Sheriff's Office Yearsof Service Jim Fryhoff - Sheriff | John Reilly - Undersheriff*

The Grand Jury finds that of the 13 deaths of detained persons reviewed, most were avoidable. (SF-01, SF-07, SF-12, SF-18, SF-29) Response: The Sheriff's Office disagrees wholly with this finding. This finding is anecdotal in its foundation. The philosophy of the Sheriff's Office is that correctional healthcare is community healthcare. Mortality in the community is largely unavoidable and thus the same standard should be applied when evaluating mortality in a correctional setting. The Sheriff's Office ensures its standards and training go above and beyond state law and state standards to prevent as many adverse outcomes as possible. Furthermore, any conclusion regarding the four cases of suicide being preventable according to "expert analysis" is hollow. Suicides, especially jail suicides, are complex and individualized and not all suicides, jail or otherwise, are preventable. Reputable mental health professionals in the field of corrections have affirmed that jail suicides are complex and individualized.

The Grand Jury finds that in general, the public is not informed of the final results of the MCU and ME's investigations of deaths of detained persons in the Ventura County jails. (SF-02, SF-03, SF-04) Response: The Sheriff's Office partially disagrees with this finding. Prior to January 1, 2023, there was no requirement to inform the public about the final results of an incarcerated person's death. On January 1, 2023, California Assembly Bill 2761 took effect which requires certain information be released to the public and updated after investigations are complete. The Sheriff's Office has complied fully with the new law. Additionally, the Sheriff's Office recognizes that legal obligations related to the privacy of Protected Health Information do not terminate upon the death of an incarcerated person. The Sheriff's Office considers these privacy rights when releasing information to the public. Response to the 2022-2023 Ventura County Grand Jury Report

The Grand Jury finds that the current training regarding suicide prevention and response does not follow recommended best practices for consistent cross-training of deputies, SSTs, and Wellpath medical personnel. We did find that current practices are compliant with state law and BSCC requirements. (SF-05) Response: The Sheriff's Office partially disagrees with this finding. The Sheriff's Office agrees that its current practices are compliant with state law and BSCC requirements. Regarding the issue of consistent training on suicide prevention and response measures recommended by the NCCHC, the Sheriff's Office has met, and exceeded, the NCCHC standard. The NCCHC standard requires annual health emergency "man-down" drills. Since May 2021, the Sheriff's Office has conducted joint custody- medical "man down" drills quarterly on each shift at each jail facility.

The Grand Jury finds that between 2016 and 2022, the VCSO committed to implementing or strengthening primary, secondary, and tertiary suicide prevention measures consistent with BSCC and NCCHC standards. Despite these efforts, detained persons committed suicide. (SF-06, SF-08, SF-09, SF-10, SF-14, SF-15, SF-16, SF-24) Response: The Sheriff's Office agrees with this finding.

The Grand Jury finds that during incarceration, multiple factors can lead to a personal crisis after the initial screening. Communication and follow-up become key for suicide prevention. (SF-06, SF-10, SF-13) Response: The Sheriff's Office agrees with this finding.

The Grand Jury finds that primary level intervention measures, including improvement of the orientation process and involvement of families, aid in the prevention of suicide. (SF- 06, SF-11, SF-12, SF-13, SF-16) Response: The Sheriff's Office agrees with this finding. Should a family member have an immediate concern about the health, and/or well-being of an inmate, they can complete an Inmate Emergency Medical Notification Form located at www.venturasheriff.org. This notification form is immediately routed to the jail Watch Commander and medical personnel. There is a drop-down box specifically for suicide concerns. Family members can also contact public reception either in person or via phone. The Grand Jury finds that current incentives to surrender illicit substances and body

searching protocols do not result in adequate detection and confiscation of increasingly dangerous drugs at PDTF and TRJ. (SF-17, SF-18, SF-19, SF-22, SF-23) Response to the 2022-2023 Ventura County Grand Jury Report Response: The Sheriff's Office disagrees wholly with this finding. The Sheriff's Office goes to great lengths to detect and confiscate illegal substances from entering any of our jail facilities. Arrestees are searched at least twice by arresting officers prior to booking. Detention Services deputies then conduct a third, and sometimes fourth physical search in booking. When reasonable suspicion arises, and approved by the Watch Commander, a visual strip search of the arrestee is conducted and documented. A fifth search using a whole person body scanner is then conducted for every incarcerated person who is not pregnant. In addition, we use our patrol K-9s to conduct random drug searches in the jail on a regular basis. And lastly, we offer immunity from criminal charges to arrestees coming into the jail if they will voluntarily surrender illegal substances into our amnesty boxes. Since the installation of the amnesty boxes at all jail facilities in March 2022, there have been 181 amnesty surrenders through July 23, 2023. This equates to an estimated half- pound of potentially deadly drugs that this incentive has prevented from entering our jails.

The Grand Jury finds that use of passive-alert drug detection dogs to discover illicit drugs is an effective methodology not fully utilized at the PTDF and TRJ facilities. (SF-19, SF-20, SF-21) Response: The Sheriff's Office disagrees wholly with this finding. The Ventura County Sheriff's Office currently has seven dogs in our Patrol Services Division. All seven of these dogs are trained in narcotics detection, which includes the ability to locate fentanyl using Scent Logix as the training aid. Our office has only been using Scent Logix (fentanyl) in training for the past year. Previous to that, our dogs were not trained in the detection of fentanyl. Our dogs do not train with the street drug fentanyl directly, as it is extremely dangerous for the dog, and the handler. Our Detention Services Division does frequently utilize our patrol detection dogs for searches in our housing units. Our handlers are available, and on-call (if not already on duty), on a 24-hour basis, so using contracted resources in this capacity is unnecessary. Although it would make sense to assume that drug detection dogs in jails would reduce or eliminate overdoses or overdose deaths, the Sheriff's Office did not find any factual evidence in the references used by the Grand Jury that drug detection dogs in a custody setting reduced or eliminated overdoses or overdose deaths. In fact, the reference used by the grand jury for Los Angeles County states clearly that they use drug detection dogs to reduce violence in their jails because drugs in jails are a type of currency and in-custody violence over drugs is a problem for them. Response to the 2022-2023 Ventura County Grand Jury Report

The Grand Jury finds that historically, medical and behavioral health treatment in Ventura County's jails often has been reactive rather than proactive, and has not included a robust "See Something, Say Something" protocol. (SF-06, SF-07, SF-25, SF-26, SF-29) Response: The Sheriff's Office partially disagrees with this finding. Inmates routinely devise new and unique means to defeat any proactive means taken to prevent self-harm. Just like in the community, correctional health care and mental health care are constantly evolving to new and unique presentations, diagnoses, and methods of treatment. Deputies and SSTs are trained in detection of suicidal behavior and suicide prevention through our Crisis Intervention Training (CIT) academy. The addition of suicide prevention posters with indicators of suicide ideation and different avenues of notifying jail staff will help inmates find alternate ways to notify staff of potential suicidal inmates. The TIMU identifies inmates at risk of suicide. The TIMU contacts willing inmate families to learn HIPPA compliant inmate triggers and de-escalation techniques. The TIMU creates inmate profiles with this information that is stored with the TIMU. The TIMU uses inmate profiles to create programs that reduce the inmate's risk of suicide. In reference to the "See Something, Say Something" protocol referenced in Reference 51, this is a training given by the University of Michigan, Department of Public Safety & Security that discusses the types of incidents that should be reported and how to report them; personal safety, prevention and dealing with threats; and suspicious behavior. Reference 51 is a study completed by clinician-researchers at Harvard Medical School and Beth Israel Deaconess Medical Center. The study "results highlight the need to explicitly support patients and families to speak up in real time about perceived errors. Hesitancy to do so represents a real safety gap." The Sheriff's Office, as well as our correctional health care partner CFMG (Wellpath), have always sought out and valued the input of the patient (incarcerated person) to prescribe individual treatment plans for each patient. The Harvard Medical School study was completed using subjects from an urban academic hospital where family members were able to have face-to-face contact with the patient. This is not possible in a correctional setting. Family members are encouraged to, and often do, provide any input they have on an incarcerated person's current or historical medical conditions.

The Grand Jury finds that the intake screening process and reassessments during incarceration do not always provide a complete evaluation of current medical and behavioral health, as outlined in the NCCHC Initial Health Assessment standard. (SF-26, SF-27, SF-28) Response: The Sheriff's Office partially disagrees with this finding. Response to the 2022-2023 Ventura County Grand Jury Report Our current initial and follow-up medical and mental health screening assessments meet the NCCHC standards. However, as is seen not only in a correctional setting, but the community as well, obtaining a complete and accurate health history is only as good as the information being provided by the patient (incarcerated person). In some cases, a patient's (incarcerated person) reported medical history at intake can be supplemented by community health records, however these are not immediately available to medical personnel during the intake process. Additionally, jail medical staff are often still reliant on a patient (incarcerated person) to report prior hospitalizations, surgeries, primary care providers, etc. Proactive searches for records are conducted in some instances after intake, however this requires significant time and personnel resources, and is not feasible to do universally.

The Grand Jury finds that involvement of the public and independent subject matter experts in the review of deaths in jail may reduce the risk of death, provide additional insight, justify additional resources and increase transparency. (SF-30, SF-31) Response: The Sheriff's Office partially disagrees with this finding. We agree that independent subject matter experts may be able to provide additional insight and increase transparency. However, it is our belief that adding members of the public in the reviewing of incarcerated person's deaths would be counterproductive. Members of the public are not afforded the same privileges and protections to review sensitive and protected medical and legal information discussed during our comprehensive reviews. The Sheriff's Office takes these privileges and protections with the utmost solemnity to protect the patient's (incarcerated person), and their family's, privacy. The Sheriff's Office would like to reiterate its commitment to safeguarding the lives and property of residents of Ventura County and responding to public concerns in a manner which is fair, unbiased, lawful and promotes neighborhoods free from crime. The foundation of this commitment is built upon the Sheriff's Seven Pillars. Although all are equally important to the stability and success of our Mission, Pillar 6 - Providing Secure and Humane Detention for Incarcerated Individuals, is one that the Sheriff is Constitutionally mandated to do, and all Detention Services personnel, including contract personnel, are dedicated to mission accomplishment. RECOMMENDATIONS