San Diego County Becomes First in U.S. to Expand Civilian Oversight to Jail Healthcare Providers

Historic vote gives Citizens' Law Enforcement Review Board authority to investigate medical staff in custody death cases

San Diego County made history Tuesday, becoming the first U.S. jurisdiction to grant civilian oversight of jail healthcare providers. The Board of Supervisors voted 4-1 to expand the Citizens' Law Enforcement Review Board's (CLERB) authority, overriding Sheriff Kelly Martinez's fierce opposition.

The unprecedented move targets San Diego's persistent crisis: the highest jail death rate among California's largest counties.

The Vote

Supervisors authorized CLERB to investigate medical and mental health providers—including contractors—but only in custody death cases. The board also tightened timelines, requiring investigations within one year and prioritizing deaths over other complaints.

"This ordinance adds oversight over medical staff for death-in-custody cases only," said Supervisor Monica Montgomery Steppe, who championed the measure. "We hope CLERB rarely needs this new jurisdiction."

The expansion fills a critical gap. CLERB Executive Officer Brett Kalina revealed the board has dismissed at least 75 healthcare allegations over three years due to lack of authority.

Sheriff's Opposition

Martinez appeared before supervisors urging delay. She proposed an independent healthcare assessment instead, incorrectly citing a Los Angeles County model that doesn't exist. Her office later acknowledged the error without explanation.

"I was elected to improve jail care, and I stand by that commitment," Martinez said. She oversees seven facilities holding 4,400 people daily, serving nearly 50,000 annually.

Martinez claimed—without evidence—the expansion was driven by activists seeking to "abolish all jails." Montgomery Steppe called this "disheartening and disappointing."

The Death Crisis

Numbers tell the stark story. San Diego County averages 3.6 deaths per 1,000 incarcerated people annually—highest among California's eight largest counties. Sacramento County, the safest, records 2.3.

A devastating 2022 state audit documented 185 deaths between 2006-2020. Conditions were so dangerous, auditors recommended legislative intervention. The audit found "deficiencies with how the Sheriff's Department provides care for and protects incarcerated individuals, which likely contributed to in-custody deaths."

Despite Martinez's reforms, eight people died in county jails this year, including Steven Curren, who died one day after arrest.

Community Pressure

Families demanded action. Paloma Serna, whose pregnant daughter Elisa died in custody in 2019, testified for accountability. The county paid her family $15 million in July.

"The individuals who have lost their lives are not just statistics," Montgomery Steppe said. "We owe it to their families to ensure deaths are investigated thoroughly, transparently and fairly."

CLERB Chair MaryAnne Pintar noted families attend every meeting pleading for medical investigations. "They ask us to look at healthcare's role in their loved one's death—but we have no authority to do that."

The Cost

High death rates cost taxpayers millions. Between 2006-2020, San Diego settled 11 death-related lawsuits for $9.2 million. Additional settlements bring the total to roughly $15 million.

The expanded authority requires funding for staff and medical experts, which Chief Administrative Officer Ebony Shelton must identify.

Healthcare Opposition

Some medical workers oppose the expansion. At a 2023 CLERB meeting, SEIU Local 221 President Crystal Irving urged engagement with staff to understand their challenges. Jail nurse Ciani Palencia warned the expansion could worsen staffing shortages.

Martinez argued medical professionals already face "stringent" oversight and the new authority would complicate hiring.

Implementation

County Counsel has 60 days to draft the ordinance. CLERB must update its rules and report back to supervisors.

The expansion caps years of advocacy. Former CLERB Executive Officer Paul Parker began pushing for change in 2021. He resigned in frustration in 2024, succeeded by career FBI agent Kalina.

National Impact

The reform could serve as a national model. No other civilian oversight body has jurisdiction over correctional healthcare providers, according to county documents.

Montgomery Steppe hopes the measure "sends a message that San Diego County is committed to accountability and putting an end to this problem."

Whether it succeeds in reducing San Diego's death rate will be closely watched nationwide.

SIDEBAR: San Diego's Deadly Numbers

County leads California's largest jail systems in death rates

San Diego County's jail mortality crisis dwarfs other major metropolitan areas. The county holds the grim distinction of California's deadliest large-county jail system.

California's Largest Counties (2009-2018):

Deaths per 100,000 inmates annually:

  • San Diego County: 245.6 (highest)
  • Los Angeles County: 175.8
  • San Bernardino County: 157.7
  • Santa Clara County: 145.9
  • Orange County: 136.6
  • Sacramento County: 93.9 (lowest)

Recent California Data (2019-2023):

Deaths per 1,000 people annually:

  • San Diego County: 3.6 (highest)
  • Riverside County: 3.5
  • Los Angeles County: 2.9
  • Sacramento County: 2.3 (safest)

National Context:

The national jail mortality rate in 2019 was 167 deaths per 100,000 inmates—an 11% jump from 2000. San Diego far exceeds this average.

Why Deaths Spike:

Research links higher death rates to:

  • High turnover (frequent admissions/releases)
  • Large populations (San Diego averages 4,400 daily)
  • Poor medical screening at intake
  • Inadequate mental health services
  • Drug overdoses (especially fentanyl)

The Toll:

Between 2006-2020, San Diego recorded 185 deaths across seven facilities—among California's highest totals. Despite reforms, 8 people died in 2025 alone.

The persistent gap between San Diego and other counties explains why advocates demanded expanded oversight when standard accountability failed.

Sources and Citations:

  1. Davis, Kelly. "San Diego County may become first in the U.S. to give civilian board oversight of jail healthcare providers." San Diego Union-Tribune, September 7, 2025. https://www.sandiegouniontribune.com/2025/09/07/san-diego-county-may-become-first-in-the-u-s-to-give-civilian-board-oversight-of-jail-healthcare-providers/
  2. McDonald, Jeff, and Kelly Davis. "Over sheriff's objections, county supervisors vote to expand civilian jail oversight board's authority." San Diego Union-Tribune, September 9, 2025. https://www.sandiegouniontribune.com/2025/09/09/over-sheriffs-objections-san-diego-county-supervisors-expand-civilian-jail-oversight-boards-authority/
  3. Davis, Kelly. "Facing heightened scrutiny, sheriff proposes third-party review of jail healthcare. But its model has a problem." San Diego Union-Tribune, August 24, 2025. https://www.sandiegouniontribune.com/2025/08/24/facing-heightened-scrutiny-sheriff-proposes-third-party-review-of-jail-healthcare-but-its-model-has-a-problem/
  4. "Board Of Supervisors Approve Changes To Citizens Law Enforcement Review Board." The San Diego Voice & Viewpoint, December 10, 2024. https://sdvoice.info/board-of-supervisors-approve-changes-to-citizens-law-enforcement-review-board/
  5. "County supervisors vote 4-0 for stronger law enforcement review board powers." KPBS Public Media, December 11, 2024. https://www.kpbs.org/news/politics/2024/12/11/county-supervisors-vote-4-0-for-stronger-law-enforcement-review-board-powers
  6. Schroeder, Lauryn. "In 5 years since investigation, little progress in stopping deaths in San Diego County jails." San Diego Union-Tribune, September 29, 2024. https://www.sandiegouniontribune.com/2024/09/29/in-5-years-since-investigation-little-progress-in-stopping-deaths-in-san-diego-county-jails/
  7. Tilden, Michael. "San Diego County Sheriff's Department." California State Auditor, February 2022. https://information.auditor.ca.gov/reports/2021-109/index.html
  8. "Lawmakers Call State Audit on SD Jail Deaths 'Deeply Disturbing,' Back Fixes." Times of San Diego, February 3, 2022. https://timesofsandiego.com/crime/2022/02/03/lawmakers-call-state-audit-on-sd-jail-deaths-deeply-disturbing-back-fixes/
  9. "State audit: San Diego County fails to curb inmate deaths." KPBS Public Media, February 3, 2022. https://www.kpbs.org/news/local/2022/02/03/state-audit-san-diego-county-fails-curb-inmate-deaths
  10. "San Diego oversight board nears authority to investigate jail medical providers." Corrections1, September 8, 2025. https://www.corrections1.com/investigations/san-diego-oversight-board-nears-authority-to-investigate-jail-medical-providers
  11. "Oversight board demands better cooperation from San Diego Sheriff's Department." NBC 7 San Diego, November 13, 2024. https://www.nbcsandiego.com/news/local/oversight-board-demands-cooperation-san-diego-sheriffs-department/3674833/
  12. "Mortality in Local Jails, 2000–2019 – Statistical Tables." Bureau of Justice Statistics, 2021. https://bjs.ojp.gov/library/publications/mortality-local-jails-2000-2019-statistical-tables
  13. Statement on Citizens’ Law Enforcement Review Board Jurisdiction Expansion By the Sheriff | North County Daily Star

Comments

Post a Comment

Popular posts from this blog

In 5 years since investigation, little progress in stopping deaths in San Diego County jails – San Diego Union-Tribune

Image
People who have lost family members while in custody at the San Diego County Jail, held photos of their loved ones during a press conference a federal courthouse on Thursday, Aug. 11, 2022 in San Diego, CA. Left-to-right, Shawn Mills, Tammy Wilson, Sabrina Weddle and Sundee Weddle. Photos l-r, Kevin Mills died in San Diego County Jail Nov 11 2020, Omar Moreno Arroyo, died while in custody Jan. 6, 2021 and Saxon Rodriguez, died while in custody on July 20, 2021. (Nelvin C. Cepeda / The San Diego Union-Tribune) Summary of In Custody Deaths in San Diego Jails Based on the information provided in the documents, here is a summary of deaths in custody in San Diego jails: 1. High death rate: - San Diego County jails have had the highest mortality rate among California's largest county jail systems in recent years. - Between 2019 and 2023, San Diego County recorded an average of 3.6 deaths annually per 1,000 incarcerated people, the highest rate among the 8 most populated Ca...
Read more

Battery Energy Storage Systems Project | Safety Standards for BESS in San Diego County

Image
Summary Here's a summary of the key points: 1. San Diego County is considering new safety standards for battery energy storage systems (BESS) following recent fires at two facilities:    - A fire at Terra-Gen's Valley Center BESS in September 2023    - A more severe fire at Rev Renewable's Gateway Energy Storage facility in May 2024, which lasted for nearly two weeks 2. The County Board of Supervisors voted on July 17, 2024, to develop new standards for BESS facilities, with potential measures including:    - Restricting locations away from residential areas    - Incentivizing placement in industrial zones    - Implementing stricter safety protocols 3. The development of these standards is expected to cost up to $1.25 million. 4. There are currently 12 active BESS applications in various stages of approval in San Diego County. 5. The board is considering several interim measures while developing the new standards, including:   ...
Read more

Miramar Road property zoned for housing is sold

Image
Miramar Landing Transforming San Diego's Landscape: Commercial to Residential Conversion Takes Shape in Mira Mesa By Claude News Service March 28, 2025 In a significant move that signals the future direction of San Diego's urban development, Pacifica Companies has purchased over 10 acres of land on Miramar Road for $30.6 million, embracing the city's vision to transform commercial areas into high-density residential neighborhoods. The January acquisition of the Miramar Landing shopping center and adjacent properties marks one of the first major investments following the December 2022 adoption of the new Mira Mesa Community Plan. This ambitious blueprint aims to reshape one of San Diego's largest neighborhoods from car-dependent suburban sprawl into a network of pedestrian-friendly urban villages. "We're witnessing the beginning of a fundamental shift in how we utilize commercial spaces in San Diego," said urban planning expert Maria Gonzalez. "Th...
Read more