Alameda County supervisors press for faster fixes after audit finds gaps in Santa Rita jail health care

Supervisor Marquez, chair of the Alameda County Board of Supervisors' Public Protection Committee, opened the March 27 meeting to hear a formal update on third-party audits of health care at Santa Rita Jail and to receive public comment. Presenters included Lieutenant Joseph Adienza of the Alameda County Sheriff's Office and consultants from Forbus Mazars, who conduct monthly audits and quarterly multidisciplinary reviews of the contractor Wellpath.

Faith Saport Santos, a registered nurse with Forbus Mazars, summarized the audit program and corrective-action process, saying Mazars conducts monthly QA audits of 15 highest-risk patients and additional CQI reviews of 30 or more records to identify root causes. She said corrective actions require Wellpath to submit a corrective-action plan within 30 days and that ACSO and Mazars verify whether fixes are sustained. "When QA and CQI audits keep finding the same problems that put patients at risk, then a corrective action is issued," Saport Santos said.

Dr. Eric Lee, Mazars' clinical and informatics expert, told the committee that sustainable improvement rests on people, process and technology. He warned that current electronic-health-record limitations create repeated manual work, slow access to vaccination and medication histories, and increase clinician burden. "I estimate there's probably 15 to 20 years of technical debt," Dr. Lee said, adding that integrating an EHR such as EPIC would reduce delays in identifying past medications and immunizations.

Lieutenant Adienza told the committee that ACSO audits Wellpath's staffing daily against a contract staffing matrix and that staffing shortfalls trigger reimbursements, penalties and, for extended vacancies, $1,000-per-position-per-day fines. ACSO reported it recovered $2,100,000 from Wellpath in 2024 in staffing reimbursements and penalties. Adienza also said ACSO expanded the Mazars contract in 2024 to include corrective-action tracking and a staffing analysis due to be released publicly.

Members pressed for next steps. Sheriff Sanchez said the current Wellpath contract runs through Sept. 30, 2027, but that planning for any future procurement is already underway and will be coordinated with the General Services Agency, Alameda County Health and Mazars. "We are incorporating a lot of services and reentry supports in the next RFP," the sheriff said, while also stressing opportunities for Wellpath to correct deficiencies.

The presentation prompted lengthy public comment. Dozens of advocates, faith leaders, nurses and family members described what they called a pattern of inadequate care and urged the county to explore alternatives to Wellpath, including having Alameda Health Systems provide in-custody care. Speakers cited multiple in-custody deaths, referenced Mazars' audit findings and warned against relying on a contractor facing nationwide lawsuits and bankruptcy filings. "Wellpath has consistently shown inadequate performance in our county jail," said Mickey Duxbury of the Stop Deaths and Harm group. Maurice Monk's sister, Elvira, recounted efforts to get care for her brother and urged accountability.

Union representatives and nurses who work in the facility also testified about operational barriers, including continued reliance on faxed medical-record requests and delays in getting medications to patients. A union organizer said frontline staff sometimes wait up to weeks to receive outside records the jail needs to continue prescriptions.

Supervisors responded by endorsing follow-up steps. Supervisor Marquez proposed a motion to bring a board letter and to convene a joint meeting of the Public Protection and Health committees to move forward on EPIC procurement, funding and oversight; Supervisor Miley seconded. Marquez also proposed a three-month review of corrective-action progress and a staffing-analysis update. The committee took a roll call for the motion (Supervisor Miley: Yes; Supervisor Marquez: Aye) and the motion passed.

Marquez told the public the county will set a joint meeting within about 4 to 5 weeks and asked GSA and County Counsel to examine the legal and procurement options, including whether the county could pursue an in-house model or whether an RFP would be required. "We have an obligation to act," Marquez said. The supervisors also asked for regular updates on corrective actions and for the staffing-analysis report to be made public.

The meeting record shows the committee treated the presentation as an informational update and did not take contract-termination action at the session. The committee scheduled a follow-up joint meeting and a corrective-action status report as the next procedural steps.