The U.S. Department of Justice has reached a settlement agreement with San Luis Obispo County, finding the county made "significant strides" in improving conditions inside the jail.
The 2021 findings of the jail conditions violating the Eighth and 14 Amendments and Americans with Disabilities Act have been resolved, the agencies announced in a Thursday news release.
The agreement comes nine years after the January 2017 death of Andrew Holland, an inmate who died naked on the floor in restraints as deputies watched for 46 hours.
The DOJ began investigating the jail's conditions in 2018. In August 2021, the agency issued a report that found the jail "violated the rights of prisoners in several ways, including failing to provide adequate health care and subjecting some prisoners to excessive force." The county did not admit to violating inmate rights in the settlement agreement. Rather, the agreement recognizes the improvements the county made in its jail.
"The county disputes the United States' findings and denies any and all allegations that the county violated, or is violating, the Eighth or Fourteenth Amendments of the U.S. Constitution. This agreement does not amount to any admission of wrongdoing by the county," the agreement said.
The "significant strides" include improved medical assessments and treatment for individuals with chronic conditions, improved mental health treatment and increased custody, healthcare staffing and progress in curbing excessive force, the agreement said.
Suicide prevention is an outstanding issue, the DOJ noted, but "many jail staff members now routinely carry cut-down tools that have been used to stop attempted hangings and appear to have saved lives."
The San Luis Obispo County Sheriff's Office said in its own news release Thursday that the 2021 DOJ report focused on the jail's conditions prior to 2019. That was when it entered into a comprehensive contract with Wellpath for physical, mental and dental health care. Since it entered its contract with Wellpath, the Sheriff's Office was recognized as an Innovator County in mental health services, received an award for excellence for its behavioral health and incentive program, and received its healthcare accreditation.
"We are pleased with the settlement agreement, as it not only highlights the significant advancements we've achieved over the years but also underscores the progress we are committed to maintaining," the agency said in the release.
According to the agreement, the jail must follow specific guidelines to implement suicide prevention in the jail. This begins with using identifying inmates with potentially life-threatening mental health emergencies and ensure they receive an immediate consultation with a mental health professional or transferred to a hospital emergency room or psychiatric hospital, the agreement said.
Inmates who partake in an emergency mental health protocol must be placed under "documented constant unobstructed visual observation" until they are checked out by a profession or transferred to an emergency room or psychiatric hospital, the agreement said.
The jail must also identify inmates who need urgent assessments, meaning someone with an urgent mental health condition that hasn't escalated to self-harm. This includes new or acute changes in behavior, behavior that could put another inmate at risk of harm or inability to respond to basic requests or give basic information. Those inmates must receive an assessment with a mental health professional within 24 hours. In the meantime, they will be placed in a setting with documented, staggered safety checks at least every 15 minutes until the assessment.
If an inmate is at-risk of suicide, the jail must place them in suicide-resistant housing within four hours and develop a plan for the inmate to gradually move from more restrictive housing and observation to less when clinically appropriate. Inmates also must be provided out-of-cell time for clinically appropriate activities and showers, the agreement said.
The agreement also requires custody staff to immediately refer inmates with serious mental illness who are decompensating in restrictive housing to a mental health professional for assessment, the agreement said. Inmates with serious mental illness must have access to meals that meet the same standards as the rest of the jail population, at least three showers a week, visitation rights, access to reading and writing materials, the ability to purchase and retain property and opportunity to meet face-to-face with a mental health professional at least once a week.
Inmates in restrictive housing for more than 30 days may also have access to radio or television, the agreement said. Inmates will also receive structured mental health programming and, if on on medication, they will receive a visit from a healthcare professional once per day.
The jail also must implement written policies for disciplining inmates with mental illness. This includes consulting with mental health staff to determine whether initiating disciplinary procedures is appropriate for an inmate with serious mental illness.
Before deciding whether to discipline an inmate with serious mental illness, staff must determine whether the inmates actions were because of the mental illness or whether the proposed discipline would interfere with the individual's mental health treatment.
If either applies and a mental health professional recommends against discipline, custody staff must not discipline the inmate unless there are documented exceptional circumstances. Restraints may only be used while out of cell only if there is an individualized, documented assessment of a security-based need for restraints the agreement said. This classification will be revisited at least every 14 days.
According to the agreement, the Sheriff's Office must ensure its use-of-force policies and procedures are in compliance with the guidelines set forth by the DOJ. This includes using deescalation techniques and crisis intervention tactics and other alternatives.
"When feasible, force shall be used only after all other reasonable efforts to resolve the situation have failed," the agreement said. Force should only be used where there is an immediate threat to the safety or security of the jail, other inmates, staff, visitors, or if an inmate is resisting and not compliant, the DOJ said.
Custody staff must only use the amount of force necessary based on the seriousness and likelihood of any perceived threat to safety and the level of actual or threatened resistance, the agreement said. Use of force and restraints must be prohibited as punishment or retaliation, the agreement said.
The Sheriff's Office must ensure there is documented communication with medical and mental health staff prior to planned uses of force, if feasible, and documented mental health assessments and medical assessments after force is used against an inmate. Custody staff must report use of force incidents immediately to the use of force supervisor, the DOJ said. All use of force incidents must be documented by the custody staff member who used it with an accurate and detailed account of the events.
The reports and statements must be prepared independently and individually by the affected staff, the DOJ said. Failure to report use of force will result in retraining or discipline, when appropriate.
Staff also cannot use "boilerplate" language, like "fighting stance" without supporting incident-specific details in the description of the incident, the agreement said.
If you or someone you know is having thoughts of suicide, the National Suicide Prevention Lifeline is a hotline for individuals in crisis or for those looking to help someone else. To speak with a certified listener, call 988. You can also call the Central Coast Hotline at 800-783-0607 for 24-7 assistance. To learn the warning signs of suicide, visit suicidepreventionlifeline.org.