Community Government Health & Wellness Police & Fire

Kitsap County, jail medical provider to pay family of deceased inmate $2.75 million

John and Judith Rapp were shocked when they heard that police had booked their 34-year-old son, Nick, into jail. Kitsap County Sheriff’s deputies arrested him at 10 p.m. on Dec. 31, 2019, after an argument with his partner escalated into a “potential domestic violence situation.”

Nick – who had never before been arrested – was in a fragile condition. His partner and mother of his child, fearing for his safety, had brought him to her home that night, according to court records. He arrived intoxicated and expressing suicidal ideations.

John and Judith were also worried, but found comfort knowing he was being held by the jail.

“I remember feeling he’s not in a good place right now. He’s very depressed, but at least if he’s in jail he’s safe,” Judith recalled. “I remember us talking about that,” John added. “We had a fair amount of confidence that [they] would get it right.”

Family sued following death

After less than three days at the Kitsap County Jail, on afternoon of Jan. 2, 2020, Nick attempted suicide inside his cell. Doctors took him off life support four days later. Asphyxiation and a “hypoxic ischemic” brain injury caused his death, according to a lawsuit filed by the Rapp family in U.S. District Court in 2021.

That lawsuit reached its conclusion last month. Kitsap County and its contractor NaphCare, an Alabama-based jail medical provider, agreed to pay the family $2.75 million to settle the lawsuit that accused them of negligence contributing to Nick’s death.

Naphcare will pay $1.75 million of that settlement, with Kitsap County covering the remaining $1 million, according to Ryan Dreveskracht, the family’s attorney. Nick’s daughter, who is a minor, will receive 80% of the settlement. John and Judith will get 10% each.

Kevin McCarty, a spokesperson for the Kitsap County Sheriff’s Office, which runs the jail, declined to comment.

The city of Gig Harbor contracts with Kitsap County to house some misdemeanor suspects at the jail in Port Orchard.

Dana Jackson, director of communication for NaphCare, said in an email they were “saddened by the loss of Mr. Rapp and wish his family healing in moving forward.”

“Suicidality is a major concern within correctional facilities and one we take seriously,” she said. “NaphCare works every day to care for our patients during their most difficult moments, and we continue to work toward solutions to save lives.”

NapchCare dropping contracts in Washington state, but not Kitsap

Naphcare, which operates across the country, has been pulling out of Washington in the years since Nick’s death. 

Their declining presence comes after juries hit the company with two hefty penalties. A jury in 2022 ordered it to give almost $27 million to the family of a woman who died at the Spokane County Jail. Last year, another jury ordered the company pay $25 million to a Pierce County man whose foot was amputated following an untreated blood clot. 

By the end of 2026, NaphCare plans to operate in only two jails in the state, a spokesperson previously told the Kitsap Sun. That includes the Kitsap County Jail in Port Orchard. The county has agreed to pay the company $6.8 million this year and $8.6 million by 2029.

Dreveskracht, who was also involved in the Pierce County case against NaphCare, said the company profits off these contracts by cutting corners and offering minimal care, often resulting in individuals receiving substandard treatment. 

According to the lawsuit, NaphCare has been a defendant in more than 250 negligence and malpractice lawsuits. Three people, including Nick, died during the company’s first year working in the Kitsap jail due to failure to implement suicide prevention measures, documents allege. 

“The way they make money is by not providing care,” Dreveskracht said. “Everything not spent on health care goes into NaphCare’s pocket.”

Insurance issues for medical providers

NaphCare was the only company that bid on Kitsap County’s most-recent call for a jail medical provider. Federal law requires jails law to provide medical care to those in their custody. Insurance requirements significantly restrict which agencies can fulfill that need. 

Virtually no insurance companies are willing to provide medical malpractice coverage to medical agencies working in prisons or jails. Most companies that provide health care in carceral facilities are self-insured.

That means that only large corporations typically can bid on jail contracts. Kitsap County, for example, explored giving its jail medical contract to Peninsula Community Health Service, a federally qualified health center based in Kitsap County. 

“The problem is it is nearly impossible for community-based providers to obtain the necessary insurance to provide care in jails,” Brynn Felix, chief corporate affairs and legal officer for PCHS, said during a state committee meeting last year. “Many of us have tried and failed to obtain private insurance to provide care in jails.”

A person in crisis, treated with ‘indifference’

John and Judith Rapp, who have been married for more than 40 years, described their family as close. Even when Nick struggled with substance use, they rarely went a day without talking to him. When they were interviewed after their son’s death, Judith recalled that everyone seemed “shocked to learn he had a loving, stable family.” 

“They considered him an NHI, a no humans involved” Judith said, referring to a derogatory slang term popularized by law enforcement, “somebody not worth loving.”

They had a similar experience trying to find a lawyer to take their case. John, a lawyer who spent hours collecting records related to his son’s death, said they tried five or six law firms before Dreveskracht agreed to take their case. Some were nice, he said, others weren’t. They were told no “jury would care,” he said.

Judith and John trace many of their son’s struggles to a broken nose he sustained playing basketball before enrolling at The Evergreen State College in Olympia. It required two rounds of surgery and doctors prescribed Nick painkillers, starting a prolonged struggle with opioid use disorder.

Nick used heroin daily for about a decade and had numerous overdoses, according to court documents. He attempted suicide at least twice. Before his arrest, he was on and off medication-assisted treatment and wanted to get sober.

Judith said he had been doing well. He was staying at a sober-living facility and Silveardale and working, but was kicked out after relapsing. 

“The whole drug part is so hard. It’s unrelenting,” Judith said. “I don’t think people understand how hard it is to break that cycle.” 

Nick’s stay in the jail

After Nick was arrested on Dec. 31, 2019, his partner – who court documents describe as a nurse at the county jail employed by NaphCare – told sheriff’s deputies she was worried about him. She relayed to them he had expressed suicidal ideations and recently attempted suicide. Despite this, officers did not indicate Nick was struggling with his mental health, intoxicated or having thoughts of self-harm on his booking and arrest paperwork, documents allege.

A NaphCare nurse saw Nick four hours later, around 2 a.m. on Jan. 1. Nick informed her he was detoxing from multiple drugs, including heroin, meth and alcohol, and had previously received medication assisted treatment. Documents allege that nobody made any effort to secure his outside medical records.

Jail staff assigned Nick to the general unit, and to undergo withdrawal assessments for alcohol and opioids. They placed him on detox watch through Jan. 6. He was listed as not currently having thoughts of suicide or self harm. 

When Nick’s partner arrived for work around 7 a.m. on Jan. 2, she noticed he was not on suicide prevention protocol. She informed her superior about his condition and recent suicide attempt, according to court documents. This information was relayed to other employees and jail staff, who documents allege “chose to treat Nick with indifference” because of his “rumored assault on their coworker.” 

‘He was loved’

A NaphCare licensed practical nurse practitioner performed alcohol and opioid withdrawal assessments between 10:30 a.m. and 1 p.m., according to court documents. At no point did did she indicate on these assessment that Nick had “thoughts of self-harm of suicide.” 

Documents allege many of these forms were filled out at a nursing station, without the nurse actually interacting with Nick. An LPN with the same name as the one who treated Nick that day had her license suspended for five years in 2021 for presenting as a registered nurse and doctor without certification, according to online Washington state Department of Health records. 

Around 1:45 p.m. officers called for backup to Nick’s cell after finding him with no pulse. First responders arrived about 10 minutes later, and took Nick to Tacoma General Hospital. Doctors took him off life support on Jan. 6, 2020.

“He was loved,” Judith said of her son. “He was someone’s precious child. He had a daughter – a daughter he adored.”