 But first, earlier this week, Jacksonville Sheriff T.K. Waters said a new healthcare provider at the Duvall County Jail has been selected after reporting from the tributary showed an increase in inmates' deaths under the former provider Armor Correctional Health Services. Nicole Manna of the tributary is here now for a closer look. And before we dive in, I should disclose that I am a member of the tributary board. I don't have anything to do with their reporting, I just support the organization. Listen, if you want to join the conversation, you can call us at 549-2937, tweet us at FCC on air, email us at FirstCoastConnect.wjct.org, or message us on Facebook. All right, so Nicole, how are you? I'm good, how are you? I am excellent. So I read your report, and before we dive into that, I want to rewind and go back a little bit. So when did the jail healthcare system become privatized? So that became privatized in October of 2017. They moved from handling their healthcare in-house. In October of 2017, they signed the contract with Armor, and then they re-signed the contract for another five years in November of last year. How much are we talking about? Like, how big are these contracts? The last contract that was signed in November was $98 million. $98 million. So we're talking about a big chunk of money. Yes. And my understanding is that switching from the jail handling, the Duval County basically handling the healthcare of inmates to privatization saved the city like $700,000 or something like that? That's my understanding as well, that there was a significant amount of money saved by doing that. So this is about partially, I guess, about cost savings for the taxpayers, at least in the eyes of the people who made that change. Yes. So talk to me about Armor. Like, what happened under their tenure in the jail? So this is all based on records that we actually obtained from the Jacksonville Sheriff's Office from 2012 to 2017. There were about four deaths per year in the jail. When Armor took over in 2017, from 2017 to now, there's been about 13 deaths in the jail per year. So that death rate tripled under Armor. Yeah, that's a significant increase. Yes. In the reporting, I was reading that one of the big, for lack of better terms, disconnect was that if someone gets arrested, a lot of times they would bring their medications with them or if they didn't have their medications, they would request their medications and Armor didn't provide it. Yeah, so what's supposed to happen is if you're arrested, you go in, you have a healthcare assessment and at that point you're able to say these are the prescriptions that I take. For example, with Dexter Berry, the man who died in November after he didn't get his anti-rejection medications for his heart, the jailed or Armor did call his pharmacy and they did confirm the prescriptions that he's taking. They got all of them other than the anti-rejection medications. Armor said that they had ordered those medications, but they didn't get them before he was released. I talked to another man, Carl Rainboldt. He was arrested within the last few months and that officer, he said, did bag up his medications and took them to the jail with him. He was in the jail for about eight days and didn't get any of his pill medications. Did start getting his insulin shots, but it wasn't until about four days after his arrest. And I could have a really detrimental effect on your health for him specifically, like not getting your insulin shots. Long problems can come out of not getting it right then. Of course. I've talked to Carl. I've talked to his daughter, Kristen. And Kristen said, this is not the dad that I had before he was arrested. He's now using a walker because he's not as strong when he walks. She said, before he was arrested, he was doing crosswords. He was 77 years old, but he didn't mentally seem 77 years old. It's how she put it. And since then, his health mentally, physically has just deteriorated because he wasn't getting the care in the jail that he was getting outside of it. So after your report came out, what were the moves that the Jacksonville Sheriff's Office took? Right. So we found out the day that the report came out, I found out Tuesday morning that the jail was going to end their contract with armor and they were going to sign with another privatized healthcare company called NAF Care. And they made that announcement Tuesday evening, confirmed that that contract was signed on Monday. We have that contract. So I've been spending time reading through it and have not gotten all the way through. But NAF Care is very similar to armor. It's another privatized company. It's another five-year contract. It's more expensive. It's $110 million. The sheriff didn't say this at the press conference, but a chief of his told me that this comes with more staff, which I'm assuming is a good thing. But NAF Care, like armor, has been sued hundreds of times. They have a similar history to armor. And a story came out that a man who was held in a jail in Atlanta actually died under NAF Care's care due to being eaten alive by bed bugs, according to reporting in Georgia. That just sounds like something out of a horror movie. And it's scary to think that this provider allowed that to happen to somebody and now that same provider is taking over the Duvall County Jail. Right. So Sheriff Waters was actually asked about that during the Tuesday press conference. Another reporter brought up that case and said, does this concern you? And his exact quote was, I wouldn't have done it if I had that kind of concern. I tell you this, you could look at any medical facility in North Florida or throughout the state of Florida and they all have issues. They've all had lawsuits. They've all had those things. But at some point you have to look through it very carefully and make sure that you're making the right decision. I think we did. That sounds to me like, like he is saying that there is no other solution and losing these lives are acceptable because there's no other solution. But yet we know that earlier, the Duvall County Health Department handled the medical care at the jail and we didn't have this type of problem. It was just more expensive. Right. And so the health care at some point, the health care department at one point handled the health care at the jail. At another point, JSO did it in house. And that is when we saw the lowest level of deaths. And we're going to go to the phone. We've got Sue and Mandarin. Sue, how you doing this morning? I'm good. Thank you. Good. My concern is in many years ago, as I said, I did some shift work at the jail and intake. I'm a nurse and people have to be screened and they have to meet with somebody who looks at them, talks to them, asks them about their medications to see what they need. And there is no excuse for not getting insulin or any kind of a critical med like those heart meds that the gentleman did not get his anti-rejection meds. Somebody, a professional person has to do that. If it's being, if it has been over the past downgraded to a paraprofessional or somebody else, it brings in a problem. They cannot be given their own medications that they bring with them. You can't allow meds to come in from the outside. That's understandable. They have to be ordered from a pharmacy and be the correct meds. So that's my concern. Thank you, Sue. I think, you know, when we're talking about privatizing healthcare in the jail specifically, privatizing healthcare is really about, you know, let's just be honest, it's about making money. Like it's a for-profit business. And so they're in business to make money. And if you're in business to make money, the first thing that you begin to look at are what are your expenses? And I would imagine that a lot of those expenses come down to personnel, because usually personnel in any business is your highest expense personnel, and then a lot of other cost-cutting measures. But I'm just wondering, in the reporting, did you find that like armor was understaffed? So, Sue brought up a great question about the 14-day screenings. You are supposed to be going through health screenings, and then you have to have one within 14 days. And we had found during one of the last inspections, accreditation inspections last year, that the jail was not doing those 14-day screenings within that timeframe. And I found that out months after that report was made and asked JSO about this and what they were doing to fix the problem. And one of the things they did say as we are talking to armor about their staffing levels, that's about as far as that conversation got. And we're going to go to the phones again. We've got Wells on the south side. Wells, how are you today? I'm fine. How are you guys? Good. I have a question and a comment. My question is, Ron Salem, who is now the current president of the city council, had a job, but I guess he still has a job as a consultant through the pharmacy part of the jail downtown. And what is his responsibility as a consultant to the pharmacy? And the other question I have or comment is that next to very, the gentleman who was a heart transplant recipient shouldn't have been arrested in first place. So what is the police accountability in this case and has, TK, what is the sheriff made any comments regarding this event that took place? Thank you. Thanks for your question, Charles. Yes. So great question. In regards to Councilmen's Salem, he is subcontracted through Diamond Pharmaceutical, who is subcontracted through Armor. Diamond Pharmaceutical is the company that runs the pharmacy. Salem is just somebody who goes in and makes sure that medication is not expired, that the fridge is working, basically just double checks that everything in the pharmacy is working correctly. He has nothing to do with ordering pharmaceuticals. He has nothing to do with and make care. He is just a consultant to make sure that the pharmacy is running properly. Yeah. So I mean, you can't tie Ron Salem to the issues that we're seeing with people not getting their medication. Those are two completely separate things. He did mention about the man who passed away after not getting his anti-rejection medication. Do we know, is there a lawsuit going on or has there been a lawsuit about that? There is a lawsuit that is being formed. It hasn't actually been filed yet, but his family does have a civil rights attorney here in Jacksonville who is doing that, and the sheriff's office has opened an internal review about what happened to Mr. Berry. I'm not sure if that also includes his arrest or just his time in the jail. I asked Sheriff Waters about that review last week, and he said that is still ongoing, so he wasn't able to comment on it at that time. And we're going to go to the phones. Charlie, in the beaches, how are you today, Charlie? I'm good, my friend. I would like to suggest that when someone goes into the jail, they should be allowed to have a private facilitator, not the jail, but a private facilitator, a person who could oversee their medications as they come into the jail and make sure that they're getting them, the private facilitator, because the person that goes in there may be suffering from depression or mental illness. And so we have to depend on the jail to make sure that person is taken care of when that person could have a private facilitator that could make sure that the person is being taken care of, and there should be a committee. Our mayor, she was a journalist, and if she had a committee and you had private individuals that were overseeing their loved ones that were going into the jail and they weren't being taken care of and they weren't being given the medications, and again, you need a private facilitator or a person to oversee that, not the jail. And then there would be a committee that that committee would go to, and you remember with Donna Deacon, she was a journalist, I can promise you that if she found out about that, it would be big trouble for the jail. Thank you. Charlie, thank you so much. I think what Charlie is advocating for there is basically like a social worker that would work with all the incoming inmates. That's a big task, though. That's a whole new division basically that you're creating. Not saying that it's impossible, just saying that you're talking about adding a lot of dollars to the column there. And we're going to go to Miriam. How are you this morning? Miriam's not there, so we'll just go to Mark on the west side. Mark, how are you doing? Real good. I was kind of echoing another caller. I'm a registered nurse. I've known lots of friends and associates over the years who have worked for the Sheriff's Office, and it doesn't seem so much like a big farmer or somebody is trying to prevent the inmates from getting their drugs. It's almost a matter of manpower, which we all know that correctional officers have had a hard time over the years. But if you're a nurse that works for the jail or works with the jail, you can't see a patient, an inmate, without a correctional officer present. And when they say days later they're sick or they're hurting or they need to see a doctor, again, it seems like they're almost, you know, it kind of gets lost in the system. So, yeah, I've had nurse friends of mine say that they've been waiting, they wait hours for a correctional officer to go in with them to see an inmate. And, you know, by that time, that cold or cough or whatever has gotten worse. And so I guess that's part of the problem. Yeah, Mark, thank you so much for your comment. I think what Mark is pointing to is not just not having enough staff on the nursing side of things, but also not having enough staff on, from his point of view, not having enough staff on the correctional officer side of things. Did you get any indication from TK that he was going to be more, that he was going to have his office be more involved in this contract and keeping an eye on the new provider? Well, he did ask him during the press conference on Tuesday, what safeguards are going to be in place to make sure that what happens under NAF care is nothing like what happened under armor. He just said that there are safeguards under the contract and I asked him for specific examples and he declined to answer that. So that's another reason why I am reading through the contract right now. Unfortunately, the last three days have been very busy, so I'm on about page 15 out of hundreds. In those 15 pages, did anything stick out to you? No, not yet. All right. We're going to go to the phones again. We got Richard on the north side. Richard, how you doing this morning? Hey, I'm doing well. Thanks for taking my call. Listen, I'm not certain if anybody has made this connection, but unfortunately, we can see what the crack epidemic did to the black community in the 80s and how it was treated as a criminal and three strikes and you're out. And then that same epidemic now is going through the suburbs and it's called the opioid and we've got even a drug to reverse overdose. We see how the abortion has been unraveled. Affirmative action has been unraveled, but no one seems to be making the connection that our current prison system is a system designed around slavery because of the 13th Amendment. The 13th Amendment makes the prison systems exist. It says neither slavery nor involuntary servitude shall exist except as punishment for crime. Now that was entered in there because of the way of the mindset that they had about black people and being free. There's just had to be this little clause to be able to continue to keep us enslaved. So if we could address the real issue and that's changing the language, and I don't know if anybody's talking about doing that. And if all we're doing is talking about how to move prisoners around and treat them while they're in jail, that's just that's not addressing the real problem. The real problem is legislatively and the real problem can be addressed by simply removing the exception that says neither slavery nor involuntary servitude shall exist period. And I think once we start having that conversation, then we'll start looking at prisons as more of a rehabilitation process than a punishment. Richard, thank you so much for your comment. And to enact something like that, like the 13th Amendment, that's an act of Congress and the President, which totally hear you on that. As far as dealing with the system that we currently have, where we are at, I think it behooves the community to keep their eye on what's happening with these contracts and the contractors and how they are navigating the work that's ahead of them. We have a tweet from Firepit Mike, and Firepit Mike says, why are these folks in jail in the first place? Folks with money can post bond, but folks without money are the ones in jail, correct? Could we eliminate cash bail so that there are fewer people in jail like some states have done? That doesn't really seem to be a movement that's really caught on here in Florida. The way it has in places like in California and certain counties in California, they're moving away from that. Has your reporting showed any of that? No, I have not been able to. I mean, that's a great question. And that's a question I would also like to ask, but have not been able to do that. We've been very much solely focused on health care in Duvall County and armor. And now soon, nafcare. Yeah, and I don't want to make light of the caller who talked about the 13th Amendment. Like what he read is exactly right. There's actually a documentary on Netflix called the 13th Amendment all about that. I'm just saying that like that is something of, that's a national conversation and where we're drilling down to is the local and what's and how it shows up in our everyday lives locally. We're going to go to Tom on the west side. Tom, how you doing this morning? Good morning. Yes. Along the lines of what you were just suggesting with cash bail, if we embrace civil citations, we would be able to reduce the number of people in jail and there would be less concern with taking care of the jail population because the problem would be much easier. Yeah, Tom, I hear you on that. I wonder if that is something that should be brought up to like the city council and to the mayor. Your thoughts? Indeed. Oh, definitely. Yeah, we need to keep the pressure up to do that because amongst other things, I mean, Ron Salem wants to move the jail is one of, I mean, to replace the jail is one of its highest priorities. And if we could just reduce the population that might become unnecessary, which would save the city a lot of money. Tom, thanks so much for calling. We're going to go to Brenda on the south side. Brenda, how you doing this morning? I'm wonderful. How about yourself? Good. Good. I'm listening to all the callers and I'm like on board with all of that. I love the is. But with regards to this medication issue, I just wonder if there's any accountability in the jailing system where when an inmate is brought in before they're even taken to a sale is their medical condition and medication put in a database in their computer system with weekly or I'm sorry, let me rephrase daily reports issued for the warden or whoever's monitoring their medical where they can stay on top of this because that seems to be like and I hate to use the word automation, but it seems to be the most logical first step in trying to manage this problem. Yeah, what you're what you're pointing to is basically like a management system that, you know, a computer program or whatever that manages their care that like you can just check it off and like know that it's happening, correct? Is that my summoning up correctly? Absolutely. Absolutely. Something so basic that so if they have it, are they using it? It just seems so logical. Yeah, it does. And I don't know exactly how the system works. We've gotten those records regarding Dexter Berry, which does show times that he was talking with nurses. It does show times that he was getting his other medication. So there is some sort of log. I think that brings up something that we actually just reported yesterday. The National Commission on Correctional Healthcare, which is a national accrediting agency for jails and prisons, actually in April, put the jail on probation. They didn't revoke their accreditation. It's just probation. And they're the jail still on probation until their next review, which is happening later in the year. And so right now we're trying to figure out exactly why it was why that happened, why they're put on probation and see if it is tied to anything regarding medications. So will the tributary be following this story? Of course. All right. We got Nicole Omana of the tributary on with us. Thank you so much, Nicole. I really appreciate you coming in and talking to me. Thanks for having me. All right.