City health director outlines steps taken at City Justice Center; deaths and overdoses decline after oversight changes

The St. Louis Department of Health told the Public Safety Committee on Jan. 26 that its yearlong oversight of medical care at the City Justice Center (CJC) has produced measurable improvements in several metrics since the department assumed responsibility in October 2023.

Doctor Matty Chachwayo Davis, identified in committee as the City’s director of health, said the department does not provide direct medical care inside the jail but does oversee and evaluate the medical contractor. “We do not provide the care. We do not make decisions about anything that happens within the city jail. We provide oversight, evaluation, and recommendations,” she told the committee.

The emergency contract with a new health-care provider, Physicians Correctional USA (PCUSA), began Dec. 1, 2023. The Department of Health said it engaged the National Commission on Correctional Health Care (NCCHC) for audits, site visits and recommendations and that NCCHC will continue periodic on-site assessments.

Key points the Department of Health presented to the committee:

- Oversight and corrective action: DOH implemented weekly coordination meetings among PCUSA, corrections leadership and DOH staff, built a living corrective-action plan addressing roughly 30-plus items identified by national reviewers (intake, detoxification and suicide prevention among the priorities), and began regular biweekly reviews with the contractor.

- Staffing and recruitment: PCUSA retained an estimated 80–90% of the prior clinical staff and brought in leadership (medical director, director of nursing and director of mental health). The department said roughly 1.5 full-time nursing positions remain open and PCUSA is recruiting additional nurses and as-needed LPNs.

- Intake and health-service requests: NCCHC standards require an intake screening within four hours of arrival; DOH said intake was a primary focus and that many intake metrics have moved from red to yellow/green under the current contract. Health-service requests (the formal inmate request pathway) were tracked starting in March and the department said follow-up/completion rates for emergent, urgent and routine requests have been high during the current contract period.

- Deaths and overdoses: DOH reported 19 deaths at CJC since 2019; two deaths occurred since DOH assumed oversight in January 2024. The department said nonfatal overdoses have declined since mid‑2024, with 13 nonfatal overdoses recorded since January and only two after June. The department contrasted that local trend with a national increase: the Justice Department has reported overdose deaths in city jails increased nationally by 211% since 2019.

- Grievances and incident follow-up: DOH described a standardized process in which PCUSA produces interim reports on serious events within 24 hours and more detailed final reviews later. The department presented a seven‑case sample of grievances its team reviewed; investigators concluded one grievance was fully true, three were partially true and three were untrue. DOH emphasized that medical privacy rules (HIPAA) limit the public sharing of individual medical records.

- Training and community linkage: DOH and PCUSA have rolled out multiple trainings (suicide prevention, crisis response, Narcan use). DOH said Narcan distribution and outreach are significant: committee testimony cited more than 2,280 linkage-to-care calls, more than 14,000 doses of Narcan distributed in the community, and participation in about 200 outreach events, all presented as part of the Department’s community-facing work.

DOH staff said the city will continue to refer detainees requiring higher-level medical care to hospitals and that a discharge planner position has been added to coordinate reentry services for people leaving custody.

Committee members praised the data-driven presentation and asked DOH staff for clarifications. Aldermen asked for the medical-examiner determinations the ME allows the City to release and asked DOH to supply more detail on the remaining backlog of medical requests. DOH staff said they would provide follow-up reports showing updated intake metrics and the status of backlog remediation.

Other operational updates presented to the committee:

- Department of Public Safety Director Charles Coyle said the administration has hired consultants and brought in additional oversight, including a new civilian-oversight commissioner, and is working on staffing incentives and infrastructure; the division has allocated funds for NCCHC oversight.

- Tammy Ross, acting commissioner of the Division of Corrections, reported on population and staffing: as of the presentation the jail held about 778 detainees (approximately 8% female; 84% Black, 16% White). Ross said the facility had 74 correctional officers filled of 198 authorized positions and that low staffing constrains recreation time and programming. Ross outlined current and planned programs including opioid-prevention work, faith-based ministry, fatherhood programming and exploratory efforts for education, sewing and vocational training.

- Consultant Doug Burris (Criminal Justice Solutions LLC) told the committee he was preparing a comprehensive report with 50–60 recommendations and said the city had already begun implementing quick repairs and programs; he singled out willingness among city leadership to act quickly on items such as broken televisions and window repairs.

Why it matters: the jail oversight changes move the Department of Health into a formal oversight role and establish national-accrediting‑body review and corrective-action mechanisms. Committee members said they want continued transparency about intake timelines, backlog remediation and medical-examiner findings where permitted.

The Department of Health committed to returning to the committee with updated metrics and requested documentation on the backlog, intake improvements and the action-tracker items in the corrective plan.