Miami-Dade County has agreed to a long and expensive list of ways to improve how it treats its inmates particularly those who are mentally ill or suicidal, bringing to an end an investigation the U.S. Department of Justice launched five years ago that found civil-rights violations at county jails.
As part of two agreements approved by county commissioners Tuesday, Miami-Dade must construct a mental-health treatment facility for inmates, which is estimated to cost between $12 million and $16 million to build and more than $29 million a year to operate.
The county must also install a $6 million electronic jail management system that will cost an additional $500,000 a year to maintain, install an additional $1.2 million in video monitoring equipment and spend $1.3 million more a year to train corrections employees.
Its time that we change the way weve been dealing with this problem, said County Judge Steve Leifman, a longtime critic of the jail system and reformer who for years has pushed for the mental-health facility. This is an excellent step in the right direction.
The DOJ wrapped up its three-year review in 2011, concluding that Miami-Dades jail system the eighth-largest in the nation engaged in a pattern and practice of constitutional violation against inmates housed in deplorable living conditions under abusive, inadequate or limited care.
Since then, officials in the countys Department of Corrections and Rehabilitation and in the Jackson Health System, which provides medical care for inmates, have been negotiating with the feds, noting improvements they have already made and hashing out the final accords.
The county and the Public Health Trust that oversees Jackson signed a consent agreement, which will be enforced by a federal judge, over the medical and mental health-care issues. The county signed a separate private party settlement agreement, not under court oversight, over jail operations issues, some of which Miami-Dade has already addressed.
Among the required changes, the jails must:
• Have a medical doctor or psychiatrist evaluate inmates with serious medical or mental conditions within 24 hours of their arrival.
• Report to the court and DOJ each death or serious suicide attempt within 45 days of each incident.
• Require suicide-prevention training for officers.
• Prohibit retaliation against inmates by sending them to suicide-watch cells.
Require visual observation every 15 minutes of inmates who are restrained.
• Provide group counseling sessions for mentally ill patients, as needed.
• Create an Early Warning System to document and track corrections officers involved in excessive use-of-force incidents.
• Report use-of-force incidents to supervisors no later than 24 hours after they occur.
Prohibit threatening inmates with the use of restraints.
• Require fire drills every three months on each shift.
Miami-Dades jail system has long been plagued with problems. Inmates sued for overcrowding in the 1970s a condition a federal judge declared unconstitutional 1984. The case was settled after 25 years. Grand juries issued blistering reports on jail conditions in 2004 and 2008.
Last month, state health inspectors investigated conditions at one jail after an employee complained about rats. Inspectors did not find rodents but did identify cracks and holes in walls and pipes that would let rats come into the jails kitchen.
Corrections Director Tim Ryan, who was hired in 2006 to overhaul the jails, said the department has changed many policies since DOJs investigation began.
Among the key changes: reducing the inmate population, which now averages less than 5,000 a day in the countys five facilities, down from 7,400 in 2008, Ryan said. Judge Leifman attributed the reduction in part to the courts training more police officers to recognize mental illness.
The corrections department also created an Alcohol Detoxification Unit and increased training for corrections officers.
Still, work remains to be done, Ryan acknowledged.
We are the largest mental-health hospital in Florida, he said.
About 500 inmates with serious mental illnesses are housed separately from the general inmate population, according to the department. Another 1,600 to 2,000 in the general population have been diagnosed with less acute conditions.
The new mental health facility, which has been in the works for years, would retrofit a portion of the jail to provide a more therapeutic environment for mentally ill inmates.
Instead of just kicking people out of the criminal-justice system out to the street and expecting them to recover and not come back to this building, well be focused on giving them all the services that they need, said Leifman, who wrote the county a letter earlier this month outlining the best options for the facility.
The agreement requires electronic medical records for inmates (estimated cost: $230,000), additional medication and supplies ($293,000), a comprehensive staff analysis ($300,000) and outside monitoring for both agreements ($125,000 and $250,000 a year, respectively).
The changes are intended to better track and care for ill inmates, after DOJ found many failed to receive proper medical attention. The jail botched the medication dosages in some cases, and did not monitor or treat some chronically ill prisoners, the 2011 study found.
The report also found the department did not adequately address inmates suicide risk and mental health. In the past five years, the corrections department has documented six suicides, including two by mentally ill inmates, said Janelle Hall, a corrections spokeswoman.
Jailers also used excessive force and retaliated against inmates, and did not properly document those incidents, according to DOJs findings. And the jail conditions were found to be dangerous and unsanitary.