The overcrowded, understaffed Douglas County Jail hit a record-high number of inmates in late July, prompting the corrections director to send other criminal justice agencies a letter asking for help in reducing the number of inmates.
The jail population reached 1,390 in July, Douglas County Corrections Director Michael Myers told the County Board last week. The jail has an official maximum capacity of 1,452. But its actual capacity is closer to 1,300, he said, because of ongoing jail renovations and the need to house some dangerous people by themselves.
By last week, it was slightly better. There were 1,327 people in the jail on Friday, but still 55 inmates were sleeping on plastic bunks on the floor of a jail gym, with access to one bathroom.
Meanwhile, understaffing problems that led to corrections officers packing a County Board meeting 1½ years ago have only gotten worse, despite a pay increase and other steps to increase hiring and improve retention. At the beginning of August, the jail was 55 officers short of its authorized strength of 396.
That has led to massive amounts of overtime; much of it mandatory in order to ensure minimum staffing levels. Combined, officers logged more than 7,000 hours of overtime in July.
“So we’re going backwards a little bit?” County Board member Jim Cavanaugh asked Myers last week during a board meeting.
“As frustrating as that is, yes,” Myers replied.
It has become a common story in jails and prisons in Nebraska and in many places around the nation. The Nebraska Legislature’s inspector general for corrections recently called conditions at the Nebraska State Penitentiary “alarming” and “disturbing.” His report cited excessive overtime and overcrowding.
In Sarpy County, chronic overcrowding of the 148-bed jail has the Sarpy County Board preparing to build a new jail, more than twice the size of the current one. There are no such plans in Douglas County, where work is underway on $10 million in jail renovations funded by a 2016 bond issue.
The State Penitentiary’s population of about 1,300 puts it at 180% of capacity. About the same number of people are locked up in the Douglas County Jail. The vast majority of people in the County Jail are awaiting trial on felony charges. Some are awaiting trial on misdemeanor charges, or serving sentences for misdemeanors.
The Douglas County Jail has been stretched to capacity for some time. It hit a then-record high of 1,360 people in July 2016, for example. The County Corrections Department, judges, prosecutors and defense attorneys have increased use of diversion programs and supervised pretrial release.
But numbers generally have stayed high, with an increasing number of people locked up who have serious mental illnesses that the jail is not equipped to deal with.
It’s unclear what’s driving the high populations. Douglas County Attorney Don Kleine and Public Defender Tom Riley both have said their felony caseloads have been climbing every year, despite Omaha Police Department reports of decreasing crime in the city.
Myers told the County Board that the number of people in jail in Omaha for probation violations has climbed dramatically — from about 60 in early 2017, to about 200 currently. He theorized that it was related to LB 605, a 2015 Nebraska Legislature bill aimed largely at reducing the number of people in state prisons.
In July, 1,959 people were booked into the Douglas County Jail, Myers told the County Board.
“We typically run in the 1,500 to 1,700 range, and 1,800 would be a busy month, so this was rather unprecedented for us,” Myers said.
And on every shift, there were corrections officers working overtime, typically an extra four or eight hours after their normal eight-hour shift.
It was worrisome enough that Myers sent a letter to local judges, Kleine, Riley, Omaha Police Chief Todd Schmaderer, Douglas County Sheriff Tim Dunning and other criminal justice leaders. The World-Herald obtained a copy of the letter through a public records request.
“We have been forced to house at least 75 people per day on cots on floors for a few weeks,” Myers wrote on July 26. “One of our gyms has 55 people sleeping on the floor with one toilet. We have to move them to other units to shower.
“Our staff have been facing large amounts of mandatory overtime in order to staff all posts and there are still times when we are short, and have to lock down units on a rotating basis, creating increased tension and resistance from the inmates in those units.”
Due to what he called “extreme circumstances,” Myers asked the various agencies to help the Corrections Department in “managing our population.”
“I am not asking in any way for consideration of actions which may put a victim or the public at risk,” the letter said.
But he asked the letter’s recipients to consider several strategies “in cases where an individual does not appear to pose a direct threat to anyone specifically or to the public at large.” Those strategies included increasing the use of “cite-and-release” for people suspected of nonviolent offenses instead of taking them to jail, putting more people on supervised pretrial release instead of setting high bail amounts for them and increased use of the county’s Offender Work Program “instead of sitting out fines in jail.”
Last week, Douglas County’s Criminal Justice Systems Management Council voted to form a committee to look for solutions. The council, chaired by Omaha City Prosecutor Matt Kuhse, includes judges and numerous court and law enforcement officials, plus representatives from the Omaha Mayor’s Office and Douglas County Board.
The new committee “will look for realistic things that we can do as agencies to alleviate these problems,” Kuhse said. “It’s not about bail reform, or new sentencing ideas. ... Obviously something needs to be done, and the people on this committee are the best suited to talk about coming up with solutions.”
In interviews last week, Myers and Sgt. Patrick Sullivan, president of the Douglas County corrections officers union, said the crowding had increased tensions. But they said it had not appeared to increase the number of fights between inmates or assaults on staff.
But clearly they were concerned.
“When I perceived that we were on the precipice of something serious, that caused me to write that letter to stakeholders,” Myers said.
“We’re trying to make sure we’re not the next State Pen,” said Sullivan, who heads the Fraternal Order of Police Lodge 8. “Reaching out to these stakeholders is a positive step.”
Sullivan said the excessive overtime has been hard on officers and their home lives. That’s one of the reasons people have been leaving the job.
In July, 20 new officers graduated from training and started work at the jail. But 13 other officers left the county. Another class will start in early September.
Sullivan and Myers said the union and county officials are talking about ways to improve the situation.
Kleine said his office and the local courts have increased the use of diversion through such programs as drug court, veterans court and young adult court, as well as pretrial release on GPS or drug and alcohol monitoring.
“We’re always listening to these things when it’s appropriate,” he said.
Even so, Kleine said, “We’re not going to change the way we do business.” His office will make sure it’s prosecuting people with the correct charges, and the county has to do “whatever it takes, whatever they need to do to have the adequate staffing and the adequate space” in the jail.
Riley said he believes some people accused of nonviolent offenses are being held on bail amounts that are too high, and that more people could be released on pretrial supervision. But he said his “biggest frustration” is seeing so many mentally ill people languishing in jail because there’s not enough mental health treatment available.
Myers “is doing his best with a very difficult situation,” Riley said.
When the City of Omaha fixes the broken-down Crown Point Avenue, it will try a different approach.
Next year, the city will repave the northwest Omaha street, but also eliminate two through lanes of traffic on what’s currently a four-lane street.
Instead of reinstalling traffic signals, it will build four roundabouts in the stretch from 72nd Street to Blair High Road.
Beyond simply fixing sidewalks, the city will build a 10-foot-wide, multi-use trail on one side of the street.
It’s part of an effort to implement a policy called “Complete Streets” — a trend in street design spreading across the nation and now finding a place in Omaha. The idea is that streets are built not only for cars, but also pedestrians, bicyclists and transit riders.
And it’s more than a passing fad. In 2015, the Omaha City Council made it the city’s official policy to approach every street project as an opportunity to “create safer, more accessible streets” for every user.
Two weeks ago, after years of work behind the scenes, the city publicly released a draft of its 85-page implementation guide, which is expected to go before the council again next year.
But already, Omaha faces a challenge in the implementation: Will a car-centric city accept streets that are not totally beholden to the car?
In the neighborhoods around Crown Point Avenue, Omaha’s complete streets push will face its first test with the general public as the city pilots some of the concepts. Having heard about the plans, some neighbors are skeptical, particularly about the roundabouts.
“Honestly, we just want it paved,” said Kirstin Peyton, who has lived in the neighborhood since 1997 and works in the area. “That’s all we want. That is all we want.”
Not only has street design entered a new era, but the community around Crown Point Avenue also has evolved since the street was built a half-century ago.
According to the city, the concrete pavement was built in 1972.
On one end of the street, Northwest High School opened in 1971. On the other end, the Vickers hydraulics production plant opened in 1969, employing more than 2,000 people at its peak.
Today, the Vickers plant has become Sorensen Park Plaza shopping center. And Sorensen Parkway serves as the primary artery through the area instead of Crown Point.
Gayle Sturdivant, design division manager for the Omaha Public Works Department, said Crown Point Avenue is overbuilt for today’s traffic. Even if the city were focusing on a project only for cars, it would never restore four lanes, she said.
“If you look at traffic today, you only need the two lanes,” she said. The revamped Crown Point also will have a middle turning lane.
In planning for the project, the city surveyed 258 people about the future of the street but didn’t present an option for maintaining four lanes.
People had a low opinion on making the street two lanes, rating that at less than 2 on a scale of 1 to 5. Three lanes scored better, but just as many people were against that idea as in favor.
When asked what issues need to be addressed for Crown Point, 92% said fixing the pavement was important. Safety and speeding rated behind that, at 46% and 40%.
Jeff Barnes, who has lived in the Stillmeadow neighborhood for 25 years, said he feels like the public’s input was ignored.
Said Barnes, “This is kind of an incubator for, in large part, how much the citizenry will accept before they say, ‘Now wait a minute.’ ”
Sturdivant said the project will give residents what they wanted — new pavement and a street that will slow traffic and improve safety.
But that will take a different form than a traditionally designed street.
Roundabouts are somewhat new to Omaha, Sturdivant said, but they have proved to reduce the number and severity of crashes at intersections.
Sturdivant said the city is recognizing that some users have needs that are different from those driving cars.
There are Metro bus riders on the corridor and school bus riders from Northwest. But not every student rides the bus, Sturdivant said. Some neighbors might want to walk or bike to Sorensen Park Plaza, which can be challenging today, she said.
Scott Dobbe, executive director of Omaha by Design, said he hopes people will be patient with the changes coming to Omaha. Dobbe, whose urban design and planning organization has contributed to Omaha’s complete streets plans, said he would ask people not to judge until they see the changes in operation.
“I really believe residents will be pleasantly surprised,” he said.
Peyton said she rides a bike and would love to use the multi-purpose trail. At the same time, she said, the trail’s western end will stop at the busy Blair High Road. That also leaves it short of the trailhead for the popular Keystone Trail at Fort Street.
Ultimately, plans call for the Keystone Trail to extend from Democracy Park at Fort Street north to Cunningham Lake. But neighbors say they’ve heard talk of that connection for years.
Sturdivant, however, says it’s on the way — and could happen within three years. In the city’s annual budget talks, Councilman Pete Festersen has proposed an amendment to plan to build that link in 2020.
Emiko Atherton, director of the National Complete Streets Coalition within the group Smart Growth America, said 1,500 complete streets policies are in place across the country, and Omaha is right on schedule by moving into implementation.
How the implementation happens is really important, Atherton said. It’s particularly important for agencies to engage the community and communicate about the changes, she said.
“Implementation is more than just laying down the infrastructure,” she said, “and I think we forget that a lot.”
Her patient's voice was panic-stricken, Emily Deans says, and her story was baffling.
"She said, 'I can't flll my prescription, it's too expensive,' '' said Deans, a psychiatrist near Boston, recalling a conversation from about flve years ago. A patient who suffered from severe obsessive-compulsive disorder called, upset that she could no longer afford her medication, a drug called clomipramine. The price of a month's supply had suddenly jumped from $16 to $348.
The increase appeared to defy logic. "This is crazy for a generic drug that's been around for decades," Deans said. Clomipramine was discovered 55 years ago; it was approved to treat OCD in 1989 and became available in cheap, generic form in 1996. Why the sudden price hike? A possible answer flnally came this year.
In May, attorneys general in dozens of states accused three pharmaceutical companies that make clomipramine — Taro Pharmaceuticals Industries, Mylan Pharmaceuticals and Novartis's generics arm, Sandoz — of conspiring to raise the drug's price in concert.
The allegation is part of a lawsuit that names 20generic drugmakers and subsidiaries in all, as well as 15 current and former industry executives. It says they communicated with one another to fix prices and divvy up customers for more than 100 drugs, treating a range of maladies from HIV to high blood pressure to fungal infections.
The companies, including those that make clomipramine, have denied the states' allegations. Nonetheless, the lawsuit, along with a similar one filed in 2016 and a federal investigation into price-fixing allegations, have rocked the generic drug industry, long regarded as consumers' haven from the spiraling prices of name-brand medicines.
Decrying "one of the most egregious and damaging price-fixing conspiracies" in U.S. history, the lawsuit alleges that generic drugmakers illegally heaped billions of dollars of costs onto patients, employers and taxpayers. During the peak of the alleged conspiracy from 2013 to 2015, drug companies raised the price of a bladder-condition drug, oxybutynin chloride, by more than 1,000%, among other price hikes.
Few drugs saw sharper price spikes than clomipramine, which weakens the powerful compulsions that cause OCD sufferers to spend hours each day stuck in rituals, like washing their hands or checking the locks and windows in their houses. It's one of only five medications U.S. regulators have approved for OCD, so clomipramine's price hikes roiled patients' treatment plans nationwide. (An estimated 1.2% of U.S. adults had OCD in the past year, and about half those cases were classified as "serious.")
The first jolt came May 1, 2013, when Taro's U.S. unit raised its price from 85 cents to $11.24 per dose — more than 1,200% — according to data from Connecture Inc., a health care technology company. In a competitive market, other companies would be expected to try to beat that price to lure customers away from Taro. But that didn't happen.
Instead, according to the lawsuit, executives for Taro were in close communication with their counterparts at Mylan and Sandoz. At least 26 phone calls took place among the three companies' sales executives in the four weeks before Taro's price increase, the lawsuit claims. "During these conversations, defendants Taro, Sandoz and Mylan agreed to raise the price of clomipramine," the states' complaint says.
Within weeks, Mylan and Sandoz raised their own prices from less than $1 per dose to $11.24 per dose — identical to Taro's price — according to Connecture's data.
Instead of competing for market share, the drugmakers worried about being too aggressive, according to the lawsuit, and instead agreed to divvy up certain customers. In August 2013, Walgreens drugstores, a Mylan customer, asked Sandoz to bid for supplying clomipramine. But a Sandoz sales executive shot the ideadown, according to the lawsuit.
A Mylan spokeswoman said company officials have "investigated thoroughly and have not found evidence of price fixing on the part of Mylan or its employees." A spokesman for Novartis, which owns Sandoz, said the company also believes the "cases are without merit." Taro didn't comment.
Clomipramine's new price has meant fatter revenue for its makers, and U.S. taxpayers have paid some of that cost. Medicare, the government-funded program that covers prescription drugs for about 43 million Americans, spent between $3 million and $4 million a year on clomipramine from 2010 to 2012, no more than 40 cents per dose. But since the 2013 price hikes, Medicare has spent about $77 million a year on the drug at $7.42 per dose.
When her son was a high school freshman, Kristin Beauparlant noticed a change.
The hockey player began getting short of breath more easily on the ice. Beauparlant could hear her son's coughing and wheezing from the stands. But it was his demeanor that scared hermost. Cade Beauparlant's anxiety and mood swings worsened, his outbursts so sudden and so explosive that his mother said she came to fear him.
It took more than three years — and help from a renowned pediatrician — to understand what was going on: Her son was addicted to nicotine, delivered by a Juul, a sleek e-cigarette that looks like a USB drive.
As e-cigarettes have skyrocketed in popularity among teenagers in the past two years, pediatricians report seeing teens who behave less like tobacco users and more like patients with substance-abuse disorders.
Some young people have resorted to stealing from their parents or selling e-cigarette paraphernalia to support their habits, addiction treatment specialists said. And even though many teens assume e-cigarettes are safe, some turn up with signs of nicotine toxicity, a condition previously seen in young children who accidentally ingested nicotine gum.
Others are reporting respiratory problems. After more than three years of vaping daily, Beauparlant was diagnosed with restrictive lung disease. His mother said she is working with an attorney to flle a class-action lawsuit against Juul that would force it to set up treatment centers.
"We were thinking about vapes just like we thought about cigarettes. Over time we realized, 'No, no, this is something really different,' " said Sharon Levy, director of the Adolescent Substance Use and Addiction Program at Boston Children's Hospital.
She and other doctors said they think they are witnessing for the flrst time the damage that repeated exposure to high levels of nicotine wreaks on young bodies.
Anecdotal evidence from leading addiction specialists in Boston and New York and from families grappling with adolescent e-cigarette addiction points to previously unseen consequences of use among teens. Several families have sued Juul, accusing it of causing nicotine addiction in their children and describing extreme addiction symptoms.
Doctors said they think the behaviors of teens addicted to e-cigarettes could be linked to their design: Many products, including Juul, allow users to ingest far more nicotine than they would with traditional cigarettes. Concerns over teen use prompted San Francisco to become the flrst major city to ban e-cigarette sales.
"With the Juuls, kids are able to get a much higher dose of nicotine — and dose matters," Levy said. "These kids have behaviors that we often see in patients who have opioid or marijuana addiction, but we didn't typically see with kids who developed addiction to traditional tobacco cigarettes."
A House subcommittee has accused Juul Labs of targeting children and teens, including at schools. Company offlcials said the effort stopped last fall and actually was designed to educate youths about the dangers of nicotine addiction.
Juul has defended the design of its products, saying they were engineered with adult smokers in mind. The company says its own clinical trials show that nicotine is absorbed more slowly through use of its e-cigarette than through cigarettes.
But doctors say teens consume e-cigarettes at far faster rates than they do traditional cigarettes, with some consuming a pod or more a day — equivalent to the amount of nicotine in a pack of cigarettes. E-cigarette vapor does not burn the throat as much as cigarette smoke does, and that makes it easier for consumers to use e-cigarettes more frequently.
In 2018, more than 37% of 12th graders reported vaping at least once in the past 12 months, according to flndings released by the National Institute on Drug Abuse, even though many were too young to legally purchase the products. A year earlier, the flgure was about 28%.
Experts say that teen brains are particularly vulnerable to addiction because they are still developing and that it is easier for teens to fall victim to addictive products because they have less impulse control.
They worry that the chemical will shape the brains of teens, priming their "reward pathways" and making them more vulnerable to other kinds of substance abuse. They worry, too, that many pediatricians lack the expertise and treatments to help young people who cannot quit.
And there are few treatment options for teens addicted to nicotine. While adult smokers seeking to quit have beneflted from nicotine patches and the drug varenicline, better known as Chantix, there is scant evidence that those treatments work for young people, said Jonathan Winickoff, a pediatrician and researcher at Massachusetts General Hospital who treated Cade Beauparlant.
"We have millions of kids now, millions of adolescents who are using mostly Juul — and in some cases other devices — who are unable to quit," Winickoff said. "It's something we don't have the infrastructure to deal with."