WASHINGTON ― About a week after Milwaukee County Sheriff David Clarke visited the Fox News set in New York to appear on the shows “Outnumbered” and “Fox and Friends,” but before he set sail on a National Review cruise, a court-appointed medical monitor visited the jail Clarke is charged with running.

From Oct. 31 to Nov. 4 ― as Clarke was calling former Secretary of State Hillary Clinton “Mrs. Bill Clinton” on the Kelly File, writing a blog post defending his use of that term, and tweeting that the “renowned” U.S. justice system doesn’t need reform ― Dr. Ronald Shanksy was interviewing staffers at Clarke’s Milwaukee County Jail.

Four people, including a newborn baby, have died at the Milwaukee County Jail since April. One man, a 38-year-old with mental health issues, died of “profound dehydration.” For a facility with a population cap of 960 that previously averaged a couple of deaths per year, the string of deaths is concerning.

During his visit, Shanksy said he was alarmed by the “extremely large number of vacancies” at the facility, particularly for medical positions.

“Questions certainly can be raised about the occurrence of these four recent deaths and the relationship to officer shortages … as well as the health care staffing vacancies and the adequacy of oversight of staff,” Shanksy wrote.

Now Clarke may be overseeing a much larger operation. Clarke was in New York City once again this week to meet with President-elect Donald Trump. He’s reportedly in the running to take over the Department of Homeland Security, and said he would accept a Trump cabinet position if asked.

Clarke’s national profile rose a few years ago when he began making regular appearances on Fox News in late 2014 to talk about policing after the unrest in Ferguson, Missouri, following the police killing of Michael Brown. Since then, he’s made a name for himself by providing a voice for those who want to believe there’s nothing wrong with our criminal justice system and to ignore America’s historic racial inequalities.

Clarke, who grew up in a white neighborhood and attended a mostly white private high school, has said African Americans sell drugs “because they’re uneducated, they’re lazy, and they’re morally bankrupt.” He calls Black Lives Matter “Black Lies Matter” and compared them to the KKK. He once claimed that “police brutality ended in the 1960s.” Clarke made an appearance in July at the Republican National Convention in Cleveland, where RNC delegates gave him a standing ovation as he proclaimed “Blue Lives Matter” and celebrated the acquittal of a Baltimore officer charged in the death of Freddie Gray.

More recently, just ahead of the election, Clarke said it was “pitchforks and torches time” and that it was time to run politicians out of Washington.

Then, after the election, he called anti-Trump protests “temper tantrums” from “radical anarchists” that needed to be “quelled.” There was “no legitimate reason to protest” the election, he declared.

But even setting aside Clarke’s extreme rhetoric, there are serious concerns about whether Clarke is qualified to oversee a massive federal law enforcement agency. Running the jail is one of the main responsibilities of the sheriff’s office, which has limited law enforcement duties in Milwaukee. And there appear to be major problems.

“Sheriff Clarke has time to promote his radical ideas on Fox News, far rightwing radio stations, and other conservative outlets. He has time to blog, tweet, and wrote op-eds to advance his divisive agenda. Yet, while he’s doing all of this self-promoting, his own jail is understaffed in in dire need of leadership,” says Erik Heipt, an attorney for the family of Terrill Thomas, the man who died of dehydration inside Clarke’s jail in April.

“American citizens are dying unnecessarily in his jail, and it would be nice if he could take some responsibility for it and address the problem,” Heipt said.

“The deaths do raise a lot of questions in terms of the training and supervision of people within his department, and they’ve had a lot of staff turnover,” said Peter Koneazny, litigation director for the Legal Aid Society of Milwaukee, who is involved in litigation about conditions in the jail. “We have concerns about the management of the jail, about the overall quality of care and treatment of inmates.”

A recent Milwaukee Journal Sentinel editorial said Clarke’s office had been “shamefully silent” about the deaths and hasn’t provided records regarding outside investigations that the county is legally required to have.

“Maybe Clarke thinks the peasants of Milwaukee County don’t need to know what’s happening at the jail. Maybe he’s hoping for a call from President-elect Donald Trump (for whom he campaigned so eagerly while people were dying in his jail) so that he can walk away from doing his job,” the editorial said.

“Whatever his faulty reasoning, he’s wrong. Clarke owes the public answers about the deaths and about the state of inmate care at the jail. And the public deserves a sheriff who will do his job.”

Heipt says the medical monitor’s report “highlights a dangerous lack of access to healthcare” and deficiencies that left them unable to detect a medical crisis.

“These deplorable conditions may have contributed to a citizen dying of profound dehydration,” Heipt said. “This is inexcusable. If Sheriff Clarke cannot protect detained citizens in his own jail, I’m not sure how he’s going to protect our entire country.”

The medical monitor’s report on the conditions in Milwaukee County Jail said there was a question of whether more careful monitoring in the unit where Thomas died “might have altered the outcome” in his case. The report said Kristina Fiebrink, who died in August, may have been been going through withdrawal but had a scheduled medical visit canceled because she had previously been evaluated during a prior admission.

The report also examines the disturbing case of a newborn infant who was delivered “unbeknownst to the staff” and was found dead:

The report does not examine the death of 29-year-old Michael Madden, who died just days before the medical monitor’s visit. But an inmate told the local Fox station that a corrections officer, believing Madden was faking a seizure and unconsciousness that followed, lifted him up and then released him. “He let Michael go. He fell backwards, he hit his head,” the inmate said.

The Milwaukee County Sheriff’s Office ― motto: “Expect the Best” ― declined to answer questions for this story. Fran McLaughlin, a spokesperson for Clarke, referred questions to a county lawyer. One of The Huffington Post’s questions was about how Clarke responded to the allegation that he was too distracted by his television appearances to fulfill his duties as sheriff.

But by Clarke’s own admission, doing his job while continuing his conservative advocacy is difficult. Last month, before he sat down for a lengthy interview with The Daily Caller, he said he sometimes questioned whether being a prominent conservative voice was worth it.

“It’s a grind,” Clarke said. “It’s all-consuming.”

The interview was posted a day after Madden’s death.