The Herald of Everett, Washington
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Published: Tuesday, August 27, 2013, 5:21 p.m.

Inmate deaths prompt jail to hire doctor, more nurses

EVERETT -- With an older, sicker and more drug-addicted population behind its walls, the Snohomish County Jail soon will hire a doctor to tend to inmates' medical needs, Snohomish County Sheriff Ty Trenary said Tuesday.
It's one of several changes the sheriff's office has in the works to improve medical treatment in a jail where eight inmates have died since 2010. At least two of the deaths involve pending legal claims.
Hiring more nurses and mental health professionals, moving from paper to electronic medical records, and more closely screening inmates before they're booked in to the jail also are part of Trenary's plan.
In March, when County Executive John Lovick was still sheriff, he asked the National Institute of Corrections, a branch of the federal Department of Justice, to offer advice on operations and medical services at the jail. Experts from Miami's Dade County in Florida and Nashville, Tenn., have visited the Snohomish County Jail and will return in September to complete their observations and make recommendations.
Shortly after being appointed sheriff in July, Trenary sought another perspective. He asked the Pierce County Sheriff's Office to examine medical operations at the 1,200-bed jail in Everett. That county has been wrestling with similar jail challenges.
"Their concern is we didn't have enough medical staffing," Trenary said.
Now Trenary's following many of the Pierce County team's suggestions, including hiring a doctor to work inside the jail. As it stands, the jail has been covered by an often-understaffed team of registered and licensed practical nurses, with a doctor available via telephone if needed. At times, that has meant the jail has had nobody inside who is qualified to provide medical care.
Initially, the newly hired doctor would work at the jail three days a week beginning after Labor Day, but Trenary hopes to make it a full-time position in 2014. He also said the jail needs to add as many as 10 more nurses, but is waiting to see what the doctor recommends. Part of the plan is to raise pay for the jail's nurses and phase out hiring from agencies providing temporary medical workers. It has been hard for the jail to keep qualified nurses, the sheriff said.
Adding a doctor, additional nurses and electronic medical records "will allow us to adequately care for inmates," Trenary said. They also need to take a closer look at their system for distributing medications and for screening inmates for medical and mental health issues during the booking process, he said.
That would include being more selective about inmates they accept under contracts from other cities and out of county. The jail takes in about 115 inmates at any given time from cities and law enforcement agencies. That earns the jail about $3.5 million a year, but some inmates come with pricey medical conditions.
"The open sign can't always be open for us," Trenary said.
The sheriff said he does not know yet how much the extra staffing and other improvements might cost. The conversion to electronic medical records alone would be a roughly $900,000 investment.
Trenary said his office will try to be creative in finding ways to pay for the upgrades from within its existing budget.
"What we are trying very hard not to do is to just hold our hand out," he said.
Jeff Miller, the newly appointed jail bureau chief, said a doctor overseeing the jail's medical operations might save money in some areas, such as prescription drugs given to inmates.
"We think with a doctor it will reduce costs," he said.
The jail also is considering other changes, including creating a team to conduct a "morbidity review" within 72 hours of an inmate death. The team, which would include medical professionals, would examine what went right or wrong with treatment. The review would not replace traditional criminal and internal investigations. Typically, there's a death investigation done by the sheriff's Major Crimes detectives and an internal review. If an inmate dies after officers use force, a team of homicide detectives from around the county takes the case, with prosecutors determining if any laws were broken.
Trenary also hopes to assemble a panel of people from within the community, including the mental health field, to provide advice on jail operations. He's not worked out the details, but he hopes the panel would include defense attorneys, corrections professionals and even former inmates.
"A year from now, my goal is we're on the right path," he said.
The National Institute of Corrections also has made several preliminary recommendations to improve safety within the jail, including improving sanitation, testing food to make sure inmates get enough calories each day, and more closely following policies. The sheriff's office requested the review last spring. The review team will return in September to examine medical conditions in the jail.
Their final report isn't expected until later in the fall. It's not an audit or an investigation that carries potentially binding recommendations.
The outside experts have found positive signs, including caring and committed workers, Miller said. The recent deaths have deeply troubled people working at the jail, where the safety of corrections workers and inmates is the top priority, he said.
The sheriff's office request for federal help followed two high profile deaths involving inmates who were both in their 20s.
Lyndsey Elizabeth Lason, 27, suffocated at the jail in 2011 when her infected lungs slowly filled with fluid. Other inmates said Lason had pleaded for medical care. A $10 million wrongful death claim is pending.
Michael Saffioti, 22, died at the jail in July 2012 from bronchial asthma triggered by severe allergies. His family has hired a Seattle attorney to press for answers. He was booked into the county jail as a courtesy because people were concerned that his health would be at greater risk in the city of Lynnwood's jail. A judge there had ordered Saffioti locked up for misdemeanor marijuana possession.
The family of Bill Williams, 59, also has raised questions about his death in September 2012. Arrested for shoplifting, the mentally ill man collapsed and died after being shocked twice with an electric stun gun.
The most recent death at the jail in July remains under investigation by the sheriff's office and the county medical examiner's office.
Eric Stevick: 425-339-3446, stevick@heraldnet.com

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