USA v. Shelby County, Tennessee, Complaint

http://www.usdoj.gov/crt/split/documents/shelby_complaint.htm

IN THE UNITED STATES DISTRICT COURT FOR THE
WESTERN DISTRICT OF TENNESSEE
UNITED STATES OF AMERICA, Plaintiff,
v.
SHELBY COUNTY, TENNESSEE; JIM ROUT, MAYOR OF SHELBY COUNTY; A.C. GILLESS, SHELBY COUNTY SHERIFF, Defendants.
COMPLAINT
THE UNITED STATES OF AMERICA alleges:
1. The Attorney General files this complaint on behalf of the United States of America pursuant to the Civil Rights of Institutionalized Persons Act of 1980, 42 U.S.C. § 1997, to enjoin the named Defendants from depriving persons incarcerated in the Shelby County Jail, located in Memphis, Tennessee, of rights, privileges, or immunities secured and protected by the Constitution of the United States.
JURISDICTION AND VENUE
2. This Court has jurisdiction over this action under 28 U.S.C. §§ 1331 and 1345.
3. The United States is authorized to initiate this action pursuant to 42 U.S.C. § 1997a.
4. The Attorney General has certified that all pre-filing requirements specified in 42 U.S.C. § 1997b have been met. The Certificate of the Attorney General is appended to this Complaint and is incorporated herein.
5. Venue in the Western District of Tennessee is proper pursuant to 28 U.S.C. § 1391.
DEFENDANTS
6. Defendant SHELBY COUNTY is a governmental subdivision created under the laws of the State of Tennessee. The SHELBY COUNTY SHERIFF'S OFFICE is a division of the Shelby County government. The County owns and operates the Shelby County Jail ("SCJ"), located in Memphis, Tennessee.
7. Defendant SHELBY COUNTY is the entity charged by the laws of the State of Tennessee with authority to maintain the SCJ and is responsible for the conditions of confinement and health and safety of persons incarcerated at SCJ.
8. Defendant MAYOR JIM ROUT is the mayor of Shelby County and serves as the chief administrator of the County government. Mayor ROUT is sued in his official capacity.
9. Defendant A.C. GILLESS is the Sheriff of Shelby County and is responsible for the day-to-day operations of SCJ. In his official capacity as Sheriff, he has the custody, control and charge of the SCJ and inmates. Sheriff GILLESS is sued in his official capacity.
10. Defendants are legally responsible, in whole or in part, for the operation of the SCJ, for the conditions there and the health and safety of persons confined or incarcerated there.

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USA v. Shelby County, Tennessee, Complaint

http://www.usdoj.gov/crt/split/documents/shelby_complaint.htm

11. At all relevant times, Defendants acted or failed to act, as alleged herein, under color of state law.
FACTUAL ALLEGATIONS
12. The SCJ is an institution within the meaning of 42 U.S.C. § 1997(1).
13. Persons confined to the SCJ are primarily pre-trial detainees, including both men and women of minimum, medium, and maximum security custody, plus a varying number of juvenile detainees who have been remanded, under state law, to face criminal charges as adults, plus a number of state-convicted inmates.
14. Defendants have engaged and continue to engage in a pattern or practice of failing to protect inmates in the SCJ from undue risk of harm by (inter alia), failing to provide adequate classification and supervision of inmates; failing to provide adequate medical and mental health care; failing to provide adequate food and shelter; failing to provide sufficient access to the courts; and failing to provide sufficient access to exercise.
15. Defendants have been aware of the unlawful conditions alleged in paragraphs 14 for a substantial period of time and have failed adequately to address these conditions, despite their knowledge of the deficiencies.
VIOLATIONS ALLEGED
16. The acts and omissions alleged in paragraphs 14 and 15 violate the rights, privileges or immunities secured or protected by the Eighth and Fourteenth Amendments to the Constitution of the United States of persons confined in the SCJ.
17. Unless restrained by this Court, Defendants will continue to engage in the conduct and practices set forth in paragraphs 14 and 15 that deprives persons confined in the SCJ of their rights, privileges, or immunities secured or protected by the Eighth and Fourteenth Amendments to the Constitution of the United States, and causes them irreparable harm.
PRAYER FOR RELIEF
18. The Attorney General is authorized under 42 U.S.C. § 1997 et seq. to seek equitable and declaratory relief.
WHEREFORE, the United States prays that this Court enter an order permanently enjoining Defendants, their officers, agents, employees, subordinates, successors in office, and all those acting in concert or participation with them from continuing the acts, omissions, and practices set forth in paragraphs 14 and 15 above, and that this Court require Defendants to take such actions as will ensure lawful conditions of confinement are afforded to inmates at the Shelby County Jail. The United States further prays that this Court grant such other and further equitable relief as it may deem just and proper.
Respectfully submitted,
JOHN ASHCROFT Attorney General of the United States
TERRELL L. HARRIS United States Attorney Western District of Tennessee 167 N. Main Street Memphis, TN 38103-1898

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USA v. Shelby County, Tennessee, Complaint

http://www.usdoj.gov/crt/split/documents/shelby_complaint.htm

RALPH F. BOYD, JR. Assistant Attorney General Civil Rights Division
STEVEN H. ROSENBAUM Chief Special Litigation Section
MELLIE H. NELSON Deputy Chief MARY R. BOHAN TAMMIE M. GREGG Trial Attorneys U.S. Department of Justice Civil Rights Division Special Litigation Section P.O. Box 66400 Washington, D.C. 20035-6400 (202) 616-2325
CERTIFICATE OF THE ATTORNEY GENERAL
I, John Ashcroft, Attorney General of the United States, certify that with regard to the foregoing Complaint, United States v. Shelby County, et al., I have complied with all subsections of 42 U.S.C. § 1997b(a)(1). I certify as well that I have complied with all subsections of 42 U.S.C. § 1997b(a)(2). I further certify, pursuant to 42 U.S.C. § 1997b(a)(3), my belief that this action by the United States is of general public importance and will materially further the vindication of rights, privileges, or immunities secured or protected by the Constitution of the United States.
In addition, I certify that I have the "reasonable cause to believe", set forth in 42 U.S.C. § 1997a, to initiate this action. Finally, I certify that all prerequisites to the initiation of this suit under 42 U.S.C. § 1997, et seq., have been met.
Pursuant to 42 U.S.C. § 1997a(c), I have personally signed the foregoing Complaint. Pursuant to 42 U.S.C. § 1997b(b), I am personally signing this Certificate.
Signed this _____ day of _____ , 2002, at Washington, D.C.
JOHN ASHCROFT Attorney General of the United States

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 USA v. Shelby County, Tennessee, Joint Motion

http://www.usdoj.gov/crt/split/documents/shelby_jointmtn.htm

IN THE UNITED STATES DISTRICT COURT FOR THE
WESTERN DISTRICT OF TENNESSEE
UNITED STATES OF AMERICA, Plaintiff,
v.
SHELBY COUNTY, TENNESSEE et al., Defendants.
JOINT MOTION
The United States, Plaintiff, and Shelby County, et al., Defendants, having entered into the attached Settlement Agreement, jointly move this Court for entry of an Order conditionally dismissing this action, pursuant to Fed. R. Civ. P. 41(a)(2), conditioned upon Defendants' achieving compliance with the terms of the Settlement Agreement. The parties respectfully request that the Court place the case on its inactive docket while retaining jurisdiction over the case until a final dismissal with prejudice is entered.
Respectfully submitted,
For the United States:
RALPH F. BOYD, JR. Assistant Attorney General Civil Rights Division
TERRELL L. HARRIS United States Attorney Western District of Tennessee
STEVEN H. ROSENBAUM Chief Special Litigation Section
MELLIE H. NELSON Deputy Chief Mary Bohan Tammie M. Gregg Trial Attorneys U.S. Department of Justice Civil Rights Division Special Litigation Section P.O. Box 66400 Washington, D.C. 20035-6400 (202) 616-2325
Dated: August 6, 2002
For Shelby County:
FRED E. JONES, JR. Senior Assistant County

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USA v. Shelby County, Tennessee, Joint Motion
Attorney 160 North Main, Room 660 Memphis, TN 38108 901-545-4230
Dated: August ____ , 2002

http://www.usdoj.gov/crt/split/documents/shelby_jointmtn.htm

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 Case 2:02-cv-02633-BBD Document 3 Filed 08/15/2002 Page 1 of 3

IN THE UNITED STATES DISTRICT COURT FOR

WESTERN DISTRICT OF TENNESSEE

UNITED STATES OF AMERICA, Plaintiff,
v.

,~ ,
Case. No. 02-2633
ORDER OF CONDITIONAL DISMISSAL

SHELBY COUNTY, TENNESSEE et al.,

Defendants.

o V

The United States, Plaintiff, and Shelby County, et al.,

Defendants, having entered into a Settlement Agreement, have

jointly moved this Court for entry of an Order conditionally

dismissing this action, pursuant to Fed. R. Civ. P. 41 (a) (2),

conditioned upon Defendants' achieving compliance with the terms

of the Settlement Agreement. For good cause shown it is hereby

ORDERED, ADJUDGED AND DECREED: That this case is conditionally

dismissed and shall be placed on the inactive docket pending

compliance with the Settlement Agreement lodged with the Court.

This Court will retain jurisdiction over the case, pending

compliance with the Settlement Agreement, until a final dismissal 1h. Cltrlt: :.. ,.{;rah,c Iv pt'/"":/I:, f,-,,/-;~..I't CI,p,e- ~:j
with prejudice is entered. 0thA- P....pl,.~ I"r~" uq/ea 'I "::, edurF.

Dated: This, the /,?!"day of ~~
a

,2002.

ThIs document entered on the docket sheet in complilillC8
WIth Rule58and1Ol78(al FRCP 00 _ _ _ __

Case 2:02-cv-02633-BBD Document 3 Filed 08/15/2002 Page 2 of 3
UNITED STATES DISTRICT COURT - WESTERN DISTRICT OF TENNESSEE
Notice of Distribution
This notice confirms a copy ofthe document docketed as number 3 in case 2:02-CV-02633 was distributed by fax, mail, or direct printing on August 16, 2002 to the parties listed.
Terrell L. Harris
us. ATTORNEY'S OFFICE
Federal Building 167 N. Main Street Suite 800 Memphis, TN 38103
John Ashcroft US. DEPARTMENT OF JUSTICE Civil Rights Divisio P.O. Box 66400 Washington, DC 20035
Ralph F. Boyd US. DEPARTMENT OF JUSTICE Civil Rights Divisio P.O. Box 66400 Washington, DC 20035
Steven H. Rosenbaum US. DEPARTMENT OF JUSTICE Civil Rights Divisio P.O. Box 66400 Washington, DC 20035
Mellie H. Nelson US. DEPARTMENT OF JUSTICE Civil Rights Divisio P.O. Box 66400 Washington, DC 20035
Mary R. Bohan US. DEPARTMENT OF JUSTICE Civil Rights Divisio P.O. Box 66400 Washington, DC 20035

Case 2:02-cv-02633-BBD
Tammie M. Gregg
u.s. DEPARTMENT OF JUSTICE
Civil Rights Divisio P.O. Box 66400 Washington, DC 20035

Document 3

Filed 08/15/2002

Page 3 of 3

Fred E. Jones SHELBY COUNTY ATTORNEY'S OFFICE 160 N. Main Street Ste.660 Memphis, TN 38103

Honorable Bernice Donald US DISTRICT COURT

 
 Case 2:02-cv-02633-BBD Document 9 Filed 11/09/09 Page 1 of 3 PageID 13

IN THE UNITED STATES DISTRICT COURT WESTERN DISTRICT OF TENNESSEE WESTERN DIVISION

UNITED STATES OF AMERICA,

Plaintiff,

vs.

NO. 2:02-cv-2633 BBD

SHELBY COUNTY, TENNESSEE; JOYCE AVERY, ACTING, MAYOR OF SHELBY COUNTY; MARK LUTTRELL, SHELBY COUNTY SHERIFF,

Defendants. ______________________________________________________________________________

JOINT MOTION OF THE PARTIES FOR ORDER OF FINAL DISMISSAL ______________________________________________________________________________

On August 13, 2002, the United States Department of Justice (the “United States”) filed a

Complaint, and simultaneously, a Settlement Agreement with the Defendants which resolved the

allegations giving rise to the Complaint pursuant to the Civil Rights of Institutionalized Persons

Act of 1980 42 U.S.C. § 1997. The parties simultaneously filed a Joint Motion to Dismiss the

case pursuant to Fed. R. Civ. P. 41(a)(2). On August 16, 2002, this Court ordered the case

conditionally dismissed, placing this case on its inactive docket.

The parties have now agreed that final dismissal of this case is appropriate, based on the

Defendants’ adequate compliance with the Settlement Agreement and the overall improved

conditions at the Shelby County Jail.

Accordingly, the parties respectfully request that the Court enter the Order finally

dismissing this case with prejudice.

Case 2:02-cv-02633-BBD Document 9 Filed 11/09/09 Page 2 of 3 PageID 14

Respectf

ully submitted,

FOR

THE UNITED STATES:

Assistan Civil

THOMAS E. PEREZ t Attorney General
Rights Division

SHANETT Special

A Y. CUTLAR Chief
Litigation Section

by:

s/MARY ARET Trial U.S. Civil Special 950 Washington, (202) Mary.Bohan@usdoj.gov

R. BOHAN HEA A. COLES Attorneys Department of Justice Rights Division
Litigation Section Pennsylvania Ave, NW
DC 20530 305-3581 (202) 514-6273 (fax)

FOR SHELBY COUNTY:

s/DEBRA

L. FESSENDEN #11818

Assistant

Shelby County Attorney

201

Poplar Avenue, Room 9-15

Mem

phis, Tennessee 38103

(901)

545-2139

(901)

545-3577 telefax

Debra.Fessenden@shelbycountytn.gov

2
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Case 2:02-cv-02633-BBD Document 9 Filed 11/09/09 Page 3 of 3 PageID 15

CERTIFICATE OF SERVICE

I, Debra L. Fessenden, do hereby certify that a copy of the foregoing has been served

electronically to Ms. Mary R. Bohan, U.S. Department of Justice, Civil Rights Division, Special

Litigation Section, 950 Pennsylvania Avenue, N.W., Washington, DC 20530 on October

2009.

s/DEBRA

L. FESSENDEN

3
L:\APPS\CNTYLAW\WPDOCS\D027\P005\00059244.DOC\L5029-06

 
 SETTLEMENT AGREEMENT I. INTRODUCTION
On August 24, 2000, the United States notified Shelby County officials of its intent to investigate conditions of confinement at the Shelby County Jail, pursuant to the Civil Rights of Institutionalized Persons Act, 42 U.S.C. 5 1997. On October 4-6 and December 11-13, 2000, the United States toured the Shelby County Jail with consultants in the fields of penology, correctional health care, environmental health and safety, and mental health care.
Throughout the course of the investigation and inspection of the facilities, the United States received complete cooperation and access to all facilities and documents from Shelby County Sheriff A.C. Gilless and the staff of the Office of the Sheriff and the Sheriff's Legal Advisor, from Chief Jailer Marron Hopkins and his staff, and from County Attorney Donnie E. Wilson and Chief Administrative Officer Jimmy M. Kelly, and staff throughout the Shelby County government.
On June 27, 2001, the United States issued a findings letter ("Findings Letter"), pursuant to 42 U.S.C. 5 1997(a) (I), which concluded that certain conditions in the Shelby County Jail violated the constitutional rights of detainees and recommended remedial measures. Attorneys for the United States met with Shelby County officials in July 2001, to begin negotiations on an agreement to address and remedy the concerns raised in the

Findings Letter. County officials subsequently provided a substantive written response to the United States that proposed corrective measures and proposed means of monitoring and documenting those changes, many of which are incorporated in this proposed agreement.
The United States acknowledges that Shelby County has already begun drafting many of the new and revised policies and procedures required by the Settlement Agreement ("Agreement"), some of which may be completed prior to execution of this Agreement.
The parties agree that this Agreement does not constitute an admission by the defendants of the truth of findings contained in the Findings Letter and does not constitute an admission of liability by the defendants. The parties enter into this Agreement solely for the purpose of avoiding the risks and burdens of litigation.
11. DEFINITIONS
1. "Countyu shall refer to defendants Shelby County, Tennessee, the Sheriff of Shelby County in his official capacity, the Mayor of Shelby County in his official capacity, and their agents and successors in office.

2. "DOJ" shall refer to the United States Department of Justice.

3 . "Inmates" or "detaineesu shall refer to individuals

sentenced to, incarcerated in, detained at, or otherwise confined

at Shelby County Jail.

4. "Shelby County Jail" ("SCJ")shall mean the jail facility

located at 201 Poplar Avenue in Memphis, Tennessee (the "Jail"),

and the facility currently housing female detainees in East

Memphis ("Jail East"), as well as any facility that is built to

replace or supplement the SCJ. The terms of this Agreement shall

apply to all SCJ facilities, unless specifically noted otherwise.

5. "Jail Compliance Unit" shall refer to SCJ's internal unit

u, responsible for conducting, inter

security audits,

including audits of tool and key control practices, and other

inspections and random checks required under this Agreement,

except where another entity or staff person is specified by this
Agreement to conduct such inspections (m,monitoring of gang

activity, health care services, food services and maintenance).

6. "Gang Intelligence Unit" shall refer to the staff members

with responsibilities related to monitoring and controlling gang

activity at SCJ.

7. "Qualified Medical Professional" shall mean an individual

with a minimum of masters-level education and training in

medicine or nursing, who is currently licensed by the State of

Tennessee to deliver those health care services they have undertaken to provide. 8. "Qualified Medical Workers" and 'Qualified Medical Staff" shall refer to individuals who have completed an educational program at an accredited school of nursing, and who have complied with licensing requirements in the State of Tennessee; or, individuals with substantially equivalent education and training, and two years of experience providing health care services. 9. "Qualified Mental Health Professional" shall refer to: a) an individual with a minimum of masters-level education and training in psychiatry, psychology, counseling, social work or psychiatric nursing, who is currently licensed by the State of Tennessee to deliver those mental health services they have undertaken to provide; except that a social worker with masterslevel education, training and experience may practice consistent with Tennessee state guidelines without obtaining a license in social work; or, b) a registered nurse with a bachelor's degree in nursing with a minimum of two (2) years psychiatric experience, or a registered nurse with a minimum of five ( 5 ) years psychiatric experience. 10. "Qualified Mental Health Workers'' and "Qualified Mental Health Staff" shall refer to individuals with a minimum of a bachelor's degree and two years of experience providing mental health services.

11. The term "special needs inmates" shall refer to those inmates who are suicidal, mentally ill, mentally retarded, intoxicated, seriously or chronically ill, physically disabled, or otherwise a danger to themselves. 12. "Security staff" shall mean all employees, irrespective of job title, whose regular duties include supervision of inmates at the SCJ. 13. The term "Semi-annual Report" shall mean reports SCJ will submit to the United States to demonstrate its compliance with this Agreement as specified in paragraph 84 (below). 14. The term "100 Day Reportu shall mean a report submitted by Shelby County to the United States within 130 days of execution of this Agreement to demonstrate its compliance with those provisions for which a 100 day report is specified.
111. SUBSTANTIVE REMEDIAL MEASURES A. SECURITY, SUPERVISION AND PROTECTION FROM HARM
Security Staffinq and Training 15. In order to improve sight and sound supervision of inmates in their housing units, the Jail shall convert the majority of inmate living spaces to a direct model of supervision in which the security staff's work station is located inside the inmate housing unit (either inside a pod or a dormitory). Within 100 days of this Agreement, the County shall provide DOJ with a written schedule for conversion of the living units that remain

to be converted, and shall notify DOJ in writing of any subsequent delays in and/or modifications to that schedule. At a minimum, the plan shall provide for the completion of the conversion within one year from execution of this Agreement. Written notification to DOJ concerning any subsequent delays shall be provided within 30 days of any such delay or modification. 16. The County shall train all security staff in the principles of direct supervision:
a. The County shall ensure that all supervisors and managers complete a course in direct supervision for supervisors and managers no later than January 1, 2003.
b. The County shall report to DOJ on the changes made to its existing pre-service training that changes the focus of this training to direct supervision as the dominant form of supervision at the SCJ.
c. The County shall continue to provide comprehensive pre-service training to all security staff.
d. The County shall develop pre-service training for all non-security staff (including civi1ians)who have contact with inmates directly to provide services or supervision of inmates. This pre-service training, at a minimum, shall address:
i) emergency and evacuation procedures; ii) preventing transmission of blood borne pathogens;

iii) recognition and reporting of signs of mental illness and/or suicide risks; and
iv) reporting requirements for use of force. 17. The County shall hire and train sufficient security staff to fill all shifts. In so doing the County shall adhere to the current overtime management policy (Chapter 106, Overtime Management). Additionally, the County shall not make any substantive changes to the Overtime Management Policy without first allowing DOJ to review the proposed substantive changes. 18. Within twelve (12) months of executing this Agreement, the County shall create and maintain individual training records for all staff, documenting the date and topic of all pre-service and in-service training completed, for all training completed on or after September, 2001.
Population Manaqement 19. The County shall continue to engage in proactive population management to prevent a recurrence of excessive crowding, including collection and analysis of data, and implementation of the population management plan, as described in the Population Management Report by consultant A. Gaston, dated March 14, 2002.
Security Policies and Procedures 20. The County shall implement revised key control and tool control procedures. Within 100 days of signing this Agreement, the County shall provide to DOJ revised policies in these areas,

and a schedule for implementation of the revised procedures. ~t a minimum, the County shall provide for implementation of revised policies within one year from execution of this Agreement. If implementation of the revised policies is not scheduled to begin within six (6) months of the date of the Agreement, then the County shall also provide, with its 100 day report, interim tool and key control plans.
a) At a minimum, the key control policy and interim measures shall:
i) assure maximum safety and security of staff, inmates and civilians in the SCJ;
ii) provide for emergency identification of keys by touch or other non-visual means;
iii) include revised post orders that reflect ongoing training in use of keys and both manual and electronic locking mechanisms;
iv) require routine testing and maintenance of keys and locks; and
v) ongoing inventory, audit and evaluation of key control.
b) At a minimum, the tool control plan and interim measures shall require ongoing inventory, audit and evaluation of tool use at the SCJ.

21. The Jail Compliance Unit shall verify that SCJ conducts and documents random checks of the security staff's familiarity with emergency tool and key procedures on a monthly basis. 22. The County shall provide security audit training for the Jail Compliance Unit and designated supervisory staff. Sufficient staff will be trained in time for the County to initiate an internal security audit within nine months of this Agreement. An internal security audit will be conducted every six months thereafter for the duration of this Agreement. 23. The County shall continue to utilize members of the specially trained Detention Response Team ("DRT") to conduct frequent and random shake-down searches of inmate housing areas, on both day and evening shifts. The County shall add to the shakedown log a section to record a summary of contraband confiscated. 24. The County shall provide timely escort of inmates, as required, to attend necessary programming.
Classification and Inmate Discipline 25. The County shall revise its inmate classification system. The revised system shall, at a minimum, incorporate the following changes :
a) Any revised classification system shall meet professional standards prior to its final implementation;

b) Inmates shall be reviewed periodically for possible re-classification (upward or downward) based on institutional behavior; and
C) The County shall implement a system of warning flags that alert intake workers of specific indicators in the records of an inmate's past incarceration at the SCJ, which, if present, require immediate referral to medical staff before classification is completed or the inmate assigned to housing. The indicators shall include, at a minimum:
i) Diagnosis or treatment for mental illness at any time during a past incarceration;
ii) Diagnosis or treatment for serious chronic illness, including but not limited to diabetes, hypertension, heart disease, seizure disorders, tuberculosis or HIV infection;
iii) Placement on heightened observation for suicide, risk at any time during a past incarceration at the SCJ; and
iv) Any medical contraindications for the use of chemical sprays. 26. The County shall include in its 100 day report a schedule for implementing a revised classification system, and any anticipated changes to the revised system. The County shall also provide an interim plan for implementing periodic re-classification reviews and a system of warning flags based on past history, pending implementation of the new classification

system. At a minimum, the County shall provide for the implementation of the new classification system within one year from execution of this Agreement. 27. The County shall implement procedures for assigning vulnerable, assaultive or special management inmates to administrative segregation and shall provide a sufficient number of single-occupancy cells to enable prompt segregation of these inmates. 28. The County shall implement an effective and timely system of inmate discipline and provide a sufficient number of single-occupancy cells for the prompt segregation of all inmates sentenced to the disciplinary segregation unit.
Use of Force Policies 29. The County shall revise its policies on the use of force, including the use of chemical agents and the use of restraints, to provide operational guidance to staff. The revised policy will be provided to DOJ for approval prior to implementation. At a minimum, the revised policies shall ensure that:
a) use of physical force is limited to those situations clearly identified by the policy;
b) SCJ shall conduct periodic inventory of chemical agents, and shall appropriately respond to indications of mis-use or excessive use of chemical agents;

C) mental health professionals are consulted before any planned use of force or non-routine use of restraints on any inmate with a diagnosis of mental illness;
d) all uses of force, including chemical agents and restraints, are reported pursuant to policy and all reports are reviewed by supervisory staff;
e) staff are subject to discipline for failure to report a use of force when policy requires such a report;
f) all uses of force and all failures to report a use of force are investigated thoroughly and appropriately by trained investigators; and
g) inmates may report allegations of the use of excessive force orally to any staff member, who shall reduce the report to writing. 30. The County shall implement an effective system for the prompt discipline of staff who violate policies on reporting and use of force. 31. The County shall revise its policy on use of the restraint chair to require pre-authorization and supervision by mental health staff for any non-emergency use of the restraint chair involving inmates with mental illnesses. 32. No hoods may be used under any circumstances. The County shall submit to DOJ for approval a revised policy to permit the use of a disposable spit cap in limited circumstances; the policy

shall, at a minimum, prohibit the use of spit caps which restrict an inmate's airway. 33. Security staff shall receive special training on all revised use of force policies. 34. The County shall require all security staff to attend annual in-service training on the use of force and de-escalation techniques.
Grievance Procedures 35. Grievance forms shall be available in all housing units at all times without the need to request one from a counselor or other staff member. The County shall provide a secure and confidential method for delivery of grievances, such as a secure lockbox in an area accessible to inmates. The County shall continue to record and maintain records of inmate grievances, including dispositions, for a minimum of one year. The County shall ensure that inmate grievances are investigated and responded to within a reasonable time frame. Inmates shall be provided at least one level of appeal. The County shall not retaliate against inmates who file grievances or appeals, and shall not limit an inmate's ability to file repetitive grievances, except as consistent with state law. In appropriate cases, the SCJ's response to a repetitive filing may be a reference to an earlier response.

36. The SCJ shall periodically review inmate grievances and the disposition of these grievances to identify trends or emergent problems that may require a management response.
Gans Manasement 37. The County shall identify and control inmates who are members of organized gangs. Illicit gang-related behavior shall be a factor considered in increasing an inmate's classification status. B. MEDICAL AND MENTAL HEALTH CARE
Screenins. Medication, and Specialtv Care 38. The County shall comply with its stated policies to provide medical and mental health intake screening to all inmates; shall provide a 14-day health assessment and examination; shall ensure continuation of prescription medications within 24 hours of intake; shall comply with stated policies to screen inmates for infectious disease; shall continue to provide mental health evaluations for all inmates whose histories or whose responses to initial screening questions indicate a need for such an evaluation; shall provide accurate diagnoses for inmates in need of mental health services; and shall continue to provide timely and appropriate referrals for specialty care. 39. The County shall comply with its stated policy for medication administration, particularly in documenting any missed doses of medication.

Sick C a l l and Staffinq
40. The County shall provide access to sick call to all inmates a minimum of five days per week; shall ensure that sick call request forms are reviewed by qualified medical staff within 24 hours; and shall ensure that, for non-emergency requests, inmates are seen by a qualified medical professional no more than 24 hours after submission of the request, or, if requests are first reviewed by qualified staff, within another 24 hours of that review, except that inmates may be seen within 72 hours of submission of a request on weekends. 41. The County shall hire additional staff to ensure that all sick call examinations are conducted by appropriately qualified and licensed medical professionals or medical staff, pursuant to licensing standards for medical professionals and nurses in the State of Tennessee. At a minimum, in its contract with its medical care provider beginning July 1, 2002, the County shall increase the number of medical doctors to a minimum of three (3) full time equivalent ("FTE") positions (one of the FTE medical doctor positions may be satisfied by substituting one and one half (1 %) FTE mid-level practitioner such as a licensed nurse practitioner or physician's assistant); the County shall also use its best efforts to hire at least ten (10) additional registered nurses to fill the currently authorized nursing positions.

42. The County shall hire additional mental health professionals to ensure delivery of necessary mental health services. At a minimum, the County shall increase psychiatrist staffing to one and one-fifth FTE positions, and shall add a minimum of two FTE positions for mental health professionals to the staffing level authorized through addendum no. 11 to its health care contract. 4 3 . The County shall assess the impact of the chargeable-care policy on delivery of medical and mental health care, consistent with the recommendations contained in the March 31, 1996 position statement on Charging Inmates a Fee For Health Care Services by the National Commission on Correctional Health Care. 44. The County shall provide to DOJ in its 100 Day Report a copy of all materials through which the SCJ explains the chargeable-care system for health care to inmates, including all materials prepared for non-literate and non-English speaking inmates. 45. Mental health workers shall make regular rounds to all housing units, including administrative segregation, in accord with SCJ stated policy; mental health workers shall speak regularly with pod officers on these rounds to assess whether inmates in general population, who have not self-identified as requiring mental heath care, should be evaluated by a mental health professional.

Mental Health Information and Intervention 46. The County shall provide sufficient qualified medical and mental health staff to respond promptly to requests from security staff for medical information/intervention, including, without limitation, assessment and monitoring of inmates identified at intake by the medical alert (or flag) system described in paragraph 25, above; intervention prior to a planned use of force on an inmate known to suffer from mental illness, as required in paragraph 29, above; and identification of inmates for whom the use of chemical agent sprays is medically contraindicated. 47. The County shall ensure that mental health professionals monitor all use of therapeutic restraints pursuant to its revised use of force policy, and shall ensure that mental health professionals are consulted prior to any planned uses of force involving inmates identified as having a mental illness.
Chronic and Critical Care 48. The County shall implement a system to track inmates with serious and/or chronic illnesses, including mental illnesses, to ensure that these inmates receive necessary diagnosis, monitoring and treatment. 49. The County shall implement a protocol for enhanced communication between medical professionals who transfer any inmate between the SCJ and an outside medical facility, including, but not limited to, transfers between the SCJ and the

Regional Medical Center ("the MED"), and between the SCJ and the Memphis Mental Health Institute ("MMHI"). The protocol shall, at a minimum:
a) be implemented within 6 months of signing this Agreement; b) shall be monitored as part of the County's quality assurance program; C) shall expressly authorize a SCJ physician to refuse, on medical grounds, to admit (or refuse to accept a transfer of) an inmate from any outside medical facility (specified above), consistent with state law; and d) in addition, SCJ internal Policies and Procedures shall be revised to provide direction to staff in accomplishing the transfer inmates to outside medical facilities once a SCJ physician determines, on medical grounds, that the inmate should no longer be housed at the SCJ. 50. The County shall revise its Policies and Procedures on segregation of special needs inmates (currently BK 5201.01-1.04 to BK 52. 02.00-05). At a minimum, the revised policy shall: a) prescribe a protocol to identify inmates requiring heightened medical and/or mental health monitoring; b) prescribe a method of triaging these special needs inmates for classification and assigning housing based on assessed need: and

C) specify means of providing enhanced monitoring for inmates who require such close monitoring, pursuant to the County's policies, but for whom no space is available in the housing unit referred to as special needs housing.
Suicide Prevention 51. The County shall continue to provide appropriate clothing, such as paper gowns or suicide smocks, to all inmates placed under suicide precautions. 5 2 . The County shall implement revised policy and procedures for suicide observation cells (currently Pod 2K) to address the lack of direct visual observation for certain of these cells. 5 3 . All SCJ staff shall receive annual training on suicide prevention.
Universal Precautions 54. The County shall, within six months, draft and implement a written infection control program to ensure compliance with universal precaution procedures in all SCJ operations. At a minimum, the program shall ensure provision of appropriate cleaning and personal protective equipment, and shall include training on preventing transmission of blood borne pathogens, as well as general sanitation issues.
Critical Incident Reviews 5 5 . The County shall request an autopsy and shall conduct a critical incident/mortality review for every inmate who

dies while in the SCJ (or at the Jail ward of the MED), as part of the County's ongoing quality improvement program. Critical incident review teams shall involve physicians, nurses and other relevant County personnel, including SCJ security staff, and shall seek to determine whether there was a pattern of symptoms or in the SCJ's response which might have resulted in earlier diagnosis and intervention. The review team shall also examine events immediately surrounding the inmate death to determine if appropriate interventions were undertaken. C. ENVIRONMENTAL HEALTH AND SAFETY
Food S e r v i c e s 56. Within 150 days of the execution of this Agreement, the County shall have in place a permanent food service provider for SCJ. 57. All food service staff must be trained in food service operations, safe food handling procedures and proper sanitation. The County shall ensure that the temporary food service provider, hired to provide food services during the transition to a private provider, is staffed with a sufficient number of properly supervised and trained personnel. 5 8 . The County shall ensure that its contract with a permanent food service provider contains provisions requiring that all civilian food service staff receive 40 hours of pre-service training in the principles of safe food handling, proper service,

and sanitation. Civilians who will have contact with inmates during food preparation or service shall, in addition, receive pre-service training relating to security, emergency evacuation and blood borne pathogen concerns. Inmate food service workers shall receive training in principles of safe food handling and sanitation, although the SCJ shall retain discretion to provide fewer than 40 hours of such training to inmate workers. 59. The County shall ensure that the SCJ1sfood sanitation practices and procedures comply with state and local health codes. 60. The County shall ensure that the newly-established environmental health and safety manager ("EHM") or his/her designee checks and records on a daily basis the temperatures in the refrigerator, coolers, walk-in-refrigerator, the dishwasher water, and all other equipment with temperature monitors. The EHM shall also verify that the manifold pressure gauge on the dishwasher is checked and recorded on a daily basis. Likewise, to ensure proper sanitation, the EHM shall verify that maintenance personnel check and record on a weekly basis the speed of the dish conveyor to ensure that it conforms to manufacturer specifications. SCJ shall purchase temperature recording strips to measure the accuracy and adequacy of dishwashing machine temperatures (for both wash and final rinse cycles), and shall purchase chemical sanitizing strips and

routinely check to ensure proper sanitizing when food service equipment is washed in sinks. 61. The County shall have inmate meals reviewed annually by a registered dietician to ensure the nutritional adequacy of inmate meals. Menus must be evaluated annually to ensure compliance with nationally recommended basic daily nutritional requirements. A dietician shall also review all special medical diets annually, or more often as necessary. The County shall provide support to its food service manager from a dietician in order to make nutritionally adequate menu substitutions on those occasions when specified menu items are unavailable. 62. The County will construct a new kitchen adjacent to the Jail Annex currently under construction, and will contract for completion of the new kitchen within eighteen to twenty-four months. In the new kitchen, the County shall install new,
properly-sized kitchen equipment, i.e.,designed to provide food
service to the rated capacity of SCJ, including refrigeration units, cooking units and dishwashing and tray washing units. 63. In its 100 day Report the County shall produce an interim plan to DOJ that corrects the problem of broken, malfunctioning, and/or improperly-sized food service equipment. At a minimum, the plan shall designate personnel to perform preventive maintenance and conduct quality assurance checks on all existing food service equipment, including daily checks and documenting of

freezer, cooler, refrigerator and holding oven temperatures and daily checks of all sanitizing equipment.
Housekeepinq, Preventative Maintenance and Pest Control 64. The County shall immediately revise its written housekeeping and sanitation plan to ensure the proper routine cleaning of housing and shower areas, which shall include routine housing inspections to assess compliance with its revised plan. The housekeeping plan shall, at a minimum, be revised to specify routine cleaning schedules for the kitchen, medical and other common areas outside inmate housing. 65. The County shall develop a written preventative maintenance plan to improve upon the recently-adopted priority-based work order system, and shall provide a copy of the written plan to DOJ for its comments and approval within 100 days. At a minimum, the plan shall specify a protocol for accurate and timely entry of information into the system, and shall provide for routine audits of the system by the Jail Compliance Unit to assess its efficiency and utility. 66. The County currently utilizes portable eye wash stations. These should be added to SCJ's preventative maintenance plan and inspected annually. To the extent SCJ utilizes any stationary eyewash stations, the County shall ensure that these stations are

inspected and flushed on a weekly basis to prevent blockages and to ensure proper pressure. This task shall be added to the preventative maintenance list. 67. The County shall ensure adequate pest control throughout the housing units, medical intake and food storage areas. The County shall maintain a contract for professional exterminator services for the main Jail and Jail East, and the new Jail Annex when it opens. Services should provide for routine spraying and additional spraying as needed.
Personal hycriene and laundry 6 8 . The County shall ensure that personal hygiene items, including an adequate supply of soap, hair shampoo, toothbrushes, toothpaste, toilet paper, a comb, deodorant, shaving equipment, and feminine hygiene products are made available, as necessary, to every inmate. The Jail Compliance Unit shall review and assess its compliance with this requirement at least twice annually, including a review of inmate grievances concerning hygiene items. 69. The County is currently soliciting bids for an outside contractor to replace the Jail's laundry services which were recently destroyed by a fire. Jail East will continue to do its own laundry. The County shall ensure that its stated policies and procedures regarding the laundering of inmate clothing are implemented by both the temporary and permanent laundry

providers, and that inmates are provided clean clothing, underclothing and bedding in compliance with policy. The County shall revise its laundry exchange schedule to ensure equitable distribution and pickup service to all housing areas. The County shall specify in its laundry policy and/or inmate handbook that it will provide inmates two sets of clothing, at a minimum. The Jail Compliance Unit shall review and assess its compliance with laundry policy at least twice annually, including a review of inmate grievances concerning laundry. 70. The County shall ensure adequate lighting in all inmate housing and work areas to enable inmates to read without eyestrain, to maintain adequate personal hygiene, and to facilitate proper sanitation. The County is currently engaged in a bidding process to procure a contractor to repair the lighting in the SCJ's cells, catwalks and showers. The County shall publish/disseminate the RFP and engage a contractor so as to provide sufficient lighting within six months of this Agreement. The County shall notify DOJ in writing of any delays in and/or modification to these time frames.
Plumbinq 71. The County shall revise its preventative maintenance plan to define plumbing emergencies, and shall specify back-up procedures to address plumbing emergencies on weekends and outside of business hours.

72. The County shall complete outstanding repair requests and maintain in good working order all toilets, lavatories and showers. These items shall be incorporated on the list of items to be addressed in the SCJ's preventative maintenance plan described in paragraph 65, supra.
Ventilation 73. The County shall ensure adequate ventilation throughout the SCJ to ensure that inmates receive an adequate supply of fresh air and reasonable levels of heating and cooling. Maintenance staff shall review and assess compliance with this requirement at least twice annually; the Jail Compliance Unit shall review inmate grievances concerning heating, cooling and ventilation on a semi-annual basis.
Fire Safety and Emerqency Preparedness 74. The County shall develop and implement a comprehensive fire safety program and ensure compliance is appropriately documented. The initial fire safety plan shall be approved by the City or County Fire Marshall. The fire safety plan shall be reviewed thereafter by the Fire Marshall at least every two years, or within six (6) months of any revisions to the plan, whichever is sooner. 75. The County shall forthwith provide DOJ with a plan that ensures that comprehensive fire drills are conducted every three (3) months on each shift. The 100 Day Report shall provide

documentation of these drills, including start and stop times and the number and location of inmates who were moved as part of the drills. The County shall ensure that fire safety equipment, including fire extinguishers and self-contained breathing apparatus, is regularly inspected and properly secured, and that inspections are documented. 76. The County shall ensure that staff are able to manually unlock all doors (without use of the manual override in the event of an emergency in which the manual override is broken), including in the event of a power outage or smoke buildup where visual examination of keys is generally impossible. The Jail Compliance Unit shall conduct and document random audits to test staff proficiency in performing this task on all shifts, a minimum of three times per year. 77. The County shall eliminate all electrical hazards, and ensure the proper use of extension cords and proper repair of wiring. 78. The County shall control combustibles and eliminate highly flammable materials throughout the institution and inmate living areas (e.q,,inmates' use of paper bags as trash receptacles, ripped fire-retardant mattress covers and, improperly stored and labeled flammable liquids and other chemicals). The County shall remove all impediments compromising

the effectiveness of sprinkler heads including, specifically, those in the food storage units in the kitchen area. 79. The Jail Compliance Unit shall conduct regular security inspections and the County shall provide ongoing maintenance to security devices such as door locks and manual unlocking mechanisms to ensure these devices function properly in the event of an emergency 80. The County shall revise and implement a specific facility tailored Emergency Response Plan within one year of execution of this Agreement. At a minimum, the Emergency Response Plan shall address fire-related emergencies, other emergencies or crisis situations such as escapes, bomb threats, hostage taking and negotiations; and provide for announced and unannounced bi-annual drills to ensure the staff and inmate population understand their respective roles in specific emergency scenarios. All training drills shall be conducted consistent with the injunctive relief ordered in American Federation of State v. A.C. Gilless, et al., CV.OO-2540 ( W.D. Tenn.). The County shall produce a copy of the draft plan to DOJ within 100 days. D. ACCESS TO THE COURTS AND EXERCISE OPPORTUNITIES 81. The County shall provide to DOJ within six months a revised policy regarding access to the law library, which at a minimum, shall ensure:

a) provision of individual storage bins or lockers in which inmates may store legal materials;
b) that inmates on locked units (psychiatric, administrative and disciplinary segregation, protective custody, and other special needs housing) receive access to legal materials and legal assistance equivalent to that of inmates in the general population;
C) that inmates who are illiterate and/or have limited or no English proficiency receive meaningful assistance in order to access legal materials and legal assistance;
d) that a trained aide be available to assist inmates with the law library resources; and
e) in the event SCJ provides computer access to inmates, inmates will be provided reasonable assistance with this resource. 82. All inmates shall be informed of the policies and procedures for accessing legal assistance at the SCJ. 83. The County shall provide inmates with routine access to outside recreational activities, consistent with the recommendations contained in the NIC Recreation/Programs technical assistance report (#02J1078), dated February 18, 2002. At a minimum, the County shall use its best efforts to provide a minimum of two and one-half (2 %) days of outdoor recreation each week, weather permitting. These efforts are to be documented and

provided to DOJ upon request. The County shall utilize the redesigned outdoor rooftop program area in addition to the gym, seven (7) days a week unless the temperature falls below freezing ( 3 2 degrees), rises above 95 degrees, or there is potentially
life-threatening inclement weather (ath, undershowers or
tornados) .
IV. REPORTING REQUIREMENTS 84. The County, through its Criminal Justice Coordinator, shall report semi-annually to the United States Department of Justice ("DOJ")concerning its compliance with the terms of the Agreement (the "Semi-annual Report"). The first Semi-annual Report shall be due six months from the date of this Agreement, and every six months thereafter, until the Agreement is terminated as provided in paragraph 98. At a minimum, the Semi-annual Report shall include the following sections:
a. A narrative summary of the County's compliance with the terms of this Agreement; where applicable, the summary shall specifically note when the County has failed to meet any deadline specified in this Agreement.
b. A training summary, in which the County reports the number of hours and type of training provided to staff during the reporting period, separately by supervisory and non-supervisory staff, and, if applicable, separately for security, medical, mental health and civilian staff.

c. A copy of all substantive court filings made during the reporting period by either the County or the Special Master in the case of Little v. Shelbv Countv, No.96-2520( W.D. Tenn.)
d. Copies of supporting data and/or reports as specified within this Agreement and itemized in paragraph 85 below. 85. The Semi-annual Report shall include the following documentation and reports:
a. an update on the status of SCJ's conversion from the indirect to direct supervision model as described in paragraph 15, supra.
b. a schedule that ensures completion of the 40 hour direct supervision training by all security staff no later than June, 2003, and a report on the SCJ's compliance with this schedule:
c. an update on steps taken to hire and retain qualified security staff, including: a summary of turnover rates and new hiring; copies of any consultant reports prepared on the issue of staff recruitment and retention; and changes in recruitment or selection procedures, job standards or job descriptions.
d. copies of the Jail Monthly Summary Report. e. documentation demonstrating the Jail Compliance Unit's monthly random checks of the security staff's familiarity with emergency tool and key procedures as described in paragraph 21, supra.

f. copies of SCJ's audits and a report documenting SCJ's progress in training staff to conduct internal audits as described in paragraph 22, suura.
g. the number and types of inmate disciplinary infractions referred to the disciplinary committee during the report period, a summary of the dispositions, and the total number of cases abandoned for lack of a timely hearing.
h. copies of one week's shakedown-logs summarizing contraband confiscated, as described in paragraph 23, supra, from any week of any month in the reporting period.
i. a summary of the number and types of force used during the reporting period and the results of the reviews conducted on the uses of force during the reporting period, including any staff discipline imposed.
j . copies of the monthly medical quality assurance committee minutes, and all audits of medical or mental health services.
k. reports on both medical and mental health staffing described in paragraph 41-42, suura, including the number of vacancies in authorized medical and mental health positions on the first day of each month.
1. copies of all audits concerning the chargeable care policy, and any findings of those audits, as described in paragraph 43, suura, and a review of any inmate grievances

concerning access to or provision of medical or mental health care.
m. copies of any revised or supplemental materials provided to inmates, including a script used by staff to explain the chargeable care policy as described in paragraph 44, suDra. The script shall be provided for DOJ's review within 100 days.
n. a copy of SCJ's protocol for enhanced communication between medical professionals who transfer any inmate between the SCJ and an outside medical facility as described in paragraph 49, suDra, and a report on compliance with the protocol.
o. documentation of the SCJ's basic blood borne pathogen training and in-service training for all staff as described in paragraph 5 4 , supra.
p. list the personal protective equipment currently available to SCJ staff;
q. copies of quarterly spore count test results for autoclaves;
r. report all mortality statistics for inmates who die in custody or upon transfer to an outside hospital, including the number of deaths; date of death; age; and suspected cause of injury or death. The County shall also describe any quality improvement measures implemented during the reporting period pursuant to the recommendation of the critical incident review committee as described in paragraph 55, supra.

s. a status report summarizing safe food handling, proper service and sanitation training received by food service employees as described in paragraph 57-58, suura.
t. a status report on SCJ's preventive maintenance efforts and documentation regarding the degree of compliance with the plan as described in paragraph 65, supra.
u. documentation describing SCJ's provision of personal hygiene items described in paragraph 68, suura, and a semi-annual review and assessment of inmate grievances concerning hygiene items.
v. documentation describing SCJ's compliance with its laundry policy described in paragraph 69, suura, including a semi-annual review of any inmate grievances concerning laundry.
w. documentation describing SCJ's compliance with the requirement to provide adequate ventilation, including its semi-annual review of any inmate grievances concerning heating, cooling and ventilation.
x. copies of the Fire Marshall's reports regarding SCJ as described in paragraph 74, suura.
y. documentation that the Jail Compliance Unit has verified that the SCJ has conducted random audits to test staff proficiency in unlocking all doors manually as described in paragraph 76, suDra.

86. In addition to the Semi-annual Report, the County shall provide to DOJ, within 130 days of this Agreement, a report describing its compliance with those tasks for which a 100 day report is specified. 87. During the term of this Agreement, upon reasonable notice, the United States and its consultants shall have access to all facilities referenced in this Agreement and to the records of inmates and compliance records to the extent necessary to assure compliance with the specific terms of this Agreement. Upon request, the County shall provide to the United States, within a reasonable time, copies of, or access to, SCJ documents or records and/or documents or records created by any agent or contractor authorized by Shelby County to work or to provide services at the SCJ. 88. The United States shall have the right to conduct confidential interviews with inmates. The County shall continue to permit inmates to send and to receive confidential legal mail to attorneys of record, courts and to representatives of the Department of Justice. 89. Nothing in this Agreement shall be construed to limit DOJ's right to request additional documentation and/or conduct inspections in addition to those specified herein.

V. IMPLEMENTATION, ENFORCEMENT and TERMINATION 90. The County shall implement immediately all provisions of this Agreement which involve the continuation of current County policies, procedures, and practices. 91. The County shall provide to DOJ each plan, policy, form and/or training materials revised pursuant to this Agreement within the time specified herein. Any subsequent revisions to these materials shall also be submitted to DOJ during the term of this Agreement. The United States shall expeditiously review all plans, policies, procedures, forms and/or training materials for which this Agreement requires approval from the United States prior to implementation. 92. In the event that DOJ does not approve policies and procedures required to be approved pursuant to the terms of this Agreement, the parties will agree to a schedule for Shelby County to submit additional revisions for appropriate approval. In any matter requiring its approval under this Agreement, DOJ shall not unreasonably withhold any such approval. 93. The parties agree to file this Agreement with the Court in conjunction with a joint motion, pursuant to Fed. R. Civ. P. 41(a)(2), for the dismissal of this case. The dismissal shall be conditioned upon the County's achieving substantial compliance with the entire agreement and maintaining compliance

for at least one year thereafter. The motion shall request that the case be placed on the Court's inactive docket. 94. Substantial Compliance with each term of this Agreement shall fully satisfy the Agreement. The burden shall be on the County to demonstrate that it is in substantial compliance with each of the provisions of the Agreement. Noncompliance with mere technicalities, or temporary failure to comply during a period of otherwise sustained compliance, shall not constitute failure to maintain substantial compliance. At the same time, temporary compliance during a period of otherwise sustained noncompliance shall not constitute substantial compliance. 95. Substantial compliance may be achieved separately in any of the four substantive areas addressed in this settlement agreement (medical and mental health care, security and protection from harm, environmental health and safety, and/or access to exercise and to the courts). If the County achieves substantial compliance in any of the four substantive areas of the Agreement, prior to achieving full compliance with the entire Agreement, and then maintains that compliance for a period of one year, then the County may discontinue those portions of the Semi-annual report which concern compliance with that substantive area of the Agreement. The County shall remain obliged, however, to provide this information, or other specific information requested by the Department, upon request.

96. The United States reserves the right to file a motion to restore this case to the Court's active docket for purposes of litigating the allegations in the Complaint if it believes Shelby County is not in substantial compliance with the Agreement. The United States shall give Shelby County thirty ( 3 0 ) calendar days' written notice before the filing of such motion and will attempt to resolve such disputes cooperatively. 97. In the event the United States believes that the County has failed to substantially comply with the terms of this Agreement, in whole or in part, and such non-compliance threatens the immediate health and safety of inmates, the United States may, without further notice, file a motion to restore the case to the Court's active docket. 98. Once the County has determined that it is in substantial compliance with this Agreement or any of its four substantive areas, the County shall notify the United States in writing, by certified mail, return receipt requested. If the United States does not provide a written objection to such determination within forty-five ( 4 5 ) days of receipt of said notice, the County will be deemed to be in substantial compliance beginning on the date of the notice. If the United States provides a written objection to such determination, in whole or in part, the parties shall make good faith efforts to resolve the dispute. One (1) year from the date the County has reached and maintained substantial

compliance with the terms of the entire agreement, the parties shall file a joint motion for final dismissal of this action. 99. In the event that the allegations in the underlying
complaint are litigated (hth, rough a trial or dispositive
motions), this Agreement shall not be introduced or used as evidence. 100. Notice under this Agreement shall be provided by Federal Express overnight delivery and shall be provided to the Shelby County Sheriff's Legal Advisor, the Shelby County Attorney, and the United States Department of Justice, at the addresses used in the signature pages of this Agreement, or as otherwise designated in written notice to all signers of the Agreement. 101. The parties do not intend to create in any other individual or entity the status of third party beneficiary, and this Agreement shall not be construed so as to create such status. The rights, duties, and obligations contained in this Agreement shall operate only between the parties to the Agreement, and shall inure solely to the benefit of the parties to this Agreement. This Agreement is not intended to impair or expand the right of any person or organization to seek relief against the County for its conduct or the conduct of County employees or agents; accordingly, it does not alter legal standards governing any such claims.

102.. Except as otherwise provided by law, nothing in this Agreement shall preclude the United States from filing an action against any of the defendants under any other applicable provision of law. 103. This Agreement shall be applicable to and binding upon all parties, their officers, agents, employees, assigns, and their successors in office, all in their official capacities 104. The County shall make the substantive terms of this Agreement available to all inmates by maintaining a complete copy of the Agreement in the law library, and providing a complete copy to any inmate upon request.
FOR THE UNITED STATES:

TERREL'L f.- RIS
United States Attorney Western District of
Tennessee

Civil Rights Division
STEVEN H. ROSENBAUM Chief S-pecial Litigation Section

MELLIE 4 . NE ON
Deputy Chief' MARY R. BOHAN TAMMIE M. GREGG Trial Attorneys U.S. Department of Justice Civil Rights Division Special Litigation Section
P.O. Box 66400 Washington, D.C. 20035-6400

FOR SHELBY COUNTY: in his official

*&!a DONNIE WILSON
Shelby County Attorney in his official capacity

FOR THE SHERIFF OF SHELBY COUNTY:

Sheriff of Shelby County in his official capacity
Dated: 6 - 8 - 0 ~

 
 Findings Letter re Investigation of Shelby County Jail

Page 1 of 20

The Honorable Jim Rout Mayor of Shelby County 160 North Main, Suite 805 Memphis, Tennessee 38103
Re: Investigation of Shelby County Jail Memphis, Tennessee
Dear Mayor Rout:
On August 24,2000, we notified you of our intent to investigate conditions in the Shelby County Jail ("SCJ"), pursuant to the Civil Rights of Institutionalized Persons Act ("CRIPA"), 42 U.S.C. Section 1997 et seq. Our investigation focused on allegations of inadequate supervision of inmates and staff that lead to excessive levels of violence in the facility, inadequate mental health and medical care, and deficient sanitation and environmental health. I am writing to report the findings of our investigation, supporting facts, and recommended remedial measures, as required by CRIPA.
On October 4-6, and December 11-13,2000, we toured the SCJ with expert consultants in prison security, correctional health care, mental health care and environmental health and safety. Our consultants subsequently prepared reports to us of their findings and recommendations. While at the SCJ, we interviewed administrators, staff, and inmates and reviewed documents, including policies and procedures, incident reports and medical records. In addition, we received and reviewed the documents provided to us before, during and following our on-site tours. We also reviewed the December 22, 2000 Opinion Finding Defendants in Contempt of Court, entered by the district court in Little v. Shelby County, No. 96-2520 (W.D. T ~ M . )(the "Little Findings"), and the March 14, 2001 Technical Assistance Report from the National Institute of Corrections ("NIC"). At the end of our October visit, our expert consultants in corrections, medical care and environmental health conducted exit interviews in which they conveyed their preliminary findings.
We appreciate the assistance provided to us by the Shelby County Sheriffs office and representatives of the county govenunent. In particular, staff at the Jail and in the office of the Sheriffs legal advisor extended every courtesy to us during our visits, and provided all documents we requested.
Based on our investigation, however, and as described more fully below, we conclude that certain conditions at the SCJ violate the constitutional rights of inmates. We find that persons confined in the SCJ risk serious injury from deficiencies in the following areas: security and protection from harm, mental health and medical care, and environmental health and safety. Crowding in the facility exacerbates these deficiencies.
I. Legal Framework
The constitutional law governing conditions of confinement for inmates has two sources, the Eighth and Fourteenth Amendments. Pre-trial detainees, individuals who have not been convicted of the criminal offenses with which they have been charged, comprise the majority of inmates at the SCJ. Under the
Fourteenth Amendment, these inmates "retain at least those constitutional rights . . . enjoyed by
convicted prisoners." Bell v. Wolfish, 441 U.S. 520, 545 (1979). Further, the Fourteenth Amendment prohibits punishment of pretrial detainees or the imposition of conditions or practices not reasonably related to the legitimate governmental objectives of safety, order and security. Id. at 535-37.
Under the Eighth Amendment, convicted inmates at the SCJ are entitled to "humane conditions of confinement; prison officials must ensure that inmates receive adequate food, clothing, shelter and

klndlngs Letter re lnvestlgatlon ot Shelby County Jall

Page 2 of 20

medical care and must 'take reasonable measures to guarantee the safety of the inmates."' Farmer v. Brennan, 51 1 U S . 825, 832-833 (1994) (quoting Hudson v. Palmer, 468 U S . 517,526 (1984)). The Eight Amendment also forbids excessive physical force against prisoners. Hudson v. McMillian, 503 U.S. 1, 9 (1992). Likewise, prison officials have a duty to protect prisoners "from violence at the hands of other prisoners." Farmer, 511 U S . at 833. The Eighth Amendment protects prisoners not only from present and continuing harm, but from future harm as well. Helling v. McKinney, 509 U.S. 25,33 (1993).
The SCJ must ensure that inmates receive adequate medical care, including mental health care. See Farmer v. Brennan, 511 U.S. 825,832 (1994); Phillips v. Michigan Department of Corrections, 73 1 F. Supp 792 (W.D. Mich. 1990, affd 932 F.2d 969, 1991 WL 76205 (6th Cir. (Mich.)). Deliberate indifference to inmates' (including pretrial detainees) serious medical needs violates the Eighth Amendment because it constitutes the unnecessary and wanton infliction of pain contrary to contemporary standards of decency. Estelle v. Gamble, 429 U.S. 97, 104 (1976); Rich v. City of Mayfield Heights, 955 F.2d 1092, 1096 (6th Cir. 1992).
11. The Shelby County Jail Facilities
The Shelby County Sheriffs Office operates the SCJ, which consists of four physically separate facilities: the main Jail at 201 Poplar Street in downtown Memphis ("Jail"), the Jail East facility for women located in East Memphis, the prison ward at the University of Tennessee Medical Center (know as the Med), and leased dormitory-style space, known as P Dormitory, at the Shelby County Corrections Facility. We were informed that, by agreement with the City of Memphis, the SCJ also detains all inmates charged by the City, which has no separate jail of its own. Thus, the SCJ houses both men and women of minimum, medium, and maximum security custody, plus an average of more than 100 stateconvicted inmates, and a varying number ofjuvenile detainees who have been remanded, under state law, to face criminal charges as adults.
The downtown Jail was opened in 1981, and had 2,789 beds at the time of our tours. Two floors of the Jail contain dormitory housing, a small number of single cells on the second floor are reserved for inmates with special needs, and the remaining Jail housing is in double-bunked cells. An addition to the Jail is currently under construction, and we are told it will contain space for as many as 250 inmates. The lower level of the Jail is used for intake, booking, classification and pretrial services. The Jail also contains a small medical area on the second floor, an indoor gymnasium, a secure roof-top recreation area, a chapel and a small room used as a law library.
The Sheriffs Office opened a facility known as Jail East in 1999, and moved all female inmates to that facility, which has a separate intake and booking area, a small medical area, and a capacity of 384. P Dormitory, space leased from the Department of Corrections, houses 200 low security male inmates. ('1 Unless othenvise noted, our findings refer to the main Jail and to Jail East.
111. Findings and Supporting Facts
A. Deficient Security and Supervision and Protection from Harm
1. Inmate-on-Inmate Violence
Inmates at the SCJ face an unconstitutional threat of violence from attacks by other inmates. In November of 1997, the district court in the Little case found that:

Pindings Letter re lnvestlgation of'Shelby County Jail

Page 3 of 20

Gang involvement is very prevalent in the Shelby County Jail. Gangs known as the Gansta Disciples and Vice Lords are present in the Shelby County Jail. Gang members are responsible for many violent acts, stabbings and rapes in the Shelby County Jail.
Little Findings of Fact and Conclusions of Law at 5 (November 12, 1997). On December 22, 2000, the court held, on plaintiffs' motion for contempt, that "[tlhose same conditions exist unchanged in the Shelby County Jail today."
Little Findings at
1. The court found that:
[Tlhere is no evidence to demonstrate that the guards are adequately supervising the inmates to ensure that the pods to which they are assigned are safe and compatible housing assignments. Rather, the evidence presented [at 5 days of testimony in November and December of 20001 demonstrates that gang members control the daily life of the inmates in 95% of the pods; that the gang members run organized brawls between gang members and non-gang members [referred to as "Thunderdome"]; that the gang
members post rules in the pods that are imposed on other inmates upon threat of physical violence . . . .
The Court heard testimony from inmates who had been assaulted in the Jail, both in Thunderdome events and for failing to participate in them, that the guards responsible for supervising the pods to prevent the inmates from assaulting each other were either away from their assigned posts, aware of the assaults but failed to stop them, or asleep.
Little Findings at 38 - 39. The County stipulated that assaults by inmates on other inmates occur in the
intake area of the Jail, and that the Gangsta Disciples are responsible for many violent acts towards other inmates in the Jail. Id. at 10-11. These facts concerning gang control and frequent assaults of inmates are consistent with the observations of our consultants.
2. Inmates Are Not Supervised Adequately.
The Jail is chronically short-staffed and plagued by high turnover and absenteeism. Interviews with SCJ officials and correctional officers, review of staffing rosters and the December 22, 2000, Little Findings confirm that the SCJ incurs substantial overtime in order to staff necessary posts. The ongoing personnel shortage compromises institutional security and the safety of inmates and staff. (2) Due to short staffing,
the SCJ routinely requires officers to supervise more than one pod (3) of inmates at a time --
notwithstanding that officers have no line of sight supervision of the cells in these pods. Little Findings
at 10, Stipulated Facts Nos. 6 - 9. Moreover, the significant crowding results in so many inmates congregating inside the dayrooms that an officer's view of the back of the dayroom is also obstructed.
Officers do not make required rounds of the catwalks to observe conditions inside the cells, and even when they make infrequent rounds, their view into the cells is obstructed by poor lighting and various obstructions hung by the inmates. Thus, housing staff cannot, and do not, supervise inmates adequately.
The recent testimony in the Little contempt hearings was replete with examples of inmates who
suffered harm at the hands of other inmates without interference from -- indeed, often without the knowledge of -- correctional officers. Little Findings at 17, 19-20, 38-39.
Staffing shortages also are blamed for consistently, dangerously low staffing in the intake area, where assaults by inmates upon other inmates frequently occur. The County admits that as many as 150 inmates may be awaiting classification in the intake area, and that only three oficers per shift are regularly assigned to intake. Id., Stipulated Facts Nos. 4, 6.

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3. SCJ Fails to Classify Inmates Effectively.
SCJ further compromises safety by classifying inmates with a system that has substantial deficiencies. First, a significant flaw with the current classification system is that an inmate's classification is not reviewed on a periodic basis, to take into account possible changes in charges and institutional behavior that might warrant an increase or a reduction in the inmate's classification level. Reviews are particularly important because many inmates remain in the SCJ for many months or years. Second, the system considers only prior convictions in assessing an inmate's criminal history, and does not consider prior assaultive charges for which an inmate currently may be on bond awaiting trial. Third, the SCJ routinely fails to discipline misbehavior while in the facility, and thus, routinely fails to incorporate information about disciplinary findings in its classification and re-classification decisions. Finally, the classification
system does not take into account gang affiliation or participation in gang-related activity -- even
activity that occurs in the Jail. These deficiencies substantially increase the likelihood of an inmate's classification not reflecting his or her true potential for violence, and increases the risk of serious harm to inmates.
In addition, the Jail's intake area consistently fails to separate and supervise inmates with a potential for
violence, leaving inmates prone to attack during the hours -- and sometimes days -- that it takes to
complete the booking and classification process. The Jail was designed with separate holding tanks on either side of a hallway of central offices used for booking, identification, preliminary classification, medical screening and pretrial services. The Jail separates inmates and processes them through either the assaultive or the non-assaultive conidor, based only on information available at arrest, primarily, their charges. Both sides of the intake area suffer from deficient staff supervision. In addition, these areas are grossly crowded, with as many as 100-150 inmates at peak times. The holding tanks, with a maximum total capacity of 75 inmates, are inadequate to contain this number of inmates, who often spill into the hallways. The identification unit and medical screening area can be accessed from either the assaultive or the non-assaultive hallways, and basic security is consistently lax, permitting assaultive and nonassaultive inmates to mix in these areas.
4. SCJ Does Not Discipline Inmates Who Violate Jail Rules.
SCJ officials have not taken the necessary steps to control inmate misconduct through the disciplinary process. Disciplinary infractions routinely result in no formal discipline, both because mandated hearings are not held within 72 hours, after which the charges expire, and because staff, knowing that follow-up with a hearing and punishment is unlikely, frequently do not initiate the process by charging or "writing up" the inmate. One of the factors contributing to this problem is the lack of sufficient disciplinary segregation beds. "Waiting lists" are common as inmates determined to have violated institutional regulations must wait for a bed in disciplinary segregation to become available. The NIC report also highlighted this problem, calling the number of disciplinary segregation beds "seriously inadequate." NIC Technical Assistance Report at 20. Furthermore, even when disciplinary action is taken, that information is not incorporated into re-classification decisions. This failure substantially increases the likelihood of inmates' classification not reflecting their true potential for violence, and increases the risk of serious harm to inmates.
5. SCJ Does Not Control Dangerous Contraband, Tools or Keys.
The SCJ fails to conduct sufficient searches of inmate living areas to control inmates' accumulation of dangerous contraband. For example, the shakedown team conducted no shakedowns at Jail East between March and December 2000. During our visit in October, inmates at Jail East complained that other inmates had accumulated stocks of disposable razors from the commissary, a clear security concern. At the main Jail, the shakedown team's log included shanks, razor blades removed from their disposable

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handles and other forms of life-threatening contraband, as well as stockpiled medications and other items frequently used for barter and extortion among inmates.
Inadequate tool and key control at SCJ create a significant risk of harm to both institutional security and the health and safety of inmates and staff. SCJ staff members at both the Jail and Jail East were unable
to identify emergency keys for unlocking doors>a and a lieutenant assigned to the key storage area could not identify any use for a number of keys under his control. The NIC team made similar observations in its tour of the SCJ in January 2001. We observed inmates with broad access to dangerous tools which could easily be used as weapons, for example, acetylene torches and heavy metal cutters used by unguarded workmen installing a railing in the lower level. We also observed the door to the DRT staging room left open to an adjoining hallway where unescorted inmates walked, despite the fact that chemical agent sprays, among other items, are stored in unlocked cabinets and file drawers in the room.
6. Excessive Use of Force Is Prevalent.
The level of force used by staff against inmates at the SCJ is excessive, and senior Jail management is aware of the problem. The Chief Jailer conceded that the use of force "may be bordering on high," the Commander of Security acknowledged that staff routinely use chemical agents before using hands-on control techniques (an express violation of SCJ policy), and a former commander of Internal Affairs confirmed the use of force outside the parameters of the staffs training. The use of pepper spray is particularly uncontrolled. The reasons include the lack of guidance in policies, the lack of inventory control for chemical agents, the lack of effective oversight or investigation of all incidents involving this type of force, and the lack of supervision to prevent the staffs use of force exceeding the limitations of policy.
a. Policies on the Use of Force Provide No Operational Guidance.
The SCJ's use of force policies and procedures are too vague to provide guidance to staff in identifying the limited appropriate circumstances for uses of force. The Constitution permits the use of force in correctional settings only to the extent that the force used by officials is reasonably necessary to respond to a threat to security or discipline reasonably perceived by officials. Hudson v. McMillian, 503 U.S. at 7 (discussing factors that courts evaluate in determining "whether the use of force could plausibly have been thought necessary in a particular situation"); Williams v. Browman, 981 F.2d 901, 905 ((jthCir. 1992) (same). The SCJ's policies, however, describe permissible uses of force more indiscriminately. For example, the SCJ "Use of Chemical Agents" policy permits the use of chemical agents when an inmate "shows no intention of complying" with a verbal order, no matter what the order or how insignificant its impact on security. Inmates complain ofbeing sprayed by officers in the course of verbal disagreements, and numerous reports indicate tbat inmates are sprayed with chemical agents on little provocation. However, if an officer states tbat the inmate refused a verbal order, the officer's behavior is safely within the bounds of SCJ policy. Less forceful alternatives to control inmate behavior, including a show of force through additional or supervising officers, hands-on control tactics, and discipline through the administrative process, are neither encouraged nor required by this policy.
SCJ policy also authorizes the use of force to prevent destruction of county property, no matter how insignificant its value. The exertion of force against inmates, including chemical sprays, to prevent insignificant property damage is excessive, yet is within the bounds of this policy. See Hudson v. McMillan, 503 U.S. at 7 (the need for force, the relationship between that need and the amount of force used, and any efforts made to temper the severity of a forceful response are among the factors properly used to evaluate whether the use of force was wanton and unnecessary); Lock v. Jenkins, 641 F.2d 488,

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496 (7'h Cir. 1981) (although the significant destruction of prison property might justify the use of tear gas, damage to a food tray does not rise to this level). This policy, in particular, should be amended to authorize force only in the face of destruction of valuable property. Sound use of force policies should provide guidance to staff so that staff's response to the threat posed by an inmate's behavior employs only the force reasonably necessary to control that behavior.
b. Chemical Agents Are Not Inventoried.
There is no inventory control of canisters of pepper spray. In fact, numerous canisters are held in unlocked file cabinets in the DRT staging room, and canisters are issued to each officer at the training academy. Depleted canisters are replaced upon application. A 1996 policy requiring canisters to be weighed upon issue and quarterly was revised in 1998 to eliminate the quarterly weighing. Monitoring
the volume of chemicals used by staff is one way to identify heavy use -- and prevent excessive use -- of
chemicals.
c. Uses of Chemical Agents Are Not Investigated.
There is no effective investigation of the use of chemical agents, the most routine use of force at the SCJ. Staff are required to fill out a form entitled "Use of Chemical Agent," but even the most blatantly
inappropriate reasons for the use of chemicals stated on these reports -- indeed, even reports with no
stated reasons -- are not investigated by the Internal Affairs ~ u r e a u . m
For example, staff spray inmates when they are verbally aggressive, as in the following report: "Inmate refused to remove his clothing after being placed on suicidal precaution and became verbally abusive and very hostile." Staff frequently spray inmates displaying behaviors characteristic of mental illness, as in the following examples: "Inmate was beating his head against tank door. He was sprayed to prevent him from hurting himself;" and "[Inmate] refused to talk sensible, he began to praise the devil pulling
off all his clothes, walking naked . . . given several orders to go to his cell, but still refused."
None of these instances was investigated, as evidenced by the fact that none appeared in the Internal Affairs Bureau's investigation logbooks. Incidents where inmates were sprayed while lying prone on the floor or while locked in their cells were also not investigated. Indeed, the use of chemicals against an inmate is seldom reported on the separate forms designed for that purpose and is even more rarely investigated. To ensure the appropriate use of chemicals by staff, supervisors should provide oversight, feedback and discipline for misuse.
d. Examples of Excessive Force
A hearing-impaired, mentally ill inmate was pepper sprayed while laying quietly in his cell, then he was forcibly removed from the cell by five members of the Detention Response Team ("DRT") wearing riot gear and gas masks, strapped into a five-point restraint chair, and a solid hood placed over his head. He was then transported to and from a shower in the restraint chair. The stated justification for this extraordinary show of force was that the inmate, who was known to be hearing impaired, had refused a verbal order to take a shower. The use of this level of force in these circumstances, upon an inmate with known disabilities that would affect his ability to comply with staff orders, appears to us to be an example of wilful and wanton infliction of pain without justification.
The policy on use of the restraint chair requires the use of a "disposable spit cap." The policy states that the spit cap is used to "eliminate any potential health hazards." Staff proffered to us that it was used to reduce the possibility of transmitting HIV. We are aware of no medical or scientific literature to suggest

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that HIV is transmitted by spitting. Moreover, the disposable mesh bag (i.e. spit cap) that was used in a demonstration on a member of the DOJ team is distinguishable from the opaque bag that was placed over the head of the deaf inmate described above. In the actual incident, as opposed to the demonstration, the inmate's eyes, ears, nose and mouth were completely covered by the "spit cap" that resembled a canvas pillow case. The canvas bag was placed back on the inmate's head after he complied with the DRT's instruction to shower and dress out. The use of the canvas hood is never appropriate. Moreover, because no valid penalogical purpose has been suggested for the disposable spit cap, its use is also inappropriate.
Inmates reported many additional examples of the use of excessive force, particularly involving pepper spray. Several inmates in one pod, independently and without collusion, told us that the DRT had sprayed gas into the dayroom of their pod during what the inmates described as a practice session, while inmates were locked in their cells. This appears to be confirmed by a DRT incident report stating that the team used two cans spray in one pod. The DRT report alleged that a number of inmates in the pod had refused a verbal order to lock down. Inmates report that pod officers routinely use pepper spray in the course of verbal altercations.
In summary, the vague policies on use of force, the admissions of senior management, the review of incident reports and complaints, and the lack of oversight on the use of chemical agents lead us to conclude that the SCJ violates the constitutional rights of inmates by permitting the excessive use of force by staff. We conclude that there is a pattern or practice of excessive use of force against inmates at the SCJ and that management has failed, in particular, to correct the clear misuse of chemical agents by staff.
B. Mental Health and Medical Care Is Constitutionally Deficient.
Shelby County contracts with Correctional Medical Services ("CMS") to provide mental health and medical care at the Jail and Jail East; critical care is provided by the University of Tennessee's Regional Medical Center. Medical and mental health services at the Jail and Jail East are critically deficient in
.several respects: initial evaluations are frequently deficient;
access to both medical and mental health care through sick call is deficient because there are too few qualified professionals on staff to evaluate sick call requests and perform examinations in a timely manner;
mental health diagnostic assessments are inadequate;
prescription medication is not managed and administered reliably;
chronic illnesses, including severe mental illnesses, are not managed effectively; and
there is no screening for emergent mental health concerns in the general housing areas
1. Deficient Access to Care
a. Intake Evaluations
There is a critical shortage of qualified health professionals to serve an inmate population the size of the

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SCJ. In the year 2000, the Jail booked more than 64,000 inmates, averaging more than 5,300 bookings per month The staff is hard-pressed to provide complete intake evaluations for such large numbers of inmates, and we noted numerous lapses in medical intake evaluations, particularly in screening for transmissible infectious diseases, taking and recording vital signs, and assuring timely continuation of prescription medications.
The following examples illustrate lapses in providing minimally competent medical intake evaluations. Problems with screening for infectious diseases were evident from the files of two inmates with recorded histories of tuberculosis, neither of whom was screened for current signs of the disease, even though our review occurred almost two months after their admissions. We discovered many cases where previously-prescribed medication was not continued upon intake, including an inmate who required seizure medication that was not ordered by a physician until four days after intake. Another inmate, a renal dialysis patient with hypertension and diabetes, received no treatment for either condition for three days, and no blood pressure or blood sugar monitoring. An inmate admitted on medications for HIV received no physician evaluation and no medication evaluation during five months of incarceration. These are all potentially life-threatening delays.
There is inadequate evaluation and treatment of substance abuse and the symptoms of withdrawal. Inmates are not asked directly about drug and alcohol use. A recently-implemented protocol to screen inmates for drug or alcohol withdrawal relies heavily upon reviewing vital signs for indications of withdrawal, yet vital signs are routinely not taken and recorded during intake evaluations. One inmate who admitted to drug and alcohol abuse at intake received no physical evaluation or physician appointment during two months of incarceration.
Failure to continue medication promptly and to monitor vital signs at intake also contributes to deficiencies in mental health care. One inmate was admitted and discharged within two days without receiving previously-prescribed medication for bipolar disorder, although the medications were identified on his intake forms. He was re-arrested a day later but his psychiatric medication again was delayed for two days. This inmate committed suicide five days after his first admission (on the third day of his second admission), having not received prescribed mood-stabilizing medication for four of his last five days. It took two weeks for another inmate to receive the psychotropic medication he had been taking at the time of his arrest.
Lack of privacy in the intake area may inhibit candid responses to the intake screening questions, increasing the chances of missing an inmate with a significant mental health or suicide concern.
Although national statistics suggest a higher prevalence of mental health concerns among female than male inmates, there is a disturbing shortage of qualified mental health professionals at Jail East. The mental health staffing for inmates at Jail East consists of a technician working two hours per day, five days per week, and a psychiatrist working three hours per week. There is no substitute staffing during staff vacations or other absences. This is insufficient to accomplish timely screening for mental health concerns, or to provide essential treatment for those with identified needs, including those on psychiatric medication. For example, the psychiatrist canceled his one-morning per week visit to Jail East during our December tour. In his absence, no new or altered prescriptions could be ordered, and inmates who required psychiatric services faced a longer wait for those services. During our October tour, a nurse at Jail East told us that an inmate who appeared to be depressed and in need of mental health treatment had not been seen by mental health staff in the four days since her admission, despite this nurse's phone calls to the main Jail's mental health staff requesting an evaluation.
b. Sick Call

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Access to non-emergency care is deficient, both because it is not timely, and because it is not provided by appropriately-qualified professionals. For non-emergency care, both medical and mental health visits are initiated by submission of a sick call slip, which inmates complained were often unavailable. One inmate told us that he used his library time to make copies of the slips because they were so hard to come by. SCJ policy states that sick call will be scheduled at least once per week for all inmates. The Jail's policy does not meet accepted national standards for largejails, which require requests for medical care to be reviewed by a qualified medical professional within 24 hours, and the patient to be seen by a qualified professional within the following 24 hours (72 hours if a weekend). The Jail's actual practice, described below, deviates even further from accepted national standards. In practice, it appears that sick call requests are triaged by a nurse, and inmates are scheduled for the next weekly sick call on their
floor - which could be as much as a full week later. One inmate, known to have AIDS, submitted a sick
call request complaining of sores and a burning sensation, but was not called for an evaluation until ten days later. If a case is deemed by correctional staff to be sufficiently urgent, an inmate instead might be escorted to the second floor medical area for an evaluation prior to the next weekly sick call on his floor. The NIC report found that the Jail's ad hoc sick call practice placed correctional staff in the untenable position of being gatekeepers for medical services. NIC Technical Assistance Report at 15.
In addition to its limited availability, sick call is constitutionally deficient because sick call examinations are conducted by staff not qualified to do so.C8)This has compromised the health of inmates and subjected them to unnecessary pain. For example, an inmate who had recently undergone surgery to repair a hernia in his groin area requested sick call in June and again in July, complaining of pain in his groin, particularly when urinating. He was examined by a registered nurse ("RN") and then a licensed practical nurse ("LPN"), but did not see a doctor and did not receive antibiotics, despite indications of an infection. In August, two months after his first complaint to the Jail, the inmate's genitourinary infection was diagnosed during a surgery followup visit at a hospital clinic. Another inmate twice requested attention for a suspected broken finger and was twice seen by an LPN, but did not see a physician for a week. These delays unnecessarily prolonged the inmates' pain andlor illness, and could have resulted in significant medical complications.
c. Mental Health Diagnosis and Treatment
All mental health staff interviewed acknowledged significant difficulty in responding to the mental health needs of inmates.~~@Th) e staff at the main Jail, but not Jail East, performs timely, cursory evaluations of all inmates with identified mental health concems, primarily those identified at intake. Outreach is necessary to identify other inmates with mental health concerns before those concems escalate to crises that require intensive intervention and threaten the health and safety of inmates and staff alike. However, no designated mental health staff persons review sick call requests to identify inmates with emerging mental health concerns. Moreover, despite CMS policy requiring mental health workers to make rounds to housing units, and national standards with the same recommendation, the only housing areas in which mental health workers conduct rounds to identify emergent needs are the pre-classification cells on the Jail's lower level. Outreach by mental health staff is particularly important because correctional staff at the SCJ demonstrate little training in or understanding of the needs of inmates with mental illness or suicidal tendencies.
Diagnostic evaluations of those inmates identified as needing mental health treatment are deficient, with only three of seventeen charts reviewed containing any diagnostic assessment at all. A diagnosis is critical to assessing the adequacy of the inmate's medication and any treatment. The SCJ employs no psychologists to assist the psychiatrists with diagnoses.
Because there is almost no outreach to identify inmates in need of mental health services who have not

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self-identified, large numbers of inmates at the SCJ receive little or no mental health care. There is no education or programming on important mental health topics, such as drug and alcohol dependance or medication compliance. Finally, as described in the context of medication administration, infra, the SCJ fails to administer prescription medication reliably. Because the dominant mental health intervention at the SCJ is medication, missed doses (both not administered and not taken) are unacceptably high and likely to have serious consequences for behavioral disorders within the Jail.
d. Care of Chronic Medical Conditions is Deficient.
Although the SCJ has a rudimentary computerized tracking system for chronic care patients, we found many significant lapses in the care of these patients. For example, one inmate who was receiving HIV medications prior to incarceration received no medication or evaluation during five months of incarceration at the SCJ. Another inmate had numerous serious medical conditions identified at intake,
including diabetes, 1,0) high blood pressure, and mental illness. He received no physician evaluation for diabetes until five months after intake, and no physician evaluation during a two month period when he was experiencing dizziness and other symptoms of hypoglycemia. He was found dead in his cell one year after his initial intake, with the probable cause of death noted to be heart disease and diabetes. It is likely that poor control of these chronic and life-threatening conditions contributed to this death. The lack of sufficient qualified staff is a likely cause of the SCJ's failure to ensure that chronic care patients receive necessary care for their life-threatening conditions.
e. There is no Infirmary Care for Inmates Requiring Close Observation By Medical o r Mental Health Staff.
There is no infirmary for observation and treatment of inmates with serious medical or mental health conditions requiring ongoing medical treatment, but not hospitalization. This is a significant deficiency. In addition to the examples of chronically ill inmates noted above, a 24-year-old inmate died at the Jail in December of pneumonia, a treatable illness. Although the inmate had visited the emergency room the day before his death, he was released and returned to general housing, where his condition deteriorated rapidly. In the day before his death, he was not observed by medical staff except for two brief encounters with a nurse (there is no indication if the nurse was an LPN or RN). Another inmate exhibited uncontrolled hypertension for nine months, during which time he suffered two strokes and possible heart injury. He was transferred to the hospital four times, and each time he was returned to general population housing. He should have been housed in an infirmary with the ability to monitor his blood pressure and medications to bring the hypertension under control, to lessen the chance of suffering the additional stroke and heart damage. A third inmate, who died of heart failure in October 2000, went back and forth between general population housing and the hospital. On his last release from the hospital, he was placed in a cell with no running water because the hospital suggested that he would exacerbate his heart condition by drinking too much water. A far more appropriate placement would have been an infirmary, where fluid intake and output could have been monitored. In each of these instances, the inmates' care was compromised, and their pain or illness exacerbated, by the unavailability of close medical monitoring in an infirmary.
2. Medication Administration is Deficient.
Both medical and mental health care is compromised by significant lapses in administration of medicaf ons. Missed doses included medications essential for conditions such as serious mental illness, diabetes, asthma, and HIV. Of 17 charts reviewed, at least 10% of the prescribed doses of psychotropics on the second floor medical housing unit and 20% of the doses on the general housing units were never delivered. On occasion, no medications were distributed to an entire pod and quite possibly the entire

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floor. Inmany instances, contrary to the stated policy and procedure, there is no documentation in the medical charts explaining the missed doses.
Staff also fails to ensure that inmates take their prescribed medication. Our review of shake-down logs confirm that numerous pills are confiscated from hordes in inmates' cells. During our December tour, we observed inmates place medication in their mouth and then turn their backs to the staff to walk back to their cells, enabling them to spit out and save the medication unobserved by staff.
3. Suicide Precautions Are Inadequate.
The cells in the area ofthe Jail reserved for suicidal inmates are unsanitary, foul-smelling, contain bunks and plumbing fixtures from which an inmate could hang himself, and cannot all be seen and heard from the control room where staff are stationed. Inmates in these cells are required to strip completely, and are not given paper gowns or blankets, despite complaints that the cells are chilly. The condition of these cells is well-known among inmates, who told us that they are loathe to say anything to staff that could result in being placed in these cells.
In addition to the inmates' expressed reluctance to self-identify suicidal thoughts, our psychiatrist noted that correctional staff throughout the SCJ appeared untrained in identifying inmates with mental illness or those with suicidal or self-injurious tendencies. Mental health professionals do not visit general housing units, despite a policy requiring them to do so. The emergent mental health problems missed due to inadequate screening and outreach include suicidal tendencies.
4. Medical Safety and Related Security Concerns
Mental health staff do not communicate with security staff. This failure has significant consequences, particularly in crisis intervention and the use of restraints. We reviewed a video tape of a use of force incident involving the deaf inmate discussed under security concerns, supra. Mental health personnel had identified the inmate as having schizoaffective disorder. Either this information was unavailable to security staff, or, staff acted upon misinformation about mental illness in their approach to this inmate. Appropriate training by mental health professionals and consultation with the mental health providers at the Jail at the time of this incident could have prevented the excessive use of force in this case.
In addition, in our review of records provided to us by the SCJ we discovered many incidents where staff used force, including pepper spray, against inmates displaying self-injurious behavior characteristic of mental illness, without consulting with mental health staff about appropriate interventions.
At the time of our visits, there were numerous lapses in maintenance and inspection of essential medical equipment. For example, there was no documentation of weekly sterility checks for the autoclave, no inspection of the temperature of the medicine refrigerator in nearly a month, and no inspection of emergency medical kits (which lacked essential equipment, as we observed when a nurse at Jail East opened one to attend to an inmate in crisis during our October tour).
Finally, SCJ's policy for the control of blood borne pathogens was not communicated to line staff through training or policy. Lapses in basic medical sanitation and safety practices pose a significant threat to the well-being of all persons confined or employed at SCJ.
C. The SCJ Does Not Provide Adequate Food, Clothing and Shelter.
Our inspection revealed deficient food service, basic sanitation and safety practices at the SCJ. Unsafe

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food handling and inadequate sanitization of kitchen utensils and cooking equipment present an unacceptably high risk of food contamination and food-borne disease. Similar risks of disease result from SCJ's inadequate level of overall sanitation and pest control. Our consultant concluded that these practices stem from a failure to train and supervise staff in rudimentary concepts of sanitation, food handling, and pest control. In addition, more maintenance and food service workers and supervisors are needed to prepare and serve food properly and to maintain food service equipment in a facility this large.
1. Unsafe Food Handling and Food Service
The freezers and food storage areas at the main Jail are filthy. There is evidence of roach infestation, gnats and rodents in the kitchen, dishwashing and food storage areas. During our tour in October, we observed servers without hair coverings, gloves or serving utensils. Personal articles of clothing were stored on a shelf in the kitchen next to clean pots and pans. In the laundry area, food service trays are stored on a shelf next to mop heads. There is a practice of serving food to inmates working in the laundry area, and washing serving trays and utensils in the mop sink in this area. There is no attempt to sanitize these items. Each of these practices violates basic tenets of sanitation and safe food handling, and should be stopped immediately.
Pots and pans and serving pieces are neither fully cleaned nor sanitized because the dishwashing equipment does not reach sanitizing temperatures. Of four units tested by our consultant, none hnctioned to sanitize cooking and eating utensils. The dishwashing area had a putrid smell, and food residue was visible on pots and pans after they had been "cleaned." Inmates complained of being given a single utensil, often of disposable plastic, and having to reuse this utensil and clean it in their cells, although sanitizing agents are not available in the cells for this purpose.
Foods on the serving line and in holding ovens and refrigerators and freezers on the day of our visit deviated significantly from temperatures recommended for safe food handling. The NIC report also found food served at improper temperatures. Food held at improper temperatures invites contamination that can sicken inmates through food poisoning.
2. Pest Control and Sanitation is Inadequate.
Roaches, rodents and spiders are present in inmate housing and the medical area at both the main Jail and Jail East. Both inmates and staff showed evidence ofbites from brown recluse spiders.
3. Lighting, Ventilation, Sanitation and Laundry Service in Housing Units Is Inadequate.
Proper sanitation is hampered by the lack of hot water in some inmate cells and shower areas. Our consultant noted numerous examples of broken plumbing fixtures and inmate cells without access to hot water or to water at all. Both staff and inmates told us that such conditions are longstanding. The lack of a preventative maintenance plan or a system for scheduling and prioritizing work orders for repairs contributes to a backlog of essential repairs.
The current policy regarding access to laundry must be reviewed and updated. The laundry service is neither frequent enough nor reliable. We heard many reports from inmates of clothing and bedding not being returned from the laundry, or coming back stained and ripped. As a result, many inmates wash clothing and bedding in sinks and toilets. This contributes to poor sanitation and threatens security, because items left hanging to dry impede staffs ability to observe and supervise inmates.
Finally, our consultant identified numerous areas where there was virtually no ventilation and where the

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lighting was not adequate to maintain hygiene, allow individuals to move around safely and prevent eyestrain.
4. Improper Storage and Handling of Hazardous Materials
We observed numerous examples of unacceptable storage of hazardous materials during our tours. Unless properly labeled, stored, and disposed, these materials can cause a variety of serious health problems. Bio-hazardous waste containers in the medical area used gray liners without bio-hazard markings, making inadvertent exposure or improper disposal likely. Caustic chemicals in the laundry and storage areas were labeled only with a marker, which can be rubbed off and contains no information about the contents, effects of exposure or appropriate first aid, or other important labeling information. In storage areas, some of these containers were "sealed" by placing latex gloves over their openings, which is inadequate. There must be an accessible eye wash fountain and training in the use of personal protective equipment for inmates who work with these caustic chemicals, yet neither appeared to be provided.
5. Fire Safety and Prevention Is Deficient.
In correctional facilities, the safety of inmates in the event of an emergency depends upon the rapid unlocking of doors. In October, two officers stationed near an exit door at Jail East had no idea how that door could be opened in the event of an emergency. During our December tour, deputy jailers on the second floor administrative segregation/deadlock unit (P and Q pods) were unable to comply with our request to manually unlock the sally port doors because the manual override was broken. (!-') This is indicative of a lack of a regular preventive maintenance program and is also a serious safety lapse in the event of a fire emergency. In the event of a power outage or smoke buildup, visual examination of keys is generally impossible, and keys should be notched for easy identification under such conditions. Yet, as noted above and in the security section, staff at both locations were unable to identify keys even after several minutes of visual examination.
Improperly controlled combustibles and highly flammable materials throughout the institution and inmate living areas dramatically increase the risk of harm to inmates. Because inmates are locked in their cells, the amount of combustible material should be limited. Yet, in many of the cells, inmates used paper bags as trash receptacles. We saw numerous examples of ripped fire-retardant mattress covers and, as mentioned earlier, improperly stored and labeled flammable liquids and other chemicals, all of which presented serious fire hazards. Sprinkler heads in the food storage units in the kitchen were rendered ineffective because cartons were stacked too close to the ceiling and sprinkler heads.
We observed serious deficiencies in fire or emergency safety training and planning. Available documentation suggests that fire drills happen infrequently, and do not occur on all shifts. Correctional officers we spoke to were unable to explain their roles in the event of an emergency. Our consultant also noted numerous examples of electrical problems that could be fire hazards throughout the Jail and Jail East.
D. Insufficient Access to the Courts
As presently constituted, the law library offers little effective assistance to most inmates. Legal materials, including the single copy of the Tennessee Code Annotated, are not up to date. A not-yetcertified paralegal is available for limited hours during weekday daytime shifts. Inmates reported that the one-hour time slots they may request to visit the legal room are often shortened because pod officers may not release them or arrange an escort for them in a timely way. One inmate complained that his

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legal mail had been opened, and that staff delayed mailing court papers. Our review of inmates' access to legal services at the SCJ was limited, and we did not identify any inmate whose ability to pursue a claim was impaired because of the deficiencies in services. Nonetheless, we are concerned that such an injury is likely to occur.
E. Insufficient Access t o Exercise
The Sixth Circuit has not defined a constitutionally required amount of exercise, however, it has recognized that one hour per day, five days per week every thirty days is unconstitutional, even as a
punitive sanction. Rodgers v. Jabe, 43 F. 3d 1082, 1088 (6th Ci.r. 1995). Inmates at SCJ receive far less
opportunity for exercise, averaging less than two trips to recreation per inmate per month in the year 2000 (the Jail's records do not specify whether the recreation period was indoors or outdoors). In the winter months of 2000, it appears from the Jail Monthly Summary Reports that inmates each received slightly more than one trip to recreation per month. lL2)
Lack of exercise opportunities, which may create a constitutional violation standing alone, may also exacerbate other constitutional violations. In Gilland v. Owens, 718 F. Supp. 665, 689 (W.D. Tenn. 1989), involving the SCJ, the district court found that a monthly average of 1.35 trips to recreation per inmate was a "near-total deprivation" of opportunities for exercise that violated the constitutional rights of inmates. 718 F. Supp. at 688. The court also held that lack of exercise opportunities was a factor contributing to unconstitutional violence at the SCJ. Id.1L-3jIn many respects, conditions at the SCJ today seem little improved from those found unconstitutional in 1989.
IV. R e c o m m e n d e d R e m e d i a l M e a s u r e s
To rectify the identified deficiencies and to ensure that the Shelby County Jail complies with federal constitutional requirements, the following minimum remedial measures must be implemented.
A. Security, Supervision and Protection From H a r m
1. To reduce inmate-on-inmate violence, the County must increase direct sight and sound supervision of inmates in their housing units. If the current configuration of the Jail, in which staff have limited direct sight and sound supervision of inmates, is maintained, then the County must significantly reduce double celling, or hire significantly more staff to supervise housing units. The County must increase the frequency of shakedowns and provide timely and sufficient escort of inmates to other areas of the Jail and for essential programming and services.
2. The County must improve the quality of staff through hiring and enhanced training. Well-trained and knowledgeable supervisory personnel must be available to supervise line staff.
3. The County must take steps to implement basic security procedures, including but not limited to key control, tool control, and the control of dangerous contraband (such as razor blades fused to toothbrush handles). Staff should be aware of these procedures, including the use of emergency keys. The County also must ensure that security inspections occur on a regular basis and must provide ongoing maintenance to security devices such as door locks and manual unlocking mechanisms.
4. The County must revise its inmate classification system to take into account gang-related information. The County must review inmates periodically for possible reclassification. Any new or revised classification system must be validated in advance of its final implementation.

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5. The County must implement an effective and timely system of inmate discipline and provide an adequate.number of single-occupancy cells for the immediate segregation of all inmates sentenced to the disciplinary segregation unit. Closely related, the County must implement procedures for assigning otherwise unmanageable inmates to administrative segregation and must provide an adequate number of single-occupancy cells for these inmates.
6. The County must take more effective steps to separate assaultive kom non-assaultive prisoners during the intake process.
7. The County must revise its policies on the use of force, including the use of chemical agents and the use of mechanical restraints, to provide clearer guidance to staff and to ensure that physical force is limited to clearly identified situations, such as threatened escape, harm to persons, or damage to valuable property. Security staff should receive special training on all the new policies.
8. The County must ensure appropriate use of the restraint chair, by restricting its use to tightly prescribed circumstances, and requiring pre-authorization and supervision by mental health staff for any use of the restraint chair involving mentally ill inmates. The chair must not be used for punishment and no hoods or disposable spit caps should be used under any circumstances.
9. Staff must report all uses of force (including chemical agents and mechanical devices). Trained investigators should investigate all such reports. These investigators must also thoroughly investigate all allegations of failure to report a use of force. The County must implement an effective system for the prompt discipline of staff who violate policies in this area.
10. The members of the Detention Response Team must be dedicated to that purpose and must not fill other posts. In addition to responding to emergencies, including necessary cell extractions, the DRT must provide additional back-up security for officers in housing units and enhance pod officers' capability to conduct housing unit shakedowns and security inspections.
11. The County must adopt an aggressive program to identify and control inmates who are members of organized gangs. While such membership itself is not unlawful, staff at the jail must eliminate all forms of control currently exercised by gangs and their leaders and must be vigilant in detecting and punishing gang-related misconduct of all forms. Illicit gang-related behavior should be an important factor in increasing an inmate's classification status.
B. Mental Health and Medical Care
1. The County must comply with SCJ's stated policies for providing timely medical and mental health intake screening of all inmates. In particular, increase timeliness of mental health evaluations at Jail East.
2. The County must ensure SCJ's continuation of prescription medication promptly upon admission
3. The County must ensure SCJ's compliance with stated policies for screening of infectious diseases, particularly tuberculosis.
4. The County must provide access to sick call to all inmates five days per week. Increase professional staff so that all sick call examinations are conducted by appropriately licensed professionals.
5. The County must ensure compliance with SCJ's policy that mental health professionals make regular

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rounds to all housing units.
6. The County must provide accurate diagnoses, or differential diagnoses, for all inmates identified as requiring mental health services at SCJ.
7. The County must improve monitoring and treatment of chronically ill inmates, including those with serious mental illness, through regularly scheduled visits to Jail medical (or mental health) professionals.
8. The County must establish an on-site infirmary at the SCJ to provide more intensive medical and mental health monitoring for inmates who are unstable or otherwise medically inappropriate for general population housing.
9. The County must comply with stated policy for medication administration, including documentation of missed doses. Ensure that oral medications dispensed to inmates are ingested.
10. The County must provide disposable paper gowns to inmates in suicide precaution cells.
11. The County must remove suicide hazards from suicide precaution cells.
12. The County must provide proper sanitation and lighting for cells in suicide precaution areas.
13. The County must provide direct line of sight supervision to all inmates on suicide precautions. Increase the number of suicide precaution beds to include sufficient beds for constant observation, and for "close" observation (meaning frequent, but not constant observation).
14. The County must train all SCJ staff in policies for the control ofblood borne pathogens. Provide adequate personal protective equipment to all staff.
C. Environmental Health and Safety
I . The County must ensure that officers who supervise the inmates serving food on the units are trained in food service operations, or, properly trained civilian staff should perform these tasks. Proper equipment for serving must be provided and used. All food service staff, including civilians, need food service training.
2. The County must assign more staff and supervisors to oversee food service and maintenance to ensure proper sanitation and safe food handling practices.
3. The County must repair or replace malfunctioning equipment, including refrigeration units, cooking units and dishwashing and tray washing units, and provide properly-sized units designed to serve a food service operation the size of SCJ.
4. The County must ensure that a dietician or nutritionist support the special medical diet operation. A dietician must also evaluate standard menus on at least an annual basis. Operations must be able to support the menu provided by the dietician.
5. The County must improve sanitation in the food service operations, housing units and medical intake and housing units. Adequate cleaning supplies and equipment should be provided on a more routine basis to help improve cell sanitation, in particular.

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6. The County must improve pest control. Supervisors must receive training to ensure that this program is implemented effectively.
7. The County must provide adequate lighting in cells and showers.
8. The County must repair water leaks in cells and showers and clogged drains.
9. The County must conduct regular cell inspections to enforce Jail rules, including those prohibiting the blocking of air vents and storing large amounts of food, which contributes to the pest control problem. As noted previously, regular inspections will also help control the accumulation of life-threatening contraband (such as razors).
10. The County must implement appropriate housekeeping policies and procedures.
11. The County must ensure that fire and emergency drills are performed quarterly, in all areas including the administrative areas, on all shifts, so that all staff may participate in the drills. Inmate movement should be included in drills, except in those situations where security may be compromised. Adequate emergency operations plans must be developed for all potential natural and man-made disasters that may affect this facility. In-service training in fire safety, including fire drills, must be conducted and documented.
12. The County must develop and implement a written preventive maintenance program and prioritybased work order system.
13. The County must provide adequate laundry service.
14. The County must ensure that quality control checks of medical equipment and supplies occur regularly, and, for some equipment, on a daily, per shift basis.
15. The County must improve the storage, labeling, and use of hazardous chemicals so that proper chemical name labels are put on all containers of chemicals and containers are stored with tight fitting caps or tops. An eye wash fountain must be provided where inmates handle hazardous chemicals, for example, in the laundry and storerooms.
16. The County must fix promptly the electrical system problems noted at Jail East, as delineated in an August 29, 2000 letter from EOC to Mr. Ward, Shelby County Maintenance Manager, especially those with a potential to affect life safety systems and those with a possibility of causing a fire.
17. The County must implement a facility-wide procedure, such as color coding and notching, to quickly identify appropriate emergency keys by touch and sight, and must train staff in use of emergency keys and manual override system for the jail's cell and sally-port doors.
18. The County must provide every inmate with a fire resistant mattress and replace paper wastebaskets with fire safe containers.
D. Access to the Courts
1. The County must ensure access to legal assistance by providing inmates with the tools they need to attack their sentences, directly or collaterally, and to challenge the conditions of their confinement.

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E. Access to Recreation
1.The County must ensure that inmates have an opportunity to exercise a minimum of one hour per day, five days a week, including outdoor exercise as often as weather permits.
Pursuant to CRIPA, the Attorney General may institute a lawsuit to correct deficiencies of the kind identified in this letter forty-nine days after appropriate officials have been notified of them. 42 U.S.C. Section 1997b(a)(l). We would prefer, however, to resolve this matter by working cooperatively with you, and we have every confidence that we will be able to do so.
In light of the County's cooperation in this matter, under separate cover, we will send you our experts' reports. Although the experts' reports and work do not necessarily reflect the official conclusions of the Department of Justice, their observations, analyses and recommendations provide further elaboration of the issues discussed above, and offer practical assistance in addressing them.
We look forward to meeting with County officials to develop solutions to the noted deficiencies
Sincerely,
William R. Yeomans Acting Assistant Attorney General Civil Rights Division
cc: The Honorable Marron Hopkins Director Shelby County Jail
Mr. A.C. Gilless Sheriff Shelby County Jail
Donnie E. Wilson, Esquire Shelby County Attorney
Don D. Strother Legal Advisor Shelby County Sheriffs Office
Lawrence J. Laurenzi, Esquire United States Attorney Western District of Tennessee
1. The Sheriffs Office also is responsible for a secure ward at the University of Tennessee's Regional Medical Center, known as the MED.
2. SCJ inappropriately attempts to counter staffing shoflages by assigning members of the Detention Response Team ("DRT"), the emergency response unit, to posts as pod officers in the housing units. We were advised that DRT members must often wait to be relieved fkom their post before they can respond to an emergency. Such a practice creates an unacceptably high security risk and compromises the safety of inmates and staff by delaying the DRT's response to emergency situations.

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3. Each pod typically contains 46 inmates in 23 double-bunked cells.
4. The NIC report concurs in the conclusion that inmate supervision is poor, finding that any benefit of the court-ordered staffing was lost by placing the staff where they cannot and do not see the inmates, supervise the inmates on a moment-to-moment basis or talk with inmates frequently and informally. NIC Technical Assistance Report at 9.
5. Conversely, inmates are reportedly able to jam cell doors and open them manually without staffs knowledge.
6. Use of Chemical Agent reports ftequently are not filled out by staff. For example, in August 2000, the SCJ's Monthly Summary Report notes 38 uses of chemicals, however, the SCJ produced only nine Use of Chemical Agent reports for this period.
7. It is a nationally accepted practice that if triage is utilized, it must be performed by a person with no less than a registered nurse's ( " R N ) training. At the SCJ, complaints are routinely triaged by licensed practical nurses ("LPN"), who have substantially less training than RNs. For example, an LPN evaluated an inmate's sick call slip complaining of an injured and swollen hand, and an LPN examined the injury six days later. The inmate was not seen by a doctor and sent to a hospital emergency room for his broken finger until seven days after his initial complaint.
8. The SCJ employs no licensed nurse practitioners (RNs with an advanced degree) or physician assistants, professionals who are licensed and qualified to examine, diagnose and treat patients and order prescription medication - tasks an RN or LPN may not perform. The only exception to this accepted practice is that RNs may evaluate and treat minor complaints pursuant to a doctor's standing orders. Thus, the only professionals licensed and qualified to examine more than 2,700 inmates at the SCJ are the Jail's medical doctors, whose hours of employment total less than two full-time-equivalent positions.
9. The SCJ provides only 23 hours per week of psychiatrist staffing, augmented by additional mental health workers equal to 5.2 full time positions. The SCJ employs "counselors" on each floor, however, they have no mental health training and their role appears to be limited to accessing hygiene items, phones, and mail.
10. It appears that no nutritionist or medical staff person provides guidance to food service in the preparation of medically-required diets for diabetics or inmates with high blood-pressure. In response to our request to review a week's menus at the SCJ, we received only regular diets. There was also no documentation of an annual menu evaluation by a qualified nutritionist or dietician. Thus it is unclear whether medically prescribed meals served at the SCJ meet basic nutritional or medical standards.
11. Similarly, deputy jailers on that same floor were unable to open cell doors with a manual override. This indicates a serious lapse in training and is a significant safety concern in the event of a fire or other emergency.
12. For example, in February 2000, when the average daily population was 2,972 inmates, the Jail reported only 3,991 trips to recreation, an average of 1.3 trips per inmate.
13. The court in Gilland cited many factors causing excessive violence in the SCJ that remain unchanged today: "insufficient security staff, the pod manlphone man system [superceded today by gang control, instead of pod man control of the phones], lack of exercise opportunity, frustration over scare resources and space, improper functioning of the disciplinary system, and an inadequate classification

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system." 718 F. Supp. at 688. The district court's supervision of the SCJ pursuant to its orders in Gilland terminated in 1993.

UNITED STATES DISTRICT COURT - WESTERN DISTRICT OF TENNESSEE
Notice of Distribution
This notice confirms a copy of the document docketed as number 15 in case 2:05-CR-29999 was distributed by fax, mail, or direct printing on June 16,2005 to the parties listed.
Monty Mothra 123456789
Honorable J. Breen US DISTRICT COURT

 
 U.S. District Court Western District of Tennessee (Memphis) CIVIL DOCKET FOR CASE #: 2:02−cv−02633−BBD

CLOSED

USA v. Shelby County, TN, et al Assigned to: Judge Bernice B. Donald Demand: $0 Case in other court: WD/TN, 2:96CV2520 Cause: 28:1331 Federal Question: Other Civil Rights
Plaintiff

Date Filed: 08/12/2002 Date Terminated: 11/16/2009 Jury Demand: None Nature of Suit: 440 Civil Rights: Other Jurisdiction: U.S. Government Plaintiff

United States of America

represented by John Ashcroft U.S. DEPARTMENT OF JUSTICE Civil Rights Division P.O. Box 66400 Washington, DC 20035−6400 202−616−2325 ATTORNEY TO BE NOTICED

Mary R. Bohan U.S. DEPARTMENT OF JUSTICE Civil Rights Division P.O. Box 66400 Washington, DC 20035−6400 202−616−2325 ATTORNEY TO BE NOTICED

Mellie H. Nelson U.S. DEPARTMENT OF JUSTICE Civil Rights Division P.O. Box 66400 Washington, DC 20035−6400 202−616−2325 ATTORNEY TO BE NOTICED

Ralph F. Boyd , Jr. U.S. DEPARTMENT OF JUSTICE Civil Rights Division P.O. Box 66400 Washington, DC 20035−6400 202−616−2325 ATTORNEY TO BE NOTICED

Steven H. Rosenbaum U.S. DEPARTMENT OF JUSTICE Civil Rights Division 950 Pennsylvania Ave., NW Housing &Civil Enforcement Section− G St. Washington, DC 20530 202−616−8484 Fax: 202−514−1116 ATTORNEY TO BE NOTICED

Tammie M. Gregg U.S. DEPARTMENT OF JUSTICE Civil Rights Division P.O. Box 66400 Washington, DC 20035−6400 202−616−2325 ATTORNEY TO BE NOTICED

Terrell L. Harris U.S. ATTORNEY'S OFFICE Federal Building 167 N. Main St. Ste. 800 Memphis, TN 38103 901−544−4231 Email: joe.murphy@usdoj.gov ATTORNEY TO BE NOTICED

V. Defendant Shelby County, Tennessee
Defendant Jim Rout Mayor of Shelby County
Defendant A. C. Gilless Shelby County Sheriff

represented by Debra L. Fessenden SHELBY COUNTY ATTORNEY'S OFFICE, LEGAL DEPT 201 Poplar Avenue Room 9−15 Memphis, TN 38103 901−222−2116 Fax: 901−222−5657 Email: debra.fessenden@shelby−sheriff.org LEAD ATTORNEY ATTORNEY TO BE NOTICED
Fred E. Jones , Jr. MEMPHIS LIGHT GAS &WATER 220 South Main Street Memphis, TN 38103 901−528−4343 Fax: 901−528−4991 Email: skipjones@mlgw.org ATTORNEY TO BE NOTICED
represented by Debra L. Fessenden (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Fred E. Jones , Jr. (See above for address) ATTORNEY TO BE NOTICED
represented by Debra L. Fessenden (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Fred E. Jones , Jr. (See above for address) ATTORNEY TO BE NOTICED

Date Filed 08/12/2002
08/12/2002

# Docket Text
1 COMPLAINT (Summonses NOT issued) ; Filing fee $ waived (AGJ) (Entered: 08/13/2002)
2 JOINT MOTION by plaintiff, defendant for order conditionally dismissing this action (PWM) (Entered: 08/13/2002)

08/15/2002
10/28/2009 10/28/2009 11/02/2009 11/02/2009 11/09/2009 11/09/2009 11/16/2009 11/16/2009

3 ORDER OF CONDITIONAL DISMISSAL by Judge Bernice B. Donald For good cause shwon it is hereby ORDERED, ADJUDGED AND DECREED: That this case is conditionally dismissed and shall be placed on the inactive docket pending compliance w/ the Settlement Agreement lodged w/ the Court. This Court will retain jurisdiction over the case, pending compliance w/ the Settlement Agreement, until afinal dismissal w/ prejudice is entered. The clerk is directed to administratively close this case pending further orders of this court. terminating case (cc: all counsel) (PWM) (Entered: 08/16/2002)
4 NOTICE of Appearance by Debra L. Fessenden on behalf of all defendants (Fessenden, Debra) (Entered: 10/28/2009)
5 Joint MOTION to Reopen Case with proposed Order submitted by all defendants. (Fessenden, Debra) (Entered: 10/28/2009)
6 ORDER granting 5 Motion to Reopen Case. Signed by Judge Bernice B. Donald on 11/2/2009. (Donald, Bernice) (Entered: 11/02/2009)
7 NOTICE by Shelby County, Tennessee, Jim Rout, A. C. Gilless of Substitution of Counsel of Debra L. Fessenden in place of Fred E. Jones, Jr. (Fessenden, Debra) (Entered: 11/02/2009)
8 NOTICE by Shelby County, Tennessee, Jim Rout, A. C. Gilless of Subsititution of Acting Mayor Avery in place of former Mayor Rout and Sheriff Luttrell in place of former Sheriff Gilless (Fessenden, Debra) (Entered: 11/09/2009)
9 Joint MOTION to Dismiss Joint Motion for an Order of Final Dismissal with proposed Order submitted by Shelby County, Tennessee, Jim Rout, A. C. Gilless. (Fessenden, Debra) (Entered: 11/09/2009)
10 ORDER granting 9 Motion to Dismiss. Signed by Judge Bernice B. Donald on 11/16/2009. (Donald, Bernice) (Entered: 11/16/2009)
11 JUDGMENT. Signed by Judge Bernice B. Donald on 11/16/2009. (Donald, Bernice) (Entered: 11/16/2009)