Tuesday, November 15, 2011

McLennan Court continues jail 'housekeeping' tasks

Waco – Dr. John Wells took a deep breath, sighed, and asked, “Can I be frank?”

Assured by the members of the Court that he could, the jail doctor exhaled, his shoulders lowering and his body visibly relaxing, and explained himself this way.

There is a jail operated by McLennan County on Highway 6. There is another jail on Highway 6. It is operated by CEC, Inc., and it's named the Jack Harwell Detention Center. Everyone nodded. They knew all too well where his narration was headed.

When inmates are in custody at the McLennan County Jail, Dr. Wells is in charge of their health care – including psychiatric medications to keep the mentally ill calm.

When they are transferred to the Jack Harwell Detention Center, which is operated by the private corporation CEC, circumstances change very quickly.

“We are about 200 yards away and there's something in the air between our jail and their jail; and on the way over there, they get sick, blind, deaf, and dumb.”

The Court erupted in laughter. But they became serious enough again when he explained that all the lab work, medication, medical examinations, evaluations, and other matters medicinal are charged to McLennan County under the terms of the contract that exists between the corporation and the local government in its ministerial duty to keep inmates in custody.

“Will you keep us posted on how that's going?” asked Commissioenr Joe Mashek. The doctor assured him he would.

He had just finished a presentation explaining a proposed joint operation with the Texas Department of Mental Health and Menatal Retardation to provide evaluative services and consulting on inmates suspected of or who have a history of psychiatic disorder.

Without doubt, there was good news and bad news.

The bad news is simple enough. You can tell it by listening to the doctor's words.
“We have one person out there who has the maturity level of an 8 or 9 year-old. He's been out there for weeks. Really, all we're doing is babysitting.” Then he let a colleague from MHMR heap a little more bad news on the Court.

It costs an estimated 8 times more to keep a mentally ill person in custody than it does to care for and feed a normal inmate.

That's where the agreement with MHMR would come in handy. As a result of the teamwork between the Sheriff's Department release officer, the Jail Magistrate, and the medical staff, they have been able to reduce an average of 408 mentally ill inmates per month to 105.

Where it takes one to 3 and half hours to take an inmate to the MHMR office to do an evaluation, it would be much quicker and better to perform the service in-house.

“We can combine forces,” Dr. Wells said. “We want to hire a clinician to work 40 hours a week to divert people who realy don't need to be in there.”

His latest budget request for such a consultant was cut to $20,000 per year. “I can't hire anyone for that type of money,” he added.

“They county's becoming the mental hospital.”

He needs enough money in his budget to supply half of an estimated cost of $80,000 per year with MHMR to do interventions with sick people who aren't necessarily criminals.

County Judge Jim Lewis agreed with him about the heaping of the mentally ill on the slim Jim medical services of the county lockup.

“They're just dumping them in the county jails,” he said. “They never cut the number of beds; they cut the funding.”

Dr. Wells re-emphasized his dilemma.

“I might be many things, but I'm not a psychiatrist...” he said. If a consulting psychiatrist is retained, he will work 40 hours a week, spending a lot of his time with the MHMR Intervention Team to do evaluations and diversions of people who can be better treated at the State Hospital or the clinics. It would be the job of the psychiatrist to make recommendations of what drugs to prescribe and Dr. Wells' job to find the generic form and make adjustments accordingly.

In other matters, the Court learned that the Bureau of Prisons will need enough space to house overflow federal prisoners in March. Accordingly, they have upgraded the Jack Harwell Detention Center and the old Downtown Jail Annex to handle between 500 and 600 inmates, up from the maximum of 100 previously certified.

According to a CEC executive named Mike Caltabriano, the reality is that the Bureau of Prisons is probably targeting an actual figure of about 300 inmates to be housed at the corporation's facilities in McLennan County.

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