The Iowa Department of Corrections announced Friday that it is no longer pursuing privatization of medical care in the state’s prisons, according to two current medical employees and Todd Copley, a local union president.
In an afternoon Zoom meeting led by Beth Skinner, the director of the Iowa Department of Corrections, employees were told the department accepted no proposals following a competitive bid process, and there are no plans to move forward with privatization. It is not yet known which companies submitted bids or what the bids included.
An employee present at the meeting told The Midwest Newsroom that a private contract to update the electronic medical records system may still be pursued. The employee also said no public announcement from the DOC about the decision is planned. The Midwest Newsroom is not naming the employee because they were not authorized to talk to the media about internal communication.
Medical employees and inmates have been awaiting a privatization decision since July, when the state first announced plans to explore privatizing prison health care. The state said rising costs and the need for updated electronic medical records were driving the move, according to an email to The Gazette.
For workers, their state retirement plans, benefits and even their jobs were at stake, according to the request for proposals. Multiple prison medical employees told The Midwest Newsroom that inmates stood to lose familiar caregivers and continuity of care if privatization was approved.
“Everybody was just sick to their stomach” walking into the meeting today, said one medical employee at the Iowa Medical and Classification Center in Coralville, who asked to remain anonymous because the discussion was internal. “We were all expecting the worst.”
The Iowa Department of Corrections did not respond to multiple requests for comment or confirmation late Friday.
The same employee said there is a big sense of relief among the staff, but said “we were just pissed that we all had to go through this for so long, and that there really wasn't any words exchanged between a lot of people.”
Not all employees waited for a decision. More than 60 of approximately 300 employees in Iowa’s prison medical care system resigned, according to two internal Iowa Department of Corrections staffing reports reviewed by The Midwest Newsroom.
Many left for other state employment to ensure their state retirement plans and other benefits were preserved, according to three current staffers.
“I know there's several nurses that left that are probably going to want their jobs back,” the Iowa Medical and Classification Center employee said after Friday’s decision.
One of the documents reviewed by The Midwest Newsroom showed that at least 40 health care workers have resigned from the Iowa Medical and Classification Center in Coralville, the state’s main intake and medical screening prison, since the request for proposals was announced in July.
A nurse at the facility, who asked to remain anonymous due to fear of retaliation, told the Midwest Newsroom before today’s decision that staying in her job has been overwhelming. She is one of 15 full-time registered nurses left to care for a prison population of 915 individuals, despite a capacity of only 585, according to the request for proposal.
The nurse said she has been mandated to work extra shifts, nurses are not taking breaks and prison officers are being trained to distribute pills to inmates as staff resignations have continued.
Medical providers inside Iowa prisons work in high-risk environments, with some carrying handcuffs and pepper spray. In 2021, a nurse and a corrections officer were murdered at the Anamosa State Penitentiary during an escape attempt.
“It’s not a job that people can just come off the street and work,” said Copley, president of American Federation of State, County and Municipal Employees Council 61, a public employee union representing workers in Iowa, Missouri and Kansas.
Over the past few months, the union has held press conferences, hosted rallies and talked to the media about the impacts of privatization.
“It was a team effort to try and bring to the forefront to the public just how bad of an idea this is,” Copley said after hearing that privatization was no longer in the works. “I'm overwhelmed, overjoyed.”
The Department of Corrections also cited a need for updated electronic management records systems and for managing the overall costs of care in the request for proposals. It currently costs the state roughly $57 million to provide inmate medical care, according to an addendum to the request for proposals.
The Department of Corrections did not respond to questions about how much hiring a private provider would have cost or whether cost was a factor in the decision not to privatize. Copley told The Midwest Newsroom that bids came in at over $100 million, about double the current costs to provide health care to prisoners.
He said that the extra costs could have ultimately fallen on taxpayers, as could any lawsuits brought by inmates alleging inadequate care. Investigations by Reuters and the Prison Policy Initiative show that liability claims and neglect lawsuits can increase when prison health care is outsourced to private vendors. There are already 15 active lawsuits against the department in Iowa listed in an RFP addendum.
With the risks and sensitivity surrounding the treatment of prisoners, Copley and other prison medical employees said they thought they deserved to be part of the conversation to seek privatization.
Instead, they said there was little communication from DOC administrative staff, and now the DOC is even more understaffed.
The Midwest Newsroom is an investigative and enterprise journalism collaboration that includes Iowa Public Radio, KCUR, Nebraska Public Media, St. Louis Public Radio and NPR.
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METHODS
To report this story, journalist Naomi Delkamiller interviewed five current and former Iowa Department of Corrections employees to learn about the current staffing levels and their impact on morale and inmate care. She reviewed the two internal staffing reports sent to the Midwest Newsroom, employee emails and FOIA receipts. She also spoke to two union members to understand how the decision to seek privatization affects workers and reached out to IPERS officials to understand what benefits current employees will lose. Delkamiller also reviewed the 130-page request for proposal, along with 16 addenda. She reached out to the Department of Corrections multiple times for comment via email, but did not hear back.
REFERENCES
005-RFP-1926-2025 Correctional Medical Services Request for Proposal (Iowa Department of Administrative Services (DAS) on behalf of the Iowa Department of Corrections (IDOC) | July 9, 2025)
005-RFP-1926-2025 Addendum 2 (Iowa Department of Administrative Services (DAS) | August 8, 2025)
005-RFP-1926-2025 Addendum 11 (Iowa Department of Administrative Services (DAS) | September 5, 2025)
005-RFP-1926-2025 Addendum 12 (Iowa Department of Administrative Services (DAS) | September 5, 2025)
Iowa prison system considering farming out health care positions, DOC email says (The Gazette | July 7, 2021)
State considering hiring private company to provide health care in Iowa prison system (Iowa Capital Dispatch | July 8, 2025)
An Act of 'Pure Evil': Anamosa Inmates Face Multiple Charges For Killing Two Staffers During Escape Attempt (Iowa Public Radio | March 24, 2021)
U.S. jails are outsourcing medical care — and the death toll is rising (Reuters | October 26, 2020)
Cut-rate care: The systemic problems shaping 'healthcare' behind bars (Prison Policy Initiative | February 2025)
TYPE OF ARTICLE
News — Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources.
