County health officials say Santa Rita Jail met Title 15 standards but recommend improvements after two in‑custody deaths

Alameda County Health Officer Nicholas Moss told the Board of Supervisors’ Public Protection Committee on Nov. 21 that the county’s 2024 Title 15 inspection of Santa Rita Jail found medical and mental‑health compliance with the applicable Title 15 articles and sections, while listing several recommendations for improvement.

"The top line finding for medical and mental health was that compliance was met with all articles and sections," Moss said, while noting the inspection team identified recommendations that did not rise to the level of noncompliance.

Moss described the inspection process — required by state law and California Code of Regulations and informed by tools from the Board of State and Community Corrections — and said the county’s public‑health and environmental‑health teams split the work. He said the inspection period covered roughly a 12‑month span following the last inspection.

While inspectors found compliance on the measured standards, Moss highlighted recurring recommendations. He urged regular continuous quality improvement (CQI) meetings to incorporate corrective‑action plans and follow‑up; he said the county has hired an outside consultant (referred to during the presentation as "Mazars") to review health‑care quality efforts since 2020 and that Alameda County clinical leaders are observing that work.

On clinical operations, the team recommended better documentation and tracking for syringe use under pharmaceutical management, and a review of medications stocked in first‑aid kits so they contain appropriate, non‑injectable first‑aid items rather than medications more suitable for clinical settings. "The issue is not with first‑aid kit availability but rather that some of the medications that are in those first‑aid kits are actually, like, injectable medications," Moss said.

Moss also reported that the inspection team verified two in‑custody deaths during the review period and noted that the Title 15 inspection team does not participate in death reviews. "There were 2 in custody deaths during the period covered," he said, offering condolences to families and emphasizing that the Title 15 process does not by itself have authority to require broader changes.

Nutrition inspections showed incremental progress and continuing gaps. Inspectors found improved servings of whole grains but said additional servings are needed to meet the Title 15 minimum; sodium levels increased slightly from the prior year; and menu substitutions were not always documented, with inspectors repeatedly noting frequent use of prepackaged cookies as a substitute. The report recommended adding third whole‑grain servings on specified days, reducing highly processed and high‑sodium items, ensuring physician signatures and timely approvals for medical diets, and implementing a system to flag diets needing physician sign‑off.

Public commenters and stakeholders at the meeting called for greater transparency on lingering compliance problems. Bob Bridal of the Interfaith Coalition for Justice in Our Jails asked that the outside consultant reports and measure‑reporting referenced in the presentation be made public so the community can see where noncompliance occurred. Richard Spiegelman urged the county to report what it has learned from death reviews and what changes have been implemented to protect people in custody.

Moss said the full inspection report includes additional details and encouraged follow‑up through county email (the presenters provided county email contact guidance during the meeting). The presentation and its recommendations were informational; no formal action was taken by the committee at the meeting.

Next steps: the full written inspection report and its appendices contain itemized recommendations; county staff indicated they will continue CQI processes and work with the sheriff's office and contractors to address the recommendations.