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Audit

Audit  Audit of the Barnstable County Sheriff’s Office—A Review of Healthcare and Inmate Deaths

A performance audit of Barnstable County Sheriff’s Office (BCSO) was conducted for the period July 1, 2019 through June 30, 2021.

Organization: Office of the State Auditor
Date published: March 16, 2023

Executive Summary

In accordance with Section 12 of Chapter 11 of the Massachusetts General Laws, the Office of the State Auditor has conducted a performance audit of the Barnstable County Sheriff’s Office (BCSO) for the period July 1, 2019 through June 30, 2021. The objectives of this audit were to determine the following:

  • whether BCSO complied with and implemented the requirements of Section 932.17(2) of Title 103 of the Code of Massachusetts Regulations (CMR) and Section B of BCSO’s Policy 600.03 (Guidelines for Serious Injury, Illness or Death) regarding the deaths of inmates in its custody1
  • whether BCSO held quarterly meetings with the healthcare vendor and reviewed quarterly reports in accordance with 103 CMR 932.01(3) and Section A of BCSO’s Policy 600.01 (Health Care/Health Services/Health Services Personnel/Emergency Health Care) for inmates’ healthcare services
  • whether BCSO provided admission medical screenings2 to its inmates upon intake and health appraisals within seven days of admission in accordance with Sections A and B of BCSO’s Policy 602.02 (Admission Medical Screening/Health Appraisal and Examination)
  • whether inmates at BCSO received medical care after submission of Sick Call Request Forms in accordance with Section D of BCSO’s Policy 602.02.

Below is a summary of our findings and recommendations, with links to each page listed.

Finding 1
 

BCSO did not ensure that its inmates received health appraisals on time and that it documented the health appraisals and admission medical screenings.

Recommendations
 

  1. BCSO should establish monitoring controls to ensure that its healthcare vendor completes health appraisals on time and documents the health appraisals and admission medical screenings. Specifically, BCSO should designate an employee to monitor the healthcare vendor’s completion of health appraisals and documentation of health appraisals and admission medical screenings.
  2. BCSO should ensure that its healthcare vendor has enough staff members to complete the health appraisals.

 

Our audit of BCSO identified one other issue, which has been omitted from this report in accordance with Exemption (n) of the Commonwealth’s public records law, Section 7(26)(n) of Chapter 4 of the General Laws, which allows for the withholding of certain records, such as confidential and sensitive information, if their disclosure is likely to jeopardize public safety.

In accordance with Paragraphs 7.61–7.62 of the Government Accountability Office’s Government Auditing Standards, as well as the policies of the Office of the State Auditor, for reporting confidential and sensitive information, we have given a separate, complete report to BCSO, which will be responsible for acting on our recommendations.

 

1.    BCSO told us that if an inmate is in custody, it means that BCSO has authorization from a court to incarcerate an inmate until the court orders their release. A death in custody is one that occurs during this period of incarceration.

2.    An admission medical screening is an assessment of an inmate’s health needs, including mental health and/or medical conditions. It is conducted upon an inmate’s arrival at the Barnstable County Correctional Facility.

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