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PLN article mentioned re CA jail's private medical contract

Bohemian, Nov. 12, 2014.

Hard Time 

Sonoma County cites staffing, performance issues with private jail health service provider

The shift of state inmates to county lockups is putting a strain on Sonoma County jails, in spite of a $32 million contract with a for-profit company to help shore up services in county detention facilities.

The Main Adult Detention Facility in Sonoma County is like many others in the state that have been burdened by the demands of "realignment"—Gov. Jerry Brown's 2011 initiative that shifted thousands of state prisoners into county jails.

As realignment's results have taken hold, the California Forensic Medical Group (CFMG), which operates under the umbrella of a $17 billion private equity firm, has highlighted its dozens of contracts around the state, easily worth hundreds of millions of dollars.

And yet Sonoma County officials, citing "staffing and performance issues" with CFMG, signed a supplemental service contract with another forensic firm in October.

Realignment has exacerbated the county's struggle to provide a safe environment for addicted, ill or mentally challenged inmates. The realignment scheme flooded county jails with offenders flushed from the state system as part of Brown's solution to state prison overcrowding.

Many "realigned" inmates around the state are non-violent offenders serving long terms—and when those sentences get transferred to the county, so to do all the inmates' health problems.

"This office has been challenged with managing the effects of realignment," says Sonoma County Supervisor Efren Carrillo. "We've done as best as we can," he adds, noting that the Sheriff's Office and county have ramped up efforts in community-supervised releases, programs for in-custody inmates, alcohol treatment and other efforts.

But the problem, Carrillo emphasizes, is happening on all over: "These issues that we are facing here in Sonoma County are similar to other issues that counties in the North Bay are facing," he says. "Jails should not be the place where many of our residents are getting the services they need."

Especially when some of those residents are dying while they wait for them. Over a period of three weeks in late September and early October, four inmates with medical or mental health issues died while in the custody of the Sonoma Sheriff's Office.

According to a sheriff's spokesperson, those inmates were under the care of CFMG, which has a new, five-year contract with the jail worth at least $32 million to provide healthcare.

The county has pledged a full investigation of the cluster of deaths, and at least one local lawyer has taken note. "I am talking to a couple of the victims' families and we are discussing options," says Santa Rosa-based attorney Jonathan Melrod, who was at the forefront in calling for police accountability following the death of Andy Lopez in 2013. "I can't say that much more."

More broadly, Melrod says he's stunned at the short-sightedness embodied in "realignment."

"In an era of limited resources, it's one thing for Gov. Brown to say, 'I balanced the budget,' but look below the surface and you are balancing the budget by dumping on the counties. Overcrowding is a huge issue, but to just force it down the chain, to the counties, it's flabbergasting," says Melrod.

The state prison system's healthcare system is under federal receivership after a 2001 lawsuit found healthcare in the state system unconstitutional. In a recent Prison Legal News report critical of realignment, Nick Warner, legislative director of the California State Sheriffs' Association, said one concern over realignment was that counties now face the same liabilities that forced the state to spend billions to remedy its prison healthcare system. The CSSA did not respond to a request for comment.

How's realignment working out for Sonoma County and its sick inmates? The county recently re-signed a contract with CFMG that also came with a $4.73 "per diem" rider pegged to expanded inmate populations—thanks, again, to realignment.

The company gets the per-prisoner fee for any increase in the inmate population above 1,200 between the two adult lockups. The Bohemian has a public records request in with Sonoma County to determine if that per diem has been invoked.

Meanwhile, the county ratified a one-year service agreement with a company called United Forensic Services on Oct. 14. Its function, say officials, is to provide backup forensic services to CFMG, which is contractually on the hook for those services.

"My understanding was that this was a secondary agreement in the event that CFMG was unable to keep up with the caseloads," says Carrillo.

Carrillo noted that the agreement came out of a recognition that "staffing and performance issues" had arisen with CFMG in 2012 and 2013. "We are working with them to solve this performance issue and the Sheriff's Office pursued alternative backup resources."

But the supplemental contract doesn't address two troubling and potentially related facts: According to its most recent contract, CFMG does not provide an on-site physician to the jail on weekends. And: Inmate Rhonda Jo Everson was found dead in her cell on a Sunday after being locked up on Friday night.

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