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Committee hears custody‑health report showing low post‑release continuation of medication‑assisted treatment
Summary
Custody Health staff told the committee that a 2024 pharmacy study tracked 61 people who began medication‑assisted treatment (MAT) in custody and found only seven continued treatment after release; attorneys and clinicians cited interoperability, data‑sharing and release practices as barriers to tracking and continuity.
Custody Health staff reported to the Santa Clara County Health and Hospital Committee on Oct. 13 that continuity of medication‑assisted treatment (MAT) after jail release is low and difficult to measure because of record access and system barriers.
Dr. Braceli Luna, director of custody health services, introduced an expert panel including custody addiction specialist Tiffany Tahata and nursing executive Dr. Jennifer Cole. Luna said a 2024 pharmacy study identified 91 individuals who began MAT in custody; researchers could access records for 61 of those people and found only seven continued MAT after release. "Those records that we do access... unfortunately, it's pretty low," Luna said.
Panel members and county staff described several causes for low documented continuation: different electronic health records between jurisdictions, limited interoperable data‑sharing agreements, privacy rules (including 42 CFR Part 2 for substance use treatment), and the operational reality that many detainees are released on short notice, limiting discharge planning time. "We can't hold them longer in order to do that planning," a county official said when explaining court‑ordered release timing.
Committee members discussed staffing and capacity: Custody Health reported a team that includes one social worker specializing in substance use, two rehabilitation counselors and seven medical doctors (two addiction specialists). Staff also provided three‑month transfer figures: across July–September there were a small number of custody‑to‑ER transfers for alcohol and drug issues (monthly totals in single digits) and about 150 patient transfers to emergency departments on average per month.
Members raised facility and program design issues, including concerns that current jail facilities limit the ability to deliver sustained therapeutic recovery programs and that contraband and other in‑custody exposures undermine treatment. Members requested follow‑up on data‑sharing with California Department of Corrections and Rehabilitation (CDCR) and on steps to improve transitions for people transferred to state custody.
What the committee did: the committee received the custody health withdrawal‑care report by voice vote (two ayes, motion carried). Staff were asked to return with findings about information sharing with CDCR and possible options for improving follow‑up and data collection.
Why it matters: Low, documented continuity of MAT after release risks relapse and overdose; county staff said improving interoperability, discharge planning for longer stays, and facility design could increase continuation of care.
