Cuyhaoga County, MetroHealth To Expand Medical Services In Jails

Cuyahoga County Justice Center
The county jail and courtrooms are found in Cuyahoga County's Justice Center in downtown Cleveland. [Nick Castele / ideastream]

Cuyahoga County has announced a new agreement with MetroHealth Hospital to provide healthcare for the three county jails. The move comes amid the controversy spurred by the deaths of eight county inmates in 2018. 

In a statement, the county says MetroHealth has agreed to assume and enhance all healthcare operations for the three county jails, a departure from the previous agreement where the county and MetroHealth divided those responsibilities. Among the enhancements are 32 additional staff members for medical, behavioral and addiction services and pharmacy needs, expanded mental health services, unifed medical operations at the Euclid and Bedford jails and performance based metrics to track program effectiveness.  The county says it will cost nearly $13.6 million per year, an increase of $5 million.

"The county has been the group that hires the nurses, so it's been a little bit of a dysfunctional and difficult arrangement," said County executive Armond Budish. "This will put it all under MetroHealth."

MetroHealth will also conduct health screenings for inmates within four hours of arrival and prompt referrals for any health issues. Budish says that should have been the norm.

"I believe that's been the plan, but this will make sure that it actually happens in every case 100 percent of the time," Budish said.

The new agreement comes on the heels of a scathing report from the U.S. Marshals that called conditions at the county jail "inhumane." The report also cited 55 suicide attempts and noted several staff shortages, particularly in the area of medical care. The eighth inmate to die in 2018 passed away December 30. He had been on life support after a suicide attempt. 

Budish says Metrohealth was not to blame for any lapses in care cited by a U.S. Marshal's report such as inmates not getting medication or proper health screenings.

"The services had been good and had been doing what needs to be done up until fairly recently when we took in the additional prisoners from the city of Cleveland," Budish said.

Budish says the new agreement will take some of the burden off the Sheriff's office. "They're not medical experts," Budish said. "MetroHealth is and this will turn it over to the medical experts."

Budish also gave updates on plans to improve the jail, stemming from a partnership with the American Corrections Association. "They start reviewing documents in just a couple weeks, and they will be in our jail for a period of time starting I believe at the first of February. And they will give us a roadmap to make additional corrections," Budish said.

In a release, county and MetroHealth leaders said:

“I am very pleased to be able to announce this new agreement between the County and MetroHealth,” said Cuyahoga County Executive Armond Budish. MetroHealth has long been an invaluable partner in our work throughout the County and in the jails. These inmates are in our care and deserve to be kept safe and healthy. This new, comprehensive program will be a model for the country.”

"Our commitment to all Cuyahoga County citizens, including inmates compels us to address health care needs quickly and effectively,” said MetroHealth President and CEO, Akram Boutros, MD. “Our new shared accountability, enhanced services, and enhanced staffing means we can improve and, in some cases, save lives. That’s what we’re committed to doing.”

“I believe this agreement is a critical step in beginning to solve our problems in the County jail and I very much appreciate the MetroHealth System’s willingness to step up and help us at this critical time,” said Council President Dan Brady.

“To have MetroHealth take over total control of the medical care at the County Jail has been a goal for many years,” said Councilman Michael Gallagher. “The council worked hard to get to this point and would like to thank Dr. Boutros for staying with us through some difficult times. I’d also like to thank the entire MetroHealth community and all the leaders throughout the hospital system in providing these much-needed services.”

MetroHealth said it would not comment further about the agreement. 

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