On August 18, the same day the Department of Justice announced it would seek to end its private prison contracts, an inmate died at a Corrections Corporation of America facility in Tennessee, where she was denied proper medical treatment after she was attacked by other inmates.

Although over 100 federal prisoners are incarcerated in the facility, the contract for the private prison where twenty-six year-old Madison Deal died may not be impacted by the DOJ’s directive. Deal’s story and other developments in the state illustrate the necessity of broader and more aggressive approaches to criminal justice reform than what President Barack Obama’s administration has put forward.

Deal turned herself in to the Hamilton County Jail on August 10 for a misdemeanor citation. According to a press release [PDF] put out by her lawyers, Deal was transferred to CCA’s Silverdale Detention Facilities because she failed to show up for three days of community service.

Deal told CCA nurses she had severe chest and head pain, and had been vomiting since the attack. They allegedly did little to treat her and her condition worsened with time. When Deal’s mother and her grandmother, who is a registered nurse, called Silverdale separately to plead for her care, CCA nurses hung up on them.

Deal was supposed to have a court date on August 17, but she collapsed at the prison. She was taken to the hospital “at some point” that day, her lawyers said. The following morning she died as news broke that the Justice Department would draw-down its agreements with private prison contractors.

The District Attorney’s office in the state has asked the sheriff of Hamilton County to open an investigation into Deal’s death.

According to the Times Free Press, the Hamilton County Sheriff’s office has a contract with the U.S. government to incarcerate around 120 federal prisoners, most of whom are being held at Silverdale. The county brings in $48.11 per federal prisoner each day.

However, CCA’s Silverdale contract may not be targeted for termination under the DOJ’s memo because, technically, the agreement is with Hamilton County.

In other words, because the federal government isn’t contracting with CCA directly, Silverdale may be exempt from the order. Mike Compton, chief of staff to the mayor, echoed this view.

CCA’s stock has only slightly rebounded since the announcement, yet the company shows no signs of slowing down. The Times Free Press reported officials are “looking at proposals from CCA and two other private operators, GEO Group Inc. and Emerald Companies, to build and operate a [new] 1,600-bed jail at the Silverdale site.”

Tennessee Governor Bill Haslam dismissed the DOJ memo, stating, “I think if you talk to Tony Parker, who’s our commissioner of corrections, he would say we provide supervision and oversight to private prisons just like we do to ours.”

There may be truth to Haslam’s statement, although not in the way he intended it. The day Deal died and the DOJ released its memo, The Nashville Scene published an article about sexual assault at the Tennessee Prison for Women. The authors recall that in May, a guard named Daniel Sievers had been fired after admitting to having sex with an inmate.

In interviews with Tennessee Department of Corrections (TDOC) staff, the inmate was asked if she “enjoyed it.”

Following the incident, the news organization received a letter from another inmate who said she had been sexually assaulted by Sievers. He wrote her love letters and snuck a Sprite bottle containing alcohol into the prison to get her drunk before raping her.

According to the report:

When investigators first interviewed the woman, she gave them a letter from Sievers, but did not reveal that the two had any sexual contact. In a subsequent interview, she says she told them about having sex with Sievers after investigators told her he had had sex with five other women in the facility.

“It was at that time that I realized I was the victim of a sexual predator,” the woman writes.

The woman says that during another follow-up interview, investigators asked whether she had an orgasm during sexual contact with Sievers.

No charges have been filed, and no arrests have been made in relation to Sievers’s conduct.

A class action lawsuit has been initiated against the TDOC by inmates with Hepatitis C, who say the state is denying them proper medical care. Brought by Disability Rights Tennessee, the lawsuit points to the high cost of effective Hepatitis drugs as the main motivation behind the state’s negligence.

Nearly 3,500 inmates have Hepatitis C in Tennessee prisons. Only eight receive proper treatment.

As of June 2015, the TDOC population was at 98.5 percent capacity. About 95 percent of all beds were filled. Under state law, the prison commissioner could ask the governor to declare an overcrowding emergency.

If an emergency is declared, some prisoners could be granted early probation by state and parole officials until capacity drops to 90 percent. However, both claimed no overcrowding emergency existed and declined to take action.

CCA is headquartered in Tennessee and operates eight facilities within the state. The company has contracts with various levels of government across the country, with facilities in at least nineteen other states.

The Silverdale contract was CCA’s first-ever, and the company has held it since 1984. Since then, Silverdale has accidentally released prisoners, failed inspections and more recently was garnered media attention for shackling pregnant prisoners.

Silverdale is not the only private prison in the state with problems. The Associated Press reported in 2015 that former prisoners from a CCA-operated prison under contract with the city of Nashville and Davidson County “worked without pay building bean-bag ‘cornhole’ games, plaques shaped like footballs, birdhouses, and dog beds so that [CCA] officials could sell them through their personal business at a flea market.”

Meanwhile, privatization is flourishing within TDOC prisons. The department recently disqualified one of the two bidders for the state’s prison food contract, and the remaining bidder, Aramark, will likely sign an agreement that could reach $118 million.

Aramark has a lengthy track record of achieving cost reductions by violating basic health standards and providing inmates with food that is both unsanitary and inedible. Its staff have been accused of smuggling contraband and sexually assaulting prisoners.

TDOC privatized food services to save taxpayers millions of dollars more than the inmate-staffed food program run by the Tennessee Rehabilitative Initiative in Correction, or TRICOR.

An audit of the TRICOR program found “TRICOR staff tried to mislead its board about the agency’s finances,” and that “documents obtained by the auditors also allude to concerns with both the size and healthiness of meals served in prison.”

In 2015, as previously covered by Shadowproof, TDOC administrators allegedly threatened and intimidated corrections officers, who spoke out against dangerous work conditions, including excessively long shifts.

Overall, the Justice Department did the right thing by seeking to end private prison contracts, but it is important to recognize even after this development the prison industry will continue to thrive. States like Tennessee will serve prison industry interests and find ways around the policy change. The struggle against private prisons will need to recalibrate to fight this effort to preserve profit in jails.