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November 30, 2020
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So. Co. Behavioral Health and Health Services in the county jail

August 9, 2019

The Sonoma County Civil Grand Jury recently released two reports related to their review of the County’s Behavioral Health Division (BHD) 2018-2019 budget and an inspection of the Jail’s Main Adult Detention Facility (MADF) health care resources and services.

The jury commended the Sheriff’s Office for doing a job “it was not designed to do and doing so competently.” This includes providing inmates with opportunities for adult education and implementing a Jail-Based Competency Restoration program. Health care-related concerns include: a need for improved treatment of certain communicable diseases, increased nursing staffing in the booking area and better discharge coordination with health care providers. They serve an inmate population that is older, sicker and/or more likely to live with a mental illness. This is a partial consequence of California’s 2011 Realignment Bill, which shifted some responsibilities for individuals convicted of low-level felonies from the state to counties. As a result, the needs for medical, dental, mental health and substance use care have dramatically increased within the MADF. The Grand Jury noted that the MADF was scheduled for inspection in May 2019. 

The jury reported that the BHD’s current leadership is making substantial efforts to address these factors; state and federal funding remain insufficient to meet needs; and despite the circumstances requiring serious staffing reductions, BHD employees continue to provide quality services. The Grand Jury examined the BHD original $19M budget shortfall for 2018-2019 (eventually reduced to $10m) which led to a reduction in staffing and identified the following contributing factors: a lack of budgeting, auditing and oversight policies and procedures; an incomplete electronic medical billing and claim system resulting in lost revenues; and operational costs at the Crisis Stabilization Unit that exceeded revenues.