Milwaukee County to audit medical care in jails after 4 deaths

Milwaukee County auditors have started a wide-ranging investigation into medical care at the county's two jails, where four people have died in recent months and a court-appointed monitor found numerous problems related to inmate treatment.

Jerry Heer, director of audits for the Milwaukee County Office of the Comptroller, confirmed this week that auditors plan to investigate whether Armor Correctional Health Services is meeting contract requirements and standards of medical care. Armor, a Miami-based for-profit company, has contracted with the county since 2013 to provide medical care at the Milwaukee County Jail and the House of Correction.

Theodore Lipscomb Sr., chairman of the Milwaukee County Board of Supervisors, requested the audit in early November, days after a Milwaukee Journal Sentinel article detailed Armor's staffing and performance issues amid the rash of deaths at the Milwaukee County Jail. Comptroller Scott Manske agreed one day later to start the audit, Heer said.

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"The supervisor wants to have as much information as available regarding how Armor has been conducting themselves, to determine if they've been doing their job or not," said Brian Rothgery, a spokesman for the Milwaukee County Board of Supervisors.

The Milwaukee County Jail is run by Sheriff David A. Clarke Jr. and houses about 950 inmates per day. The House of Correction is managed by county officials and holds about 1,250 inmates.

All four deaths at Clarke's jail remain under investigation and as a result, detectives and the medical examiner's office have released few details about them. But some information has emerged through public records in three of the cases. 

The April death of Terrill Thomas, 38, was determined to be caused by profound dehydration, and the medical examiner's office deemed the manner of death as "homicide." The July death of a newborn came after an inmate gave birth in her cell without any jail or medical staff noticing. And the August death of Kristina Fiebrink, 38, came after medical staff failed to put her on preventative detoxification protocol — she was a known heroin addict with several recent jail stints — or properly assess her following her arrest. 

The causes of death for the newborn and Fiebrink have not been released. No information has been disclosed following the October death of 29-year-old Michael Madden. Investigators haven't said whether the actions or inaction of jail and medical staff contributed to any of the deaths.

At the same time, Armor has failed to staff the two jails with full-time employees — about one-third of all positions are vacant — and medical staff have let some requests for medical care languish for weeks, a court-appointed monitor found. 

The monitor, physician Robert Shansky, first documented the problems in May. He then wrote in November that the issues hadn't been resolved.

Shansky tours the jails twice a year and authors reports as part of a 2001 legal settlement known as the "Christensen decree," which outlines standards of care at Milwaukee's two jails. In the 15 years since the settlement was reached, Shansky has never found the county and Sheriff's Office to be in full compliance.

"Given that all these years after Christensen, that the problems still exist, it's appropriate to have another body like us come in and take a look at things," said Heer, the audit director.

Clarke, who has been largely silent about the four deaths, declined to comment about the audit through a spokeswoman.

But Brian Peterson, Milwaukee County chief medical examiner, told the Journal Sentinel this week that the sheriff called him on Oct. 28 and "verbally pummeled" and "threatened" him over information that Peterson's office made public regarding the deaths of two inmates at the jail earlier this year. Peterson said his office followed appropriate protocol in the cases cited by the sheriff.

In a Nov. 21 court filing related to the 2001 legal settlement, a lawyer for the Sheriff's Office wrote that it is "false" to suggest dangerous conditions exist at the Milwaukee County Jail. The lawyer, Charles Bohl, also wrote that any connections between the inmate deaths and jail or medical staff "represent conjecture at this point."

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Armor officials declined to answer a series of written questions regarding the audit and the company's performance at the jails. In a statement, the company said its "sole focus is consistent delivery of quality patient care. Armor is proud of its dedicated employees and its standard of excellence in its delivery of service to patients."

County officials intend to fully cooperate with the audit, said Melissa Baldauff, spokeswoman for Milwaukee County Executive Chris Abele. Baldauff has said House of Correction staff plan to work on correcting issues raised by Shansky, while noting his report often did not specify whether the problems were found at the House of Correction, the Milwaukee County Jail, or both facilities.

Heer said Armor and jail officials haven't been notified yet of the impending review because auditors are still crafting an investigation plan. Heer expects to hire a health care consultant to provide expertise on proper medical care and standards. Auditors will not conduct independent investigations into the inmate deaths, but will likely review medical records and other documents related to them, Heer said.

There is no timetable for the completion of the audit. The findings will be presented to Milwaukee County supervisors.

In the meantime, members of a Milwaukee County Board of Supervisors safety subcommittee have scheduled a Dec. 15 meeting to question sheriff's officials about the deaths. The meeting is open to the public, but the discussion about the deaths will be behind closed doors because at least some of the inmates' families are expected to sue the Milwaukee County Sheriff's Office.

"We do have some oversight role, so it just seems to me appropriate that we ought to get a handle on what's happening," Supervisor Anthony Staskunas said.

Daniel Bice of the Journal Sentinel staff contributed to this report.