by Michael Dean Thompson

Centurion of Delaware, a former prison healthcare contractor for the state, is the subject of a whistleblower lawsuit that has been joined by the state’s Attorney General, Kathy Jennings (D). The lawsuit alleges that Centurion of Delaware profited from fraud as it was paid hundreds of millions of dollars for healthcare and drug treatment. Furthermore, the care they provided was so deficient as to cause undue suffering, which included maiming and neglect.

But the state also failed to notice the suffering of those in its charge until it was too late. Delaware’s Division of Legislative Services (DLS) was tasked with looking into the state’s oversight committee to understand how such problems might be unearthed or missed altogether. The May 2026 Staff Report provided by DLS determined, “Delaware lacks a health care oversight system with the independence, structure, and data-driven processes needed to identify systemic issues and support meaningful improvement.” The report shows that the committee has all but abdicated its oversight responsibilities.

The Adult Correction Healthcare Review Committee (ACHRC) was created in 2008 with the goal of ensuring “prisoners receive quality care while recognizing that untreated diseases could have outsized impacts both within the prisons and communities to which the incarcerated people eventually return.” The legislature was responding to pressure from carcerally-impacted families and trying to solve a problem that came to light in 2006. That year, the Civil Rights Division of the U.S. Department of Justice (DOJ) found significant problems in the Delaware Department of Corrections’ (DOC) medical and mental health services. The federal intervention forced the state to enter an 87-point Memorandum of Agreement, from which they were released in 2012, after reforms were implemented.

The DOJ investigation had itself followed a six-month investigation by The News Journal. That investigation revealed numerous horror stories, including one of a prisoner named Anthony Pierce. Pierce was suffering from a brain tumor that was so large, fellow prisoners called him the “Brother with Two Heads.”

The ACHRC advises the governor, General Assembly and the Commissioner of the DOC about healthcare services and reviews the statistics arising from those services. They likewise review prisoner deaths and related autopsies. Nine unpaid members serve on the committee, including a Delaware licensed physician, forensic psychologist, psychologist, registered nurse, psychiatrist and a correctional healthcare specialist. The team is rounded off by a substance abuse treatment expert, member of the Delaware Bar, and a representative of the prisoners or a local civil rights organization. There are three additional non-voting members: the Chief of the Bureau of Healthcare, Substance Abuse, and Mental Health Services, Chairperson of the House Corrections Committee and the Chairperson of the Senate Corrections and Public Safety Committee. The voting members are appointed by the governor and confirmed by the Senate to serve three-year terms.

ACHRC is statutorily, however, solely an advisory committee. It can review the process by which grievances are handled and track infectious diseases. Accordingly, it can also compel documents from both the DOC and its current healthcare providers. And in the case of a serious failure, it can also refer providers to licensing boards. But it cannot initiate change in the DOC or the DOC’s contractor.

In reviewing grievances, the ACHRC is directed to “receive and review monthly summaries of inmate, staff, public, and other health-care related grievances and the resolutions of these grievances in order to be fully apprised of the state of health-care services.” Yet, that is not happening and the pattern of overlooking oversight opportunities repeats itself in almost every place.

When DLS looked at meeting notes, they found the committee was only receiving verbal summaries of numbers with no breakdowns of the details. Just one meeting identified categories of Step 3 grievance concerns: insufficient care, delays in consultations and unmet equipment needs. No attempt was made during that meeting to elucidate the categories and outcomes, nor did they provide or request a follow-up. Likewise, the committee does not routinely identify trends at the facility level or provide any root-cause analysis. In fact, it does not appear the committee performs any meaningful oversight of the grievances. Their annual meeting reports show very little variance, and zero “detailed data, longitudinal analysis, or evidence of sustained monitoring.”

Absent the appropriate analyses, DLS concluded ACHRC’s current approach could not identify systemic issues, verify grievance resolution, or create recommendations for healthcare service provisions based on factual analysis.

The failure to meaningfully examine grievance processes comes despite the DOC having procedures in place to do so. Audits, trend analyses, and reporting mechanisms intended to find problems and support solutions are available. But the committee has not integrated those systems. Sadly, it was not even clear to DLS’s analysts whether the committee even knew the systems were available.

Much like the failure to meaningfully analyze grievance data, it is also unclear that they receive information about or are aware of the other policies that impact the ability of incarcerated persons to access medical care. The committee appears to focus on mortality and critical incident reviews. Yet, they may not be aware of critical, available report documentation available from medical and mental health leadership.

According to DLS, the committee lacked a structured approach that would enable it to constantly detect problems or recurring problems. The report points out, “Case discussions appear to occur primarily on an individual high-level basis, without clear mechanisms to document, track, or aggregate findings over time.”

Neither does the committee conduct broader, systems-level assessments. This includes rarely performing crucial site visits, direct observation of care, routine contractor engagement, or review of accreditation surveys.

In one case in November of 2022, the ACHRC committee voted and agreed to review quarterly sick-call timeliness reports. The 2022 annual report indicates the DOC had begun sending in quarterly data, including sick-call response times. The data was derived from routine audits that showed a 90% compliance with policy (though DLS did not explain what that number meant). The April 2023 meeting minutes show that ACHRC reviewed the July-September 2022 quarterly report, but neither the meeting minutes or annual reports ever mention the data again. There is no documentation of where analysis of results, identified trends or follow-up actions were presented at meetings.

Although one of the explicit statutory duties is to participate in the “construction of health-care contracts that provide health-care services,” DLS was unable to identify a formal process in which the committee participates in the process or even offers feedback. Nor does the DOC ask for ACHRC’s advice. While the committee spends its time almost exclusively focusing on deaths and struggling to receive timely autopsy reports, it is surprising they have taken so little interest in this aspect of their duties. Active engagement in healthcare-related contracts would allow them to influence which metrics are collected and how those metrics impact whether contracts, such as those covering autopsy service provisions, should be extended, renegotiated, or rebid through a competitive Request for Proposal process.

The committee has accordingly completely ignored its role in “monitoring the quality and appropriateness of contracted health-care services.” In each of the contracts since ACHRC was established (seven in all, including separate contracts for behavioral healthcare in two cases), vendors have experienced “recurring operational, clinical, and legal challenges.” Yet, there was no consistent evidence that ACHRC systematically aggregated data gained from the litigation, external investigations, or contractor performance issues.

The DLS report includes copies of ACHRC’s annual reports for the previous six years, which state Rep. Melanie Ross Levin (D-Talleyville) called “pretty much cut and paste every year.” The News Journal points out that ACHRC’s website has not been updated since 2019. In addition, it has incorrect information, does not publish any recent annual reports there and there is no place for the public to comment.

Rep. Ross Levin said in a May legislative hearing that the report shows a gap between what ACHRC is “supposed to do and what they’re actually doing.” The result is that people incarcerated in Delaware are a “vulnerable population at severe risk.” She added, “We must be able to identify the problems before people are harmed. And we know people are being harmed, and we need to do better.”

ACHRC members are unpaid for their immediate services, and this may be a big part of the problem. They have very little staff support yet the breadth of their responsibilities is demanding. But, as the executive director of the Criminal Justice Council, Christian Kervick, pointed out to lawmakers, “oversight” was not used in the law that created the ACHRC committee. It is only intended to provide advice. He said, “I don’t disagree that changes need to happen. We oftentimes get committees that have no teeth.”

Meanwhile, it appears that there has been some conflict of interest at play. Dr. Laura Cooney-Koss is the owner of Forensic Associates of Delaware. She is also the Chair of the committee. In the role of forensic psychologist, she has represented the DOC as an expert witness against Delaware prisoners. She received $20,000 for that work, but told The News Journal in a series of emails that no conflict exists. Despite her argument that she only reviewed the psychological analysis conducted by experts for the prisoners, voting members such as her are not allowed to be DOC staffers or contractors.

Lawmakers are considering reforms. Legislators voted on recommendations to reformat the committee so that it is more in line with its intended oversight duties. But those were also advisory and await a report on potential reforms and law changes for the next legislative session in January 2027.  

Sources: Delaware May 2026 Staff Report, The News Journal

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