San Francisco County Jails Our Largest Mental Health Facility Needs Attention

Additional Recommendations 3

These recommendations are not explicitly linked to specific findings.

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  Have Case Manager or designee accompany the patient to first continuing care appointment, and assess patient needs to assure future appointment compliance.
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  Set up a meeting of the Community Case Manager with the patient prior to his release, in order to have a visual connection. R.E.2. The Sheriff and the Director of Public Health should request the Controller to conduct a benchmark survey of “release assessment” and other performance measures for mental health services in county jails and suggest best practices for adoption at the San Francisco Jails. R.E.3. The Sheriff and the Director of Public Health should contact appropriate departments in Bay Area universities to determine potential interest in having graduate students analyze performance metrics and prepare reports on mental health services provided in San Francisco Jails. R.E.4. The Sheriff and the Director of Public Health should seek out local mental health organizations, such as NAMI and MHB, for recommendations on mental health services provided in the San Francisco Jails and related reentry services. CONCLUSION San Francisco Jails have challenges due to both the facilities that skew towards old and unsafe and the difficulty of staffing enough to allow for training and rotation without excessive overtime. To deal with these challenges, the Jury recommends improvements in intake/custody transfer, facilities, information sharing, and personnel management ­ especially training. Most importantly, the Jury recommends increased focus on treatment of people with mental illness who end up in our jails. Across the country, there are ten times as many individuals with serious mental illness in our jails and prisons as there are in our state psychiatric hospitals.37 As long as the jails in San Francisco continue to serve as the place for treatment of individuals who commit violent crimes while experiencing mental health crises, there is a need for more behavioral health services in our jails and for discharge and reentry planning that is coordinated with the requisite community mental health services. Kupers, ibid, preface ​ REQUEST FOR RESPONSE A. Jail Intake: Transfer of Custody # FINDING # RECOMMENDATION RESPONDER F.A.1. There is currently no R.A.1.a. Jail intake should develop a Chief Deputy of jail procedure that system to communicate and Custody accounts for those track cases where the triage Operations, arrestees referred for nurse determines that the Director of Jail hospital care. arrestee must be taken to a Health Services hospital for emergency medical or psychiatric care before admission to Jail. R.A.1.b. The SF Police Chief and Sheriff, Chief of Sheriff should revisit their Police MOU regarding transport and custody transfer. # FINDING # RECOMMENDATION RESPONDER F.A.2. Arrestees and their R.A.2. In the interest of obtaining a Chief Deputy of arresting officer may more complete medical history, Custody not always understand the Sheriff and the Director of Operations, the importance of full Jail Health Services should Director of Jail disclosure of medical update Intake policies and Health Services history. practices to seek informed consent to contact and receive records from the arrestee's Case Manager, primary provider, and family or friends who may have information about the arrestee’s medical history and therapeutic medications. # FINDING # RECOMMENDATION RESPONDER F.A.3. When an arresting R.A.3. The Sheriff should review Sheriff agency brings an current Field Arrest Card arrestee to the Jail for content and procedures to intake, there is a field assure that best practices are arrest card. employed, and information necessary for the health and safety of the arrestee and jail personnel is communicated in writing. The information should include circumstances of arrest and any observations or concerns the arresting officer may have about the medical or psychiatric condition of the arrestee. # FINDING # RECOMMENDATION RESPONDER F.A.4. Although the Sheriff R.A.4.a. By early 2017, the Sheriff Sheriff has access to multiple should implement a policy and criminal data bases, the procedure requiring arresting arresting agencies do agencies to provide a digital not necessarily share copy of the arrest report, arrest records with the including charges and a Sheriff’s custody staff description of the arrest, within at the time of custody six hours of the transfer of the transfer. arrestee. R.A.4.b. Once the “share the arrest Sheriff record” process of R.A.4a is in place, the Sheriff should require all arresting agencies to comply with the process. # FINDING # RECOMMENDATION RESPONDER F.A.5. The results of a R.A.5. The Sheriff and Director of Sheriff, Director preliminary psychiatric Public Health, in consultation of Health, City evaluation conducted with the City Attorney for Attorney by Jail Behavioral issues related to HIPAA, Health at intake could should develop and implement be helpful to the a policy for sharing with an arrestee’s long term arrestee’s Case Manager (if mental health care if any), the results of a shared with the preliminary psychiatric arrestee’s Case evaluation conducted at Intake. Manager, if any. # FINDING # RECOMMENDATION RESPONDER F.A.6. Although there are R.A.6 The Sheriff should add to the Sheriff and several ways for family inmate handbook a paragraph Director of Jail members and friends to about the importance of Health Services contact custody staff contacting a family member or regarding concerns friend and should provide a about their loved ones 24/7 number that the inmate who are in jail, models could give to this contact. for improvement are available. B. Facilities # FINDING # RECOMMENDATION RESPONDER F.B.1. In Jail #4, old locks R.B.1.a. The Sheriff should prepare a Sheriff jam frequently, causing supplemental budget request safety concerns. Other for funds to immediately maintenance issues address problems with old continue to arise. locks at Jail #4 and any other remaining serious maintenance issues; R.B.1.b. The Mayor should include in a Mayor supplemental budget request the Sheriff’s request for funds to address the problems with old locks at Jail #4 and any other remaining serious maintenance issues; and R.B.1.c. The Board of Supervisors Board of should approve the Mayor’s Supervisors supplemental budget request for funds to address the problems with old locks at Jail #4 and any other remaining serious maintenance issues. # FINDING # RECOMMENDATION RESPONDER F.B.2. Ending use of Jail #4 R.B.2. The Sheriff should make Sheriff would also require interim plans for replacing
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  Have case manager or ​ designee accompany the the patient to at least the first continuing care appointment and assess patient needs to assure future appointment compliance.