Title
Initiate contract negotiations for the Sheriff’s Office with the California Department of State Hospitals and California Forensic Medical Group to host a Jail Based Competency Treatment Program in the Monterey County Jail. (CORRECT VERSION OF BOARD REPORT ADDED VIA SUPPLEMENTAL)
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors support the Sheriff’s Office, CAO’s Office, and County Counsel’s Office to pursue state funding and begin negotiating a contract with California Forensic Medical Group (CFMG) for a Jail Based Competency Treatment (JBCT) Program in the Monterey County Jail.
SUMMARY/DISCUSSION::
County Jails throughout the State of California house large numbers of offenders that have been deemed incompetent to stand trial (IST). There is a lack of sufficient state hospital beds to treat these offenders on a timely basis. To help address the lack of capacity, the Department of State Hospitals (DSH) started contracting jail beds in various counties to expand treatment capacity for IST inmates.
The JBCT program is designed to provide treatment to patients who are accused of a felony and lack the mental competency to assist in their own legal defense. Declared by a judge to be incompetent to stand trial pursuant to CA Penal Code Section 1370, these patients would otherwise be treated at a state hospital to restore their competency and enable them to face the charges against them. Due to limited hospital beds for treating ISTs, however, DSH has added capacity through the JBCT as part of its continuum of care.
DSH launched the first Jail-Based Competency Treatment program (JBCT) in 2010 at the San Bernardino County jail. Since then, similar programs have been established at the jails in Riverside and Sacramento counties. Last year, an additional JBCT opened in the Sonoma County Jail; plus, Stanislaus County Jail just opened a new JBCT this year. DSH still needs additional capacity, and continues to expand JBCT services to new counties.
DSH expressed interest in utilizing the Monterey County Jail to host a new local JBCT site. A team of staff from the Offices of the Sheriff, County Counsel and CAO have participated in multiple conference calls with DSH to discuss the program, the potential of developing a contract, and providers for the psychiatric services required in the JBCT. DSH works with a few different psychiatric providers in other JBCTs. The two newest programs are hosted by Sonoma County Jail (2017) and Stanislaus County Jail (2018). Both of those counties’ psychiatric services are being provided by CFMG. CFMG also provides inmate health care in both counties. DSH advised they are very pleased with the Sonoma program, the services from CFMG, and the advantages of utilizing the same provider for health and mental health services.
In January 2018 two of the CFMG nurses who helped with the startup of the JBCT program in Sonoma County, were hosted by the County team from the Sheriff, County Counsel and CAO. We asked them to look at current jail housing units and treatment / therapy areas to determine whether there was sufficient space to host a JBCT in the County Jail. Based on the site visit, it was determined there is appropriate custody housing in the main jail and adequate treatment space in the adjoining rotunda area.
In February 2018, the Sheriff’s Office made a presentation about the JBCT concept to the Community Corrections Partnership (CCP) at a scheduled public meeting. The purpose of the presentation was to offer information to the CCP, the public, and other stakeholders of our local corrections system. CCP members expressed support of the concept.
In early April 2018, the Sheriff’s Office and County Counsel, hosted DSH personnel at the Monterey County Jail. DSH toured the housing units and proposed treatment areas. DSH also believes the available housing / treatment areas are appropriate to host a JBCT.
During the initial discussions, the Department of State Hospitals reviewed the IST admissions from Monterey, Santa Cruz, and San Benito Counties. Based on the current numbers of ISTs, DSH is willing to sponsor and fund a 12-bed program supporting all three counties. Local JBCTs have proven to take pressure off the State Hospitals by increasing the overall capacity of the system to treat ISTs. Additionally, local JBCTs have been able to successfully restore ISTs at a faster pace when compared to the state hospitals. Hosting a local JBCT in Monterey County will give ISTs much quicker access to treatment and prevent them from being in the long wait list for admission to a state hospital. This regional, tri-county approach will benefit the inmates, their families, and the correctional systems in all three counties.
OTHER AGENCY INVOLVEMENT:
The County Administrative Office and County Counsel’s Office have been involved in the initial planning of this project.
FINANCING:
Typical DSH contracts are based on a “per bed / per day” rate so the County would receive funding when the beds are occupied or empty. The “daily rate” model allows for a stable revenue source to support any personnel or contract services tied to the JBCT. Moving forward, we plan to develop a proposal that is completely cost neutral to the County. Once initial negotiations come into focus, we would return to the board of supervisors with the full contract, detailed operational requirements, and fiscal considerations.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
This request meets the Board’s strategic initiatives by:
“Improve health and quality of life through County supported policies, programs, and services”
Mark a check to the related Board of Supervisors Strategic Initiatives:
Economic Development
Administration
X Health & Human Services
Infrastructure
Public Safety
Approved by: Steve Bernal, Sheriff-Coroner, X3856