Sacramento County Jail Medical Care Scrutinized

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By Sacramento Bee

Published: 01/02/2003

Following a rash of inmate suicides and bureaucratic feuds, Sacramento County wants to transfer responsibility for medical and mental health services in the jail from the coroner to the sheriff.
The overhaul would reallocate 177 jobs -- and $28 million of the coroner's $32 million budget -- and give Sheriff Lou Blanas control of all medical care at the jail, officials said. The proposal also calls for adding about 30 positions to the understaffed infirmary, which lost its state accreditation 18 months ago.
In addition, the coroner would lose 51 jobs for juvenile medical services to the Department of Health and Human Services. A physician, pharmacist and program manager also would be added to the program, which provides health care in youth detention facilities.
Blanas pushed hard for the reorganization amid public outcry over seven suicides and eight other reported attempts at the downtown jail this year. The sheriff is a defendant in a lawsuit filed Nov. 15 against the county by the family of a Carmichael man who hanged himself in his cell last March.
'Under the law, I'm the guy who's held accountable,' Blanas said Monday. 'Since I'm the one being named in some of the things that have occurred, I should have complete control of what goes on at the jail.'
The transfer is supported by Coroner E. Paul Smith and other county officials. The supervisors have been asked to approve the move after hearing details at 11:30 a.m. today at 700 H St., Sacramento. Meetings are broadcast live on Metro Cable Channel 14.
The proposal outlines the second reorganization for correctional health services since August 2001. Smith, who oversaw infirmary services for incarcerated adults and juveniles for seven years before becoming coroner, took over the program again in a bureaucratic shake-up.
The outbreak of suicides and infirmary problems led to finger-pointing between sheriff's officials and medical supervisors at the jail. Deputies complained a severe staffing shortage resulted in poor treatment, including canceled sick calls and inmates not receiving pills. In one case, an inmate received a high dose of the wrong medication.
County officials acknowledged the lack of adequate staffing, especially among nurses. But they also blamed problems on lack of access to patients because of a shortage of deputies, which sheriff's officials disputed.
Since then, progress has been made on both sides, officials said. The county recently approved higher salaries for nurses, which has helped cut vacancies from about 30 to 13, said Administrator Penelope Clarke of the Public Protection and Human Assistance Agency.
Meanwhile, the sheriff has added a total of about 40 permanent and on-call deputies at the jail, Chief Deputy Daniel Drummond said.
The reorganization also would improve internal communication and efforts to prevent inmate suicides, officials said. The transfer of jail infirmary services 'really makes a lot of sense,' said Smith, who will continue to oversee coroner services.
The proposed new positions include nurses to reduce booking delays, increase sick calls and pill calls, and provide permanent weekend staffing, a report said. In addition, the infirmary has added a second eight-hour physician's shift, Blanas said. Based on a successful mock exercise in October, officials expect the jail will regain its health-care accreditation next year, Clarke said.
While the jobs could be funded by savings from vacancies this year, the cost for 30 new staff and extra relief help could cost the strapped general fund as much as $3.5 million next year, a report said. Clarke said the price would depend on how many positions are filled, but she acknowledged that paying for them would require tough spending choices.
Minimum medical care for jail inmates 'is a mandate,' Clarke said. 'We cannot afford not to fund these positions.'

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