📋
Extracted from Consolidated Report
This investigation was originally published as part of a larger consolidated report containing multiple investigations. View the consolidated PDF for the complete document.
Santa Cruz County Grand Jury
• 2007-2008
• Front St., Inc., 11 beds • River Street Shelter, 20 beds reserved for people referred by County Mental Health
⚠️ Translation Notice: This content has been automatically translated. The original English text is the official version. Translation may contain errors.
⚠️ Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.
Note: Missing finding numbers detected: F45, F46, F47, F48, F49, F50, F51, F52, F53, F54, F55, F56, F57, F58, F59
Findings 48 findings
F1
Page 61
Santa Cruz County governmental agencies (with the exception of Scotts Valley) have joint powers agreements with Net Com specifying how emergency calls are routed for fire, police and medical assistance. Net Com then routes calls to the appropriate authorities for response.
F2
Page 61
Net Com assigns emergency calls a priority rating from one to nine, one requiring the most urgent response. The calls rating and the case details are reflected on the mobile data terminal in all squad cars.
F3
Page 61
The County’s only booking facility is at the Main Jail in Santa Cruz so all law enforcement officers must transport arrestees there. Approximately 13,000 persons are booked at the Main Jail each year. This often results in overcrowding in the Main Jail 51 2007–2008 Santa Cruz County Grand Jury Final Report booking area and delays for the law enforcement officers. The officers must wait and cannot return to other duties until the arrestee has been processed through the system. Response from the County: AGREES.
F4
Intake process: • All squad cars and persons are monitored via video surveillance as they enter the vehicle sally port (an enclosed area secured by locked doors at each end, only one of which can be opened at any one time). • Officers then lead suspects through a pedestrian sally port and into the booking area. • Officers of the same gender pat down the suspects and complete the suspects’ health intake questionnaires. • For medical reasons, the facility nurse may refuse suspects admittance to the jail. If refused admittance, they are taken directly to Dominican Hospital. Upon receiving medical clearance from the hospital, suspects are taken back to the Main Jail to complete the booking process. • An audio and video recording is made of the booking and kept in storage for a period of two years.
F5
Page 62
After walking through a metal detector, suspects are put into a group holding cell. Special needs arrestees and women are kept in separate cells. Intoxicated arrestees are put into the jail’s “drunk tank” for a minimum of five hours. If intoxication prevents them from standing or communicating coherently, they are taken to a local medical emergency room for detox. A violent arrestee is placed in a restraint chair in a private safety cell with two large viewing panels and checked every 15 minutes.
F6
Page 62
At the start of the booking process all personal property, except one shirt, a pair of pants, underwear, and socks, is taken from the detainee, labeled and stored either in the jail’s property room or a valuables locker. These items are returned when the inmate is released.
F7
Page 55
The Grand Jury commends Sutter Maternity & Surgery Center for providing the services of medical specialists to those in need. Medical Staff Recruitment and Salaries 2000-2001 Grand Jury Recommendation 11: In the recruitment of health care professionals, salary surveys conducted in nearby agricultural counties are no longer pertinent to this County. In the next round of County salary negotiations, surveys should be conducted that use counties more comparable to the emerging characteristics of Santa Cruz County. County Response: The County has utilized the nine-County comparison for over thirty years, and this long-term base of information is useful in evaluating salaries. The nine- County comparison is used as a guide along with other information such as the Consumer Price Index, turnover statistics, recruitment and retention rates, the relationship between positions within the County, changes in classifications, and operational changes. Other jurisdictions are also surveyed, as appropriate. 2007-2008 Grand Jury Findings
F8
Page 56
The Grand Jury commends the Health Services Agency for the innovative way it has succeeded in providing quality health care to county low-income residents despite financial limitations.
F9
Page 62
Newly housed inmates can shower and must change into jail-issue clothes. Personal clothing is labeled and stored with the rest of the inmate’s property. Money in the possession of the suspect at the time of arrest is posted as a credit to a personal jail account. Main Jail 2007–2008 Santa Cruz County Grand Jury Final Report
F10
Page 63
Each inmate is issued a kit, which includes clothing, bedding, utensils, and hygiene items.
F11
Page 63
Prior to admittance, a nurse performs a medical review of each inmate, including taking vital signs. A doctor is on call if needed.
F12
Page 63
In March 2008 the Sheriff’s office implemented a new fingerprint picture system called the Automated Fingerprint Identification System (AFIS). This system includes photographs, palm print and fingerprints of a suspect. The AFIS system provides positive identification of a suspect throughout the intake process and interfaces with the state mug shot system. In the near future a pilot project will be implemented making AFIS available to law enforcement officers on squad car monitors.
F13
Page 63
Those arrested for drug or weapons offenses, or suspected of hiding drugs or weapons, may require body inspection. This procedure – a visual, non-contact search must be approved by a supervisor and performed by a correctional officer of the same gender. For this type of inspection, the Sheriff’s Office recently constructed a separate room to ensure privacy. Those refusing to cooperate are x-rayed. If x-rays reveal contraband, approval is then secured through a court order and the person is taken to Dominican Hospital for removal of the contraband.
F14
Page 63
After voters approved Proposition 69 in November 2004, the Sheriff’s Office implemented a new procedure requiring all convicted felons to submit a DNA sample. A cheek swab sample from offenders is sent to the Department of Justice for processing and inclusion in the State database. Staffing
F15
Page 50
The County’s mental health program is active and in good hands and is continually adapting to the changing needs of the community.
F16
Page 50
The Division works well, has effective coordination with many nonprofit organizations in the county, and maintains a constant effort for structural improvement.
F17
Page 50
Financing mental health programs is a continual struggle. Clients sometimes have problems finding appropriate services because they do not meet the funding requirements. Mental health staff strive to find creative ways to match client needs in spite of restrictions placed on various funding sources.
F18
Page 50
The Division recognizes cultural issues in treating county mental health patients. This perspective is important to ensure the effective delivery of services because cultural issues may make that more difficult, such as when families feel embarrassed by a member with a mental illness and may not acknowledge it as a legitimate health problem.
F19
Page 50
Effective programs have been developed that recognize the importance of family relationships. Both children and adults are treated. Establishing more peer counseling is a priority.
F20
Page 50
A comprehensive approach is the most pressing need in the system. Along with counseling and medication, affordable housing, tenured living spaces, and job development are all necessary for proper treatment.
F21
Page 54
While all “safety net clinics” are not geared toward families, they are putting forth their best efforts to meet the various needs of the uninsured and Medi-Cal patients in Santa Cruz County.
F22
Page 54
Santa Cruz County needs to recruit more specialists and internists because of the increase in the number of elderly patients with complex health problems. A Promise Kept 2007–2008 Santa Cruz County Grand Jury Final Report Commendation
F23
Page 55
The Health Services Agency is able to recruit adequate medical staff and negotiate appropriate wage and benefit packages under very difficult circumstances. A Promise Kept 45 2007–2008 Santa Cruz County Grand Jury Final Report
F24
Page 56
The County has found innovative ways to meet the medical needs of low-income residents through grants and creative staffing. Anticipated budget cuts threaten this tenuous balance, but the Grand Jury believes that the County is going to be able to continue to provide a basic level of staffing to meet the minimal needs of low-income residents. Commendation
F25
Page 65
According to Titles 15 and 24, inmates must have individual cells, a group day room, and a group patio area. Title 24 requires 35 square feet of floor space per inmate in the dayrooms and tables and seating to accommodate the maximum number of inmates allowed at any given time. Due to the overcrowding at the facility, these requirements cannot always be met.
F26
Page 65
Showers and bathrooms are located in each of the units. The 2005 State report indicated many of the bathroom and shower areas were “filthy, as are the majority of the cells, which are cluttered with paper and leftover food from meals.” In 2006, the Sheriff’s Office spent $99,000 on remodeling and mildew removal in one of the shower facilities at the Main Jail. The 2007 State Inspection report indicated shower areas and individual cells were in compliance with Title 24 standards. However, County Environmental Health Services completed an annual evaluation in 2007, and the jail was granted an environmental health clearance with the exception of the shower areas, which the report indicated are still in need of repair. In November 2007, two female jurors on an unscheduled visit to one of the women’s housing units inspected H unit shower area, the community bathroom and an inmate cell. These areas were found to be clean and in good condition. In December 2007, two male jurors on an unscheduled visit inspected the men’s housing units E, F and Q and found the shower, toilet areas and the individual cells clean but not tidy. In March 2007, two female jurors on an unscheduled visit inspected the G unit shower area. They found it to be badly in need of repair with toilet paper stuffed around the shower head, and the entire shower and the walls in the adjacent dressing room area covered with water. Mold and the smell of mildew were also present. Inmates have complained that some of the shower areas have small flies that swarm inside the shower and bugs that come up from the drain.
F27
Page 65
Each inmate is responsible for the cleanliness of his/her housing area including the showers. Floors must be swept and mopped daily. All inmate privileges are withheld until the housing area is clean. This is a non-directed activity. Correctional officers provide each unit with a mop, bucket with water and cleanser on a daily basis (or more often if requested) to clean the floors and shower areas. Periodically a stronger disinfectant is provided to alleviate bacterial growth in the shower areas. Response from the County: AGREES.
F28
Page 65
The heating, ventilation, and air conditioning system (HVAC) is aging and outdated and does not provide consistent heating and cooling throughout the facility. Some areas of the jail are very cold while others are too warm. Maintaining the HVAC system is the responsibility of the General Services Department (GSD). Its response Main Jail 55 2007–2008 Santa Cruz County Grand Jury Final Report to the Sheriff Office concerns has been slow, repairs take too long, and, to date, the problems have not been corrected. Response from the County: AGREES. The Main Jail at 259 Water does not have cooling in the inmate housing area. The heating system was designed with an occupancy load for a much lower population. To meet the current air changes for the increased population, more outside air needs to be introduced to the facility that will in turn create a higher heating load for the building. The existing equipment was not designed to maintain the increased load which results in heating inconsistencies in the building. As for the response time, the work order data base shows that General Services responded either the same day or the next working day to reported problems.
F29
Page 66
Many inmates have filed Inmate Request Forms (green slips) about being too cold or too hot. No sweaters are allowed in the jail. Two thin cotton blankets are allowed in the summer and three in the winter. Additional blankets must be requested via a green slip. Correctional officers determine if an additional blanket will be issued. It is rare for an inmate to receive more than the allotted number of blankets. According to inmates, correctional officers confiscate any additional blankets they find.
F30
Page 66
As a result of the fire marshal 2007 inspection, the facility was granted a fire and life safety clearance.
F31
Page 66
While there are no outside windows in the inmate housing units, the front of each has windows facing a central area where the correctional officers are located. The central command area has dimmed red lighting so the officers can see into each of the well- lighted housing units. Food trays and medicine are dispensed from this central area through openings in the main door of each unit. This type of detention facility in which no correctional officers are located within the inmate housing areas is called a “podular design” system. Such a configuration contrasts with a direct supervision detention facility in which the correctional officers are located directly in the inmate housing areas.
F32
Page 66
In 2005, a computerized program was established to monitor inmate classification, housing movements and disciplinary actions. The Sheriff’s Office Detention Bureau hopes to replace that system with a comprehensive jail management system in the next two years that will integrate the current classification system with medical, commissary, food, and inmate records management (currently located across the street in the county building). To date no funding has been secured for this project.
F33
Page 66
Department 11 of the Santa Cruz Superior Court handles the drug cases and is now located at the Main Jail. Fifty to 100 inmates are taken from their cells to court each week in shackles and chains. Having drug court located at the Main Jail has eliminated the need for transport to the county court house on Ocean Street and has facilitated a more efficient handling of drug cases.
F34
Page 66
Policies and procedures are in place to ensure the facility’s security, but it is an ongoing concern for the staff. Last year, two inmates attempted unsuccessfully to escape. Main Jail 2007–2008 Santa Cruz County Grand Jury Final Report Inmate Services
F35
Page 67
Inmates may see visitors in one of the five visiting rooms during visiting hours. All visits are audio recorded. Inmates and visitors are separated by a wire and plexiglass barrier. Inmates must complete a visitor request form before any visits will be allowed. Staff must pre-approve all visitors before they are scheduled. The inmate’s visitor lists can be updated only once every 30 days from the date the original list was completed.
F36
Page 67
Professional interview rooms are available 24 hours a day for the inmates and their attorneys or the clergy. To preserve client confidentiality, no recordings are made in these rooms.
F37
Page 67
Each of the housing units has a secure outdoor area for basketball, handball and exercise. Board games, cards and puzzles are also available. Newly released movies are rented from Swank distribution for monthly movie viewing.
F38
Page 67
Other services available include television (both Spanish and English from 7 a.m. to 11 p.m.) and a limited selection of paperback books. Inmates may purchase any book or periodical accepted for distribution by the U.S. Post Office. A law library is available to provide legal research assistance for inmates and UCSC Women’s Center Inside-Out offers writing workshops.
F39
Page 67
Inmates are served three meals per day (at 6:00 a.m., 11:30 a.m. and 5:00 p.m.). A maximum of 30 minutes is allowed for consumption and/or disposal of a meal. The county nutritionist plans the meals according to the standards set forth in the California Code of Regulations. The inmates receive a total of 2,600 calories a day according to Title 15 standards. The kitchen area was originally built to serve 90 inmates. The kitchen passed the 2007 State Standards review even though it is outdated and extremely small for the current jail population.
F40
Page 67
Once a week, inmates have access to a commissary. They may purchase from a pre- approved list of items, such as snacks, canvas shoes, nail clippers, cosmetic items. Inmates must use money placed in their individual accounts to purchase commissary items. Upon their request, inmates with less than $3 in their accounts may be given the following items once each week: six sheets of paper, two stamped envelopes, two shampoo packets, a pencil, a toothbrush, toothpaste, and a comb.
F41
Page 67
Friends Outside, a program provided by Volunteer Center of Santa Cruz County, helps maintain outside contacts, and assists inmates in conducting basic and necessary transactions, such as banking and paying bills. They also provide reading glasses.
F42
Page 67
The jail chaplain provides religious services while several local churches of numerous denominations provide Bible studies, communion services and prayer groups.
F43
Page 67
Drug counseling is provided by Alto and Janus of Santa Cruz. Programs are also offered by Alcoholic Anonymous (AA) and Narcotics Anonymous (NA), Dual Diagnosis Group, and Criminal Gangs Anonymous.
F44
Page 67
Inmates qualified to vote may request voting material from the Elections Department. Corrections personnel deliver material to the election department for the inmates. Main Jail 57
F60
Page 55
Currently Santa Cruz County uses eight nearby counties in salary surveys: Monterey, Santa Clara, Alameda, Napa, Sonoma, Marin, Solano and San Mateo. For the most part, these are more similar to Santa Cruz than the nine counties formerly used in that they are not strictly agricultural and have living costs comparable to Santa Cruz.
F61
Page 55
Recruiting and retaining physicians and other medical professionals is uniquely difficult in Santa Cruz County because it is labeled by Medicare as a rural county. The Medicare reimbursement rate is the same as Butte, Imperial and other counties with a much lower cost of living.
F62
Page 55
The county health programs must compete with Dominican and Sutter for physicians and other medical professionals. Hospitals are in a unique position to pay higher salaries as their Medicare reimbursements are based on actual costs. A national Medicare study released in 2007 shows hospitals in Santa Cruz County have the highest labor costs in the country, which local health officials say means higher medical costs and insurance premiums for patients. This situation creates a difficult challenge when it comes to recruiting medical professionals.
F63
Page 55
Salaries and working conditions for physicians and other medical professionals employed by the County are negotiated with the respective unions. Conclusions
Recommendations 25
-
R6Page 49The County is to be commended for developing and supporting vibrant mental health programs managed by experienced and dedicated staffs. The programs are dynamic and flexible enough to keep up with the demands of clients and changing methods of treatment. Clinic Reconfiguration 2000-2001 Grand Jury Recommendation 10: County clinics should be reconfigured to family-oriented primary and preventive care, backed by clinical specialties and case- managed group therapy for persons at high risk or suffering chronic and recurring illness. These measures will require the recruitment of full-time county physicians and allied practitioners. County Response: This recommendation is being implemented. 2007-2008 Grand Jury Findings
-
R7Page 52The Grand Jury commends Sutter Maternity & Surgery Center for providing the services of medical specialists to those in need. Medical Staff Recruitment and Salaries 2000-2001 Grand Jury Recommendation 11: In the recruitment of health care professionals, salary surveys conducted in nearby agricultural counties are no longer pertinent to this County. In the next round of County salary negotiations, surveys should be conducted that use counties more comparable to the emerging characteristics of Santa Cruz County. County Response: The County has utilized the nine-County comparison for over thirty years, and this long-term base of information is useful in evaluating salaries. The nine- County comparison is used as a guide along with other information such as the Consumer Price Index, turnover statistics, recruitment and retention rates, the relationship between positions within the County, changes in classifications, and operational changes. Other jurisdictions are also surveyed, as appropriate. 2007-2008 Grand Jury Findings
-
R8Page 54The Grand Jury commends the Health Services Agency for the innovative way it has succeeded in providing quality health care to county low-income residents despite financial limitations. Recommendation
-
R11Page 49The Grand Jury recommends that the Health Services Agency continue to build the network of mental health services countywide. Response from the County: HAS BEEN IMPLEMENTED.
-
R12Page 49Staff development, including improved training and new methods for reviewing program results, would increase the effectiveness of the Health Services Agency. Response from the County: HAS BEEN IMPLEMENTED. HSA will further expand staff development as additional funding becomes available.
-
R13Page 49The Grand Jury recommends that the Board of Supervisors support coordination of the various funding streams by the Health Services Agency so that available funds can be used to match the diverse needs of the clients. A Promise Kept 2007–2008 Santa Cruz County Grand Jury Final Report Response from the County: HAS BEEN IMPLEMENTED. HSA will continue efforts to coordinate and increase various funding streams to meet the needs of our clients.
-
R14Page 49The Board of Supervisors should ensure adequate funding for patients’ employment services, which play an important part in mental health treatment. Response from the County: HAS BEEN IMPLEMENTED. The Board of Supervisors restored $50,000 for employment services in the 2008-09 budget.
-
R15Page 49It would be beneficial for the Health Services Agency to continue developing mental health outreach and education programs to provide even more community social support for recovering patients, so they can feel welcome in their communities. Support resources can include churches and neighborhood organizations. Response from the County: HAS BEEN IMPLEMENTED. HSA will continue developing outreach and educational programs as funding becomes available. Commendation
-
R16Page 56The Grand Jury urges the Health Services Agency to continue to seek grants and other alternative sources for funds to pay competitive salaries to health professionals. Response from the County: HAS BEEN IMPLEMENTED and will continue to be a high priority for the Health Services Department.
-
R21Page 51While all “safety net clinics” are not geared toward families, they are putting forth their best efforts to meet the various needs of the uninsured and Medi-Cal patients in Santa Cruz County.
-
R22Page 51Santa Cruz County needs to recruit more specialists and internists because of the increase in the number of elderly patients with complex health problems. A Promise Kept 2007–2008 Santa Cruz County Grand Jury Final Report Commendation
-
R23Page 54The Health Services Agency is able to recruit adequate medical staff and negotiate appropriate wage and benefit packages under very difficult circumstances. A Promise Kept 45 2007–2008 Santa Cruz County Grand Jury Final Report
-
R24Page 54The County has found innovative ways to meet the medical needs of low-income residents through grants and creative staffing. Anticipated budget cuts threaten this tenuous balance, but the Grand Jury believes that the County is going to be able to continue to provide a basic level of staffing to meet the minimal needs of low-income residents. Commendation
-
R52Page 50In the County of Santa Cruz, “safety net clinics,” (i.e., county or nonprofit clinics), take patients that are uninsured regardless of their ability to pay.
-
R53Page 50Current public and non-profit clinics, as a whole, have not been reconfigured to family-oriented and preventative care, but rather each clinic has an area or multiple areas of concentration which are listed below. Santa Cruz Clinics A Promise Kept 41 2007–2008 Santa Cruz County Grand Jury Final Report Santa Cruz Women’s Health • Primary Care for Women and Children • Family Planning • Health Benefits Advocacy • Illness Prevention and Health Promotion • Gynecology and Prenatal Care • Pediatrics • Acupuncture, Chiropractic, Naturopathy Westside Health Center (Planned Parenthood) • Primary Care Services • Family Planning • Health Benefits Advocacy • Illness Prevention and Health Promotion • Obstetrics and Gynecology • Pediatrics • Abortion Services Emeline Clinic • Primary Care Services • Walk-in Immunizations • Health Benefits Advocacy • Pediatrics • Child Health and Disability Prevention • Orthopedics • Family Planning • Laboratory, Radiology, and Pharmacy Coral Street Clinic • Urgent Care and Primary Care • Integrated Case Management • Mental Health and Substance Abuse • Health Benefits Advocacy • Counseling Beach Flats Clinic • Primary Care Services • Women’s Health • Pediatrics • Family Planning • Dental Care • HIV Testing • Obstetrics and Gynecology Dientes Community Dental Care • Emergency Dental Care • Full Range of Dental Services 42 A Promise Kept 2007–2008 Santa Cruz County Grand Jury Final Report • Oral Health Advocacy Dominican Pediatric Clinic • Pediatric Services Elderday Adult Day Health (Salud Para La Gente) • Adult Day Health Watsonville Clinics Salud Para La Gente • Primary Care Services • Family Planning • Dental Care • Eye Clinic / Optometry • Health Prevention and Promotion • Health Benefits Agency • Pediatrics • Obstetrics and Gynecology Diabetes Health Center • Diabetes Self-Management • Medical Nutrition Therapy • Group Classes • Insulin Training • Glucometer Training Clinica del Valle Del Pajaro • Primary Care Services • Dental Care • Family Planning • Women’s Health • Pediatrics • Child Health and Disability Prevention • Obstetrics and Gynecology South County Clinic • Primary Care Services • Immunizations • Health Benefits Advocacy • Pediatrics • Child Health and Disability Prevention • HIV Prevention • Laboratory • Radiology • Breast Cancer Early Detection Programs • Family Planning A Promise Kept 43 2007–2008 Santa Cruz County Grand Jury Final Report Clinic Mariposa (Planned Parenthood Mar Monte) • Primary Care Services • Family Planning • Health Benefits Advocacy • Pediatrics • Obstetrics and Gynecology • Illness Prevention and Health Promotion Children’s Resource Center • Pediatrics • Child Health and Disability Prevention • Dental Care Green Valley Clinic • Obstetrics and Gynecology • Women’s Health
-
R54Page 51Santa Cruz Women’s Health and Planned Parenthood specialize in women’s health, family care, and reproductive health.
-
R55Page 51Specialists are available when necessary, usually through Sutter Maternity & Surgery Center, which provides some free services to the community.
-
R56Page 51The County of Santa Cruz currently employs 20 full-time doctors: five primary care physicians (including two pediatricians), and 15 psychiatrists, four of which are bilingual.
-
R57Page 51The recruitment of allied health practitioners and full-time county physicians is often a challenge. Response from the County: AGREES. The Health Services Agency and the Personnel Department have developed a number of successful initiatives to increase the County’s ability to recruit for various classes of health practitioners and physicians.
-
R58Page 51The high cost of housing in Santa Cruz County makes recruiting primary care physicians difficult.
-
R59Page 51Psychiatry has only one vacant position, and nurse practitioner positions are filled through a “feeder program” from San Jose State University. Conclusions
-
R60Page 53Currently Santa Cruz County uses eight nearby counties in salary surveys: Monterey, Santa Clara, Alameda, Napa, Sonoma, Marin, Solano and San Mateo. For the most part, these are more similar to Santa Cruz than the nine counties formerly used in that they are not strictly agricultural and have living costs comparable to Santa Cruz.
-
R61Page 53Recruiting and retaining physicians and other medical professionals is uniquely difficult in Santa Cruz County because it is labeled by Medicare as a rural county. The Medicare reimbursement rate is the same as Butte, Imperial and other counties with a much lower cost of living.
-
R62Page 53The county health programs must compete with Dominican and Sutter for physicians and other medical professionals. Hospitals are in a unique position to pay higher salaries as their Medicare reimbursements are based on actual costs. A national Medicare study released in 2007 shows hospitals in Santa Cruz County have the highest labor costs in the country, which local health officials say means higher medical costs and insurance premiums for patients. This situation creates a difficult challenge when it comes to recruiting medical professionals.
-
R63Page 54Salaries and working conditions for physicians and other medical professionals employed by the County are negotiated with the respective unions. Conclusions