County leaders and concerned community members are pointing to the impact of drugs on deaths in the jail, and plans are in the works to reimagine how the county jail operates.
According to sheriff’s office risk management files obtained by the newspaper through Ohio’s public records law, at least three deaths at Montgomery County Jail this year were confirmed to be linked to drug intoxication.
Steven D. Blackshear, 54, of Dayton, was booked into the jail Jan. 26 and awaiting trial for misdemeanor theft. He died Jan. 29. The coroner’s office investigation found that he died of intoxication by fentanyl. The risk management report said he was taken for medical testing two days before his death on complaints of chest pain. The nurse who worked with him noted that Blackshear was shaking in a fetal position and was vomiting.
Blackshear reportedly denied any drug use to the nurse but later called for help from his cell for leg pain. Inmates surrounding his cell reported he was going through withdrawals. The man tested positive for cocaine and other substances, and medical staff reportedly placed the man on detox protocol, which required medical staff to check on him twice daily.
He was found unresponsive in his cell, covered only in towels. The report said that it’s unclear if Blackshear brought fentanyl into the jail when he was booked on Jan. 26 or if he obtained it while in custody.
Aaron Dixon, 52, was being held on drug charges when he died on Jan. 13. He had been in the jail for four days. The coroner’s office said the cause was “Fentanyl and buprenorphine intoxication.”
The risk management report completed after Dixon’s death said that on Jan. 11, he told jail staff that he was going through withdrawal after he was found convulsing in his cell. After sustaining an injury in a fall during a seizure, he was taken to the hospital for treatment. He was returned to the jail on Jan. 13, and he was found unresponsive in his cell after being alert and making small talk with corrections officers hours before.
The risk management report states that a toxicologist ruled Dixon “more likely than not” used the drug fentanyl after he was taken into custody.
Amber Goonan, 41, was arrested on charges of drug possession and booked into the jail on Feb. 19. She died on Feb. 24 of “multiple drug intoxication” including fentanyl, fluorofentanyl, and others, according to the coroner’s office. Bronchopneumonia was a contributing factor.
Before her booking, she was taken to Grandview Hospital for treatment related to drug use. Her hospital discharge paperwork indicated that she was treated at the hospital for an overdose. After she was screened by medical staff, she was placed on detox watch. She was checked on again by medical staff, where she reported she was able to eat full meals but was experiencing muscle aches.
Early in the morning on Feb. 20, she was found unresponsive while a corrections officer was bringing in her morning detox medications. She was taken to the hospital, where she was pronounced dead days later.
Investigations are pending for other inmate deaths that were reported in recent months:
Isaiah Trammell, 19, was arrested on charges of domestic violence on March 13 and died March 16. His cause of death is still under investigation, but a preliminary report does not indicate drug use was related to his death.
Amanda K. Campbell, 44, of Vandalia, was arrested on a warrant from Vandalia Municipal Court for theft, warrants from Montgomery County Eastern Division for receiving stolen property and obstructing official business and a warrant from Kettering Municipal Court for falsification.
She was booked into the jail April 2 and died there on the morning of April 4. According to the sheriff’s office spokesperson, Campbell’s death was “naturally caused because of her extensive health issues.” The investigation of her death is also pending. A preliminary report of her death only indicates that she was found unresponsive.
Gerald Ford, 47, died on June 10 at a local hospital after being found during a medical emergency in the direct-supervision unit, which is used for inmates who need extra monitoring, hours after his booking.
Naphcare responding to more overdoses
The health care provider of jail occupants has said opioids are impacting Montgomery County’s facility more than any other of the spaces the company works with.
In the first six months of the year, medical staff at Montgomery County’s jail already responded to 32 suspected overdoses, according to jail health services provider Naphcare. This already outpaces the total number of overdoses — 27 — to which Naphcare staff responded in Montgomery County last year.
The county signed a $12.8 million contract for health services with Naphcare in 2022. It is set to expire on Dec. 31 this year with the option of a three-year renewal.
Naphcare provides a wide spectrum of services to Montgomery County inmates, ranging from health screenings to dental work to mental health and addiction assistance.
Every person who is booked into Montgomery County Jail is screened by a registered nurse for substance use and the possibility of withdrawal, according to Naphcare.
NaphCare healthcare professionals in the Montgomery County Jail staff a full clinic with treatment provided by doctors, nurse practitioners, nurses, mental health professionals, EMTs and other specialty providers based on patient needs.
Typically, up to eight medical staffers are scheduled for each shift, along with clinical leadership, mental health professionals and physician staff, according to Naphcare.
Patients at risk of withdrawal receive treatment and daily monitoring from Naphcare nurses, nurse practitioners and physicians. During medical emergencies like suspected overdoses, all health staff on shift are alerted. Narcan is available for all emergency responses, according to the company.
Changing staff, community concern
The Montgomery County commission revised its contract with Naphcare last week to replace four EMTs who work in the booking portion of the jail with four nurses.
Montgomery County Administrator Michael Colbert said Tuesday that the amendment allows the sheriff’s office to have employees who can make a “higher level of health care diagnoses at booking,” something commissioners agreed is important.
Montgomery County Jail Coalition member Yvonne Curington, who is also a nurse activist and patient advocate, said the experience and training of registered nurses is crucial to the safety of people occupying the jail.
“They may catch things others cannot,” she said. “And every person coming into the jail is a patient and should be looked at as a patient.”
The jail coalition consists of members of the community who are concerned with deaths at the Montgomery County Jail, calling the deaths at the jail a crisis.
The coalition has called on the county to take action to prevent deaths at the jail, particularly calling on a reconsideration of its contract with Naphcare.
Montgomery County Sheriff Rob Streck said his office is pleased with the work of Naphcare’s local team of healthcare providers.
“But we’re not happy with how long (inmates) are being watched at a hospital,” Streck said.
More time with direct supervision in a clinical setting could make a difference for inmates detoxing or at risk of overdose, he said.
Safety measures, challenges
Streck said the deaths at Montgomery County Jail are not caused by new drugs flooding into the facility.
“They’re using, then coming in,” Streck said. “Hours, even days later their bodies are giving up. This is the sickest, most mentally ill and most addicted population the jail has ever seen.”
The Montgomery County Sheriff’s Office uses body scanners and K9 dogs to keep drugs out of the jail. Inmates are changed into their jail uniforms immediately, too.
All mail coming into the jail is scanned and presented electronically as another safety precaution. Visitations are also done by kiosk or iPad, with no face-to-face visits. All of these are methods to deter drugs from entering the facility, said Streck.
His office is also continually looking into new safety-centric technology, as the kind of drugs that gain popularity are growing increasingly more powerful in small doses.
Xylazine is increasingly an issue, for example. Xylazine is used to cut fentanyl, and the substance is resistant to Narcan.
Streck said inmates who are dying of drug-related issues are passing away in their sleep. Jail staff cannot wake inmates up every hour.
State inspections, reporting
The Ohio Department of Rehabilitation and Correction (ODRC), which oversees Ohio’s incarceration system, tracks the deaths reported in the state’s jails. According to data the newspaper obtained through a public records request, roughly 20 deaths have been reported in Ohio jails in the first half of this year.
This figure is in pace with the total number of inmate deaths in Ohio last year: 44.
Montgomery County Jail has passed all of its recent inspections and was re-accredited by the American Correctional Institution in 2020.
ODRC sends inspectors to Ohio’s facilities annually. To be deemed “compliant” by the state, jails must meet all standards deemed “essential” by ODRC and at least 90% of standards that are labeled as “important.”
In its inspections since 2019, Montgomery County Jail met all essential standards annually and only failed to meet standards for between five and eight of the more than 120 important standards.
These standards that weren’t passed included notes about jail capacity, cell space and some minor maintenance issues in the older portion of the jail, according to ODRC inspection reports.
The 2022 inspection report said the Montgomery County Jail’s capacity is 903 inmates. On the date of the jail inspection, there were 573 inmates incarcerated.
The Ohio Department of Rehabilitation and Correction recommended housing capacity for the jail is 443.
Seeking solutions for a short-term facility
Streck said plans are underway for revising a portion of the jail property to include a mental health facility and medical exam space.
Overall, the jail is not set up like a hospital. Medical staff at the jail have spaces to conduct assessments, but the facility doesn’t have an “infirmary” space for patients.
“We were designed to be a pre-trial, short-term facility,” Streck said. “We don’t have the facilities to directly deal with this.”
Curington said this kind of facility would be “a great compromise” and a step in the right direction.
“Change is a process,” she said. “It will take time.”