NC lawmakers seek answers for jail inmate deaths

State lawmakers at a committee meeting Wednesday asked about ways North Carolina jails could reduce inmate deaths, particularly in cases where evidence showed inmates were denied needed medications.

In the past three years, 90 inmates have died in jails across the state, said Steven Lewis, the state Department of Health and Human Services section chief who oversees jail regulations. Another 14 died in medical facilities after becoming infirm in jails; Lewis noted the jail regulations don’t require those out-of-custody deaths to be reported.

Two of those three years — 2015 and 2017 — are among the highest numbers of inmate deaths since the state began tracking them in 1997.

Lewis said it’s not easy to extrapolate trends, but he said North Carolina’s rising death numbers and some of the factors behind them are in line with what many other states are seeing.

“We are trending the same way that it is across the nation,” he said.

DHHS Secretary Mandy Cohen said her staff is working on ways to get those with mental illness and drug addictions into “stable treatment,” as opposed to having them enter the justice system. The challenges jails are facing dovetail with the opioid crisis that is fueling big jumps in overdose deaths.

“It’s a very expensive place for them to be,” Cohen said of the jails, “and they are not getting the treatment they need.”

Lawmakers asked about the supervision and health care of inmates. Lewis confirmed that supervision is a problem in many deaths, but there was little discussion about how to fix it.

A News & Observer series in August found that there were supervision issues in 51 of the 150 deaths over the previous five years. That’s one out of three deaths, and of those the state investigated, it’s one out of every two deaths.

That trend continued last year, as state investigations found supervision issues in roughly half of the 39 inmate deaths.

“One thing that does kind of run through a lot the deaths is the supervision is not being conducted as it should,” Lewis said.

He clarified that the lack of supervision wasn’t the cause of the deaths. Suicides, overdoses and infirmities are the causes for most jail deaths, but the lack of supervision raises concerns whether some of them could have been prevented.

State Sen. Joyce Krawiec, a Kernersville Republican, asked about the case of Jennifer Eileen McCormack Schuler, a pregnant inmate at the Forsyth County who died in 2014. The jail contracts its health care to Correct Care Solutions, which recently settled a lawsuit with her estate. The terms were not disclosed.

Schuler’s death is one of several cases in recent years in which deceased inmates’ families allege that jails denied needed medications.

The lawsuit claimed Schuler, 31, who was an opioid addict, was denied access to an anti-nausea medication, causing her to repeatedly vomit food, liquids and other medications. A medical examiner found she died of a lack of oxygen to the brain, with acute renal failure and dehydration contributing to her death.

“It was obvious that she wasn’t given the care that she needed,” Krawiec said.

Krawiec wanted to know what the state could do to make sure inmates aren’t denied these medications. Lewis noted that the jail regulations leave medical questions to county or regional health departments. Jails are county facilities and are required to follow a medical plan approved by the local health department.

“The plan really does address that in most cases; it’s just a matter of whether it’s being carried out,” Lewis said. “But it could be directed that the plan specifically address those issues.”

Outside of the meeting, Krawiec said she didn’t rule out filing legislation in the upcoming session that would make clear jails are required to provide needed medications.

Forsyth jail officials did not notify the state of Schuler’s death because she died in the hospital. Lewis’ staff didn’t investigate her death until a year later, after receiving an inquiry. The state investigation found she was properly supervised by jailers, but didn’t delve into the medication questions.”

Krawiec said the state should be quickly notified of all inmate deaths, whether they die in jail or in a hospital after becoming infirm.

“It absolutely should,” she said. “No question about that.”

This story was originally published February 28, 2018 at 5:49 PM with the headline "NC lawmakers seek answers for jail inmate deaths."