People in Massachusetts Prisons Say For-Profit Medical Company Leaves Them Without Teeth

Allen Freda entered the Massachusetts prison system in 2017 while in his mid-50s, with a full set of dentures and unable to hear in his right ear.

Shortly after he arrived, officers took him to “the hole,” where he’d stay for the next several years—locked in his cell 23 hours a day, he told The Appeal.

The night that officers took him to segregation, he had left his bottom dentures in a cleansing cup, he said. He didn’t have a chance to put them in before he was moved and it appears the officers never packed them. He hasn’t had them since.

“I’ve been fighting since 2017 to try and have them make me new dentures,” said Freda, who’s now 62. “It’s not just the dental, it’s the medical. It’s this company called Wellpath. Ever since they’ve taken over medical, it’s been a nightmare.”

Freda’s experience is indicative of widespread neglect of prisoners’ healthcare needs in Massachusetts, say advocates. Wellpath, which is owned by private equity firm H.I.G. Capital, provides the state’s prisoners with health services, including dental, medical, and mental care. But Wellpath’s critics say the company puts profits above patients’ needs. Advocates hope the Massachusetts Department of Correction (MADOC) will finally cut ties with the company when the contract expires next year. The contract was initially going to expire this summer, but in February, MADOC renewed it for another year.

MADOC defended Wellpath’s care in its statement to The Appeal.

“The Department’s independent medical provider, Wellpath, provides a comprehensive dental program to those entrusted to our care,” MADOC said. Wellpath did not respond to requests for comment.

But that has not been Freda’s experience. He told The Appeal he repeatedly asked for replacement dentures, but his requests were denied. Initially, the dentist asked if he could wait until he got home to get dentures.

“I said, ‘There’s no way I’m gonna wait eight to 12 years to get teeth,’” he said. “I did it like every six month, I would request it … They just kept denying me and every time they would make a different excuse.”

Because he’s gone without dentures for so many years, the shape of his face has changed, he said.

“My jaw has no muscle,” Freda said.

Wellpath’s care has long been under scrutiny in Massachusetts. In December, the U.S. Department of Justice entered into a settlement agreement with MADOC, which mandates that MADOC make a number of changes to its mental-healthcare system, including increased contact between mental health staff and prisoners who are in crisis. The DOJ investigation revealed that people with severe mental illness were left in isolation and denied adequate care.

Paul Carmichael, who is incarcerated at MCI-Shirley, told The Appeal that prisoners’ mental health needs are largely ignored until they’re decompensating.

“[When] they start throwing urine and smearing feces all over their cell and doing stuff like that, then they say, ‘Oh, this guy, he’s going crazy, then you get mental-health [care],” he said. “I’ve been putting in to see mental health for over eight years. Once in a while I see them.” Carmichael told The Appeal that he’s also struggled to receive dental care and that PLS has advocated on his behalf.

Disability Law Center, a nonprofit legal aid group that the governor tasked with monitoring facilities in Massachusetts that treat people with disabilities, also recently sounded the alarm about MADOC and Wellpath’s practices. In a report released last year on Bridgewater State Hospital (BSH), the nonprofit found that “Wellpath uses force daily on [persons served] at BSH in the form of manual holds and other physical restraints.”

The group concluded that “the promise of optimal services under Wellpath, while encouraging at first, has not been realized[.]” Additionally, the report stated that people leave BSH “without receiving meaningful access to mental health programming and burdened by new traumatic experiences.” Disability Law Center recommended that the state transfer oversight of BSH from MADOC to the Department of Mental Health and construct a new hospital.

According to a survey by Deeper Than Water, a coalition that advocates for the state to drop Wellpath and deprivatize the prison healthcare system, numerous people reported that they have been denied adequate dental care. The group surveyed 141 Massachusetts prisoners, mostly at MCI-Norfolk and published its initial results last year.

About 43 percent of respondents said they had experienced tooth deterioration due to lack of treatment, and about 26 percent had requested a dentist but been ignored. More than 45 percent reported that they had teeth pulled that could have been repaired. Close to 80 percent of survey respondents reported that they had had an obvious medical condition ignored by medical staff.

“Wellpath is by far the worst medical provider I’ve seen in my 38+ years of incarceration,” wrote one respondent. “Wellpath is focused on profits, not the health and well-being of prisoners.”

Without his bottom teeth, Allen Freda said he’s unable to chew “anything crunchy” and has developed digestive problems. Most of the food they’re served is “mush,” but anything that isn’t, he crushes with a utensil.

His diet is even further restricted because he can’t purchase items from the commissary until he pays a $49.95 restitution fee for “misuse or waste of issued supplies, goods, services, or property” after he reported that he had lost a watch MADOC had provided to him, according to a disciplinary report. He’s been losing his hearing in his left ear since he was attacked by more than a dozen officers in 2020, according to a lawsuit he filed earlier this year. MADOC had given him a vibrating watch to help him follow the prison’s schedule because he cannot hear announcements.

Freda said now that he’s at MCI-Norfolk, a medium-security prison where he can interact with others, he feels self-conscious about his appearance.

“I usually grow my beard out to try and hide the structure of my jaw,” he said. “The beard sort of makes it look like I still have jaw muscles, but it’s sort of embarrassing.”

William Soper, who is incarcerated in Massachusetts, says he has also struggled to receive adequate dental care. In 2021, he broke his front tooth when he bit into his food, according to a letter PLS sent to MADOC on his behalf. Even though a dentist then recommended a removable prosthetic tooth that’s known as a “flipper,” his request was denied because he was not within six months of his release date, as required by both MADOC and Wellpath policies.

“Having me walk around without a front tooth, that’s embarrassing,” he told The Appeal in a phone interview.

MADOC and Wellpath policies limit who can receive dentures. MADOC’s dental policy on “Case-by-Case Elective Care” states that people will be considered for flippers only if they are within six months of their release date, unless the prosthetics are necessary for “mastication or function,” in which case they can be provided at any time. (Flippers are provided at the medical contractor’s expense.) The policy also states that root canals and the capping or crowning of teeth are to be provided “on a limited, case-by-case basis.”

The Appeal asked MADOC for the number of requests and denials for prosthetics in 2022. The agency said it did not keep those records and directed The Appeal to Wellpath.

Elizabeth Matos, the executive director of PLS, told The Appeal the policy on flippers is “detrimental” to people’s physical and mental health and “impedes people’s ability to eat properly.”

Now, with Wellpath’s contract set to expire next year, advocates are demanding that MADOC finally change course and prioritize the health of incarcerated people. Matos says the state should stop outsourcing healthcare to private corporations like Wellpath and instead rely more on providers in the surrounding communities who would treat incarcerated patients “more humanely.”

“Most things could and should be done outside of the carceral system,” she said.

But for Freda, any potential reforms may come too late.

“It’s really, really discouraging when all it would have taken was a half-hour [to make a] new mold back in 2017,” he said. “Now it’s way past that.”