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Date: |
September 1, 2026 |
18 |
Title
Sheriff - Receive Presentation on Commitment to Jail Improvements (Districts: All)
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Overview
On August 16, 2022 (23), the Board of Supervisors (Board) directed a series of actions focused on supporting the San Diego Sheriff's Office (Sheriff’s Office) in fulfilling the County of San Diego's (County) duty of providing sufficient care for incarcerated persons. The Sheriff’s Office continues to transform its jail operations with a focus on modernizing systems, strengthening care standards, and creating safer, more therapeutic environments. These significant changes have been achieved by prioritizing accountability, engaging external experts, assessing relationships with contracted service providers, refining operational workflows and safety standards, creating specialized teams, and leveraging technology. The Sheriff understood the public expectation for significant culture change in the jails. She has focused on reducing in-custody deaths, carceral healthcare, and creating urgency for improvement. This commitment is rooted in the belief that a safer, more therapeutic, and more accountable environment benefits incarcerated individuals, deputies, Sheriff and County staff, and contract providers. This commitment prompted new policies aligned with the Americans with Disabilities Act (ADA) requirements and improvements in mental health, medical services, and dental services. Strategic investments such as placing physician-level care at intake and partnering with NCCHC Resources Incorporated (NRI), a firm specializing in improving correctional health care quality, safety, and compliance across jails, prisons, and juvenile facilities, demonstrate the Sheriff's Office's strong commitment to achieving accreditation and formally recognize it as a leading model of excellence in jail operations and care.
Process changes and investments are grounded in a commitment to high-quality custodial care while proactively supporting pathways to self-sufficiency for individuals reentering the community. Building on a foundation of recognized reentry success, the Sheriff’s Office is advancing partnerships that strengthen long-term community stability and recovery for participating individuals. Expanding reentry partnerships-which include the Assessor/Recorder/County Clerk (ARCC), community organizations, and programs connected to Community Assistance, Recovery and Empowerment (CARE) Court-all support successful transitions, reduce barriers, and help individuals stabilize upon return to the community. The approach of the Sheriff's Office reflects a comprehensive strategy to address acute needs while supporting incarcerated people's long-term recovery and stability.
The Sheriff’s Office presentation provided today provides an overview of the reform initiatives and how they demonstrate the Sheriff's commitment to responsible stewardship, continuous improvement, and effective outcomes for the county and our communities.
Body
Recommendation by the Sheriff:
Receive the Sheriff's Office presentation on its “Commitment to Jail Improvements.”
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Equity Impact Statement
The Sheriff’s Office initiatives collectively promote more equitable access to care and improved outcomes for individuals who come into San Diego County jails, many of whom are underserved. Expanded medical coverage at jail intake ensures early identification of chronic and acute conditions, reducing disparities in health outcomes. Strengthened behavioral health programming such as Early Access and Stabilization Services, Jail-Based Competency Treatment, and expanded Outpatient Stepdown beds support individuals with serious mental health needs. Building detention facilities that focus on recovery, stability, and personal growth benefits the individuals in custody, deputies, staff, and contracted providers who work with them every day, and the community as a whole.
Sustainability Impact Statement
The efforts of the Sheriff's Office support the County of San Diego's Sustainability Goals of engaging the community; providing just and equitable access; and protecting health and well-being. Efforts to improve transparency, including community tours and publicly shared performance metrics, help build trust and reinforce accountability with our community. Additionally, expanding Medication Assisted Treatment (MAT) services at Las Colinas Detention and Reentry Facility (LCDRF) ensures equal access for women. The Sheriff's Office has continued to improve quality and consistency of medical, dental, and substance use treatment provided in custody. Together, these efforts reduce longstanding inequities, strengthen community partnerships, and support a more just and responsive system.
Fiscal Impact
There is no fiscal impact associated with today's action. There will be no change in net General Fund costs and no additional staff years.
Business Impact Statement
N/A.
Advisory Board Statement
N/A.
Background
The San Diego Sheriff’s Office (Sheriff's Office) has the legal and moral obligation to care for individuals in its custodial setting. The Sheriff's Office operates a system of seven uniquely designed detention facilities located throughout San Diego County. The Sheriff's Office provides a wide array of onsite services and programs at the detention facilities, including medical care, mental healthcare, food services, counseling, recreation, religious accommodations, education, and reentry services.
On August 16, 2022 (23), the Board of Supervisors (Board) directed a series of actions focused on supporting the Sheriff's Office in fulfilling the County of San Diego's (County) duty of providing sufficient care for incarcerated persons. Soon after, under the administration of newly elected Sheriff Kelly Martinez, the Sheriff's Office fundamentally recognized the challenges and opportunity to improve with a vision to build on the work that was already underway while addressing longstanding deficiencies through meaningful reform, sustained staffing and infrastructure investment, and a culture shift rooted in improving. The Sheriff's Office has pursued a comprehensive approach to strengthening jail operations, modernizing aging infrastructure, supporting its workforce, and achieving better outcomes for individuals in custody. This focus and determination reflect a shared commitment to building a safer, healthier, and more effective detention system.
In 2024, a major development in healthcare outcomes involved restructuring physician-level staffing at detention facility intake by carving out primary medical care provider services from the comprehensive Naphcare contract. Today, the Sheriff’s Office directly contracts with Correctional Healthcare Partners (CHP) to provide these services. This change allowed the Sheriff’s Office to significantly expand the level of care, and place physician-level care directly at intake, improving the early identification of both chronic and acute health issues. This change has enhanced access to care and contributed to a reduction in the risk of in-custody deaths, an important indicator of improved medical responsiveness and system performance. It reduced the amount of time it takes to see a doctor upon admission and allowed CHP to identify chronic health conditions that may have previously gone unnoticed or addressed. It also ensures that individuals can begin both previously prescribed and newly prescribed medication more promptly.
Response to External Oversight and Litigation
Parallel to the Sheriff's Office's commitment to improving and enhancing service delivery across all detention services disciplines, external oversight recommendations and litigation outcomes have been integrated into the comprehensive direction of reform. These efforts have included a number of improvements over the past several years, including following the California State Auditor Report 2021-109, released in February 2022, which focused on suicides, in-custody deaths and the sufficiency of mental health services. The Sheriff’s Office has created a more robust mental healthcare system, expanded the Detention Safety Program and further developed several specialized housing units to foster a therapeutic environment for individuals with serious mental illness. In the Dunsmore class action filed in March 2020, the County has also entered into four settlement agreements to resolve claims related to the Americans with Disabilities Act (ADA), Mental Health, Medical Services, and Dental Services. The Sheriff's Office has implemented numerous new processes and policies in accordance with these agreements and is proactively working to comply with remaining requirements.
One significant remaining requirement under the Dunsmore litigation is the hiring of a Chief of Psychiatry dedicated to oversight of mental health care delivery within the seven detention facilities. Currently, the Sheriff's Office has a Chief Medical Officer who oversees all medical operations, clinical practices, and approves medical policies and procedures. However, there is no mental health equivalent to the Chief Medical Officer position. The system has expanded at such a rate that there is a need for Sheriff's Office clinical executive leadership and oversight. The Sheriff’s Office intends to hire a Chief of Psychiatry this fiscal year to meet its clinical oversight mandates under the Dunsmore mental health settlement agreement. This significant role, which will go operational in the fall, will serve as an essential component of the detention Medical Services leadership to ensure high-quality, safe, and strategic mental health care across detention services and further underscore the robust mental health system offered to the incarcerated population.
The Sheriff's Office has taken proactive steps to reshape its culture through transparency and community engagement. The Sheriff's Office has built very collaborative, open, and engaged partnerships with our oversight boards to include the Citizens' Law Enforcement Review Board (CLERB), San Diego County Grand Jury, Past Grand Jurors Association Implementation Review Committee (PGJAIRC), and Board of State and Community Corrections (BSCC). Several presentations have been provided to these oversight bodies regarding the Sheriff’s Office’s progress. Tours for local leaders, civic groups, students, media, and oversight organizations have opened the facilities to public understanding, and participation in community events has furthered education about custody-related initiatives.
Seeking National Accreditation and Expert Outside Input
The Sheriff's Office is further strengthening its systems through national accreditation efforts. The National Commission on Correctional Healthcare (NCCHC) is a nationally recognized organization that evaluates medical and mental health practices and policies in custodial settings. It is an impartial and unbiased expert organization dedicated to recognizing and fostering improvements to the field of correctional healthcare. In November 2025, the Sheriff's Office procured consulting services of NCCHC Resources Incorporated (NRI) to survey all our detention facilities to assess areas of concern in preparation for accreditation. NRI visits Sheriff's Office detention facilities quarterly and maintains a record of areas that require change for NCCHC compliance. Each facility must be accredited separately and must meet NCCHC standards. The Sheriff’s Office applied for accreditation for the Las Colinas Detention and Reentry Facility in June 2026, and the accreditation site survey will likely take place in January 2027. Upon earning the NCCHC accreditation of Las Colinas Detention and Reentry Facility, the Sheriff's Office will seek the independent accreditation of the other six facilities.
Treating Substance Use Disorder and Combating Drugs Entering Facilities
The Sheriff's Office has instituted a multi-pronged approach to preventing drug overdoses in the County jails. Substance use treatment services has significantly expanded since 2023. Medication-Assisted Treatment (MAT) modules opened at Vista Detention Facility (2023) and at Las Colinas Detention and Reentry Facility (2026), with a third module planned at Rock Mountain Detention Facility later this year. The MAT program is offered to any incarcerated person entering our facilities who has substance use disorder. Each individual is assessed during intake screening and is prescribed suboxone based on their symptoms and medical history. Individuals who choose to participate in counseling, receive therapy treatment to aid in the symptoms of addiction, and have medication administered for symptoms of withdrawal are categorized as MAT patients. Individuals who choose to only receive medication for physical symptoms are categorized as Medications for Opioid Use Disorder (MOUD) patients. As of July 2026, there were 265 incarcerated individuals participating in MAT and 650 individuals participating in MOUD. Vista’s integrated MAT module program model (which combines deputies, clinicians, and reentry specialists) is considered a best-practice model statewide and was recently featured in a national correctional publication.
Recognizing that substance use disorders treatment includes preventing exposure to illicit drugs, the Sheriff's Office has invested in preventing drugs from entering the jails. Initially introduced as a pilot program in 2023, the Visitor and Perimeter Enforcement Detail (VPED) combined existing perimeter and visit deputies into a unit specifically trained to deliver proactive perimeter and visitor security. Canine deputies and their partners are also integrated into the VPED team and play an important role in narcotic detection. In 2025, deputies seized over 50 weapons (including both registered and non-registered firearms, knives, tasers and pepper spray) as well as approximately 1,000 grams of hard drugs and over 15,000 grams of marijuana. These seizures and arrests helped in preventing these items from entering the facilities while at the same time keeping the Mesa Detention Complex (George Bailey Detention Facility, East Mesa Reentry Facility and Rock Mountain Detention Facility), the Las Colinas Detention and Reentry Facility and the surrounding communities safe.
The Sheriff's Office has invested personnel to mitigate the threat of drugs and other contraband by creating the Contraband Narcotics Interdiction Team (CNIT). CNIT is a dedicated and highly trained team that improves the jail intake process and stops the smuggling of narcotics and other contraband into the detention facilities. The work of CNIT has led to increased discovery of concealed narcotics and contraband not just at intake, but throughout the facility operations, including return-from-court transfers.
In addition to CNIT, random facility-wide searches are conducted and supported by deputy and canine resources. These searches reinforce the interdiction network by removing contraband that manages to enter housing units in the jails. During these robust searches, deputy and canine resources are pooled from around the bureau to aid in large-scale searches of housing units one facility at a time to prevent narcotic activity, remove contraband, and maintain a safe housing environment for all incarcerated individuals. Random employee screenings add a crucial accountability layer, ensuring that employees entering the secure perimeter pass through robust safety checks. During these random screenings, sworn and professional staff employees are screened before entry into our jails using X-ray machines, metal detectors, and narcotic detection canines. Together, these initiatives form a comprehensive, multilayered defense system designed to prevent contraband from entering the jails, disrupt narcotic activity inside, and maintain a secure, stable environment for individuals in custody, deputies, Sheriff and County staff, and contracted providers who work within the facilities.
Partnering for Comprehensive Behavioral Health Care
The Sheriff's Office has continued building a comprehensive behavioral health approach within its facilities that incorporates engaging external continuity of care partners. The Sheriff’s Office has evaluated the need to create more programs focused on restoration of competency, medication compliance, and providing those with mental illness the same reentry opportunities and access to community-based organizations. Partnering with external care partners provides individuals the opportunity to continue their care once they leave custody.
The Sheriff's Office partners with the Department of State Hospitals (DSH) to facilitate the Early Access and Stabilization Services (EASS) program and the Jail-Based Competency Treatment (JBCT) program. The EASS program quickly identifies individuals who are deemed incompetent to stand trial (IST) and begins providing services with nurses, mental health clinicians, and case managers while the individual awaits housing in a more acute environment. Many felony IST defendants are unhoused, disconnected from Medi-Cal reimbursable services, and cycle frequently through the criminal justice system due to untreated mental illness. By providing early stabilization services, timely access to psychotropic medications, increased clinical engagement, and competency education while individuals await State placement, the Sheriff's Office helps mitigate the long delays that have disproportionately harmed these vulnerable individuals. The EASS program supports delivery of critical interventions and contributes to a more equitable, humane, and responsive competency-restoration system for individuals who have been historically underserved.
The JBCT program involves 8-10 hours a day of group programming in a therapeutic environment. Placement in JBCT is in lieu of a transfer to the State Hospital for restoration. By identifying individuals who are incompetent to stand trial early and beginning restoration services within custody rather than waiting for transfer to a State Hospital, individuals experience less delays, improved outcomes, and strengthened continuity of care across court, custody, and community settings. In 2025, the Sheriff's Office restored 76 individuals to competency while housed in detention facilities.
To meet acute mental-health needs more efficiently, the Out-Patient Step Down (OPSD) Unit was relocated from the San Diego Central Jail (SDCJ) to the newly renovated Rock Mountain Detention Facility (RMDF), providing additional patient capacity. OPSD programming is now all inclusive regardless of classification status and classification levels, ensuring that individuals across the system have access to robust mental-health support in settings appropriate for their needs. Expansion of the OPSD program has increased access for individuals with serious mental illness to ensure they receive appropriate care coordination. The OPSD efforts are supported by dedicated staff and incentive-driven programming. Collaboration with Behavioral Health Services (BHS) has brought in clinically trained staff working side-by-side with Sheriff's deputies and medical personnel in specialized units such as OPSD. Sheriff's personnel, in partnership with County BHS clinicians, identify individuals with Serious Mental Illness who may require intensive community-based services upon release. These clinicians also actively screen for Community Assistance, Recovery, and Empowerment (CARE) Court eligibility within custody, laying the groundwork for seamless linkage to community treatment, supportive services, and court-supervised care plans once individuals return to the community.
The Sheriff's Office also works closely with the Public Conservator and BHS's Forensic Evaluation Unit, providing them access to assess individuals’ clinical needs, determine eligibility for conservatorship, and coordinate care transitions. This collaboration ensures individuals with the most significant psychiatric needs have a continuity of treatment that does not end when they leave county jail. This continuity of treatment includes stabilizing medication plans, therapeutic placements, and legal oversight supporting long-term safety and stability. These partnerships create an integrated behavioral health system that supports individuals across all phases of incarceration and reentry, aligning clinical care, legal pathways, and community-based treatment to promote stability and reduce the likelihood of crisis or reoffending. Successful outcomes make the jails safer for deputies, Sheriff and County staff, and individuals who are in custody, which ultimately contributes to public safety.
Enhancing Reentry Support
The introduction of CalAIM has further strengthened care within the detention system by allowing Medi-Cal reimbursement for approved services delivered up to 90-days pre-release, historically paid entirely by counties. This change will reduce reliance on grants or local funds and improve continuity of care for individuals transitioning back to the community. Overall, CalAIM supports staffing, in-reach provider contracts, data/reporting infrastructure, and care coordination systems. Implementation remains on track for the September 30, 2026 deadline and the Sheriff's Office plans to monitor and report back via memo on its assessment of cost-savings within 90-days of implementation, as stated in the March 24, 2026 Board action (3).
Reentry services continue to grow, with more than 3,000 coordinated releases in 2025. Partnerships with organizations such as the San Diego Assessor/Recorder/County Clerk (ARCC), Union of Pan Asian Communities, PATH San Diego, and Southwestern College support community reintegration, housing stability, and educational advancement. Correctional Counselors deputized by the ARCC can now issue vital records directly to incarcerated individuals, removing barriers to reentry. The addition of sustainability-focused programs, such as composting and horticulture, provides meaningful skill-building opportunities. By expanding services and investing in each individual's potential, we continue to elevate the standard of reentry services while preparing participants to reunite with their families, contribute positively to their communities, and build brighter futures.
Advancing Technology and Innovation
The integration of technology in our Detention Services Bureau has allowed us to expand services, elevate patient care, and improve transparency. In 2024, the Sheriff's Office introduced Body Worn Cameras (BWC) into the jails which supplemented an aging CCTV system. By early 2025, every facility was equipped with BWC and every deputy assigned to the Detention Services Bureau has been trained in the use of and issued a BWC.
In November 2025, continuous glucose monitoring devices were introduced to diabetic incarcerated patients, a high-risk population, on a voluntary basis. This monitoring device eliminates finger sticks for the patient, improves medication pass times and allows nursing staff to get accurate blood sugar readings. In 2026, biometric monitoring technology was initiated at the Las Colinas Detention and Reentry Facility and San Diego Central Jail in the Medical Observation Units. There are plans to expand the program to the Vista Detention Facility.
The Sheriff’s Office upgraded its Wifi infrastructure throughout all the detention facilities, which has allowed for broader use of mobile applications into detentions operations. The addition of Wifi provides the ability to use tablets for telehealth, access to court and attorneys online, mobile charting for medical staff, and many other benefits. The secure Titan application pilot, launched in 2025, allows Sheriff's deputies and staff to access real-time information in the Sheriff's Jail Information Management System (JIMS) from office-issued mobile devices. Investment in mobile applications such as Titan will help streamline communication, increase efficiency, and support Sheriff’s deputies, Sheriff staff, and the contracted workforce's responsiveness throughout jail facilities.
From modernizing healthcare and expanding behavioral-health services to enhancing reentry support, disrupting contraband networks, and integrating innovative technologies, these efforts reflect a comprehensive strategy to improve safety, transparency, and outcomes for individuals in custody. Through these articulated reforms and improvements, the Sheriff's Office continues building a safer, more therapeutic, transparent detention system to exceed national standards and community expectations.
Linkage To The County Of San Diego Strategic Plan
Today's Board action advances the Equity and Justice Strategic Initiatives in the County of San Diego's 2026-2031 Strategic Plan by taking steps to increase the overall well-being of individuals in custody in San Diego County detention facilities and ensuring there are modern systems, processes, infrastructure, and the necessary personnel to deliver quality care, reduce recidivism, and improve public safety.
Respectfully submitted,
Kelly A. Martinez
Sheriff
Attachment(s)
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