Community and union call for ending Wellpath contract after Mazars audit at Alameda County committee

A third-party quality assurance presenter told a joint meeting of Alameda County's Health and Public Protection Committees that inspections and chart reviews have shown persistent gaps in medical care documentation and follow-through at Santa Rita Jail, renewiting calls from community members and union representatives for the county to begin seeking alternatives to the current contractor, Wellpath.

Faith Sapor Santos of Mazars, the county's contracted medical quality reviewer, described the auditor's approach: monthly QA reviews of 15 of the most complex charts and CQI reviews of 30 or more randomly selected charts. She said the county narrowed its focus from 29 compliance indicators to the 10 most critical areas under national correctional health standards and that the QA data in early 2025 showed alarming shortfalls. "Governance compliance stayed at a low at 12 percent. Patient care and emergency response at 48 percent. Medical legal at 6 percent," she said.

Mazars explained it moved some underperforming areas to formal corrective action plans (CAPs) in 2024 and into 2025, and described the CAP roadmap: a 30-day vendor response with root-cause analysis, a resolution plan and proof-of-practice documentation, followed by independent review and verification. Faith Sapor Santos said some areas have shown measurable improvement in follow-up spot checks; initial health assessments and non-emergency sick-call responsiveness have improved and were marked as corrected, while access-to-care documentation and medically supervised withdrawal protocols remain partially or not corrected.

Wellpath's president of operations, Cole Casey, disputed portions of the Mazars analysis and pointed to documentation and systems issues that his team says undercount provider activity. "We have some concerns with the data and the methodology that Mazars does put together," Casey said, noting that multiple electronic systems and shared responsibility between medical and behavioral health can make consistent cross-system documentation difficult. Casey also highlighted contractual mechanics for staffing penalties and said Wellpath consistently provides hours above contracted levels.

Public comment at the meeting was strongly critical of Wellpath. Speakers who identified themselves as county residents, union representatives, clinicians and faith leaders urged the county to start the RFP process now and consider county-run or nonprofit alternatives. Several speakers cited litigation and investigative reporting about Wellpath's national record. "We have been made aware of several situations where medically necessary dental care was denied," said Mickey Duxbury of Stop Deaths and Harm, and one speaker cited a reported case in which a court found evidence was destroyed in litigation involving Wellpath.

Union representatives and clinicians at the meeting asked the county to ensure worker retention and to include frontline providers and formerly incarcerated people in any selection process. The National Union of Healthcare Workers clarified it does not partner with Wellpath and said its members have raised safety and staffing concerns to supervisors.

County health staff present said they are participating in oversight and will advise the sheriff on CAP review. Chair Supervisor Marquez said she plans a public listening session in July with Sheriff Sanchez and a reconvening of the joint committees in September to receive status updates on corrective actions. Because the item was listed as informational, no contract decisions were made.

Provenance: Mazars and ACSO presentations began with the third-party presenter and ran through the public comment period (Mazars presentation and QA discussion: SEG 577; public comment and closing: SEG 1618 through SEG 3056).