An additional $2.3 million to reform and expand health care services for jail inmates has been added to San Luis Obispo County's 2018-19 budget after a year of public debate and controversy over the death of a mentally ill man in County Jail.
The county Board of Supervisors on Tuesday formally introduced a recommended balanced budget that included funding to reform jail medical services and additional behavior health staff, despite the county facing "a modest budget gap" of $3.6 million.
The additional expenditures include the cost of a new chief medical officer responsible for the oversight of health care to inmates and additional funding to provide more comprehensive health services to inmates that will either be provided by the county, as they are now, or by a contractor.
The county also plans to add new mental health therapist positions that staff said will benefit its Stepping Up Initiative to reduce the number of people with mental illness in County Jail.
Balancing the budget
The county proposes to pay for those expenses and close the budget gap by decreasing the general fund contribution to road repair by $1 million, by funding some maintenance and a one-time contribution to the San Luis Obispo Art Museum with reserves and by reducing department's budgets by $1.9 million.
The budget gap is driven by flattening state and federal revenues, increased investment for county facility repairs and the cost of salary and benefit increases for county employees, according to Emily Jackson of the county Administrative Office.
Three days of budget hearings, where the Board of Supervisors will toil through details of each department's proposed expenses — making cuts and fighting to fund projects — are scheduled to begin June 11.
Will there be transparency?
Reforms the county are currently contemplating include contracting a third party to provide medical and/or mental health services at County Jail. The county already put out a request for proposal, and responses are due at the end of May.
Th details of why those services might be contracted out and what exact problems the $2.3 million intends to fix, might not be made clear to the public.
The county commissioned an independent review from San Diego County Chief Medical Officer Dr. Alfred Joshua to assess the current services and needs at the jail and make recommendations for improvements. That will include advising whether contracting outside medical and mental-health providers would be more efficient given the county’s difficulty in retaining full-time psychiatric and medical staff.
The county has received that report, but its findings are not yet being released to the public and will be presented to the Board of Supervisors in August.
On Tuesday, Supervisor Adam Hill asked County Counsel Rita Neal when the results of the report will be released to the public, in the name of transparency.
“Regardless of what may have been the origin of that report, I think that has to be something that we’re able to have public so we can explain why we’re going in the direction we’re going,” Hill said.
Neal said she did not have authority to release it at this time, given a handful of administrative claims and civil lawsuits currently in process related to County Jail.
“The difficulty I find myself in… is that there’s that balance between transparency and certainly improving our system and wanting to do the best we can for healthcare and the jail, and then the current pending claims and lawsuits,” Neal said.
The county is facing at least three lawsuits in state and federal court and at least one administrative claim — the first step in filing a lawsuit — related to treatment and services in County Jail.