SLO County Jail care ‘has not significantly improved,’ DOJ says. Sheriff, Wellpath disagree
The San Luis Obispo County Jail’s treatment of inmates — especially those with mental and medical health needs — “has not significantly improved” since a private company took over healthcare services there, the U.S. Department of Justice says in a recently released report.
But both that company, Wellpath, and the Sheriff’s Office, which runs jail operations, say the report’s findings only cover the period when the jail was “transitioning” away from county-provided inmate care and “does not reflect care currently provided in SLO,” Wellpath’s president said by email Friday.
On top of serious lapses in inmate healthcare such as denial of medication, chronically rescheduled appointments, and Wellpath’s staff using long-term seclusion as a response to mental illness-related misbehavior, federal investigators also said in the report released Aug. 31 that jail custody officials who engage in excessive force are subject to little oversight.
The report lists dozens of examples of scenarios from 2018 through mid-2020 in which inmates were neglected, misdiagnosed and denied medical or mental health treatment.
Inmates suffered serious injuries from their stays at the jail, including overdoses, infections, and even a miscarriage.
One inmate who nearly died after health staff refused to send him to an emergency room for a week had lost almost half his blood volume when he was finally intubated at a local hospital, where he remained in critical condition for five days, the DOJ says.
The Justice Department investigation was launched in October 2018 amid a series of inmate deaths, lawsuits and an FBI investigation into alleged civil rights abuses of mentally and medically ill County Jail inmates, namely Atascadero resident Andrew Holland.
Holland died in the jail after being bound naked in a restraint chair for 46 hours. Surveillance footage reported by The Tribune showed that Sheriff’s Office deputies watched as he writhed on the floor, lost consciousness and later died.
In addition to costs to defend against several lawsuits, San Luis Obispo County paid a $5 million settlement to Holland’s family in July 2017. Holland’s death prompted outrage throughout San Luis Obispo County and raised questions about treatment of mentally and medically ill prisoners at the County Jail.
The contract with Wellpath, which went into effect in 2019 at a cost of more than $6.7 million, has been cited by county officials as the largest reform put into place since Holland’s death.
The DOJ report lists 65 “minimum remedial measures” needed to resolve “constitutional and statutory violations” identified in the report.
In an Aug. 31 letter to the county, the DOJ said it could initiate a lawsuit under the Civil Rights of Institutionalized Persons Act within 49 days to force county and Wellpath officials to correct the various problems cited in the report “if jail officials have not satisfactorily addressed them.”
The federal agency wrote that it hopes to resolve the matter “through a more cooperative approach.”
Assistant County Counsel Nina Negranti said Friday that her office is reviewing the report.
“We anticipate reaching agreement short of litigation,” she wrote in an email to The Tribune.
Wellpath, SLO County sheriff respond to DOJ report
The report notes that between January 2012 and June 2020, 16 inmates died while in jail custody. Three of those deaths occurred during the course of the federal investigation.
After the report was released on Tuesday, the Sheriff’s Office issued a news release saying that the county agency “recognize(s) the issues and concerns brought forth” in the report, but that it “fails to take into account the many remedial measures undertaken by the Sheriff’s Office” since the investigation began in 2018.
The agency noted several new policies and programs put into place and claimed in the news release that any allegations of inappropriate uses of force by deputies have been investigated by the Sheriff’s Office’s Professional Standards Unit and those found true resulted in disciplinary action.
“The Sheriff’s Office has worked cooperatively with the Department of Justice over the past three years to investigate deficiencies and determine appropriate improvements to ensure our jail facility is fully compliant with federal law,” Sheriff Ian Parkinson said in the release. “We are pleased with our progress so far and will continue to work diligently to provide a safe and secure jail facility.”
Asked whether the Sheriff’s Office would answer followup questions about the report, Sheriff’s Office spokesman Tony Cipolla wrote in an email that the agency is “not commenting any further beyond the statement we released.”
Kip Hallman, president of Wellpath, responded to submitted email questions from The Tribune, saying that “we and the Sheriff’s Office are appropriately proud of the care we provide to the patients we both serve.”
“Wellpath came to SLO as it does many new partner sites, at a time when the Sheriff’s Office had made a commitment to improve the quality of care,” Hallman said, noting that when the company took over in February 2019, the DOJ investigation was already several months in, and continued for six more months.
Hallman wrote that during the first six months of Wellpath’s tenure, there was a “transition of services, when staffing, policies and procedures are not yet fully stable.”
In the time since the DOJ investigation, Hallman said, Wellpath and the Sheriff’s Office “have made significant progress and virtually all issues identified in the DOJ report ... have been resolved.”
Asked specifically about several findings of the report, such as the allegation that many medical appointments are often rescheduled or canceled altogether, Hallman said Wellpath “has made significant enhancements to the process for scheduling and completing off-site medical appointments, resulting in minimizing the number of canceled or rescheduled appointments where this is under our control.”
The report noted that oftentimes sheriff’s custody division staffing levels affect the ability of medical staff to transfer inmates for appropriate care.
“There will always be cancellations or rescheduled appointments for reasons outside our control,” Hallman said. He said that in 2020 and 2021 the medical staff significantly reduced offsite visits for non-urgent healthcare matters due to COVID-19. “This has occurred nationally in all corrections settings.”
However, Hallman said the number of on-site chronic care visits doubled from 2019 to 2020 and remains high today.
Another finding of the report included the refusal or delaying of treatment to inmates who are nearing their release date. The report includes stories of inmates whose care was put off for months, even if an inmate’s release date was months away. Many inmates who had long-requested care never received it before they were released.
“This has never been a Wellpath policy,” Hallman said. “Wellpath provides medically necessary care to all patients throughout their length of stay.”
Another allegation made in the report is that Wellpath does not take seriously the inmate grievance process, and one supervisor was caught belittling inmate grievances with an inappropriate meme in an employee presentation.
“Wellpath takes all grievances very seriously. While we do not comment on personnel matters, the individual who used the inappropriate image (during the presentation) is no longer employed by Wellpath,” Hallman said.
He added that the volume of inmate grievances received by Wellpath staff declined by more than 22% from 2019 to 2020, and the volume has further declined by another 56% in 2021, though the Sheriff’s Office has said the jail population declined significantly due to COVID-19 precautions and early releases.
Hallman said that certain medical accommodations — such as wheelchairs, special shoes and double mattresses — are now widely available to inmates with medical conditions, despite DOJ officials finding otherwise.
“This report covers a period when the county was transitioning from county-provided care to Wellpath and does not reflect care currently provided in SLO,” Hallman wrote. “Wellpath has worked closely with the SLO Sheriff’s Office to improve patient care, and we are confident that working together we have done just that.”
Asked whether the problems identified in the report “are current issues that persist” despite the Sheriff’s Office’s characterization, Department of Justice spokesman Thom Mrozek told a reporter in an email, “I think you are reading that correctly.”
Andrew Holland Foundation responds
The Andrew Holland Foundation, a nonprofit formed by Holland’s family to advocate for mentally ill individuals in the criminal justice system, said in a statement released on social media Friday that the Sheriff’s Office and other county agencies’ effort to institute changes within the jail “has not gone unnoticed.”
“However, the report just released by the Department of Justice detailing inhumane patterns and practices continually found in the County Jail comes as no surprise,” the statement reads.
Despite the county’s efforts toward change, the foundation’s statement reads, it still receives many calls regarding mistreatment of the mentally ill.
“The Justice Department’s exhaustive and comprehensive report found gross negligence toward those with mental illness and special needs for one reason — the jail is the wrong place to house and treat those with mental illness,” the statement says. “We don’t need more money for jail expansion. We need accessible treatment that will house and rehabilitate those with brain disease.”
The statement continues: “When we have a jail trying to perform as a mental hospital, they will fail, and the cost is enormous both in dollars and lives. However, we must decide we can no longer fail those suffering with mental illness, and instead provide a lasting solution.”
