The county’s care of mentally ill jail inmates continues to be lacking and could expose taxpayers to “significant liability,” the Marin County Civil Grand Jury reported.

The panel, which serves as a government watchdog group, wrote the report as a followup to its investigation on the same subject during its 2016-17 session.

In the earlier report, the grand jury concluded that mental health services at the Marin County Jail were “inadequate” because of “deficiencies in policies, organization, management, and staffing levels.”

Among other findings, the report said the jail often has no dedicated mental health staff on duty; that mentally ill inmates are sometimes kept isolated in padded cells for longer than 24 hours at a time; and that the jail does not provide individual or group psychotherapy.

The 2016-17 report sampled the jail population in two months, February 2016 and August 2016, and found that about 20 percent of the inmates were receiving one or more psychiatric medications. The number of inmates was 309 in February and 325 in August.

The report made 13 recommendations to improve the care. The followup report, which was released on Wednesday, says only a few of the recommendations have been implemented.

“Marin County may be vulnerable to lawsuits that could lead to costly legal fees and onerous judgments, as has occurred in some other California jurisdictions,” the report says. “In addition, the 2016-17 report pointed to certain practices as violating the Constitutional prohibition against cruel and unusual punishment.”

The grand jury made additional recommendations, including that the jail have a psychiatrist available on-site eight hours a day for five days a week and on-call around the clock. The panel also recommends that mentally ill inmates have “10 hours of unstructured out-of-cell time as well as 10 hours of structured therapeutic or programmatic time per week.”

Sheriff Robert Doyle, whose department runs the county jail, said he and his staff will take “a fresh look” at the issue. He noted that the county is always exposed to potential lawsuits on any number of issues.

Doyle also said the grand jury performs “an important service” but it is not responsible for delivering any government functions or paying for them.

“I think the grand jury’s a bit naive that they make a bunch of recommendations and we’re going to drop everything and implement them,” he said.

Dr. Grant Colfax, the director of the county Department of Health and Human Services, said he is reviewing the report. He noted that the grand jury credited the county for implementing some of the recommendations.

“We remain committed to providing to good behavioral health services in the jail,” he said.

The new report, which includes the prior recommendations and responses, is at bit.ly/2FhDM9k.