Jail care for women is criticized

Female inmates in the Los Angeles County jail system have waited weeks, even months, before receiving medical treatment that should have been provided within 24 hours of their requests for help, according to a monitor’s report released Friday.

Additionally, Sheriff’s Department officials have inadequate written policies on how to treat sick or pregnant women housed in their jail facilities, according to Merrick Bobb, a special counsel hired by the county Board of Supervisors to monitor the department.

For instance, Bobb noted that the department has no policy forbidding the shackling of a female inmate during childbirth even though state law prohibits it.

Although deputies told Bobb’s staff that they generally don’t shackle women giving birth, a county hospital delivery nurse said “leg chains, which are heavy but long enough to allow the inmate to get to the bathroom, are often present during childbirth,” the report stated. Bobb recommended that the department adopt a policy that conforms with state law.

In his semiannual report to the Board of Supervisors, Bobb also recommended that “every woman who asks for medical attention or to see a nurse gets to do so within 24 hours of the request,” in compliance with national standards for jails and prisons set by the National Corrections Commission on Correctional Health Care.

In response to the report, Sheriff’s Department spokesman Steve Whitmore said department officials have decided to implement a new procedure ensuring that female inmates get to see a medical worker within 24 hours of their requests. He said the department plans to extend the number of hours that nurses are made available to inmates.

Whitmore, however, disputed suggestions that women were shackled during childbirth. He said restraints are only used on inmates who have mental health problems.

Each year, the Century Regional Detention Facility in Lynwood houses more than 30,000 women and averages about 2,000 women in custody daily. Many women are sick when they arrive, Bobb said. And, he noted, the jail treats as many as 1,400 pregnant women a year.

Though he praised the dedication of the jail’s medical staff, Bobb said sheriff’s officials needed to implement clearer policies for nurses, deputies and other staffers on how to provide women with proper care.

He said there were not enough nurses and other medical staffers to accommodate the inmates’ needs. And, he said, the county has also been slow to fill many of the vacant medical employee positions in the jails.

Bobb’s conclusions were similar to findings in a Times investigation in December 2006, which determined that a lack of nurses, doctors and other medical workers resulted in long delays and breakdowns in medical care and left medical conditions for male and female inmates untreated

In Bobb’s investigation, he found that some women with conditions such as passing blood clots, hives and yeast infections waited days, weeks and even months before receiving treatment. In some cases, the inmates were released from custody without getting help for their maladies.

“Delays in the provision of medical services are not even tracked, contrary to good practice as defined by the medical profession,” Bobb wrote. Because of the poor record keeping, he said it was impossible to determine precisely how long some inmates waited to receive treatment.

According to Bobb, about 10 to 25 female inmates per housing area ask to see the nurse each day. But fewer than five women a day get to see a nurse. As a result, the number of inmates requesting medical attention mounts over time.

Another problem Bobb identified in the jails was the limited time mothers were given to visit with their children. Because visits are arranged on a first-come-first-served basis, children sometimes wait all day in visiting areas without seeing their mothers.

Whitmore said that Sheriff Lee Baca planned to adopt Bobb’s recommendation to implement a system that would allow children to schedule their visits for a specific time.

Bobb also reviewed the last six years of litigation against the Sheriff’s Department and found that there has been a reduction in lawsuits in recent years, particularly concerning use-of-force complaints. He credited the reduction to better risk-management practices.

Yet, while the cost of force-related litigation has declined, Bobb noted that costs of jail-related cases have increased. Of the 17 lawsuits settled for more $100,000 in fiscal 2006-2007, six cases were custody-related lawsuits that accounted for payouts totaling more than $5.6 million -- more than 50% of all legal payouts.

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richard.winton@latimes.com