Jail Facilities recommendations

The Jail Facilities category includes 38 recommendations. 23 recommendations (61 percent) have been audited and completed, 13 recommendations (34 percent) are covered by consent decrees and monitored by experts under federal court oversight, and 2 recommendations (5 percent) are not covered by the consent decrees and subject to audit by OCLEM.

	Not covered by Consent Decree/subject to audit by OCLEM.
	Covered by Consent Decree and subject to monitoring by federal court appointed experts.
	Completed, audited, and presented to the Board.

Recommendation	Master List Number	Status (Updates are in progress)
Restructure the operation of the current acute “inpatient” psychiatric unit of the jail (Unit 8A) to ensure that it operates as a therapeutic environment that supports inmate recovery and wellness.  This would include ending restrictive housing on 8A and ensuring sufficient program and out-of-cell time per day for each inmate; increasing the number of therapeutic and recreational individual and group program offerings on the unit; and ensuring compliance with state standards for operation of a licensed Correctional Treatment Center.	100
The Department needs to reopen an “Assessment and Observation” unit. This is an important unit to house inmates in the first 24 hours after arrest. During the first 24 hours, the module officer will monitor inmates’ behavior and can render medical or mental health services promptly.	104
Improve sanitation and health for detainees and staff by: 1.Provide more frequent complete changes of clothing, extra towels and linens. 2. Provide easy access to cleaning supplies. 3. Provide easy access to hygiene items such as soap, deodorant, shampoo, and feminine hygiene needs.	152
Inmate Barber Equipment and Hair–Cutting Services: My recommendation is each module should have their own barber kit and hair-cutting services should be available when inmates are out for dayroom time or at least once per week, not once per month.	153
Razors: I recommend the Department to purchase enough electric razors for inmates who are housed in a special management dorm.	154
Provide a quiet staff break room. Corrections work is one of the most stressful in law enforcement. Staff need a place to go to escape the hustle and bustle of the workplace. The ambiance of the break room can impact morale and motivation. Department should provide a clean, quiet break room for officers to unwind and rejuvenate to help them reduce stress in order to be an effective officer, especially if they are working in a high stressful area such as acute psych area (8A), Intake Booking, Medical Infirmary, etc.	159
The Sheriff’s Department or other entity that may be in charge of jail operations, in collaboration with community stakeholders, should develop a best-practices protocol for the operation of the cameras installed in the jails, which protocol should be made available to the public via the Department’s website. The protocol must include procedures for storage of the footage and for access to the footage by non- Department members.	160
Place cameras in all elevators.	161
Explore the feasibility of staffing the women’s section as an autonomous facility.	177
Inventory and assess current equipment needs into sets of priorities, so when resources  become available purchases can be made quickly, but wisely.	198
Ensure HD digital cameras are placed throughout the facility and operated legally and consistently with best practices: Cameras in jail visiting areas; Complete (“blanket”) coverage of jail facilities, no blind spots; Complete (“blanket”) coverage of jail facilities, no blind spots; Footage stored for 24 months.	323
Implement cameras with a policy of "write, review, amend," whereby correctional officers can view footage after they write up standard reports and can amend their reports if they see something they missed. However, review of footage would be halted during any use of force investigation, and footage would only be made available to the investigator.	324
Implement an upgrade of computers, software, and security technology to meet best practices and standards for county jails.	325
Direct FAF to immediately resolve poor plumbing, water temperature, heating, lighting, and access to water for showers and consumption. Inmates should not have to wait for a new building to be constructed to resolve this human rights concern.	337
Ensure that inmates are allocated sufficient and effective cleaning supplies to maintain the hygiene and safety of their cells and dorms.	338
Increase and modernize the video camera surveillance system throughout custody facilities.	364
Replace aging Main Jail South with a quality facility that will provide additional bed space, increased programming and expanded  medical and mental health treatment options for inmates.	419
Complete structural modifications in the Main Jail North Booking Area to allow medical and mental health staff to screen inmates for sensitive health care information in a confidential setting to comply with federal HIPPA requirements.	422
Expand the number of medical beds at Elmwood Correctional Facility.	423
Begin the necessary repairs and physical improvements to Elmwood’s M1 building that will result in the addition of 80 more medical beds. Funding has been allocated and construction has commenced.	424
Establish dedicated FAF maintenance and repair crews to work directly with custody personnel. This will allow FAF to quickly identify, prioritize and complete maintenance, repair, and improvement projects of custody facilities.	425
Complete identified improvement and modernization projects at Main Jail and Elmwood.	426
Expand structured and unstructured “out time” for inmates by making improvements to housing units that have been closed due to age or physical conditions.	427
Request immediate funding for facility improvements at Elmwood to move low‐level, pre‐trial inmates to Elmwood and create a minimum camp for Protective Custody inmates.	428
Implement an automated tracking system that documents inmate infractions, custody staff involved, infraction type, and consequences for an infraction.	429
The Jail must update its data systems with 21st-century technology.	510
The Jail should take immediate measures to meaningfully improve conditions, enhance supervision, and alleviate crowding in Main Jail South.	520
The policy on the Security of Dental Instruments should be revised to specify a role for custody.	558
Neither of the clinics have a panoramic radiograph device. Inmates deemed to need a panoramic radiograph are sent to a County health clinic off-site. In preparation for the Interceptive Care Phase (Phase 2), Dr. Shulman highly recommends taking panoramic x-rays of long-term inmates who request a dental examination. Consequently, he recommends that a panoramic device, which he estimates costs $25,000, be available to inmates at Elmwood and at Main Jail as well as trained dental assistants, which is not a fulltime position, to operate them.	563
The DOC should consider the feasibility of expanding one of the clinics at Elmwood or identifying space for a larger clinic due to Dr. Shulman's proposal to increase staffing and clinic hours.	564
As Interceptive and Routine Rehabilitative Care are introduced, Dr. Shulman notes that there will be a need to make study models and do minor denture repairs and adjustments. He recommends identifying a dedicated space for a small laboratory that is outside the patient treatment area.	565
The construction plan for the new jail should be evaluated to make sure that there is sufficient space for clinical operations as well as for inmate holding. In addition, he suggests that the clinic contain adequate counter space for proper instrument cleaning and disinfection, adequate wheelchair access, sufficient storage space for supplies, and at least two dental operatories. Moreover, the clinic should contain a small dental lab for minor denture repairs and pouring and trimming study models.	566
Dr. Shulman recommends that dental treatment provided to inmates be recorded using the American Dental Association's Code on Dental Procedures and Nomenclature. Dental progress notes are currently maintained in a paper chart, while other data entered by dentists, such as medication orders, are entered in the electronic medical record. Dr. Shulman recommends that the tooth diagram currently used on the paper chart be changed, but noted that this issue may become moot if an electronic dental record (EDR) is purchased. Dr. Shulman also recommends that the dental component not be part of a commercial EDR (which generally does not serve the unique needs of dentistry) but rather an off-the-shelf dental system that can interface with the EDR.	567
Dr. Shulman recommends that the number of Custody Officers be increased to facilitate inmate transport to the dental clinic. Currently, only one dentist is present in the Elmwood clinics, which have two chairs. If increasing treatment requires these clinics to be staffed by two dentists (or a dentist and a dental hygienist), Dr. Shulman notes that holding cell capacity will have to be increased; or alternatively, the frequency of inmate transport will have to be increased to ensure that inmates with incompatible custody levels are not scheduled for the same clinic period. Dr. Shulman notes that the frequency of transport may also reduce refusals. Dr. Shulman also recommends that Custody Officers be given responsibility to dental tool control in the dental clinics for security reasons.	569
The intake facility would benefit from a redesign of the physical plant. At a minimum, the nursing interview stations where the intake assessments are done need to be modeled after traditional health care design. This would eliminate the standup desk in favor of sit-down stations that guarantee privacy and enable the nurse to have full observation of the patient as well as access to the patient to conduct a proper physical examination.	573
Additional room functionalities need to be added to the intake area to enable staff to isolate and to separate patients when appropriate. These room functionalities should include isolation cells, padded cells, biohazard cells, and an area where a more extensive physical exam could be conducted if necessary.	576
The intake facility should implement a comprehensive tracking methodology for all requests for outside medical records, reconcile requests against what has been received, and document follow-up requests when the information has not been received.	581
The intake facility should investigate whether additional consent is necessary from prisoners in order to obtain their health care records in a way that is compliant with HIPAA standards.	582