Healthcare suffers at L.A. jails

Healthcare suffers at L.A. jails

By Scott Glover and Matt Lait

Los Angeles Times Staff Writers (California, USA)

12:07 AM PST, December 24, 2006

Excerpts:

The Los Angeles County Jail system lacks enough doctors, nurses and other medical workers to meet the most basic needs of inmates, resulting in long delays in treatment for conditions ranging from hernias to heart disease.

"We face unique challenges, and we do the best we can," Smith said. "These are difficult, angry, messed-up people. We try to treat people with the respect, not that they necessarily deserve, but that human decency demands."

Smith cited recent improvements in the quality of care: Medical records have been computerized, allowing for better tracking of doctors' orders, and distribution of prescription drugs has been automated, reducing medication errors. He said the department plans to launch a "telemedicine" program that will expand the reach of doctors by allowing them to remotely diagnose and treat inmates via computer and teleconference.

Smith acknowledged, however, that staffing shortages still exist and "bad outcomes" occur.

An average of about 200,000 people enter the county jails each year. On most nights, the population hovers around 18,000, with more than a third requiring medical care. Many are in fragile health because of drug abuse, homelessness or chronic illness. For some, the only time they see a doctor is when they're behind bars.

The county Sheriff's Department, which runs the jails, is required by state law to provide basic medical care to all inmates — 90% of whom have not been convicted of the charges against them.

"Today's jail population is older and sicker than it was a decade ago," Smith said. "The healthcare system is broken on the outside, and we see that in here."

"I could have every doctor in the county of Los Angeles here, and it still wouldn't be enough," said Sander Peck, chief physician in the jail system.

"The case ...llustrates how errors, oversights and inaction have contributed to inmate deaths."

Since 2005, the county has allocated about $20 million to hire 280 more nurses and 13 more doctors, officials said. The Sheriff's Department, however, has been unable to fill nearly 100 of those positions, in part because of competition from private hospitals and clinics.

That is the best that can be hoped for, he said, since inmates are not a political constituency.

"This is an underserved population for a reason," he said.

(photo credit: cjbj )

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