13 Investigates: Harris Health vows to 'do better' with inmate care

ByPooja Lodhia and Sarah Rafique KTRK logo

Tuesday, March 28, 2023

Harris Health talks to ABC13 about jail care after inmate deaths

The health agency exclusively serving the Harris County Jail explains to 13 Investigates about the changes made inside the detention facility after multiple inmate deaths.

HARRIS COUNTY, Texas (KTRK) -- When Harris Health System took over healthcare services for the county jail last year, leadership at the health system told us they knew they "inherited some risks."

Harris Health System Vice President Michael Hill said he also knew changes were needed to improve care for the nearly 10,000 inmates housed at any given time.

Now, one year later, Hill said the health system is still working on implementing those changes and more, including working with jail staff to ensure nurses have the escorts they need to provide medication to inmates on time.

"We work very closely with the sheriff on this process," Hill told ABC13's Pooja Lodhia during the health system's first on-camera interview since taking over the jail on March 1, 2022. "It's a very complicated process, and it requires both of us to come to the table and make some changes within our processes. We aren't satisfied either, and we won't be satisfied. We go to bed every night. We wake up the next day. We want to make this the safest jail in the country."

13 Investigates has been analyzing overcrowding and inmate care at the jail for nearly a year.

Our investigation found the jail has been cited for the same healthcare deficiencies more than once, and it is still non-compliant with state jail standards, including for not booking inmates within 48 hours and not delivering medication in a timely manner.

The jail also violated state standards by not providing insulin and blood pressure medication to an inmate who died exactly one year ago today, according to the Texas Commission on Jail Standards.

Matthew Shelton, who turned himself in on a DWI charge, died on March 27, 2022, of diabetic ketoacidosis. He had been in jail just five days, and his sister told 13 Investigates he was worried about his diabetes and was not getting his insulin.

One year later, his family said they still remain "in the dark" about what happened that day.

"To this day, the sheriff's office, the jail staff, the County, and Harris Health have shared no information with the family," John Flood, who represents the Shelton family, said in a statement on Monday. "There already exists a powerful health and safety management protocol for dealing with an inmate who is an insulin-dependent diabetic. Don't withhold life-saving medicine from him. Tragically, that minimum level of regard for Matthew and his rights wasn't met by the sheriff's office, the jail, or Harris Health."

TCJS, which looked into whether or not state standards were met by the county after Shelton's death, found medications weren't delivered in Shelton's case.

Harris Health said it couldn't speak to certain cases but said the timely delivery of medications is something Harris Health said it's been working on since taking over last March.

"We need to do a better of the delivery of medications, and we need to do a better job of taking care of chronic illness and sick call visits, so those aren't new, and those aren't a result of the deaths," Hill said. "Those were identified early on."

Dr. Reggie Egins, Harris Health's chief medical officer of correctional health, said nurses and physicians treating jail staff are always busy, from scheduled appointments and emergencies to patients with chronic illnesses or those requiring constant care.

"It is a continuous clinic. We see at least 600 patients a day, and you can imagine we have 10,000 potential patients here. Every detainee that walks into this facility can become a patient," Egins said. "If you think about it, the largest hospital in the Texas Medical Center, I think, probably has a little over 1,000 beds. And so if you have to think about us having to prepare for taking care of potentially 10,000 patients, this does become a big piece."

Last year, 27 Harris County inmates died - the highest in a decade. The jail population is also the highest it's been in a decade, with nearly 10,000 inmates locally and hundreds more outsourced to other counties.

"My sincere condolences go out to every family who's lost a loved one inside this jail. No one should ever take their last breath in jail, and we come to work every day to make sure that doesn't happen again," Hill said. "We are constantly looking at our processes to make sure individuals who come through those doors are taken care of the way I would want my loved one to be taken care of."

Despite being cited in December 2022 for failing to provide insulin to Shelton once he was housed, the county is still working on fixes.

The jail submitted an action plan to the state, but a recent re-inspection in February found the medication issues, and others, still exist.

During the latest state inspection, from Feb. 13-17, TCJS reviewed 60 random inmate files and found "two inmates were not attended by medical staff within 48 hours, as required by the facility's operation plan."

The inspection cited an inmate who "was not seen by dental for 38 days."

The report mentions another inmate who put in a request for medical treatment due to a bullet lodged in his neck on Oct. 4, 2022, but was a "no show" for his appointment three days later, though there was no documentation indicating why he didn't show up. A second request was put in on Oct. 28, 2022, but he wasn't seen by medical staff until 10 days later, according to the state jail commission's findings.

Earlier this month, Sheriff Ed Gonzalez told commissioners the jail has actually been noncompliant with state jail standards for 14 of the last 20 years.

The jail staffing is down 150 detention officers, he said.

"As you might imagine, we have struggled to recruit and retain enough qualified staff to work in this challenging environment. For $19.75 an hour, there are plenty of other options in a more competitive hiring market," Gonzalez told commissioners at the county's March 14 meeting.

Staffing is something both the jail and Harris Health said they're struggling with.

"Staffing certainly plays a role. Staffing is not contained to Harris County Jail," Hill said. "It's a nationwide problem on the medical side. Nurses are at a premium to the fact where it's hard to recruit a nurse, let alone bring them into a correctional healthcare environment to recruit nurses. We have enough budget dollars. The county's been very generous with the budget dollars they've given us. It's that ability to find those resources. Our retention is very good. (The difficulty) is actually recruiting the staff to come inside the jail."

One thing Hill said has helped is that the sheriff's office is committed to providing Harris Health with the jail escorts they need to ensure inmates receive their medication when they need it.

Egins said nurses also do an audit evening and overnight to make sure any patients who return to the jail facility overnight continue to receive their medication.

Additionally, the sheriff's office and Harris Health meet every Monday to go over any issues that may have come up over the previous week.

"Any issues that have come up over the past week, we identify those issues, we bring them to the table, and we try and find a corrective action plan to prevent any serious events because these may have been good catches that we found," Egins said. "What we want to do is implement a plan by which it doesn't result in a serious event."

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