ACLU Report Urges Better Medical Screening at 2 County Jails

Medical services at Los Angeles County’s two principal jails have improved in the last three years, but some measures still should be taken, particularly those to identify prisoners with tuberculosis and sexually transmitted diseases, according to a doctor who inspected the facilities for the American Civil Liberties Union.

Dr. Kim M. Thorburn, in charge of Hawaii’s prison medical services, told the Sheriff’s Department in a 12-page report that she was encouraged that many of her recommendations had been implemented from 1992 inspections of the Men’s Central Jail and Sybil Brand women’s jail.

But Thorburn expressed concern that the system for identifying communicable diseases--such as gonorrhea and tuberculosis--”is not optimal,” and in the case of sexually transmitted diseases, may be less comprehensive now than in 1992.

She also recommended that the Sheriff’s Department take over direct control of mental health functions at the jails from the county’s Mental Health Department, and she said sick calls from prisoners and the use of restraints on some being treated need to be better recorded.

Susan Weekly, in charge of medical services for the Sheriff’s Department, responded that the department is implementing improvements along the lines suggested, but labeled some suggestions difficult or infeasible.

Thorburn’s report was most critical of the jails’ system for identifying sexually transmitted diseases.

“In 1992, all women admitted to Sybil Brand Institute were screened for gonorrhea and chlamydia vaginitis,” the physician noted. “This program has been discontinued. Currently, women who are arrested for prostitution and pregnant women receive [such] screening. All other women must request gynecologic examinations.

“Most incarcerated women have risks for sexually transmitted diseases,” Thorburn said. “Testing based on symptoms is not effective in women, many of whom are asymptomatic.”

Except when pregnant, inmates are not screened for cervical cancer in conjunction with sexually transmitted disease tests, she also reported.

She said “significant effort” has been devoted to improving tuberculosis screening among inmates in the last three years, but she said more needs to be done.

“Graphs showing the annual totals of active TB cases identified by the Sheriff’s Department TB program clearly demonstrate that TB is epidemic,” Thorburn wrote. “While charts are used to demonstrate the fact that active cases are being identified, they must also be understood to represent the magnitude of the problem.”

Weekly responded that random sampling for sexually transmitted diseases of all female inmates entering Sybil Brand “will be considered as funding and resources permit.”

About tuberculosis, she said: “In the absence of a specific funding increase for TB skin testing for the general inmate population [costing $8 million to $10 million], and in view of the decreasing availability of public health and personal health services in Los Angeles County, it is vital that we continue to focus . . . on screening for active disease.”

Thorburn’s inspections came out of an agreement between the ACLU and the Sheriff’s Department.