* Ailing Inmates at Cook County Jail May Soon Find Their Troubles Compounded

by Leah Fabel - Medill News Service

Recent personnel changes and proposed county budget cuts at Cermak Health Services, the medical center for the jail’s 9,500 inmates, have caused the National Commission on Correctional Health Care to suspend the center’s accreditation pending a full review in March.

Cook County officials say the accreditation was withdrawn at the health service's request, as part of its plan to upgrade record-keeping procedures at the South Side facility. But critics argue that the NCCHC's action resulted from a decline in the quality of care at the health center.

“We are now aware of some significant changes that are ongoing that would affect the provision of health care services and compliance with the NCCHC 2003 standards for health services in jails,” said Judith A. Stanley, the agency’s director of accreditation. For confidentiality reasons, Stanley declined to name the specific problems that led to the suspension.

Personnel changes at Cermak include the January 29 removal of five top administrators, including medical director Dr. Sergio Rodriguez. The positions have yet to be refilled, though county officials expect it to happen soon.

Among the proposed changes in Cook County President Todd Stroger’s amended 2007 budget are a medicine and surgery department cut by nearly one-third, including a halving of the tuberculosis and STD infection control team; a halving of in-patient mental health services; and a cut in dental services from 15 employees to four.

“What we’re dealing with are issues of public health. Correctional health care, particularly jail health care, is part of the continuum of public health,” Stanley said. “If we can catch tuberculosis on an inmate coming in, we’re protecting not only the jail population, but the community at large.”

In 2006, Cermak performed 100,056 intake health screenings and had 129,474 clinic and emergency room visits. Nearly half of Cook County inmates are released within a week of their arrival.

NCCHC placed Cermak on probationary status in June, 2006, due to “a significant number and type of compliance issues that required corrective action.” The move for suspension is not ordinarily a part of the process and indicates considerable cause for worry, Stanley said.

“This borders on criminally irresponsible,” said Charlie Fasano, director of the jails and prisons program for the John Howard Association, a not-for-profit oversight agency advocating corrections reform.

His agency is considering the possibility of legal action, citing a 1982 federal consent decree that governs the treatment of mentally ill inmates at Cermak. According to the county, about 10 percent of Cook County Jail inmates have mental illnesses.

Although NCCHC accreditation is voluntary, it provides oversight for correctional health centers that are not liable to strict regulation. Because Cermak Health Services does not receive state or federal regulation, its limited oversight comes only through the State of Illinois’ Department of Corrections, according to Fasano.

“There’s no easy way to find statistics on the quality of care,” Fasano said. “It has not been established conclusively that the quality has been diminished, but there’s considerable evidence that that could be the case.”

Steve Mayberry, Stroger’s spokesman, claims that Cermak withdrew its voluntary accreditation in cooperation with NCCHC.

“It made no sense to sit back and wait to be suspended,” he said. “We were in dire need of changes and withdrew voluntarily.”

Ed Harrison, president of NCCHC, disagrees. “They say they have made a decision to withdraw prior to getting a notice from us. Unfortunately, we didn’t get anything in writing from them, so we felt obligated to put something in writing.”

County officials intend to work toward reinstatement of accreditation over the next 12-18 months, citing the need for time to implement electronic record-keeping.

“Care is going to remain substantially the same or better,” said David Fagus, Cermak’s chief operating officer. “Accreditation doesn’t guarantee that you’re providing good service or not; our problem is mainly documentation. On care, we have one of the best records there is.”

According to Mayberry, county health chief Dr. Robert Simon is “looking at what needs to be kept and what needs to be eradicated in order to protect the taxpayers.”

Both Mayberry and Fagus cited non-emergency dental care as an extraneous service.

“Emergency dental care will still be available,” Mayberry said. “However, the standard that they were getting that was not mandated by the law will not be continued.”

The county's downplay is a bluff, according to Fasano. "It's a lie. They had plenty of opportunities to choose to withdraw. They did not exercise those opportunities."