Wednesday, September 03, 2008

Jail standards commission needs greater healthcare focus

Interested readers should see recommendations for the Texas Commission on Jail Standards submitted to the Sunset Commission from Matt Simpson at the ACLU of Texas, compiled in response to a survey of advocates. Key proposals include stricter evaluation of medical care provided at county jails and improving medical care and services for pregnant inmates.

I agree with most of what Simpson has proposed, but this statement in particular strikes me as only 2/3 correct: "Currently, the statutory authority of TCJS does not allow it to inspect in a meaningful way the quality of medical care, the quality of mental health services, or the conditions of confinement."

While it's accurate TCJS has no capacity for meaningful oversight of jail medical services, they do a pretty good job IMO of identifying problems with "conditions of confinement." The bigger dilemma in that regard, and TCJS' own agency self-evaluation (pdf - p. 13) said the same thing - is that the agency suffers from a "lack of enforcement options available to bring jails into compliance." In other words, TCJS rules need more teeth.

Simpson's right, though,that TCJS presently has no staff qualified to evaluate jails' delivery of medical care. Current TCJS inspections ensure at least that medical grievance procedures exist, but the agency has no way to tell whether appropriate care was given. What's more, TCJS has no authority nor capacity to go in after specific incidents to see whether rules have been broken.

In particular, I'd like to see TCJS perform after-action reviews in certain jail deaths - perhaps along the lines of hospitals' morbidity and mortality conferences - to identify causation and what if any procedural fixes might have prevented what happened. Perhaps that's not necessary in every instance, but we've seen jail deaths recently that cry out for greater oversight by the state.

For more on this subject, see earlier recommendations for the jail commission's sunset review from Bob Libal at Texas Prison Business and from the Texas Jail Project.


Anonymous said...

Forgive me for my opinion but there are people in our prisons that has cruelly took a childs life causing them severe pain. And I am afraid I can find no justification in treating these evil people if they fall sick.

Gritsforbreakfast said...

Kacy, do you have any idea how many people are in prison or jail and what a tiny, tiny percentage "took a childs life causing them severe pain"?

I can forgive your opinion, it's your ignorance I find particularly troubling.

Anonymous said...

Kacy, both you and I enjoy freedoms granted by the U.S. Bill of Rights. Among these rights is freedom from cruel and unusual punishment.

Denial of Health Care is cruel. the person you refer to is in prison because he broke the law, the very same laws protect his right and yours to decent health care.

Gritsforbreakfast said...

I just deleted a comment that added zero substance but lots of bile to this discussion. I've said before, folks, and I wasn't just talking about death penalty posts - such routine name calling and demeaning rhetoric about those with whom you disagree is unacceptable here. I'm done with it and don't care if you feel you've been censored.

Be polite and respectful. Use language you'd be comfortable using when speaking with your own young children or your grandmother. If you can't do that, don't comment here. I won't let one or two jerks poison the well for everybody else.

Anonymous said...

If you think jailers and guards are mean and cruel; you should see the medical personnel.....

Anonymous said...

I don't think we should deny anybody from health care. Whoever he/she maybe.