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Cost of jail reform remains murky in SLO County budget 

As San Luis Obispo County prepares to pass a multi-million dollar budget for the 2018-19 fiscal year, the exact cost of reforms to medical and mental health services at the county's jail remains unclear.

During hearings on the county's proposed budget, 3rd District Supervisor Adam Hill and 2nd District Supervisor Bruce Gibson both raised concerns about additional funding set aside to pay for promised reforms to the SLO County Jail's health services, noting that it was still unknown how the bulk of that extra funding would actually be spent.

"There's a little discomfort I have with a kind of blank-check approach here," Hill said at the June 11 hearing.

The proposed budget transfers the responsibility of jail health care from the County Health Agency to the Sheriff's Office, and allocates an additional $2.3 million from the county's general fund to expand jail health care services. While more than $300,000 of that money will go to paying for the jail's newly hired chief medical officer, the budget does not specify how the remaining money will be spent. Part of that funding may go to contracting medical and/or mental health services to an outside company. While the county developed a request for proposal (RFP) and is accepting bids, Hill and Gibson said the board hadn't seen the RFP, or the reports and evaluations used to create it, before it was released.

"I think we got out a little too fast on this RFP before we decided what system needs to be in place," Gibson said.

County staff said that the board would still need to approve expenditure of the funds, including awarding any contract under the RFP, and expected to go back before the board for a "comprehensive" discussion about the RFP in late August or early September.

The emphasis on expanding medical and mental health services at the jail was the result of public concern and outcry following a spate of inmate deaths at the county jail, most notably that of 36-year-old Andrew Holland, whose death after a 46-hour stay in a restraint chair led the to the county paying out a $5 million settlement. In addition to improving and expanding health services at the jail, the county also committed to participating in "Stepping Up," a national initiative aimed at helping local governments reduce the number of mentally ill people in jail. At the June 11 hearing, County Budget Director Emily Jackson told the board that no allocations for specific resources for Stepping Up were included in the proposed 2018-19 fiscal year budget.

"Development of some of the recommendations is going to be a collaborative process that we are currently engaging in," she said. "We are going come back to your board with specific recommendations at a later date."

Jackson did note that the budget included funding for an additional 4.5 full-time employee positions within the county's behavioral health agency to increase mental health services countywide, as well as the addition of 18 residence recovery beds.

"Though that's not specific to Stepping Up, it undoubtedly gets us closer to where we need to be in that respect," she said.

Both Hill and Gibson voiced the need to have a thorough public discussion about Stepping Up and the details of the extra funding for the jail, and to give the public more information about how the promised reforms will be implemented and evaluated.

"We know we have work to do," Hill said. "We have trust to earn back." Δ

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