RIVERSIDE COUNTY, Calif. — Inadequate staffing is depriving Riverside County jail prisoners of their legally entitled mental health services and compromising fiscal oversight by the internal audit division, according to two civil grand jury reports released Wednesday.
The grand jury panel, which scrutinizes county government operations, recommended that the county hire more mental health professionals and auditors.
Without the added staff, providing treatment to prisoners for mental health issues ranging from substance abuse to schizophrenia will either not happen or it will cost more because inmates will have to be transported to appointments with off-site clinicians.
Without more auditors, reported fiscal abuses will go unchecked, the grand jury said.
County officials said they would review the reports and provide a response after some analysis of the findings and recommendations, which are not binding.
"We're taking it seriously," county spokesman Ray Smith said. "Until we have a chance to review (the grand jury reports) and develop the response, that is all we can say."
Questions about staffing levels are not new for either department. Other grand jury reports in the past decade have encouraged the county to hire more auditors and mental health professionals.
The grand jury's newest report on the issue found that the counseling and help available to inmates has fallen farther behind since last year, a situation made worse by state prison realignment. Jurors heard testimony that 21 of 40 positions to treat adult prisoners and three of nine dedicated to juvenile mental health services are vacant.
Reasons for the staffing shortage ranged from a tight county budget to difficulty attracting mental health professionals based on the salaries offered.
Grand jurors also found fault with the lack of acceptable background checks for mental health staff members who work in juvenile facilities, gaps in coverage because of the distances mental health providers must travel to far-flung jails, and late filing of some paperwork associated with patient care.
Jailhouse mental health services are provided by the county's Department of Mental Health under an agreement with the Sheriff's Department. Officials are trying to hire more people specifically to work inside the corrections department, said Jerry Wengerd, mental health department director.
"A lot of change has already happened and more change is happening," Wengerd said.
Asked to be more specific, Wengerd said he could not provide details, citing the need to respond to the grand jury report.
Some additional relief might be coming in the next fiscal year, Smith said in an email.
"Despite cuts in many areas of the county budget, mental health detention rises slightly for the budget year that begins next month," he said.
Since fiscal 2010-11, spending for mental health in the jails has risen from $4.3 million to $5.3 million.
"We still have a little ways to go with medical and mental health services, but we're getting there," said Jerry Gutierrez, the chief deputy who oversees the five adult jails in Riverside County.
But the progress is not fast enough for some prisoners' rights advocates. The Prison Law Office, a Berkeley-based nonprofit, wrote Riverside County officials in January asking for improvements in health, mental and dental care for inmates.
"They have not responded substantively," Sara Norman, the agency's managing attorney, said of county officials.
Without adequate care, notably timely access to diagnosis and medicine, Norton said prisoners' health can deteriorate.
The problem is increasing as the county jail population grows. California's 2011 prison realignment has funneled low-level offenders from state prisons to county jails. More than 25 percent of Riverside County's adult inmates are former state wards, Gutierrez said.
According to the grand jury report, 23 percent of youths in the county's juvenile system are former state trustees.
Norman said that growth requires a system that can quickly diagnose and treat medical and mental problems.
"The counties are going to struggle even more and, if they do not have a system, they have to build it," she said.
Norman said the Prison Law Office has not ruled out filing a lawsuit against Riverside County, similar to one filed in December in Fresno County.
In a separate report, grand jurors found lapses in the county's ability to root out fraud and abuse via the internal audit division. The internal auditors, part of the auditor-controller's office, are undermanned and unable in some cases to investigate complaints, grand jurors said.
A fraud hotline received two calls about overtime abuses after it was set up in 2009, the report said.
The auditors did look into a complaint about such abuses at the Department of Mental Health, the report said. "The second scheduled audit involved potential overtime abuses in the Sheriff's Department. This investigative audit was canceled due to lack of manpower or because it was not mandated by government code. It is the considered judgment of this Grand Jury that if either situation exists, the importance of asking County employees to identify fraud, waste, and abuse in County departments is negated."
Grand jurors also found auditors needed better training and oversight in order to ensure the integrity of county spending and policies.
Spending for the internal audit division in the next budget is up 66 percent to $1.6 million, Smith said.
The grand jury is made up of applicants who agree to sit on the jury from July 1 to June 30. Its reports must be released by the end of the term.