Bexar County commissioners authorised a collection of adjustments to enhance medical care and oversight on the county jail following months of scrutiny over inmate deaths.
The actions, authorised unanimously by Commissioners Courtroom, embody a $250,000 settlement with College Well being to increase medical screening on the Bexar County Grownup Detention Middle by funding the development of a modular medical screening room on the jail consumption space. The funding additionally directs county workers to develop a public-facing dashboard monitoring jail deaths, inmate inhabitants information, medical referrals and different efficiency measures.
County officers described the measures as instant operational enhancements whereas acknowledging the broader effort to deal with overcrowding, behavioral well being and the rising variety of medically weak folks coming into the jail.
“What we’ve accomplished immediately is principally get some instant options that can assist alleviate the jail, however extra importantly acknowledge the wants of the folks which are coming into the jail, particularly these which are medically fragile or have medical points,” mentioned County Choose Peter Sakai on the assembly on Tuesday.
Beneath the initiative, the county will transfer enhanced medical screening nearer to the start of the jail consumption course of by developing a modular medical screening facility contained in the Justice Consumption and Evaluation Annex’s automobile sally port.
Officers say the redesigned consumption course of will enable College Well being clinicians to determine acute medical situations, behavioral well being crises and substance withdrawal signs earlier, serving to decide whether or not somebody wants instant therapy earlier than being admitted into the jail.
County officers mentioned the suggestions grew out of a assessment of jail deaths and the present inmate consumption course of.
County information reveals that 39 of the 91 in-custody deaths since 2020 occurred inside the first seven days after reserving, with 25% of these deaths labeled as pure causes and 37% died from substance toxicity with mixed acute medical points.
College Well being officers mentioned they may even work to create devoted housing items for detainees experiencing substance withdrawal so nurses can monitor them extra intently, administer intravenous fluids when obligatory and reply shortly if their situations deteriorate.
In line with the presentation on the public assembly, the well being system additionally plans to assign around-the-clock nursing workers to the items, work towards stationing an emergency medical technician on the jail and standardize medical communication between the town’s Central Justice of the Peace Workplace and the county jail in order that vital well being info follows detainees all through the reserving course of.
Commissioners additionally directed county workers to return with suggestions for a public dashboard monitoring jail deaths, inmate inhabitants traits, medical referrals, hospital transports and different efficiency measures by Oct. 1.
Diversion, twin magistration and long-term targets
Commissioners on the assembly targeted on longer-term efforts to cut back the variety of folks coming into the jail within the first place and shorten the time medically weak detainees stay in custody.
One recurring matter was the town’s long-standing dual-magistration course of, during which many individuals arrested by San Antonio police are first taken to the town’s Central Justice of the Peace Workplace earlier than being transferred to the county’s Justice Consumption and Evaluation Annex.
Officers mentioned the method can delay complete medical evaluations by a number of hours as a result of the county’s extra in depth screening doesn’t start till after detainees arrive on the county facility.
In February, after securing a brand new coaching website for the sheriff’s academy on the former Wilshire Elementary College campus, Sheriff Javier Salazar proposed repurposing the division’s Toudouze coaching facility right into a centralized reserving, Justice of the Peace and diversion heart serving each the town and county.
In a letter searching for federal funding for the challenge, Salazar mentioned the power would eradicate duplicate reserving and Justice of the Peace procedures whereas permitting folks experiencing psychological well being crises to be related with therapy earlier within the legal justice course of.
“The very best and finest use for that facility could be to, with some modifications, flip it right into a reserving facility,” Salazar instructed commissioners. “Drop them off there to us on the Toudouze constructing, they’d be capable to get extra instant medical care, medical screening and diversion or deflection away from the jail system if want be.”
Salazar mentioned metropolis officers have toured the Toudouze facility and discussions are ongoing. However on Tuesday, commissioners authorised terminating the sheriff’s lease on the former Wilshire Elementary College citing the anticipated price of remediating the old-fashioned campus.
Salazar mentioned the sheriff’s academy will stay on the Toudouze facility till one other coaching website is recognized, delaying potential plans to transform the constructing right into a centralized reserving heart.
“We’re continuing as if it’s in all probability going to occur in some unspecified time in the future,” he mentioned. “ I simply need to discover a appropriate coaching facility to maneuver my cadets to.”
The courtroom additionally previewed diversion initiatives anticipated to return later this 12 months, together with a proposed pilot program designed to maintain some folks experiencing psychological sickness or substance use issues from ever coming into the jail.
The proposal, being developed by the joint city-county diversion and deflection committee alongside the Middle for Well being Care Companies, UTHealth Houston College of Public Well being and different group companions, would create a 15-bed voluntary residential diversion heart for adults arrested on sure low-level, nonviolent misdemeanor prices the place untreated psychological sickness or substance use is believed to be a contributing issue.
As an alternative of being booked into jail, eligible people would endure an preliminary behavioral well being screening within the subject by legislation enforcement officers earlier than being evaluated by a clinician by STRAC’s MedCom system to find out whether or not they’re acceptable for diversion. If accepted, they might be transported on to the diversion heart moderately than the county jail.
Dr. Amber Pastusek, chief medical officer for the Middle for Well being Care Companies, mentioned individuals may stay on the facility for as much as two weeks whereas receiving major medical care, psychiatric therapy, substance use providers, counseling and case administration. Discharge planning would start instantly, with aftercare groups persevering with to work with individuals for about 90 days after they depart this system to assist safe housing, advantages and ongoing therapy.
Pastusek mentioned the pilot is modeled after a diversion heart she helped set up in Harris County, which initially targeted on folks arrested primarily for legal trespassing earlier than increasing to further low-level misdemeanor offenses as this system matured.
If funding will be secured, officers hope to launch the pilot in late 2026 or early 2027. Pastusek mentioned challenge companions have already developed a proposed working funds and are assembly with group stakeholders to safe funding however declined to reveal the estimated price.
On the similar time, UTHealth Houston is conducting a feasibility examine utilizing Bexar County jail information to find out what number of diversion beds the group in the end wants. The examine is predicted to wrap up by the tip of the 12 months, with a closing report anticipated in January 2027.
