Washington County Sheriff Charles F. Mades defended the operation of the Washington County Detention Center Tuesday, saying many of the deficiencies have been corrected.
"We have a good, efficient operation here," he said.
Mades said County Attorney Richard Douglas is "answering all these items in a detailed letter."
Isabelle Katz Pinzler, acting assistant U.S. Attorney General in the Justice Department's Civil Rights Division, said she and others who toured the jail at 500 Western Maryland Parkway were impressed by many features, but felt some problems existed. Those included:
Suicide prevention: Three prisoners committed suicide at the jail over a four-month period in 1995, two from hanging and one from wounds from a safety razor blade. There have since been five suicide attempts, including one this year.
The report noted that grates that prisoners could use to secure sheets for a suicide attempt were covered, portable radios were bought to enable quicker response and a psychiatric worker was hired.
But the report said "suicide prevention remains inadequate," and said it was apparent focus has been on "physical `hardware' problems to the exclusion of mental health and other less tangible issues."
The report said there were no provisions for 24-hour observation of at-risk inmates, deemed necessary after an inmate used a razor in an attempt to slit his throat.
Since then, the jail has changed its razor policy, issuing razors only for the time it takes to shave, according to both the report and Mades.
"We have all now had training," Mades said, disputing the report's contention that only a few had the training to know how to identify symptoms that might precede suicide attempts.
Mades said that without more staffing, round-the-clock observation of prisoners would be difficult.
Medical care: The report said medical care at the detention center was generally found to be "substandard: intake physical exams are not comprehensive enough to ensure adequate treatment (especially for women)...the treatment itself is often inappropriate, with inadequate follow-up."
The report said "Compounding the problems of poor care, staff attitudes appear unprofessional in many instances."
The report suggested that some of the problems might be a result of insufficient staffing.
At the time of the tours, the jail was switching from in-house medical care to Prime Care Inc., a group Mades said has improved health-care delivery.
"We were just notified we are in compliance with all Maryland requirements now in that area," Mades said. He said state inspectors have evaluated Prime Care's performance.
The federal report also said medical care for inmates infected with HIV "is practically nonexistent, posing immediate danger to their health."
Mades said he wasn't aware of any HIV-positive inmates now in the jail. The report said HIV-positive inmates were in the jail at the time of the initial tour last fall.
"Prime Care has addressed that issue," Mades said.
Medical care for prisoners with other chronic illnesses, such as asthma, heart disease and diabetes, also was inadequate, according to the report.
Mades took issue with the allegation that inmates with chronic health problems weren't receiving adequate treatment. He said, for example, that inmates with maladies such as asthma now have access to inhalers.
Co-payments for medical care: The report suggested that the jail's co-payment system creates a barrier to health care. Under the system, jail accounts are assessed a fee for medical care unless the care is required as a necessary treatment.
Mades said he is convinced that co-payments cut down on unnecessary visits to the nurse or doctor.
"Sick call dropped by 50 percent when we started that," Mades said.
The federal study recommends that the co-payment policy be amended to eliminate barriers to required treatment.
Opportunity for outdoor exercise: The report said that inmates frequently go one to four months without the chance to be outside and recommends they be allowed to exercise outside regularly.
Mades said he won't increase outdoor exercise and recreation until he has enough staff for the prisoners to be taken outdoors safely.
The Washington County Commissioners are expected to provide funds for Mades to hire 12 additional correctional officers.
Hygiene: If an inmate was jailed on Friday night, it was often Monday before the prisoner was processed into the jail, and in the meantime could not take a shower, and had no clean clothes or hygiene items, the report said.
"We now have an additional person working Sunday in intake and that cuts back that delay to one day," Mades said.
Sanitation in female housing: The report noted that complaints of not enough sinks in the women's section means inmates are drinking from the sink in the mop room.
"We have three sinks and 30 female inmates so there are going to be delays," Mades said. He said that using the mop room was an inmate's choice.
Access to law books for case preparation: The report said the law library at the jail is inadequate.
Mades agreed that the law library at the jail isn't adequate. But he said most inmates at the jail are at the pre-trial stage and have lawyers.