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Letter to Mayor Ward Va Chesapeake City Jail Investigation Results 1995

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U.S. Department of Justice
Civil Rights Division

Office of 'Jio Assistant Anomev

Ha.rhir.gton. DC. 2OOJS

December 5, 1995
The Honorable William E. Ward
Mayor, City of Chesapeake
Office of the Mayor
City Hall
3 06 Cedar Road
Chesapeake, Virginia 23320

Notice of Findings from Investigation of
Chesapeake City Jail

Dear Mayor Ward:
On February 8, 1995, we notified you of our intent to
investigate the Chesapeake City Jail ("CCJ") pursuant to the
Civil Rights of Institutionalized Persons Act ("CRIPA"),
42 U.S.C. §1997 et seq. Consistent with the requirements of
CRIPA, the purpose of this letter is to advise you of our
findings from this investigation, the supporting facts, and to
recommend necessary remedial measures.
Our investigation consisted of a tour of the facility with
expert consultants, the examination of documents, and extensive
interviews with prisoners and staff at the facility. We were
accompanied on our tours by three consultants: a penologist, a
medical expert, and a fire safety/environmental sanitarian, all
with expertise in jail facilities. Throughout the course of this
investigation, City officials and CCJ staff extended to us and
our consultants their cooperation, for which we wish to convey
our thanks.
In making our findings, we recognize that CCJ confines both
pre-trial detainees and post-conviction inmates. In general,
inmates may not be subjected to conditions that are incompatible
with evolving standards of decency or deprive them of their basic
human needs while incarcerated. See Estelle v. Gamble, 42 9 U.S.
97 (1976). With respect to the pre-trial detainees, the
Fourteenth Amendment prohibits punishment of these persons and
restrictive conditions or practices that are not reasonably
related to the legitimate governmental objectives of safety,
order and security. Bell v. Wolfish, 441 U.S. 520 (1979). For
those convicted of a crime, the standard to be applied is the
Eighth Amendment's proscription against cruel and unusual
punishment. Wilson v. Seiter, 501 U.S. 294 (1991); Rhodes v.
CRIPA investigation


Chapman, 452 U.S. 337 (1981). When convicted prisoners are not,
as here, separated from pre-trial detainees, the Fourteenth
Amendment standard applies to all inmates. Based on our
investigation, we believe that conditions at the Chesapeake CityJail violate the constitutional rights of prisoners housed there.
The Chesapeake City Jail has two main sections, one built in
1962 and the other built in 1987. The Jail has a reported
capacity of 213 inmates. On the day of our tour the Jail housed
472 inmates. On average, the Jail houses between 450 and 500
inmates, with a high of 556 inmates several months prior to our
We realize that the City is currently constructing a jail
addition and that the City plans to participate in a regional
jail. These steps alone are insufficient to remedy the
deficiencies we have found. Further, a number of current
policies and procedures are deficient.

Correctional Deficiencies.

A. Incidents of violence. Inmate-upon-inmate assaults at
CCJ are frequent and routine. According to incident reports, a
number of these fights were sufficiently serious as to require
medical care.
Our consultant concludes that severe and dangerous crowding,
coupled with an extremely high level of idleness, creates an
unusually tense environment at CCJ which leads to violence.
1. Crowding. As noted above, CCJ's rated capacity is 213
and yet it routinely houses over 450 inmates at any given time.
Contrary to acceptable correctional practices, numerous inmates
sleep on mattresses on the floor. The daily population of CCJ is
so far over its design capacity that our consultant concluded
that such density of population is not acceptable under any
Additionally, the overcrowding of the Jail makes it
difficult to classify inmates properly in order to separate
incompatible inmates. This practice is unacceptable.
City officials are currently constructing a new jail which
will replace most of the current Jail. Construction is expected
to be completed by January 1996. Significantly, if the new jail
were in use today, it would open at 70 percent of its capacity.
In light of predictable increases in jail population as a result
of recent legislation in Virginia, our consultant expressed
concerns regarding the adequacy of the new jail addition.
Notably, CCJ's construction plans provide for possible additions
to the new jail, that is additional wings may be built at a later

- 3 time. The additions may be needed earlier than anticipated by
CCJ officials.
CCJ inmates spend nearly all of their time in the same
cramped housing unit to which they are assigned and where nearly
every space is occupied. Indeed, the dayroom areas are so
crowded with inmates that they are virtually unusable for any
kind of physical activity. Inmates throughout the Jail
continually complained to our consultant about other inmates
being "in your face." Such crowded conditions inevitably creates
friction and tension which, in turn, leads to violence.
2. Staffing and supervision. CCJ fails to provide adequate
inmate staffing and supervision. Our consultant concluded that
some officers do not conduct required rounds of the housing
units. Moreover, while CCJ received additional staff two years
ago, the level of staffing fails to keep up with the burgeoning
inmate population. Indeed, CCJ remains over 40 staff positions
deficient. Staffing, which is ordinarily important and crucial
in any secured facility, becomes even more important in a
severely crowded facility like CCJ. In sum, the level of officer
staffing is inadequate for the population routinely housed at
B. Out-of-cell/exercise time is insufficient. CCJ fails to
provide adequate out-of-cell opportunities for exercise. Inmates
at CCJ are confined for months and possibly years, with no
opportunity for exercise outdoors. Our consultant found this
practice to be unconscionable. While CCJ has an outdoor
recreation yard, our consultant concluded, based on the condition
of the yard (e.g., significant amount of leaves, tall grass) that
it had not been used in a long time. Indeed, the recreation
deputy, who began the position at the end of 1994, informed our
consultant that he had never taken a group of inmates outside,
but that "maybe next month" inmates would be taken outside for
outdoor exercise.
CCJ has a multi-purpose room/gym for purposes of indoor
recreation. The room is equipped with a ping pong table,
exercise equipment and a universal weight machine. Inmates,
however, only have access to this indoor recreation area once
every two and a half weeks.
In sum, out-of-cell opportunities for exercise at CCJ are
woefully inadequate.

Deficiencies in Medical Care.

Our consultant concluded that the health care and health
related conditions at CCJ are substandard and inadequate. The
extreme crowding creates unhealthy conditions. It is the

- 4 underlying or contributing cause of many, although not all, of
the problems and deficiencies in the health care system.
The severe crowding at CCJ is unhealthy according to our
medical consultant as it increases the potential for transmission
of infectious diseases.
Furthermore, our medical consultant discovered that beds are
allocated to inmates purely on the basis of seniority (i.e.,
length of time in the Jail). CCJ fails to make any provision to
provide beds for infirm inmates and pregnant women in the latter
half of their pregnancy to prevent them from sleeping on the
floor. This is unacceptable as it may further exacerbate the
existing medical conditions of inmates or expose them to
unacceptable health risks.
A. Deficiencies in screening and treatment of infectious
diseases. The tuberculosis ("TB") screening and treatment
program for infectious diseases at CCJ is woefully inadequate.
CCJ does not have a formal infection control program or an
infection control manual. There is no effort to monitor TB skin
test conversions, which would indicate disease transmission in
the Jail. No log or tabulation of results of TB skin tests is
maintained, so it is not possible to ascertain the rate of TB
Furthermore, several inmates told our consultant that their
skin tests were not read. Still other inmates reported that they
were told not to present themselves for a reading unless they had
a reaction. This instruction is an inappropriate delegation of
medical responsibility to the patient-inmate.
Our consultant noted deficiencies in CCJ's treatment of HIV
positive inmates. Medical staff report that they are not
qualified to draw blood for HIV testing. Consequently, scheduled
tests for HIV are significantly delayed. Further, CCJ fails to
have a policy that mandates a chest x-ray on all HIV positive
B. Inadequate access to medical services. Inmates at CCJ
access medical care by submitting a medical care request slip.
The slip often serves as written communication between the
inmate and medical staff, without physical examination of the
inmate-patient. Our consultant discovered that a number of the
exchanges via the sick call slip were argumentative in nature and
bordered on being punitive. Such responses did not inform
inmates how to care for their health and how to seek medical care
appropriately. Inappropriate responses to sick call slips impede
access to health care.

- 5 Access to health care at CCJ is also impeded by the fee
system. CCJ not only charges inmates a copayment for medical
services, but also charges exorbitant prices for over-the-counter
medications and prescription medications. These practices have
significant implications for public health. Specifically, CCJ
charges inmates infected with tuberculosis for necessary
medication, which notably can be obtained free of charge. CCJ
also charges pregnant inmates for pre-natal vitamins, and chronic
care patients for chronic care medication (e.g., insulin). Our
consultant found these practices to be potentially quite
dangerous from a public health standpoint. For example, one
inmate medical record indicated that CCJ medical staff had
difficulty persuading an inmate who tested positive for
tuberculosis to take necessary medication (INH, pyridoxine)
because the inmate did not want to pay the required ten dollars.
Significantly, while CCJ inmates have no opportunity to earn
money, they are responsible for medical copayments as well as
purchasing hygiene items, unless indigent (maintain a zero
balance in inmate account for 30 consecutive days). Although a
payment system is not illegal per se, it is imperative that all
inmates receive adequate medical treatment, regardless of their
ability to pay.
C. Medical policies and procedures are deficient. CCJ does
not a have a medical policy and procedure manual for medical
services, including chronic care treatment. CCJ only maintains
an assortment of disjointed memoranda and very few treatment
protocols. Further, CCJ does not have a quality assurance
program, an essential process to formally assess the quality of
medical services provided to inmates.
D. Medical staffing. There is insufficient medical staff
to provide adequate medical services at CCJ. The Jail has a
contract with a medical doctor who is on-site three (3) times per
week. The Jail's on-site medical staff is comprised of an LPN
chief medical officer and five correctional assistants. Notably,
neither the chief medical officer nor the correctional assistants
are trained or qualified to perform physical examinations or
diagnose medical conditions. Furthermore, the on-site medical
staff does not have the ability to prescribe medications. This
further compromises the adequacy of the medical care provided.
E. Medical facility is inadequate. While the conditions in
the medical unit are very neat, clean and tidy, our consultant
concluded that it is inadequate to provide sufficient medical
care to CCJ's large population. The size of the medical clinic
at CCJ is too small to provide effective medical care. It is not
large enough to even perform adequate pelvic examinations.
Furthermore, medical equipment at CCJ is also deficient.

- 6 F. Medical records are deficient. Recordkeeping is
deficient. The medical records do not contain problem lists or
flow sheets, data which would make inmates with serious medical
problems readily identifiable to health care professionals.
Indeed, medical records are maintained in a manner which makes
review of the material difficult.
G. Dental services are inadequate. All dental care is
provided off-site. On average, only four patients per week
receive dental care. During the time of our on-site
investigation, CCJ was six weeks behind in providing dental
H. Mental health services are inadequate. Necessary
routine mental health services are not provided to inmates.
Mental health services are provided for crisis intervention only.

Environmental Health and Safety Deficiencies.

A. Fire safety is deficient. CCJ does not conduct fire
drills. Further, there has been no training in the use of the
Jail's air breathing tanks.
Additionally, unacceptable and dangerous amounts of
combustibles, such as hanging clothing and bags of paper, are
present throughout CCJ housing units. This practice is dangerous
as it increases the possible spread of fire and interferes with
evacuation in the event of fire.
B. General sanitation, personal hygiene and severe
crowding. Numerous inmates complained of roaches in the housing
areas. As a practical matter necessary cleaning supplies are not
available and, even if available, one housing unit is so crowded
that it cannot be cleaned properly.
Inmate clothing laundered by the Jail do not appear clean.
Inmates are required to wash their personal clothing (i.e..
undergarments) in buckets or in toilets. This practice is
The Jail maintains a biohazardous waste container for used
sanitary napkins in the shower area with easy access by inmates.
The container is only emptied once per week. This practice is
C. Plumbing is deficient. Numerous plumbing fixtures in
CCJ are in ill-repair and inoperative. In at least two areas,
our consultant found plumbing leaking onto the mattresses of
inmates sleeping on the floor. This is unacceptable.

- 7 Further, CCJ does not have an adequate amount of showers for
the number inmates housed at CCJ. This leads to unsanitary
shower facilities, poor hygiene and transmission of disease.
Most of the showers do not have adequate ventilation when in use;
consequently there is a build-up of scum and mold. Indeed, most
of the showers are filthy.
D. Ventilation is inadequate. CCJ fails to provide
adequate fresh air in the housing units to adequately prevent the
transfer of infectious diseases. Numerous air vents are blocked,
resulting in significant restrictions to air flow. In one
housing unit there is no air flow at all.
E. Food services are deficient. The food at CCJ is not
served at the correct temperatures. Food contact surfaces are
not thoroughly cleaned and sanitized. Further, food service
personnel do not perform their duties consistent with generally
accepted sanitation standards.

Remedial Measures Regarding Correctional Deficiencies.

A. Incidents of Violence. Immediate action must be taken
to significantly reduce the severe crowding. Inmates must be
provided safe sleeping accommodations i.e., a bed, and each
ensured adequate square footage. No pregnant inmate or medically
infirm inmate may be kept overnight at the Jail without a bed
upon which to sleep.
Security and supervision of inmates must be significantly
enhanced by increasing the number of qualified deputies and other
security personnel to reduce violence and otherwise ensure the
reasonable safety of inmates. Records regarding violent
incidents must be evaluated at appropriate intervals to enable
jail administrators to properly deploy security personnel.
Visual inspections of the housing areas must be conducted and
properly documented. Inspections of the housing areas must not
be compromised due to staff scheduling or shortfalls.
Ensure appropriate compliance with CCJ's objective
classification system.
B. Out-of-cell/exercise time. Inmates must be provided
with exercise, outdoors when weather permits, one hour per day,
five days per week.

Remedial Measures Regarding Medical and Mental Health Care.

A. Screening and treatment of infectious diseases. Develop
and implement a formal infection control program. Ensure that
skin test conversions are monitored so as to accurately ascertain
the rate of TB infection. Ensure that all PPD implants are read
by trained CCJ medical staff and the results are appropriately recorded.

- 8 Ensure compliance with CCJ's policy regarding HIV testing.
All HIV seropositive inmates must have an annual chest x-ray.
B. Access to medical services. Ensure that medical staff
do not respond to sick call slips in a punitive manner or manner
that impedes access to medical services.
CCJ must evaluate its fee charging system to determine the
effectiveness of its medical services program, the adverse
consequences of the disincentive to seek care, and the specific
problem areas that require resolution. CCJ must ensure that all
inmates, irrespective of their ability to pay, receive adequate
and timely medical treatment. Necessary medications must be made
reasonably available to inmates.
C. Medical policies and procedures. Create and implement
comprehensive written policies, procedures and protocols
regarding the provision of medical care. Develop and implement a
comprehensive quality assurance program.
D. Medical staffing. Ensure adequate staff of medical
professionals to meet the medical needs of inmates. The on-site
medical staff must include physician assistants and/or nurse
practitioners who are trained and qualified to perform physical
examinations, diagnose medical conditions and prescribe
E. Physical plant. Increase the size of the medical unit
sufficiently to address the medical needs of inmates. Ensure
that the physical examination of female inmates upon admission
includes a pelvic examination. At a minimum the following must
be provided: one examination room with a mechanical table
suitable for pelvic examinations and minor surgery; a second
examination room with a simple exam table; office space with desk
surfaces for the staff including the physician; and separate
spaces for medical records and for medications.
F. Medical records. Ensure that medical records are
maintained in a manner consistent with medical standards.
G. Dental services. Ensure that adequate and timely dental
services are provided. At a minimum, 20-25 inmates per week
should be able to receive dental services. Dental services must
not be limited to extractions.
H. Mental Health. Ensure that adequate mental health
services are provided to inmates on a routine basis. Create and
implement comprehensive policies and procedures for the provision
of mental health care. Create and implement suicide precautions.
Ensure that all staff are trained in recognizing and promptly
referring to qualified professionals, individuals exhibiting

- 9 common symptoms of mental illness and suicidal behavior. Ensure
that necessary routine mental health services are provided.

Environmental Health and Safety.

A. Fire safety. CCJ must routinely conduct and document
fire drills throughout the facility on each shift. CCJ should
provide training in the use of its air breathing tanks.
Ensure the removal of unreasonable amounts of combustibles,
including clothing which is hung on or attached to cell bars, and
other combustible materials from the housing areas.
B. General sanitation. Review, implement and document
compliance with a Jail housekeeping plan. Ensure routine
cleaning of all housing and toilet areas, particularly shower
Ensure that inmate laundry is properly cleaned.
The biohazardous waste container in the female dormitory
area must be removed and secured in a locked area. Covered
containers for sanitary napkins may be utilized in each female
area but must be emptied daily into the biohazardous container
that is in a secured area.
C. Plumbing. Repair, maintain and clean all plumbing
fixtures. Provide an adequate number of showers for the number
of inmates in each cell block. Proper ventilation of the showers
must be provided.
D. Ventilation.

Ensure that inmates are provided adequate

E. Food services. Ensure that food is served at proper
temperatures to protect against food-borne illnesses. Ensure
proper handling of food and drinks. Food personnel must be
trained accordingly.
Pursuant to CRIPA, the Attorney General may initiate a
lawsuit to correct deficiencies at an institution 49 days after
appropriate local officials are notified of them. 42 U.S.C. §
1997b(a)(1). We expect to hear from you as soon as possible, but
no later than 49 days after receipt of this letter, with your
response to our findings and a description of the specific steps
you have taken, or intend to take, to implement each of the
minimum remedies set forth above. If you do not respond within
the stated time period, we will consider initiating an action
against your jurisdiction to remedy the unlawful conditions.

- 10 -

We look forward to working with you and other City officials
to resolve this matter in a reasonable and expeditious manner.
If you or any member of your staff have any questions, please
feel free to contact Shanetta Y. Brown, 202/514-0195, the
attorney who is assigned to this matter.

Deval L. Patrick
Assistant Attorney General
Civil Rights Division

Mr. Clarence V. Cuffee
Chesapeake City Manager
Ronald S. Hallman, Esquire
Chesapeake City Attorney
Mr. John R. Newhart
Sheriff, Chesapeake City Jail
Helen F. Fahey, Esquire
United States Attorney
Eastern District of Virginia



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