Investigating the nightmarish health care crisis inside Maricopa County’s jails. BY KATYA SCHWENK M issed doses of medication. Urgent health request slips left to collect dust in drawers. The health care crisis in Maricopa County’s troubled jails is worsening. New internal documents obtained by Phoenix New Times illuminate the toll that understaffing has taken on the health services in the county’s jails. In the fall, New Times found, Maricopa County tapped a group of consultants to investi- gate its correctional health system. They uncovered serious failures. The resulting 84-page “Correctional Health Services workplace environment assessment,” which New Times obtained, shows that over a three-month period, from September through November, audi- tors documented nearly 40 occasions in which nursing staff failed to provide any medication to an entire jail. Health needs requests that, according to policy, must receive a response within 24 hours, were regularly left unattended for far longer periods — sometimes for weeks. Furthermore, wound care, changing bandages, and tending to open sores and cuts was skipped for days at a time. Experts told New Times the findings could have an adverse impact on patient health. The findings also could expose the county to lawsuits and threaten the jails’ accreditation status, the consultants noted. The issues “might not seem particu- larly life-threatening, but they absolutely have been,” said Ricky Camplain, an epidemiologist and assistant professor at Northern Arizona University who focuses on health in prisons and jails. Medical conditions are common among people in custody, and that would make it “extremely dangerous,” Camplain said, to miss a dose of medication. The six jails in Maricopa County are run by the Maricopa County Sheriff’s Office, which is headed by county sheriff Paul Penzone and custody chief Barry Roska. But health care in the jails is managed by another branch of the county, Correctional Health Services, which oper- ates outside the jurisdiction of the sheriff. In written responses to detailed ques- tions from New Times, Assistant County Manager Lee Ann Bohn said that this spring, the county has taken action in response to the “clinical concerns” iden- tified in the report, which was finalized in February. Most of the recommenda- tions suggested by consultants are being implemented, Bohn wrote. She said the county has increased correctional nurse salaries by 14 percent The Maricopa County Sheriff’s Office headquarters in downtown Phoenix. and restructured CHS leadership. As a result, Bohn claimed, the county has seen a “consistent decline” in the issues identi- fied in the report. “CHS’s goal has always been to provide exceptional care to patients,” she wrote. “While the report helped us pinpoint areas to improve, we are not aware of any adverse medical outcomes tied to the concerns identified in the report.” After New Times contacted each member of the county board of supervi- sors, a county spokesperson said they would not grant interviews or comment for the story. Bill Gates, the board’s chairman, did not reply to several written questions in lieu of an interview. The body that accredits CHS, the National Commission on Correctional Health Care, did not respond to questions about issues at the Maricopa County jails and their accreditation status. Per policy, NCCHC does not comment on specific jail systems or cases, according to the organi- zation’s website. A Long History of “Inadequate” Care On any given day, there are typically 6,100 people in custody in Maricopa County’s jails. Many of them have not been convicted of a crime and are merely awaiting trial. The rest are serving short sentences — typically shorter than a year — for minor offenses, or waiting to be sentenced. Despite this, jail is not always a tempo- rary place. There are people in the jail system who have been there for years — a decade, even — awaiting trial in complex cases. For these people, CHS can serve as their only source of health care for years. As in most jails and prisons, medical issues run rampant. According to figures published by CHS on its website, around 23 percent of people in Maricopa County’s jails have chronic illnesses — diabetes, hypertension, heart disease. Another 16 percent suffer from a “significant” mental illness, though it’s unclear how the county defines this. Among the 6,100 or so inmates, the county also says it conducts around 400 checks each day for people experiencing withdrawal from drug or alcohol abuse. It’s not clear how often any given person in withdrawal gets checked. 12 James Deak Medical care in Maricopa County’s jails has long been troubled. Court cases over the years have helped shed light on lapses in the medical system, including one lawsuit waged by the American Civil Liberties Union that spanned four decades. The lawsuit, Graves v. Arpaio, dealt with deficiencies across the jails and health system. It focused, though, on mental health care in the jails, which one expert testified suffered “many serious problems.” The Graves case began in 1977, when three men in the county jails brought a suit that alleged myriad issues: over- crowding, poor diet, and harsh, dangerous conditions. By the 1990s, the jails’ failing mental health care was a key focus of the suit. The case dragged on for decades, continually revived as new laws were passed relating to prison conditions and as plaintiffs complained the jails were — still — failing to reach the bare minimum stan- dard of care. Until 2019, the jails were still subject to ongoing court oversight due to the case. “County and CHS leadership are pleased they were able to meet the expec- tations of Judge [Neil] Wake in September 2019 to conclude the Graves lawsuit,” Bohn wrote of this history. Under former longtime Maricopa County Sheriff Joe Arpaio, record keeping of medications and mental health issues was “inadequate,” according to one 2010 opinion by two U.S. Ninth Circuit Court of Appeals judges in the Graves case. “Sheriff Arpaio does not know which pretrial detainees are taking which medications,” the judges found. As a result, inmates on psychotropic meds, for example, were being kept in unsafe conditions. Legal trouble has not subsided in the years since Graves ended and Arpaio left, court records show. The ACLU has brought another ongoing court battle against the county, alleging it failed to properly protect jail inmates from COVID-19. The county declined to comment on that suit, citing pending litigation. In 2020, Pedro Esquivel sued the county over an incident in September 2019, claiming he was forced to walk bare- foot across hot asphalt on a 106-degree day after being booked at the jail. CHS, JUNE 2ND– JUNE 8TH, 2022 PHOENIX NEW TIMES | MUSIC | CAFE | FILM | CULTURE | NIGHT+DAY | FEATURE | NEWS | OPINION | FEEDBACK | CONTENTS | phoenixnewtimes.com
