From 2001 through June 2009, 142 jail prisoners died in Harris County. The DOJ twice performed on-site inspections of the county’s jail system, and concluded in a June 4, 2009 report “that certain conditions at the Jail violate the constitutional rights of detainees.” The DOJ went on to say that “the number of inmates’ deaths related to inadequate medical care ... is alarming.”
Citing its oversight authority under the Civil Rights of Institutionalized Persons Act (CRIPA), 42 U.S.C. § 1997, DOJ inspectors visited all four jails in Harris County before giving the jail system failing marks in “(1) medical care; (2) mental health care; (3) protection from physical harm; and (4) protection from life safety hazards.”
Houston’s main jail houses nearly 11,000 prisoners, not including satellite facilities. In 2007, over 130,000 detainees cycled through the county’s jail system. The DOJ noted major deficiencies in medical care provided to this revolving population of prisoners – especially those with serious mental health conditions. The two most serious problems involved re-cord-keeping and follow-up treatment at the jail’s clinic.
One 74-year-old prisoner who had previously undergone open heart surgery went to the clinic complaining of incontinence. The medical staff sent him back to his unit without examining him or taking his vital signs. The next day he re-turned with the same symptoms plus high blood pressure. This time he was sent to the hospital; however, he died shortly after his arrival.
Another prisoner with diabetes went to the clinic complaining of leg pain and swelling in her knees. She was given pain medication. Five days later she returned with the same symptoms. Again she received pain pills. When she returned later that day she collapsed in the clinic, but medical staff didn’t try to revive her and failed to provide emergency care. She died without receiving any help.
A male prisoner with a history of cirrhosis of the liver visited the jail clinic multiple times over the course of several weeks, complaining of swelling in his leg. He was prescribed blood pressure medication even though his blood pressure was normal. Despite his repeated trips to the hospital, jail staff ignored the hospital’s instructions and kept him on his original course of treatment. His condition deteriorated so severely that he died during his last hospital visit.
The level of medical treatment at the jail – or the absence of same – led DOJ inspectors to note that the “discontinuity of care and lack of follow-up by staff are of serious concern....”
The DOJ report cited several other cases in which prisoners with mental health problems were either not treated or were improperly treated for conditions such as self-starvation, self-mutilation, bipolar disorder, alcohol detox and suicide risk. Three of those prisoners suffered physical injuries as a result.
Even more frightening than the jail clinic’s lack of adequate care was its tendency to improperly medicate when staff did provide treatment. One prisoner was diagnosed at intake with an acute psychotic state; he was prescribed medication but it was never received. As his mental condition deteriorated, he became less and less cooperative. He was eventually injected with an intramuscular drug that rendered him unconscious. A short time later he died.
Another prisoner had already spent nearly a year in a state hospital before being declared “not competent and not restorable” by the court. Instead of being returned to the hospital he was placed in the jail’s general population and allowed to keep his medication on his person. After he suffered a seizure he was sent to the clinic. Medical staff decided that he was merely “sleepy” from his psychotropic medication, and sent him back to his cell. He died soon thereafter.
Beyond inadequate medical and mental health care, federal inspectors expressed “serious concerns” about excessive use of force by Harris County jailers. The DOJ report noted that the jail had no policy or training to instruct staff on prohibited use of force restraints. The jail did not have a policy to distinguish between planned and unplanned use of force, nor did it provide routine videotaping, incident reports or collection of witness statements for use of force events.
Although the DOJ report did not specifically list any deaths in 2009 related to excessive use of force, PLN recently reported several examples that occurred in 2008 and 2007. In one of those incidents, prisoner Clarence Freeman was choked to death by jail guard Nathan Hartfield after Hartfield took him to an area where there were no video surveillance cameras. Hartfield and a sergeant were fired following an investigation into Freeman’s death, but neither was indicted. [See: PLN, Oct. 2009, p.1].
Overcrowding was also identified as a major area of concern by DOJ inspectors. According to their report, “the Jail’s crowded conditions currently exacerbate many of the constitutional deficiencies” found at the facility.
The DOJ report cited a 10-month period in which over 3,000 fights and 17 sexual assaults were reported at the jail. Investigators attributed this high rate of violence to overcrowded conditions. The report stated that not only was the jail not equipped to “routinely investigate violent incidents,” but jail staff could not “distinguish between disturbances caused by detainees with mental illness and other detainees.”
Due to overcrowding, the Houston jail routinely had unsanitary conditions in a variety of areas. Inspectors found there were not enough washers to sanitize linens and clothing, and of the few washers the jail did have, several were not functional. Unsanitary bedding, clothing and mattresses were endemic and caused an immediate danger of spreading infectious diseases.
Barbers at the jail used dirty blades, equipment and supply boxes. Plumbing was deteriorated and in need of maintenance. Some intake cells still used “holes in the floor” as toilets.
The 24-page DOJ report concluded with 20 recommended areas for improvement, and warned that failure to remedy the identified problems at the jail could result in legal action against the county. Harris County Attorney Vince Ryan responded to the report on August 25, 2009 with a 300-page rebuttal that strongly disagreed with the DOJ’s findings, claiming that Houston’s “jail system of the past and present meets minimal [constitutional] standards.”
Although county officials have acknowledged the overcrowding problem at the jail, they are hard pressed to find solutions. A proposed 2,193-bed expansion of the jail system would cost $256 million plus about $9.65 million per year in additional staffing costs. Due to the current economic crisis, the county is preparing for budget cuts in the 2010-2011 fiscal year. The Sheriff’s Office is facing cuts of up to 16%.
In December 2009, Harris County Commissioner El Franco Lee proposed putting more jail prisoners to work and in-creasing the work credits they receive from two days’ credit to three per day of incarceration, which would result in earlier releases. “I’m putting it up for discussion because there has been overcrowding and it is an issue that would bring Harris County in consistency with other parts of the state,” said Lee, who chairs the Criminal Justice Coordinating Council. Three-for-one credits are offered in other Texas counties for prisoners who participate in work programs.
Harris County voters rejected a proposed jail expansion in November 2007 that would have been funded with $195 mil-lion in bond financing. Critics have complained that county officials have not implemented other options that would make an expansion of the jail unnecessary – such as issuing citations for some low-level misdemeanors in lieu of arrests, granting more personal bonds for arrestees, and cutting back on probation violations in order to reduce the jail’s population.
Sources: Houston Chronicle; www.dallasnews.com; www.khou.com; U.S. Department of Justice, Civil Rights Division, Investi-gation of the Harris County Jail (June 4, 2009)
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