In an effort to improve medical and psychiatric care in the Los Angeles County jail system, Sheriff Sherman Block announced Wednesday that he will shut down the dilapidated hospital wards in the Men's Central Jail and move hundreds of ill inmates into the new Twin Towers facility.
"I'm determined we will operate a constitutional jail," said Block, whose announcement came just days after a Times story detailed a series of deaths and amputations blamed on poor medical care at the jail system's antiquated medical facilities.
Starting Jan. 10, Block said, about 1,300 inmates--most of them suffering from mental illness--will be transferred into Tower One of the new jail, next to Men's Central Jail. The most seriously ill patients will be placed in about 200 beds in the gleaming new medical wards.
Although Twin Towers opened a year ago, the state-of-the-art medical facility has remained largely unused because Block said he has lacked the money to operate it. Now, under mounting pressure to do something about the poor conditions plaguing medical and psychiatric wards at Men's Central Jail, sheriff's officials said Wednesday that they decided to open the Twin Towers wards after receiving assurances from county officials that the department would receive an additional $4.6 million in 1998 to cover the costs.
Attorney Merrick Bobb, special counsel to the Board of Supervisors who is looking into problems at the Sheriff's Department, praised the planned move, calling it a "necessary first step."
"This is a down payment and a show of good faith in terms of responding to the criticism," said Bobb, who recently issued a report calling for vast improvements in the treatment of sick inmates.
Meeting with reporters at his monthly open house, Block said the department is studying the possibility of turning over responsibility for jail health care to the county Department of Health Services or a private contractor. Currently, nurses and doctors employed by the Sheriff's Department provide medical care to hundreds of ill inmates, while psychiatrists employed by the county Department of Mental Health provide services to the mentally ill.
"The delivery of medical services is not our primary business," Block said. "We can't work miracles in the jails. We do the best we can, but we just can't clean up the debris that is left over from the failure of established institutions. That's not what jails were designed to do."
In the wake of chronic overcrowding in the county lockups, the Sheriff's Department has been struggling to provide adequate care for thousands of inmates, many of whom have never been treated, with illnesses ranging from tuberculosis to AIDS to schizophrenia.
It is not unusual for ill or injured prisoners to wait hours in cramped holding cells to see a doctor. Even after they are examined, there is no guarantee that they will get follow-up care. Doctors' orders are often lost or misplaced in the jail's chaotic, paper-based system of tracking medical records, which are often incomplete, illegible or inaccurate.
Making matters worse, the medical and psychiatric facilities are old and shabby. Cold air blows constantly from air ducts, the ceilings leak, the walls are cracked and the plumbing is old, making it difficult at times to get hot water.
Occasionally, there have been incidents resulting in severe injury and even death. Over the last five years, according to court records, at least three inmates have undergone limb amputations after gangrene and infections raged out of control; one man lost an eye because he did not receive follow-up care for a puncture wound; another inmate, who was awaiting trial on arson charges, died of an asthma attack after deputies declined to immediately take him to the jail medical clinic for treatment.
In an extensive report issued in February, the U.S. Department of Justice found that the conditions were so bad for mentally ill inmates that a discharge from mental health housing may be the only way to improve an inmate's mental condition. Justice officials, saying the sheriff was running an "unconstitutional" jail, placed the department on notice to either improve the care or face a federal lawsuit.
Sheriff's officials have been taking steps to correct the problems. Now, with assurances from the county chief administrative office that additional funds would be available, custody staff have put in motion their plan to close the old wards in Men's Central Jail.
On Jan. 10, jailers will begin moving hundreds of mentally ill inmates out of dark, dingy suicide-watch cells--referred to by sheriff's deputies as "ding tanks"--and place them in one-man jail cells in Twin Towers. The following day, the physically ill inmates will be moved into the new hospital facility, which has beds for 200 prisoners. The medical staff at Men's Central will move to Twin Towers.
Once the changeover is complete, department officials will continue to work to get online a computer system that will track medical records for all inmates.