TX - Inspectors fault medical care at Dallas County Jail

Inspectors fault medical care at Dallas County Jail 11:07 PM CST on Wednesday, February 4, 2009

By KEVIN KRAUSE / The Dallas Morning News kkrause@dallasnews. com

A team of federal inspectors says Dallas County's jail health system still can't perform even the most basic tasks, such as giving medicine to prisoners when they arrive at the jail. After four years of pouring millions of dollars into jail improvements, county officials say they expect the jail system, the nation's seventh largest, to be a model for the rest of the country.

And in their latest report, federal inspectors wrote that they remain impressed by the county's progress. But they said "infirmary care, tracking chronic illness and mental health programming remain as significant obstacles."

It was a lack of proper medical and mental health care that brought intense federal scrutiny upon the county in 2005.

The inspection was conducted over several days in late September and early October, but the final report was only recently made public.

Inspectors noted delays in issuing medications, a lack of medical evaluations, inconsistent care, lack of medical care for mental- health patients, a long backlog in sick-call requests, and sanitation and maintenance lapses.

The inspectors reserved their harshest language for the Lew Sterrett jail kitchen, where they found moldy ceilings that dripped water, live wires next to standing water and condensation so thick it was almost impossible to see across the room.

"This combination of live electrical wires and a very wet floor poses a severe electrocution hazard," the report said.

While noting the problem was quickly fixed, the inspector wrote that it didn't excuse the fact that it had gone unnoticed. "The electrical hazard was blatantly obvious," he said in the report.

Conditions were so bad, the report said, it appeared that a jail quality-assurance team had never even been to the kitchen, which prepares food for up to 6,000 inmates a day.

Sheriff's spokeswoman Kim Leach said the county facilities department has an on-duty maintenance person in the kitchen at all times. She also said the excessive condensation mentioned in the report was caused by a broken pipe.

Parkland Memorial Hospital has provided jail health care since early 2006. Sharon Phillips, Parkland's vice president in charge of jail health, declined to comment because she hadn't yet read the report, a hospital spokeswoman said.

Commissioner John Wiley Price, who oversees jail improvements, said people get better medical care in county jails than they do in hospitals and doctors' offices.

"How many doctors' offices are open 24 hours?" he asked. "We're running a small city over there. And a city would not have to meet the stringent regulations that are being heaped upon us."

County commissioners have committed millions of dollars to the jail system for more staff and medical facilities to make up for inadequate spending in the past. Several large projects are nearing completion, such as new fire-safety systems and a $65 million jail tower.

But the county so far has been unable to devise a system for quickly issuing needed medications to sick inmates.

That has resulted in another federal lawsuit against Dallas County. This week, the family of a former inmate with sickle-cell anemia filed suit, saying he went without vital medications for at least several days in 2007 while in the jail, resulting in a permanent brain injury.

Lee Jefferson Jr. remains in a permanent vegetative state, according to the lawsuit, which accuses the county of violating his constitutional rights.

A monitoring team visits the jails every six months to evaluate the county's progress as part of a 2007 agreement with the federal government. Earlier that year, the U.S. attorney general sued the county to force jail improvements.

The latest report, the government's third so far, said the county was "substantially compliant" with 12 court-ordered improvements, partially complaint in 22 areas and noncompliant in two areas (fire safety and infirmary care).

An infirmary is still in the design stage and will open in about 20 months, officials said. Another key deficiency, the lack of a working smoke-removal system, will be corrected soon, they said.

Inviting federal jail scrutiny can bring financial hardship on counties, which have to meet high standards of care, staffing and cleanliness – far more than what state regulations require.

Dallas County has found itself in that situation because commissioners voted in 2002 to leave jail health to a contractor as a means of saving money. When problems surfaced, commissioners blamed the contractor.

But in two jail neglect lawsuits, it was the county, not the contractor, that had to answer the allegations. The county settled one case and lost the other, forcing two separate payouts totaling almost $2 million.

JAIL DEFICIENCIES