Five months after a state board suspended the license of a doctor whose company has been under scrutiny for its role in the deaths of people held in jail, several Minnesota counties have taken steps to find a new jail medical provider.
MEnD Correctional Care contracts with dozens of counties in Minnesota and other Midwestern states to provide health care for people incarcerated in jails.
The Sartell, Minn.-based company, however, has faced allegations of failing to provide adequate care to inmates, including 27-year-old Hardel Sherrell, who died in 2018 in the Beltrami County jail after his pleas for help were ignored by jail and medical staff.
About a dozen counties including Anoka, Beltrami, Clay, Crow Wing, Clearwater, Mille Lacs, Morrison, Olmsted, St. Louis and Wright have changed providers or are exploring other options.
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Some cited issues with MEnD's services not having enough staffing. Others said they switched because they wanted to offer expanded health services to people in jail.
Sherburne County leaders this week agreed to drop MEnD for a different company.
The Minnesota Board of Medical Practice in January found that Dr. Todd Leonard, MEnD’s owner, demonstrated a willful or careless disregard for a patient’s health, welfare or safety in Sherrell’s case.
MEnD declined a request for an interview. In a statement sent by his attorney in January, Leonard said he was “profoundly saddened and disappointed” by the board’s decision.
“This death was a tragedy, but to my core I believe our care was appropriate, especially given the incredibly rare nature of this patient’s condition,” he stated.
Leonard also said the board’s decision is a judgment against him personally, not against MEnD or its employees.
According to the state medical board’s findings, MEnD hired a new corporate medical director in early 2021, and Leonard’s role in the company was limited to president and CEO.
‘Lives are at stake’
Nearly a dozen Minnesota counties told MPR News they are still contracting with MEnD, and don't have plans to switch.
“I do not see us changing medical providers unless someone else is willing to provide as good of service for less money,” Hubbard County Sheriff Cory Aukes said in an April 14 email to MPR News.
In other counties, leaders weighing other options cited dissatisfaction with MEnD’s services or concerns over Leonard’s recent licensing troubles. Others said they are looking to expand or improve health care for people in jail.
The Sherburne County board of commissioners voted Tuesday to contract with Nashville-based Wellpath LLC for health care services for inmates and immigration detainees in its jail. Sheriff Joel Brott declined to be interviewed about the change.
Last year, Sherburne County and MEnD agreed to pay $2.3 million to the family of James Lynas, who died by suicide in 2017 after spending nine days in the Sherburne County Jail.
The lawsuit alleged that Lynas reported having suicidal thoughts, but jail and MEnD staff did not promptly schedule him to see a mental health counselor or do thorough safety checks while he was in his cell.
An attorney with the law firm that represented the Lynas family said it’s surprising that more counties haven’t moved more quickly to end their contracts with MEnD in the wake of costly legal settlements.
“You pay for the care that you get,” said Katie Bennett with the firm Robins Kaplan. “If it’s bad care, you might pay out after, in the form of settlements or verdicts. Continuing on, knowing MEnD’s structure, is problematic, and it probably will be if they stay with them.”
St. Louis County has contracted with MEnD since 2012, but recently sought bids from other providers. Sheriff Ross Litman said the county was happy with MEnD’s services, but the contract automatically renews every year.
“I thought it was really prudent and reasonable to put out just to see what other services and proposals might be available,” Litman said. The county also is looking to expand the hours that nursing and mental health care are available, he said.
Litman said the county is considering three possible providers – MEnD, St. Luke’s health care system and Tennessee-based Advanced Correctional Healthcare. A contract likely will be brought to the board in August or September.
St. Louis County Commissioner Ashley Grimm has been pushing the board to consider ending its contract with MEnD.
Grimm wants to see the county contract with a nonprofit health care provider, such as St. Luke’s, to care for people in the jail. She’s skeptical of the for-profit model of health care for people incarcerated in jail, who have statistically higher rates of medical issues but the least amount of voice.
“I feel so strongly that we not only have to treat every person like they have human dignity, but also that we have to make sure that we don't end up having people die under our care,” she said.
Jamey Sharp worked for MEnD as a health technician for about six months in 2020 in the St. Louis County jail, where he was tasked with delivering medications to inmates.
Sharp said MEnD was growing rapidly and expanding into other counties, but there was not enough staff to address all of the problems that came up in the St. Louis County jail.
“The initial thing that I think was really surprising was people's concerns were not necessarily taken as seriously as they would have in other places I've worked,” said Sharp, who is co-chair of the criminal justice committee at the Duluth branch of the NAACP.
Inmates who complained of a medical problem were told to fill out a form, and typically didn’t get a response for two or three days, he said.
Sharp said he quit his job after reading about the wrongful death lawsuit filed by the family of Hardel Sherrell in Beltrami County, worried that something similar could happen in St. Louis County.
“I saw that the conditions were right, the structure was the same, that would create a case like that to get missed where I was working,” he said. “And I knew that I could not live with myself, if that happened to somebody under my care.”
Sharp also said he sees problems with the for-profit model for jail medical care.
“When you don't have people with the freedom to choose, and then you have companies with incentives to grow instead of provide proper care, without necessarily proper regulations (and) people keeping an eye on them, they're behind locked doors, it's a recipe for disaster,” he said.
‘On our radar for a while’
Other counties say they’d been considering looking for a new provider well before Leonard’s license was suspended.
“To be honest, it's been on our radar for a while,” said Heath Fosteson, jail administrator for Crow Wing County, which has used MEnD for 11 years but is now seeking bids from other firms and recently received a bid from Advanced Correctional Healthcare.
Factors, including concerns about MEnD’s staffing issues, played a role in seeking new bidders for the work, he added. “Of course, everything that's been played out in the media is also influencing decision making.”
Clearwater County switched from MEnD to Advanced Correctional Healthcare starting April. Sheriff Darin Halverson said he couldn’t comment on the specific reasons other than the county had some issues with staffing levels at MEnD.
“We'd been talking about it for a while and we just finally decided it was time to make a change,” he said.
Morrison County also decided to switch from MEnD to Advanced Correctional Healthcare, in part because it had more to offer for mental health services, Sheriff Shawn Larsen told MPR News in an email.
“Unfortunately every county deals with mental health and it is one of the biggest issues that we deal with in our jails across the nation,” Larsen wrote. “We felt Advanced Correctional Healthcare was a good fit for our facility.”
Earlier this year, Wright County decided to switch from MEnD and contract with CentraCare, a nonprofit health care provider that operates St. Cloud Hospital and several others in central Minnesota, beginning Oct. 1.
CentraCare has a correctional health division that serves other county jails, including Stearns County in St. Cloud.
The county didn’t experience any problems with MEnD but has been looking to provide improved health care for people while they’re in jail and continuing on after they’re released, said Pat O’Malley, the county’s jail administrator.
As a large health care system, CentraCare has resources that a private provider doesn’t, including a medication-assisted treatment program for opioid addiction, O’Malley added.
“This would have been a deal that I would have looked into, regardless of MEnD’s situation, simply because it provides the jail a lot more opportunity,” O’Malley said.
‘Stand for something’
After hearing testimony last July on the circumstances surrounding Sherrell’s death in the Beltrami County jail, Administrative Law Judge Ann O’Reilly concluded Leonard, MEnD’s owner, failed to meet minimal standards of acceptable medical practice by not getting Sherrell to the hospital or having his staff assess him and get his vital signs in the days before he died.
A medical examiner determined that Sherrell died of pneumonia and brain swelling. A private expert hired by Sherrell’s family determined he likely suffered from Guillain-Barre Syndrome, a rare autoimmune disorder that causes muscle weakness and sometimes paralysis.
“A tragedy like this should never have occurred,” O’Reilly wrote. “And it must never be allowed to happen again.”
The judge urged state authorities to scrutinize MEnD’s contracts with other Minnesota cities and counties.
After Sherrell’s death, his mother, Del Shea Perry, started a nonprofit called Be Their Voices to advocate for the health and safety of people in prisons and jails.
“These are somebody's sons and daughters out here, somebody's mom and father, and they are human beings,” she said. “They have a right to receive basic medical care.”
Last year, the Minnesota Legislature passed the Hardel Sherrell Act, which established minimum standards for medical care, mental health, suicide prevention and death reviews in jails and prisons. Gov. Tim Walz signed the bill into law in September.
Perry said she’s concerned that some counties don’t seem to be aware of the law’s passage or what it requires of them.
“The Hardel Sherrell Act can’t just be some words on a fancy document that mean absolutely nothing,” she said. “It has to stand for something.”