Finding #1: At the main jail, medical referrals for serious medical conditions are frequently delayed or left unresolved.


Recommendation #1: The Sheriff should review the history of referral requests to the medical services provider and take appropriate action if necessary to ensure that inmates are diagnosed and referred to appropriate medical facilities in a timely manner.


RESPONSE TO RECOMMENDATION #1: The Sheriff’s Department disagrees with the finding in regards to "Medical referrals."


Doctor Edelstein of County Public Health conducts monthly peer review audits of thirty randomly selected jail medical charts from inmates currently incarcerated. These audits are conducted on current inmate records to ensure up-to-date treatment is being received. Doctor Edelstein reports:


"During my monthly chart reviews, I have seen no evidence that the patient/inmates at the SB Co Jail have been denied or had slowed referrals or consultations with outside Doctors, or Clinics, or Emergency Rooms, when indicated. Emergencies are handled appropriately and urgently, and less urgent consultations are arranged for in a timely manner."


Assistant Director of County Public Health, Ms. Tara Brown reviews medical grievances and staffing reports each month. She reports only .2% of all grievances reflect an inappropriate delay in medical health care provided to inmates incarcerated in County adult facilities. Both Assistant Director Brown and Doctor Edelstein question all delays to make certain that appropriate and timely medical care is provided to all inmates.


However, with respect to issues of Mental Health, the Sheriff’s Department does agree there have been problems with referrals, which have resulted in delays, or they were left unresolved. We have reviewed mental health issues with members of the Santa Barbara County Alcohol, Drug, and Mental Health Services Department in an effort to resolve this issue. We believe a shortage in mental health personnel assigned to the jail is the key issue here.


The Sheriff’s Department budget proposal for the fiscal year 1999/2000 addresses shortages in Mental Health personnel assigned to the jail. In addition to the current services provided by Mental Health, this budget provides for a Psychiatric Nurse and increased services from a Psychiatrist II.


Currently, the Sheriff’s Department has developed and implemented plans to centralize housing of inmates with mental health problems in a module made available as a result of recent new cell construction. This new location provides for reasonable access to private and secure interview rooms for consultation with Mental Health workers.


Beyond the 1999/2000 budgetary increases, the County of Santa Barbara was recently awarded a "MENTALLY ILL OFFENDER CRIME REDUCTION GRANT." Funds acquired through this grant will provide resources to administer this program designed to treat mentally ill offenders in an effort to reduce recidivism. Although grant funds must remain separate from current efforts, this grant should have a significant positive impact on mental health issues in the jail over the next year.



Finding #3: The computer system at the New Cuyama substation is not connected to the Sheriff Department’s main computer.


Recommendation #3: The Sheriff should provide resources to immediately connect the New Cuyama substation to the main computer network


RESPONSE TO RECOMMENDATION #3: The Sheriff’s Department agrees with the recommendation from the Grand Jury. However, technology issues have kept the Cuyama Station from being connected to the Sheriff’s Department main computer network until very recently. Through time, the Department has defeated each of these technological obstacles. Within the past month the Sheriff’s Systems and Technology Bureau has tested software that provides security to the County of Santa Barbara Computer Systems. Computer testing of that software through an independent Internet provider is in progress and telephone connectivity to the Internet from Cuyama is under review. We expect that e-mail, the Sheriff’s Records Management System and word processing will work from Cuyama at that time.