Changes at the El Paso County jail meant to decrease deaths were on display this week as Sheriff Joe Roybal led county commissioners on an annual walk-through of the facility.

The El Paso County jail has received scrutiny over recent deaths in which inmate families have alleged neglect from the facility. In 2022, 11 people died in custody, including 18-year-old Dezaree Archuleta whose suicide prompted a federal lawsuit and a $1 million settlement with the county.

In the past two months this year, two more inmates have died while in custody. In September a 22-year-old inmate was found unresponsive in his cell after a presumed suicide attempt. He died later in an area hospital from his injuries. On Oct. 7 a male inmate with a terminal illness died in the jail’s medical housing unit according to the Sheriff’s Office.

In a presentation to commissioners, Roybal said that jail deaths come from natural causes, suicides and drug overdoses. He said the jail had taken steps to avoid all three this year.

“I set different expectations,” he said.

In January, the Sheriff’s Office switched medical providers from WellPath to VitalCore. One of the largest immediate differences between the providers, Roybal said, was in intake medical refusals.

Refusals require an arresting law enforcement officer to take a suspect to the hospital instead of allowing the person to enter the jail. According to Sheriff’s Office statistics, the jail only refused 19 people in 2022 out of all intakes.

Roybal said that the jail refused “no one” in 2019, and that several people had died during the intake process before they entered the jail. The new medical refusal criteria implemented by VitalCore has led to 178 refusals so far in 2024, a more than 800% increase from two years ago and a 173% increase from 2023.

Roybal said that the changes have garnered attention from hospital staff and ire from some law enforcement officers, who spend more time transporting suspects.

“I’m responsible for a jail,” said Roybal. “I’m not responsible for a patrolman just because they’re late for lunch.”

He said that the change in providers has also brought jail medical and mental health providers together to collaborate on inmate cases. In a walk-through of the facility, Roybal highlighted a new workspace where inmate care providers share cubicles.

The sheriff said the jail was also focusing on lowering the number of inmates incarcerated awaiting court-ordered competency evaluations from the Colorado Mental Health Hospital in Pueblo. As of August, there were 432 inmates for whom the issue of mental competency was raised. Dozens still await evaluation in the jail, some for more than a year.

To address a backlog of mental health cases, Roybal said he was bringing in state hospital evaluators to do their work at the jail to avoid the necessity of transporting inmates to a hospital chronically low on available beds.

The sheriff also told commissioners he was working with the 4th Judicial District Attorney’s Office to prosecute cases where inmates bring drugs into the jail, one of the causes he cited for deaths. In one case he highlighted, an inmate overdosed after taking drugs from another. The smuggler was convicted and given a lengthy prison sentence.

The jail has implemented an amnesty policy for any drugs surrendered during the intake process.

“Turn in your drugs to avoid additional charges!” reads multiple signs in the intake facility.

“We are very, very vocal about our amnesty program, and what will happen if you bring drugs into the jail,” he said.

The jail has also discontinued a program that allowed “trustee” inmates to work outside the facility at certain job sites after Roybal said an investigation found one of those inmates had smuggled drugs back into the jail.

Inmates can now only work in food service at the jail in exchange for commissary dollars.