Ledes from the Land of Enchantment

UNM, Bernalillo County officials say health care at the jail will improve

After years of inadequate medical care, numerous deaths and countless cases of incarcerated people’s illnesses being neglected at New Mexico’s largest jail, local officials say they expect things to improve with University of New Mexico Hospital staff replacing the private contractors who had worked there.

The contract between the Bernalillo County Metropolitan Center and the previous health care provider YesCare, formerly known as Corizon Health, officially expired July 25.

UNM Hospital staff first arrived at the jail at midnight on July 26, said Douglas Ziedonis, executive vice president for the UNM Health Sciences Center and CEO of the UNM Health System. He was speaking at a gathering of state and local officials outside the jail’s visitor entrance on Wednesday morning.

According to Bernalillo County officials, the work with UNM Hospital will help the local government comply with its obligations under the settlement agreement and court orders in McClendon v. Albuquerque, the decades-long class action lawsuit against the jail and the police who take people there.

The county’s Detention Center Advisory Board in May endorsed a Joint Powers Agreement, which states Bernalillo County and the hospital “desire to work together” to achieve “substantial compliance” with the mental health and medical aspects of the settlement in McClendon.

Bernalillo County Manager Julie Morgas Baca said she is confident that UNM Hospital will provide “quality and compassionate medical and mental health services to each and every” person held inside the county jail.

“Every time an inmate dies, is injured, or suffers a medical emergency, it weighs heavily on myself, on staff — especially, it’s so heartbreaking for the families and the community, and we acknowledge that,” Morgas Baca said. “Providing care for our inmates means taking a hard look at our current policies and procedures and determining how we can improve the outcomes.”

Bernalillo County Manager Julie Morgas Baca speaks outside the visitor entrance to the Metropolitan Detention Center on Aug. 2, 2023. (Photo by Austin Fisher / Source NM)

Emergency room visits

One of the issues documented in McClendon has to do with trips between the jail and hospital emergency rooms. Court records show jail health care staff were unfamiliar or unpracticed in responding to medical emergencies, there have been delays in follow up and continuity of care upon return from the emergency room or hospital after having a medical emergency.

MDC Warden Jason Jones said the jail is lowering the threshold for when an incarcerated person is sent to the hospital emergency room, “ensuring our sickest inmates are receiving the highest level of care possible.”

Dr. Rebecca Fastle is associate chief medical officer for special projects at UNM Hospital. She said she doesn’t know what the previous threshold was, “but we will send who needs to go.”

She said the hospital is sending a rapid response team of trained paramedics and emergency medical technicians to the jail on evenings and weekends, and they hope to expand it so they can be there 24/7.

Detox and intake

A former health care worker previously told Source NM incoming inmates aren’t screened correctly when they’re entering the jail.

Along with regular work shift duties, MDC often had a single nurse cover both detox and psychiatric care — or didn’t staff a detox nurse — that means people suffering from substance use disorders do not get the right treatment, the worker said.

That can be deadly. 

People incarcerated at MDC have also said they told jail officials upon intake that they were on methadone treatment, but instead of being given a dose, they were put into a detox unit for several days — sometimes more than a week.

People jailed at MDC denied methadone, attorney says

Fastle said on Wednesday she wasn’t familiar with either of those practices, but they will not continue.

“We have no intention of doing that,” she said. “We will not be continuing that practice, but across New Mexico, staff shortages are an issue. We are actively recruiting to improve that staff, and that’s not our policy at all.”

Fastle said the Health Care Authority is “looking at how do we make detox standardized,” and how to bring incarcerated people in and get them the relief they need so detox is successful.

Jones said guards will be more able to identify what specific drugs incarcerated people are on when they arrive, “to determine the best detox practices and if they are well enough to be booked into the facility, or if they actually need hospitalization instead.”

“Our inmates deserve the best possible care, and we are committed to doing everything in our power to provide, and I know UNM Hospital staff feel the same way, as shown in the comprehensive care they have provided in this past week,” Jones said.

Metropolitan Detention Center Warden Jason Jones speaks outside the visitor entrance to the county jail on Aug. 2, 2023. (Photo by Austin Fisher / Source NM)

Sick calls and wound care

Fastle said the Health Care Authority will also address the jail’s sick call processes.

Calls for help by incarcerated people in medical emergencies, including seizures, have gone unanswered. At times, there were 1,500 pending sick calls under YesCare, Fastle said.

She said incarcerated people have lost faith in submitting sick calls because of the backlog.

Jail is hemorrhaging medical staff, doesn’t have a doctor, court documents show

People incarcerated at MDC often have wounds that, if left untreated, could turn septic and fatal.

At one point over the 2021-2022 holidays, a former health care worker previously told Source NM the jail didn’t do its daily wound clinic for a week because there was no wound care nurse to run it.

When UNM staff arrived last week, Fastle said, there were at least 15 people with wounds that needed to be treated.

Fastle said she has asked for those people to be triaged to make sure that the people with the most urgent needs are seen immediately in the wound care clinic, even when there is not a wound care nurse.

“It’s not acceptable to ignore wound care; wound care is one of our top priorities as well,” she said.

Dr. Rebecca Fastle, associate chief medical officer for special projects at UNM Hospital, speaks outside the visitor entrance to the Metropolitan Detention Center on Aug. 2, 2023. (Photo by Austin Fisher / Source NM)

Medication-assisted treatment

In most states, whenever someone is incarcerated, they lose their Medicaid coverage, according to the Prison Policy Initiative.

New Mexico’s Medicaid program last year asked the federal government for permission to re-enroll incarcerated people into Medicaid so they can start providing medication-assisted treatment to them 30 days before they are released, along with a 30-day supply of medication when they leave.

Other states have received similar waivers, including California and Washington, said Dr. Rodney McNease, senior executive director of governmental affairs at UNM Hospital.

New Mexico’s HSD proposes medication-assisted treatment for incarcerated people

In a 275-page application to the U.S. Centers for Medicare & Medicaid Services by the New Mexico Human Services Department published in December, HSD said it hopes to ensure formerly incarcerated people stay on their medication after release, don’t commit more crime, end up in an emergency room or become unhoused.

McNease has overseen UNM’s takeover of health care at the jail along with Fastle. From now on, MDC will report to him when they need something from the hospital network..

McNease said he assumes a Medicaid-funded drug treatment at the jail will happen in the future, but as of Wednesday he had not yet spoken with anyone at the Human Services Department about a future program.

“I think we will get to the point where we could get that potentially implemented, but it is going to take some work at the state level,” he said.

Source NM asked HSD for comment but as of Wednesday afternoon, they had not responded. We will update this story if and when they do.

In the meantime, UNM Hospital will pay for medication-assisted treatment, and Bernalillo County will then reimburse the hospital, McNease said.

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