Mental-health and medical conditions in the Santa Barbara County Jail have been so bad for so long that even modest gains — eked out over the past 18 months — have provided fodder for a special Grand Jury report, issued late last week. The report’s language was tentative and timid, yet still optimistic.
The decision to fire the jail’s previous health-care provider and hire a new one — California Forensic Medical Group — the Grand Jury concluded, “offers the possibilities for the change that the Sheriff’s Office has sought for many years.” With “an effective working relationship” between the sheriff and the new provider,” the Grand Jury suggested, “the promises of a new mental health and handicapped treatment can be fulfilled.”
Propelling this blandly stated hope are several recent changes born of long-festering pain and exasperation — expressed over the years by a cadre of mental-health advocates — coupled with the threat of a major lawsuit by Disability Rights California, a state-sanctioned nonprofit. Over the years, mental-health advocates regularly regaled county supervisors with horror stories of what happened to the mentally ill people incarcerated in County Jail, but very little happened.
Last February, Disability Rights issued a scathing report accusing the County Sheriff’s Office of stockpiling mentally ill inmates in solitary confinement, putting them in safety cells that lacked beds, toilets, or sinks for excessive periods of time. Disability Rights also charged that inmates weren’t getting their medications in a timely fashion, if at all, and that the County Jail constituted an ongoing assault upon the Americans with Disabilities Act. This got the supervisors’ attention as well as Sheriff Bill Brown’s. No lawsuit has been filed, but Disability Rights has been negotiating operational changes at the jail almost ever since. Those negotiations remain ongoing.
“I was glad to see the Grand Jury looking at the same issues we’re looking at,” said Aaron Fischer, senior counsel with Disability Rights. “I hope the county sees it as an additional motivator.” Fischer said he was heartened by the job California Forensic Medical was doing but cautioned, “It’s still too soon to tell. There’s a lot of work to be done.”
California Forensic started only in April. But already, it’s expanded staffing levels for skilled psychiatric and medical case workers at the jail and significantly reduced the amount of time inmates spend in solitary safety cells by putting them in “step-down cells” instead, after they’ve become less acutely inflamed. In addition, California Forensic has adopted more rigorous inmate screening procedures to ensure they’re given the right medications and that they’re taking them.
Still, there have been a few hiccups. To date, no on-site psychiatrist has yet been hired per the terms of the contract. There’s an acute shortage of psychiatrists nationwide, and the search remains ongoing. One prospective hire reportedly failed a background test; another wanted to start work later in the day than the contract would allow. In the meantime, a psychiatrist is available via teleskyping for 24 hours a week, and twice monthly, the founder of the company — a psychiatrist — makes house calls at the County Jail. On top of that there are two full-time psychiatric nurses and four family therapists. Likewise, the jail remains without a nursing director since the one recently hired left after a day on the job, having not fully understood her job description. Her replacement is expected to start July 13.
Mental-health advocates with Families ACT — always on the alert for official doubletalk — are notably impressed by the initial changes. Alan Bagby, running the County Jail operations for California Forensic, meets regularly with them and is accessible; the exchange of information is good. “They’re really trying to improve things,” said Lynne Gibbs. “And the standards of care have been raised.”
Perversely, it doesn’t hurt California Forensics that its predecessor, Corizon Health, set the bar so low. Only after Corizon left was it discovered that the company had held onto 300 requests from inmates seeking medical or mental-health attention that were never acted upon. Also discovered were about 30 grievance letters that likewise never made it to Lt. Mark Mahurin, a 32-year veteran of the County Jail, who was appointed 16 months ago to serve as the jail’s grievance supervisor.