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Fred Farris picked up his girls from softball practice on the evening of Thursday, April 7, and headed to the Island County Jail.

He lit a candle there for his boy.

Farris has stood outside the jail, in the rain and sun, countless times during the past year. His message hasn’t wavered: His son didn’t deserve to die, alone and sick, inside a jail cell.

“It doesn’t get any easier, missing our guy. It gets different, but it doesn’t get easier,” Farris said to an Everett Herald reporter. “We are encouraged that Keaton’s story, and those like his, are opening some people’s eyes.”

The Coupeville jail has undergone substantial changes to its medical and mental health services since Keaton Farris, 25, died of dehydration and malnutrition a year ago.

The small jail recently earned praise in an audit by Disability Rights Washington, a nonprofit group that watches out for people living with disabilities.

The group released preliminary findings on April 7 after touring each of the state’s 38 county jails last month. The agency has authority to access jails, prisons, homeless shelters and psychiatric hospitals to monitor the treatment of people with disabilities.

It is estimated that nationwide 40 percent of jail inmates have a disability, such as a brain injury, developmental impairments, mental illness or physical limitations.

The agency’s lawyers and staff and students from Gonzaga University School of Law reviewed jail policies and interviewed inmates and corrections staff to monitor how well jails are meeting the needs of people with disabilities. More in-depth reports are expected in the coming months.

“Jails are unduly burdened with serving those people all others have refused to serve,” wrote the group’s executive director, Mark Stroh.

Jails often are understaffed or operating with insufficient resources, leading to inconsistent and unlawful practices, he added.

“More importantly, it risks or results in serious harm to people with disabilities,” Stroh wrote.

Keaton Farris died April 7, 2015, on the floor of a dirty jail cell. He was suffering through a mental health crisis without access to treatment.

Frustrated Island County corrections officers turned off the water to his cell after he plugged the toilet with a pillow. The officers failed to regularly check on Farris or offer him sufficient water. They failed to seek adequate medical treatment after Farris repeatedly refused food and water. He didn’t get any medication during the two weeks he was housed in Coupeville, despite his family telling jail staff that he suffered from bipolar disorder.

The Farris family was told a nurse was checking on their son. The jail nurse only saw him once — the day before he died. She didn’t go into his cell. She looked in on him through a slot in the door.

The next day Keaton Farris was dead.

Farris had been shuffled between three other jails before being moved to Island County. He was arrested in Lynnwood on a warrant after missing a court date in San Juan County. He was charged with identity theft after allegedly forging a $355 check.

The Lopez Island man’s care was inconsistent between the jails. He regularly saw a nurse and mental health provider during the three days he was housed in the Snohomish County Jail. A mental health professional declined to see him while at the Skagit County Jail.

His medication and medical records didn’t follow him to the Coupeville lockup.

Disability Rights Washington’s statewide jail audit concluded that there aren’t consistent standards for caring for disabled inmates.

State and national organizations offer some standards and accreditation but the state doesn’t require county jails to meet those, beyond constitutional rights, according to the report. Jails are operated by every county in Washington except for Douglas County in Eastern Washington.

Overall the audit found six common problems for inmates with disabilities at Washington’s jails. Those include: inadequate screening to identify people living with mental illness, developmental disabilities and brain injuries; limited access to medication; unnecessary use of solitary confinement; limited access to therapeutic programs; inaccessibility for inmates with physical and sensory disabilities; and lack of access to voting.

“These aren’t true across all jails,” said David Carlson, the group’s director of legal advocacy. “We also found that a lot of jails want to work on these issues.”

Snohomish County Jail welcomes the recommendations, sheriff’s bureau chief Tony Aston said. He’s been overseeing the jail for nearly two years. It is a conversation, he said, that doesn’t belong just in jails.

Jails have become de facto mental health hospitals and detox centers because community resources and responses have been inadequate, Aston said.

Meanwhile he and his staff are focused on continuing to improve medical and mental health services at the jail. They also are working to provide better discharge plans for people living with mental illness and addictions. It is critical that there are housing and treatment plans when inmates are released, Aston said.

“Otherwise, they’ll be right back, and pushing them somewhere else isn’t the answer,” he said.

The statewide audit gave Snohomish County high marks for its mental health services.

“It has more mental health treatment going on than most jails around the state, including a mental health unit,” said Heather McKimmie, the associate director of legal advocacy for DRW.

The audit also found room for improvements, McKimmie said. The agency would like to see more therapeutic programs for people with disabilities and better screening for mental illness. Aston said the jail’s medical director also has recommended more robust screening to determine if an inmate needs special accommodations.

Across the water, auditors praised the Island County Jail for improving policies that affect inmates with disabilities.

Those changes came after Keaton Farris’ death.

Fred Farris and his family reached a $4 million settlement in December with Island County, San Juan and Skagit counties. As part of the agreement, Island County agreed that a corrections expert hired to evaluate the lockup’s operations will monitor the jail for 18 months. He made recommendations in October to improve medical care for inmates, including more attention to those with serious health conditions.

Island County hired two nurses and an advanced registered nurse practitioner. Nurses are now working seven days a week during business hours. The medical director also is on call after hours. Nurses make rounds daily, interacting with every inmate.

“There have been a lot of changes. They’ve been moving pretty quickly in the right direction,” Fred Farris said.

The Whatcom County prosecuting attorney and FBI continue to review the case for possible criminal charges.

“We’re holding our breath,” Farris said. “It’s hard to know where this ends.”

Farris will continue to push for a memorial outside the jail to honor his son. The idea has been met with some resistance, he said.

He wants a permanent reminder to those in the community and to those who work in the jail. His son didn’t deserve to die.