Santa Barbara County’s jail health care provider charged the full amount for years, even as the company failed to meet staffing minimums, and the Sheriff’s Office paid it anyway, according to a Grand Jury report.

Staffing shortages, late reports and the “accounting shortfalls” were detailed in the Santa Barbara County Civil Grand Jury report released last week.

Wellpath is not supposed to be compensated for unstaffed shifts in clinical positions, according to its county contract. When it misses more than 2% of staffed hours, Wellpath is supposed to reduce its invoice amounts to the county accordingly.

Even with known staff vacancies, there were no credits or deductions in the monthly invoices for 2021, 2022 or 2023.

“These invoices were submitted to the Sheriff’s Office and were approved for payment in full,” the Grand Jury report said. Both parties are supposed to track contractor staffing.

“Unlike the financial department in the Juvenile Probation Department, which has noted vacancies, the Sheriff’s Office has not brought the missed hours that exceed the 2% rule to light,” the Grand Jury report stated.

It’s unclear how much money should have been credited to the county over the years of the contract.

“One estimate provided to the Jury was that in 2023 the credits would have been approximately $135,000,” the report said.

Sheriff’s Office staff told the Grand Jury that custody deputies are not trained in financial accounting. However, the Sheriff’s Office does have a bookkeeping/accounting department, and the Grand Jury recommended that those staff “provide accurate oversight to ensure proper entries of credits coupled with transparent deductions in payments.”

The “accounting shortfalls” could have been intentional leniency, because of Wellpath’s work increasing health care staffing and services as part of a civil case settlement, according to the Grand Jury.

Report Recommends More Staffing, More Training, Penalties for Late Reports  

“Staffing shortfalls negatively impact services provided,” the report stated.

The Sheriff’s Office should add more jail health care positions in the next contract and higher compensation to attract staff, the Grand Jury recommended.

Wellpath and the Sheriff’s Office should expand staff training for mental health and crisis intervention, according to the report.

The 2023 Grand Jury report recommended 24/7 mental health staff, but this group stated that more training and better intake screenings could address the problems.

“Recognition at intake of a mentally unstable inmate is key to mitigating negative mental health consequences, thereby lessening the need to have an underutilized mental health provider 24/7,” the report said.

Psych nurses work at the jail daytime shifts five days a week and a staff psychologist is on site once every two months, and is on call for telehealth visits the rest of the time.

The county should insist on timely annual reports and impose financial penalties when it’s tardy, the report recommended.

Wellpath’s 2022 annual report was seven months late and presented to the Board of Supervisors in December 2023.

The Board of Supervisors and Sheriff’s Office must respond to the report in 60 days. The written responses will address whether they agree with the findings, and what they plan to do about the recommendations.

Read the full Grand Jury report here.

County, Wellpath Contract Negotiations Underway

The Grand Jury frequently reports on the county’s detention facilities, including the Main Jail, Northern Branch Jail and juvenile hall.  

This report comes as the Board of Supervisors and advocates are calling for more accountability of the jail health care contract, and as the Sheriff’s Office is negotiating a one-year contract extension with Wellpath.

The previous one-year extension ended in March.

Santa Barbara County used Public Health for Main Jail health care until 2009, then contracted with Corizon Health from 2009 to 2016. The county has contracted with Wellpath since 2017.

Wellpath is paid about $14.7 million a year for medical and mental health services to people in county jail custody.