Business Columns & Blogs

Nancy Napier: The Invisible Hospital

The men's dorm area of the Ada County Jail.
The men's dorm area of the Ada County Jail.

I’ve been learning about a very exclusive, invisible hospital, just three miles from the Idaho State Capital building. Care to guess? Not the usual suspects-- St. Luke’s, Saint Alphonsus, or the Boise VA Medical center, although it has about the same number of beds as the VA.

It’s the hospital at the Ada County jail.

Granted, you don’t just stroll in for treatment. It’s for people who probably don’t really want to use it. But inmates are patients and patients need health care, both physical and mental.

In 2014, the Ada County jail booked over 15,000 people, meaning we each might know one of them. Perhaps a neighbor’s kid who broke into a car, a colleague with a DUI, or a relative with chronic mental health concerns. Even the Statesman’s Tim Woodward has written about his granddaughter’s addiction and drug court experience, which started with an arrest for stealing So it makes sense to understand how people are treated and who takes care of them. As one deputy said, knowing more about the jail should “help alleviate some of the stressful thoughts friends and family members have while their loved ones are in our care.”

I’ve studied the Ada County Sheriff’s Office to learn about its culture and innovations. But I’d never really known much about the Health Services Unit until I did time at the jail, including spending a night.

So what’s it like?

The 33 health service staff (nurses, social workers, administrators) and part-time contract medical staff (dentist, doctor, psychiatrist) join 159 deputies to cover three shifts, 24/7 at the in the jail. The sand colored two-story building they work in has narrow vertical rectangle windows evenly spaced along the outer walls. The glass is frosted, letting diffused light into the cell blocks. In square feet, the building is about the size of 3.5 football fields, and would fit just inside the State Capitol building grounds.

I asked people who work there what the biggest misconceptions are. First, most of us confuse jails with prisons. A jail is like a waiting station while a prison is a final destination. People in jail have been arrested, are presumed innocent, and wait for their trials. A few who have been convicted remain until sentencing or transfer to a corrections facility. But most inmates don’t stay long. The average stay is 34 days, but that’s skewed because a few spend more time (120+ days) while most leave after a few days or weeks.

Second, erase your image of television jails. This one has uncluttered polished floors, steel mesh instead of bars, no weird smells, and inmates aren’t forced to walk down a hallway with their right shoulders touching the wall. Still, it’s a jail. Fights happen, inmates complain, and so deputies and health providers stay on guard. The outside recreation area walls, topped with concertina wire, are probably 15 feet high, meaning the view is straight up, so inmates can’t see trees or landscape. The maze of brightly lit white or light green painted hallways seem designed to confuse an outsider. It works. Even after several visits, I could not have found my way alone through the six steel doors to the one that says Health Service Unit in white letters at the upper right corner.

One more misconception: that jails want to keep people in them. In fact, the Ada County jail was one of 20 (out of 200 applicants) to receive a MacArthur Foundation grant to help keep people out of jail and lower chances of being rearrested. Wouldn’t that be interesting if the jail put itself out of a job? Not likely anytime soon so in the meantime, we’ll hear about the stories of those who care for people who are inside.