San Luis Obispo County Juvenile Hall Adopts Positive Behavior Methods what behavior is expected, what behavior is

The use of PBIS with our incarcerated youth teaches them the criteria of demonstrating safe, responsible and considerate behavior as adults. COMMENDATIONS The SLOCJH and the SLOCOE are to be commended for their cooperative effort in implementing a research-based method of behavioral improvement into JH. This method has the long-term potential to positively impact the prosocial behavior and general culture of youth while in JH. REQUIRED RESPONSES “This is an information report. No responses are required.” Presiding Judge Grand Jury Presiding Judge Jacquelyn H. Duffy San Luis Obispo County Grand Jury Superior Court of California P.O. Box 4910 1035 Palm Street Room 355 San Luis Obispo, CA 93403 San Luis Obispo, CA 93408 2 019-2020 San Luis Obispo County Grand Jury Final Report 26 San Luis Obispo County Juvenile Hall Adopts Positive Behavior Methods APPENDICES, ATTACHMENTS, BIBLIOGRAPHY, GLOSSARY AND SUGGESTED READING Bradshaw, C.P. (2013). Preventing Bullying through Positive Behavioral Interventions and Supports (PBIS): A Multitiered Approach to Prevention and Integration, Theory Into Practice, 52:4, 288-295, DOI: 10.1080/00405841.2013.829732 Cook, Clayton R.; Frye, Megan; Slemrod, Tal; Lyon, Aaron R.; Renshaw, Tyler L. & Zhang, Yanchen (2015). An integrated approach to universal prevention: Independent and combined effects of PBIS and SEL on youths’ mental health. School Psychology Quarterly, Vol 30(2), 166- 183. Cooper, J.O., Heron, T.O. & Heward, W.L. (2019). Applied behavior analysis. Hoboken, NJ: Pearson. Horner, R. H., & Sugai, G. (2015). School-wide PBIS: An example of applied behavior analysis implemented at a scale of social importance. Behavior Analysis in Practice, 8(1), 80–85. https://doi.org/10.1007/s40617-015-0045-4 Simonson, B. & Sugai, G. (2013). PBIS as Prevention for High-Risk Youth in Alternative Education, Residential, and Juvenile Justice Settings. Education and Treatment of Children., Vol. 36, No. 3. Simonson, B., Britton, L., & Young, D. (2010). School-wide positive behavioral support in an alternative school setting: A case study. Journal of Positive Behavioral Interventions. Vol. 12, No. 3. 180-191. 2 019-2020 San Luis Obispo County Grand Jury Final Report 27 This page intentionally left blank. 2 019-2020 San Luis Obispo County Grand Jury Final Report 28 PSYCHIATRIC HEALTH FACILITY: A REVIEW OF BEHAVIOR PATTERNS INTRODUCTION/PURPOSE The State of California requires county grand juries to inspect all jails and prisons within their county on a yearly basis. Since incarcerated persons may be sent to the Psychiatric Health Facility (PHF), this facility is now routinely inspected. It is noted that the PHF is actually a medical facility and not a part of our county’s jail system. In this report, the 2019-2020 San Luis Obispo County Grand Jury documents the results of our inspection of the County’s PHF. AUTHORITY The issuance of this report is authorized under investigative powers of the Grand Jury pursuant to California Penal Codes § 919, 921 and 925. The San Luis Obispo County Psychiatric Health Facility (PHF) is a hospital facility licensed by the California State Department of Health Care Services (DHCS) and is located at the former San Luis Obispo County General Hospital complex. San Luis Obispo County Health Agency oversees the facility. The PHF is licensed to serve 16 patients at any one time from 72 hours to 14 days. The PHF serves: • Individuals who may be involuntarily detained due to indications of a mental disorder or indications they may be harmful to themselves or others. (Welfare and Institutions Code §5150); • Persons in custody of the county jail who are charged with a misdemeanor, but who have been determined to be incompetent to stand trial, are treated for restoration to competence so they can participate in legal proceedings. (Penal Code §1370); • Conserved individuals (gravely disabled and permanently housed elsewhere) who are in need of stabilization. 2 019-2020 San Luis Obispo County Grand Jury Final Report 29 Psychiatric Health Facility: A Review of Behavior Patterns SUMMARY The Grand Jury toured the PHF facility and interviewed staff members as part of its routine inspection. A primary staff concern was the transfer of inmates from the county jail (Penal Code §1370). It was reported that sheriff’s deputies transport these inmates to the PHF and leave after signing off. According to PHF staff, jail transfers may be violent and pose a security problem for PHF personnel who are not law-enforcement trained. During the inspection Grand Jurors inquired as to the general frequency of behavior problems. Grand Jury members learned of staff concerns regarding a variety of physical altercations among inmates, who are now patients, despite patient checks that occur every 15 minutes 24 hours per day. Data reflecting recorded behavior problems were solicited. These data are normally collected as part of standard procedure. The San Luis Obispo Board of Supervisors approved a contract (August, 2019) for additional security staff. The Grand Jury wanted to determine whether the additional personnel would positively impact the data reported for January - October, 2019, and requested follow-up data following the hiring of additional personnel. DEFINITIONS FOR THE FOLLOWING CHART • Assaulted: This would be categorized as an act by one person on another causing perceived injury. An example would be one person being struck on the left side of their head by another person with a right closed fist. • Assaultive: This would be an act by one person on another of physical contact, attempted physical contact or threat when the ability is credible that would lead to injury. An example would be a person picking up a chair and swinging it like a club toward another person. • Destructive/Vandalism: This would be any damage to property. An example would be a person breaking a fire sprinkler in the ceiling causing a flood leading to tens of thousands of dollars in damage to the building. • Staff Injury: A staff member experiences pain during an event. An example would be staff members physically contain an aggressive person who is attempting to hit others. During the containment, the employee suffers neck pain. 2 019-2020 San Luis Obispo County Grand Jury Final Report 30 Psychiatric Health Facility: A Review of Behavior Patterns • Penal Code (PC) §1370/Welfare and Institutions Code §4011 Clients: Clients who have been sent from the County Jail to PHF for stabilization. • All Other Clients: Clients who may be involuntarily detained due to indications of a mental disorder, or indications they may be harmful to themselves or others. Data reflecting altercations occurring between January and October, 2019 were as follows: Period 1 – Prior to additional security January – October, 2019 1370/4011 Clients Total All Other Clients Total All Clients Total Assaulted 0 Assaulted 2 Assaulted 2 Assaultive 6 Assaultive 10 Assaultive 16 Destructive/Vandal. Destructive/Vandal. Destructive/Vandal. Staff Injury 5 Staff Injury 2 Staff Injury 7 Total 14 18 32 Data reflecting altercations occurring between November, 2019 and July, 2020 were as follows: Period 2 – Following additional security November 15 - July 01, 2020 1370/4011 Clients Total All Other Clients Total All Clients Total Assaulted 2 Assaulted 4 Assaulted 6 Assaultive 11 Assaultive 17 Assaultive 28 Destructive/Vandal. Destructive/Vandal. Destructive/Vandal. Staff Injury 2 Staff Injury 1 Staff Injury 3 Total 20 30 50 2 019-2020 San Luis Obispo County Grand Jury Final Report 31 Psychiatric Health Facility: A Review of Behavior Patterns Given the different number of days in each period, incident data are most accurately reported as rate data, or number of incidents per day: Period 1: January – October, 2019: N Rate 303 days Assaulted 2 0.01 Assaultive 16 0.05 Destruction 7 0.02 Staff Injury 7 0.02 Total 32 0.11 Period 2: November, 2019 – June, 2020: N Rate 235 days Assaulted 6 0.03 Assaultive 28 0.12 Destruction 13 0.06 Staff Injury 3 0.01 Total 50 0.21 Rate data presented in graph form: Average Incident Rate Per Day 0.25 0.21 0.2 0.15 0.12 0.11 0.1 0.06 0.05 0.05 0.03 0.02 0.02 0.01 0.01 0 Assaulted Assaultive Property Staff Injury TOT Destruction Jan '19-Oct '19 Nov. '19-Jun -'20 This data indicates an increase in the rate of overall incidents from Period 1 (January, 2019) to Period 2 (November, 2019 - June, 2020) 2 019-2020 San Luis Obispo County Grand Jury Final Report 32 Psychiatric Health Facility: A Review of Behavior Patterns The following factor must be considered in interpreting this data and its accuracy: • Given the frequency of turnover in the PHF client population, the degree of variability in behavior of the clientele may vary considerably from one time period to the next, making direct comparisons difficult. For example, staff reported during November - December, 2019, two extremely violent individuals were on site, necessitating a disproportionate amount of staff involvement, and possibly affecting the data reported for that general time period. • Staff injuries decreased despite increased incidents in other areas. The accuracy of this data was confirmed by PHF at a subsequent interview with GJ members. The data appears to be an accurate reflection of behavior patterns during Period 2. This suggests the addition of an estimated 2.1 - 3.62 full-time equivalent (FTE) staff had minimal effect on overall reported behavior patterns. It was the expectation of PHF supervising personnel that four FTE security would be hired, trained, and on duty by late fall, 2019. PHF staff report that since January, 2020, at least two additional (FTE) additional security guards have been on duty, and as of the last interview with PHF staff (July, 2020) current strength was at 3.62 FTEs. Staff indicated there has been considerable turnover with the newly funded security guard positions since hiring began in October, 2019. The turnover in both staff and client population makes drawing any correlations between the effectiveness of additional staff and reported incidents problematic. FINDINGS