Cory Shaffer, cleveland.com

Former top Cuyahoga County Jail official Ken Mills resigned last week ahead of a blistering U.S. Marshals report on the conditions of the jail.

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CLEVELAND, Ohio -- Cuyahoga County fails to provide jail inmates with the basic necessities they to need live. It withholds food and water and doesn’t provide medical and mental health care for inmates, according to a blistering report released Wednesday by the U.S. Marshals.

The report says that the inmates’ constitutional rights are routinely violated.

The report offers a clear picture of a jail rife with deplorable conditions, described by marshals' investigators as inhumane.

The jail investigation comes after the deaths of seven inmates between June 10 and Oct. 2. Cleveland.com learned of the seventh death during some two months of investigating the jail. Three of those inmates committed suicide. Fifty-five other inmates tried to take their own lives within the past year, the marshals found.

The county doesn’t investigate what led to the deaths, the report says.

Among the findings in the 52-page report made public Wednesday:

· Warden Eric Ivey withholds food as punishment and inmates aren’t fed properly.

· Jail staff shut off water to toilets and sinks.

· Pregnant women are forced to sleep on mats on the floor.

· Vermin infest the kitchen.

· Inmates sometimes are denied toilet paper and toothbrushes.

· Officers decked out in paramilitary gear routinely threaten inmates until they fear for their lives, going so far as to call some prisoners snitches in front of other prisoners.

· Medical staff lack proper licenses to provide treatment.

· Inmates with mental illness are denied care, even while they’re in isolation.

· Children are housed with adults.

· Inmates spend long stretches of time locked in their cells, sometimes up to 27 hours at a time, once for 12 days in a row.

The problems are so egregious that the U.S. marshals say the county won’t be able to fix them in a timely manner.

The marshals’ team that performed the review consisted of U.S. marshals from Washington and Cleveland, and FBI agents who investigate civil rights violations and economic fraud.

“They need to have a strong leader to implement all of these changes,” U.S. Marshal Pete Elliott said of the jail. “They need a strong leader with corrections experience to make it up to standard with other jails. I have full confidence in the sheriff that he’s going to find someone who is able to do that.”

Cuyahoga County Executive Armond Budish asked for the marshals' review. His top jail official, Ken Mills, resigned last week ahead of the release of Wednesday’s report.

In an interview Wednesday, Budish said he based his previous conclusions about jail safety and conditions on state inspections that never raised the breadth of the issues raised after the marshals' investigation. Budish and Sheriff Clifford Pinkney said they were stunned by the marshals' findings.

The report was made public just days after Mills tendered his resignation shortly after the U.S. marshals’ presented its preliminary findings to county officials.

Budish said that fixing the problems in the jail is now his top priority, but both he and the sheriff acknowledged that significant changes in leadership at almost every level is needed.

“We need to make sure that our prisoners and our staff is safe in the jail. That is number one,” Budish said.

The list of findings by the marshals is long, and at times, overwhelming. Cleveland.com is providing the full list so that the public, which foots the bills for the jail, can understand the magnitude of the problems.

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Former Jail Director Ken Mills, who resigned last week ahead of a scathing U.S. Marshal report about the conditions of the county jail, talks April 5 about the opening of the Bedford Heights Jail. (Cory Shaffer, cleveland.com)

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County doesn’t investigate jail deaths

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After seven county inmates died this year, Cuyahoga County spokeswoman Mary Louise Madigan said the Sheriff’s Department would investigate what led to the deaths. That never happened, the report says.

The county never performed post-mortem reviews and provided the marshals with insufficient and unclear answers about the recent deaths, including two that remain unexplained today. The county doesn’t review its own policies, procedures or any other possible contributing factors to the deaths.

There are no debriefing reports or mortality reviews, no required documentation, minutes of debriefing, medical summaries, timelines of incarceration, notifications, or autopsy reports in the county’s case files in the medical unit, all in violation of county policy.

The warden kept no files regarding the deaths.

The marshals also found that after every inmate death, someone took the housing unit’s logs, which document routine information, emergencies, and unusual incidents. Someone removed the logs and replaced them with a new one. Those new logs never mentioned why it was necessary to start new logs.

The marshals also had issues uncovering any information about inmates and said their records are stored in various locations throughout the jail, making them difficult to find. The jail has no central place for all inmate records.

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Jail officials, along with Cuyahoga County Executive Armond Budish, far right, at an April 5 ribbon cutting ceremony at the Bedford Heights Jail.

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Inmates with medical and mental illness don’t get treated

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The jail’s most vulnerable inmates, those with chronic and mental illnesses, are denied consistent and proper treatment. Some nurses and medical staff don’t have the necessary qualifications to administer health care.

Medical files provided to the marshals were surprisingly deficient. Of 10 nurses hired in October, no records were available for review. Of the files provided, four medical staff members had expired professional licenses; one nurse had no license on file; one medical staff member was not certified to perform CPR and two had only partial CPR certifications; a medical technical assistant had no diploma, and a nurse and nurse practitioner had board actions against them with no documentation of their disposition.

Inmates with serious mental-health needs, developmental disabilities, physical impairments, or inmates who are frail or elderly don’t get specialized treatment that takes into account their conditions.

Some inmates with mental illnesses who are placed in isolation don’t receive the mental health care they need, and never receive mental-health treatment for the entire time they’re in isolation. They don’t have access to therapeutic activities either inside their cell or outside their cell.

There’s no documentation of mental-health providers making face-to-face contact with isolated inmates, which violates federal guidelines.

Cleanliness and sanitation in mental-health-care unit is “minimally acceptable.”

Medical staff doesn’t maintain lists of patients who need medical care for chronic health issues. Treatment schedules for those conditions aren’t tracked on a patient-by-patient basis.

There’s a quarterly meeting that identifies problems with health care in the jail, but when a recent meeting found that there were problems administering medicine to inmates, nothing was done about it.

Jail staff “pass” on training about administering medication. The method used to track missed medications involves a numerical code without a description of what that code means.

Medical and mental-health appraisals aren’t conducted within the required 14 days after an inmate’s arrival at the jail. The people that Cleveland police arrest and take to the jail never get an initial medical screening . Medical staff are only made aware of those inmates’ health concerns when they become urgent, such as a “diabetic inmate who has not had his/her insulin for four days, or others who become symptomatic due to not having hypertensive or psychotropic medications.”

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Cuyahoga County Executive Armond Budish speaks before the swearing in of Carole Rendon as U.S. Attorney for the Northern District of Ohio. Joshua Gunter, Cleveland.com

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‘Men in Black’ threaten inmates, use excessive force

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The Special Response Team, a specialized unit in the jail decked out in riot gear, frequently threatened, harassed and intimidated inmates, sometimes withholding basic necessities as a way to control inmate behavior.

Marshals interviewed 100 inmates who described this team as the “Men in Black” because of their paramilitary uniforms. The marshals also viewed the response team's body cameras to reach their conclusions.

The marshals described a chilling scene where members of the specialized team escorted inmates to interviews with the U.S marshals’ investigators, and officers threatened and intimidated the prisoners and called them “snitches.”

The intimidation was so pervasive that guards bullied inmates in full view of the marshals' investigators. The behavior concerned investigators, prompting them to request that 10 inmates get released from the jail “for fear of SRT members retaliation, and the legitimate fear of detainee/inmate safety.”

The inmates interviewed described the Men in Black as routinely abusive. They placed inmates in isolation or segregation and refused to give them blankets when they were cold. They withheld hygiene products such as toothpaste and toilet paper, forcing inmates to use old towels, rags or clothing.

In one case, a response team officer told an inmate that toilet paper is only handed out on Wednesdays and handed him a paper towel.

The team used excessive force on inmates during cell extractions.

The officers verbally abused the inmates with explicit language and used “prejudice and unofficial authority to dictate and control” inmates.

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A cell at the Cuyahoga County jail in the Justice Center. Photographed Wednesday, June 27, 2012. (Lynn Ischay/The Plain Dealer)

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Child inmates are treated like adults

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Child inmates are held in the same areas as adult inmates while assigned to isolation or segregation. This is in violation of federal jail standards.

While child inmates charged as adults are held in the main county jail, they aren’t supposed to mix in with the general adult jail population for their safety.

Those children don’t receive the extra nutrition or exercise they need for development, and don’t receive programs that are educational or aimed at brain development.

They are subjected to the same extreme lockdowns as adults. That means they often don’t have access to hygiene, recreation and time outside of their cells.

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A video that a judge ordered Cuyahoga County to release to cleveland.com shows a jail supervisor taking a naked and mentally ill female inmate to the ground and spraying her face with pepper foam.

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Food used as punishment

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The jail warden personally ordered guards to deprive certain inmates of food as punishment, according to the report. The food inmates do receive is stored in rooms that reek of dead vermin.

Inmates held in isolation are given less food, and much lower-quality food than inmates held in the general population. The report says that inmates in isolation don’t receive enough calories, and their meals don’t meet basic medical or nutritional standards.

The report cites rotten bologna sandwiches packed in bread loaf bags and stored in unrefrigerated areas before they were served to inmates. Heavily-stained food trays smell and ooze dirty, moldy water.

The food service areas are infested with mice and other vermin. Pans, food equipment and kitchen walls are encrusted with grease and dirt, and aren’t sanitized.

Inmates that need certain diets for medical reasons aren’t given proper meals, and the jail doesn’t provide adequate food to the juveniles housed there.

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Lynn Ischay

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New inmates at the Cuyahoga County Jail are searched in the hallway after booking and before moving them to the intake pod on Wednesday, June 27, 2012.

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Staff shuts off running water

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Inmates awaiting court hearings are held in a room known as the “Bull Pen.” Twelve inmates are packed into cells that are designed for two people. They are left unsupervised and locked in the cells for more than 10 hours at a time, with no access to running water, working toilets or a place to sit.

Some inmates eat meals off the floors, as there is no place to set down their food. In some showers, bugs are flying around the ceilings and walls.

Sanitation is poor throughout the jail. Inmates sleep on damaged mattresses that are not cleaned after someone else uses them, or even monthly.

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Inmates at the Cuyahoga County Jail watch the Jerry Springer Show on Wednesday, June 27, 2012. (Lynn Ischay/The Plain Dealer)

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Constitutional Rights violated

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Inmates are denied due-process rights in direct violation of their constitutional rights under the 5th and 14th Amendments, the report says.

If they are suspected of serious rule violations, the findings of the investigation are sent to the warden, who imposes up to 30 days in isolation without any type of formal hearing.

Inmates are forced into isolation, even if they violated a rule that shouldn’t result in isolation, per federal standards.

And when inmates file a grievance about conditions or an incident inside the jail, they must write to the county sheriff at his business address. Grievances aren’t properly tracked once they are filed with the jail administration.

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Lynn Ischay

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The Cuyahoga County jail at the Justice Center, photographed on Wednesday, June 26, 2012.

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Jail staff ignores religious needs

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Inmates who need specific meals for religious reasons don’t receive them because the jail doesn’t have a religious-diet menu, meaning the jail isn’t in compliance with religious dietary laws.

Muslim inmates said they don’t have access to an Imam.

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The Cuyahoga County Jail at the Justice Center. Photographed Wednesday, June 27, 2012.

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Forced lockdowns for 27 consecutive hours

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Inmates are often forced into lockdowns because the jail is short-staffed. Isolation is often reserved for violent inmates or prisoners who break the rules, but the Cuyahoga County Jail uses isolation to cope with a lack of staff. The jail is short 93 corrections officers, and existing officers often call off work, leaving the remaining jail staff incapable of supervising inmates. So, the jail puts all prisoners into isolation in a practice called red-zoning.

The red-zoning “greatly impacts detainees’/inmate’s basic needs,” the report says.

Large groups of inmates are often locked down in pods for up to 27 consecutive hours in their cells; in one instance, for 12 days in a row.

The isolated inmates are often held without toothbrushes, toothpaste and toilet paper. They have no access to day rooms, showers, telephones and outside recreation areas.

Jail employees at various levels and in various positions told the U.S. marshals that they are concerned for their safety and security due to understaffing. They said morale in the jail is low, and jail workers are frustrated by their inability to improve conditions or voice concerns to management.

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Inmates put in segregation, isolation for minor reasons

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Inmates are routinely thrown into segregated or isolation areas, often for committing minor infractions, including some that federal standards say do not warrant such harsh of punishment.

The jail has no written policies about when jailers should place inmates in segregation or isolation, and no one checks inmates for signs of deteriorating mental health. Isolated inmates aren’t told when they will be released or returned to the general population.

Inmates in “no contact housing” are denied privileges they are entitled to because they’re not confined for disciplinary reasons. They also are subject to red-zoning for 27 hours. They are denied access to basic education, commissary and library services.

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Entrance to the Mental Health Unit inside the Cuyahoga County Jail, Thursday, December 11, 2008. (Marvin Fong/The Plain Dealer)

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Jail isn’t inspected

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Ivey, the jail warden, and associate wardens don’t make weekly visits to the housing units and don’t document their inspections when they do complete them.

Jail staff doesn’t perform daily security inspections, and weekly security inspections of the jail aren’t conducted.

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Jail is overpopulated

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The jail is designed to hold about 1,760 inmates, but is routinely over capacity by hundreds of inmates. The jail held 2,420 inmatesl when the marshals conducted their review.

When state inspectors told the jail to come up with a plan to reduce the crowding, jail staff didn’t comply and never addressed the problem.

Because of the overpopulation, inmates must sleep on mattresses on the floor. The marshals found that a woman who was nearly eight months pregnant was forced to sleep on the floor, as was a woman who was five months pregnant.

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Keys are in reach of inmates

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Corrections officers often lose track of their keys or store them in a place within arms’ reach of inmates.

The lack of a plan for where keys go is pervasive throughout the jail, the report says. Keys were on hooks inside of the officer’s station within armed reach of the inmates. They were also found lying around or hanging on unsecured hooks and nails.

No one keeps tabs on how many keys are lost.

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Jail non-complaint with Prisoner Rape Elimination Act for three years

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The jail has been out of compliance with the federal Prisoner Rape Elimination Act for three years. The 2003 law seeks to curbs to sexual violence in jails and prisons.

The jail underwent a voluntary pre-PREA Audit in 2015. The inspectors found 119 areas of deficiencies or of non-compliance. Jail administrators haven’t addressed any of those areas of concern in three years.

The marshals' report doesn’t detail what the area of concerns are, nor does it provide details regarding the 52 instances of PREA infractions in the last year.

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Fire hazards throughout the jail

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Fire hazards are rampant at the jail. The sprinkler system doesn’t cover the entire jail and there is no smoke alarm or other automatic alert in the inmates' housing pods and cells. Flammable items are strewn across the jail with no one keeping track of what they are or where they are stored.

In one case, the marshals' team watched a fire drill. The staff forgot to bring a fire extinguisher and emergency keys. The marshals determined jail workers lack the ability to evacuate inmates and staff in the event of a fire.

The marshals also found the jailers do not do enough fire-safety drills. The jail isn’t up to city, state or federal fire-prevention codes.

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The kitchen at the Cuyahoga County Jail at the Justice Center. Photographed Wednesday, June 27, 2012. (Lynn Ischay/The Plain Dealer)

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Inadequate training

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Training of corrections officers is lacking, the marshals found.

Corrections officers have no training regarding the implications of incarcerating young adults and the impact on their brain development. They have no training on de-escalation tactics for the officers in the segregation and isolation units.

The officers aren’t trained in proper use-of-force and de-escalation techniques.

They fall short of federally required hours of training by 32 hours per year. They need 40 hours of training and only get eight. If they are in their second year on the job, they get two hours, the report found.

Officers don’t undergo annual training for the following: security, safety, fire, medical emergency procedures, supervision of offenders and how to deal with sexual abuse and assault.

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The 'no contact' visitation rooms at the Cuyahoga County Jail at the Justice Center. Visitors sit on one side of the glass on a metal stool, inmates on the other side. they speak on phones. (Lynn Ischay/The Plain Dealer)

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Other issues

The report also covers a variety of other issues. Those include:

Inmate handbooks and guidelines aren't offered in a language other than English, meaning the jail's Spanish-speaking population doesn't have access to basic information about the jail. Spanish speaking inmates also don't receive information in Spanish about how to obtain medical care.

Inmates with limited mobility or disabilities have no access to programs and service areas such as outside recreation.

Inmates aren't paid for work.

Biohazard or infectious waste collected from the medical unit is stored in a box on the floor out in the open, in violation of local, federal and state regulations. The boxes aren't clearly marked or locked and are stored in containers that could easily break open.

Dangerous items inside the jail aren't tracked as they should be, meaning it is impossible to tell if syringes, needles, and hand tools are accounted for. Some inmates receive culinary equipment to help prepare meals, but the jail lacks defined rules governing which inmates have access to tools.