Santa Cruz County Civil Grand Jury Hwy1ontheSlowCoast the Reports

Jail programs like “Stepping Up” steers the mentally ill to community-based mental health care, reducing the number of mentally ill inmates in jail.

The Santa Cruz County Civil Grand Jury was not permitted to interview inmates serving sentences at the Rountree Rehabilitation and Reentry Facility as required by the Bureau of State Community and Corrections. Speaking to some inmates about their experiences and opinions of the programs would have greatly enhanced the Jail investigation and report.

Increasing the number of programs that focus on rehabilitation, education, and restorative justice to prepare for reentry would show positive improvement to public safety and a reduction in recidivism for reentering inmates.

The current practice of reviewing inmate classification monthly is too long of an interval and may endanger inmates suffering from mentally illness.

The failure of Wellpath to recruit and retain adequate staff adversely impacts the overall effectiveness of the mental health services provided to inmates.

By not filling essential positions for months at a time, services for residents suffer harm when vacancies persist.

Local roads in unincorporated Santa Cruz County are severely underfunded and as a result are in deplorable shape. The Grand Jury feels the best opportunity to increase substantial funding is to address the deficiency in Special District 9D. The NCE’s report predicts that under the current spending level, our roads will deteriorate even further. The County cannot afford this increasing liability. Additional funding sources (e.g., Measure D and K) are helpful but wholly inadequate to address the current and projected deferred road and culvert maintenance. This leaves unincorporated County residents at a higher risk of delayed emergency response and strandings. Santa Cruz County Local Roads published June 5, 2024 Page 13 of 22 14 Santa Cruz County Civil Grand Jury

As reflected in this report’s Findings and Recommendations, the Grand Jury is deeply concerned with the poor mental health treatment provided to our inmate population. This extends to the treatment of inmates living with or developing mental health challenges, through jail time and post release. This abiding concern is abundantly detailed in this report. The treatments described, such as solitary confinement, are inflicted on people that are still presumed innocent. But not everything about our jail system is dark and foreboding. The Grand Jury investigation brought to light the many positive reentry programs available while a person is in custody. Then once released, many of these programs are available and continued in the community. It is a testament to our compassionate community that so many institutions exist to help people who have served their sentence and now need a helping hand in their return to society. Not only does it make us safer, it reduces the chances of reincarceration. The Grand Jury strongly urges the continued development of these programs in and out of custody. The Grand Jury believes that better inmate mental health treatment and positive reentry programming, as suggested in this report, will enhance inmate wellness and create a better community for all of us. We Can Do Better With Our Jails! published June 11, 2024 Page 21 of 45 44 Santa Cruz County Civil Grand Jury Findings and Recommendations Group 1: State Standards (Title 15) Compliance Issues F1. The failure of Wellpath, the medical provider contracted by the Sheriff to provide data from required Health Service Audits, has adversely affected inmate health and resulted in poor health care and lack of pharmaceutical services for inmates. R1. By the end of calendar year 2024, the Grand Jury recommends the Sheriff instruct Wellpath to begin the Health Service Audits. (F1) F2. The failure of Wellpath to implement a comprehensive discharge plan causes inmates to be released without community connection to medical treatment and medication. R2. By the end of calendar year 2024, the Grand Jury recommends the Sheriff instruct Wellpath to improve the medical discharge processes for better continuity of care. (F1, F2) F3. The failure of the Sheriff”s jail staff to properly address inmates' mental illness crises has caused mentally disabled inmates to be held in Safety Cells for excessively long periods. F4. The improper use of Safety Cells by the Sheriff’s jail staff to isolate inmates who are greatly in need of mental health care and/or have made suicidal statements causes a violation of required procedure. F5. The use of Safety Cells for punishment has resulted in violations of Title 15 section 1055 and the Sheriff’s Policy and Procedures Manual policy 516.2. This may expose the Sheriff’s department to lawsuits. R3. By the end of calendar year 2024, the Grand Jury recommends the Sheriff retrain staff about the proper use of Safety Cells according to Title 15 section 1055 and the Sheriff’s policy and procedures manual. (F3, F4, F5) F6. The practice of excluding mentally ill patients from 5150 hold and transfer until discharge results in a violation of both Title 15 and Sheriff’s Policies and Procedures manual policy 516.2. R4. By the end of calendar year 2024, the Grand Jury recommends the Sheriff retrain staff with the proper use of a 5150 hold and the transfer of inmates to a mental health facility according to Title 15 and the Sheriff’s policy and procedures manual. (F6) We Can Do Better With Our Jails! published June 11, 2024 Page 22 of 45 2023–2024 Consolidated Final Report 45 F7. The failure of Jail administrators to transfer inmates with suicidal ideation or in a mental health crisis to an out-of-county LPS facility adversely impacts inmate mental health care. R5. By the end of the calendar year 2024, the Grand Jury recommends the Sheriff train staff on how to transfer suicidal inmates to an LPS facility for mental health care. (F7) F8. The failure of the Crisis Intervention Team to issue a 5150 hold and transfer before an inmate is discharged adversely impacts inmate mental health care. R6. By the end of calendar year 2024, the Grand Jury recommends the Sheriff direct the CIT team to not withhold a 5150 hold and make a transfer until release because this is not proper or best practice for inmates in need of mental health care. (F8) F9. The practice of placement in Administrative Separation (solitary confinement) causes inmates to suffer mental health problems including, but not limited to, anxiety, insomnia, paranoia, aggression, and depression. F10. The failure of Jail administrators to transfer Inmates who are suffering from mental health crises symptoms to an LPS Facility adversely impacts inmate mental health care. R7. By the end of calendar year 2024, the Grand Jury recommends the Sheriff develop a plan to transfer all inmates in mental health crises to LPS facilities and budget the extra cost of transferring patients out of the county. (F9, F10) Group 2: Better Jail Conditions, Rehabilitation and Reentry Preparation F11. Opening the closed unit at Rountree and increasing the number of re-entry programs would result in better conditions for inmates and less stress for the correctional officers. R8. By the end of calendar year 2024, the Grand Jury recommends the Sheriff reopen closed units and move all qualified inmates to Rountree Medium Security and the Minimum Security Rehabilitation and Reentry unit. (F11) F12. Increasing the number of programs that focus on rehabilitation, education, and restorative justice to prepare for reentry would show positive improvement to public safety and a reduction in recidivism for reentering inmates. R9. By the end of calendar year 2024, the Grand Jury recommends the Sheriff develop a comprehensive plan to increase the number of programs that steer inmates towards reentry into the community with new job skills development, education, work release and transitional programs. (F12) We Can Do Better With Our Jails! published June 11, 2024 Page 23 of 45 46 Santa Cruz County Civil Grand Jury F13. Jail programs like “Stepping Up” steers the mentally ill to community-based mental health care, reducing the number of mentally ill inmates in jail. R10. By the end of fiscal year 2024-2025, the Grand Jury recommends the Sheriff develop a plan to implement more Jail diversion programs (like Stepping Up) that steer the Mentally Ill away from jail and to the help they need. (F13) F14. The current practice of reviewing inmate classification monthly is too long of an interval and may endanger inmates suffering from mentally illness. R11. By the end of calendar year 2024, the Grand Jury recommends the Sheriff change the Reclassification examination of mentally ill inmates from a monthly basis to a weekly basis to prevent misclassified inmates from suffering needlessly. (F14) F15. The failure of Wellpath to recruit and retain adequate staff adversely impacts the overall effectiveness of the mental health services provided to inmates. R12. By the end of the calendar year 2024, the Grand Jury recommends the Sheriff conduct an analysis of the effectiveness of Wellpath in regards to all mental health services of incarcerated persons. (F15) R13. By the end of calendar year 2024, the Grand Jury recommends the Wellpath be directed to provide round-the-clock medical and mental health care availability to the Jails. (F15) Group 3: Access to Inmate Interviews and Rehabilitation Programs F16. The Santa Cruz County Civil Grand Jury was not permitted to interview inmates serving sentences at the Rountree Rehabilitation and Reentry Facility as required by the Bureau of State Community and Corrections. Speaking to some inmates about their experiences and opinions of the programs would have greatly enhanced the Jail investigation and report. R14. The Grand Jury recommends the Sheriff begin to allow the Santa Cruz County Civil Grand Jury interviews of inmates per Penal Code 916 including observing inmate classes and programs within 90 days. (F16)

Santa Cruz has more homeless people per capita than anywhere else in California. A majority of these homeless residents are in need of behavioral health services. Compounding the problem is that the County’s general budget is limited. Santa Cruz County is also an expensive place to live and therefore recruitment of health care providers is a challenge. Given these facts, Santa Cruz County is facing an uphill battle to provide adequate Behavioral Health Services both in terms of dollars and not having enough personnel. The Behavioral Health Services owes it to taxpayers to rigorously apply outcome-based metrics to determine which programs give the biggest bang for the buck. The Grand Jury’s preliminary analysis of regional service levels indicates South County residents have limited access to healthcare and lag other areas in socioeconomic indicators. Programs that improve socioeconomic indicators in South County will reduce behavioral healthcare and mental services costs in the long run.

As previously mentioned in the Summary, the 2023-24 Grand Jury reviewed responses to three of the nine 2020-21 reports and found that, to varying degrees, commitments were kept. In some cases, the agencies are implementing recommendations but it’s not clear if the actions are in response to the Grand Jury or whether they were instigated by the agencies. The Grand Jury continues to recommend that all organizations create and regularly update formal records of the actions they take to address Grand Jury recommendations, and to share those records with the public, in accordance with CA Penal Code section 933(c). Honoring Commitments to the Public published June 17, 2024 Page 11 of 14 100 Santa Cruz County Civil Grand Jury

This investigation was undertaken as a result of complaints received by the Grand Jury. Complainants believed that CPS policies regarding child safety were not being followed. The investigation was hampered by data that was largely insufficient or unobtainable. This results in Resource Families' perception that child safety is not being prioritized. The Grand Jury was not able to substantiate this claim based on the available data reviewed. The Grand Jury remains concerned that this perception will persist unless there is more transparency of both data and operations. This perception may prevent a sufficient number of Resource Families from signing up to provide this valuable service which is critical for the protection of neglected and abused children in our community.

The litany of obstacles to rebuilding is long and complex. From Grand Jury interviews with fire victims and those agencies primarily responsible to aid and assist in restoration and rebuilding, we found much to note. Many victims struggled with the permitting process, insufficient insurance coverage, or a lack of knowledge or understanding of the applicable agency and regulatory requirements. Others simply were so dispirited by the experience that no amount of money could see them through to completion. It is good to remember that we too often get lost in numbers. Numbers don’t completely hide the human cost from view, but sometimes make it more difficult to see and feel. As Grand Jurors, we saw it and felt it all the more deeply as we re-lived every experience, every delay, and every difficulty with every victim we interviewed. That being said, this report is respectfully submitted as a story of both success and failure in which two seemingly contradictory concepts exist side by side. This report is offered to reconcile those concepts and to inform and guide our community. With those thoughts in mind, the 2023-2024 Santa Cruz County Civil Grand Jury respectfully submits the following Findings, Recommendations, and Commendations.

The main function of the Civil Grand Jury is to improve transparency and accountability in local government. If adopted, the four recommendations from the Civil Grand Jury will help the City clarify its Inclusionary Housing regulations. Doing so will provide the City and the community with clear data on which to base claims and conclusions about who occupies affordable housing in the City of Santa Cruz.

The Grand Jury recommends changes that improve efficiency and effectiveness of the county’s hiring processes. This is done to improve service levels for County residents that support the local agencies with hard-earned tax dollars. All of the recommendations below are specific, but do not call out the elephant in the room: County services for residents suffer because management is not able to prioritize staffing levels, or deploy time-saving integrated software, or fix broken processes. Residents deserve the improved services that fully staffed departments can deliver. For county residents, the “just business as usual” attitude of local agencies towards filling these critical vacancies is very concerning. The Recommendations in this report anticipate continual improvement in County hiring and recruiting. These will result in more completely staffed agencies and departments that deliver high quality services on time with improved morale. The County will accrue cost and time savings through integrated data and processes. Time is money and the clock is ticking. The Grand Jury thinks this problem is urgent and needs to be addressed now. New Recruiting Ideas for the Personnel Department published June 27, 2024 Page 15 of 24 174 Santa Cruz County Civil Grand Jury Findings and Recommendations Group 1: Fast-track Candidate Pool Quality / Quantity Add Department-level Recruiting Expertise and Bandwidth F1. Requiring candidates for difficult to fill positions coordinate with Personnel rather than directly with hiring managers in departments slows the hiring process and reduces candidate interest. F2. The Personnel Department recruiter training does not provide recruiter skills to the hiring managers necessary in today’s job market. F3. Outdated personnel “candidate pool” rules and Civil Service recruiting policies inadvertently force long term vacancies for supervisory and credentialed positions. F4. By not sending candidates for difficult to fill positions directly to hiring managers the chances of hiring well qualified candidates are reduced. F5. Most county departments lack dedicated hiring managers leading to overloaded administrators. R1. The Grand Jury recommends that by December 31, 2024, in order to reduce the backlog of difficult to fill positions, the Personnel Department creates dedicated recruiter positions for the HSA, HSD and Public Works departments. (F1–F5) Improve Marketing to Candidates F3 applies to this area as well. F6. The Personnel Department has not changed policies and procedures in the face of fewer candidates applying for County positions resulting in additional vacancies and slower recruitment and hiring processes. F7. The Personnel Department’s website advertising continuous open positions without regular updates makes it very difficult for candidates to find opportunities on search engines because the information is stale and not up to date. R2. The Grand Jury recommends that by December 31, 2024, the Personnel Department update recruitment and hiring procedures. For example, requiring the updating of job postings on a regular basis in order to improve search engine visibility. (F3, F6, F7) R3. The Grand Jury recommends that by December 31, 2024, the Personnel Department begin publishing per-position candidate pool policies and hiring results on a semi-annual basis. (F3, F6, F7) New Recruiting Ideas for the Personnel Department published June 27, 2024 Page 16 of 24 2023–2024 Consolidated Final Report 175 Promote from Within F8. Continuous improvement for promoting existing employees in departments with difficult to fill positions can help to maintain effective staffing levels. F9. Promoting employees within departments with many difficult to fill positions can limit the damage caused by attrition, especially at more senior levels. R4. The Grand Jury recommends that by December 31, 2024, the Personnel Department, in collaboration with HSA, HSD and Public Works, embrace continuous improvement and publish a skills and advancement plan to accelerate promotion from within, including budget requirements and goals. (F8, F9) Group 2: Improve Hiring and Recruitment Results Adopt Integrated HR System F10. The months-long hiring process is frustrating to candidates and jeopardizes the County’s chances of hiring good candidates. F11. The time required for complex paper processes steals time from creative recruitment and ongoing contact with candidates. R5. The Grand Jury recommends that by December 31, 2024, the Personnel Department publish a cost/benefit analysis comparing their current approach with that offered by integrated HR solutions. (F10, F11) Embrace Continual Improvement within Personnel Department F6 applies to this area as well. F12. Despite the finding in F9, having leadership in Personnel Department positions filled by long-time employees that have spent most of their career in the department has led to limited acceptance of ideas that have worked elsewhere in hiring for difficult to fill positions. R6. The Grand Jury recommends that by December 31, 2024, the Personnel Department develop a plan detailing how they will solicit and evaluate employee recommendations that could help reduce the backlog of difficult to fill positions. (F6, F12) R7. The Grand Jury recommends that by December 31, 2024, the Personnel Department publicly document how they have engaged external expertise which would likely improve hiring and promoting processes. (F6, F12) New Recruiting Ideas for the Personnel Department published June 27, 2024 Page 17 of 24 176 Santa Cruz County Civil Grand Jury Evaluate Peer Counties for Best Practices F6 applies to this area as well. F13. The 8-county salary comparison in place since 2002 is no longer a useful benchmark for wages and salaries given the high cost of living in Santa Cruz County resulting in many vacancies. F14. To attract a wider pool of candidates for difficult to fill positions, pay needs to be at least 90% of what Santa Clara County offers. R8. The Grand Jury recommends that by December 31, 2024, and annually thereafter, the Personnel Department conduct a salary comparison study based on nearby counties. It is recommended that this study include counties which have routinely recruited Santa Cruz County employees and residents. (F6, F13, F14) Create a Public Dashboard of Key Hiring and Recruitment Metrics F15. The County Personnel Department was consistently unable to provide comprehensive hiring statistics. Without accurate data, Personnel and other departments cannot make sound judgements on how to measure improvements in the hiring process for difficult to fill positions. F16. The Personnel Department expects the department units themselves to track hiring and recruitment metrics and keep important data such as turnover statistics and vacancy rates. This leaves the Personnel Department and oversight bodies without a clear picture of the situation and depth of the problem. F17. By not filling essential positions for months at a time, services for residents suffer harm when vacancies persist. R9. The Grand Jury recommends that by December 31, 2024, the Personnel Department post a public dashboard, based on real time data, to include time-to-hire and vacancy rates for difficult to fill positions in County departments. (F15, F16, F17)

City Ordinance 81-29 Section 3 (a) states, “It shall be the policy of the City of Santa Cruz that the prevention of rape and domestic violence shall be one of its highest priorities.” It is clear from each priority criterion evaluated for this investigation that the City is ignoring its mandate. This inaction leaves the community vulnerable and ill-informed with respect to rape and domestic violence. By adopting the Grand Jury’s recommendations, the City can bridge the gulf between their long-standing legal obligations and their current neglect of these critical services. The result will be a community better informed, better prepared, and less vulnerable to rape and domestic violence. Preventing Rape and Domestic Violence published June 27, 2024 Page 20 of 30 2023–2024 Consolidated Final Report 203

C1. The Santa Cruz County Civil Grand Jury believes CalAim is an excellent program expanding health coverage to the incarcerated in Jail because it will enroll inmates in Medi-Cal for their medical care and support them as they reintegrate back into the community. We Can Do Better With Our Jails! published June 11, 2024 Page 24 of 45 2023–2024 Consolidated Final Report 47 C2. The Santa Cruz County Civil Grand Jury found numerous County funded programs and services in and outside of the Jail that help inmates to prepare for reentry into the community and reduce recidivism rates. C3. The Santa Cruz County Civil Grand Jury found the Jail staff are truly concerned about the well-being of inmates and this concern was well expressed with their motto “Reentry begins at Booking.”

C1. County Behavioral Health Services are to be commended for their dedicated service to the community. They provide compassionate care with limited resources, all while being understaffed. Given the Behavioral Health Services high job vacancy rate, existing resource providers continue to provide exemplary services. County Behavioral Health Services published June 11, 2024 Page 13 of 20 82 Santa Cruz County Civil Grand Jury

C1. The Santa Cruz County Civil Grand Jury commends the Recovery Permit Center and 4Leaf for its outstanding service to our community and particularly its work in assisting and supporting victims of the CZU Lightning Complex Fire in their recovery and rebuilding efforts. C2. The Santa Cruz County Civil Grand Jury commends the Long Term Recovery Group for its outstanding service to our community and particularly its past and continuing work in assisting and supporting victims of the CZU Lightning Complex Fire in their recovery and rebuilding efforts. C3. The Santa Cruz County Civil Grand Jury commends Catholic Charities and Community Bridges for their outstanding service to our community and their continuing work in support of CZU Lightning Fire victims and their families. C4. The Santa Cruz County Civil Grand Jury commends the Community Foundation of Santa Cruz County for providing financial support to the Long Term Recovery Group and for the preparation and publication of the Atkins Debris Flow Analysis Report. C5. The Santa Cruz County Civil Grand Jury commends Stephen Homan, a retired registered environmental health specialist, who helped 50 CZU fire survivors obtain their environmental Pre-Clearance. A fire victim himself, he donated his time to this effort. Victims of the CZU Wildfire - Four Years Later published June 21, 2024 Page 16 of 26 2023–2024 Consolidated Final Report 129

C1. The Grand Jury commends the Personnel Department for testing ways to improve recruiting for difficult to fill positions. These include preparing a video selling the lifestyle of Santa Cruz County, attending job fairs, having a booth at the County fair, attending conferences where professionals meet, advertising in magazines that target professionals with needed skills, reaching out to universities and meeting students about to graduate. C2. On the recommendation of the Personnel Department, the Board of Supervisors eliminated the civil service requirement for a top ten list for a set of hard to fill positions. Department hiring for those positions accelerated since managers were able to interview candidates more quickly. New Recruiting Ideas for the Personnel Department published June 27, 2024 Page 18 of 24 2023–2024 Consolidated Final Report 177