Good Behavior

New Sonoma County jail facility to catch up with reality of mentally ill inmate explosion

Last month, Sonoma County secured
$40 million from the state to fund the lion’s share of a proposed $48 million, 104-bed facility for a growing population of mentally ill and substance-addicted offenders.

The county got the award thanks in large part to Carter Goble Associates (CGL). The firm was paid $336,450 to complete an outside review of the county jail system and submit the application to the state for the
$40 million, a $120,000 contractual add-on approved by the Sonoma County Board of Supervisors this summer.

In its final report, released Dec. 8, CGL unsurprisingly recommended that the county close the security-challenged North County Detention Facility, a “major liability.” And it recommended that the county build a new behavioral health facility. The major through-lines of the audit highlighted significant deficiencies in the way mental-health services are delivered at the Main Adult Detention Center, many related to the design of the facility itself. CGL noted that 17 percent of inmates at the MADF have serious mental-health issues. The report also described failures in transitional housing programs for homeless inmates and identified a huge gap in available substance-abuse services between men and women at the Main Adult Detention Center. In short, there’s no drug-counseling programming for the men.

And the report notably criticized the jail’s intake-assessment system, which is split between county behavioral health workers and contract staff with the California Forensic Medical Group. County clinicians provide mental health services; CFMG is the medical provider.

“This approach results in fragmentation of the assessment process,” CGL reported. “Combining the efforts of these two programs and having a single entity managing and performing assessments, case management and treatment placement for eligible offenders would result in greater efficiency and consistency in directing offenders to treatment resources.”

The for-profit CFMG has contracts with 27 facilities around the state and has come under intense scrutiny in recent years for the services it provides to county lockups. There were three deaths over three weeks at the Sonoma County jail in late 2014, occurring against a backdrop of grand jury and media investigations from around the state that laid bare CFMG’s checkered record.

In January, the Sacramento Bee found that “[i]n a 10-year period ending in May 2014, 92 people died of suicide or a drug overdose while in the custody of a jail served by CFMG,” which the paper reported was “about 50 percent higher than in other county jails.”

One inmate died in a so-called mental-health module at the Sonoma County lockup; another died in a cell while withdrawing from drugs. The county maintained that the deaths were unrelated.

The county told the Bohemian in August that CFMG would continue to be the medical-health provider for inmates. The company would work, as needed, in the new facility—at least through the end of its contract, which expires in August 2019.

The county expects to break ground on the behavioral-health unit in January of that year, and hopes to have it open by 2020.

They can’t get it built fast enough. Sonoma’s new facility is catching up with the realities wrought by “realignment” in the state penal system, the diversion of low-level offenders from state prisons into county lockups, and the bleak acknowledgment that jails are often the only available mental-health services.

Sonoma County is not alone in the state in over-utilizing solitary confinement to house the mentally ill, a disturbing trend highlighted in a federal class action lawsuit filed last month in Santa Clara by the Berkeley-based Prison Law Office. The inmate advocacy group told earlier this month that after it was done in Santa Clara it would immediately file suit in another California county.

In the midst of a growing county-level jail crisis, the state Legislature voted to approve $500 million for new facility construction last year (it has sent $2.2 billion in jail-construction money to counties and cities since 2007) to leverage a court-ordered depopulation of state prisons. Sonoma County had already been turned down under two previous jail-construction bills, but Mary Booher, administrative analyst with the Sonoma County, says that this time around, “the programming that we described in our new facility, the higher level of mental health [services], was very appealing.”

The county voted to expand its contract with CGL in July to complete the funding application for construction funds made available under SB 863. The new facility will be split between a 72-bed behavioral-health unit designed for “competency restoration for mentally ill offenders awaiting trial,” and another 32 beds for treating seriously mentally ill inmates.

Who is going to design and build it? Remains to be seen. Bids are due by Jan. 22.

Sonoma County Library