The Sonoma County Grand Jury tackled several big issues this year, including health treatment in the county jail, protecting local water systems against earthquakes, problems with the county’s mental health budget and the chronic neglect of county-owned properties. This week we’ll look at their discussion of health care in the county jail.

Positive report card on the county jail


A CLOSER LOOK — The Grand Jury’s report was released in June.

As mandated by the California Penal Code, the Sonoma County Grand Jury examines the local jails every year. This year it decided to investigate how the Main Adult Detention Facility (MADF) in Santa Rosa meets the medical, mental health, dental, substance abuse treatment and educational needs of inmates.

The MADF was built to hold short-term prisoners — those awaiting trial, those unable to make bail or those serving sentences of less than a year.

Since 2011, however, in order to reduce overcrowding in state penitentiaries, local jails like the MADF have been housing more serious criminals serving longer terms. According to the report, these felons now represent 19% of the jail population.

This, combined with the rise in arrests of the homeless, means that prisoners come into the jail in poorer health and with more serious mental health issues.

Main Findings

The report’s first finding struck a positive note, noting that “The Main Adult Detention Facility, through its contractors, is providing quality medical care, drug treatment, dental care, mental health treatment and adult educational opportunities to its inmates. The Sheriff’s Office is to be commended for its management of social services at MADF.”

It particularly praised the Sheriff’s Office for its “Jail-based Competency Restoration” program, which has significantly reduced the time needed to ready mentally ill inmates to stand trial — down from 10 months to just two-and-half months. The program relies on a combination of psychological testing, psychotherapy tailored to restoring legal competency and psychiatric medication (including petitioning the courts for involuntary use of psychiatric medication for patients suffering from schizophrenia and bipolar disorder).

This improvement has been so impressive that, according to the report, “Staff from other California jails now visit MADF to learn how the program is achieving such remarkable results.”

The Grand Jury did find some serious room for improvement, however. Some of their findings were procedural — insufficient nursing staff during evening and night shifts contributes to delays in the booking process — but others were health-related.

The report, for example, urges the jail to reexamine its practice of forcing addicts to go “cold turkey,” rather than having them use maintenance medications such as suboxone or methadone.

The report also suggested that the jail’s health contractor, Wellpath, do more comprehensive screening for tuberculosis, HIV/AIDS, syphilis and other STDs. It also chastised Wellpath for switching inmates using certain HIV/AIDS medications to “alternative medications, which may not be as effective or well-tolerated.”

In addition, the Grand Jury called the lack of a comprehensive vaccination program at MADF “a missed opportunity,” noting that the jail could receive vaccines for free from the county if it had a medication refrigerator with a temperature alarm.

The report also suggested that the jail work more closely with local public health agencies to ensure that prisoners who are being released into the community in the middle of, say, a course of antibiotics for tuberculosis finish their mandated treatment protocols.

The Grand Jury’s final finding addressed the jail’s education system. Although the jail offers 50-plus courses for inmates and provides incentives for taking classes, including GED prep courses, the report noted MADF’s inability to award a GED certificate “is a weakness in the MADF education program.” They note, however, that the jail has already lined up a new program, called Five Keys, which will go into effect this fall and will remedy this shortcoming. 


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