Report 2020-102 Recommendation 5 Responses

Report 2020-102: Public Safety Realignment: Weak State and County Oversight Does Not Ensure That Funds Are Spent Effectively (Release Date: March 2021)

Recommendation #5 To: Alameda County

To ensure that county jails have sufficient information to determine appropriates housing and supervision of inmates with mental illness, by June 2021 Alameda should develop a process requiring mental health providers to share with jails the mental health status of all inmates, such as whether they have a mild, moderate, or serious mental illness.

1-Year Agency Response

Currently all incoming inmates are screened at booking for the presence and severity of mental health and substance abuse disorders. A brief clinical risk assessment conducted by AFBH staff determines the presence and severity of symptoms.

AFBH and ACSO are finalizing the updated data sharing MOU, which will allow AFBH to share information on the mental health status of AFBH clients with ACSO for the purposes of classification, housing, care coordination, client safety, and supervision. The data sharing MOU is on target to be completed by the identified date of June 30, 2022.

California State Auditor's Assessment of 1-Year Status: Pending

Alameda did not provide documentation to support its assertion that it screens all inmates for the presence of mental health disorders during it booking process. We look forward to reviewing such documentation and its data sharing agreement during Alameda's next annual response.

6-Month Agency Response

Currently all incoming inmates are screened at booking for the presence and severity of mental health and substance abuse disorders. A brief clinical risk assessment conducted by AFBH staff determines the presence and severity of symptoms.

AFBH and ACSO are developing an MOU to address the sharing of legally allowable information for inmates being served by AFBH. The MOU is estimated to be completed and approved by December of 2021. AFBH also provides ACSO leadership with a monthly aggregate report for AFBH clients. Currently, all incarcerated persons, who have been evaluated by AFBH, and deemed a Behavioral Health Care Inmate are classified and housed with that information taken into consideration. AFBH is responsible for notifying ACSO when an incarcerated person's Behavioral Health status changes. If an incarcerated person is determined to be Severely Mentally Ill, AFBH places a notation in the jail management system. AFBH determines an individual's acuity level as: stable, assaultive, agitated, suicidal, history of assault, cooperative, homicidal, threatening, or no longer suicidal, or other.

ACSO is working on several aspects to further improve the classification process, housing unit capital improvement, and additional staff training. We anticipate these changes will roll out in early 2022.

California State Auditor's Assessment of 6-Month Status: Pending

As we discuss in our evaluation of Alameda's response to Recommendation 4, Alameda recognizes that it does not conduct a comprehensive mental health screening during its booking process. We look forward to reviewing Alameda's progress toward conducting mental health screenings of all inmates upon admission to the county's jails and requiring its mental health providers to share the mental health status of all inmates with the jails during its 1-year response.

60-Day Agency Response

Currently all incoming inmates are screened at booking for the presence and severity of mental health and substance abuse disorders. A brief clinical risk assessment conducted by AFBH staff determines the presence and severity of symptoms.

AFBH and ACSO are developing an MOU to address the sharing of legally allowable information for inmates being served by AFBH. The MOU is estimated to be completed and approved by September of 2021. AFBH also provides ACSO leadership with a monthly aggregate report for AFBH clients. Currently, all incarcerated persons, who have been evaluated by AFBH, and deemed a Behavioral Health Care Inmate are classified and housed with that information taken into consideration. AFBH is responsible for notifying ACSO when an incarcerated person's Behavioral Health status changes. If an incarcerated person is determined to be Severely Mentally Ill, AFBH places a notation in our jail management system. AFBH determines an individual's acuity level as: stable, assaultive, agitated, suicidal, history of assault, cooperative, homicidal, threatening, or no longer suicidal, or other.

ACSO is working on several aspects to further improve our classification process. We anticipate these changes will be implemented in June of 2021.

California State Auditor's Assessment of 60-Day Status: Pending

We look forward to reviewing Alameda's progress in implementing this recommendation as part of its 6-month response.

All Recommendations in 2020-102

Agency responses received are posted verbatim.