August 9, 2014

Spokane County Jail asks for more nurses

By The Spokesman-Review
 

The aging Spokane County Jail, filled to the brim with inmates requiring mental health care, needs more help screening arrestees coming through the doors, officials say.

“What we need is to have nurses in our booking area, 24 hours a day,” said Kristina Ray, mental health manager at the jail.

Cmdr. John McGrath expects to ask Spokane County commissioners for an additional $500,000 to hire five new nurses so that a medical professional is on hand at all hours of the day to screen inmates. The goal is to cut down on gaps in medical care, which internal figures show cost taxpayers $1.3 million last year following a decades-long history of grievances, lawsuits and other legal entanglements blamed in part on continued overcrowding.

One of the common legal complaints has involved the jail’s policy on medications from outside sources. While the written policy says the jail will accept and screen medication for distribution brought to the jail by family members, in practice staff will not hand over prescriptions delivered. Instead, Ray said, jail nurses take the information from the bottle, verify the dosages with doctor’s records and administer medication it already has on hand or order the medicine – giving preference to generics – from a provider.

The policy is in place to keep unapproved drugs, including potentially illicit or dangerous substances disguised as prescription medicines, from being administered by jail staff.

In some cases, the vetting process is expedited. Having additional staff on hand to process new inmates would help identify who requires a quicker screening process, Ray said.

“An individual can come in, let’s say, mom brings anti-seizure medications,” she said. “We’re not going to wait; we’re going to order them those critical medications.”

Costs for this prescription service vary wildly from month to month, according to records. In May, the jail spent more than $90,000 on prescriptions, but often the costs are much less. Most of the medical care costs incurred at the jail are related to outside appointment costs,  which exceeded a monthly total of $100,000 twice since December, according to jail records.

Many people have alleged breakdowns of the system. At least three lawsuits have been filed in recent months alleging civil rights violations by withholding medication from inmates. The jail has countered by saying those inmates either refused to accept their medicine or did not cooperate with its procedures for ensuring prescriptions were authentic.

The family of Robert Lee III, who arrived at the jail in May 2013 to serve a third-degree assault sentence, has hired Spokane civil rights attorney Jeffry Finer to handle its claim against the jail. The family said it provided ample documentation that Lee needed daily medications to treat multiple mental disorders several days before he reported to jail. Yet bureaucratic mistakes kept him from receiving those medications for almost a month, and he continued to receive the incorrect dosages until his release in October, the family alleges, causing mental and physical harm.

Finer said the case is just one of several in the area that illustrate potential Eighth Amendment violations against prisoners, by allegedly exposing inmates to cruel and unusual punishment.

The jail previously has been sued successfully for depriving inmates of potentially life-saving medication. The family of Venus Elder, who died of a blood clot in her brain after a mistake over her surname kept her from receiving prescribed warfarin for almost a week, received $250,000 from the county in a 2004 settlement. Elder had been booked into Spokane County Jail and Geiger Correctional Facility on drug possession charges.

Sheriff Ozzie Knezovich, who is named in the most recent lawsuits against the jail, said that during his years in charge of the jail additional medical staffers were hired to handle the caseload, and wages were increased to help with recruiting and retaining nurses.

Knezovich also dismissed claims that access to medication was a pervasive problem in the jail during his tenure, saying there were “absolutely” no issues during his tenure. He referred to the overcrowding of the jail as the most important issue that continues to plague the 28-year-old facility.

“It cannot run, the way it is, anymore,” Knezovich said.

McGrath said he expects to request more nursing staff from county commissioners, who took over control of the jail last summer, at some point in the coming months, though nothing has been scheduled. The county will spend about $26 million on confinement this year, according to its budget.


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