Cell Disease

Being sick in Dallas County's troubled jail can be a death sentence

Lost in all the legal wrangling is the fate of the man who inspired it all, James Mims. A mentally ill inmate, Mims suffered renal failure and wound up in Parkland Memorial Hospital in grave condition last year after guards turned off the water in his cell when Mims flooded it. The sheriff's own investigators found that the guards who turned off the water did not properly report their action up the chain of command, although none of them were formally disciplined. Nor did any of them realize that he wasn't drinking any water. Meanwhile, internal investigators cited the jail's medical provider, the University of Texas Branch at Galveston, for failing to give Mims the psychiatric medicine he needed, which contributed to his bizarre behavior. Investigators also blamed the jail's psychiatric department for not giving him an evaluation, even though the medical department referred him three times.

Keliher declined to comment on the specifics of the commissioners court's legal strategy, except to say that they have an obligation to protect taxpayer dollars. Suppressing a damning consultant's report might stymie the plaintiffs' extraction of a large settlement from the county, of course, but that raises a philosophical question: Should the commissioners court be playing hardball to protect taxpayer dollars or should it be looking to settle a case where its own sheriff's department has corroborated many of the lawsuit's allegations?

On any given day, there are more than 7,000 inmates in Dallas County's jail system, whose main facility, Lew Sterrett Justice Center, is located on Industrial Boulevard in the shadow of downtown's skyline. Making sure that the inmates are safe and that the sick are receiving care is a logistical nightmare. It's also a grueling job for everyone who works there. Unruly, deranged inmates will throw feces at guards, provoke fights and take part in vandalism such as clogging up toilets and overflowing sinks. Salaries for detention officers begin at $27,000, which is less than Tarrant and other neighboring counties pay. Still, employees who have worked at the jail say that most of the guards, though certainly not all, exercise remarkable restraint and good judgment.
Lew Sterrett, possibly the worst place in North Texas to get sick.
Lew Sterrett, possibly the worst place in North Texas to get sick.

For the poor and sick, who may not receive any medical care at all in the community, incarceration often means the best health care of their lives. But the problems at the jail that incite lawsuits and headlines seem to be more entrenched than episodic, particularly the issue of how guards and medical staff respond to chronically ill inmates. Independent observers, including judges and doctors, corroborate that ill and healthy inmates alike are failing to receive medications or enduring long periods of neglect while in custody; even the state's own correctional facility watchdog confirms the jail's deficiencies.

"We have found more complaints from the Dallas County jail about the medical care, and we have found more incidents arising from the inmates at Dallas County than any other big county jail in Texas," says Terry Julian, the executive director of the Texas Commission on Jail Standards.

Last year, Sterrett failed inspection with the commission, in part because it was short on staff and neglected to perform adequate health screenings of its inmates. It failed again in 2005, having been found in violation of at least 10 state standards, including staff shortages, incomplete tuberculosis testing and a lack of prompt care for sick inmates. State standards require that county jails have at least one corrections officer per 48 inmates; in recent unannounced state inspections, the jail has fallen just short of that for "significant periods of time," according to inspectors. While the Dallas County commissioners are finally taking steps to correct some of the jail's nagging problems, including hiring enough detention officers to meet state standards, they're only beginning to address the institutional defects that have been allowed to linger and grow for years.

"The jail did not fall out of compliance overnight," says Julian, who credits the current commissioners for finally tackling one of the fundamental problems with the place, lack of money. "Dallas County was certified for many, many years. It was a facility we could all be proud of. But now, over the last couple years, it has declined. We're seeing more inmates and more of them have medical needs that are not being met."

To a degree, some of the county's problems can be traced to funding. Until this year, a tax-averse commissioners court would typically ask the sheriff's office to reduce its operating budget, and the sheriff would cut staff. Sheriff's office employees say the commissioners exacerbated the problem by pressuring them to freeze overtime pay last year, which they say led to the low staffing ratios that caused the jail to fail inspection. This year, the county will likely fund a budget increase that would allow the sheriff's office to hire at least 70 jailers, although the department originally hoped for up to 400. The county's budget office maintains that the 70 new positions should still be enough for the jail system to meet state standards.

As the Texas Commission on Jail Standards and others single out Dallas County for a range of problems, it's hardly surprising to find that it spends considerably less money on its jail than its closest peer, Harris County, even after accounting for a smaller inmate population. Last year, Dallas County budgeted $77 million for its jails, including operating costs, food and health care. Harris County, which has around 2,500 more inmates than its North Texas counterpart, allocated $135.9 million for jail expenses. But Dallas County is hardly the only big county jail in Texas with problems. Both the Harris County and Bexar County (San Antonio) jails have also failed inspections recently.

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