Battered by pandemic, Sacramento County loses medical director for troubled jails

Sacramento County is searching for a doctor to oversee the beleaguered health care system inside its two jails after the previous medical director resigned from the post after 17 months.

Dr. Tammy Morin, who served in the role since March 2019, left the job with the county’s Department of Health Services at the end of August where she oversaw a broad range of programs for adult inmates, including behavioral and dental health.

Her departure comes as the county is trying to improve health services offered after a class-action lawsuit alleged poor conditions at the Sacramento County Main Jail and the Rio Cosumnes Correctional Center. A judge approved a consent decree in January that forces the county to address issues around staffing, health services and the quality of its buildings.

Board-certified in family medicine, Morin previously worked for Kaiser Permanente and the California Department of Public Health. She announced her departure in an Aug. 18 email to her deputy and Aron Brewer, chief of correctional health services.

Now the county must try and recruit a replacement during a COVID-19 crisis that has placed more strain on medical staff in the jails.

“There will be challenges in filling the position, both because of the workforce shortage in the industry as well as the pandemic,” county spokeswoman Kim Nava said in an email. Close to a half dozen people have already applied and the interview process started this week, she said.

Under internal and public pressure, public health leaders throughout the country and California have resigned from top jobs as the demands of the pandemic create more duties and scrutiny. Kaiser Health News and The Associated Press recently found that 49 state and local public health leaders have resigned, retired or been fired since April across 23 states.

Dr. Robert Padilla, the jail’s chief medical officer, was appointed as the acting medical director. Attempts to reach Morin by phone were unsuccessful and a message to her LinkedIn profile went unanswered.

Since earlier this year, the county jails have been under increased pressure to correct long-standing issues around the treatment of inmates in need of medical care. In 2015, the nonprofit Disability Rights California published a report that concluded the jail staff excessively isolated inmates, offered inadequate mental health services and effectively violated the rights of those incarcerated with a disability.

The group was in talks with the county on ways to make jail conditions better until the discussion fell apart. In 2018, Disability Rights California and the Prison Law Office sued the county on behalf of several inmates, alleging they were kept in “dangerous, inhumane and degrading conditions.”

The lawsuit alleged that the jail staff failed to properly screen inmates for mental or other health concerns; did not provide canes, wheelchairs, glasses or hearing aids for disabled inmates; and that the facilities were chronically understaffed.

The case was settled in 2019 and the agreement to overhaul the jail’s health system was approved in January 2020. Now, court monitors submit reports to a judge every 180 days to track the county’s progress. The first report was submitted earlier this month.

COVID-19, turnover slow early efforts

Improving services for people with chronic conditions, such as diabetes and heart disease; improving specialty care and detox procedures for people addicted to drugs or alcohol were at the top of the list.

The county said it would address those issues within the first three months of the year but has been stymied by the pandemic, employee turnover and health provider shortages, officials said.

At least three specialty care providers resigned.

Aaron Fischer, an attorney with Disability Rights California who was co-counsel on the case, said the problems continue to put their clients at risk of serious harm.

“They have not done what the consent decree requires on those topics. Those were time-sensitive requirements, requirements with deadlines and those have not been completed. That is of concern to be sure,” Fischer said.

“The inability to get that done is certainly related to the all-consuming COVID-19 pandemic that they’re dealing with. We’re still pressing them on it and I hope they will make progress but they’re behind.”

In the first progress report, officials said daily COVID-19 management and monitoring is “staff intensive” and has also delayed the health care improvements.

As of Oct. 7, more than 4,600 COVID-19 tests were provided in the jails; 103 were positive and all but one of those positive cases were discovered during the intake process. There have been no deaths linked to COVID-19 in either jail, according to the Sacramento County Sheriff’s Office website.

“Recruiting providers has been challenging, as there is a healthcare shortage due to high demand for primary care and specialty providers. Because of the workforce provider shortage, work is delayed on the chronic disease management and detoxification protocols,” Nava said in an email.

“The plaintiffs are aware the COVID-19 pandemic has required extensive resources and has disrupted the remedial plan work, and they are aware the County is implementing the work as quickly as possible.”

This story was originally published October 14, 2020 at 12:49 PM with the headline "Battered by pandemic, Sacramento County loses medical director for troubled jails."