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WellPath/Sheriff staffing shortfalls at the Santa Barbara County jails occurred frequently, which could lead to delayed healthcare provision to the inmates. Sheriff's Office Response: Agree. Both the Sheriff's Office and WellPath have experienced significant difficulties in recruiting and retaining personnel to work within our Santa Barbara County Jail facilities in recent years, particularly in the wake of the COVID-19 Pandemic. However, both organizations have worked individually and collectively to mitigate the operational impacts of the vacancies. This has included the use of overtime coverage, part-time/extra-help coverage, telemedicine and close coordination between the operations of both organizations. Furthermore, in recognizing the importance of closing staffing gaps, both the Sheriff's Office and WellPath have invested considerable effort and resources toward enhancing our respective recruitment efforts and hiring processes, but are still challenged to overcome a number of strong societal changes relating to the workforce. A recent Wall Street Journal article concisely pointed out a number of workforce factors that are particularly challenging given the realistic constraints that come with operating 24/7/365 jail facilities (https://www.wsj.com/lifestyle/careers/americans- attitude-work-data-0c2e487c). Specifically, the article explained that jobs in the post-Covid era that require in-person work and fixed shifts are particularly hard to fill. Both of these factors are necessary for the successful operation of a 24/7/365 jail facility. The Sheriff's Office and WellPath continue to explore opportunities to further expand and refine our individual recruitment efforts.

A lack of accounting within the Sheriff's Office did not acknowledge WellPath staffing shortfalls which exceeded the agreed upon 2% vacancy level for which credits should have been applied. Sheriff's Office Response: Disagree partially with an explanation. Over the course of the contract with WellPath, changes were made to the contractual staffing obligations, the measurement of compliance and staffing shortfall remedies. This was particularly influenced by the COVID-19 Pandemic and the early opening of the Northern Branch Jail. These and other factors resulted in a degree of confusion and disagreement as to how vacancy rates should be calculated and credits applied. During the first couple of contract years, Sheriff's staff believed Wellpath was generally meeting the 2% criteria, but in the wake of post-Pandemic staffing challenges, it became apparent that Wellpath was no longer meeting the contractual staffing criteria. In October of 2023, the Sheriff's Office conducted a review of monthly WellPath staffing reports for the first 6 months of the contract term (April 2023 through September 2023). The WellPath reports provided aggregate hours for clinical healthcare staff classifications (i.e. Registered Nurses, Licensed Vocational Nurse, Psychiatrist, etc.). After further review and consultation with the County Executive Officer's Budget and Auditing staff, a request was submitted to WellPath asking for more granular data. The process of studying the more detailed staffing data is nearing completion, and will result in a formalized standard process for receiving and analyzing WellPath staffing reports and calculating future contract credits. This will occur prior to the ratification of the current contract's final amendment and will be an ongoing process in future contracts.

There is an absence of WellPath 24/7 mental health providers at both County Jail sites. Sheriff's Office Response: Agree.