Decades-old cell block becomes modern inmate clinic

Nori Leybengrub, Tribune News Service

What for decades was an eighth floor cell block housing 30-55 inmates in the Norfolk City Jail is now a fully-equipped medical and mental health services clinic, expanding the jail’s ability to meet inmates’ daily medical needs on-site, rather than relying on transport to local hospitals.

In under two years and with over $1.5 million in city funds, construction crews gutted out the concrete showers, steel benches and sinks of the nearly 60-year-old cell block, replacing it with six examination rooms, mental health and telehealth consultation spaces.

Before this year’s renovation, the jail had two examination rooms for hundreds of inmates. Those requiring medical care would wait in line on a metal bench. The goal was to take the kind of care that required two sheriff’s deputies per inmate to spend up to eight hours a day travelling and receiving care at a local hospital and make it available in the new wing.

“It is our hope that this clinic becomes a model for correctional care across the commonwealth,” said Sheriff Joe Baron at a ribbon cutting ceremony on Monday. The new clinic includes biometric medical monitoring equipment, a lab to test blood and urine samples and on-site access to speciality providers in physical and occupational therapy, optometry, gynaecology and more.

Last year alone, nearly 200 inmates needed to be transported to local hospitals — whether for emergency services, scheduled surgical operations, appointments with specialists or routine critical care treatments. Each time an inmate leaves the jail for the hospital, two deputies are required to accompany them — often taking up to eight hours a day in time away from the jail.

In 2025, two inmates needed to travel to a hospital to receive routine kidney dialysis treatment as often as every day. Now with two state-of-the-art dialysis machines in the jail, four deputies are saving hours of time each day. Norfolk’s jail, Baron said, is the only one in Hampton Roads with its own dialysis machines.

Previously, inmates would have to wait weeks for a slot on a physician’s schedule and availability for transport from the jail to access speciality care. Now with access to the telehealth space, patients can more quickly consult with specialists contracted by MEDIKO for issues involving gynaecology, infectious diseases and more.

Erin Topalian, the jail’s director of mental health treatment, used to see patients in a large space shared with several other physical health providers. Now a spacious room — with a bright blue plush rug and a wall decorated with a photo of snow-capped mountains hugging a lake — is devoted to mental health treatment.

All of the jail’s over 670 inmates are Topalian’s patients, she said — whether it’s the 30% who experience severe mental illness, including schizophrenia, bipolar disorder or PTSD, or someone who had a fight, lost a difficult court case or is having a bad day. Over a dozen patients have scheduled consultations every day. Topalian said she notices inmates taking their jail-issued slides off and rubbing their feet in the soft threads of the rug.

“I’m noticing that they are more calm and comfortable,” she said. “The space has made patients more open to speaking with me.” The vast majority — an estimated 70% — of all medical care required for inmates has always been done in-house, said the jail’s medical director and primary care physician Pamela Littles.

She said many patients pre-incarceration lacked access to primary care and therefore have yet to be screened for conditions such as high blood pressure, diabetes and even cancers. Littles said that for some, incarceration is “the only time they have had a physical or received monitoring for certain conditions.”

“We’ve unfortunately detected cancers that hadn’t received treatment before and it can be gratifying to catch it when they come in.”

“Jails in the US turn out to be the urgent care centres of the incarceration industry,” said Kaven Ofogh, founder and CEO of MEDIKO, the medical care provider contracted by the jail since 2023 to fulfil inmate medical services. All of the jail’s healthcare professionals — including Topalian and Littles — are employees of MEDIKO. The correctional health services provider has operated medical services for dozens of jails across the U.S. for 30 years. Ofogh said out of all the jails they work in, Norfolk’s has the highest number of healthcare professionals per inmates. Many inmates, coming from lower socioeconomic statuses and lacking education, have under-diagnosed physical and mental health conditions.

“The urgent care centre can never close 24/7,” Ofogh said. Norfolk is slowly transferring all inmate medical care into the new space, which is expected to be fully operational this summer. While several correctional centres across Hampton Roads have seen major improvements in the 2000s and 2010s, Norfolk’s jail hasn’t had a renovation since Tower 2 was built in the 1990s, said Lt. Col. Janetta Grizzard, who has worked in the jail since then. Grizzard is in charge of all jail operations.

Sheriff’s deputies will still have to take inmates on trips to the hospital for conditions requiring emergency care, such as cardiac arrest. But the new wing is dramatically cutting down on the number of trips they’ll need to take. This, Baron said, will help deputies maintain the safety, security and privacy of all inmates, whether or not they are actively receiving medical treatment.