Bernalillo County jail audit found glimmers of progress among lingering issues in health care

Nurses and doctors running to emergencies because the golf cart is out of battery power. Outdated thermometers for refrigerators holding laboratory specimens. Ongoing concerns about drugs getting into the facility, leading to overdoses behind bars.

Those are just a few issues outlined in a recently released audit of health care at the Bernalillo County jail.

Dr. Muthusamy Anandkumar, who has conducted the audits over the past few years, found “there is still much work to be done to ensure that all inmates receive timely and adequate health care.”

He said that there was delayed and inadequate care for those with special needs, an “unreliable” process to make medical requests leading to “avoidable emergencies,” and take-home medicine not being given upon discharge from the Metropolitan Detention Center.

Anandkumar’s report, done during a May 20-22 visit to the jail, noted progress has been made but pointed out that the lingering deficiencies affect those most at risk of dying.

He said the improvements include establishing an addiction treatment program and revamping policies and procedures, such as using sitters to watch detox patients, better communication between medical staff and MDC officers and the Suboxone program being taken over and built out.

Collected as part of the Metropolitan Detention Center’s jail-reform settlement agreement, the findings came from the second report filed since the University of New Mexico Hospital took over health care at the jail in July 2023.

Rodney McNease, the senior executive director of governmental affairs at UNMH, told the Journal many of the specific issues mentioned in the report have been remedied: the golf cart has been replaced — although he was unsure if the new one is in use yet — and staffers are now doing temperature checks on the refrigerator holding lab specimens.

“We believe a fair number of those (problems) have been resolved since the last audit,” he said.

McNease said some other specific problems identified by Anandkumar, like the medical clinic phone not always being answered and blood being drawn in the hallway, were one-offs that occurred during the visit and have been addressed further through logging calls and educating staff.

McNease said the addiction clinic has allowed them to ramp up Suboxone prescriptions for those detoxing and in withdrawal, getting hundreds of people onto the medicine in a matter of months.

He said they continue to have issues hiring permanent staff, particularly psychiatrists, and addressing a rise in booking numbers, which ebb and flow as authorities do warrant roundups and larger-scale arrest operations.

Prior to UNMH coming in, the facility had two for-profit providers come and go while MDC faced a rising death toll among inmates, most of whom were detoxing at the time.

Since 2020, 30 people have died at the facility or died after being injured or falling ill at the jail, many of them while in detox. Six of those people have died after UNMH took over.

The most recent, 35-year-old Cassandra Yazzie, was found dead July 14 in the pod used for detox. A jail spokeswoman said staff had been doing checks on Yazzie and others as required.

The incident “does not appear to be a result of a staffing issue,” an MDC spokeswoman said. Yazzie was the seventh person to die or fall fatally ill while being housed in the detox pod, RHU 7, since 2021.

Katherine Loewe, who represents incarcerated people in MDC’s reform settlement, said there has been progress at the jail, calling the addiction treatment clinic an “amazing” development.

She added that the bottom line, as Anandkumar pointed out in the audit, is: “The most vulnerable people at the jail really remain at risk.”

“The doctor identified many systemic issues that are still creating harm to individuals at the jail — anything from an intake process that doesn’t capture all the information needed or get it to the right people, to a system that builds in delays to access the appropriate level of care,” Loewe said.

“The providers out there … I really admire them and the work they’re doing. We just need to figure out how to get this system more functional so they can provide the care they’re capable of providing.”

Addiction treatment

Anandkumar said in his report that UNMH running the Suboxone program at MDC is “a significant undertaking.” He wrote that UNMH has hired several nurses and providers, including a doctor specializing in addiction medicine, to support the program.

McNease said the results are already starting to show.

He said they have hugely increased the number of those in detox receiving Suboxone for withdrawal symptoms — part of a court order related to MDC’s settlement agreement — from only 67 inmates in March to 574 as of late July. McNease said there are now up to 160 people on Suboxone at any given day, around the same number as those detoxing at MDC, although he said up to 300 people “express an interest” in the drug but don’t “meet the criteria.”

Anandkumar pointed out that, while those in detox units are given Suboxone, “there is no reliable process” to ensure that those in the detox program, but housed in the general population, receive withdrawal assessments and treatment.

McNease said, “I’m sure there is a degree of a gap” between those who need Suboxone and those who are receiving it. He said many more resources are needed to provide detox treatment to inmates in different areas of the jail.

“We have added resources, and we’re trying to do more monitoring of that group,” he said. “Having to balance all these demands with the security level, medical needs. It just becomes difficult.”

Anandkumar also said there are issues of overdoses behind bars and drugs getting into the jail.

McNease had previously said they treat 10 to 15 overdoses a month, including some in the detox unit, where many of the 30 deaths at the facility have occurred.

Warden Steven Smith said they have adjusted some body scanners and ordered a mattress scanner to try to keep drugs out of the facility and find the ones that make it in.

“Our number one goal is to reduce (drugs coming in); I would love to say eliminate it, and I hope I get to that, but right now it’s a goal,” Smith said.

From September 2022 to July 2023, drugs — mostly fentanyl and methamphetamine — were seized at least 180 times, according to records obtained by the Journal through an Inspection of Public Records Act request. It was not uncommon in those cases for the drugs to be seized from inmates in the detox unit, with sometimes large amounts of fentanyl or methamphetamine being found.

McNease said it’s not always clear if the people overdose after taking something before being booked or after getting drugs on the inside. He said he was aware of at least one person being given too large a methadone dose by Recovery Services, which doles out the drug to inmates.

Loewe, the attorney who represents incarcerated people in MDC’s reform settlement, said increases in bookings — particularly of drug abusers on low-level crimes — is not helping.

“The solution to our situation in Albuquerque is not arresting everyone and taking them to jail. That’s not an appropriate place to take people when you recognize that they need medical treatment,” she said. “We need to do more as a community to link those people to services, to create places that they can go that aren’t jail. Because jail is a place of great risk, jail is not a place of comfort or care and, what we know from so many people dying over the last three years, is it’s a place where people who are withdrawing from substances are at risk of death, even when there’s people who are great providers and have great intentions out there.”