Healthcare in the Maricopa County jails has been the subject of a series of lawsuits, studies, and reports that have concluded the same thing: Inmates get grossly inadequate healthcare.

In September 2008, the jails' healthcare system lost its accreditation from the National Commission on Correctional Health Care. It has not been reinstated.

In an order issued just last week, U.S. District Court Judge Neil Wake gave a devastating assessment of the conditions: inadequate record-keeping, medication management, staffing and mental health treatment threaten the lives and well-being of thousands of inmates every day.

Saying that the level of healthcare is unconstitutional and puts detainees in real danger, Wake ordered the sheriff and Correctional Health Services, the county agency that administers healthcare in the jails, to fix the problems by the end of this year.

The order came on the heels of a lawsuit that alleged violations of inmates' constitutional rights, and worked its way through the court system for years. The sheriff lost that suit, Graves v. Arpaio, in October 2008. And Wake ruled that the sheriff and the county Board of Supervisors, which runs CHS, must make massive improvements to jail healthcare.

Nearly 18 months later, problems remain.

In fact, Oropeza would likely get no better care today than she did nearly a year ago — despite the court's demand for improvements. She entered jail with one of the most common serious medical conditions doctors and nurses see in the jails: dependence on drugs or alcohol. (In her case, prescribed medication.)

A court-ordered report issued last month assessing improvements — or lack thereof — at the jails, found that nearly 15 percent of patients don't get their medications as prescribed, including those who are carrying them. Oropeza says her prescription medications were in her purse when she was picked up.

But the problem is bigger than that — sometimes patients don't get the right dosage, they have adverse reactions to medications, or face other complications. Many experience withdrawal symptoms that can be "life-threatening or extremely painful," according to the report, which was written by a medical doctor assigned to monitor the jails' progress after Judge Wake's ruling.

"Maricopa County jails are not alone," says Peggy Winter, the associate director of the ACLU's National Prison Project and lead counsel on Graves v. Arpaio. Especially in the largest urban jails, officials inevitably struggle with the overwhelming medical and mental health needs of many detainees, she says.

A big part of the problem in Maricopa County is that doctors don't get timely information because the jails' medical records system is inadequate.

With so many inmates, CHS is likely unable to manage medical records or track inmates with medical needs without an electronic system, the report says. The system now is almost entirely manual, often relying on handwritten records.

CHS Director Betty Adams says her department is working to improve the records system. "If I could wave a magic wand, I would hope for some additional technology," she says.

But that is only one deficiency on a long list of things that need improvement. "I have, like, 16 top priorities," she says.

Deputy Chief Mary Ellen Sheppard of the Sheriff's Office says CHS needs to make better record-keeping its top priority. "It boils down to the lack of a tracking system that measures the care being provided and the quality of that care," she says. "It's hard to fix something that you don't have a handle on."

Hard doesn't begin to describe it.


Fixing all the problems in the jails would be a tall order for any government agency. But in Maricopa County, it's even tougher. Here, the sheriff and members of the Board of Supervisors are embroiled in an endless legal battle over seemingly every aspect of the jails — their healthcare system included.

The Sheriff's Office insists that it should have control over healthcare in the jails it runs. But that duty resides with CHS, which has been running healthcare services in the county's jails for decades.

The dispute ended up in Maricopa County Superior Court last year, with Arpaio attempting to wrest power over CHS from the county Board of Supervisors. He claimed that the board is inept and the Sheriff's Office would do a better job of providing healthcare in the jails.

The judge ruled otherwise, throwing out the case last week.

Arpaio's claims came just when evidence began to show that CHS, though far from being a model of correctional healthcare, is actually improving.

Eric Balaban, a lawyer with the American Civil Liberties Union's National Prison Project who toured the jails in September, says he saw progress.

"There certainly is movement in the right direction," he says. "But they were starting from ground zero."

The court-ordered report released in March also makes it clear that CHS employees are making some improvements: They are doing their best with an inadequate records system; more patients are getting healthcare assessments within two weeks of entering the jail, and those with chronic diseases are getting better care.

But, according to Judge Wake, the only real improvements that have been made are the ones that have cost the county little or no money.

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18 comments
Pearyb
Pearyb

The mistreatment of prisoners has long been notorious in the Valley. Jail can be a strange place, and for many it is in the death game. Without your freedom you are the walking dead, socially I feel if the punishment doesn't fit th crime, you got a future of more crime. Stress and anger are involved with the creation of crime, criminally treating prisoners makes more criminals.

Beatnikjd
Beatnikjd

A near death sentence for mere possession of a harmless plant. Only in amerikkka!!

Jane Walters
Jane Walters

I so wish we had a system in the UK that was a little like Joe Arpaio's, here we let child murderers sue the Prison Service for compensation because they got beat up in a cell, we let prisoners have anonymity, we give them TV, Menu choice, single cells and somehow allow the drug culture to continue. We focus on the person the crime has been perpetrated against but as soon as the criminal is caught the injured parties take a back seat and the liberals do all in their power to make the prisoner 'hard done by' We in the UK should get rid of the Human rights bill pushed on us by Tony Blair and his fellow lackeys, get out of Europe and become a State of the US, then we would have a good law and order system.Jane Walters, Mablethorpe, England

Armyretiree44
Armyretiree44

ya know i could care a less about medical for prisnors.. lets think bout this. we have soldiers in COMBAT that are dying becuase they cant get to medical facilities in time beucase of location, or combat.. and here you have people that BREAK the LAW and expect the best treatment that is out there. Seems to me that the only one thats are complaining are the people that are BREAKING the law and expect to be treated like normal law abiding citizens.. I have it that some LAW breakers have medical conditions but this lady was busted for Weed.. and is addicted to Pain killers(probably on tax payers money 2).. I LOST part of my foot in COMBAT and dont expect any special treament. Just a thought though. one of many i am sure.

CC
CC

I moved to AZ from Texas in 99 and lived there for 5 years...really bizarre place, that state. Never want to live there again amongst the Arpaio weirdos wallowing in their pseudo-conservative muck. Im a real conservative, the phoney being the Bush whacko "I wanna go to Iraq and fight for our freedom" type, so many people in this country who decided to turn their brain inside out for their fuhrer Bushie...its just sickening...and AZ, a sheriff that is politically motivated...thats exactly what happened in Nazi Germany! Politically motivated kangaroo courts, judges wearing Nazi emblems.....didnt America already fight a war against that type of trash?And now, this bizarre Bush freako generation wants to bring it all back...and bring it all here!

CC
CC

As per the comment made by one poster:"The withrdawal symptoms were not going to kill her"

I really dont think sir, that you have any medical qualifications at all to make any type of conclusion like this or otherwise about drugs, especially opiates. As a degreed Chemist with a background in pharacology, I can inform you that you are wrong about that on all counts. Oxycontin withdrawl is notorious for being deadly and has taken countless lives to date. Refer to the "oxycontin tragedy" for more information about that.

Opiate addiction is known to be so painful, psycologically tramatic, and frightening, that some heroin addicts have been known to commit suicide for no other reason than to avoid going through the withdrawl.

Lets keep politics out of the subject of drugs...okay? Leave it to the doctors, pharmacologists, technitions, scientists...you know...the people that are qualified to deal with it? That would exclude neo-Nazi Repulican whackos who are convinced that they know everything when in fact they never know anything.

Do us all a favor..go to Iraq..and dont come back. Really, I dont think anyone will miss you or your political judgements about what you dont know.

gina
gina

Why is he still there. he is on the wrong side of the bars..... He is a murderer............................

So many are sent to jail that are innocent. what a shame..... This is the system we pay for.

Ben
Ben

This is the most ridiculous story ever. Although I don't think smoking marijuana should be a crime, I don't see why disallowing her to take opiates while in prison is a bad thing, nor do I see how this has any relation to Arpaio. The withrdawal symptoms were not going to kill her, and the lack of sympathy by one guard has nothing to do with Arpaio. However, if anything the guard should be praised for trying to help her quit a five-year addiction to opiates.

mary
mary

I was just in Estrell jail from March 17-April 14th. I also became very sick while I was there, kept putting in tank orders for medical. Was running high fever, chills, severe headache, couldn't barley walk. On the 2nd day I seen a nurse and she told me to just drink more water. What a joke! By the 4th day I was worse, went to medical again with same symptoms finally they let me see the docter, was given finally tylanol and the Z-pac. Why did they wait so long, don't understand. Also they violated my rights. I am disabled, from the moment I got there I explained my situation about my disability. I cannot walk without a cane do to a severe back injury, I am still in recovery from spinal surjury. The docter aproved me to get a cane, but detention had the final say. Needless to say I was never provided with a cane, nor was I given the correct pain meds. I was always told to walk faster, hurry up, tried to tell the DO's my situation and they did not care. I am going to look into fileing a law suit. I was given this advise from my lawyer who handles my Workmans Comp lawsuit. County jail is know place to be if your ill or disabled. They just don't give a damn.Mary

Peggy Plews
Peggy Plews

This is scary. The courts should really stop sending people there, especially for BS charges. Thanks for the coverage, Lauren and PNT.

Marcy
Marcy

It's such a terrible shame when people who use and abuse legal and illegal drugs suffer withdrawals.

It bothered me for about 5 seconds but now I'm over it.

Because one ding-dong didn't bother to use her seat belt society is stuck taking care of her for the rest of her life and she repays society by being a criminal.

Lovely, don't look both ways when you cross the street Ms.Oropeza

Amir
Amir

Its distrubing to read about controled jail systems treat residents of that state or any other state like animals in the wild.

I believe that Sheriff Joe Arpaio and his bandit of guards will FALL, shortly.

6616
6616

I just read this and it makes me SICK!I spent 30 days in Sheriff Joe's Tent City a DUI. I actually composed a letter to submit about the very same issue mentioned in this article. I do not take medication and I am in very good health. However, the lack of concern and care for inmates who require medication is deplorable. Medication for the inmates is not stored in a temperature-controlled environment; it is stored in a locker OUTSIDE! Last time I checked, most medication, state clearly on the bottle that you should keep them in a cool dry area, and not in an area that is over 73 degrees. These are a few examples of the lack of concern, compassion, consistency, and inventory for dispersing inmate medications that I experienced first hand:I saw a woman have a seizure for not getting her “anti seizure” medication on time. There was an elderly woman who was diabetic and did not get her medication in a timely manner on multiple occasions after BEGGING the guards and, standing in front of the little window waiting for someone to acknowledge her (as the guards sit point and laugh for about an hour). She was ultimately taken out on a stretcher...last I heard she was very close to slipping into a diabetic comma.One inmate’s medication dosage was to take four times a day. Well, medications a are only dispersed twice a day, sometimes three, never more than that. The inmate mentioned that to the guard and was told “too bad” and “no you can not take an extra pill”Medications were stolen out of the lockers, so much so that the inmates in my tent took their medications home and went without. The medications are stored outside in lockers with letter’s A-Z marked. Therefore, if your last name ends in a “C” you, go to the locker marked “C” and rummage through all the other inmates with the last “C” pull your meds out.Thing is, if you see medication that you want there is no one really stopping you from taking it. There is no sign in roster or any way of tracking who is taking what medication. There is not a medical professional onsite to monitor any of it.Most of the women who were incarcerated along with myself, where in Tent City due to DUI convictions. Yes, we made a mistake, but that is no reason to deny a person basic human needs. I have served two tours in Iraq and know first hand that we treat POW with more respect, more dignity, and more compassion than the staff at Sherriff Joe’s Tent City.

6616
6616

I just read this and it makes me SICK!I spent 30 days in Sheriff Joe's Tent City a DUI. I actually composed a letter to submit about the very same issue mentioned in this article. I do not take medication and I am in very good health. However, the lack of concern and care for inmates who require medication is deplorable. Medication for the inmates is not stored in a temperature-controlled environment; it is stored in a locker OUTSIDE! Last time I checked, most medication, state clearly on the bottle that you should keep them in a cool dry area, and not in an area that is over 73 degrees. These are a few examples of the lack of concern, compassion, consistency, and inventory for dispersing inmate medications that I experienced first hand:1.I saw a woman have a seizure for not getting her “anti seizure” medication on time. 2.There was an elderly woman who was diabetic and did not get her medication in a timely manner on multiple occasions after BEGGING the guards and, standing in front of the little window waiting for someone to acknowledge her (as the guards sit point and laugh for about an hour). She was ultimately taken out on a stretcher...last I heard she was very close to slipping into a diabetic comma.3.One inmate’s medication dosage was to take four times a day. Well, medications a are only dispersed twice a day, sometimes three, never more than that. The inmate mentioned that to the guard and was told “too bad” and “no you can not take an extra pill”4.Medications were stolen out of the lockers, so much so that the inmates in my tent took their medications home and went without. 5.The medications are stored outside in lockers with letter’s A-Z marked. Therefore, if your last name ends in a “C” you, go to the locker marked “C” and rummage through all the other inmates with the last “C” pull your meds out. Thing is, if you see medication that you want there is no one really stopping you from taking it. There is no sign in roster or any way of tracking who is taking what medication. There is not a medical professional onsite to monitor any of it.Most of the women who were incarcerated along with myself, where in Tent City due to DUI convictions. Yes, we made a mistake, but that is no reason to deny a person basic human needs. I have served two tours in Iraq and know first hand that we treat POW with more

6616
6616

I just read this and it makes me SICK!! I speng 30 days in Sheriff Joe's Tent City a DUI. I actually composed a letter to submit about the very same issue mentioned in this article. I myself do not take medication and I am in very good health. However, I saw a woman have a seizure for not getting her medication on time. There was an elderly woman who was diabetic and did not get her medication in a timely manner on multiple occcasions after BEGGING the guards to give them to her. She was ultimatly taken out on a stretcher...last I heard she was very close to slipping into a diabetic comma.

Tom
Tom

This just makes me sick to my stomach. These fucking clowns at MCSO just continue to think they are above the law. The shit never ends with these fools.

David
David

The MCSO and its "leader" are simply beyond belief! Sheriff Arpaio seems to think that anything he does is subject only to the law of Sheriff Arpaio. Has he finally become the law unto himself, above all that annoying law that the elected legislature created for the benefit of all citizens? Does he even realize how far down the path of the Constitution's destruction he has wandered, or is he simply focused on "winning" over all those that oppose him, whatever the cost?

The voters and, at the moment more importantly the judiciary, and the legislature with the power of impeachment and conviction, need to remove this man from office and investigate him, his Chief Deputy, former County Attorney Thomas and the entire MCSO leadership for their ongoing destruction of basic freedoms, human rights and Constitutional law. This is Kafkaesque in its brazen arrogance and even more arrogantly solipsistic abuses of authority and the humanity of all those he holds prisoners. I am willing to guess that Mr. Arpaio would never live in a tent, or wear pink underwear, and that he would be the first to file a bevy of lawsuits complaining about his rights being violated if he was forced to live in the same circumstances he imposes on County prisoners - even those that have been convicted of nothing and arrested for simply driving while Hispanic.

Does Sheriff Arpaio understand that disagreeing with him, opposing him politically, and not liking him or his tactics, and even just speaking rudely about him and calling him names he so richly deserves is not a crime? Or does the First Amendment not apply in Maricopa County or the Sheriff's little alternate planet? How many more people will he indict for not letting him have his complete and unfettered way in everything he wants, when he wants it, how he wants it, now, now now - not unlike my 5 year old.

This gentleman is nothing more than the essence of creeping moral and venal corruption. I honestly don't think he means to be corrupt. I am pretty sure that he simply has wandered so far down the bunny trail that he is seeing deep sea fish and calling them rabbits. Mr. Arpaio no longer has a political crisis - he now has a serious constitutional one. His complete disregard of basic human rights, his arrogant lack of accountability to anyone, his inability to work with, or submit to, the supervisory authority of the elected County Commission and the rule of the Constitution and laws of the United States and Arizona make Mr. Arpaio manifestly unfit to hold any office of trust or confidence in our government. He is no longer enforcing the law, but rather, in my opinion at any rate, operating an ongoing criminal enterprise designed to replace the rule of law with the rule of Sheriff Arpaio; enforcing his own ideas of what, and who, the fundamental rights of life, liberty and the pursuit of happiness are and who is entitled to enjoy them.

I might have a solution. Perhaps the Sheriff would like the County to pass a law allowing him, and him alone, to decide who is a criminal, and who isn't. To decide which laws count and which don't. To decide who is law abiding and who doesn't. Who is worthy of any rights at all and who is expendable, neglectable, and abusable while allowing the Sheriff to be completely excusable simply on his own say so. I even have a name for this proposed law. There was a piece of legislation passed in the 1933 called the Enabling Act. It made Hitler the law itself, answerable to no one for nothing, in Germany and led to the complete destruction of his own nation and much of the rest of the world. But no one argued with Hitler while he led them to destruction. They couldn't. Hitler made it against the law to do so.

I have been trying for a long time to understand where Mr. Arpaio is coming from in what he says, and more importantly what he does, and I am slowly coming to the realization that Sheriff Joe is not just some colorful character - he is a dangerous lunatic, or an evil, and completely sane, power monger and manipulator, or perhaps just a befuddled old man being manipulated by others. If he remains in office much longer, and his disgrace of a Chief Deputy was well with him, the citizens of Arizona may not have any law left to enforce. They will simply have Mr. Arpaio's law in Mr. Arpaio's neighborhood. That will be one dangerous and deadly neighborhood to live in. Perhaps someone should point out that his family also, like most white Americans, is an American family because of immigration. They came from somewhere else seeking a new and better life, freedom and a hopeful future. Just like all those people he throws in jail for conspiracy to smuggle themselves into America. He seems to think people want to conspire to work at some coyote's slave labor shop here in the States for years for their journey to the American Dream.

I guess I just don't get it. He has a true double standard. I respect his service in the Armed Forces, but it appears that he learned nothing from his military experience, except of course how to be a military policeman and have unfettered power over others so he felt so very much more important than they were. Nor did he learn the importance of following physician's instructions and prescriptions while serving in an Army Medical Detachment Division in France. Perhaps he feels that only MCSO personnel are entitled to proper health care, or medication that they have been legally prescribed, or life, or anything else. Perhaps he understands and simply doesn't care one little bit. Perhaps he simply doesn't understand at all. However well intentioned he may or may not be, however committed he may or may not be to the rule of law, he has now become, simply put, a disgrace to law enforcement, to decency, to his political party, to the United States and its values and beliefs, and ultimately to humanity. He has, whether through intent or incompetence or complacency or doddering senility, become all that he professes to despise and seeks to defeat. Ms. Oropeza was, after all, a human being that almost died, as many others were also human beings that have died in the custody of the MCSO, strapped to restraint chairs, mysteriously dying without cause or explanation or consequence, and denied basic human rights and dignity all the while. That denial is Mr. Arpaio's one consistency. He denies everything to everyone that is not one of his own. We are not at war with Mexico, and yet he treats people with barely a shirt on their back or a penny to their name as an invading army sent for him personally. I applaud that he goes after the coyotes, who are even worse at denying the humanity of that flood of desperation that crosses our borders every hour, seeking life, liberty and the pursuit of happiness that we take for granted and refuse to share.

It is time for Mr. Arpaio and Chief Deputy Hendershott and every other complicit leader in the MCSO to FACE justice themselves - finally.

Until then Maricopa County will be the lawless Wild West, and its people - and the freedom, hope, justice and the future to which they have a fundamental right to - will continue to wither on the vine of complacency of the politicians, prosecutors and the judiciary alike whose fear of Mr. Arpaio leave them impotent and immobilized. Left much longer, the very rule of law Mr. Arpaio claims, and swore, to uphold will die on the vine. Along with who knows how many more prisoners. And millions of dollars. And countless amounts of human dignity, human life, human liberty and the all too human pursuit of happiness and meaning. The very ideas that makes the United States of America great will die with it. Complacency will allow Sheriff Arpaio to continue to destroy all that Maricopa County holds dear.

Mr. Arpaio needs to be impeached and removed from office.

That will require the Legislature to have the courage to act. Now.

Alan
Alan

Methadone is never dispensed in the county jails. This means that anyone who is legally prescribed methadone and taking it when jailed goes through full immediate withdrawal. All medical experts agree that it is only safe to reduce methadone by 5% per week. It is NEVER safe and ALWAYS life threatening to withdraw completely all at once "cold turkey" from methadone. The county jails place dozens of inmates at risk of death every day with "cold turkey" methadone withdrawals. This is a known medical fact. Methadone is a legal medical drug that should be dispensed in jails if prescribed outside by a legal MD. Other states do this but not AZ. This is a crime that is killing people. Addiction is a brain disease that should not be punished by withdrawing necessary drugs in jails in an effort to kill the unfortunate and needy sick.

 
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