National Institute of Corrections Recommends Sweeping Changes at Multnomah County Jails

The scathing report calls for a leadership overhaul, saying health department officials are denying corrections deputies crucial health care information.

Multnomah County Inverness Jail. (Brian Burk)

A report submitted to Multnomah County on Jan. 12 by a National Institute of Corrections contractor calls for the sheriff to hire an independent health administrator, wrenching some control of the jails’ broken health care system away from the beleaguered Multnomah County Health Department.

Currently, jail security and jail health are siloed under two different elected officials: corrections deputies who work for Multnomah County Sheriff Nicole Morrisey O’Donnell, and health care employees who work for the Corrections Health Division of the county’s Department of Health, overseen by County Chair Jessica Vega Pederson.

The two organizations are not working well together, the contractor found, noting that deputies—and herself—were denied information about the health care needs of inmates, which the county considers confidential. “This stance is inconsistent with good health practice in a corrections agency, it is contrary to the [National Commission on Correctional Health Care] instructions, and it literally places every detainee who enters into this system in a position of jeopardy.”

This exacerbates existing problems in the jails, the report says. Ten people have died in county custody in the past two years, and both the sheriff’s office and the Corrections Health Division are struggling with ongoing short-staffing. Many deputies left during the pandemic, and ones who remain are younger and inexperienced, the report says.

Meanwhile, despite an overall decrease in the number of people behind bars in recent years, the number of inmates with mental illnesses has increased, jail staff told the contractor. The result has been delays: “At present, incarcerated persons must wait up to 10 days to have contact with a mental health clinician, and three weeks or more to see a prescriptive provider,” the report notes.

After uncovering “serious health care and operations issues in the Multnomah jail system” and having “experienced the unwillingness of [Corrections Health] to fully participate in your efforts to head off additional inmate deaths,” the NIC contractor told O’Donnell to hire a new “CEO” of health services that would report to her and oversee the delivery of health care in her jails.

“I believe that seeking the county’s support in hiring or contracting with someone who is independent of [Corrections Health], who understands the legal, ethical and health mandates of jail systems, and has a vision of what interdependent practice and mutual support can and should look like in your world, would be wise,” the contractor, Margaret Severson, a professor emerita at the University of Kansas School of Social Welfare, told O’Donnell.

Severson, invited to submit recommendations to the county at O’Donnell’s request in August, visited the county’s two jails in late November, interviewed dozens of people, and ultimately wrote a 41-page report published Friday.

The report outlines wide-ranging issues at the jail, many previously reported by WW last year. The jails lack key health care staff members, including an onsite psychiatrist. Units housing the jail’s highest-risk populations are frequently short-staffed, resulting in inmates suffering from mental illness being denied time outside their cells.

Severson also documented deficiencies in deputy training. Mandatory biannual training in how to identify mental illness, required by the jails’ accreditor, the National Commission on Correctional Health Care, weren’t being offered. The only mental health training offered by the Multnomah County Sheriff’s Office was for new recruits, and “the curriculum, which I reviewed, is insufficient,“ she wrote.

The county did not immediately respond to a request for comment.

O’Donnell wrote in a response to the report, which was published alongside it on the Multnomah County Sheriff’s Office’s website on Friday: “In the coming weeks, I will be engaging my leadership team and criminal justice system stakeholders in our work to develop plans and strategies to move recommendations forward.”

The report includes a total of 36 recommendations, beginning with the appointment of a new health administrator. Twelve of the remaining recommendations are “quickly implementable,” including some designed to address immediate dangers to inmates.

Among them: retrofitting the showers in the Multnomah County Detention Center, where Martin Franklin hanged himself in June, to eliminate ligature points, and stopping the practice of “closing” mental health units when the jail is short-staffed.

In the longer term, the report says the county needs to overhaul its data collection practices and address the staffing crisis. “Time is of the essence,” Severson wrote. “At the exit briefing and again in this report, I suggested that the MCSO should brace itself for additional deaths in custody.”

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