Medical care in the Dallas County jails continues to improve, but the lack of an adequate jail infirmary continues to create a ripple effect of problems, according to the federal government's latest inspection.
The county plans to spend about $50 million to build an infirmary in the north tower jail at the Lew Sterrett Justice Center. But the project is still in the design stage, and completion is up to three years away.
Despite the substandard infirmary care, the county received its best federal evaluation of inmate health care so far, indicating that the takeover of those duties by Parkland Memorial Hospital in 2006 is working.
"The overall improvements since our last visit have been remarkable," the report said.
The report also reveals the extent of the fire safety problems in the county's largest jail that contributed to a seventh straight failed state inspection at the end of March.
Only three weeks before the Texas Commission on Jail Standards inspection, the north tower's smoke removal system performed so dismally during a test that a housing area had to be evacuated, according to the Justice Department report.
The report was based on a four-day inspection of the jails that began March 2.
County officials hope to soon see an end to the required inspections every six months by Justice Department jail health consultants that the county must pay for.
The regular visits are a condition of a 2007 agreement between the county and the federal government that arose from a lawsuit over conditions at the jail.
The lawsuit was intended to make sure the county corrects 58 problems, mostly with inmate-health issues, that the Justice Department found after a lengthy investigation. Parkland and the county have corrected a little less than half of those problems and have made significant progress in most other areas, the latest report says.
"I'd say that's a pretty positive report," county Commissioner Mike Cantrell said. "The efforts of everybody working together has got us to this point."
Besides the lack of infirmary care, other nagging issues included a slow response to sick calls, failure to track seriously ill inmates and lack of proper maintenance, which has contributed to the fire safety problems, according to the report.
The inspectors looked at 27 sick call requests, for example, and found that 12 patients weren't seen at all.
It's still taking two to three days for inmates to receive medications, although that's an improvement over the four-day average delay found during the previous inspection.
During the last inspection, the inspectors pointed out high numbers of inmates being sent to Parkland's emergency room. That number, however, has fallen by 45 percent, indicating "better on-site services," the report said.
Except for the jails' ventilation system, the "overall cleanliness of the facility was very good," the report said.
The federal inspectors expressed concern about fire safety problems in the north tower and George Allen jails.
The George Allen jail has since been emptied. On the north tower's third floor, the smoke removal system took almost twice as long as it should to clear the area of smoke during a test, according to the report.
"According to the fire marshal, this was not an isolated problem. He indicated that the north tower has recently failed other smoke evacuation tests," the report said.
Inspectors found exhaust ducts "heavily laden with dust due to years of neglect," which they identified as a fire hazard. The report said a recent fire incident in the north tower jail appeared to be caused by a spark from mechanical equipment igniting a layer of dust on the equipment.
The layers of dust that accumulate in the air handling system can also hamper smoke removal, greatly increasing the risk of harm in the event of a fire, the report said.
"In addition, when the smoke detectors located in the ductwork become clogged with dust, they may not activate or may not reset themselves properly, as was the case in the fire drill," the report said.
Also, few jail guards who were questioned knew the jail's fire and emergency procedures, the report said.
Dallas County commissioners voted Tuesday to form a special jail maintenance team to address the concerns of both federal and state inspectors.
"We're making progress," Commissioner John Wiley Price said about the jail system. "It's a small city."
