Study of Jail Health Care to Be Made : Wieder and Gates Agree to Work on Communications

Board of Supervisors Chairman Harriett Wieder and Sheriff Brad Gates agreed Wednesday to tackle “communications problems” at the Orange County Jail that prompted the jail’s medical team last week to threaten a work stoppage.

After months of uneasy relations between jail health care workers and sheriff’s officials--climaxing in November when the jail commander ordered mental health employees out of the jail--Wieder and Gates met Wednesday and decided to assign two staff members to come up with a “coordinated effort” for delivering health care services to jail inmates.

The study could eventually produce another system for providing those services. It will also produce for the first time in a decade a formal agreement on the respective roles of the Sheriff’s Department, which runs the jail, and the Health Care Agency, which runs the medical ward, when it comes to providing health care for jail inmates.

Issue Is Critical

The issue is a critical one, both because of the relatively high number of inmate deaths at the jail in recent years and because of a number of flare-ups between the two departments in the past several weeks over the apparent suicide of jail inmate John Ray Stephenson on Nov. 6.

Jail Capt. George King ordered several mental health workers out of the jail shortly after Stephenson’s death when they refused to give him the inmate’s psychiatric records. The sheriff eventually went to court to obtain the documents.

Then Gates, in a memo to board members last week, raised questions about the psychiatrist handling Stephenson’s case, pointing to a wrongful death suit that had been filed against the doctor in what Gates described as a similar case.

Wieder said jail mental health workers threatened to walk off the job last week after the memo was distributed until she and other supervisors assured the employees “that we were behind them, we had no problem with them.”

“Had it not been for that previous incident, when they were ordered out of the jail, they might not have been so thin-skinned. I guess maybe they got to feeling persecuted,” she said.

Interim Health Care Agency Director Robert Love responded angrily to Gates’ memo this week in a memo of his own. “It is most unfortunate that an employee who is considered to be a very good clinician by those who have worked with him throughout his career finds himself being evaluated through a letter containing innuendoes that have now been published and aired by the media,” he told Gates.

Morale Problems

“This action has not only affected this employee but has caused significant morale problems among the mental health team in the jail,” he said.

Love made the proposal eventually endorsed by both Wieder and Gates, calling for representatives from the two agencies to sit down and work out their differences.

“When I first came to the agency, I asked staff to give me any documents that delineate the relationship between the sheriff and our staff located within the institutions that are under your jurisdiction,” he said in his letter to Gates.

“I was amazed to find that the only document that exists dates back to 1975 (before Orange County even had a Health Care Agency),” he said. “It is my opinion that without such a document, communication problems will exist and staff at times will be confused regarding their roles and responsibilities.”

Love has designated Richard DeGreve, newly hired to head a special medical program office that will oversee health care at the jail, to meet with Gates’ designee, who has not yet been selected.

“Basically, the problem seems to be the age-old one of lack of communications,” Wieder said. “I think there has to be a better . . . understanding as to their respective roles.”

Gates said Wednesday that jail officials have been working with the Health Care Agency for the past several months to better coordinate their efforts, and though Love says the past attempts have been inadequate, Gates countered:

“That may be his view. I think the cooperation as far as I’m concerned between the two agencies has been good . . . . We’re going to continue the good cooperation that we’ve had with the Health Care Agency. We’ve been working on improvements in procedures, and we’re going to continue to do that.”