Audit of the Essex County Sheriff’s Department - A Review of Healthcare and Inmate Deaths (April 18, 2024)

This is a Massachusetts State Auditor performance audit of healthcare and inmate deaths at the Essex County Sheriff’s Department for July 1, 2019 through June 30, 2021.

“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 Essex County Sheriff’s Department (ECSD) for the period July 1, 2019 through June 30, 2021.”

Auditors checked whether the department followed rules for inmate deaths, healthcare oversight meetings, admission screenings, physical exams, and sick-call care.

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

Delayed medical exams can mean health problems are missed or treated late, which can affect the safety of people in custody.

“If ECSD does not provide its inmates with timely physical examinations, then those inmates with healthcare issues may not have their issues identified and treated in a timely manner or at all.”

For the public, this report shows whether a county jail system is meeting basic healthcare responsibilities for people it holds in custody.

“As of June 30, 2021, ECSD had 784 employees who supervised and cared for the inmates in ECSD’s custody.”

The auditor found two main problems: late physical exams and late face-to-face follow-ups on some sick-call requests.

“ECSD did not follow up on all sick call requests in a timely manner.”

The auditor recommended stronger monitoring and periodic checks so the healthcare contractor follows timelines for exams and sick-call requests.

“ECSD should conduct periodic evaluations of its internal controls to ensure that its contracted healthcare provider follows up on all sick call requests in a timely manner.”

The audit projected that hundreds of inmates may have been affected by delays during the audit period.

“Based on this, we are 95% confident that ECSD did not follow up on at least 627 HRFs with face-to-face meetings with QHPs within 24 hours upon receipt.”

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

“According to Wellpath’s “Nonemergency Health Care Requests and Services Policy” (HCD-100_E-07) for ECSD, to request access to healthcare, an inmate completes a Healthcare Request Form (HRF) with the following information: the type of service requested (medical, dental, or mental health); the nature of the problem or request; their personal information, including their name, patient identification number,14 date of birth, and housing unit; and their signature and the date.”