Stations Santa Barbara County Bill Brown Sheriff - Coroner Buellton Headquarters*

Being placed in a prone position while restrained contributed to JG's death. Sheriff's Office Response: Disagree partially with an explanation The Sheriff's Office disagrees that the position JG was restrained in was a contributing factor in JG's death, but rather that it was the physical exertion that JG exerted against staff's efforts to restrain him that contributed to his death.

The arresting officers failed to inform the intake staff that JG had complained of back and chest pain. This lack of communication was a missed opportunity to ascertain whether JG needed timely and appropriate medical care. Sheriff's Office Response: Agree

Custody Deputies removed JG from the medical intake screening process before completion. The failure to prioritize JG's medical needs at intake raises serious concerns about the potential for harm to individuals in custody. Sheriff's Office Response: Disagree partially with an explanation The Sheriff's Office agrees that JG was removed from the medical intake screening process. However, the custody staff involved were not only charged with ensuring that JG's medical needs were met, but also with maintaining the safety and security of everyone present, including incarcerated persons, other staff, visitors, and the public. In this instance, JG displayed behaviors that placed the safety of everyone present in jeopardy, and we determined that moving JG to another, more secure location would mitigate the safety risks. The decision was made based on the information available to them at the time. Their actions conformed to current policy, sound correctional practice, and California regulations and laws regarding the use of force and restraint. The safety and security of the facility for everyone, including inmates, deputies, medical staff, and visitors, is paramount. Once the inmate is safe and the facility's security is not at risk, the medical screening process will be completed. In the meantime, the inmate would be checked on every 15 minutes to ensure their well-being.

LR's physical injuries and cognitive abilities worsened during his three days of incarceration at the Main Jail, an admitted alcoholic, he was not treated for alcohol withdrawal symptoms when examined by mental health or medical personnel. Sheriff's Office Response: Agree

When the Public Health Medical Advisor position has been filled, this medical professional will be working with Wellpath staff at the jails. Sheriff's Office Response: Agree

RU and DL suffered from drug addiction and died within two days of entering the jails. Sheriff's Office Response: Agree

SP spent over 12 hours confined in a safety cell without a mental health evaluation being conducted by a C.A.R.E.S. Mobile Crisis Unit during that time. Sheriff's Office Response: Agree

There was a failure to initiate a collaborative safety plan with SP prior to his release from the mental health observation cell which is intended to provide support and decrease the chance of self-harm during a critical period of time. Sheriff's Office Response: Agree.

Ongoing renovations and upgrades within the IRC 300 housing unit had resulted in the in-cell intercom system, certain video surveillance systems, and the electronic locking mechanisms being non- operational at the time of SP's death, causing delayed response times by custody and medical staff. Sheriff's Office Response: Agree

There were only 11 Custody Deputies on shift at the time of SPs' death. The level of safety inside jail facilities is directly affected by the number of Custody Deputies on duty. If more than one critical incident were to occur at the same time, it could be extremely difficult to manage. Sheriff's Office Response: Agree.

SP, who had clearly expressed an intention to harm himself in any way that he could, was nonetheless placed in a cell located in a two-level housing unit, which provided SP with easy access and the means to jump to his death from the second level of the unit. Sheriff's Office Response: Agree

The Public Defender's Office currently conducts an entry interview to establish a connection with newly incarcerated persons booked into the Northern Branch Jail, which continues until the incarcerated persons are discharged. Sheriff's Office Response: Agree

The Grand Jury investigations of deaths in custody rely heavily on information provided by the Santa Barbara County Sheriff's Office. Completion of the investigations was impeded greatly by a lack of timely cooperation by the Sheriff's Office. Sheriff's Office Response: Disagree The Grand Jury's assertion that "Completion of the investigations was greatly impeded by a lack of timely cooperation by the Sheriff's Office" is incorrect. Any delays that may have occurred were related to staffing or information availability. This generalization prevents the Sheriff's Office from addressing particular processes and does not accurately reflect the significant efforts made by the Sheriff's Office in support of the Grand Jury and its mission. Upon the empanelment of the 2023-2024 Grand Jury, the Sheriff's Office promptly provided the contact information of the Sheriff's Adjutant, who was designated as the liaison for the Grand Jury. The Adjutant's role is to streamline communication between the Grand Jury and the appropriate personnel within the Sheriff's Office, thereby facilitating efficient and timely responses. The Adjutant works closely with Grand Jury members to determine what documentation they need and to provide that documentation as soon as possible. In fact, in an effort an effort to make this process as smooth as possible, a secure, cloud-based document sharing portal was specifically established for the Grand Jury. Furthermore, many of the requests for information made by the Grand Jury required clarification and/or were for data not currently at our disposal. The Adjutant's role is to assist the Grand Jury in determining what documents are available and helping refine their search efforts, thereby ensuring a more efficient process. To enhance cooperation and ensure timely responses, the 2023-2024 Grand Jury was introduced to the Deputy Sheriff's Association (DSA) Counsel. It was agreed that all subpoenas for DSA members whom the Grand Jury wished to interview should be channeled through the DSA Counsel and the Sheriff's Adjutant. This procedure ensured proper and timely responses from the Sheriff's Office, during the 2022-2023 Grand Jury term. The 2023-2024 Grand Jury did not utilize this procedure; the Sheriff's Office recommends that future Grand Jurys use this procedure in order to enhance the efficiency and timeliness of their request. The Sheriff's Office is committed to cooperate with the Grand Jury. By adhering to the established procedures and leveraging the role of the Sheriff's Adjutant, we will continue to provide the Grand Jury with the necessary resources and information.

Five of the six deaths in this report occurred within the first three days of entering the jail. The main factors for jail deaths involved issues of inconsistent and inadequate observation. Sheriff's Office Response: Disagree with an explanation The Sheriff's Office asserts that the only event that involved potential observation issues was that of SP. The others were either under direct observation (JG), had secreted illicit drugs obtained from someone in their housing area or prior to their arrests (RU and DL), or were not observed because the inmate denied being in alcohol withdrawal, having a history it or displaying objective symptoms of withdrawal (LR). <b>Recommendation 14</b> The Sheriff's Office, working in conjunction with Wellpath, Behavioral Wellness and Public Health, shall have procedures in place to more closely monitor at-risk incarcerated persons when they enter the jails. Sheriff's Office Response: Has been implemented, with a summary of the implementation actions taken The Sheriff's Office continues to collaborate with WellPath, BeWell, and Public Health in more closely monitoring at-risk incarcerated persons.