County agencies outline responses to rising in‑custody deaths; supervisors press for technology and health investments

County health and custody officials updated the Los Angeles County Board of Supervisors on Nov. 18 about an increase in in‑custody deaths and the steps they have taken to reduce preventable deaths. Correctional Health Services (CHS) reported rolling expansions in medication‑assisted treatment (MAT), naloxone availability and programmatic steps intended to lower the risk of suicide and overdose.

CHS Director Tim Belovich presented the data the department has compiled through Oct. 1, 2025: 17 deaths the medical examiner ruled as natural causes, 10 classified as overdose and 7 as suicide. "Seventeen deaths are natural causes, ten due to overdose and seven due to suicide," Belovich told the board.

Belovich described recent investments: 21 FIP step‑down units (approximately 450 beds) that provide day treatment and gender‑responsive programming for high‑need youth within adult custody settings where appropriate, an increase in licensed psychiatric (LPS) beds and a large, continuing push to expand MAT. CHS reported administering tens of thousands of oral MAT doses and thousands of long‑acting injectable doses across 2023–2025, and it emphasized naloxone distributions and harm‑reduction vending machines in visiting areas and release points.

Assistant Sheriff Tokar outlined LASD measures to reduce immediate risks inside jails: enhanced Title 15 cell‑check compliance and quality audits, increased double‑celling in some units for supervision, more frequent randomized supervisory audits, expanded canine and mail‑screening operations that uncovered hundreds of narcotics in mailed items, and deployment of upgraded body scanners. Tokar said compliance for safety‑check protocols has risen to 93 percent in recent internal audits.

Both agencies proposed further investments: CHS requested roughly $10 million and about 70 positions to build a primary‑care population health model to move from a reactive system to proactive disease management (screening, treatment and follow‑up). CHS also proposed automation of health request forms and an electronic ticketing system to triage and reduce an estimated 10,000 paper health requests per month. LASD described technology pilots including a 90‑day vital‑sign monitor pilot (about $20,000 to test 50 monitors) and an RFP for in‑cell tablets to reduce contraband and improve communications; the tablet rollout is expected to take about 9–12 months after contract award.

Supervisors pressed for details: CHS acknowledged MAT and other programs have expanded materially but said reimbursement for jail MAT through Medi‑Cal is limited, with potential CalAIM Justice Initiative coverage coming in 2026 for transition periods. Supervisor questions focused on wait times for health requests (CHS said non‑emergent requests often take two to three weeks currently and CHS wants a seven‑day target), compassionate release metrics, and whether the county’s pharmacy and MAT budgets are sustainable.

Public commenters — including family members of people who died in custody, community health and harm‑reduction groups, and formerly incarcerated advocates — urged immediate MAT access, better harm‑reduction practices, independent oversight and noncarceral alternatives. Board members asked for prioritized budgets and clearer lines for program funding, and requested additional reporting on compassionate release outcomes and QA measures.

Officials said they will return with line‑item cost estimates, updated staffing plans, and pilots’ results to support decisionmaking on automation, vital‑sign monitors and expanded MAT.