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Friday, October 6, 2017

Blogger Comments:  The past two days of hearing with Barney Lovelace played out like a game.  The psychiatric physician for the jail was replaced on July 29, 2017.  Convenient isn't it?  He could only speak about mental health conditions for the past two months.  Hum!  He talked a good talk but it appeared that his walk was a little shaky.  He talked about all the calls made back and forth between the jail nurses including the psychiatric nurse.  The number of times and the hours spent in the Morgan County Jail. If I understood his testimony he did not keep logs of those calls or any medication he prescribed.  The doctor also stated that when the jail has urgent needs, Nurse Nick would call him immediately but he did not keep records of those calls.  According to the expert witness Dr. Coffman if it isn't in the record it didn't happen.

According to Dr. Shankar Yalamanchile he works at least 6 different facilities: Shelby County, Princeton Baptist Medical Center, Medical Director of Mental Health at another location, River Region Phychiatric facility, Montgomery County and City Jail, and Morgan County Jail.  All I can say is wow!  No wonder he did not annotate logs of his communications with the Morgan County jail nurses.  Hopefully, the nurses did.  Dr. Yalamanchile also seemed to have a difficult time locating the Intake sheet.  According to one witness who was in the Morgan County Jail, he denied ever seeing the intake sheet and denied providing some of the information on the sheet.  In addition, when Dr. Yalmanchile's took over as the Psychiatric Physician for the Morgan County Jail, his contract was never changed to reflect the new assignment at the jail.  The contract was not modified to lay out the number of hours worked at the jail, the contract assignment had not been provided to the MC jail's attorney, nor does the contract reflect the number of hours Dr. Yalamanchile will work at the MC jail.

Dr. Yalamanchile also stated that he spends approximately 2 or 3 hours per week at the Montgomery County jail and the City jail.  Doctor Yalamanchile stated that he does not decide which patients he sees when he comes to Morgan County.  The nursing staff makes those decisions.  Is this before or after the initial 6-minute medical assessment?  

Dr. Yalamanchile also testified that he has not seen all of the patients on the list yet.

So what will the judge find?  Who knows?  
    

Expert calls mental health care at Morgan County Jail inadequate


  • By Evan Belanger Staff Writer
  •  
  • Updated 

An expert witness testified in federal court Wednesday that psychiatric care provided at the Morgan County Jail was “inadequate,” as attorneys argued whether court orders governing the treatment of inmates at the jail should be preserved.
Dr. Kelly Coffman, a psychiatrist and professor at Emory University School of Medicine in Atlanta, took the stand for the Southern Center for Human Rights.
Based on a review of jail records and interviews with current and former inmates, she said jail policies did not ensure adequate care for inmates and, in some cases, could endanger them.
“The worst that can happen is that they kill themselves or someone else,” she said.
Coffman said inmates had to wait too long to see a psychiatrist after booking, in some cases several months, and that the psychiatrist was not spending enough time with each inmate even when they were seen.
She said Dr. Shankar Yalamanchile, who provides psychiatric care under contract with the jail’s contracted health provider, Quality Correction Health Care, spent just 6.3 minutes with each patient he saw at the jail in August.
“No one can conduct a psychiatric evaluation in 6.3 minutes. I’m not sure how that is possible,” Coffman said.
In some cases, Coffman said jail policies that prohibit the prescribing of any medications for inmates who had positive drug screens for a period of 30 days or the prescribing of certain commonly abused prescriptions could cause life-threatening withdrawal symptoms or worsen psychiatric problems. That decision should be made by a psychiatrist on a case-by-case basis, she said.
Coffman also said inmates who are identified as having psychiatric problems during intake are not automatically flagged for psychiatric treatment.
Instead, they must request an appointment, she said, and pay a $3 copay so they can see a psychiatric nurse. The nurse, who cannot prescribe medication, puts them on a waiting list to see the psychiatrist, she said.
“They were told to be patient and that the waiting list was long,” she said.
Attorneys for the Southern Center also called to the stand a former inmate, Kenneth Crowder, who testified it took two months for him to receive medication for a mental health disorder and that he eventually threatened to hit a jailer with a broomstick so he could see the psychiatrist.
“I said I have bipolar schizophrenia and I just want my medicine,” he said.
On cross examination, Coffman said she did not speak with Quality Correction Health Care medical staff when preparing her assessment and that she was not aware of anything in the medical records she reviewed that could have resulted in a claim for medical malpractice.
Barney Lovelace, attorney for the county and Sheriff's Office, said they offered for Coffman to speak with medical staff.
Yalamanchile, who has been under contract to provide psychiatric care at the jail since July 28, testified there was no co-pay to see the psychiatric nurse or the psychiatrist and that if there was a significant wait list before he started, he thought it had been resolved.
He also testified that care provided at the Morgan County Jail is better and faster than what the inmates would likely get in the community.
“I just can’t see a similar patient in an outside setting is going to get anywhere close to this kind of care,” he said.
He said he visits the jail at least once a week, but he was not certain who made the list of patients he sees each time. He saw 46 patients in 10.25 hours at the jail in September and 39 patients over 5.42 hours in August, according to the Southern Center.
Yalamanchile also said it was not the national standard to have certain commonly abused drugs in a jail setting and that effective alternatives were available.
Coffman testified she was paid $300 per hour to review procedures at the Morgan County Jail and spent about 20 hours reviewing records and 11 hours interviewing inmates.
The court orders stem from a 2001 lawsuit over treatment of inmates.
Attorneys for the Southern Center have agreed to drop all but two of those court orders, including some regarding the feeding of inmates and use-of-force policies at the jail. District Judge Abdul Kallon has approved that agreement.
The two provisions require that the jail ensure inmates who take prescribed medications be allowed to see a physician so that treatment can continue within 48 hours of intake, if prescribed by the physician.
They also require that inmates who appear to be suffering from serious mental illnesses or suicidal tendencies during intake are promptly seen by a health specialist.
The county and Sheriff's Office are asking for the court to eliminate those final two provisions. Hearings are expected to continue today.

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