WATCH: El Paso County Jail Medical Care Was ‘Dysfunctional’ For Years

When John Sebastian was locked in one of El Paso County’s bare, concrete medical cells in 2012, it was supposed to be for his own good.

Instead, he said, it made things worse.

Sebastian, a 49-year-old father of four with no criminal history, had been arrested for aggravated robbery, a crime he says he committed after his doctor abruptly changed bipolar medications he had used for decades. He arrived at the jail in a manic state, barely aware of his surroundings.

Sebastian’s arrest and the events that followed came during a turbulent period in the relationship between the El Paso County Sheriff’s Office, which runs the jail, and its medical contractor, Correctional Healthcare Companies. The jail had just come off a probationary period imposed by one of two accreditation companies because of a lapse in standards set forth by the National Commission on Correctional Health Care. Among the standards deemed inadequate was mental health screening and evaluation.

Upon arrival at the jail in August 2012, Sebastian was put into an empty medical cell with no bed or toilet, where he was kept naked, his hands cuffed behind his back, with no food or water for 23 hours, he said.

“I kept begging for water again and again. I asked for a blanket, I asked them to let me go to the bathroom. They wouldn’t listen,” said Sebastian, who lived in Pueblo West.

The only times the door opened, he said, multiple guards forced him to the ground and held him down so a medical worker could take vital signs. Sebastian’s wife, Sandra Baca-Sebastian, obtained a jail surveillance video of a portion of Sebastian’s time in the cell. The video confirms much of what her husband told The Gazette.

Sebastian ended up in the hospital, covered in cuts and deep bruises, dehydrated and smeared in his feces, he and his wife said. Baca-Sebastian provided photos of her husband’s injuries to The Gazette.

Former jail medical workers say treatment like Sebastian’s was a symptom of a barely functional medical unit where high turnover kept the system designed to help the inmates from running properly.

“The place was dysfunctional; I’m surprised no one has died,” said Sonja Clark, who was head of mental health at the jail from January 2012 through August 2012.

In an interview Tuesday, El Paso County Sheriff Terry Maketa acknowledged ongoing medical frustrations in the jail that admits about 22,000 inmates a year. The average stay lasts about 23 days, the sheriff said.

“When it comes to operating a jail, medical is the most complicated issue,” he said, noting that correctional facilities typically have a revolving door of medical staff, which adds to the challenges.
ACLU suit dismissed

Treatment of mentally ill inmates has long been an issue at the jail, prompting the American Civil Liberties Union to file suit in 2001. The legal director for ACLU Colorado, Mark Silverstein, said the suit was filed because of failures in health care for inmates.

“We had several suits against the jail,” Silverstein said, noting that from 2001 to 2008, the case bounced from court to court and was eventually dismissed.

But serious issues remain, employees said, and they laid most of the blame on the sheriff and undersheriff.

The more recent failed 
NCCHC accreditation review came in late 2011 and the jail was placed on probation until June 2012, according to the official accreditation review documents. The review, dated Nov. 18, 2011, cites 11 standards in which the jail was noncompliant. Among those were the jail’s performance in health assessments, continuity of care, chronic disease services, infirmary care and mental health screening and evaluation. The next audit is scheduled for October, Sheriff’s Office spokesman Sgt. Greg White said.

He said during the 2012-13 time frame there were several basic performance issues with the contractor, such as nurses not responding to wards and an unqualified administrator interfering with the administration of doctor-ordered medications.

“It was a mess at one point, and we came close to canceling the (medical) contract,” White said.

Maketa defended himself and Undersheriff Paula Presley, saying their involvement in the medical operations at the jail has been to hold the medical contractor and its staff accountable. He added that many of the accreditation lapses came because of failed communication by the contractor and its staff.

“There are times when it’s brought to my attention and the undersheriff’s that someone didn’t receive care,” he said. “And it is dealt with immediately. And I would say 99 percent of the time (the contractor’s) corporate office is in agreement.”

Employees said the jail has struggled to meet minimum standards for holding federal inmates, failing a recent quarterly review by U.S. Immigration and Customs Enforcement.

This year, the Sheriff’s Office said by email, “The Criminal Justice Center has not failed any accreditations in the past four years, or ever for that matter.” Jim Cheney, a representative of Correctional Healthcare, echoed that response in an email Thursday, noting that “the health unit recently received a perfect score on an inspection” by Immigration and Customs Enforcement.

The jail never lost its accreditation status from NCCHC despite the probationary period in late 2011 and early 2012, but Silverstein said renewed accreditation is not a strong gauge for compliance.

“Once a jail is accredited, the accreditation agencies are viewed as notoriously lax,” he said. “There are jails that are accredited and are still providing constitutionally inadequate health care.”

Silverstein said that is a big reason the ACLU’s suit in 2001 failed. He added that complaints about the El Paso County jail continue to come into his organization, which aims to “protect the civil rights and civil liberties of all people in Colorado,” according to its mission statement.

Silverstein described multiple complaints against the jail in 2014 alone, noting claims similar to those of John Sebastian. The attorney said complaints this year included deputies banging an inmate’s head on the floor, inmates with serious injuries who didn’t receive proper medical care before being locked up, an inmate who said he did not receive treatment for HIV and one inmate who claimed that administered medications caused delusions and other medical conditions.

“We just don’t have the ability to investigate the bulk of complaints we have,” Silverstein said.

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