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King County Jail Wa 2007doj Statement to Staff

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Statement on Department of Justice review of the
King County Correctional Facility
Today we are responding to a report that we have received from the Civil Rights Division
of the United States Department of Justice that reviewed operations at the King County
jail. The report is critical of past practices at the jail. We welcome the DOJ’s review of
our practices, and have provided them with full access to inmates, records, and personnel.
We strongly support and appreciate outside review and analysis of our program, and
believe it is essential for on-going improvement of systems and operations.
We strive at all times to provide safe, secure, and humane conditions for the over 50,000
inmates for whom we are responsible each year. We disagree that the constitutional
rights of inmates are being violated, but we are in complete agreement with DOJ that
there is room for improvement in the areas they evaluated. We are concerned by the
issues raised in the report and in fact have been planning and implementing improvement
strategies even before their review began. We will be working collaboratively with DOJ
in the coming months to better understand their analyses and to further develop processes
and procedures that are responsive to their concerns.
Department of Adult and Juvenile Detention
The Department of Adult and Juvenile Detention is committed to providing safe, secure
and humane conditions of confinement. We have policies, procedures, training and
accountability measures in place to help us meet that commitment.
At the same time, we strive to continuously update and improve our practices. We have
sought outside evaluation of our policies, procedures and practices. For example, in early
2006, we requested and received technical assistance from the National Institute of
Corrections regarding prevention and response to staff sexual misconduct, implementing
improved policies and additional training for staff.
In each of the areas of concern identified by the Department of Justice, we have been
taking action to improve our practices, and will continue to do so. We are committed to
working closely with DOJ to improve in each of these areas.

Use of Force: Our policy is to only use that force which is reasonable and
necessary under the circumstances. We have recently taken steps to review our
policies and increase training for staff in this area. We will continue this review
specifically with regard to use of pepper spray and hair holds.


Investigation of Staff Misconduct: DAJD holds staff accountable for misconduct
as a key part of providing an adequate environment for inmates. We investigate
and take action when staff members are found to be in violation of our policies.
For a key example, we investigated, terminated and supported the criminal
prosecution of staff who engaged in custodial sexual misconduct. We have
previously commissioned outside review of our investigations unit, and have

added positions to address the level of workload. We are committed to continuing
to improve the investigations unit in response to the DOJ recommendations.

Suicide Prevention: Preventing inmates from self-harm while in our facilities is
one of our paramount duties. We experience a low rate of suicides in our
facilities. We intend to follow-up on each of the DOJ’s recommendations in this


Infection Control/Cleanliness: The Department shares the DOJ’s concern and
focus on preventing transmission of infectious diseases within our facilities. We
have taken several steps to address this concern on the detention operations side,
including replacing mattresses, using new cleaning products and taking steps to
ensure they are used correctly. We are also currently working on a plan for
changing out and/or cleaning inmate underwear, uniforms and linens more
frequently, and other steps, including those recommended by the DOJ.

Jail Health Services:
Inmates are among the most medically vulnerable people in King County. Most have no
medical insurance or ongoing medical care, and arrive at the jail with a wide range of
acute and chronic medical and mental health needs.
In 2006, Jail Health Services provided over 30,000 medical visits for inmates and
dispensed over 190,000 prescriptions. Despite the best efforts of our professional staff,
mistakes occur, as they do in every health care setting. Our goal is to systematically
identify mistakes and continuously improve our systems to minimize them.
Jail Health Services is accredited by the National Commission on Correctional Health
Care (NCCHC), whose standards meet constitutional requirements for providing
healthcare in a jail setting. Accreditation is based on compliance with 73 NCCHC
standards as measured by 331 indicators. As an accredited institution, we are focused on
delivering excellent, timely and appropriate medical care to all inmates in need. We are
building the systems to support efficient and quality medical services and to identify
patterns of problems so that we can make the system changes needed to minimize future
In recent months, we have been focusing on new systems to further improve the quality
and timeliness of medical care; support efficient and timely staff hiring, retention, and
training; ensure the routine update of our clinical guidelines; and track and control skin

Electronic Health Record: Jail Health Services has recently implemented a new
Electronic Health Record (EHR). This new system will allow medical providers
and Jail Health Services management to systematically monitor, evaluate and
improve the quality and efficiency of jail health care services.


Clinical practice guidelines: As part of a routine review, we have updated clinical
guidelines, based on NCCHC standards of care, for clinical management of
diabetes, seizures and asthma, as well as for the identification and treatment of
skin infections.


Recruitment and hiring: Recruitment and retention of qualified staff has been
difficult throughout the medical industry, including jail health organizations.
Steps to improve our staffing shortage include raising the salaries of staff, and
aggressively seeking qualified candidates through a variety of means including
expanded advertising and outreach.


Training for staff: We have developed a new orientation process for newly hired
medical providers and nursing staff that ensures an in-depth understanding of Jail
Health services, standards, protocols and procedures. We also require and
provide ongoing staff training to support NCCHC standards for clinical practice.


Enhanced monitoring and control of skin infections: Most inmate skin infections
are already present when the inmate comes into the jail, and are diagnosed at
intake. Currently, we monitor skin infections through monthly lab reports on all
skin and soft tissue wound cultures. Positive cultures are reviewed for sensitivity
to antibiotics and housing locations in order to identify possible clusters of cases.
In addition to the measures DAJD identified above regarding infection control
and cleanliness, the Electronic Health Record system will provide more detailed
and timely information that will allow us continue to improve our infection
control systems.

The Department of Justice will make the report available on its web site.