Doesn't it sound like things have gotten worse since the feds told Harris County in June that the jail "fails to provide detainees with adequate: (1) medical care; (2) mental health care; (3) protection from serious physical harm; and (4) protection from life safety hazards"?
One day last month, Harris County Jail medical director Dr. Michael Seale arrived at the 1200 Baker St. jail and learned that about 100 detainees were lined up in the halls waiting to see a doctor.
Seale was told that one of two overnight doctors hadn't shown up. Seale then called UT Health Science Center, a longtime county contractor that provides the jail's doctors, and was told, according to sheriff's spokesman Alan Bernstein, that UT had decided to cut the doctor, for financial reasons.
It was a “shocking surprise,” to Seale and others at the sheriff's office, who were given no notice of UT's decision to cut a doctor the school added only a year earlier to meet growing clinic demands, Bernstein said.
“They didn't call in and say the doctor's not coming. … They said nothing,” said Bernstein, who spoke on behalf of Seale and Sheriff Adrian Garcia, neither of whom responded to my requests for interviews.
Bernstein said the sheriff's office now must pay $105 per hour for a doctor to fill the slot. He stopped short of accusing UTHSC of violating its contract, which doesn't require a specific number of doctors.
“They're not selling beer at the Astros game,” Bernstein said. “They're selling care, to keep humans healthy and alive.” ...
For UTHSC's part, its associate dean of Harris County programs, Dr. Stephen Brown, told me the reduction of jail staff shouldn't have shocked anybody at the sheriff's office, first because the school left word of the decision through UTHSC's on-site medical director, and second, because the school had warned the sheriff's office that the $3.1 million contract, approved by county commissioners this year, was woefully inadequate.
“We don't even cover our overhead,” Brown said. “It wasn't the amount we requested, nor the amount necessary to provide the care for the increase in volume that had occurred since 2006.”
Brown estimates that increase in jail clinics at 57 percent. He said UTHSC wanted $3.7 million, but agreed to the lower amount in a “good faith” compromise, with a vocal commitment from Seale that the contract would be renegotiated.
At the time, the Justice Department told the county they wanted to work cooperatively to fix the problems but that USDOJ would sue them in federal court if they continued. Now, if the county isn't fully staffing its medical facilities, that gives the feds even more reason to step in.
The decision to contract for healthcare instead of providing it in-house was made long before Sheriff Garcia got there and bottom line: He can't approve a larger budget. It's up to the county commissioners court to pony up for jail health costs.
For that matter, even if the county sends inmates elsewhere instead of housing them in Houston, Harris County is still responsible for ensuring they receive adequate healthcare wherever they send them. That's the price you pay for operating a jail that's bigger than 19 states' prison systems. Including those housed elsewhere under contract, the Harris County Jail incarcerates about the same number of people as all the state prisons in Massachusetts.
Bottom line: Mass incarceration is a pay to play activity, and at the local government level you don't get to play with borrowed money. Spending on inmate health is a big part of that expense, and if the commissioners court won't voluntarily foot the bill then the feds are poised to make them.