Jail Woes Too Big for County

Critics have come to use words like “Dickensian” and “medieval” to describe Los Angeles County’s system of caring for medically ill jail inmates. And given the conditions documented last week by Times reporter Tina Daunt, such terms are not far off the mark.

In the rat- and roach-infested central jail that houses the system’s most seriously ill inmates, medical records are often lost or misplaced, medications go undispensed, infections spiral out of control and severe mental illnesses go undiagnosed. A few months ago such conditions led the U.S. Department of Justice to threaten to sue the county over a “deliberate indifference to inmates’ serious medical needs,” a condition that violates the 8th Amendment through “unnecessary and wanton infliction of pain.”

Despite abundant evidence to the contrary, county officials have recently begun claiming they have solved or are about to solve the system’s worst problems. Their claims would seem mysterious were it not for the fact that later this month, Justice Department inspectors are scheduled to make another visit to the county’s jail system. Clearly, the officials are chary of admitting that the county has been deliberately denying care because of limited resources.

But that is what the county needs to admit. Its problems are insurmountable without more state, federal and public support. The U.S. government is quick with criticism but hesitant to help. It could, for instance, pick up some of the county’s costs for jailing illegal immigrants, a federal responsibility. Similarly, the public supports but does not want to pay for the three-strikes law, which has forced judges and jailers to incarcerate people whom some believe could be punished more cheaply and effectively through sanctions like fines and mandatory drug treatment.

The county, however, cannot expect to enlist support from anyone until it confronts its own deficiencies candidly. Sheriff Sherman Block’s announcement that he will open the medical facility in the new Twin Towers jail is a step in the right direction but will not solve more fundamental problems, including the county’s inability to properly diagnose inmates’ medical problems upon admission.

Part of the failure is due to the county’s antiquated paper filing system, which makes medical records all but impossible to find and track. Block is now visiting private donors, hat in hand, trying to drum up funds for computerized record-keeping. But the county should make a better case for public funding, laying its problems bare and plainly insisting what its officials are trying so hard to deny: that given its current revenues it cannot run jails that respect constitutional rights.

The county can, however, end practices that deter inmates from declaring their medical problems upon admission. Mentally ill inmates, for instance, are dressed in orange jumpsuits that stigmatize them and render them vulnerable to attacks by predatory inmates, thus discouraging them from admitting their problems upon admission.

Delivering better health care to jail inmates is in the wider public interest. If the system continues to allow tuberculosis, hepatitis and AIDS to run rampant, it will only encourage their spread outside the jails. And if it continues to deny substance abuse treatment to inmates, the cycle of crime is likely to continue and more serious chronic medical problems are likely to develop.

Many jail inmates have not been convicted of crimes. And even those who have are entitled to decent medical care. As it is now in Los Angeles, some are losing limbs or even their lives for the lack of care. We repeat to county officials: Just saying you can solve the problem won’t make it so.