Wellpath Contract Services Provided to Santa Barbara County and the Sheriff's Office

Conclusions 1

• CL1
  Ensuring access to timely and appropriate healthcare for all detainees and inmates in the County jails is a fundamental human right. Adherence to accepted standards within the framework of the correctional system can effectively deliver such care. Wellpath, the privately held corporate healthcare provider, and their staff work collaboratively with the Sheriff’s Office staff. Both 2023-2024 Santa Barbara County Grand Jury 9 entities maintain a positive working relationship and jointly strive to meet or exceed established standards, but they sometimes fall short of achieving all contractual requirements. The Jury’s recommendations are intended to assist in the formulation of and compliance with an improved contract among the chosen healthcare provider, the Sheriff, and the County Board of Supervisors.

Commendations 5

• CM1
  Wellpath/Sheriff staffing shortfalls at the Santa Barbara County jails occurred frequently, which could lead to delayed healthcare provision to the inmates.
• CM2
  A lack of accounting within the Sheriff’s Office did not acknowledge Wellpath staffing shortfalls which exceeded the agreed upon 2% vacancy level for which credits should have been applied.
• CM3
  There is an absence of Wellpath 24/7 mental health providers at both County Jail sites.
• CM4
  The annual Wellpath report to the Board of Supervisors has routinely been delayed.
• CM5
  All Wellpath staff members exhibit integrity, compassion, and a willingness to be the very best healthcare providers they could be. The Sheriff custody deputies demonstrate dedication and sincerity in their mission of safeguarding the public while concurrently providing care to persons incarcerated. Findings and Recommendations Finding 1 Wellpath/Sheriff staffing shortfalls at the Santa Barbara County jails occurred frequently, which could lead to delayed healthcare provision to the inmates. Recommendation 1a The Sheriff’s Office shall include more healthcare positions in the upcoming 2024 contract. Recommendation 1b The Sheriff’s Office shall institute higher initial compensation to better assist recruitment of qualified healthcare staff in the upcoming 2024 contract. Recommendation 1c The Sheriff’s Office shall negotiate for competitive incentive programs in the upcoming 2024 healthcare contract. These would include signing bonuses, retention bonuses, enhanced benefit packages, transportation allowances, or other housing assistance packages commensurate with the high housing costs in Santa Barbara County. Finding 2: A lack of accounting within the Sheriff’s Office did not acknowledge Wellpath staffing shortfalls which exceeded the agreed upon 2% vacancy level for which credits should have been applied. Recommendation 2a For the balance of 2024, prior to end-of-month invoice submission from Wellpath, financially knowledgeable Sheriff custody staff shall work with the Wellpath Health Administrator to examine, concur, and record any staff vacancies that exceed the 2% limit. Recommendation 2b This agreed upon vacancy credit shall be clearly delineated in Wellpath’s end-of-month billing invoice. 2023-2024 Santa Barbara County Grand Jury 10 Recommendation 2c The bookkeeping/accounting department in the Sheriff’s Office shall provide accurate oversight to ensure proper entries of credits coupled with transparent deductions in payments. 2d: The Board of Supervisors shall require Public Health Department resources to carefully oversee and regularly report on performance measures and Contractual Agreement adherence. Finding 3 There is an absence of Wellpath 24/7 mental health providers at both County Jail sites. Recommendations 3a The Sheriff’s Office shall instruct Wellpath to expand in-depth training for nursing staff to better recognize and address both potential and existing mental health issues and crises to be initiated by the end of December 2024. Recommendation 3b The Sheriff’s Office shall expand in-depth training of all custody deputies to better identify potential and existing mental health issues and crises to be initiated by the end of December 2024. Recommendation 3c The Board of Supervisors shall ensure the presence of a Behavioral Wellness crisis team adjacent to the jail facility ensuring the presence of trained crisis response team members in the nighttime hours (11 p.m. – 7 a.m.) to be initiated by the end of December 2024. Recommendation 3d The Sheriff’s Office shall instruct Wellpath to conduct a thorough assessment of the accessibility and benefits of telepsychiatry, focusing on optimization of this service in the nighttime hours (11 p.m. – 7 a.m.) to be initiated by the end of December 2024. Finding 4: The annual Wellpath report to the Board of Supervisors has routinely been delayed. Recommendation 4a The Board of Supervisors shall immediately insist on the timely generation and submission of annual reports. Recommendation 4b The Jury recommends that the Board of Supervisors impose penalties in payments when annual reporting extends beyond the 60-day end of the contract year. Requirements for Responses: Pursuant to California Penal Code §933 and §933.05, the Grand Jury requests each entity or individual named below to respond to the Findings and Recommendations within the specified statutory time limit. Santa Barbara County Sheriff: 60 Days Finding(s): 1, 2, 3 Recommendation(s): 1a, 1b, 1c; 2a, 2b, 2c, 2d; 3a, 3b, 3d 2023-2024 Santa Barbara County Grand Jury 11 Santa Barbara County Board of Supervisors: 90 days Finding(s):1, 2, 3, 4 Recommendation(s): 1a, 1b, 1c; 2d; 3c; 4a, 4b Responses to Findings shall be either: - Agree - Disagree with an explanation - Disagree partially with an explanation Responses to Recommendations shall be one of the following: - Has been implemented, with a summary of the implementation actions taken - Will be implemented, with an implementation schedule - Requires further analysis, with an analysis completion date of fewer than 6 months after the issuance of the report - It will not be implemented with an explanation of why 2023-2024 Santa Barbara County Grand Jury 12

Agency Responses 2

Government agencies' official responses to this report's findings and recommendations. Click on a response to see the structured breakdown.