The Hampshire County Sheriff’s Office Did Not Retain Sufficient Documentation Confirming That Its Inmates Received Initial Medical Screenings.

The Hampshire County Sheriff’s Office (HSO) did not retain sufficient documentation confirming that its inmates received initial medical screenings.

Overview

The Hampshire County Sheriff’s Office (HSO) did not retain sufficient documentation confirming that its inmates received initial medical screenings. During the audit period, there were 811 inmates committed to the Hampshire Sheriff’s Office Jail and House of Correction (HJHC) (excluding regionally arrested individuals) who were subject to an initial medical screening upon their admission. During our testing, we selected a random, nonstatistical sample of 70 of these inmates and found that 4 of them did not have initial medical screening forms in their medical files. Furthermore, during our substantive testing of initial medical screenings and health assessments, we found that 1 inmate, out of our sample of 60 inmates, did not have an initial medical screening form in their medical file.

If HSO does not ensure that these initial medical screening forms are retained, then there is no evidence that the health authority completed and approved these initial medical screenings.¹³ This then leads to a higher-than-acceptable risk that inmates’ medical issues are not identified and treated, ultimately affecting the health and safety of all HSO inmates.

Authoritative Guidance

According to Section 932.06 of Title 103 of the Code of Massachusetts Regulations,

Admission Medical Screening (Required)

1. Written policy and procedure shall provide for an admission medical screening to be performed by health trained personnel or qualified health care personnel for each inmate upon arrival at the county correctional facility. The findings of the screening shall be recorded on a printed form approved by the health authority.

Reasons for Noncompliance

HSO does not have monitoring controls to ensure that it retains sufficient documentation confirming that initial medical screenings are completed upon an inmate’s admission to HJHC.

Recommendation

HSO should establish monitoring controls to ensure that it retains sufficient documentation confirming that initial medical screenings were completed upon inmates’ admission to HJHC.

Auditee’s Response

Regarding the findings, our goal is to always be in 100 percent compliance. And although only five individuals were identified as not having adequate documentation, this issue came about during a pandemic, resulting in staffing shortages, and other personnel matters that occurred during the audit period. We have addressed this issue, effective January 1, 2022, with the current Director of our Health Services Department implementing a CQI (Continuous Quality Insurance) order to assure that initial medical screenings are performed and documented. The goal of the CQI is to perform 85 percent of initial screenings within four hours of admission to the Hampshire County Jail and House of Correction, and 100 percent of initial screenings performed within 24 hours of admission.

The CQI also calls for an internal study to determine appropriate staffing levels to meet this goal and to explore ways the booking and intake process might be streamlined.

Auditor’s Reply

Based on its response, HSO has taken measures to address our concerns on this matter.

13.    It is possible that the health screenings were never performed or that inmates refused the initial medical screenings and did not sign refusal forms.

Date published:	November 16, 2023