complained too much. Over the next 10 days, Durham repeatedly asked for what he needed. Finally, he experienced what he called “severe shooting pain” while showering. Without his cane, a shower chair, or handrails, he says he fell to the floor. Officials took him in a wheelchair to the prison clinic, where he was treated for several days.

In March 2021, Durham filed suit against the prison guards and nurses. The latter group is overseen by a company called University Correctional Health Care (UCHC), which provides health care for all New Jersey prisons. A District Court initially dismissed the complaint. But upon appeal, in September 2023, a judge writing on behalf of a three-person panel ruled that the lawsuit could proceed. According to the ruling, Durham sufficiently argued that prison officials showed “deliberate indifference” to his health and that he had a diagnosed disability. “It is not hard to imagine how dangerous a shower could be for someone suffering from back pain and an inability to walk or stand on their own,” the judge wrote. Durham’s case was sent back to the lower court.

Durham was not alone. UCHC and its staff have been named in numerous lawsuits, with adult and juvenile inmates and detainees alleging neglect, abuse, and maltreatment. In 2016, the former medical director at Northern State Prison in Newark was fired and had his medical license suspended for five years after he failed to do even basic testing for an inmate suffering from fainting, disorientation, and muscle weakness. The inmate died shortly after. In 2019, a detainee at a facility for sex offenders in Central New Jersey was allegedly ignored by medical personnel after prison guards assaulted him and left him for dead. (One guard was indicted for official misconduct, and a lawsuit filed by the detainee’s family is pending.) In 2023, the family of an inmate who allegedly died because the effects of his post-brain-surgery steroids were not monitored filed a suit that likewise remains pending.

UCHC is a nonprofit operated by Rutgers University. Instead of providing care directly or through a private provider, New Jersey grants UCHC responsibility for providing medical, mental-health, and dental care to roughly 20,500 adults and juveniles in New Jersey’s jails and juvenile facilities and on parole. According to the current contract, which began in 2019 and has been extended every year through the end of 2024, the state paid UCHC almost $170 million annually for its services. The organization, which now has about 1,100 staff and faculty members, was formed in 2005. It is headed by a psychologist, Frank A. Ghinassi, but other top administrators come from backgrounds in private health-care delivery, such as the chief operating officer, J. Chad Knight, formerly the CEO of a network of Atlanta physicians.

Rutgers is among several universities that have formed separate organizations to provide health care to inmates and detainees. Commonly called “academic-correctional health partnerships,” the modern form of these arrangements originated in the 1990s in Texas. But they have since expanded to New Jersey, Georgia, and Connecticut, among other states. Most programs are small, but in some cases, like at Rutgers, universities have taken over health-care delivery for the correctional departments of entire states, replacing the work normally done by government agencies. Indeed, after government agencies, academic medical centers are now the most common source of health care for incarcerated people in the country, surpassing private providers. Contracts between these organizations and state and federal correctional agencies can be worth hundreds of millions of dollars and affect tens of thousands of inmates.

Advocates for academic-correctional health partnerships say they offer prisoners the expertise of scholars and university-affiliated doctors, provide training opportunities to medical students, and save money. “UCHC has made performance improvement a key ingredient of its health-care service-delivery model,” Ghinassi said when accepting the 2019 award for “Program of the Year” from the National Commission on Correctional Health Care, a trade association. Arthur Brewer, UCHC’s medical director, told a Rutgers alumni magazine that the organization is a model, improving outcomes and decreasing hospitalization and mortality. “A great deal of oversight ensures that no one’s care is overlooked,” the magazine reported. A spokesperson for Rutgers told The Chronicle in an email that UCHC “serves New Jersey by ensuring individuals in the correctional system receive the medical care they deserve.”

Is that true? There is little evidence that academic-correctional health partnerships improve health outcomes for inmates and detainees, let alone that they grant prisoners the care they deserve. In some cases, the programs have been canceled after proving to be as bad as or worse than the systems they replaced. “There is not a lot of measurement of quality that goes on in these systems,” says Warren Ferguson, professor emeritus at the University of Massachusetts Chan Medical School. Asked if academic institutions are better at delivering health care to inmates than other providers, Ferguson says, “The answer is, nobody knows.” And this despite the huge sums that are injected into these programs. Marc Stern, a professor at the University of Washington School of Public Health, says that while the schools promise they provide top-notch services for inmates, there isn’t much support for these statements: “No one’s ever really studied it.”

In 1976, the Supreme Court ruled that inmates in U.S. prisons were entitled to adequate health care, the absence of which would count as “cruel and unusual punishment,” prohibited by the Constitution. In the following two decades, the prison population exploded, ballooning health-care costs for municipalities, states, and the federal government. In 1993, the Texas Legislature took a novel approach by establishing the Correctional Managed Health Care Committee (CMHCC), a partnership between the state’s department of criminal justice and its public medical schools and hospitals that provides health care to inmates.

The University of Texas Medical Branch (UTMB) manages care for nearly 80 percent of the state’s roughly 150,000 inmates, with Texas Tech University handling the rest. The UTMB-Texas Department of Criminal Justice Hospital is an eight-story building within the constellation of buildings on the UTMB campus in Galveston. It is, according to its website, “the first and only hospital specializing in offender care on the campus of a major medical center and teaching institution,” with 172 inpatient beds, an operating and recovery room, and a multi-service ambulatory-care center, all secured by locked gates. Although many Texas prisons have their own infirmaries, inmates from across the state are routinely sent to the prison hospital for surgeries and other complex services. Through CMHCC, the state paid UTMB around $630 million for its services in fiscal year 2024 and $646 million in 2025.

For decades, UTMB officials have touted Texas’ system as a model for other states. “Significant improvements in the provision of medical and psychiatric care to Texas’ prison population have occurred during the nine years that the managed-care program has been operational,” two UTMB officials reported in a 2004 issue of the Journal of the American Medical Association. In particular, they wrote, vacancy rates for medical staff declined, compliance levels with performance standards increased, and, most importantly, there were decreases in patients’ rates of diabetes, cholesterol, hypertension, and AIDS. More recently, the school bragged that it has plans “to be the recognized world leader in the delivery of correctional health-care services.”

Critics find these purported advances unimpressive. “If you start with a dysfunctional health-care system, almost any intervention, especially a thoughtful one, is going to result in improvements,” says Stern, who formerly worked as the assistant secretary for health care in Washington’s corrections department. Small improvements in just a few areas, starting from a very low level, do not justify the claims made by UTMB, he says. The advances they cited could have occurred by chance, even without UTMB’s involvement, simply because conditions couldn’t get much worse.

Nor are Texas prisons improving over time; the mortality rates in 2017, 2018, and 2019 were higher than in any year prior, going back to 2001. In 2018, a Houston Chronicle report found that UTMB and the state corrections department were giving toothless prisoners pureed food instead of dentures. “There’s this misunderstanding that dentures are the only way to be able to process food,” Owen Murray, UTMB’s vice president of offender services, told the Houston Chronicle. In fact, he insisted, “our ability to provide that mechanically blended diet is actually a better solution than the mastication and chewing process.”

“Generally speaking, someone with no teeth should be offered dentures,” Jay Shulman, a Texas A&M adjunct dentistry professor who has testified in lawsuits over prison dental issues, said at the time. “The community standard for dental care has not been applied to prisons.” Following the newspaper’s report, prisoners were provided with dentures.

Lawmakers have repeatedly criticized UTMB’s use of public funds. In 2011, a state audit of UTMB’s correctional health care found that the school was paying its doctors higher-than-standard reimbursement rates, double- and even triple-charging for some expenses, and charging the state for prohibited expenditures. (UTMB disputed some of these charges and claimed the program operated at a loss.) A 2020 state audit noted some improvement in these areas, but the same problems were still evident. For instance, “from September 1, 2017, through February 29, 2020, UTMB charged the program $18.2 million for UTMB employees’ salaries and benefits” without appropriate documentation. The school continued using the program to pay for staff members’ employee-referral bonuses and even conference-registration fees.

Partly because of budgetary pressures, UTMB helped pioneer telemedicine, allowing health professionals to treat inmates remotely instead of requiring cumbersome in-person visits. Texas prisons recorded 40,000 telemedicine visits in 2010–11 and 140,000 in 2019, saving the state between $200 and $1,000 on each. Indeed, the Texas system is now the largest telehealth network in the world. In 2010, the former head of UTMB Correctional Managed Care argued that “just about every routine exam” could be performed remotely.

Interviews with UTMB inmates and their advocates suggest that telemedicine can have significant drawbacks. “Telehealth is really ineffective for what these people deal with,” says Brittany Robertson, founder of Texas Prison Reform, a nonprofit that works to end solitary confinement in the state. While virtual appointments might be appropriate for bug bites or sinus infections, they are dangerously ill-suited to detecting when patients have cancer or diabetes, she says. “They swear by it, and it probably is cost-effective,” then-State Sen. John Whitmire, currently the mayor of Houston, said in 2019. “But I ain’t so damn sure. It’s not the way I’d want my family treated.”

UTMB expressed pride in its unique ability to meet the challenges of Covid; officials attributed their success in part to their telemedicine program. Murray, the UTMB executive, told a reporter during the pandemic: “We’ve done a very good job managing those patients’ care within the prison system. … We really have done a very good job with our testing and access to testing and ability to — within these prisons — quarantine and restrict movement, quarantine patients who are certainly positive for the virus but also quarantine those that have come in contact.”

In fact, during Covid, Texas prisons saw a 74-percent mortality increase, with 253 additional deaths over the previous year’s total. A report from the University of Texas at Austin found that from April to August 2020, Texas had more inmates and staff who died from Covid than any other state. This might seem commensurate with its high prison population, but even proportionately, Texas prisons had some of the highest death rates in the country. In May 2020, Murray said that “the mitigation-effort steps the department has taken has been exceedingly helpful.” That very month, 46 people died of Covid in Texas prisons.

The Albert C. Wagner Youth Correctional Facility was a detention center in South Jersey that held 600 people until it closed in 2019. Nikeelan Semmon served four years in the U.S. Navy and two years in the Army Reserves before becoming a prison guard there. In 2016, at age 36, he was a senior corrections officer, married with a young son, and a member of Jesus My Light Holy Temple. On July 1 of that year, Semmon had chest pains and difficulty breathing. He went to the nurse’s station for assistance.

The nurse on duty, overseen by UCHC, told Semmon that his symptoms weren’t severe enough to keep him from working, according to a lawsuit his family filed. A few hours later, he returned to the nurse’s station. This time, a prison guard took him seriously and called an emergency code. According to the lawsuit, the guards who arrived to help said the nurse in charge failed to call 911 immediately, declined additional medical help, and needed to be told to get the proper equipment. The guards performed CPR on Semmon and paramedics rushed him to a nearby hospital. But it was too late — he died of a heart attack.

Hundreds of prison guards lined a New Jersey street as Semmon’s body was taken to and from a memorial service. Nearly one year later, Semmon’s widow and son attended a candlelight vigil for him held at the Capitol Mall in Washington, D.C. His name was added to the National Law Enforcement Officers Memorial wall for those who died in the line of duty. Lawyers working on behalf of Semmon’s family alleged that if he had received timely and appropriate medical treatment and had been transferred to a hospital earlier, he would not have died. In 2021, UCHC paid his family $1.5 million in a settlement.

Like UTMB executives, UCHC officials have long portrayed New Jersey as a model for how it handles the health of inmates. “In a civilized society, prisoners should get adequate care; it’s the right thing to do,” Jeffrey L. Dickert, then-UCHC’s chief operating officer, said in 2016. (He has since retired.) In a 2014 paper in the Journal of Correctional Health Care, five experts at UCHC and Rutgers concluded that the state’s prison system, as well as its patients, benefited from the partnership. “UCHC is currently providing a level of mental-health and medical services to inmates in the prison system that is achieving better outcomes than what is typically found in the community,” they wrote. As proof, they cited evidence that inmates in New Jersey prisons had lower hypertension rates than Medicare and Medicaid patients and that a higher percentage of inmates received diabetic care in New Jersey than in Michigan. In addition, about 80-percent fewer inmates had been transferred to the state’s forensic psychiatric hospital since UCHC took over mental health for the prisons, without an increase in suicides. “Most [inmates] return to society after three to five years,” said Donald Reeves, UCHC’s director of psychiatry. “It’s our goal to return them in better shape than when they arrived.”

The overall health of individuals in New Jersey prisons remains poor, however, even accounting for any progress introduced by UCHC. Data compiled by the state and obtained through public-records requests show that the average age of death of individuals in state prisons (except a facility that holds sex offenders following their sentence completion) has ranged between 52.2 and 60.7 since 2009. This is well below the state’s average life expectancy of 77.7 years in 2020. Similarly, a 2024 report in The Guardian found that men in New Jersey’s prisons died, on average, more than 12 years earlier than the overall population, often after receiving little care while they were ill. Black men died an average of 14 years earlier than all men in the overall population and seven years earlier than Black men in the overall population. Some prisoners died of treatable cancers, while others died from treatable symptoms of chronic diseases. “The numbers suggest that neither age distribution nor socioeconomic background and race completely explain why men in New Jersey prisons are dying so young, leaving the finger pointing at standards of health care in state prisons,” according to the report.

In 2016, Brewer, UCHC’s medical director, said inmates have easier access to health care than the public. But during Covid, New Jersey prisons were some of the deadliest places to be incarcerated in the United States. A study from the University of California at Los Angeles found that 47 more deaths occurred in the state’s prison system in 2020 than in 2019, a staggering 142-percent mortality increase — even though the prison population decreased that year, as inmates deemed to be low-risk offenders or especially vulnerable were released. This was far worse than the overall national increase of 62 percent. A facility in Central Jersey that detains sex offenders indefinitely after their criminal convictions, and where UCHC oversees health care, had the single highest Covid mortality rate of any institution in the United States.

Under the terms of the state contract, UCHC must provide the Department of Corrections with a range of monthly and annual reports measuring things like the mental health of inmates, litigation, grievances filed, incident reviews, compensation and benefit plans, and much else. But the corrections department told The Chronicle that it possessed only a few reports from just three months in the spring of 2024. A UCHC spokesperson referred The Chronicle back to the DOC. In addition, under the contract terms, the DOC is required to compile reports assessing UCHC’s performance. It couldn’t find those reports, either.

UCHC insists that it delivers high-quality care to inmates — and that doing so is cost-effective. The program “makes economic sense for New Jersey,” Dickert said in 2016. “Inmates can sue if health care is withheld, and this litigation is costly. Those who are denied care may require hospitalization. This costs taxpayers even more money.”

But an audit of the state prison’s medical contracts found that, between the summer of 2013 and the summer of 2015, UCHC charged medical providers $905,300 in claims for inmate hospitalization expenses that it never incurred, was reimbursed for employee salaries at improperly high rates, and had staff members inaccurately logging the hours they worked. The audit, which noted that many other UCHC procedures were adequate, was conducted by the state legislature and obtained through a public-records request.

More generally, health-care costs for inmates in the state have continued to skyrocket. Indeed, they have been the driving cost of the continued increase in New Jersey’s prison budget, which has risen steadily — it saw a 12-percent increase over 2023 alone — even though the inmate population is down 30 percent since 2020 and the state has shuttered four prisons. A 2023 report from the state Department of Corrections Ombudsman found that the second-most common complaint inmates had, after concerns about their property, was related to health care. According to the report, “A significant number of incarcerated people and their families contacted the Ombudsperson Office about pending requests to be seen by health-care providers, accessing follow-up information about test results and labs, wait times for specialist appointments, and medication refills.”

Meanwhile, Ghinassi, UCHC’s president and CEO (who also heads Rutgers’s mental-health-care system), drew a salary of $792,467 in 2023; Arthur Brewer, the medical director, earned $361,683. Conversely, as of June 2024, the Department of Corrections refused to spend the $2.6 million that state lawmakers allocated more than a year ago to give inmates their first wage increases in more than 20 years. Some inmates make one dollar per day at their prison jobs, and the highest wage is less than eight dollars per day. Until the policy was suspended in 2020, the state required that inmates pay for any medical care they incurred while locked up. Inmates are still charged a fee if they take prescribed medicines.

Nearly all UTMB’s medical students and residents complete a rotation in the prison hospital. Academic-correctional health partnerships frequently tout the experience that idealistic young people obtain in working with a deeply vulnerable population as a major benefit of the initiative. “The physician-assistant students who train at [the prison hospital] often comment that it has been their best rotation, because they are able to learn so much from just one patient,” according to UTMB Health, the school’s newsletter. A doctor explained in the newsletter that inmates have rare conditions, offering unique learning opportunities for students.

But some students approached Jason Glenn, an assistant professor who was then at UTMB and who studies incarceration and health care (now at the University of Kansas), to say their experiences had made them uncomfortable. Over three months, beginning in December 2014, Glenn and his colleagues conducted focus groups with UTMB medical trainees. The results, first published in 2020 in the journal Health & Justice, were dismaying. Instead of expressing a unique empathy, the medical trainees mimicked a widespread suspicion that administrators and senior staff members taught them: Inmates were usually feigning illness. This suspicion remained even after inmates were properly treated, proving they had needed care.

Even as trainees were conditioned to think inmates were quick to feign illness, each of Glenn’s focus groups still commented on the shockingly advanced pathology of the inmate patients. “There are a lot of interesting diseases and things you don’t get to see in a developed country,” one trainee explained. Advanced cancers were particularly common, as was the risk of tuberculosis. Alarmingly, respondents said they were given more responsibility to treat and help operate on patients than they would have been if the patients weren’t prisoners. “When I was in surgery … I was first assist on at least half the cases that I scrubbed into,” one student confided.

UTMB students routinely indulged their curiosity by searching for their patients’ criminal histories, often easily available online. There were no institutional guidelines around such behavior. Invariably, some trainees let their negative moral judgments of the patients influence their work. “If I know what they did and it’s something that I felt strongly about,” one student admitted, “I may not even do it on purpose, but I may not do the hardest that I can. I may not do my best.”

Glenn and his colleagues put together a list of all the universities that partner in one way or another with prisons. Alongside the direct providers like UCHC and UTMB are more common, smaller collaborations that exist across the country, from New Mexico to Washington and from Florida to New York. Individual faculty members sometimes volunteer or work at jails and prisons. In other cases, initiatives primarily train students and residents as part of a course in underserved populations, as part of a community-residence rotation, or as part of a fellowship, while other trainings are devoted entirely to correctional health. For instance, George Washington University’s School of Medicine and Health Sciences offers an elective course entitled “Introduction to Correctional Medicine,” in which students work in local jails for four weeks. They also have a volunteer program for students to help deliver health education to detainees. George Washington offers some of the country’s first academic programs in correctional-health administration: an online graduate certificate and a master’s degree.

Glenn’s team reached out to each program to inquire about their standards. Although they had been around for decades, Glenn wanted to know if there were common procedures or best practices. “What we found is they’re all just kind of winging it,” he said.

In compiling the list of academic-health partnerships, Glenn found that nearly 35 initiatives of varying sizes existed at one time or another — but that some had been canceled. Soon after UTMB’s program was established, the University of Connecticut partnered with the state’s Department of Corrections to establish Correctional Managed Health Care (CMHC), which provided all medical, mental-health, pharmacy, and dental care for inmates. The arrangement continued for more than two decades. In 2017, the contract was worth $82.7 million. In its annual report that year, CMHC pledged to become “a national leader in correctional health care.”

Alas, 2017 would be the last year CMHC existed. State auditors had long noted that the CMHC’s negligence in keeping adequate records led to major failures. For instance, three prisoners with foot troubles — a loss of sensation, amputated toes, a worn-out prosthetic foot — were reportedly denied care. But it was impossible to determine if they received proper care because officials didn’t keep proper records. The state paid $1.3 million to an inmate after he claimed CMHC staff delayed identifying and properly treating his skin cancer by more than a year. “They don’t treat us like human beings,” the man said.

Finally, in 2018, Connecticut ended the partnership and returned responsibility for health care to the corrections department after a consultant’s report found CMHC’s system provided “untimely” health care and lawsuits kept piling up. In the second decade of CMHC’s work with the state, the attorney general fielded more than 1,000 complaints and lawsuits from inmates about the shoddy health care and medical conditions in its jails. The University of Connecticut denied providing substandard care. But when the state contract ended, so did CMHC.

The University of Connecticut was not alone in failing to realize its ambitions to be a leader in correctional health care. In 2016, the sheriff’s office in Fulton County, Ga., awarded a nearly $20-million contract for prison health care to a Tennessee-based private company called Correct Care, which subcontracted with Morehouse College’s medical school.

But beginning in August 2017, five inmates died within a 75-day period in the jail, The Atlanta Journal-Constitution reported. First, three people recovering from opioid addiction killed themselves in short succession. Authorities said medical-intake officials should have been prepared for the inmates to have psychiatric struggles and potentially be a danger to themselves. Soon after, a woman who was in jail for violating probation on a drug conviction complained of pain and trouble breathing. She was later found lying on the floor, naked, unresponsive to a nurse’s question — but the nurse walked out and said there were no medical concerns beyond mental-health problems. Within minutes, the woman was dead. Finally, days later, a diabetic man with exceptionally high glucose levels died after Morehouse officials failed to give him his prescribed insulin. As a result of the spate of deaths, Fulton County declined to renew the contract. “Morehouse is not qualified to do any of this,” Fulton’s chief jailer said, according to the Journal-Constitution.

Some universities have found novel ways to cash in on prison health care. In 1998, the University of Massachusetts Chan Medical School began providing mental-health services to the state Department of Corrections. “Movement into correctional health care makes fiscal sense for medical schools,” two UMass staff members explained in a 2002 paper in Psychiatric Services, co-written with a corrections staff member. “The medical school benefits by building its revenue base.” Making good on this promise, UMass has pioneered a different model — it operates a consulting division, now called ForHealth Consulting, with more than 400 contracts and 1,100 employees in more than 25 states. Since 1999, ForHealth has been working with the Bureau of Prisons (BOP), and one of its projects, since 2012, is acting as a third-party administrator managing comprehensive medical services for about 5,500 inmates at a federal prison in Butner, N.C.

In September 2023, an NPR investigation found that one in four inmates who die in the country’s 120-plus federal prisons do so at Butner. Because the prison has a hospital and the largest cancer-treatment facility in the country, terminally ill inmates are routinely routed there. But the high mortality rate might not be only a matter of size. A 2022 Justice Department audit of UMass’s contracts with Butner and prisons in Massachusetts and New York — totaling more than $300 million — found that the BOP personnel there “did not have a reliable, consistent process in place to evaluate timeliness or quality of inmate health care.” In addition, the BOP kept shoddy records at UMass prisons, bought equipment without open competitions, and went beyond its authority in approving invoices. “We believe it is difficult for the BOP to determine whether inmates are receiving care within the required community standard,” the report added.

As a for-profit company, ForHealth isn’t required to disclose its clients or financial records, despite being closely associated with a public university. In an email, a spokesperson told The Chronicle: “Our history, background, and milestones as part of UMass Chan Medical School are available via our website. Our clients and partners include health-care and human-service organizations in states across the country and our annual revenue contributes to UMass Chan’s mission.”

A few years ago, Glenn and several other academic health experts nationwide decided they had seen enough. They were particularly disturbed by reports of shackling incarcerated women while they gave birth. No laws mandate such a thing, but prisons and jails have significant leeway to tell medical personnel that it’s done for safety reasons, usually with little pushback. Similarly, prisons and jails often prohibit academic medical centers from contacting the family members of inmates facing important medical situations.

Glenn and others started drafting a Patients’ Bill of Rights that outlines to prisoners the minimum care they are entitled to receive and explains to academic medical centers the laws in different states and their obligations to the inmates under their care. “All the ethical obligations that medical providers have to patients do not cease just because those patients are under the jurisdiction of any given state’s department of corrections,” Glenn says. The bill is meant to be an open-source resource that details academic institutions’ authority when dealing with correctional institutions — an authority they don’t always understand. Glenn presented a paper on the bill at the 2023 conference of the Academic Consortium on Criminal Justice Health in Raleigh, and the document is currently being finalized.

Some of the experts interviewed for this story caution that, even though the model is unproven or flawed, academic-correctional health partnerships have the potential to improve the woeful state of American prison health care. “Many academic health-science centers consider their role as not just providing high-quality care for people who have means, but to also ensure that there is health equity in providing health care and quality health care to all populations who are at risk. And that’s inclusive of people who are incarcerated or people who are involved in the legal system,” says Ferguson, of UMass’s Chan Medical School. He says that while universities generate revenue from partnering with prisons, the programs are also costly and require a lot of infrastructure development. Newton Kendig, a clinical professor of medicine at George Washington University, says that academic centers can offer benefits, providing incarcerated patients access to telehealth subspecialty care services that are not otherwise available in many rural settings.

At this point, however, scant research supports the notion that these programs can significantly improve upon state-run correctional agencies. The experiences of the systems in Texas, New Jersey, and Connecticut do not bolster claims by universities that they are able to provide high-quality care to inmates. Indeed, they raise questions about whether universities can change the status quo at all — or whether they merely become complicit in a negligent system. As Dickert, UCHC’s former chief operating officer, has said, “We’re guests in the DOC’s house, and we conduct ourselves accordingly.”

This story was produced with the assistance of Freelance Investigative Reporters and Editors and co-published and supported by the Economic Hardship Reporting Project, two journalism nonprofits.