A Disability Rights NC Report on NC’s Failure to Regulate Dangerous Jails

Executive Summary

North Carolina’s (NC’s) 109 jails confine thousands of people with disabilities each year. The people of North Carolina rely on elected Sheriffs to provide safe and humane conditions in the jails. NC laws establish minimum standards (the “Jail Rules”) that jails must operate by – but do they follow these rules? And what consequences do jails face when they don’t?

Disability Rights NC (DRNC) conducted an investigation of NC jails’ compliance with the Jail Rules, and the state’s oversight and enforcement of the Rules. We found that far too many jails don’t follow the Rules and that the oversight system we rely on is under-resourced and ineffective. Weak enforcement of the Jail Rules by an extremely short-staffed state investigative team at the Department of Health and Human Services (DHHS) allows North Carolina’s jails to remain open, despite dangerous and sometimes deadly conditions.

Our analysis revealed that nearly 40 percent of the jails failed every inspection for the three-year period from 2017-2019. In addition, state inspectors with DHHS’ Division of Health Service Regulation (DHSR) cited over half of the jails for the same failures in supervision, capacity, fire safety, and construction/ sanitation issues, over and over again. Although regulators require the jails to submit plans to correct violations of the Rules, the deficiencies often go uncorrected. As you will read, several people have died in these chronically non-compliant, dangerous jails, and based on DRNC’s preliminary analysis of the most recent data (2021 – 2022), the hazards are unrelenting.

Further, new state laws that took effect this year at the urging of the NC Sheriff’s Association severely hamper the state’s already-compromised ability to enforce compliance with critical minimum standards.  Sheriffs can now appeal safety findings without having to make any changes during the lengthy appeals process which can take months, and even years. These long delays will further erode the capacity of DHSR to provide meaningful oversight and enforcement of the Jail Rules. This new law also strips transparency from the inspection and compliance process, making it even more difficult for communities to hold their elected sheriffs accountable for dangerous jail conditions.

At any given moment, between 17,000-19,000 people are awaiting trial or serving low-level criminal sentences in North Carolina’s local jail and detention facilities. There is no disagreement among law enforcement officials that people with disabilities are over-represented in our jails. NC’s abject failure to adequately invest in community-based mental health services means many people go untreated and end up in crisis, instead of receiving much needed care and treatment. With scant community mental health resources, these people often end up in jail.

Experts widely accept that the jail environment exacerbates mental health disabilities, heightens vulnerability, and increases the risk of self-harm and suicide.[2]  A conservative estimate based on data from the state reveals that more than 60 percent of individuals in NC jails have a “behavioral health condition.” Because people in jail with intellectual or developmental disabilities, traumatic brain injury, physical disabilities, and undiagnosed conditions are omitted from this estimate, the actual number of disabled persons in jails is likely much greater. Compounding this crisis, many jails lack proper resources to effectively support mental health and other disabilities, exacerbating the dangers of confinement.

Dangerous conditions in NC jails are pervasive, endangering the lives of thousands of incarcerated people and jail staff. Unsafe conditions in jails also affect the greater community. Families and loved ones are harmed by the diminished wellbeing of incarcerated individuals and jail staff. As we learned throughout the pandemic, our lives are interconnected. Ninety percent of people in jails return to our communities, and it benefits all if they return as healthy as possible.


State regulators found and documented numerous instances of lax jail operations and dangerous conditions, yet allowed jails to remain open in spite of repeated citations for failing to correct dangerous operations. Examples include:

  • Four people died in Rowan County Jail from 2017-2020. DHHS investigators found missed supervision rounds and severe overcrowding in the jail during this time. These deaths were attributed to overdoses, medical reasons, and suicide. Loss of life was not inevitable. Experts agree more frequent supervision rounds and less crowding prevent deaths.
  • Between 2017-2021, eight incarcerated people died in the Edgecombe County Jail, including four who died by suicide while state regulators repeatedly cited the jail for failing to supervise people as required by law. The autopsy of one of the men indicated guards saw paper covering his cell window but did not check on him. Following another suicide in which jail staff had been warned by a doctor not to leave the individual alone, the person was put into an isolation cell and “review of the documented supervision rounds found that officers were not actually making their rounds; and…that in fact, the officers were doing other activities.”
  • In 2018, an incarcerated person died in the Richmond County Jail, which was overcrowded at 130 percent capacity. From 2014 to 2020, DHHS inspectors repeatedly cited the Richmond County Jail for dangerous overcrowding. This jail remains one of NC’s most overcrowded jails, continuing to endanger incarcerated individuals and staff.
  • State inspectors repeatedly cited the Carteret County jail for overcrowding during every inspection from 2017-2019. Census reports since then and into 2022 show the jail continues to operate well over-capacity with no consequence, even after state regulations were updated to require jails to move people out of overcrowded jails and into facilities with available beds.
  • Over a three-year period, the state allowed the Orange County jail to remain open despite repeated citations for storing combustible materials in the main electrical room, not maintaining the jail’s sprinkler system up to code, and dangerous overcrowding conditions.
  • In the Ashe County Jail, DHSR documented that staff falsified fire drills at the direction of jail leadership. Staff also falsely documented supervision rounds. Staff told inspectors in 2017 that quarterly fire drills were never performed.
  • DRNC found that fifteen jails didn’t fail a single inspection during the period of review. In an additional thirteen jails there was just one inspection where jail regulators found one or more problems, and in these instances, jail administrators took quick action to correct the issues, showing that the minimal standards set forth in the Jail Rules are reasonable and can be easily met.

These findings are shocking and clearly demonstrate the need for swift attention and action.

Since 2017, DRNC staff have issued public reports about the alarming, rising number of deaths by suicide  and overdose/withdrawal in NC jails. DRNC also issued a public report about a design flaw in a State program that financially rewards some NC jails for operating overcrowded jails. This report is a continuation of DRNC’s work investigating the safety of NC’s jails.

NC’s jail population is needlessly large, yet DRNC’s multiple reports and appeals to sheriffs and legislators to improve conditions in NC’s jails have gone largely unheeded – with devastating consequences.

DRNC recommends the following changes in state regulation of jails:

  • Regulators need more tools, including fines and the ability to require immediate corrections. This helps ensure that jails are not permitted to repeatedly fail inspections without making corrections. DHSR inspectors of hospitals, group homes, and adult care homes have these tools
  • Increase the number of DHSR jail inspectors. Currently, a three-person team is responsible for conducting twice-yearly inspections at each of the state’s 109 jails, in addition to providing technical assistance and investigations into complaints and deaths. House Bill 841 (2021) would have added two Jail Inspectors and a Facility Compliance Consultant to DHSR, allowing for improved follow-up and technical assistance. That bill did not pass, and DHSR remains understaffed.
  • Improve DHSR regulation using the existing system. When necessary for the protection of health and life, DHSR and DHHS must use their existing powers to ensure the safety of people incarcerated in our jails, as well as jail staff.
  • Increase transparency about the operations of, and dangerous conditions in, NC jails by allowing the public to easily access information online about their local jails, including inspection reports, jail death investigations, and population levels; and by requiring jails to report the number of attempted suicides and other events resulting in physical and psychological harm. Currently, only deaths are required to be reported. Legislation like House Bill 841 (2021), which would have required jails to report attempted suicides with follow up by the NC DHHS, must be enacted.

DRNC’s Jail Inspection reports detail human suffering and preventable deaths. These are critical safety issues for disabled people in our jails and communities, and their loved ones. The very lives of people who are incarcerated or work in these facilities depend on an oversight system that ensures their safety and the safety of the broader community. DRNC demands meaningful reform to improve safety in NC jails.