When a county jail goes from a place where most people who are arrested spend a few hours, days or weeks to a facility where inmates are incarcerated for months or even years, managing the operation of a 710-bed jail gets more complicated than feeding, housing and guarding prisoners.

Add into the mix a pandemic that’s stretching into its third calendar year, quarantines, a crisis-level felony court backlog and a halt to in-person visitation, and that’s what Indian River County Sheriff’s Office Deputy Chief Milo Thornton – who took over the job of managing the Indian River County jail just a year ago Jan. 5 – faces every day.

“I have been working on a plan that will offset these costs to the taxpayers, while increasing the level of services to our inmate population,” Thornton said.

It costs $95 per day to feed and house one inmate, a number that has increased from $65 just a few years ago. On top of that, the jail spends at least $2.2 million each year for medical care, plus $1.4 million per year for staffing of medical units by nurses and other professionals. 

It could have seemed like one of those jobs where you’re not quite sure where to start, but Thornton focused first on the mental and physical health of the people in custody, something he describes as the “basic human dignity” of those behind bars. His goal was to boost preventative care, to avoid costly outpatient and hospital procedures caused by unmanaged chronic illness.

“We had a doctor one day a week for four hours,” Thornton said of the jail, which sees about 540 different people booked into custody each month. The current jail population as of Monday press time was 500 people.

Through an arrangement with Treasure Coast Community Health, Thornton quadrupled the time that a doctor was on site, so more patients could be seen, more infections prevented or caught early, and more chronic health conditions managed better to head off emergencies.

Every time an inmate must leave the jail for emergency or outpatient treatment, it’s a drain on staff time for corrections officers and even the jail fleet over and above costly medical or psychiatric care. Better routine care, and getting and keeping inmates on the proper medications keeps everyone safe, Thornton said.

“Our No. 1 goal in providing good medical care is to keep inmates out of the hospital,” Thornton said. But when a hospital visit is necessary, he said, “Cleveland Clinic has been a very good partner with us. We get super cost savings for their services. The taxpayers should be happy.”

The arrangement with TCCH also gives inmates a way to continue their medical and psychiatric care with the same doctors after they are released from jail. “If people get out and can’t get their medication, they will likely turn to street narcotics and we will 100 percent see them back again at our door,” Thornton said. “Their actions appear to be criminal, but they have mental health and other issues. Once you get these folks regimented on their medications, they’re normal people.”

The jail sees longer-term inmates of a wide range of ages, including senior citizens — not just 20-somethings who maybe made a bad decision in their youth. In fact, the longest-standing resident of the jail is 63-year-old Asbury Lee Perkins, a former South Beach resident awaiting trial for the shooting death of his estranged wife, Cynthia Betts. Arrested in November 2015, Perkins has been held in the jail for 73 months.

The diverse jail population of 500-plus men and women come in the door with a wide range of serious, chronic health problems like high blood pressure, diabetes and heart disease, and even untreated injuries from before they were arrested.

Dialysis treatment necessitates a lot of transports, so Thornton hopes to bring in dialysis equipment soon, because that would save multiple transfers weekly for inmates to get kidney dialysis under guard, and ensure that inmates get dialysis on schedule. Every time inmates are out in the community for a medical appointment, it’s not only costly but it increases the risk of introducing COVID-19 into the jail.

To help prevent COVID outbreaks in close quarters, the Indian River County Health Department hosted a vaccination event for Sheriff’s Office employees, and Treasure Coast Community Health vaccinates any inmate who wants the shot. Thornton said “the Lion’s share” of the jail’s inmates are fully vaccinated.

“When I get a COVID case in the jail, we have to shut down a whole housing unit because one person tests positive. That person and potentially 30 others can miss court,” Thornton said, because sick or quarantined inmates cannot be transported to the courthouse. Those inmates also cannot have attorney consultations or report for in-house or trustee jobs.

Thornton said the entire housing unit is monitored and treated as if all had COVID-19. So far, he said of cases in the jail, “Considering how many people are all stuck together, it’s not been that significant.”

The jail’s medical wing consists of 23 units that can accommodate three people each. To be ready to handle long-turn COVID-19 surges, or other disease outbreaks, Thornton said he’s remodeling an old, unused reception area of the jail into another medical unit that can be used for quarantine. “We are positioned, with the Sheriff’s guidance, to deal with this pandemic or any other pandemic.”

Social isolation due to COVID protocols was another problem Thornton found when he took over, and he contracted with a company to provide virtual visits, as well as mail processing and digital scanning services to safely get inmates their correspondence. A by-product of these new systems has been the elimination of outside contraband being introduced into the jail.

“It’s a company called Smart Communications. They provide the ability for inmates to have on-demand calls with their families anywhere in the world using iPads,” Thornton said, adding that the technology allows inmates contact with loved ones while minimizing traffic at the jail and keeping COVID-19 outbreaks to a minimum.

In addition to providing healthcare and a safe way to communicate with the world outside jail walls, Thornton said making sure inmates are afforded the due process of law is of the utmost importance. Though certain court hearings can still be attended virtually, in-person attorney meetings are permitted at the jail because they need to be kept private.

The felony court backlog of more than 1,400 defendants waiting to go to trial hasn’t created any of the above challenges at the jail, but the lingering caseload keeps people with chronic diseases or mental illness in the jail longer, and it keeps violent offenders locked up longer with each other.

Because of custody classifications, inmates up on murder charges are paired with other inmates up on murder charges. Inmates up for sexual assault are paired with other accused sex offenders, inmates facing drug or weapons charges are housed with their peers, and so on.

Past violent crimes are also taken into consideration when housing an inmate accused of a minor offense. The longer these inmates are behind bars together, the tougher it is for corrections officers to keep the peace. The more serious felony cases that land people in the jail with high bail or no bail, for longer periods of time, the tougher it is to keep inmates properly separated or in protective custody if they might be in danger at the jail.

The jail is also housing more convicted felons than usual because the Florida Department of Corrections ceased or drastically reduced its weekly intake of inmates into state prisons due to the pandemic, so those criminals are stuck in the county jails indefinitely. Finally, Thornton said, he was able to transfer 12 men and one woman to state facilities in mid-December after only being able to transfer a handful at a time previously in the pandemic.

COVID-19 has also interfered with efforts to rehabilitate inmates. Thornton said face-to-face substance-abuse counseling and spiritual counseling and worship services are still not allowed in the jail due to the pandemic, so for a lot of inmates that critical lifeline is no longer available.

There’s one bit of positive news though, in that Thornton said he’s finally been able to fill all his open positions at the jail. This will help reduce the overtime costs partially caused by the pandemic and partially caused by a change to 12-hour shifts at the jail. Thornton said a good number of experienced corrections officers from northern states have taken the open jobs, in part due to recruitment bonuses offered by Gov. Ron DeSantis.

Officers leaving the state prison system have also come to work for the Sheriff’s Office, as some state facilities were closed down or scaled back due to the pandemic.