Josephine County: Sheriff Daniel Smokin’ After Roastin’ by Health DepartmentBy John Taft, Investigative Reporter 8-5-01 Ed/Doc
Grants Pass, OR -- The Oregon Observer is calling for a full investigation of the Josephine County Sheriff’s department run by Sheriff Dave Daniel. Daniel appears to have been roasted on his own spit of alleged incompetence. It’s Daniel’s paid job to see that all functions of the sheriff’s department operate smoothly, including the jail. Prior to Daniel’s election, former District Attorney Tim Thompson stated, "Effective law enforcement requires a balance of patrol functions, detective work, and administrative support. Sheriff Calvert understands this concept, and his opponent (Daniel) does not." In a letter to the editor the former DA also claimed Daniel wasn’t qualified to be sheriff. In the view of many county residents, time has shown Thompson was correct in his assessment of Daniel. The following information lends support to a needed investigation of Daniel’s handling of healthcare for inmates in the JoCo jail.
The Observer recently obtained a Health Department memo signed by Director of Nursing, Pam Dykes. The Observer has consistently pointed out serious problems in the sheriff’s department. The new charges by the county health department lend additional credence to the Observer’s charges.
County Health Department Cancels Agreement
A recent agreement between the sheriff’s department and the Health Department and Community Action to assist in the county jail was terminated by the health department after being in effect for only 11-days. The health care in the county jail appears to be substandard, causing some incarcerated inmates misery and suffering. Many inmates are reportedly unable to see a doctor in a timely manner. Medications for inmates appear to be administered on a hit-miss procedure in the JoCo jail. Inmates have made these types of charges to this investigative reporter many times in the past. A county agency, the health department, learned first hand how the jail clinic is operated. It seems it found conditions in the jail so abysmal that it had to terminate an agreement to protect its employees from a hostile work environment and potential liability issues. It’s rare that an agency other than an another police agency, which can normally be relied on to keep its mouth shut, gets into the jail. Daniel created a bogus issue to keep this investigative reporter from interviewing inmates inside the jail. However, there are other ways around his jail ban. See last month’s Observer story, "Was a Police Dog Beaten Bloody in the JoCo Jail?"
Liability Looms for Taxpayers
The memorandum signed by the Director of Nursing, Ms. Dykes, states: "Unsafe practices are occurring that jeopardize patient safety of the inmates, nursing licensure and pharmacy regulations. The potential for significant county liability is imminent." The concerns include the following.
• Unresolved issues regarding outdated medications
• Outdated medical supplies
• Pharmacy law violations or questionable practices
• Lack of standing orders
• Hostile work environment for our staff
Giant Boil Festers on Face of Sheriff’s Department
Ms. Dykes: "Outdated medications continue to be stocked throughout the clinic and include vials of injectable insulin and topical sprays. Some of the outdated drugs included influenza vaccine that expired on 6/97, injectable insulin outdated on 1/19/2000, and Albuterol inhaler that outdated in 2,000. The health department advised the sheriff’s department to get rid of these medications. The medications were packed and moved to the new facility last fall and again stocked into the clinic. Outdated medical supplies are stocked throughout the clinic, including outdated culture tubes, gauze, tincture of benzoin, and medication bottles that were so old that they have yellowed. Some had expiration dates ranging as far back as July 1988. These old outdated supplies are unsafe and if used would present a health hazard to the patient. After the expiration date, supplies are no longer considered viable and could be contaminated."
These charges are shocking when the health and liability factors are considered. The alleged incompetence of the sheriff’s department appears to know no limits. Unfortunately, under Daniel’s leadership this situation may be only the tip of a gargantuan boil festering on the face of the sheriff’s department.
State Pharmacy Laws may Have Been Violated
Ms. Dykes: "Individual medication packets are prepared for each inmate by a local pharmacy. Each medication must be ordered by the physician and must have a label indicating the name of the patient, dosage, date of order, expiration and directions for use."
Ms. Dykes: "These drugs are reportedly saved by the jail clinic nursing staff after the inmate has been released from the jail. They are used if the inmate returns to the jail later. Additionally, they are dispensed to other inmates who have not yet had their medication orders filled by the pharmacy."
Ms. Dykes: "The jail lieutenant stated that nurse manager, Dave Barbian, has been reprimanded for ordering prescription medications for inmates without a doctor’s order."
Ms. Dykes: "Non prescription medications are given to inmates without a doctor’s order. No standing orders exist to administer these medications."
What’s A Standing Order?
No, it’s not a greasy burger and slick fries oozing with hydrogenated vegetable oil, or a private standing in the hot sun at attention. Quoting from Ms. Dykes’ memo, "During the March 23, 2001 meeting with the jail staff, we discussed that our nurses need to work under signed medical standing orders by the physician and that standing orders are needed for non prescription drugs as well as for prescription drugs. They also are in need of standing orders for ordering lab work, treating, and assessing patients. When stating this to the jail clinic nursing manager, he told our staff that he does not work for the Health Department’s Director of Nursing, and that standing orders are illegal!" At the time this was written standing orders were not in place. Again consider the liability factor for county residents on this one issue. Inmates do have a right to sue!
Health Department Workers Take Heat From Sheriff’s Staff
The Oregon Observer is familiar with hostility from a few of the sheriff’s department employees who have been boycotting the paper’s advertisers for over a year. Daniel declares it (the boycott) to be free speech.
Ms. Dykes states, "Our nursing staff have been subjected to a hostile work environment during their orientation in the jail clinic. Comments that they have been subjected to include:
• Accusations by the extra help nurse that our staff was placed in the clinic to scrutinize their work and to spy on them.
• Accusation to one of our nurses that she snitched or told on them when expressing concerns about the outdated medical supplies and medications.
• Negative comments, anger and retaliation to the nurse who expressed concerns to her manager about outdated medications and supplies in the clinic."
Accreditation Lacking as of April For Jail Clinic
Ms. Dykes: "In summary, the Department of Health and Community Health Administration received your request several weeks ago to assist you (Sheriff Daniel) with your nursing staffing levels in the jail clinic. As a result of your move to a larger jail during 11/2000, the inmate population caseload increased significantly from 64 to almost 200. Your nursing manager and extra help staff were unable to keep up with the responsibilities to maintain accreditation of your clinic. Our role was to increase nursing services and to assist you in reaching accreditation requirements. We provided you with nursing staff swiftly and with the intention to partner with you to provide the services that your clinic needed."
Ms. Dykes: "It was our understanding that the deficiencies regarding outdated medications were resolved and that our staff would work under established medical orders, as their nursing licenses require. It was never our intent to place our staff in a position where they were met with hostility or potential liability issues."
Observer Calls for Local and State Investigation
The preceding statements reveal serious problems in the jail clinic and the handling of medication for inmates. The Oregon Observer is requesting that the county commissioners launch an immediate investigation into the allegations made in Ms. Dykes’ memo to Sheriff Daniel and the County Commissioners. At this time I am unaware of any public record of the county commissioners recommending an investigative probe into the issues discussed. The state correctional division will also be asked to investigate.
Daniel seems to use intimidation as a means to achieve his objectives. He attempted intimidation of the Oregon Observer, Commissioner Frank Iverson, (see the article by John Taft in this issue), and now the county health department refuses to work in the jail clinic because of a hostile environment. This nonsense must stop!
Daniel Given Chance to Respond to Allegations
On Monday Daniel was sent an e-mail informing him this article was being written and giving him the opportunity to respond, by Wednesday, to the charges made in Ms. Dykes’ memo. Daniel chose not to respond, as it appears the memo is accurate and the charges are indefensible.
The Observer Compliments the JoCo Health Department
The Observer is pleased to be able to compliment Ms. Dykes and the county health department for standing up to the alleged tyranny and intimidation they encountered while attempting to help inmates receive health care in a professional and responsible manner in the JoCo jail. Ms. Dykes is a breath of fresh air in a county where the smell of dead fish is polluting the political scene.
Put Health Department in Charge Of the County Jail Clinic
The Observer also recommends commissioners work to reopen the doors of the jail to allow the Health Department back into the jail to do the job it is professionally qualified to do. All alleged harassment directed at county health department employees by deputies or others must be stopped. It appears the sheriff’s department has neither the expertise nor humanitarianism necessary to run the jail clinic. Therefore, if there is no regulation to prevent it, the commissioners should consider making the county health department the supervisory authority over the jail clinic. The sheriff’s department nursing staff would then work under the county health department. The county health department is better suited to run the jail clinic and over- see the health care of inmates.
Commissioners Haugen and Iverson have given questionable extra funds to the sheriff’s department while shortchanging the county health department. The funds to cover the costs for this change would come from the sheriff’s budget. There would be no extra costs to the health department’s present budget. There may be cost savings provided by this plan:
• Duplication of some services would be eliminated in time, resulting in cost savings.
• Responsible medical care for inmates would be available.
• The advantage of greater protection for the community from communicable diseases.
• A reduced risk for any liability suits brought against the county for incompetent medical care given inmates.
The county would be much better served with this arrangement.