Sheriff Kelly Martinez faced a tough crowd Wednesday night. It was the first time she had attended a meeting of the county’s law enforcement review board since taking office in January 2023. More than a dozen relatives of people who have died in San Diego County jails filled the seats. Many had attended a debate nearly two years ago where she avoided their pleas to speak to her, slipping out a back door. During public comment at the start of the meeting, they described how jail staff had failed their loved ones, and expressed their frustration with what they see as a lack of attention to reforms. “Why did your staff not follow protocol?” asked Diana Sanchez, whose 25-year-old daughter Vianna Granillo died at the Las Colinas women’s jail in 2022 while suffering through severe opioid withdrawal. “I want transparency. I want justice. I want answers.” John Settles, whose brother Matthew Settles struggled with schizoaffective disorder and died by suicide in an isolation cell at the George Bailey Detention Facility, asked the sheriff and review board why more people keep dying. “A lot of people are wondering why we are still here, years later?” he said. Martinez did not speak to the deaths, their causes or their impact on the public treasury. Instead, she walked the board and audience through a brief slideshow touting new programs and renewed efforts to improve deputy practices. “We recognize the importance of investing in our county jails,” she began. “The way we incarcerate people directly impacts public safety. We will be a leader in jail innovations to create and maintain safe facilities.” For some, the presentation fell short of what they were hoping to hear. Paloma Serna, whose daughter Elisa was suffering from heroin withdrawal, pneumonia and dehydration when she died in November 2019, said the sheriff had yet to meet with her family, as stipulated in a $15 million legal settlement the family agreed to in July. “I’m waiting for you to not only reach out to us, but to other families,” she said. “When are we going to have our meeting?” Martinez did not respond directly to the families, but said she appreciated the chance to hear from them. “There are changes that have been made and that will continue to come,” she said. “I’m very committed and invested in changing the way we incarcerate people in San Diego County.” Andrew Noriega, 9, left, with the support of his sister Sabrina Weddle, addresses the Citizens’ Law Enforcement Review Board about missing his older brother Saxon Rodriguez, who died of a drug overdose in the San Diego Central Jail in 2021, on Wednesday, Oct. 2, 2024 in San Diego. (Ana Ramirez / The San Diego Union-Tribune) Earlier that day, Martinez sat down for an extended interview with The San Diego Union-Tribune. Over nearly two hours, she detailed plans for the department and reiterated steps it has already taken to improve jail operations and better protect the people in her custody. “We’re hoping to do a better job of helping people understand what we’re doing,” she said. The new initiatives include a 19-bed wing being built at Paradise Valley Hospital to provide treatment for people in custody who require more formalized medical care. For people coming off opioids or alcohol, the jails have implemented a medication-assisted treatment program. Martinez said doctors and nurse practitioners were being added to the booking process to better evaluate people entering jails. She also said the department had implemented periodic wellness checks by deputies and clinicians to make sure people with mental illness don’t fall through the cracks. Earlier this year, the county’s medical examiner took the rare step of ruling a jail death a homicide. Lonnie Rupard died in 2022 of pneumonia, malnutrition and dehydration accompanied by “neglected schizophrenia” and “ineffective” care, his autopsy report said. Just last month, the coroner took that rare step again, ruling Keith Galen Bach’s death one year ago a homicide. Martinez did not discuss specific claims or allegations of negligence or misconduct by her staff, noting the cases were under investigation or subject to civil lawsuits that prevent her from commenting. But she insisted the sheriff’s office reviews each case to determine if a death was preventable. The department, she said, had learned “an enormous amount” from Elisa Serna’s death, which she was able to discuss because the family’s lawsuit was settled. “She didn’t deserve what happened to her,” Martinez said. “We have learned from each of these cases, and we continue to learn — but we’re also trying to be preemptive.” Members of the of the Citizens’ Law Enforcement Review Board listen to members of the public on Wednesday, Oct. 2, 2024 in San Diego. (Ana Ramirez / The San Diego Union-Tribune) Martinez’s predecessor, Bill Gore, had declined multiple interview requests from the Union-Tribune, made over several years, about why San Diego jails had become so deadly under his leadership. Gore retired in 2022 on the day the California State Auditor released a damning report outlining major deficiencies in San Diego County jails and in department transparency about them. The audit was prompted by “Dying Behind Bars,” a three-part investigation by the Union-Tribune, published in 2019, that revealed that San Diego jails had the highest mortality rate among large California counties. An update to that investigation published last week found that over the years that followed that investigation, San Diego jails’ average mortality rate continued to exceed that of other large counties, including Los Angeles. During the interview, Martinez, a department veteran of nearly four decades who began her career working in the county jails, repeatedly sought to contrast her tenure with that of her predecessor. She noted that most of the 200-plus in-custody deaths since 2009 were not on her watch. Martinez said she and Assistant Sheriff Dustin Lopez, who oversees the detentions bureau, are both relatively new to their responsibilities. “Neither of us were involved in the jails at that time, or detentions,” she said when asked about a death that preceded her election. “I started in the jails when I started my career 39 years ago as a deputy. I’ve never worked in our jail system since.” She and Lopez said they are relying on the expertise of consultants to guide new initiatives, including a nearly $500 million overhaul of older jails. Sheriff Kelly Martinez speaks about jail deaths on Wednesday, Oct. 2, 2024, in her department’s headquarters in San Diego. (Ana Ramirez / The San Diego Union-Tribune) Efforts to improve medical and mental health services hit a snag last year when NaphCare, the Alabama-based correctional medical giant brought in to manage jail health care, was found to be out of compliance with its contract. The department ordered the contractor to fix its deficiencies, finding it was deploying unlicensed staff, ignoring requests to repair or replace medical equipment and failing to fill hundreds of shifts and that it had failed to implement a program to help detainees detox from drugs and alcohol. The document was uncovered by attorneys for plaintiffs in a class-action lawsuit challenging jail conditions. In the interview, Martinez and Lopez defended the decision to continue with NaphCare. Lopez said the provider had taken corrective action in response to its warning. “When you’re looking at a large-scale health care provider and an $80 million contract providing to 4,000 inmates, I hope that we’re always digging down and finding the things that we do not like and that we think can be provided better provided,” he said. Martinez also defended her decision to release only summaries of internal reviews of jail deaths by her Critical Incident Review Board, or CIRB. The 2022 state audit expressed concern that the department was not being transparent enough with the public about the results of such reviews. Martinez said that what her office currently posts online — a basic summary of how a person died and whether the board felt further action was warranted — is sufficient. “That’s the substance of what the incident was and what we recommended moving forward,” she said. Attorneys who have sued to obtain CIRB-related documents say there is more to the reviews than what the sheriff has made public. The Union-Tribune has sued for access to CIRB reports. A hearing was held before the 9th U.S. Circuit Court of Appeals last month, and a decision could be issued at any time. From left to right, John, Brenda and David Settles participate in a Citizens’ Law Enforcement Review Board on Wednesday, Oct. 2, 2024 in San Diego. Matthew Settles died by suicide in the George Bailey Detention Facility. The family said he had a long history of mental illness and the jail failed in preventing his death. (Ana Ramirez / The San Diego Union-Tribune) In the push to improve jail safety, the biggest challenge, Martinez said, is staffing. Some 170 deputy positions remain unfilled in the Detention Services Bureau alone, and dozens of medical positions are waiting to be filled. Mental health clinicians are also in short supply, despite generous pay incentives — a significant shortcoming given that 40 percent of people in local jails have a diagnosed psychiatric condition, up from 28 percent a decade ago, department records show. Nineteen people died in San Diego jails in 2022 — a record. Deaths fell sharply to 13 in 2023, Martinez’s first year in office. Six people have died in sheriff’s custody this year. A seventh died in a hospital shortly after being released. Martinez says the decline in jail deaths since she took office should be evidence enough that she is serious about addressing past failures. If no one else dies in San Diego jails this year, it will be the least deadly year over the last decade.