Audit of the Dukes County Sheriff’s Office - A Review of Inmates’ Healthcare Services (March 4, 2024)

This is a Massachusetts State Auditor performance audit of healthcare services for inmates at the Dukes County Sheriff’s Office for July 1, 2020 through June 30, 2022.

“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 Dukes County Sheriff’s Office (DCSO) for the period July 1, 2020 through June 30, 2022.”

Auditors checked whether the sheriff’s office followed state rules for inmate medical screenings, health assessments, mental health assessments, sick call care and records, and healthcare oversight meetings.

“The purpose of our audit was to determine the following:”

If required health checks are late, inmate medical problems may go unnoticed or untreated, which can affect everyone’s safety inside the jail.

“Because DCSO does not ensure that its contracted healthcare provider completes health assessments within the required timeframe, there is a higher-than-acceptable risk that inmates’ medical issues may not be identified and treated, ultimately affecting the health and safety of all of DCSO’s inmates.”

For residents, this audit is about whether a public agency is protecting people in custody, following state rules, and keeping records that show medical care was handled properly.

“If DCSO does not retain copies of sick call request forms, which contain all information that supports that the sick calls were triaged on time, then there is a higher-than-acceptable risk that some inmates may not have their healthcare issues properly resolved in a timely manner or at all.”

The sheriff’s office passed some parts of the review, including admission medical screenings, mental health assessments, and quarterly healthcare meetings, but failed on timely health assessments and sick call record retention.

“Below is a list of our audit objectives, indicating each question we intended our audit to answer; the conclusion we reached regarding each objective; and, if applicable, where each objective is discussed in the audit findings.”

The auditor recommended that the sheriff’s office add policies, procedures, and monitoring so health assessments happen on time and sick call forms are saved in the medical records system.

“DCSO should implement policies and procedures over its health assessment process to ensure that the contracted healthcare provider completes the health assessments for DCSO inmates on time.”

The audit found a concrete failure: 6 of 14 inmates who needed a required health assessment did not get it within the required 14-day window.

“We found that the contracted healthcare provider did not complete health assessments for 6 of these 14 inmates within 14 days of admission to DCJHOC.”

A sick call request is the form an inmate uses to ask for medical, dental, or mental health help.

“Inmates request access to healthcare by completing a sick call request form and including the type of service requested (medical, dental, or mental health), the date the inmate completes the form, and the nature of the problem or request.”