Pauli Halstead: Improving inmate health care at Nevada County jail
Adequate medical and mental health treatment in the field of correctional medicine demands a high degree of professionalism and is a hallmark of a civilized society.
Jail inmates are overwhelmingly poor, many are seriously mentally ill and addicted, many are minorities, and all are stigmatized by having been charged with crimes. Alarmingly, the most recent data shows inmate deaths are on the rise.
While in jail inmates are essentially without power and few in our community are concerned with their welfare. Why should anyone care whether the health services provided to inmates is adequate? The reason we should care is that inmates have a constitutional right to be protected under the Eighth Amendment, “nor cruel and unusual punishment inflicted.” It is the responsibility of the Sheriff’s Office to see that inmates are protected and no harm comes to them; and that includes harm from inadequate medical and mental health care.
Correctional health care is a relatively new industry and most counties in California use the services of a “for-profit” medical provider. At Wayne Brown, the county is contracted with Correctional Medical Group Companies, Inc (AKA, WellPath). There are three medical services contractors in California to choose from and unfortunately all have been sued for inadequate delivery of services. In the case of CMGC the lawsuits complain they do not provide sufficient staff 24/7 and that their staff does not have the required medical credentials for the job they are doing.
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Curious about this I set about trying to obtain relevant documents to see if CMGC was in compliance with their contract, if they scheduled staff 24/7, and what were the medical credentials of the staff. I was amazed at the response from the Sheriff’s Office, responsible for overseeing CMGC, that they did not have “any” requested documents, nor did the Board of Supervisors clerk. Nor, as is required by law, was I provided with a written reason the documents were not available. I was also shocked that the County Auditor is not required to have a breakdown of services; he just pays the submitted invoice, which was $206,478 per month.
It is important that the Sheriff has oversight of CMGC and maintains all documents related to the contract. The lack of transparency and oversight regarding one of the County’s largest contracts is unacceptable. How can the Sheriff’s department and the County protect themselves from exposure and liability if there is no oversight of CMGC and no one has any documents? County Counsel explained to me that the contractor does not have to provide documents from a Public Records request, even though the Contract is with the Board of Supervisors. This is not my understanding of the California Public Records Act.
The Contract with CMGC is up for renewal on June 30th. My recommendation to the Board of Supervisors, in renewing this contract is to make sure there is oversight in the ongoing performance of the company. Since taxpayers are footing the bill for these contracts transparency is essential. When a Public Records request is made, those documents should be easily accessible for “anyone” to review. This should be standard for a correctional medical provider in California. A contract with the Board of Supervisors is the public’s business after all.
It is also important for the Board of Supervisors, and the Sheriff’s department, that the medical services contractor has the necessary accreditation when it comes to delivering quality healthcare at Wayne Brown. This is to ensure that systems, policies, and procedures are in place, which will produce the best outcomes for the inmates. One such accreditation service is the National Commission on Correctional Health Care.
In making the application for accreditation an NCCHC survey team made up of physicians, nurses, and health administrators, will visit the jail and review medical records, as well as policies and procedures. They will interview health staff, correctional officers and inmates and tour the facility. An exit conference is then held to share their preliminary findings. Any problems will then be addressed so corrections can be implemented and accreditation can ensue.
When a correctional facility receives accreditation from NCCHC, it is understood that the Board of Supervisors and the Sheriff’s department are committed to providing state-of-the-art medical and mental health services, which adhere to the highest standard of care for the inmates. Apparently the Sheriff’s department is looking into applying for accreditation by NCCHC. This would surely be a good move and hopefully eliminate any problems with liability exposure of inadequate care by the medical contractor.
Pauli Halstead lives in Nevada City.
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