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The family of Janice Dotson-Stephens didn’t know she had been arrested until they received a phone call that she had died.
The 61-year-old spent five months in custody after being charged with criminal trespassing. During that time, she was diagnosed with “schizoaffective disorder,” a chronic mental health condition characterized by symptoms of schizophrenia. She refused to eat or drink at least 102 times and ultimately lost 136 pounds. Despite University Health System physician Brian Skop’s insistence that Dotson-Stephens receive inpatient treatment, her medical chart gave no indication she was treated, though doctors, nurses, and counselors saw her nearly 500 times. She ultimately died of atherosclerotic cardiovascular disease, caused by high blood pressure.
Since Dotson-Stephens’ death at the Bexar County Adult Detention Center on Dec. 14, eight more inmates have died while in custody at the jail. The deaths raise questions about operational standards and staffing at the jail, the third-largest in the state, with roughly 4,000 inmates and the capacity to hold more than 5,000.
During a news conference in December, Michelle Dotson, Dotson-Stephens’ daughter, said her mother had been arrested in the past but in those instances had undergone medical evaluations at the jail, which led to her landing in mental health facilities. However, Dotson said, her mother’s name was incorrect on her paperwork, which hampered her family’s ability to find her and get her the help she needed before it was too late.
Dotson-Stephens’ story is not an exceptional one in the Bexar County jail system. She was one of two inmates with documented mental health issues who died while in custody in the jail. In both cases, a line of negligence can be traced to their deaths. The jail failed one inspection in February and a second in May. Of the failures noted by inspectors, the main error came from jailers not consistently checking on inmates.
Supervision is “Jail 101,” TCJS Executive Director Brandon Wood said.
“You need to be supervising those inmates and that requires you to do a face-to-face check on them,” Wood said. “That’s the basics. If you’re not doing that, then, unfortunately, everything else you’re doing right may not matter at that point.”
The two most recent jail deaths were suicides. Enrique Perez, a 25-year-old charged with murder in the death of his common-law wife, was found unresponsive Aug. 5 by his cellmate, who alerted an officer. The Bexar County Sheriff’s Office said all face-to-face checks had been conducted on time.
Three days’ before Perez’s death, Ashanti Taylor, 19, died after a July 27 suicide attempt put her on life support.
The Bexar County Sheriff’s Office said Friday that Taylor’s death was reported to the Texas Commission on Jail Standards “to ensure that all policies, procedures, and TCJS rules were met leading up to this suicide attempt.” Perez’s death also was reported to the commission.
At least two of the inmates who died had been jailed for weeks, charged with low-level offenses such as criminal trespass. However, they were unable to post bail, a problem that District Attorney Joe Gonzales has vowed to address by recommending personal recognizance bonds for low-level, nonviolent offenders.
Jack Ule, a 63-year-old homeless man who died in April, was held in lieu of $500 bail and would have been able to get out of jail by posting bond of about $50. Dotson-Stephens was held in lieu of $300 bail. Neither were given the opportunity to receive a personal recognizance bond, which asks individuals to sign agreements saying they will return to court but does not require them to post bail.
All inmate deaths are investigated by the jail standards commission, Wood said. If violations are found, they are added to the jail’s noncompliance report.
“We have to determine if there are any violations of minimum jail standards, find out if this is an issue previously cited or a new issue,” he said.
When inmate deaths occur, the National Commission on Correctional Health Care said, jails should conduct a mortality review, an administrative review, “and in the case of suicide, a psychological autopsy.”
“The purpose is to determine the appropriateness of care and whether changes to policies, procedures or practices are warranted; and to identify issues that require further study,” NCCHC said in an email. “If it is determined that corrective action is needed, these actions are monitored through the continuous quality improvement process for systemic issues and through the patient safety program for staff-related issues.”
|Name and age||Date of Death||Cause of Death|
|Enrique Perez, 25||Aug. 5, 2019||Suicide|
|Ashanti Taylor, 19||Aug. 2, 2019||Complications of suicide attempt|
|Leon Causey, 24||July 18, 2019||Pending|
|Alexander Wise, 29||May 30, 2019||Homicide|
|Jack Ule, 63||April 8, 2019||Pending|
|Jarnell Kimble, 45||March 29, 2019||Pending|
|Joshua Miranda, 19||Jan. 11, 2019||Natural – diabetic ketoacidosis|
|Fernando Macias, 61||Dec. 16, 2018||Natural|
|Janice Dotson-Stephens, 61||Dec. 14, 2018||Natural|
|Source:||Bexar County Sheriff|
Ule’s death spurred a policy change under which the district attorney’s office would not pursue cases that involve criminal trespass and no other crimes. Bexar County Sheriff Javier Salazar supported the measure.
“In my opinion, this inmate [Jack Ule] should not have been in jail,” Salazar said in a statement in April. “The Adult Detention Center should not be used to house the mentally ill or those who simply cannot afford to pay their way out. I will continue to work with District Attorney Joe Gonzales and Judge Nelson Wolff on a long-term fix.”
Les Sachanowicz, the attorney representing Dotson-Stephens’ family and Ule’s family, said both people were arrested for low-level offenses and taken to jail instead of going through the mental health court, where they would have been given mental health care and monitoring.
“My hunch is it’s easier to take them to the jail and drop them off there rather than do a mental health detention,” he said.
Sachanowicz filed a wrongful death suit on behalf of Dotson-Stephens in May and plans to file a similar suit on behalf of Ule by the end of August.
Taylor also had a history of mental health issues. The sheriff’s office declined to give more details about Taylor’s medical history but said she was given mental health and medical treatment during her one-month stay at the jail. They confirmed that she was not put on suicide watch, which requires detention officers to check on inmates in person every 15 minutes.
However, the inmate’s arrest report said Taylor threatened to kill herself “the first chance she got” after being taken to jail. A spokeswoman for University Health System, which provides health care for jail inmates, said Taylor was placed in solitary confinement against UHS recommendation.
“We are very sorry to learn of Ashanti Taylor’s death,” UHS spokeswoman Elizabeth Allen said in a statement. “It is our understanding that Ms. Taylor was placed in a solitary confinement/lockdown unit by the Bexar County Sheriff’s Office. This decision was contrary to the recommendations of UHS staff.”
Sheriff’s spokesman Johnny Garcia defended the supervision of Taylor, saying jail personnel “adhered to the recommendations of their doctors.”
He added that all prisoners brought into the Justice Intake Annex are assessed by medical staff.
Taylor’s death is being investigated by BCSO Internal Affairs and the Public Integrity Unit, Garcia said.
Coupled with the sheriff’s attempt to regain compliance with the Texas Commission on Jail Standards is the struggle to have adequate staff in the jail. Detention jobs are taxing and require a lot of mental and physical stamina, Bexar County Sheriff’s Office psychologist Brandi Burque said in a July interview.
“When you’re working in the jail, you’ve got men and women working ridiculously long hours,” Burque said. “You’re looking at sometimes a 16-hour shift or more. One of the big recruiting issues is that you’ve got these individuals that, if we don’t have deputies working in the jail or streets, there’s chaos and they don’t get paid very well. Then they don’t get to see their families.
“If we’re not getting people in, I’ve had officers who can’t go to the bathroom.”
Salazar said the jail has enough officers manning their posts, but the sheriff’s office has been understaffed. The County has had to pay for thousands of hours of overtime for deputies working the Bexar County Jail in 2019 alone. Salazar said his office is continuing to recruit new officers.
“We’d love to hire another 60 officers on the law enforcement side, and 90 on the detention side of the house,” Salazar said in July.
Wood said the commission always urges jails to have enough staff employed to avoid using overtime. TCJS requires a ratio of one officer per 48 inmates.
“We don’t care how you meet the staffing – meet the staffing,” he said. “But we caution people that extensive overtime may result in higher turnover due to burnout.”
Wood said the commission stays in contact with the Bexar County Sheriff’s Office – as it does with other jails found to be out of compliance – and monitors its efforts to return to compliance. After the sheriff’s office submits a formal request for re-inspection and documentation that all issues have been addressed, a new inspection can be scheduled. The commission is still waiting for the sheriff’s office to finalize its corrective plan of action and ask for a new inspection.
“We continue to monitor their situation,” he said.
The sheriff’s office has until February to return to compliance. Should the office fail to meet its one-year deadline, the board members of TCJS would discuss its future, which could include ordering the jail to comply with minimum standards or reduce their jail population by housing inmates out, Wood said.