Das Williams First District Board of Supervisors Laura Capps County Administration Building Second District, Vice Chair*

R5

The Public Health Medical Advisor shall help oversee and advise treatment for medically compromised individuals entering the jails, especially during the critical first week of incarceration. This recommendation will be implemented. Public Health's Chief Correctional Health Medical Advisor, in conjunction with the Correctional Health Quality Care Improvement Coordinator, will advise on and monitor the quality of healthcare services in the jails and will independently assess compliance, as well as adequacy and appropriateness of care for all incarcerated individuals. This will include reviewing and approving all clinical protocols, advising Wellpath and Custody staff on enhancement in workflows and clinical care especially within the first week of incarceration. In addition, the Medical Advisor will serve as co-chair on the death review committee and the Medical Advisory Committee (MAC) and will provide regular updates to Public Health's Chief Medical Officer and department Director. The Medical Advisor and Quality Care Improvement Coordinator are currently under recruitment by Public Health. The Quality Care Improvement Coordinator is scheduled to start work on September 30, 2024, pending successful completion of a background check. Recruitment for the Medical Advisor position has been more challenging, but Public Health aims to have a candidate identified by November 2024. In the meantime, the Chief Medical Officer will continue to serve as the interim Public Health Medical Advisor and will onboard and orient the Quality Care Improvement Coordinator upon start. Position duties of the Medical Advisor include: providing advice and expert opinion to the Sheriff's Office, Probation, and the contracted healthcare provider to ensure delivery of evidence-based and comprehensive healthcare services; advising on implementing best practices and National Commission on Correctional Health Care (NCCHC) standards of healthcare; evaluating existing services to identify needs and develop long-range goals and service plans; leading the MAC and participating in the Committee of Quality Improvement (CQI); reviewing and analyzing internal program reviews and external audits to identify problem areas; and working closely with the Quality Care Improvement Coordinator to implement continuous quality improvement efforts.

R6c

The Sheriff's Office shall work with Public Health and Behavioral Wellness to increase staffing of the Medically Assisted Treatment program at both jails. This recommendation has been implemented. The recent contract extension negotiated with Wellpath includes additional staffing for a Substance Use Disorder Counselor position dedicated to the Medically-Assisted Treatment (MAT) program at the jails, with funding for the new position provided by the County's Opioid Settlement funding allocation. Nursing staff were also enhanced, and it was noted that these additional resources would support MAT expansion. The Board ratified this extension on June 25, 2024, with the added positions effective July 1, 2024. Additionally, MAT expansion at the jail will be addressed through the CalAIM Justice- Involved Initiative for Medi-Cal beneficiaries. Behavioral Wellness will also launch CalAIM Behavioral Health Linkages in fall 2024 to coordinate care in the community for individuals upon release from jail.

R12

The Sheriff's Office shall work with the Public Defender's Office to initiate a similar program at the Main Jail. This recommendation will be implemented. The Public Defender's Office and Sheriff's Office are working together to initiate Early Representation services at the Main Jail. A one-year pilot program is anticipated to begin in fall 2024. While the Early Representation pilot in North County (READY program) is currently funded by a combination of Board of State and Community Corrections (BSCC) and Community Corrections Partnership (CCP) funding, there is not currently funding available for a South County program. However, because of early promising results of the North County pilot, the Public Defender's Office and the Sheriff's Office are collaborating to launch a South County program, with the hope of securing future funding to sustain and grow the program once more data is available to support this funding priority. In order to launch the pilot program in South County, the Public Defender's Office will leverage its current resources and will also modify the program from in-person meetings with clients, to scheduled teleconference meetings, to address infrastructure challenges associated with the Main Jail facility.

R14

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 jail. This recommendation has been implemented. Departments including the Sheriff's Office, Behavioral Wellness, and Public Health, as well as Wellpath, meet on a monthly basis to review procedures and collaborate on ways to more closely monitor at-risk incarcerated persons when they enter the jail. However, ultimately the Sheriff's Office is accountable for developing the appropriate Sheriff-issued documented procedures and ensuring that those procedures are consistently followed.