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Testy Board Session Leads to 18-Month Jail Health-Care Contract

Santa Barbara County Board of Supervisors approves pact with existing contractor Corazon Health, but calls for other proposals

Ater a two-week delay, Michael Miller, vice president of business development for Corizon Health, gives a presenttation to the Santa Barbara County Board of Supervisors on Tuesday. The board approved an 18-month contract with the company to provide jail health care.
Ater a two-week delay, Michael Miller, vice president of business development for Corizon Health, gives a presenttation to the Santa Barbara County Board of Supervisors on Tuesday. The board approved an 18-month contract with the company to provide jail health care. (Janene Scully / Noozhawk photo)

After several hours of fiery questioning, the Santa Barbara County Board of Supervisors approved a health-care contract Tuesday with a private company that services the county jail, but with a promise to look at other providers in the meantime.

Corizon Health and its predecessor, Prison Health Services, has provided jail health care for the county for almost two decades, and returned this year to ask for a renewal of its contract for the next 10 years. 

The company provides medical, dental and psychiatric care to inmates.

On Tuesday, the board unanimously approved an 18-month contract with Corizon that would end in March 2017. 

A request for proposal, or RFP, process will be started to compare other companies that could provide the services in the jail.

The supervisors also approved a grievance coordinator and a contract monitor to be put in place to make sure needs are being met.

At the start of the meeting, Santa Barbara County Undersheriff Barney Melekian gave a short presentation to the board, saying that the department takes its obligation to provide health care for inmates very seriously.

However, Melekian said the perception that an inmate is receiving poor care, especially by someone close to that person, will trump data every time.

“If someone’s loved one is in custody and there’s the perception they are not receiving health care… That is a problem,” he said.

Melekian said that the department wanted to conduct a study to identify national best practices in order to evaluate health-care service in the jail.

This prompted a round of prickly questions from First District Supervisor Salud Carbajal.

“How can we have a vendor for 20 years and not know that we are meeting best practices?” Carbajal asked. "It just blows my mind."

Corizon’s Michael Miller was on hand to address the board on Tuesday, and told the supervisors that the biggest mistake they could make would be rushing the RFP process to choose a company for the services.

Miller admitted that transparency between the company and the department had not been ideal in the past, and that in the future, “there will be more information that will be shared.”

The company fell below its service goals to inmates in several key areas.

In 2015, the company only met 90 percent of its goal of seeing inmate sick call requests within three days, and ended up seeing most patients within six days.

The company also fell below its 95-percent goal of giving inmates a health appraisal within 14 days of their booking date.

The company maintained both of these shortfalls were due to facility space and staffing limitations, but has since hired a full-time registered nurse to help with health assessments.

Corizon also stated it has added more provider hours in order to answer sick calls in a more timely manner.

Another point of contention was where the jail stands in its process to become an accredited health-care facility.

County staff confirmed that the jail had been accredited by an organization called the Institute for Medical Quality up until 2007, but no one could answer directly why that accreditation had gone away.

The jail reportedly is in the process to become accredited by another organization, the National Commission of Correctional Healthcare.

However, Corizon officials couldn’t confirm when the NCCHC application had been sent in, until Melekian spoke up and said that the department had not submitted it because there is uncertainty whether the could would meet the criteria.

Currently, an exam room is being constructed in the jail, using the space that was formerly used as a broom closet, and “the facilities are incredibly antiquated,” Melekian said, adding that those issues present a challenge to accreditation.

When Corizon’s Harold Orr couldn’t answer how many jails across the state were NCCHC certified, Carbajal pounced.

“If this is your profession, you’re telling me you have no idea what the rate of certification is?” he railed against the company official. “You seem to not have any basic answers… I’m just bewildered by that.”

Orr responded that he knew about Corizon’s certifications, which include one certification, and three in the works across the state.

About a dozen members of the public spoke, most of whom encouraged the supervisors to take a close look at the company.  

Some urged the supervisors to remember that some inmates have mental-health issues and are unable to request care if they need it.

Elizabeth Mason, a local marriage and family therapist, urged the supervisors to think about how former inmate Ray Herrera’s death might have been prevented earlier this year.

“We are not providing adequate health care,” said James Robertson, who has been a volunteer at the county jail for years.

He added that prescriptions are being denied, and there are delays, often up to a month, before medical needs are addressed.

Informal requests for care, known as “kites,” and the formal grievance process are different, Melekian said.

From July 2013 to July 2015, there were 771 grievances filed, and 551 were medical. As for the kites, staff takes them seriously, the undersheriff said.

“They don’t simply vanish into the ether,” Melekian said.

ACLU ombudsmen have been in the jail for years, Melekian said, and that to his knowledge, they’ve never come forward with cases of concern to the department.

Where they have shown up is in the offices of the supervisors, Carbajal confirmed.

“They’ve been in my office consistently making the case which has culminated in today,” Carbajal responded.

“Somewhere it feels like the ball is being dropped,” said Chairwoman Janet Wolf.

The perception of the company isn’t great, but neither are the numbers, she said.

“My level of confidence and trust has not been established. In many ways, it is too little, too late,” she said.

Wolf said she couldn’t support the contract, and knew it couldn’t be changed overnight, so would support a one-year agreement with an outside contract monitor to make sure things were going as expected.

She also asked that the county Public Health Department and ADMHS submit bids in the RFP process so that costs of keeping services “in house” could be compared.

“The Sheriff’s Office has failed to enforce this contract, and it’s really having an impact on both of these parties,” said Supervisor Peter Adam, who recommended an 18-month contract ending in March 2017, and said a grievance coordinator and a contract monitor should be funded by SBSO and Corizon.

“You guys ought to step up to the plate,” Adam said.

Carbajal was the last to speak, saying he felt the discussion went a long way to restoring the public’s trust.

“I’m glad we’re going in the direction we’re heading. Hopefully this means a better day and better care for our inmates.”

Noozhawk staff writer Lara Cooper can be reached at .(JavaScript must be enabled to view this email address). Follow Noozhawk on Twitter: @noozhawk, @NoozhawkNews and @NoozhawkBiz. Connect with Noozhawk on Facebook.

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