Other Matters in the Audit of the Bristol County Sheriff's Office

Audit reviewed other issues regarding health care worker and inmate ratios, facility overcrowding, and suicide rates.

Overview

During our audit, certain concerns were brought to our attention in relation to the operations of the Bristol County Sheriff’s Office (BCSO). The work we performed regarding our audit objectives covered some of these concerns, such as those related to the Sheriff’s travel expenses and agency revenue. We considered all of the concerns that were not part of our audit objectives, and for those that appeared to be significant and within our ability to assess, we performed some limited review work. For a number of concerns, such as those that involved the treatment of inmates, we deferred to the work conducted by the American Correctional Association⁶ (ACA) on BCSO as detailed in the standards compliance accreditation audit report for BCSO issued by the ACA Commission on Accreditation for Corrections on October 3, 2016. Below is a brief description of the concerns we reviewed during our audit, as well as the results of our review.

1. Concern: BCSO Has an Insufficient Number of Healthcare Workers.

BCSO did not give us any information regarding authoritative requirements or generally accepted standards related to the ratio of healthcare personnel to inmates. We interviewed BCSO’s chief financial officer (CFO) to obtain an understanding of the process BCSO uses to calculate the number of healthcare workers needed for the inmate population. Although we were not given any documentation to substantiate this assertion, the CFO stated that he consults with other prisons across the state and with medical professionals providing services to such prisons to determine the most appropriate number of contracted healthcare workers. We initially reviewed the October 2016 ACA accreditation report and learned that it found no significant concerns or problems in this area. During our audit period, BCSO contracted with a vendor, Correctional Psychiatric Services, to provide healthcare to its inmates. Under this contract, BCSO provided 20 healthcare workers: 5 full-time and 3 part-time mental-healthcare workers and 12 full-time non-mental-healthcare workers (1 medical director, 1 health service administrator, 1 director of nursing, 1 nurse practitioner, 6 licensed practical nurses, and 2 floating intake nurses). BCSO also employs 16 full-time social workers, who act as intermediaries between the inmates and contracted healthcare workers. These numbers reconciled to what was noted in the accreditation report. Because the Suffolk County Sheriff’s Department (SCSD) is similar to BCSO in size, we then compared BCSO’s healthcare worker staffing level to the level indicated in the ACA accreditation report on SCSD dated March 1, 2017. We determined the ratio of healthcare personnel to inmates for SCSD to be similar to BCSO’s: approximately 1 healthcare worker per 32 inmates.

2. Concern: BCSO’s Facilities Are Overcrowded.

We determined BCSO’s inmate count as of December 2017 and reviewed the Massachusetts Department of Correction’s (DOC’s) Quarterly Report on the Status of Prison Capacity, First Quarter 2017⁷ and Quarterly Report on the Status of Prison Capacity, Second Quarter 2017. These reports indicated that BCSO was at 226% capacity during these two quarters. We contacted DOC to verify these calculations. According to the DOC official with whom we spoke, the calculations that DOC used to determine occupancy for this report were based on the original design capacity of the BCSO facilities and did not include any additions that may have increased the facilities’ operational capacities. However, the Bristol County House of Correction in North Dartmouth opened in 1990 with a designed capacity of 360 inmates, and its operational capacity has since increased to 1,386 inmates. Similarly, BCSO’s lockup facility at 26 Ash Street in New Bedford was built in 1888 with a design capacity of 206 inmates, but BCSO has since increased the capacity of the facility to 226 inmates. Based on this information, we reviewed the October 2016 ACA accreditation report. According to this report and BCSO’s inmate count as of December 25, 2017, BCSO had 751 inmates and 198 Immigration and Customs Enforcement detainees living at its House of Correction, placing the facility at 68% of its current capacity, and 187 inmates at its lockup facility at 26 Ash Street in New Bedford, placing it at 83% of its current capacity.

3. Concern: BCSO’s Suicide Rate Is High Compared to Those of Other Prisons.

We determined that during our audit period, BCSO experienced five inmate suicides: four in 2016 and one in 2017. BCSO’s inmate population also experienced four unsuccessful suicide attempts in 2016, two in 2017, and none in the first half of 2018. As shown below, there was a downward trend in the number of suicides during our audit period, and the suicide rate (number of suicides as a percentage of the total inmate population) for BCSO was similar to that of other Sheriffs’ Departments in the Commonwealth.

Sheriff’s Department*	2016 Suicides	2016 Suicide Rate†	2017 Suicides	2017 Suicide Rate†	January 1, 2018– July 27, 2018 Suicides
Bristol County	4	0.33%	1	0.08%	0
Suffolk County	1	0.06%	2	0.12%	1‡
Barnstable County	0	0.00%	2	0.50%	0
Plymouth County	0	0.00%	1	0.10%	0
Norfolk County	0	0.00%	0	0.00%	0

*    Information regarding suicide counts was provided by each Sheriff’s Department.
†    Percentages are based on actual inmate populations, which vary significantly among Sheriffs’ Departments. For example, as of December 2017, the Barnstable County Sheriff’s Office reported 317 inmates and SCSD reported 1,598.
‡    The medical examiner’s determination of the cause of this death is pending.

4. Other Issues

Below are examples of additional concerns that were brought to our attention during our audit. We did not perform any audit work related to these concerns; rather, in the case of these concerns, we reviewed the related sections of the October 2016 ACA audit report for BCSO to determine the extent of any problems.

a. Concern: Inmates are given poor-quality food.

During our audit, we toured BCSO’s Dartmouth facility twice and its New Bedford facility once. Although the purpose of our tours was not specifically to assess food quality, these tours took us through inmate holding areas and the kitchen and food-preparation areas. We viewed the inmate lunch preparation and noticed that all kitchen personnel exercised proper hygiene in preparing and handling food.

According to the October 2016 ACA audit report,

Members of the visiting committee sampled an inmate meal (Tuesday lunch) during the course of the audit. The food served was hot and palatable, and the portions were ample.

​​​​​​​b. Concern: The temperature where inmates are housed is excessive in summer.

We experienced a temperate and comfortable temperature while touring the Dartmouth and New Bedford facilities and all their buildings. Further, we reviewed the October 2016 ACA audit report, which stated,

Members of the audit team spoke with inmates and staff members throughout the facility and received no significant complaints regarding environmental conditions. The audit team did not observe any equipment or building structure in need of repair.

 

6.    ACA’s website states that the organization publishes standards that “address services, programs and operations essential to good correctional management.”

7.    Section 21 of Chapter 799 of the Acts of 1985 authorizes and directs the Commissioner of Correction to report, “by facility, the average daily census for the period of the report and the actual census on the first and last days of the report period. Said report shall also contain such information for the previous twelve months and a comparison to the rated capacity of such facility.”

Date published:	February 13, 2019