“People are thrown into the snake pit,” Santa Barbara County resident Kate Smith said about the jail and the county’s mental health care system during public comment at a recent special meeting.
“You can talk about this year’s crop of buckets we could shoot people in to help, [but] it’s no different,” Smith said. “I don’t mean to be down on you people, but it’s time we formed that movement to create a mental health system for our loved ones.”
Smith was one of the several public commenters at an April 3 Santa Barbara County jail health care special meeting held at Direct Relief in Santa Barbara. Panelists from the Santa Barbara County Department of Behavioral Wellness, the Sheriff’s Office, jail health care provider Wellpath, the League of Women Voters, and Clergy and Laity United for Economic Justice discussed jail health care improvements and ongoing health care needs after several 2023 Santa Barbara County grand jury reports found deficiencies in the jail’s current system.
Concerns about how to keep Wellpath, the county’s jail health care provider, accountable echoed throughout the day. Santa Barbara County pays Wellpath $14.7 million annually to provide medical and mental health services, but the contract doesn’t require monitoring to ensure Wellpath is providing those services, nor does it lay out any consequences if Wellpath fails to do so.
“We’ve got some good public accountability, but as long as the sheriff is paying out a 12th of the yearly contract every month no matter how much staffing there is, I wouldn’t call that accountability. I think the contract needs to be changed,” 1st District Supervisor Das Williams told the Sun.
Santa Barbara County isn’t alone in facing jail health care challenges or its issues with Wellpath. The private company oversees health care operations at more than 550 facilities throughout the U.S. and Australia, according to the company’s website, and has faced thousands of jail health care-related lawsuits, including in neighboring Monterey County, according to Monterey County Weekly reporting.
Monterey County and Wellpath faced a 2013 lawsuit over inadequate care at its jail, which was settled in 2015 and ordered the Monterey County Sheriff’s Office, the county, and Wellpath to comply with higher medical, mental, and dental health care standards.
However, a recent court order found the county and Wellpath were noncompliant with the settlement agreement, hitting 80 percent below its benchmark for health care standards during its first round of audits in 2017, and 26 people died since the settlement, according to the Weekly. Wellpath didn’t respond to the Sun’s request for comment.
Statewide, inmate deaths are increasing, with more than 2,700 people dying in California jails since 2005, as jail populations are decreasing, according to CalMatters reporting.
“Oftentimes people who are in jail struggle with personal challenges in life that many people outside don’t. They experience a lot of trauma in their childhood years and as adults,” Sheriff Bill Brown said. “I think often people jump to conclusions that people die because they are in jail, and that’s not the case.”
While Santa Barbara County’s jail health care services have improved since replacing its previous provider—which landed the county in a class-action lawsuit and settlement agreement to make improvements in the jail’s facilities—Supervisor Williams said that there needs to be adequate health care staffing levels to provide all needed services. Either that, or the contract should lay out that the county only pays for the services it actually receives.
“I definitely hope that the meeting gave the sheriff some negotiating power, some negotiating strength by showing Wellpath that the county is united in getting to a better place,” Williams said. “Any contract that comes before the Board of Supervisors is not a done deal, meaning we will scrutinize it.”
Nearly 60 percent of the inmate population qualifies for a mental health caseload placement, and more than 13 percent require specialty mental health care, according to county documents. However, Wellpath does not provide 24/7 mental health coverage at either of the jails, leaving a gap from 11 p.m. to 7 a.m. that the Sheriff’s Office is still trying to address, Custody Cmdr. Ryan Sullivan said during the April 3 meeting.
A 2023 county grand jury report that investigated an inmate’s suicide found that Wellpath did not share the inmate’s mental illness history with custody staff, which could have informed staff “to make more effective classification and program decisions,” according to the report.
The county also saw an increase in inmate grievance reports, which are complaints submitted by inmates with medical, dental, and mental health-related concerns. More than 1,600 grievances were filed in 2023, jumping from 1,292 in 2020 and 931 in 2021, according to the staff report. The Sheriff’s Office received the most grievances in 2022 with 1,692.
Of the 1,646 filed grievances in 2023, 275 dealt with medical concerns, 119 with access to medications, 38 for mental health, and 27 with dental. Each grievance category saw an increase over the five-year average—with a 35.7 percent increase in mental health grievances, 33.1 percent in medical, 45.6 percent in medications, and 42.1 percent in dental, according to the grievances report.
“We feel that we shouldn’t have the number of grievances we have, and some are reflections on things that need to be improved,” Santa Barbara County’s National Alliance on Mental Illness (NAMI) Public Policy Chair Lynne Gibbs told the Sun.
Gibbs serves on the Community Corrections Input Group, which formed in 2016 and suggests grievance process and jail mental health care system improvements.
“Our utmost priority is that they have 24/7 mental health coverage so that someone is available during a mental health crisis during the night. That’s our primary ask, and the sheriff has indicated that he’s trying to do that,” Gibbs said.
Sheriff Brown told the Sun that the Sheriff’s Office is in negotiations with Wellpath for a one-year contract extension that will expire April 2025 and will go before the Board of Supervisors for final approval. Following the extension, the county plans to go to a request for proposal process where other organizations, including Wellpath, can come forward to present jail health care plans to the county.
“There are a lot of aspects that need to be confidential, but I can say to you that we are working on increasing the role of [county] Public Health and Behavioral Wellness, both who are presently involved in reviewing and evaluating Wellpath’s provision of service, but there will be an expansion of that,” he said.
Public Health Director Mouhanad Hammami said during the April 3 meeting that the department is enhancing its auditing tool to look at time limits and “the appropriateness in the way health care is processed,” and adding a correctional health advisor position to work with the Sheriff’s Office to monitor the quality of care.
Behavioral Wellness Director Toni Navarro told the Sun that the department was scheduled to start providing Wellpath with rounds on April 15 to help with overnight staffing needs as part of its overnight crisis response team. One team will be stationed out of either the North or South County jail and a clinician in the other to help respond to jail crises along with calls from the community.
“We will do as much as we can do. We also have staffing challenges in the overnight hours. It’s one of the emerging issues of the overnight staffing of the mobile crisis benefit,” Navarro said. “This is an overnight crisis team for the whole county. If they are responding to a crisis in the community, that is a priority because they are not in a secured facility.”
Reach Staff Writer Taylor O’Connor at [email protected].
