On prison health care administration

On Tuesday, July 26, the Riverside County Board of Supervisors (Board) voted on staff recommendations in response to a May 11 grand jury report on the administration of prison health care. On May 24, the Board directed staff to prepare the Board’s response to the grand jury’s recommendations regarding Riverside County Mental Health Detention. The Sheriff’s Department filed a separate, but largely concurring, response. Both the Board’s and Sheriff’s responses found many points of agreement with the findings. Differences were generally the result of funding and intra-departmental organizational issues.

Key findings of the grand jury identified deficiencies with medical and psychological screening at time of prisoner intake; delays in accessing medical care, both with mental health evaluation and medication administration; problems with timely transfers of inmates to Emergency Treatment Services and the Detention Care Unit; timely medication orders for prisoners with mental health problems; the absence of a designated “treatment facility” to administer court-ordered antipsychotic medication to inmates identified as incompetent to stand trial; timely transfer to a state mental hospital of those inmates found to be incompetent to stand trial; timely transfer of inmate information packets to the state mental hospital; adequacy of mental health staffing at all county jail facilities; hand-carrying of mental health records of prisoners between facilities; and faulty or inadequate policies regarding involuntary medication of inmates and mental health discharge planning.

In a separate letter to the presiding judge who convened the grand jury, Riverside County Sheriff Stan Sniff noted that his Department, “… generally concurs with the findings of the grand jury and has been outspoken on the need to remedy these issues over the last two years.”

Sniff noted that as budgets worsened during fiscal year 2010-11, he asked the state’s Corrections Standards Authority to evaluate county mental health services in the county’s jails to see if they met the state’s regulations for prisoner rights and requirements.

Sniff referenced a May 24 meeting with the Board of Supervisors, County Executive staff, Sheriff’s Department and Forensic Mental Health staff, where it was recommended and subsequently agreed to restore, as an interim fix, funding for prisoner mental health to the 2008-09 funding levels.

“The Sheriff’s Department believes that this issue is now well on its way to being remedied and that we can once again comply with Title 15 [the state legislative code section] jail requirements,” Sniff said in his response.

Sniff had previously asked that funding levels to the Mental Health Department be restored or that his department be given funding to administer mental health services directly. Sniff had long noted that state law tasked his office with prisoner care, but did not give him direct supervision over the services through which that care was provided. “Finally, the single remaining issue is to establish a Memorandum of Understanding between Forensic Mental Health Services and the Sheriff’s Department identifying the level of service to be provided by Forensic Mental Health Services, so that [these] issues do not arise again,” he said.

Sniff wants that memorandum to establish accountability for “responsibilities and appropriate levels of service and staffing necessary to ensure continuity in the delivery of humane care.” Sniff pointed out that his department is working with the Board to correct the problems noted by the grand jury.