Failure To Address Jail Inmate Drugging Haunts Thomas’s HS Takeover

CaSonya Thomas

CaSonya Thomas

By Mark Gutglueck
Even before CaSonya Thomas is set to assume the position of San Bernardino County’s director of human services next month, she and the county find themselves immersed in controversy over charges she lacks a sufficient technical knowledge and understanding of the myriad disciplines she will be called upon to oversee. Accompanying that question is concern as to whether she possesses the strength of character to buck the county’s current bottom line-oriented managerial philosophy to insist that the county’s various social service divisions be headed by leaders possessing in-depth knowledge and expertise regarding the service each specific department provides.
In the recent past, San Bernardino County has found itself repeatedly reproached when the intricacies of some departmental operations have eluded the expertise of managerial staff. Indeed, Thomas, who is currently the head of one of the county divisions that falls under the authority of the larger human services division, the behavioral health department, has become the object of scrutiny and accusations that the service her current department is supposed to supply to county residents fell short because of her inability to exercise sufficient oversight on account of her lack of licensure and knowledge with regard to the psychological and psychiatric fields the behavioral health department is involved in.
Now, Thomas is poised to step up to overseeing the entirety of the human services division, which includes aging and adult services, animal care and control, behavioral health, child support services, children and family services, the so-called Children’s Network, environmental health services, homeless services, preschool services, public health, transitional assistance and veterans affairs.
Four of those divisions – behavioral health, children and family services, child support services and homeless services – are facing challenges at present. At least a portion of those challenges consist, observers have noted, of what underlings in those divisions consider to be unrealistic constraints, policies and performance criteria being imposed, or inadequate technical support being provided, by department management.
The county’s current administrative and managerial culture is a major function of the managerial and administrative philosophy and approach of the county’s top dog, county chief executive officer Greg Devereaux. Devereaux’s approach is to appoint what one member of the board of supervisors refers to as “bean counters” to head the county’s various departments. Merriam-Webster defines the term bean counter as “a person who helps to run a business and who only cares about money” and “a person involved in corporate or government financial decisions and especially one reluctant to spend money.” The sense of the supervisor’s statement was that county department heads are not steeped in the discipline or technical minutiae their particular departments are involved in but are there to conform the department’s operation to the financial parameters dictated by the board of supervisors, Devereaux and the county’s economic reality.
Devereaux’s reputation proceeded him before he was chosen to serve as the county’s chief executive officer in 2010. In Southern California he had made his first major mark when he stepped in to become Fontana’s director of redevelopment and housing in 1992. He quickly was handed further responsibility as the director of that city’s community development department. Fontana at that time was scandal-plagued and broke, teetering over an abyss of bankruptcy as a consequence of the bribery-tainted giveaways orchestrated by one of Fontana’s previous city managers, Jack Ratelle, in the 1970s and 1980s and its previous redevelopment/development director, Neil Stone, in the 1980s. Under Devereaux’s skillful guidance as housing, redevelopment and development director, Fontana began to rebuild itself. In July, 1993, the city council elevated Devereaux to the position of city manager and in that billet he righted Fontana’s listing financial ship, returning the city to solvency and laying a foundation that to this day serves as the bedrock by which Fontana has grown to become, well after his departure, what is the county’s second largest city population-wise.
So successful was Devereaux in Fontana that in September 1997, the City of Ontario poached him, persuading him with a $30,000 increase in salary to jump westward to become city manager there. Over the next dozen years, Devereaux used his seemingly innate ability to run a large organization and his nearly encyclopedic knowledge of how governmental entities articulate with one another, the applications and advantages of agency-to-agency privilege and courtesy and his mastery of the arcane world of tax law and the ins-and-outs of governmental revenue to transform Ontario into the county’s most expansive municipal governmental entity. For example, Devereuax used his realization of how governmental rules apply to sales tax revenue generation to embark on a concerted effort to persuade large corporations, through the use of incentives and other inducements, to establish their corporate headquarters within Ontario’s city limits. In this way, Devereaux made Ontario the “point of sale” for all transactions involving those companies, generating for Ontario tens of millions of dollars in sales tax revenue every other city in the county was missing out on. Under Devereaux, Ontario grew to become the single largest government operation – measured by revenues in and expenditures out – of all 24 of San Bernardino County’s cities, at its apex boasting a budget approaching $670 million dollars annually – two thirds of a billion dollars running through all of the city’s various funds. Ontario’s budget was more than three times its closest competitor within the county and more than the budgets of the county’s second, third, fourth and fifth next largest cities, combined.
Devereaux, whose governmental financial acumen was unparallelled locally, bestrode Ontario and indeed San Bernardino County and Southern California as a municipal managerial colossus, and Ontario was the object of envy by nearly every other city in the region over its fortune in having harnessed Devereaux’s genius for its betterment.
In late 2009, when relations between three of San Bernardino County’s supervisors and its then-county administrative officer Mark Uffer soured and Uffer was shown the door, supervisor Gary Ovitt, who had been Ontario mayor before his election to the board and had been a member of the Ontario City Council that lured Devereaux away from Fontana, inspired his colleagues to turn to Devereaux as Uffer’s replacement. In making that coup, however, the county board of supervisors made a raft of precedent-setting concessions. First, Devereaux was given the title of county chief executive officer, an uprating from county administrative officer that was both symbolic and real. Second, he was provided with a so-called superbonus, that is, a heretofore unheard of level of job security, specified in his employment contract as protection against his being terminated on a simple majority, i.e., 3 to 2, vote of the board. Rather, to effectuate his firing, the board must do so by either a 4 to 1 or 5 to 0 vote. Accompanying that was a two-year severance package, guaranteeing him 24 months of pay if he is terminated. Even more significant, however was that part of the contract that effectively puts him in charge of running the county unfettered by the board. While technically the board of supervisors remains as the county’s ultimate authority and Devereaux’s boss, in the most practical sense it is Devereaux who is in charge of virtually everything in the county. Traditionally, it was the board that provided the commanding vision of the county’s direction and set what the county policy was to be, and the county administrative officer would then execute on that vision and policy. In the Devereaux era it is Devereaux, based in some measure on the input he is given by the county’s department heads, who formulates what the county policy is. He presents that policy to the board, which then essentially ratifies, for the record, his policy. In only the rarest of circumstances over the last half dozen years has the board of supervisors exercised its authority in questioning or second-guessing Devereaux’s guidance of the county. Rarer still are the occasions where the board used its authority to countermand his decisions.
For the slightly more than half dozen years of Devereaux’s tenure as county CEO, the county has barreled ahead, overcoming the fiscal challenges that had stymied it previously. To be sure, on occasion the county has been buffeted by scandal or a problematic development; nevertheless, with Devereaux’s steady hand on the tiller, it has emerged intact, if not entirely unscathed. Devereaux, with aplomb, has insulated and protected the board from any, or at least most, untoward publicity that has resulted from the county’s operational faux pas.
If there is a legitimate criticism of Devereaux as a public administrator, it is one that rises out of his very strength: He is heavily bottom-line oriented. His focus falls more along the lines of keeping the institution solvent and up-and-running and capable of sustaining itself. When a conflict between adhering to the structure of budgetary limitation and departmental staff’s commitment to maintain the quality or comprehensiveness of a particular department’s real or philosophical goals emerges, decisions are generally made in favor of remaining with the spelled-out financial parameters. That is not to say Devereaux is not capable of slipping into micromanaging mode in which he will devote energy and time to nuts and bolts issues; staff at both the county and with cities where he previously worked have recounted incidents where he has on occasion at least temporarily proven himself almost obsessively dictatorial with regard to issues or projects that loomed large before the public or the governing boards he answers to. But because of the sheer enormity and span of his responsibility, his management ethos, nonetheless, is one that calls for installing managers atop each department that are loyal to him and on board with his goal of running all aspects of the operation in accordance with and within strict budgetary guidelines.
Devereaux’s aptitude and affinity for adherence to budgetary regimentation when he came to San Bernardino County was magnified as a consequence of the economic climate under which he was hired: As 2010 began, San Bernardino County was, as indeed were California and the entire nation, in the throes of a lingering recession, accompanied by dwindling revenues to governments in general and particular, which necessitated an extreme round of belt-tightening and forced economies. In that milieu and the years since the recession abated in 2013, the board of supervisors has been highly indulgent of Devereaux’s managerial and administrative approach, providing him with virtual carte blanche to choose county department heads and employ them in accordance with his overarching philosophy.
That policy has not been without its downside.
For years, in the county’s children and family services division, an unhealthy situation had been brewing. Workers within the division who had encountered during the normal course of their function what they considered to be circumstances in which children were in danger or being subjected to mistreatment or maltreatment, made little headway in reporting those circumstances up the chain of command and achieving what they hoped would be a salutary resolution. In some cases, the ultimate decision maker, the children and family services department head, failed to heed the reports or allowed the workers who made the reports to be disciplined for pursuing action that might complicate the department’s function, untrack previous decisions, strain department resources or result in greater expense. In one case, a worker who persisted in making the reports of child abuse lost his job when the department failed to retain him past his one-year probationary term as a county employee. The circumstance manifested into a full blown scandal last year when the deaths of two of the children at the hands of their parents or foster guardians were publicly revealed in a nationwide television report by Fox News. Earlier this year, the California Attorney General’s Office launched an investigation into the deaths and other circumstances in which San Bernardino County Children and Family Services failed to protect the children under their supervision in the face of indications they were living in abusive circumstances. Lawyers have taken up the cases of more than fifty children under the supervision of the children and family services division. Pending and contemplated lawsuits involving these children against the county represent a potential liability in the hundreds of millions of dollars.
Another prickly issue is one involving CaSonya Thomas both directly and indirectly. Former inmates in the county’s jails report that the sheriff’s department routinely makes use of anti-psychotic drugs, tranquilizers and sedatives to render a significant portion of the inmates housed in the San Bernardino County Sheriff’s Department more manageable. These drugs in many cases have been dispensed against the will of the inmates, who report they are forced to take the drugs under pressure from their jailors, who often use other members of the inmate population to threaten those inmates with physical retribution if they do not ingest the pills they are given. Inmates who have spoken with the Sentinel estimated that as many as a third of the jailed inmates are being medicated. Neither the sheriff’s department nor the county has responded to Sentinel inquiries as to how many inmates or what percentage of the inmate population are being provided with anti-psychotics, tranquilizers or sedatives.
Into this mix is the consideration that Liberty Healthcare has dual contracts with the county/sheriff’s department, one for the provision of psychiatric care of inmates and one for providing so-called return-to-competency therapy for inmates previously declared by a court to lack the mental competency to face trial, therapy which is intended to be completed upon Liberty’s certification that the inmates are now capable of participating in their own defense and are ready to stand trial.
By law, drugs such as anti-psychotic agents, tranquilizers or sedatives cannot be dispensed to an individual without an order or prescription originating from a licensed psychiatrist. The clear inference is that psychiatrists employed by Liberty signed off on prescribing the drugs to the inmates. Neither Liberty nor the sheriff’s department has responded to inquiries concerning the protocol for prescribing and dispensing that medication to inmates. There have been suggestions that the dual contracts Liberty has for psychiatric care of inmates and for the return-to-competency services is a legal and professional conflict that is endangering the psychiatric and general welfare of the inmates upon whom the drugs are being foisted. It has been suggested that in order to keep its lucrative contract for providing the return-to competency service, Liberty has acquiesced in having its psychiatrists prescribe anti-psychotic drugs, tranquilizers and sedatives to inmates who do not, in fact, need them.
As the director of the county’s behavioral health department, Thomas authored or co-authored reports to the board of supervisors in which she recommended that Liberty be accepted as the contractor to provide both the psychiatric services and return-to-competency therapy and certification to inmates. In one of those reports, Thomas acknowledged that her department, the department of behavioral health, would be responsible for the continuing provision of medication to the inmates being medicated during their incarceration after their incarceration ended.
As public attention toward the circumstance involving the drugging of jail inmates has burgeoned, Thomas, in conjunction with higher and lower county officials, have sought to distance her from the controversy. At issue is the very core of Devereaux’s management approach. The question has become whether Thomas knew about the widespread chemical tranquilizing of jail inmates and whether, if she knew of it, she was able to appreciate the seriousness of the situation. Because she is not herself a psychiatrist or even a psychologist, Thomas may not have been sensitive to the consideration that such overuse of behavior altering substances was uncalled for and improper.
Had Thomas been a psychiatrist herself, she might have moved to countermand the profligate use of drugs in the jails. It has further been suggested that Thomas, in keeping with the ethos of Devereaux’s bottom-line oriented approach, simply went ahead with the policy of using drugs as a inmate population behavioral management tool because it met the imperative of limiting costs. While one county official, in an off-the-record statement, said that such an interpretation was not likely correct because of the cost of the medication involved, others have suggested that the county would be able to limit such costs because of the sheer volume of drugs being purchased and the economies of scale to be achieved with such bulk purchases.
A further suggestion is that Thomas is being rewarded at this point with the promotion to the head of human services because of her willingness to go along with a policy she knew was wrong and which other county higher-ups recognized as one that is highly questionable on a functional level, but in keeping with the county’s budgetary constraints.
The Sentinel persistently sought to reach Thomas for her input and response to such questions and to engage her in a dialogue involving these issues. The questions were diverted to her spokeswoman within the department of behavioral health, Aimara Freeman, who initially promised responses to questions if they were put in writing so Thomas could consider them in a contemplative setting. After the Sentinel submitted 22 such questions, Freeman responded with a two sentence response: “The department of behavioral health has no authority over the provision of jail mental health services or the contract with Liberty. Please direct your questions to the sheriff’s department.”
Captain Sam Fisk, who is the sheriff’s department’s administrative liaison with the board of supervisors, told the Sentinel that “we [the sheriff’s department] work with behavioral health in providing mental health care in the jails.” Fisk said the sheriff’s department coordinated with the department of behavioral health to ensure that inmates released from the jails continue to have access to the medication they were provided while incarcerated, adding it was “up to them,” i.e., the former inmates as to whether they wanted to continue with the medication once they were no longer in custody.
Freeman was unwilling to resolve the discrepancy between her insistence that Thomas had no oversight role over the provision of jail mental health services and Fisk’s statement. Nor was Freeman willing to square her statement that Thomas exercised no authority over the county/sheriff’s department contracts with Liberty Healthcare and Thomas’s co-authorship of the report relating to Liberty’s provision of the psychiatric care to inmates and its arrangement to provide competency restoration services to inmates, which the board of supervisors relied upon to approve those contracts.
Thomas spurned a question as to whether she would, as the director of human services, initiate a policy of requiring that all human service division department heads have licensure or a degree relating to the discipline that particular department involves.
Nor was she willing to provide information with regard to how many county residents formerly incarcerated in the county’s jails who had been provided with anti-psychotic drugs, tranquilizers or sedatives were subsequently provided with the same medications by her department following those inmates’ release from custody.
David Wert, the county’s official spokesman, said the Sentinel was “misinterpreting things. I have the distinct impression you believe the department of behavioral health has some degree of oversight over the provision of mental health services throughout the county or is some kind of regulating agency over the provision of mental health services generally throughout the county. That is not the role of the department of behavioral health. The department of behavioral health is a safety net organization. Its mission is to provide mental health services to individuals who otherwise cannot obtain mental health services on their own.”
Wert continued, “One doesn’t have to be a mental health practitioner to be director of the department of behavioral health. State law sets forth the qualifications for a department of behavioral health director, not county policy. CaSonya actually does possess academic healthcare certifications in addition to degrees in public administration and business. And to use the term ‘bean counter’ to describe an administrator indicates you don’t know what the term ‘bean counter’ means. You should look it up. She has to be able to manage a very complex department and in that department there is more to it than just what is on the mental health side. She must manage its budget, its contracts, its personnel. The department exists to provide mental health services to residents of the county who cannot afford them. It does not have oversight over hospitals, private practitioners and it doesn’t have oversight over the provision of mental health services in the jails.”
With regard to Thomas having coauthored the reports relating to Liberty’s contracts for providing mental health services in the jails, Wert said, “That may have been because CaSonya may have provided some input into determining who would get the contract. It is the sheriff’s responsibility to provide mental health care at the jails. The department of behavioral health does not have any oversight over operations at the jails. Nor does the board of supervisors have any oversight responsibility for mental health services at the jails, which are facilities operated by an independently elected official. It would be a horrible conflict of interest to have the board insert its will into something the voters have entrusted to another person. I don’t know why CaSonya’s name was on that agenda item. One possibility is that the department of behavioral health staff assisted the sheriff’s department in seeking out a qualified contractor, which turned out to be Liberty, but I don’t know that for sure. What I do know is that county departments of behavioral health, which under state law are under the authority of boards of supervisors, have zero oversight authority over the provision of mental health services in county jails, which under state law are under the jurisdiction of sheriffs who, under state law, are independently elected.”
With regard to the sheriff’s department’s practice of dispensing anti-psychotic agents, tranquilizers and sedatives to render the jail population more manageable, Wert said, “First, it seems to me that you haven’t established that what you say ‘appears’ to be happening is actually happening. I don’t think accusations by anonymous people who might have something to gain by claiming it’s happening is enough to make the leap you’re trying to make. It’s not right to accuse people of wrongdoing for allowing or not stopping something you haven’t established is happening. Have you even filed a California Public Records Act request for documents that might give weight to any of your claims? Feel free to come back when you have some documented proof, someone who is willing to identify themselves and state exactly what happened to them, or produce some documentation or doctor’s testimony that they were mistreated, or are willing to file a lawsuit and prove that something happened to them.”
The sheriff’s department has not responded to the Sentinel’s California Public Records Act request pertaining to its protocol for dispensing anti-psychotic drugs and tranquilizers, how many inmates were dispensed such drugs, what percentage of the jail population is on such a medication regime, and whether sheriff John McMahon has considered whether having the same vendor, Liberty Healthcare, providing both psychiatric care for the jails’ inmates and return-to-competency therapy and evaluations constitutes a conflict of interest.
Thomas is scheduled to assume the post of director of human services from the current director, Linda Haugan, in mid-October. Thomas holds a bachelor’s degree in business administration and a post-graduate degree in public administration, both from California State University San Bernardino. She also holds a certificate in health care compliance.
Thomas began her career with the county in 1991, in the entry-level position of eligibility worker in what is now known as the transitional assistance department. She has held a number of positions within human services over the course of her 25-year county career, including director of behavioral health, and executive and management positions within human services.
At the time of her selection by the board of supervisors in July, the county put out a statement that in part said, her career and promotion was an illustration of “the county’s successful efforts – mandated by the board of supervisors – to identify and develop talent from within the county organization, and ensure the county maintains a bench of qualified managers and executives to promote when vacancies occur. This practice will allow a nearly three-month transition for Thomas to work closely with Haugan before assuming her new role.”
Now, however, with her takeover date approaching and the scandals involving the abuse and deaths of children entrusted to the oversight of the children and family services division, the failure of the behavioral health division to stay atop the questionable and perhaps even illegal dispensing of anti-psychotic drugs and tranquilizers to inmates in the county jails and lesser but still serious problems in the child support and homeless services divisions, the board of supervisors is faced with questions about Thomas’s strength of character and ability to deal forthrightly with matters that if left unresolved have the potential of costing the county and its taxpayers hundreds of millions of dollars in court judgments.

Leave a Reply