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President Donald Trump on Monday recommended avoiding groups of more than 10 people in order to prevent the spread of COVID-19. That may be simple enough for people with the ability to work from home, shop at off-peak hours and skip church.
But how to maintain social distancing in Missouri's penal system, where correctional facilities regularly exceed the number of inmates they were designed to hold, is less clear.
In October, while speaking about the need for a new Callaway County Jail, Sheriff Clay Chism said the current jail has general population space for 74 inmates but has been averaging 80-85 inmates on a daily basis.
Callaway County alone is home to the Callaway County Jail, Fulton State Hospital, the Fulton Reception and Diagnostic Center, the Cremer Therapeutic Community Center and the Fulton Community Supervision Center.
As of Thursday, no cases of the novel coronavirus had been diagnosed in Callaway County correctional facilities, or in any Missouri Department of Corrections facility.
Callaway County Jail
On Tuesday, Chism said the jail already relied on video visitation system, so the only outside visitors regularly entering the jail were from a local Gideons organization. Those visits have been suspended.
"Inmate visits with their families have not been compromised by this situation," he said.
Inmate screening procedures were already in place, too, as outlined by the jail's medical provider, Advanced Correctional Healthcare. ACH has provided an updated screening questionnaire for intake staff to use. If the initial screening's result point to a possible COVID-19 case, the jail nurse or physician will conduct a more extensive assessment.
Any incoming arrestee believed to potentially have COVID-19 will be instead taken to a hospital, still in custody, until given medical clearance to enter the jail.
Inmates currently at the jail have free and ready access to soap and warm water, Chism said. The U.S. Centers for Disease Control and Prevention recommends frequent, thorough handwashing as one of the best ways to slow the virus's spread.
The jail, which relies on frozen meals, typically has a two-week supply of food on hand — that's all the freezer can fit. Chism said over the past several days, the jail has worked with Moser's Foods to increase the supply to four weeks.
"Moser's has graciously allowed us to keep the additional two weeks at their store in Fulton for pick-up as needed," he said. "It's been a great reminder of why we choose to stay local."
Should a case be detected within the jail despite precautions, the jail will look to ACH for advice. But following isolation protocols could prove difficult due to the jail's consistently high population.
"Due to jail overcrowding, we have very limited opportunities to move inmates around," Chism said. "That has been a problem the last few years and has a potential to become more problematic moving forward. Ultimately, just as we do every day now, administrative decisions are made on a case-by-case basis as to the housing and separation of inmates."
Chism said there's no plan to try to decrease the jail's population.
"While I understand the need to safeguard the jail from disease, I also have the responsibility to safeguard the community from criminals," he said. "As the sheriff, it's my duty to make sound and comprehensive decisions for the safety of the community and not fall victim to rash, knee-jerk decision-making in a panic."
If corrections officers, rather than inmates, get sick, road deputies and administrative staff will step in to support jail operations. Chism described needing to pull in road deputies as a "worst-case scenario," and said they'd be paid overtime to work at the jail on their days off.
"As sheriff, I'm diligent in remaining calm throughout this situation, not falling victim to panic and ensuring my decisions represent what's best for the public safety of our community," he added.
Additionally, the Callaway County Courthouse began limiting public access Thursday.
"We ask that the public conduct their business with Callaway County by phone or email when possible," Callaway County commissioners wrote in a press release. "If you must visit the courthouse, we will do our best to serve your needs while following the state and federal guidelines for social distancing and cleanliness."
Fulton State Hospital
The maximum-security Fulton State Hospital houses hundreds of Missourians receiving treatment for mental illness, including persons found not guilty or unable to stand trial by reason of mental disease or defect. Preparations to weather COVID-19 are underway at FSH, said Debra Walker, director of public and legislative affairs for the Missouri Department of Mental Health.
"Fulton State Hospital staff is doing everything possible to prevent the spread of COVID-19 and ensure the safety of its patients and employees," Walker said Wednesday.
The facility has doubled the supply of food it has on hand.
Visitation has been suspended, and patient travel into the community is restricted to medically necessary specialty care and court hearings. Likewise, employees have been discouraged from traveling into the community, and several trainings have been canceled.
Every employee is screened and has their temperature taken upon arriving for work. Screeners are health care workers trained to ask questions and seek additional guidance from FHS's infection preventionist registered nurse as needed, Walker said.
Any staff member coming to work sick or with a temperature will be sent home and asked not to return until 24 hours after the temperature returns to normal. If COVID-19 is suspected, they will be told to contact a physician immediately.
If an FSH resident tests positive, they'll be put into isolation within the facility.
"FSH has a four-bed infirmary for this purpose," Walker said. "Staff working with isolated patients will use appropriate personal protective equipment."
Residents who've been in contact with the patient may go into quarantine for up to 14 days.
Department of Corrections
Missouri Department of Corrections facilities — such as the Fulton Reception and Diagnostic Center and the Community Supervision Center — have suspended offender visits, aside from attorney-client visits, for 30 days (until mid-April).
"While we recognize that visiting is an essential part of rehabilitation, the department must protect the health and wellness of all who live in, work in, and visit state prisons," the department stated March 12.
Offender transfers between facilities also has been suspended, except in undefined "extenuating circumstances," the DOC said Wednesday.
However, as a reception center for the DOC, the FRDC is still receiving new inmates from county jails, DOC spokesperson Karen Pojmann said. Those inmates can't be transferred away.
"We're not (full) yet," Pojmann said Thursday. "There has been decline in prison population in past couple of years, so crowding isn't an issue yet."
So far, she said, the DOC is not considering furloughing older inmates or those with health conditions that might make them particularly vulnerable to the virus.
Pojmann said DOC facilities are being cleaned more often. At most facilities, each cell has its own sink, and prisoners are provided with "as much soap as they need," she said. Prisoners share sinks in some facilities.
"We don't have sanitizer available for offenders because it contains alcohol," Pojmann added.
The DOC has implemented a "quick and simple" verbal screening process for staff reporting for work. A staff member who does not pass the screening will be given information about "next steps," though the DOC did not specify what those would be.
Staff nurses and DOC officials are in frequent contact with the Department of Health and Senior Services and have a protocol in place for identifying COVID-19 symptoms. That includes screening every offender at intake using a CDC-designed screening tool.
"Right now we're really focused on preventing it from coming in," Pojmann said — especially at the FRDC, with its frequent batches of new inmates.
Any offender showing signs of the virus will be placed in isolation. A test for the coronavirus may be administered following guidance from medical professionals, though Pojmann said no DOC inmates have been tested yet. Each prison has been directed to prepare isolation beds/wings, the DOC said — though, again, the ability to do so likely varies from prison to prison.
Offenders who handle hospital laundry are using protective gear and have received safety and risk-mitigation training.
Any offender reporting to a Probation and Parole office who shows signs of the disease will be asked to leave the premises and report to a physician or the county health department for an evaluation. Alternative methods of reporting, in lieu of face-to-face visits with offenders, may be used, the DOC said.
The 42-bed Fulton CSC is still open, Pojmann said.
"The women are still there; the program is still going on," she said. "(But) we have canceled the next graduation from the CSC."
The program targets women at risk of going to or returning to jail due to probation or parole violations through a 120-day, four-phase program including job readiness training, mental health/substance abuse services and more. Unlike most DOC programs, participation is technically voluntary: The women aren't locked in, and they can leave at any time. However, doing so is treated as a probation/parole violation, and a warrant will be issued for their arrest.