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Attorneys have asked a judge to take control of the DeKalb County, Ga., jail, following a report that says medical care at the facility is so bad that inmates are “at high risk of pain … and perhaps death.” On Wednesday, attorneys working with the Southern Center for Human Rights in Atlanta filed a motion with DeKalb Superior Court Judge Hilton M. Fuller Jr., asking that the DeKalb County Jail — the fifth-largest jail in the country � be placed in receivership. Attorneys also asked Fuller to hold county officials in contempt for violating a March settlement agreement in which they had agreed to improve jail health care dramatically. Adams v. Dorsey, No. 98-cv-11747-5 (DeKalb Super. July 25, 2001). The March settlement was negotiated under the supervision of Fuller, who said when the settlement was announced that conditions at the county jail “make one’s flesh crawl.” “When government takes someone into custody, it has a responsibility to treat that person humanely,” Fuller said from the bench that day. He also chastised former DeKalb County Attorney Jonathan Weintraub as “ill-advised” in orchestrating a campaign of “petty procedural squabbles designed to delay and direct attention from the real issues. These efforts achieved little, if anything, and were conducted at great costs in county funds and human misery. “I suspect that Nero had better legal advice than did the county … in the early stages of this litigation.” REPORT: INMATES’ HEALTH AT RISK Since the settlement was signed, medical conditions at the jail actually have deteriorated, says Southern Center attorney Tamara H. Serwer. As evidence, she cites a report issued last week by a physician that Fuller appointed last year to monitor medical services at the jail. Dr. Robert B. Greifinger, a national expert on correctional health care, also has been appointed by senior federal Judge Marvin H. Shoob of the U.S. District Court for the Northern District of Georgia to monitor troubled medical service in the Fulton County Jail. Last week, Greifinger conducted his first inspection of the jail since the settlement was signed, and county officials agreed to make immediate improvements in medical services. The report says inmates “are at high risk of pain, deterioration of function, and perhaps death.” The motion accuses county officials of “having failed utterly to comply with virtually every substantive provision of the [settlement] agreement” resulting in conditions that reflect “a shocking level of deliberate indifference.” Calling the request for receivership “an extraordinary action,” Serwer says if Fuller grants the request, it may be the first time that a Georgia jail has been placed in receivership by a county judge. “Receivership is really an extraordinary action, and we know that,” she says. “We’re not taking that lightly at all. We would not be asking for such an extraordinary sanction if we didn’t think it was the only thing that would change what’s happening over there.” Serwer says attorneys representing DeKalb County jail inmates are filing a “notice of conflict” challenging DeKalb County Attorney Charles G. Hicks’ role as attorney for both the county and newly elected Sheriff Thomas Brown. The county has issued a rule barring the new sheriff and his staff from getting copies of any jail medical records, Serwer says. County officials also have barred medical staff hired by Healing Touch Inc. from communicating with the sheriff, who runs the jail, according to Serwer. Healing Touch was awarded an emergency, three-month contract last April. At the time, over Brown’s objections, county officials agreed to pay Healing Touch approximately $570,000 a month to provide medical services at the jail . The county is supposed to consider recommendations for a new medical service provider in August. COUNTY CALLS REQUEST ‘IMPROPER’ Neither Hicks nor Assistant County Attorney Xernia L. Fortson, who participated in settlement negotiations last spring, returned calls for comment. But Hicks did fax the Daily Report a copy of a letter he sent to the inmates’ attorneys on Wednesday that challenged their request for receivership as “improper.” The settlement agreement requires the inmates’ lawyers to resolve disputes by filing a motion to enforce the agreement after notifying the county attorney in writing, Hicks’ letter said. According to the agreement, the county has a month from the date of notification to “cure any problems.” But the inmates’ attorneys, in a separate motion, claimed they had “engaged in good faith attempts” to obtain medical records and documentation that the terms of the settlement had been met only to be ignored, rebuffed or hampered by interminable delays. Fuller has given the county until 4:30 today to respond. The allegation that county officials interfered with the sheriff’s ability to manage health care is supported by the affidavit of Peggy Howard, a registered nurse who worked at the jail for more than two years until she left in June. She says in the affidavit that Healing Touch CEO Nathaniel Johnson III warned jail nurses not to communicate with the court-appointed jail monitor or any of the DeKalb sheriff’s employees. Doing so would result in severe repercussions for the nurses, who, Johnson said, he would “run over like a freight train.” The county ban on communication between the sheriff and the medical provider “severely limits the sheriff’s ability to adequately supervise the quality of medical care,” Serwer says. “The sheriff’s main liaison between the medical contractor and corrections has been completely disempowered. This medical company really is operating almost completely unchecked by anybody.” Brown was out of town Wednesday and unavailable for comment. His spokeswoman, Mikki Jones, says the sheriff “is not at liberty to make in-depth statements” because of the ongoing litigation. “Sheriff Brown says, as he said in his campaign, that the single most important issue of concern to him is bringing quality medical care to the inmates because the quality of medical care also affects the general population. “However, that is done through the vendors. The current provider, Healing Touch Inc., was not the sheriff’s recommendation to the board of commissioners.” In a letter to County Attorney Hicks last April, attorney Chip Rowan, who is working with Serwer and the Southern Center, wrote: “I am profoundly disappointed in the County’s choice of medical providers. … Not only doesHealing Touch have extremely limited correctional experience, but as you know, they have a dismal track record at the Jail. Healing Touch’s incompetence was one of the reasons why this litigation was brought in the first place. It is therefore incomprehensible to me why the County would have made this choice, especially considering that Sheriff Brown had recommended other, more competent vendors.” Healing Touch has never provided medical services at any jail other than DeKalb, Serwer says. The firm was a subcontractor of Correctional Healthcare Solutions, the troubled medical services delivery company that Fulton County Sheriff Jacquelyn Barrett terminated last year. DeKalb County commissioners contracted with CHS in December 1999, saying later they were unaware that the firm’s deficiencies had caused Fulton County jail inmates to sue. Ann Kimbrough, DeKalb County’s communications director, says that County CEO Vernon Jones did not recommend that county commissioners hire Healing Touch. In DeKalb County, the CEO has no vote, and Jones did not make a recommendation, she says. Healing Touch’s Johnson could not be reached for comment Wednesday. There is no telephone listing for Healing Touch at the corporate address provided to the Georgia Secretary of State. Forrest B. Johnson, the registered agent for Healing Touch, identified himself as Nathaniel Johnson’s attorney but declined to say if he was related to the company’s CEO. He said he would call his client, but declined to provide even a corporate telephone number for Healing Touch. CLASS ACTION SUIT BROUGHT In 1999, Fuller appointed Decatur attorney Robert L. McGlasson III to represent jail inmates who had complained they received little or no medical attention. McGlasson eventually filed a class action suit that sought no monetary damages but asked that medical services be improved drastically. Fuller appointed two independent jail monitors and also ordered the county to pay McGlasson’s legal fees. County officials refused, winning on appeal. They also attempted, but failed, to have Fuller forcibly removed from the case. After Jones was elected CEO last year and Brown was elected sheriff in a special election in March, the county settled the case. Since then, say the inmates’ attorneys, conditions have only become worse. “We’ve been playing political and legal games for years,” Serwer says. “During that time period, 75,000 inmates have come in and out of that jail.” The inmates’ attorneys filed the receivership motion just days after receiving Dr. Greifinger’s report on jail medical services. Last week, Greifinger made his first official visit to the jail since the settlement was signed. His findings, Serwer says, were “just abysmal. … The care is horrible. The staffing is almost nonexistent. There is evidence of falsification of medical records.” Among Greifinger’s findings: � The use of a technician rather than a licensed pharmacist to dispense medication in violation of Georgia law; � The use of college students without medical training to screen medical requests by inmates; � Staff that is both untrained and “inadequate for a jail of this size”; � The falsification of inmates’ medical records to reflect treatment or medications that they never received; � The use of “archaic” medications that cause serious side effects “instead of more modern, more effective and safer ones,” especially for the treatment of people with mental illness; � Mismanagement of the treatment of diabetics to the point that “over 50 percent have blood sugar levels that imminently subject them to blindness, heart disease, end stages [of] kidney disease, amputation and death”; � “Uncounted hundreds” of unanswered sick call requests, some more than a month old; � Failure to establish certified tuberculosis isolation rooms “despite a large expenditure of funds”; � Instances when inmates with contagious tuberculosis were housed with the jail’s general inmate population, potentially exposing other inmates, jail staffand the public; � Denial of prenatal care to pregnant women; � Failure to treat people with sexually transmitted diseases; and � Failure to provide medication to HIV-infected inmates or those suffering from high blood pressure or mental illness. JAIL COMMUNITY ENDANGERED In his report, Greifinger said inmates “are not able to access care. There is no coherent medical record. There is no continuity of care and no coordination of care with outside specialists. Screening is inadequate. Basic public health safeguards are being ignored. … These poor practices endanger staff working in the facility, and ultimately the community to which the staff and inmates return.” Serwer says she hopes that Fuller not only will grant the request for receivership but appoint someone with experience in jail operations with “the power to hire, fire, fund and do what is necessary … to get this totally destroyed system into reasonably adequate shape.” “Unless there is someone empowered to do that, who is outside the politics of DeKalb County, nothing will change. … The reality is the elected officials have demonstrated a total inability to properly manage that money, to get even a minimally adequate service delivered. … It’s a disaster, total disaster.”

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