Questions Mount Over Delayed Monroe County Jail Medical Inquiry

A dispute over Monroe County's failure to investigate its jail medical provider has intensified after Legislature President Yversha Román acknowledged that she knew about a state directive calling for an inquiry in January but decided the Legislature should wait before acting.

The 2023 death of 62-year-old Brian Harmon at the Monroe County Jail was deemed preventable by the NYS Commission of Correction

County Legislator Rachel Barnhart says Román's written explanation confirms that the state-directed inquiry into PrimeCare Medical of New York did not simply fall through the cracks. Instead, Barnhart contends, Román made a decision not to initiate it without informing other members of the Legislature.

The dispute stems from a New York State Commission of Correction investigation into the 2023 death of 62-year-old Brian Harmon at the Monroe County Jail.

The Commission concluded Harmon's death from sepsis resulting from a urinary obstruction was preventable and identified multiple missed opportunities to intervene in his deteriorating medical condition. PrimeCare provides medical and mental health services inside the jail.

As part of its December 2025 report, the Commission directed the Monroe County Legislature to review its findings and conduct an inquiry into PrimeCare's fitness to continue providing medical services at the jail.

Eight months later, no such inquiry has been conducted.

In a written response to legislators, Román acknowledged that she became aware of the Commission's "Actions Required" directive in January.

Román said she believed the Legislature should wait until the Commission completed additional follow-up concerning corrective actions identified in its report.

"It was my opinion that no review or inquiry should occur until that information and review are completed and provided," Román wrote.

Román has said the state report was sent to her Gmail account in mid-December and that she began reviewing the material in January. She has also cited questions about the Legislature's authority, the absence of a deadline, the need for additional information and concerns surrounding confidential medical information as reasons for not immediately proceeding with the inquiry.

She said she wanted the Legislature's response to be grounded in law, proper legislative procedure and sufficient information.

But Barnhart argues that Román's latest explanation establishes something significant: the Legislature's failure to act was not merely an administrative oversight.

"President Román's response confirms that this directive did not simply fall through the cracks," Barnhart said. "She knew about it in January and made a decision that the Legislature should not act. But the directive was addressed to the Legislature, and the investigative authority in the County Charter belongs to the Legislature. This was not a decision for one person to make."

Barnhart argues that regardless of Román's reasons for wanting to delay the inquiry, the full Legislature should have been informed and allowed to decide how to respond to the state's directive.

One of Román's central explanations has also been challenged by the state.

The New York State Commission of Correction said its recommendations to the Legislature were not dependent upon the Commission completing other actions first.

"The report clearly identifies the actions necessary to address its findings, and the recommendations directed to the Legislature were not contingent upon any other actions occurring first," the state told News 8 WROC.

The state further noted that because decisions involving the hiring, retention or termination of the county's medical provider fall within county authority, the Legislature's review would be relevant to those decisions.

That response appears to undermine the argument that lawmakers needed to wait for the Commission to complete additional work before beginning their own inquiry.

However, the Commission did not establish a deadline for Monroe County to conduct the review. A Commission spokesperson has also said there is no automatic penalty if the Legislature fails to act. The state would have to seek a court injunction to compel compliance.

Another issue is why the remaining members of the 29-member Legislature were not informed that the state had directed their body to investigate PrimeCare.

Most legislators apparently did not learn about the directive until this summer, after Harmon's son filed a federal lawsuit over his father's death and the issue became public.

Barnhart argues that concerns over medical confidentiality did not prevent Román from simply informing lawmakers that the directive existed.

"The need for more information was a reason to begin an inquiry, not a reason to postpone one," Barnhart said. "And concerns about confidential medical information did not prevent the President from telling legislators that our body had been directed to act."

Republicans in the Legislature have also criticized Román's handling of the matter.

Republican Conference Leader Sean McCabe previously accused Román of making decisions while keeping the Legislature "in the dark" and questioned whether her handling of the directive reflected the judgment expected of the Legislature's president.

The criticism therefore crosses party lines, with Barnhart, a Democrat, joining Republican legislators in questioning Román's handling of the matter.

PrimeCare Contract Renewed While Inquiry Remained Dormant

Adding to the controversy is what happened while legislators remained unaware of the state directive.

PrimeCare's contract was renewed Feb. 4 for another year at an estimated cost of $13.6 million. The extension allows the company to continue providing medical services at the Monroe County Jail through January 2027.

The renewal occurred roughly one month after Román says she became aware of the state's directive to examine PrimeCare's fitness.

Román has said the Legislature did not participate in the decision to extend the contract and that she wants clarification about how the renewal occurred.

The contract structure allowed the Sheriff's Office to exercise an extension without another vote by the full Legislature.

That leaves an important distinction in the controversy: Román did not personally renew PrimeCare's contract. But the Legislature also did not conduct the state-requested fitness review before the county extended the company's agreement.

Barnhart says that sequence should concern lawmakers.

"The most troubling thing about President Román's response is what it never acknowledges," Barnhart said. "She doesn't say legislators should have been told. She doesn't express concern that PrimeCare was renewed before we examined its fitness. And she doesn't acknowledge that her decision deprived the rest of us of the opportunity to exercise our own responsibilities."

The controversy also comes amid evidence that complaints about PrimeCare's care at the jail extend beyond Harmon's death.

A WXXI review of federal court records found at least 10 lawsuits filed since 2019 involving PrimeCare's operations at the Monroe County Jail. Allegations have included failure to provide medication, incorrect insulin doses and inadequate treatment of serious medical conditions.

The lawsuits contain allegations that have not necessarily been proven in court, and their existence does not by itself establish wrongdoing by PrimeCare.

Sheriff Todd Baxter previously defended the provider. In March 2025, Baxter said his department was "pretty happy" with PrimeCare while acknowledging the company had not performed perfectly. He said the contract was reevaluated before renewal and that an outside auditor conducted spot checks.

PrimeCare terminated three medical employees following Harmon's death, according to the state investigation.

The developing controversy now raises questions extending beyond Román's handling of the state directive.

The Commission's report was sent not only to Román but also to the Monroe County Sheriff's Office, according to News 8 reporting.

That raises another potentially significant question: What did county officials responsible for renewing PrimeCare's contract know about the state's findings before the Feb. 4 extension was approved?

The Sheriff's Office has declined to discuss the matter, citing pending litigation.

Román, meanwhile, said she did not begin consulting with the County Law Department about the PrimeCare matter until Aug. 13, according to the account she provided to legislators.

Barnhart argues that the Legislature already possessed broad investigative authority under the Monroe County Charter, including the ability to seek records, obtain professional assistance and compel testimony.

She is now calling for the PrimeCare fitness inquiry to begin immediately and for it to be conducted independently, outside Román's authority or management.

"This is now bigger than PrimeCare," Barnhart said. "We need to determine whether PrimeCare is fit to continue providing medical care in our jail, but we also need to restore the Legislature's ability to exercise its own oversight authority. The public needs to have confidence that this review is independent and credible."

The controversy has consequently expanded beyond questions about the quality of medical care inside the Monroe County Jail.

It now encompasses the county's system of checks and balances: who receives state findings involving deaths in county custody, who must be informed, who has authority to decide whether the Legislature investigates, and whether a county contractor should be renewed before questions about its fitness have been examined.

For Monroe County lawmakers, those questions may ultimately prove as consequential as the investigation into PrimeCare itself.