Audit of the Hampshire County Sheriff’s Office - A Review of Healthcare and Inmate Deaths(November 16, 2023)

This is a State Auditor performance audit of the Hampshire County Sheriff’s Office covering inmate healthcare and deaths from 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 Hampshire County Sheriff’s Office (HSO) for the period July 1, 2019 through June 30, 2021.”

Auditors checked whether the sheriff’s office followed rules for inmate deaths, healthcare oversight meetings, intake health screenings, sick-call care, and medical recordkeeping.

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

If intake screenings are not documented, the public cannot be sure that medical problems were caught and treated when people entered custody.

“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.”

For residents, this is about whether a public jail is keeping people in custody safe, humane, and medically monitored using taxpayer-funded services.

“We strive to operate a clean, safe, and humane facility, manageable in size with an appropriate range of services, which recognizes the individual needs of each offender.”

The audit found one main problem: HSO needed better controls to keep proof that required intake medical screenings were completed.

“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.”

The auditor recommended that HSO create monitoring controls, and HSO said it had already started using a quality-improvement process for screenings and documentation.

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

This was not a finding that healthcare was broadly failing; auditors said HSO met the other tested requirements, including death procedures, quarterly healthcare meetings, sick-call care, and medical-care documentation.

“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.”

“Health authority” means the person or organization responsible for inmate healthcare oversight; “initial medical screening” means the first health check when someone enters the jail.

“The health authority may be a physician, health administrator, or health agency whose responsibility is pursuant to a written agreement, contract, or job description.”