Santa Barbara County needs more oversight of its jail health care contractor, which is not meeting basic standards for medical and mental-health services, advocates say.
County leaders hosted a community meeting about jail health care last week that pointed to deficiencies in the system and possible solutions.
“I think something we desperately need is accountability on the Wellpath contract,” Supervisor Das Williams said after the three-hour meeting. “There is the desire to make the system better,” he said, adding that some people have more urgency than others.
Wellpath is paid about $14.7 million a year for medical and mental-health services to people in county jail custody.
The Board of Supervisors has approved two one-year contract extensions, despite concerns about performance.
The most recent extension ended in March and the Sheriff’s Office is negotiating another one-year contract extension with Wellpath, spokeswoman Raquel Zick told Noozhawk this week.
“The most wrenching calls and emails I’ve gotten in my career are from parents of adult children with mental illness who are deteriorating in the jail, and they’re helpless to intervene in what’s going on,” Supervisor Joan Hartmann said.
“We want to prevent that from happening with a broader system of care outside and a better system of care inside the jail.”
Supervisor Laura Capps echoed several advocates, and said the goal is to keep people who are not a public safety threat out of the county’s jails.
Deficiencies in County Jail Health Care System
When the civil Grand Jury investigated four in-custody deaths last year, it found that 24/7 mental-health care is badly needed in the jails, and so is crisis intervention training for custody staff.
A county report revealed that hundreds of people in the county’s jails have significant mental-health issues and need treatment the jail doesn’t provide.
This comes after a class-action lawsuit settlement between the county, the Sheriff’s Office and disability rights groups for “dangerous and unconstitutional conditions” in the Main Jail.
The contractor and the county are not in compliance with the settlement plan, and people in jail are harmed by it, said representatives from CLUE and the League of Women Voters groups that advocate for criminal justice reforms.
There should be clear consequences and financial penalties for shortfalls in required staffing and health care services, said Larry Severance of CLUE — Clergy and Laity United for Economic Justice Santa Barbara.
Some people miss medical appointments because custody deputies aren’t available to escort them from their cells to medical areas, he said.
There are long waitlists for medication-assisted treatment, and the county should expand that program “because that’s a stepping stone back into being healthy in the community,” Severance said.
Custody Commander Ryan Sullivan said the Sheriff’s Office had 223 people go through the MAT program last year, and expects twice as many to participate this year.
The program includes medication and counseling to treat people with opioid-use disorders.
The barrier to more participation is Wellpath and substance-abuse counselor staffing, he said.
Wellpath and the Sheriff’s Office, which oversees jail operations, have blamed low staffing for noncompliance issues, waitlists for care, and not providing additional crisis-intervention training.
“Many of the jail’s problems boil down to inadequate jail staffing,” Sheriff Bill Brown said, adding that his department hasn’t been able to solve that problem.
“Every custody deputy is working an extraordinary amount of mandatory overtime, and it’s having a significant detrimental effect both on individual wellbeing and collective organizational morale,” Undersheriff Craig Bonner said.
“It’s the No. 1 reason custody deputies are leaving. They are burned out.”
Increasing County Oversight
Public Health Director Dr. Mouhanad Hammami said his department is adding positions specifically to oversee jail health care.
A new correctional health adviser physician and quality-care coordinator nurse will serve at the jails for a “more proactive and enhanced way of monitoring the quality of care,” he said.
Behavioral Wellness is going to start daily rounds in the jails, said Dr. Ole Behrendtsen.
Staff get daily updates on patients held in jail safety cells – usually people experiencing a mental-health crisis and/or seen as a danger to themselves or others. Sometimes those people are transferred to the county’s Psychiatric Health Facility, as space allows.
Starting April 15, BeWell staff will also do rounds for general population people in custody with mental-health needs, Behrendtsen said.
Santa Barbara County needs more inpatient mental-health treatment beds so more people can access the treatment they need, said Leonard Marcus, speaking during the meeting’s public comment.
There are only 16 beds in the Psychiatric Health Facility, and the shortage leads to long emergency room mental-health holds and the county spending millions to send people out of the area for treatment.
“We need to spend money on the problem and do something about it rather than throwing money at the problem and having terrible results,” Marcus said.
