Santa Barbara County privatized its mental health system for jail inmates in mid-2009, and as part of that move, handed oversight of inmate services from the county’s Alcohol, Drug and Mental Health Service Department to a private company.
But a recent grand jury report recommending an audit of Corizon, formally called PHS Correctional Healthcare, to determine its performance to date was rejected by the county Board of Supervisors at its Oct. 4 meeting.
The report released in May examined mental health services available to the mentally ill, uninsured and homeless individuals who cycle in and out of jail. It states that the jail system, where much of the county’s health-care treatment begins, lacks resources to address the problem and recommends improving overall management of resources to improve the situation.
“The jury believes the cost of jailing and tending to the medical needs of these individuals on an ad hoc, recurring basis is greater than the cost of a planned and sustained effort that addresses their problems at the outset,” the report stated.
The jury gave the county credit for endorsing the 10-Year Plan to End Homelessness, a blueprint that – along with the cities of Santa Barbara, Goleta, Lompoc and Santa Maria – the county is using to curb a rise in homelessness among the mentally ill. But the jury raised concerns about the absence of licensed professionals to provide inmates with mental health screening during booking at the county’s main jail near Goleta (where more than a quarter of the inmates are taking psychotropic drugs).
The board’s response to this finding stated the contract with Corizon never required mental health screening during booking, but noted that Sheriff Department staff who oversee booking have received training to identify those with mental health issues.
Many of the jury’s recommended changes were acknowledged by the board but ultimately rejected because of budgetary constraints. Instead of an audit, Second District Supervisor Janet Wolf asked that the Sheriff’s Department regularly report to supervisors on Corizon’s performance.
“This is a private company that we’re outsourcing our health services to, and we need to know what’s going on,” Wolf said. “The board needs to be updated on those meetings, whether it’d be quarterly or every six months.”
The report also recommended that the board and Sheriff Bill Brown prepare a cost analysis of converting a proportional number of jail beds into licensed treatment beds for the mentally ill. It suggested the county look into establishing an out-patient treatment center for the mentally ill indigent and homeless at the Santa Barbara Juvenile Hall facility or other locations in the county.
ADMHS Director Ann Detrick was frank about her department’s inability to provide services to moderately mentally ill people who lack insurance.
“There are a number of people who don’t have any insurance who may have a depression, but it’s not life-changing for them, even though it needs to be treated,” she said. “There are many needs there that are not met among people who don’t have insurance, and we simply don’t have the resources to meet all those needs.”
She also noted that the department’s Crisis and Recovery Emergency Services unit is staffed weekdays from 8 to 5 p.m., but is understaffed during the weeknights and during the weekend. Although the board’s response letter pointed out that financial constraint at the county and state levels made some of the recommendations unfeasible, Supervisor Doreen Farr and Wolf urged Detrick and the Sheriff’s Department to look for funding sources, particularly grants.
Farr contended that the inadequate or no treatment for the mentally ill not only causes problems for the individuals, their family and friends, but also costs the county money in the long run. “If these people end up in jail, we’re paying for them through the whole jail and court system, so what is the cost of that?” she said. “From a purely fiscal standpoint, the county is already spending a lot of money when we could be spending a lot less and take care of these people in a much better way.”
Detrick said some of her staff has received training to help those who suffer from mental illness to apply for medical and Social Security income. “That project is underway right now. We have 70 people enrolled,” she said. “We’re seeing successes there in helping people get the benefits they’re entitled.”
The county will move forward on a recommendation for the county CEO to compare the current annual costs of jailing mentally ill homeless people with the costs of providing housing, medical and psychological services, case management, outpatient care and other services. The process is expected to take four months.
In other county news, on Tuesday the board unanimously agreed to continue its redevelopment agency, which uses property taxes to subsidize development projects, build affordable housing, revive rundown buildings and give streets face-lifts. But that decision will cost the county $1,953,000. Thereafter, it must pay the state $495,000 every year.
The county is among 398 redevelopment agencies statewide that were faced with the decision of eliminating their agencies or paying the state what some call “ransom” to keep the agencies going. Last summer, Gov. Jerry Brown, approved a two-bill budget package to save $1.7 billion by eliminating the nearly 60-year-old funding system.
The county Board of Supervisors on Aug. 9 decided that the county should become the successor agency, even though the California Redevelopment Association and others are challenging the constitutionality of ABX1 26, which abolishes all redevelopment agencies effective Oct. 1, and ABX1 27, which allows RDAs to continue if the county makes an initial one-time payment and continued annual payments to the state that would go to local governments and schools to restore funding the state can no longer foot.
Until the Supreme Court rules, redevelopment agencies cannot enter into any new contracts. The court has stayed the two bills, but the matter is still pending and a ruling is expected in January. The court could uphold both laws, one or none.
Survey: Buellton, Solvang obey tobacco law
Although sales of cigarettes to minors in Santa Barbara County are alarmingly high, stores in Solvang and Buellton are obeying state law, according to a recent undercover survey.With the help of local law enforcement, the Santa Barbara County Health Department conducted an operation – carried out by undercover decoys – showing that 17% of the 275 stores were willing to sell tobacco to minors. This is nearly three times the statewide average of 6%, according to Dawn Dunn, Tobacco Prevention Program administrator for the Health Department.
Sales rates varied across the county. Lompoc topped the list with a rate of illegal tobacco sales to minors at 31%. Santa Barbara, Goleta, Carpinteria, Guadalupe and unincorporated parts of the county also surpassed the state rate at 18% and 19%. Meanwhile, Solvang and Buellton had no sales to decoys of tobacco products. This means from last year, sales in Lompoc doubled from 14%, while they dropped from 40% in Buellton and 25% in Solvang.
Last year, the county enacted a new tobacco ordinance that strengthened the state tobacco licensing law by increasing compliance checks, increasing the penalties for violations, doing away with a warning letter for the first offense, and imposing a $435 annual fee to cover the cost of enforcement, which includes educating store owners and personnel about the amended law.
Federal law requires store clerks to check the identification of every customer who appears under 27 who attempts to buy tobacco products. Clerks caught in stings conducted by law enforcement are faced with a $200 fine for the first offense, $500 for the second and $1,000 for the third. Store owners can also be disciplined.
More than 75% of smokers took their first puff before age 18, one-third of teens who begin smoking will die prematurely of tobacco-related illnesses, and 15% of 11th grade students in the county are current smokers, according to the Health Department.
“It takes time for new regulations to have the desired impact,” noted Dawn Dunn, Tobacco Prevention Program Administrator for the Public Health Department. “There is definitely a learning curve here. We’ve seen this in other communities around the state. Several cities are now looking at adopting the new tobacco ordinance, so we’re optimistic that sales to minors will decline in future years.”
For more information about youth access to tobacco or tobacco retail licensing, contact Dunn at 681-5407 or dawn.dunn@sbcphd.org.