County Santa Barba Bill Brown Stations*

Under the existing agreement between the County and WellPath, Santa Barbara County does not provide mental health professional care onsite in the Jails from 11 p.m. to 7 a.m. Sheriff's Office Response: Agree. <b>Recommendation 1</b> That by the end of the second quarter of FY 2023-24, Santa Barbara County amend the existing agreement between the County and WellPath to provide Jail inmates, in both the north and south facilities, with overnight (24/7) mental health professional onsite services. <b>Sheriff's Office Response</b>: This will not be implemented. The Sheriff's Office relies on a recent (April 26, 2023) analysis of WellPath Health and Mental Health Services entitled, "SANTA BARBARA COUNTY SHERIFF'S OFFICE JAIL HEALTH SERVICES STAFFING REVIEW" conducted by Avocet Enterprises. In their review, the experts did not indicate that additional coverage for Mental Health services was required as the Grand Jury suggests.

WellPath medical staff do not receive advanced training on mental health crisis intervention, which can be critical in circumstances when mental health staff are not on duty or not otherwise available and is required under a federal court order. Sheriff's Office Response: Disagree partially with an explanation. WellPath disagrees that there is any causal relationship between the training of its staff and patient JT's unfortunate death, which was determined by the medical examiner to have been accidental and due to somatic medical causes, including morbid obesity, dilated cardiomyopathy, acute methamphetamine intoxication, and active resistance. WellPath does not oppose providing additional mental health training to jail medical staff. WellPath does provide all staff with mental health-specific training at hire and annually after that. While this training does include suicide prevention and risk reduction, we are always looking at ways to improve staff training and appreciate the Grand Jury's focus on this issue. <b>Recommendation 2a</b> That by the end of the first quarter of 2023-24, Santa Barbara County amend the existing agreement between the County and WellPath (or its successor) to provide all medical staff with advanced 40-hour mental health crisis response training. Sheriff's Office Response: Requires further analysis. WellPath will work to create more in-depth training for medical staff, which will include de-escalation techniques and crisis intervention. WellPath's Regional Mental Health team will develop this. This proposed training program will not replace the annual mental health training provided at hire and will supplement existing training. The hours needed to train staff will be determined by the regional team. We aim to develop this training by the end of the first quarter 2024.

The majority of the Santa Barbara County Sheriffs Office custody staff hired pre-2021 have not been provided 40-hour mental health crisis response training. Although the Santa Barbara County Sheriff's Office offers an advanced mental health 40-hour training course for members of its patrol co-response teams and for Santa Barbara County Sheriffs Office custody staff recent hires, it does not mandate this for custodial staff hired before 2021. Sheriff's Office Response: Disagree partially with an explanation. The Sheriff's Office continually offers advanced mental health 40-hour training for co- response and certain other patrol and allied staff. Custody staff hired since 2021 have each received 40 hours of CIT training in their Core basic training course. In addition, some other patrol, custody, and dispatch staff have received additional advanced mental health training from 8 to 40 hours. <b>Recommendation 3</b> That by the end of the first quarter of FY 2023-24, Santa Barbara County and Santa Barbara County Sheriff's Office provide funding so that the Sheriff's Office implement effective advanced mental health crisis response training consisting of at least 40 hours of instruction and annual refresher training consisting of at least eight-hours for its custody staff. <b>Sheriff's Office Response</b>: Will not be implemented. All custody deputies hired since 2021 have received and all newly-hired custody deputies are receiving 40 hours of mental health crisis training in their Core academy. Due to present staffing levels and substantial financial constraints, we are unable to offer this training at the moment. In the event that funding becomes available, the Sheriff's Office will proceed with additional advanced mental health training for pre- 2021 custody staff as staffing levels permit.

Lawfully shared data collection and analysis among multiple Santa Barbara County law enforcement agencies (Santa Barbara County Sheriff's Office, Santa Barbara County District Attorney's Office, Santa Barbara County Public Defender, Santa Barbara County Probation Department), the municipal police departments in Santa Barbara County (Guadalupe, Lompoc, Santa Barbara, and Santa Maria), mental health (County. Behavioral Wellness) and public health (County Public Health) agencies would provide relevant county personnel with better tools to effectively serve community members with mental health illness. Sheriff's Office Response: Agree <b>Recommendation 5</b> That by the end of the first quarter of 2024 Santa Barbara County, the Santa Barbara Sheriff's Office, Santa Barbara County District Attorney's Office, Santa Barbara County Public Defender, Santa Barbara County Probation Department, and all local municipal city councils with police agencies (Guadalupe, Lompoc, Santa Barbara, and Santa Maria), mental health (County Behavioral Wellness), and public health (County Public Health) agencies adopt relevant recommendations for more effective data sharing in the referenced San Diego Association of Governments (SANDAG) study. Sheriff's Office Response: Agree The County has a committee dedicated to sharing data amongst the criminal justice partners and public health and behavioral health agencies. They report their progress regularly to the Board of Supervisors. We will present the Grand Jury's

The Santa Barbara County Sheriff-Coroner investigation and the District Attorney's Office review of the medical cause and manner of JTs death that left the Jury with questions: a) whether within reasonable medical certainty, the custody staff's use of on-stomach prone restraint and JVs vigorous resistance to it was the direct cause of DTs cardiac arrest; and b) whether the custody staff followed Santa Barbara County Sheriffs Office training policies when they employed the on-stomach prone restraint hold on JT. Sheriff's Office Response: Disagree wholly. In this case, the Sheriff's Office concurs with the forensic pathologist's finding of JT's cause of death, which he opined was due to the five factors: morbid obesity, dilated cardiomyopathy, acute methamphetamine intoxication, active resistance, and restraint. His opinion is that all five of those factors acted in synergy, and he emphatically believes that any one of them (i.e., physical restraint, as questioned by the Jury) cannot stand alone as the primary cause of death. <b>Recommendation 6</b> That the County of Santa Barbara and the Sheriff-Coroner's Office request an independent review from the State Attorney General of all facts and circumstances leading up to the death-in-custody of JT, and any legal consequences that result from that review to include the following questions: 1. Whether within reasonable medical certainty, the custody staff's use of on-stomach prone restraint and JVs vigorous resistance to it was the direct cause of DTs cardiac arrest; 2. Whether the custody staff followed Santa Barbara County Sheriff's Office training policies when they employed the on-stomach prone restraint hold on JT. <b>Sheriff's Office Response</b>: Will not be implemented. As previously stated, the Sheriff's Office concurs with the forensic pathologist's finding of JT's cause of death, which he opined was due to the five factors: morbid obesity, dilated cardiomyopathy, acute methamphetamine intoxication, active resistance, and restraint. His opinion is that all five of those factors acted in synergy, and he emphatically believes that any one of them (i.e., physical restraint, as questioned by the Jury) cannot stand alone as the primary cause of death. Additionally, on October 6, 2022, District Attorney Joyce Dudley concluded that the physical force used by custody deputies to restrain JT prior to his accidental death was reasonable and lawful, and that they bear no criminal liability.