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

The Sheriff's Office has not determined childhood vaccination rates of inmates in County jails, potentially placing the inmates and staff at risk. Sheriff's Office Response: Disagree partially, with an explanation. The Sheriff's Office agrees that it has not determined childhood vaccination rates of inmates in County jails. The Sheriff's Office disagrees that not capturing this data places inmates and staff at risk. There have been no recorded cases of measles, chicken pox, mumps, rubella, diphtheria, or polio in at least the last nine years, we did have one case of whooping cough and, in surveying a number of long-term employees, there is no recollection of any such cases in the past thirty years. While there was one probable case of whooping cough in December of 2019, the probable case was identified and appropriate mitigation measures were taken to prevent the spread of the disease. <b>RECOMMENDATION 3</b> The Grand Jury recommends that the Sheriff's Office collect data during health intake screenings at the County's jails to determine childhood vaccination rates. To be implemented by December 1, 2025. Sheriff's Office Response: Will be implemented. The Sheriff's Office will work with its contracted healthcare provider to inquire about an individual's immunization history and/or status. This should include direct inquiries about prior immunizations, as well as indirect evidence of vaccination such as attending elementary school in California or serving in the military (both have mandates for childhood vaccination). Vaccine eligibility will be determined based on age, medical condition and/or risk factors, in accordance with the Advisory Committee on Immunization Practices (ACIP) and Centers for Disease Control (CDC) guidelines. In addition, the Sheriff's Office supports the recommendations of the National Commission on Correctional Health Care (NCCHC) to screen and offer immunizations as clinically indicated to update incarcerated persons immunization status. The process will be finalized and implemented by December 1, 2025.

There is no program in place at the County's jails to provide childhood vaccinations to unvaccinated inmates, increasing risk for the inmates and staff. Sheriff's Office Response: Disagree partially, with an explanation. The Sheriff's Office agrees that no formal program exists to provide childhood vaccinations (e.g., MMR, Tdap, varicella, polio, etc.) to unvaccinated inmates. The Sheriff's Office believes that not providing childhood vaccinations to unvaccinated inmates does not significantly increase risk for the inmates and staff, since only one possible instance of a disease in this category appears to have been identified at the Santa Barbara Jail system in decades. <b>RECOMMENDATION 4</b> The Grand Jury recommends that the Sheriff's Office implement a program to administer required childhood vaccinations to unvaccinated inmates. To be implemented by December 1, 2025. Sheriff's Office Response: Requires further analysis, with an analysis completion date of fewer than 6 months after the issuance of the report The Sheriff's Office recognizes the potential public health benefits of administering childhood vaccinations to unvaccinated inmates, but requires further analysis to determine the feasibility, resource requirements, and costs of such a program. Furthermore, it is challenging to identify individuals who did not receive childhood vaccinations, and even if inmates who were not immunized can be identified, they cannot be forced to vaccinate. The Sheriff's Office recognizes the importance of addressing this gap and will explore partnerships with County Health and Wellpath to assess the feasibility of a vaccination program. The Sheriff's Office will provide a written response of its analysis to the Grand Jury by December 1, 2025.

There is no procedure in place at the County's jails on when or how to isolate unvaccinated inmates, increasing potential risk of a disease outbreak in the jails. Sheriff's Office Response: Disagree partially with an explanation The Sheriff's Office disagrees partially with the finding that there is no procedure in place for isolating inmates. While there is no specific procedure targeting the isolation of unvaccinated inmates based solely on their vaccination status, the Sheriff's Office has established protocols for isolating inmates who exhibit symptoms of infectious diseases, such as COVID-19. For example, during the COVID-19 outbreaks beginning in 2020, symptomatic inmates were promptly isolated in designated areas to prevent disease spread, and testing was conducted to identify additional cases. These protocols are part of the Sheriff's Office's broader infectious disease control measures, which include coordination with Wellpath for medical assessments and adherence to CDC and County Health guidelines. The Sheriff's Office maintains robust isolation protocols for inmates showing symptoms of infectious diseases, such as COVID-19, which include immediate medical evaluation, testing, and placement in designated isolation units. These measures were effectively implemented during the COVID-19 outbreaks, with 249 inmates isolated during the December 2021 outbreak at the Main Jail. However, these protocols do not account for vaccination status, as this information is not currently collected. Thus, isolation decisions are symptom-based rather than vaccination-based, as absence of vaccination by itself does not pose a significant risk for disease outbreaks. <b>RECOMMENDATION 5</b> The Grand Jury recommends that the Sheriff's Office develop and enforce a procedure on when and how to isolate unvaccinated inmates. To be implemented by December 1, 2025. Sheriff's Office Response: Will not be implemented. The Sheriff's Office will not implement this recommendation as prolonged isolation can negatively impact an individual's mental health and is a known risk factor of suicide by incarcerated persons. An incarcerated person who lacks childhood vaccinations may be more susceptible to illness, but their lack of immunization does not indicate they are infectious and require isolation. The Sheriff's Office supports the use of least restrictive housing and concludes that the potential harms of isolating unvaccinated but asymptomatic individuals without a known exposure to an infectious disease outweighs any potential benefits. This recommendation is inconsistent with, and does not meet the threshold as outlined in, California Code of Regulations, Title 15, §1051 - Communicable Diseases, which states, "The facility administrator, in cooperation with the responsible physician, shall develop written policies and procedures specifying those symptoms that require medical isolation of an incarcerated person until a medical evaluation is completed." The Sheriff's Office currently works collaboratively with its contracted healthcare provider and County Health to identify persons with communicable diseases and stop them from entering the general populations of the jail, and to mitigate risk whenever communicable infections are identified.