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San Diego County Jail Changing Medical Model For Needs Of Long-Term Inmates

Alfred Joshua, MD, chief medical officer, San Diego County Sheriff's Department.

Transcript

Prison realignment has had a significant impact on San Diego County jails. A report released by SANDAG this month shows more than one-third of all the inmates in San Diego County jails are now offenders who previously would have served their time in state prison.

The county is building more jail space to house the increasing number of inmates being housed at county facilities. The county continues to hire deputies and probation officers in order to meet the new demand.

Lack of access to medical care in state prisons was a significant part of the problem that eventually resulted in prison realignment. Ironically, one of the side effects of prison realignment in San Diego is being seen in the medical care being dispensed at San Diego County jails.

All felony prisoners, who were sentenced to longer than a year in jail, used to be sent to state prison. Now all non-serious, non-violent and non-sexual offenders are kept in county jails, in some cases for as long as 10 years.

This means the variety and severity of illness that has to be treated in county jails has increased dramatically.

San Diego County has a new chief medical officer for the Sheriff's detention services bureau. Dr. Alfred Joshua said he's introducing something of a managed care system for county jails, with a focus on follow-up in the community for discharged inmates.

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