The County has taken the following actions in recent weeks:

PERSONNEL
● Removed one contract nurse from service.
● Reprimanded one nurse.
● One corrections officer terminated

OUTSIDE AUDITS
● Requested the accrediting agency to expedite its audit of Justice Services.
● Identified outside companies to conduct a potential independent assessment of Justice
Services.
● Requested that Clayton Police Department determine whether there has been a pattern
of deficiencies at Justice Services.

COUNTY EXECUTIVE OVERSIGHT

● Inspected the Justice Services facilities involved, including visiting the cells where the
individuals died.
● Read the medical reports concerning all three individuals.
● Met with Tashonda Troupe, the mother of Lamar Catchings.
● Reached out to the other two families and asked for meetings

POLICIES AND PROCEDURES IN JUSTICE SERVICES

● Formalized the Department of Justice Services organization chart, which did not
previously exist.
● Completed an annual report.
● Reorganized top staff to improve efficiency.
● Established regular staff meetings, which had not previously existed.
● Began preparation of policy to improve medical delivery and oversight of inmates.
● Started a recruitment drive to fill open vacancies to ensure it is not understaffed.
● Formalized a first-line supervisor training to improve employee oversight.
● Began work to establish a critical incident review team.
● Exploring ways to improve initial medical assessments of people brought into the jail.

POLICIES AND PROCEDURES AT THE HEALTH DEPARTMENT

● Changed policy so that either the corrections officers or inmate can make request for
inmate to receive medical care.
● Reviewed and updated standing orders.
● Revised withdrawal orders, policies, and protocols to lower the thresholds for
intervention.
● Updated the infirmary care manual.
● Created a comprehensive intake and transfer tool.
● Developed a standardized template for sick calls.
 ● Revised the crash cart stocking procedures to align with current system trends.
● Arranged standardized check outs with supervisory staff on weekends.

IMPROVED COLLABORATION
● Held several meetings of the Departments of Health and Justice Services to improve
communication.
● Created a regular meeting schedule between the County’s Chief Medical Officer,
Clayton EMS and St. Mary’s Emergency Department Director to coordinate care.
● Clarified and strengthened communications between Corrections Medicine and Justice
Services and EMS staff to ensure accurate medical information is shared in a timely
manner.

EQUIPMENT
● Deployed cordless phones to nurses to increase communication capacity in the
infirmary.
● Provided laptops to nurses to enable access to medical information when taking sick
calls.
● Prepared plans to install cameras in the infirmary.

CULTURE AND STAFFING

● Trained Corrections Medicine staff to implement the revised policies and procedures.
● Arranged EAP support sessions for Corrections Medicine staff following patient deaths.
● The Chief Medical Officer met with all Corrections Medicine staff to debrief adverse
events and outline expectations moving forward.
● The Mental Health Manager is assisting in the development of a plan to further
strengthen the work culture.