Mendocino County

Grand Jury

Final Report

2000– 2001

2000– 2001

Mendocino County Grand Jury

Final Report

Table of Contents

Introduction

2000– 2001 Grand Jurors

Preface

California Penal Code § 933

California Penal Code § 933.05

Grand Jury Reports

Mental Health Services for Children ................................................................ 1

Mendocino County Mental Health : Patients’ Rights Advocate..................... 29

Juvenile Hall Update ....................................................................................... 35

Mendocino County Jail .................................................................................... 45

Chamberlain Creek and Parlin Fork Conservation Camps ........................... 51

City of Fort Bragg Public Safety: Police and Fire Protection......................... 55

Redwood Coast Fire Protection District ( Point Arena Area).......................... 65

Environmental Health Department: Septic System Complaint Process....... 69

The Noyo Harbor District ................................................................................ 81

Mendocino County Employee Health Benefit Program.................................. 89

Mendocino County Promotional Alliance........................................................ 95

Certification of Part- Time Coaches ............................................................... 111

Mendocino Unified School District Board of Trustees.................................. 113

Mendocino- Lake Community Board of Trustees .......................................... 117

Parking Lot C, North of Mendocino County Library, Ukiah........................ 135

Review of Responses and Implementation of Recommendations to Previous

Grand Jury Reports........................................................................................ 141

2000– 2001 Grand Jurors

Oath of Grand Jurors:

“ I do solemnly swear ( affirm) that I will support the Constitution of the United

States and of the State of California and all laws made pursuant to and in

conformity therewith, will diligently inquire into, and true presentment make, of all

public offenses against the people of this state, committed or triable within this

county, of which the grand jury shall have or can obtain legal evidence. Further, I

will not disclose any evidence brought before the grand jury, nor anything which I

or any other grand juror may say, nor the manner in which I or any other grand

juror may have voted on any matter before the grand jury. I will keep the charge

that will be given to me by the court.” ( California Penal Code § 911)

Jack Boone

Fort Bragg

Russell Borland

Redwood Valley

Sam Caponio

Mendocino

Dixie Cardoza

Ukiah

Dotty Coplen

Ukiah

James Crelan

Ukiah

Frankie DeMartini

Redwood Valley

Verleen Eidsmoe

Ukiah

Donna Gover

Laytonville

JoAnn Henrie

Talmage

James Kenney

Willits

Carolyn King

Calpella

Horace Mann

Fort Bragg

Boyd Mathias

Willits

Sally Maxson

Ukiah

William Mayfield

Ukiah

Marsha Miner

Willits

Laura Teschendorf

Ukiah

Robert White

Fort Bragg

30 June 2001

Eric Labowitz, Presiding Judge

Mendocino County Superior Court

In compliance with California Penal Code Section 933, the 2000– 2001 Grand Jury

submits its Final Report, which presents our Findings and Recommendations.

We believe this report will give the citizens of Mendocino County additional insight

into the workings of various departments, agencies, and districts in their county.

We hope the citizens find the results of our work useful. Likewise, we hope that our

elected officials and the people who run the various departments, agencies, and

districts find this report helps them better perform their duties.

Respectfully,

Russell Borland

Russell Borland

Foreman

Preface

The California Penal Code gives a Grand Jury the mandate to review the methods of

operation of County departments, agencies, and special districts and to inquire into the

needs of County officers. After such reviews and inquiries, the Grand Jury is required to

submit to the Presiding Judge of the Superior Court a final report of its findings and

recommendations that pertain to county government matters. The Grand Jury comprises 19

ordinary citizens who act as a watchdog for the citizens of the County.

The 2000– 2001 Grand Jury wishes to thank County staff, the staffs of entities

reviewed, and private citizens for their cooperation. Also, the Grand Jury thanks the staff of

the County Administrator’s Office for their cooperation and professionalism.

The Grand Jury found many County departments, agencies, and special districts that

are well run and some that are less well run. In particular, the Noyo Harbor District is well

run, the certification of part- time coaches in the schools is comprehensive even though

records are not standardized, and County Employee Health Plan works well despite some

funding problems. In other cases, as in past years, the Grand Jury found familiar problems.

 County departments, agencies, and special districts report the need for

additional, qualified staff and a concomitant need for funding of staff and

programs

 Lack of Policies and Procedures or a lack of conformance with existing Policies

and Procedures or a lack of staff to adequately perform and enforce Policies

and Procedures.

 Contracts

 Lack terms for significant Board of Supervisors’ monitoring and control

 Lack measurable outcomes such as Return on Investment

 Lack measures for compliance and enforcement

 Inconsistent enforcement or lack of enforcement of County codes

 Lack of written complaint procedures

All of these problems may be summed up either as loose or sloppy business practices or

as the result of the County lacking the revenue sources necessary to provide “ urban- style”

services over a large, topographically divided area, to a decentralized, largely rural and

agricultural population.

In addition, the Grand Jury encountered several instances when corrective activity

seemed to begin during the Grand Jury’s reviews, investigations, follow- up checking, or

even simple inquiries. The Grand Jury feels gratified that its attention leads to correction of

problems, but this is not proper operating procedure for County departments.

The Board of Supervisors should be monitoring and directing departments and the

department heads to assure that proper operating procedures are in place and being

followed correctly and consistently. It is important to have a Grand Jury to investigate

complaints of citizens whose concerns have not been addressed by elected officials.

Citizens should not, however, have to resort to complaints to the Grand Jury to get County

departments, agencies, or special districts to perform properly their responsibilities.

California Penal Code § 933

( a) Each grand jury shall submit to the presiding judge of the superior court a final

report of its findings and recommendations that pertain to county government

matters during the fiscal or calendar year. Final reports on any appropriate

subject may be submitted to the presiding judge of the superior court at any

time during the term of service of a grand jury. A final report may be submitted

for comment to responsible officers, agencies, or departments, including the

county board of supervisors, when applicable, upon finding of the presiding

judge that the report is in compliance with this title. For 45 days after the end of

the term, the foreperson and his or her designees shall, upon reasonable notice,

be available to clarify the recommendations of the report.

( b) One copy of each final report, together with the responses thereto, found to be in

compliance with this title shall be placed on file with the county clerk and

remain on file in the office of the county clerk. The county clerk shall

immediately forward a true copy of the report and the responses to the State

Archivist who shall retain that report and all responses in perpetuity.

( c) No later than 90 days after the grand jury submits a final report on the

operations of any public agency subject to its reviewing authority, the governing

body of the public agency shall comment to the presiding judge of the superior

court on the findings and recommendations pertaining to matters under the

control of the governing body, and every elected county officer or agency head

for which the grand jury has responsibility pursuant to Section 914.1 shall

comment within 60 days to the presiding judge of the superior court, with an

information copy sent to the board of supervisors, on the findings and

recommendations pertaining to matters under the control of that county officer

or agency head and any agency or agencies which that officer or agency head

supervises or controls. In any city and county, the mayor shall also comment on

the findings and recommendations. All of these comments and reports shall

forthwith be submitted to the presiding judge of the superior court who

impaneled the grand jury. A copy of all responses to grand jury reports shall be

placed on file with the clerk of the public agency and the office of the county

clerk, or the mayor when applicable, and shall remain on file in those offices.

One copy shall be placed on file with the applicable grand jury final report by,

and in the control of the currently impaneled grand jury, where it shall be

maintained for a minimum of five years.

( d) As used in this section " agency" includes a department.

California Penal Code § 933.05

( a) For purposes of subdivision ( b) of Section 933, as to each grand jury finding, the

responding person or entity shall indicate one of the following:

( 1) The respondent agrees with the finding.

( 2) The respondent disagrees wholly or partially with the finding, in which case

the response shall specify the portion of the finding that is disputed and shall

include an explanation of the reasons therefor.

( b) For purposes of subdivision ( b) of Section 933, as to each grand jury

recommendation, the responding person or entity shall report one of the

following actions:

( 1) The recommendation has been implemented, with a summary regarding the

implemented action.

( 2) The recommendation has not yet been implemented, but will be implemented

in the future, with a timeframe for implementation.

( 3) The recommendation requires further analysis, with an explanation and the

scope and parameters of an analysis or study, and a timeframe for the matter

to be prepared for discussion by the officer or head of the agency or

department being investigated or reviewed, including the governing body of

the public agency when applicable. This timeframe shall not exceed six

months from the date of publication of the grand jury report.

( 4) The recommendation will not be implemented because it is not warranted or

is not reasonable, with an explanation therefor.

( c) However, if a finding or recommendation of the grand jury addresses budgetary

or personnel matters of a county agency or department headed by an elected

officer, both the agency or department head and the board of supervisors shall

respond if requested by the grand jury, but the response of the board of

supervisors shall address only those budgetary or personnel matters over which

it has some decision making authority. The response of the elected agency or

department head shall address all aspects of the findings or recommendations

affecting his or her agency or department.

( d) A grand jury may request a subject person or entity to come before the grand

jury for the purpose of reading and discussing the findings of the grand jury

report that relates to that person or entity in order to verify the accuracy of the

findings prior to their release.

( e) During an investigation, the grand jury shall meet with the subject of that

investigation regarding the investigation, unless the court, either on its own

determination or upon request of the foreperson of the grand jury, determines

that such a meeting would be detrimental.

( f) A grand jury shall provide to the affected agency a copy of the portion of the

grand jury report relating to that person or entity two working days prior to its

public release and after the approval of the presiding judge. No officer, agency,

department, or governing body of a public agency shall disclose any contents of

the report prior to the public release of the final report.

2000- 2001 Mendocino County Grand Jury Final Report 1

Mental Health Services for Children

The Mendocino County Department of Mental Health Services ( Mental Health) is

the agency in the County that is funded to provide mental health services for

children. The Children’s Services unit of Mental Health has grown over 400% in

staff during the past three years and the current focus is expanding the base of

Medi- Cal payments, rather than identifying and providing critically needed

assessment, planning, and treatment services to children. This rapid growth has

occurred without a comprehensive written plan for the agency. The following

quotes from the Children’s System of Care ( CSOC) and a local student demonstrate

the gulf between the administration and the client.

Budget Year Position Requests

The State Senate is currently quite supportive of Early Periodic Screening

Diagnosis and Treatment Medi- Cal. This is a unique form of Medi- Cal that

allows for 100% reimbursement for services to youth under 21 who have Medi-

Cal. The probability is high that within the next year or two, this entitlement

will be “ Capped” and Counties will be “ frozen” for years to come at the baseline

they achieved before the capitation. The Children’s Unit is looking at the year to

come as one last dramatic expansion in services designed to capture this funding

source for years to come so that the children of Mendocino County are assured of

the treatment they need. ( CSOC 2001- 2002, April 20, 2001.)

WHAT IS GOING ON PEOPLE!

One day I went to school and I told my teacher that I have been harassed by my

mom’s boyfriend and the teacher told me to go see my counselor and at break I

went to see my counselor and I told her and I said “ I think I will kill him.

Someone told me to do it.” So she got on the telephone and called Mental Health.

They told her that she “ need to wait until tomorrow to bring me in.” That same

night my mother’s boyfriend made fun of me and about 10 minutes later I heard

a mad voice. The voice told me to kill my mom and her boyfriend tonight when

they’re asleep. The next day I went straight to my counselor and told her what

happened last night and she told me that she will try to call Mental Health and

have them see me A. S. A. P. So she called and was told to bring me down at 12: 30

p. m. and it was 8: 20 a. m. When we got there we had to wait 15 minutes and then

some man came out and took me in and talked with me. About 30 minutes later

we went back to school and I heard a voice telling me to kill my teacher, but I did

not listen. A CPS worker came to school and talked to me and took me to respite.

Three days passed and I had a doctor appointment [ at Mental Health] and my

counselor went with me and my counselor told the doctor about what was going

on and the doctor said he needs to be put on a 5150 [ involuntary 72 hour hold for

danger to self or others], so I had to stay after school until they find me a bed, and

someone called and said there are no beds and they will keep on trying during the

2000- 2001 Mendocino County Grand Jury Final Report 2

weekend ( that time it was Friday) so my counselor called my grandma. So I got

to stay with her. On Monday my counselor tried to see if there are some beds and

the people at Mental Health said the doctor can’t put me on a 5150, so my

counselor took me to Mental Health to see a person and the person asked me the

same thing as the doctor asked me, and my grandma was there and that made me

feel sad to talk about these things. After my grandma took me back to her house.

Tuesday came ( today) and I have a meeting. At this meeting they will put me in

a place where I am going to stay for good. ( Written by a local high school

student. Printed with student and parent permission .)

Critical needs of children are not met, and it is not because of lack of funding.

Mental Health Children’s Services is poorly managed and lacks a process for

immediate interventions when children experience acute emotional or behavior

problems unless they are at risk of out- of home placement. Then the system shifts to

try to keep the children at home.

Method of Investigation

The Grand Jury interviewed Mental Health administration and staff; Mental Health

clients, parents, and attorneys; public school administrators and staff; Protection

and Advocacy staff members. The Grand Jury visited Mental Health facilities and

school day treatment programs. The Grand Jury attended a Policy Council on

Children and Youth meeting for a presentation of Mental Health services. The

Grand Jury reviewed the following: applicable State laws, Mental Health Policies

and Procedures, the Mental Health 2000- 2001 Compendium of Services

( Compendium), CSOC ( Children’s System of Care) 2001/ 2002 Budget Year Position

Requests, the Day Treatment Behavior Plan, Children and Families First minutes

and Mental Health correspondence. Upon issuance of a subpoena and parent

permission, the Grand Jury reviewed school Individual Education Plans ( IEPs) with

names deleted for students requiring Mental Health services.

Background Information

Since receiving the System of Care Grant 1997 to provide interagency interventions

for children placed or at risk of placement out- of home, the Children’s Mental

Health staff has grown from 8.5 Full- time Equivalent Clinicians in 1997 to 50 Full-time

Equivalent Clinicians, Clinical Services Associates, and Human Service

Workers in 2001.

The Compendium Children’s Services section indicates the following programs:

Systems of Care, Day Treatment Programs, School- based Services, and Juvenile

Hall Services. Juvenile Hall services are reviewed in another Grand Jury Final

Report, Juvenile Hall Update.

2000- 2001 Mendocino County Grand Jury Final Report 3

Service Delivery

Background Information

Welfare and Institutions Code § 5600.5 states: “ The minimum array of services for

children and youth meeting the target population criteria established in subdivision

( a) of Section 5600.3 should include the following modes of service in every

geographical area, to the extent resources are available:

a) Precrisis and crisis services.

b) Assessment.

c) Medication education and management.

d) Case management.

e) Twenty- four- hour treatment services.

f) Rehabilitation and support services designed to alleviate symptoms and foster

development of age appropriate cognitive, emotional, and behavioral skills

necessary for maturation.”

Findings

1. Mental Health does not provide the “ minimum array of services” specified

above.

Response ( Mental Health): Agree. Even though the Department has been

aggressive in expanding services to outlying areas, it will never achieve the

“ minimum array of services” in all geographic locations of the County.

Response ( Board of Supervisors): The Board agrees in part with this finding.

The law refers to providing the “ minimum array of services” to the extent

resources are available. The Mental Health Department has done a

commendable job of expanding services to the outlying communities by making

the best use of financial resources and inter- agency partnerships.

a. Precrisis and crisis services are inadequate.

1) Parents and school counselors reported that children did not receive

needed services when they were in crisis.

Response ( Mental Health): Disagree in part. There may be isolated instances

of children not receiving crisis services, but many children do receive timely

intervention.

Response ( Board of Supervisors): The Grand Jury did not provide enough

information to agree or disagree with this finding.

2000- 2001 Mendocino County Grand Jury Final Report 4

2) Mental Health Clinic Services Associate crisis workers screen

children in crisis. The Clinic Services Associate position has no

requirement for licensure or training in children’s services.

Response ( Mental Health): Agree.

Response ( Board of Supervisors): The Board agrees with this finding. The

Board approved five new positions for Crisis Services, including one designated

for a Children’s Services specialist.

b. Even though Mental Health states assessments are being done, thorough

assessments of children are not completed before treatment plans are

developed.

Response ( Mental Health): Disagree. The standard practice is that three

sessions are spent in assessment and by the fourth session the Managed Care

Plan requires a treatment plan be in place. Staff is regularly instructed in this

procedure.

Response ( Board of Supervisors): The Board disagrees with this finding, based

on the explanation offered by the Mental health Department.

c. Clients and parents testified that Mental Health provides no medication

education. Mental Health states that this education is provided “ in

pamphlets handed out and available in the reception area, and through

dialogues with psychiatrists and clinicians.” Some medication

management is provided via telemedicine.

Response ( Mental Health): Disagree. Pamphlets and written materials are

provided in the lobby and by staff. Education on the uses and effects of

medications are routine parts of sessions with medical staff. Clinical staff

appropriately refers such questions to medical practitioners. Excellent

medication management with pediatric psychiatrists is provided via

telemedicine.

Response ( Board of Supervisors): The Board disagrees with this finding.

While the Grand Jury may have received such a comment, mental health staff

work closely with medical practitioners regarding medication. Further, the

Board commends the Department for implementation of its telemedicine

program as a creative solution for rural areas without child psychiatrists.

d. Mental Health provides case management for only the few children served

through the System of Care ( See System of Care, next page)

Response ( Mental Health): Disagree. Mental Health also provides case

management for children with IEPs on school sites who have not necessarily

2000- 2001 Mendocino County Grand Jury Final Report 5

been reviewed by IACMT. IACMT has reviewed a total of 206 children

( unduplicated count) since its beginning in the Fall of 1998. There are currently

130 active CSOC files.

Response ( Board of Supervisors): The Board disagrees with this finding. The

Board agrees with the Mental Health Department response. The Grand Jury

appears to have out- of- date information.

e. There are no twenty- four- hour treatment facilities for children in the

County. Mental Health states, “ We provide transport to these out of county

services.”

Response ( Mental Health): Agree; there are no 24- hour facilities in the County

to utilize. The Department provides transport to these facilities and pays for

children to receive these services.

Response ( Board of Supervisors): The Board agrees with the Grand Jury and

Mental Health Department.

f. Mental Health provides rehabilitation and support services to a few

clients. Mental Health states that these services “ are provided by out-patient

counseling, day treatment programs, CSOC programs such as the

Family Strengths ‘ Wraparound’ Program, Therapeutic Behavioral Services,

and school based counseling services.”

Response ( Mental Health): Disagree. The unduplicated count of children seen

as reported by the DMH has increased from 346 in 1998/ 99 to 383 in 1999/ 00

and 650 in 2000/ 01.

The Children’s unit has provided a corresponding increase in the number of

direct service and/ or case management hours as follows: 1998/ 99 - 19,007 hrs.

1999/ 00 - 27,582 hrs and 2000/ 01 - 38,270 hrs.

Response ( Board of Supervisors): The Board disagrees with this finding. It is

unclear what the Grand Jury means by “ a few clients.” As is evident by the

Mental health Department’s response, the number of children served has been

increasing steadily since the inception of CSOC.

2. Mental Health does not have a staff child psychiatrist, even though the

Compendium states that psychiatric services are provided.

The County has no child psychiatrist present for diagnostic services for

children.

Response ( Mental Health): Agree. There is a statewide shortage of Child

Psychiatrists.

2000- 2001 Mendocino County Grand Jury Final Report 6

Response ( Board of Supervisors): The Board agrees with the Grand Jury and

Mental Health Department.

a. Child psychiatrists in Riverside, California prescribe medications for

children in Mendocino County through telemedicine hookups, without in-person

contact.

Response ( Mental Health): Agree. This program is seen as “ cutting edge”

elsewhere in the state, and is being widely replicated. Families and children

have reported high levels of satisfaction with this program. ( One study has

shown a higher percentage of patients prefer telepsychiatry to meeting with an

in- person psychiatrist.) It is accepted practice, and fully recognized as such by

Medi- Cal and other third- party payors.

Response ( Board of Supervisors): The Board agrees with this finding. The

Board commends the Department for implementation of its telemedicine

program as a creative solution for rural areas without child psychiatrists.

Mental Health does not employ a child psychiatrist to provide therapeutic

services, including family interventions or behavior plans.

Response ( Mental Health): Agree. Even if Mendocino County did employ

Child Psychiatrist, medical doctors would not typically provide these services

Response ( Board of Supervisors): The Board agrees with the Grand Jury and

Mental Health Department response.

b. Current and former Mental Health staff testified that there is a need for

the services of an in- person child psychiatrist.

Response ( Mental Health): Department is unaware of staff responses to Grand

Jury's inquiry. The Department has a Telepsychiatry program which provides a

televised link to pediatric psychiatrists in Southern California.

Response ( Board of Supervisors): The Board does not have enough

information to either agree or disagree with this finding.

c. A local pediatrician told the Children and Families First Commission that

stress symptoms in young children can be identified, but personally felt

there were not resources to refer them to. The pediatrician stated that

resources need to be in place before children can be diagnosed and

referred.

Response ( Mental Health): Disagree. Mental Health assessment and diagnosis

falls into the scope of practice of licensed clinicians. There are over twenty

clinicians who work full time in the County system that can provide assistance.

2000- 2001 Mendocino County Grand Jury Final Report 7

There are also many competent private providers who treat mental illness in

children. There is no reason why a child should not be diagnosed and treated in

Mendocino County

Response ( Board of Supervisors): The Board disagrees with this finding. The

Board agrees with the response presented by the Mental Health Department.

d. Mental Health staff suggested that the services of a Mental Health staff

psychiatrist for children could be available to the Superior Court,

Department of Probation, and the Department of Social Services.

Response ( Mental Health): Agree in part. All the children of Mendocino

County should receive treatment. As per ( d) above Mental Health does not have

a pediatric psychiatrist and has been unable to successfully recruit for all

psychiatric positions available.

Response ( Board of Supervisors): The Board agrees in part, as explained by the

Mental Health Department response.

3. Mental Health does not provide services for pre- school children who are

experiencing psychosocial problems.

Response ( Mental Health): Disagree in part. Mental Health screens every

referral that comes in. The fact is not many preschool children are referred.

Mendocino would benefit from proactive screening for preschoolers. Staff

experience shows that there is a huge reluctance to identify very young children

with mental health problems.

Children’s Services Staff serve on interagency preschool collaborative teams and

provide consultation and strategies to partner agencies.

Response ( Board of Supervisors): The Board disagrees in part with this

finding. The Board agrees with the response presented by the Mental

Health Department and encourages staff to continue working with

interagency collaborative teams regarding preschool age children.

4. Even though Mental Health states that the Patients’ Rights Advocate

represents all clients of its department, all parents and most staff, including

parent advocates, interviewed stated that they were unaware of the existence

of a Patients’ Rights Advocate for children.

Response ( Mental Health): Agree in part. The Patients’ Rights Advocate has

focused most of her attention on the Adult System of Care. The Children's

services staff has discussed specific children’s issues with the Patient Rights

Advocate, but there have not been many instances of this.

2000- 2001 Mendocino County Grand Jury Final Report 8

Parent Advocates are on CSOC staff and assist with advocating for appropriate

services to children. They have responded to virtually every request from

parents/ providers and/ or partner agencies. PAN representatives have

functioned as surrogates on behalf of schools for local Group homes, have

attended court with families, have met with families referred from AODP

regarding CPS issues ( in Ft. Bragg) have traveled with parents to out of county

IEP’s, have traveled with families in the process of interviewing residential

group homes for their children. Department policy has been to respond to every

request and to offer Parent Advocate availability to every family the CSOC

comes in contact with.

Response ( Board of Supervisors): The Board agrees in part and has a solid

record supporting the establishment of Parent Advocate positions within the

Children’s System of Care.

5. Mental Health has no system for evaluating the outcomes of services

provided.

Response ( Mental Health): Disagree. Every family who remains in the system

and has either a year of service or a planned discharge receives an assessment

tool called a Client Satisfaction Questionnaire developed by the University of

California in San Francisco.

The PACE program has been evaluated by the State for recidivism and school

progress and has shown progress in both areas.

Every family who enters the system is evaluated by five standardized

instruments adopted by the State; YSR, CBCL, CAFAS, CSQ8 and CLEP.

Response ( Board of Supervisors): The Board disagrees with this finding. The

Board agrees with the response presented by the Mental Health Department.

System of Care ( SOC)

Background Information

The State Department of Mental Health made funds available for promoting

interagency coordination of services for severely emotionally disabled children at

risk of out- of home placement with the intent of providing services in the

community, reducing costs of placements, and keeping children in their own

communities whenever possible.

In 1997, Mental Health applied for and received 3- year State grant of $ 750,000 to

implement the System of Care. Mental Health, the Department of Social Services,

the Department of Probation, Alcohol and Other Drugs Prevention, and the

2000- 2001 Mendocino County Grand Jury Final Report 9

Mendocino County Office of Education collaborated to provide individual case

management for severely emotionally disabled children at risk of out- of- home

placement in facilities that offer extensive supports.

Mental Health states that the County will now receive from the State an on going

$ 313,000 annually to continue System of Care.

The SOC Director is a Department of Social Services employee who works under

the director of the Mental Health, Children’s Services Program Manager.

Out- of- home placements in group home settings by the Department of Social

Services, Probation, and Mental Health were as follows:

 In 1996- 97, 52 children,

 In April, 2001, 79 children.

The Compendium, p. 16 states:

“ Mission/ goal( s) of program: Treatment of children deemed severely

emotionally disabled [ SED] and their families; reduce need for

hospitalization or placement out- of- home in the SED population.

Description of program/ activity: Evaluation/ Referral/ Treatment

 Short- term outpatient family therapy

 Coordination of services with other System of Care partners.

 Case management for student in residential treatment or other placement.

 Referral Criteria:

Families, school personnel, probation officers, police, social workers and

individuals who contact the department all make referrals. All request for

services are handled by the CSOC process.”

Findings

6. Mental Health has focused on System of Care as the primary provider of

services to children. Responses to questions posed to Mental Health about

services for all children are answered in System of Care jargon and signed by

the System of Care Director. Mental Health staff responsibilities are blurred.

Response ( Mental Health): Disagree. There are three “ intake teams” in the

County; Ukiah, Willits and Fort Bragg. These teams meet weekly or more often

if necessary to triage and assign new referrals. This process is a combined effort

of both Children’s Mental Health and System of Care. This is a common

practice through out the State. If responsibilities appear blurred, it is because

there is so much teamwork occurring it is not necessary to remind each other of

roles. Each staff person has a specific written job description as outlined in the

children’s procedure manual. In a collaborative effort it often appears that

responsibilities are blurred. They are in fact shared.

2000- 2001 Mendocino County Grand Jury Final Report 10

Response ( Board of Supervisors): The Board disagrees with this finding. The

Board agrees with the response presented by the Mental Health Department.

7. System of Care provides services to a small percentage of the reported

number of children receiving services.

Response ( Mental Health): Agree. Children’s Mental Health does serve more

children than the CSOC. The CSOC is multi- agency effort to reach out to

families with children with most severe disturbances. The Mental Health

Department has dramatically expanded services to all children both in scope

and in numbers. The children in CSOC represent a small proportion of reported

services.

Response ( Board of Supervisors): The Board agrees in part with this finding.

The Board agrees with the response presented by the Mental Health

Department, pointing out that CSOC deals with the most severely emotionally

disabled youth.

a. Mental Health staff report that approximately 300 children are receiving

services from its department.

Response ( Mental Health): Disagree. This past year the department has served

more than 650 children. The complete year’s data was not available at the time

of the interviews with the Grand Jury.

Response ( Board of Supervisors): The Board disagrees with this finding. The

Board agrees with the response presented by the Mental Health Department.

b. System of Care is intended for a limited number of children who are at

risk of out- of- home placement in facilities for children with severe

psychosocial problems, not the broader population of children who may

be in need of Mental Health services

Response ( Mental Health): Agree. The goal is to focus on the most severely

disturbed children and then reinvest savings into earlier interventions.

Response ( Board of Supervisors): The Board agrees with this finding. The

Board agrees with the response presented by the Mental Health Department.

c. Through the System of Care, 10 children, as of April 17, 2001, receive

wraparound services, such as respite care, shopping, and housecleaning,

which provide support to families so that the children can remain at home.

Two full- time Clinicians coordinate support staff of eight, plus a pool of

extra help, in order to provide services for the 10 children.

2000- 2001 Mendocino County Grand Jury Final Report 11

Response ( Mental Health): Agree: There are currently 12 families being served

through Mendocino’s Family Strengths “ Wraparound” Program. In all but one

of these families there are other children and/ or family members or care givers

who have mental health issues who are benefiting from the intense services

Wraparound provides. This unique program, funded through State Department

of Human Services, allows complete flexibility to meet intensive service needs

that have previously been met in a high level residential home or would

currently require placement in a high level residential home at an average

monthly cost of $ 12,000-$ 15,000. per child. There are two Family Strengths

“ Wraparound” teams, each consisting of 1 facilitator/ clinician, 3 case managers,

1 human service worker and support for Parent Advocates. Each team ( one in

Willits and one in Ukiah) can serve 7- 8 families depending upon the complexity

and breadth of needs of those families. The staffing to provide a team for the

coastal area has recently been approved by the Board of Supervisors.

Response ( Board of Supervisors): The Board agrees with this finding. The

Board agrees with the response presented by the Mental Health Department.

8. Parents reported a need for wraparound services on the Coast where services

are planned, but have not been provided. The staff position of parent

advocate for the Coast has been vacant for the past year.

Response ( Mental Health): Agree. A team is planned for the Coast in the

coming year. Funds are available to hire a person who is qualified for the

position.

There has been an ongoing effort to find a parent on the coast to fill the Parent

Advocate position. However, in the interim, a PAN representative has been

assigned and travels to the coast, out- of- county etc. to meet these needs.

Response ( Board of Supervisors): The Board agrees in part with this finding.

The Board agrees with the response presented by the Mental Health

Department, and notes that staff for a coastal Family Strengths team was

recently approved.

9. Parents of children returning from out- of- home placement testified that

Mental Health was negligent in providing services specified in an IEP, and

did not make provisions for the child’s return to the community or assist

adequately in finding another placement. Witnesses testified that because

Deputy County Counsel was not available, Mental Health staff refused to

attend a required emergency meeting attended by all other agencies involved

in planning for immediate client services.

Response ( Mental Health): The needs of every child returning from out of

home placement are reviewed by the IACMT in order to arrange for a variety of

2000- 2001 Mendocino County Grand Jury Final Report 12

support services including wrap- around, Therapeutic Behavioral Services ( TBS),

outpatient treatment and/ or school support. In most cases, if a new placement

is required, the IACMT works with Mental Health Department case managers to

locate an appropriate placement as quickly as possible. Regarding IEP

meetings, Department staff has never knowingly missed a required meeting.

Mental Health clinicians are only required to attend IEPs when placement is

being discussed. Other IEPs, in which academic goals are being determined, are

not the purview of Mental Health staff, and they likely would not attend. If

lawyers are present representing parents or the School District, the Department

prefers to also have legal counsel on hand. Staff is not in the position to make

commitments such as financial agreements or timing of placements, for

example, on behalf of the County, so having an attorney present can actually

promote resolution of issues in these meetings.

Response ( Board of Supervisors): The Grand Jury did not provide sufficient

information for the Board to either agree or disagree with this finding. The

Board agrees with the response presented by the Mental Health Department.

10. System of Care promotes the idea that with appropriate support and

intervention, all children remain at home.

Response ( Mental Health): Agree.

Response ( Board of Supervisors): The Board agrees with this finding.

a. Out- of- home placement is not always detrimental. Former group home

residents testified that placement in an out- of- county treatment program

had been beneficial.

Response ( Mental Health): Agree.

Response ( Board of Supervisors): The Board agrees with this finding.

b. Some children with severe behavior management problems need

specialized school programs that are not currently provided in the County.

Response ( Mental Health): Agree.

Response ( Board of Supervisors): The Board agrees with this finding.

School Services and Day Treatment Programs

Background Information

Mental Health operates Day- Treatment Programs and offers counseling services at

school sites. Mental Health Clinicians provide mental health evaluations for IEPs

2000- 2001 Mendocino County Grand Jury Final Report 13

when a team of school personnel and parents determine that a child’s mental health

is interfering with education.

School- based Mental Health Services: the Compendium, p. 18 states,

“ The mission/ goal of program “ To provide services to those students in

outlying areas who qualify for mental health services.”

Description of program/ activity: Provides counseling with individuals and

families at settings donated by school districts.

Must meet Mental Health requirements of DSM IV [ Diagnostic and Statistical

Manual of Mental Disorders IV] diagnosis along with severity, duration and

impairment in functioning as indicators of medical necessity.”

Day Treatment Programs: the Compendium, p. 17, states,

“ Mission/ goal of program: A psychiatric treatment program allied with

special education instruction, to provide habilitative treatment to children in

the least restrictive setting who are at risk for placement out- of- home

and/ or school failure.

Description of program/ activity: All children are assessed and determined to

be Severely Emotionally Disabled. An Individual Education Plan is

developed. Program combines special education, psychiatric treatment and

intensive family therapy.

Referral criteria: These students must be identified as qualifying for special

education services, as well as qualifying for mental health services.”

Findings

11. Mental Health staff states that the best way to provide services to children is

through the schools. However, no clear list exists for school services available

in the County.

Response ( Mental Health): Disagree. Several lists were provided.

Response ( Board of Supervisors): The Board disagrees with this finding. The

Board agrees with the response presented by the Department of Mental Health.

12. There are contradictions between the Compendium and the information

received in interviews with school personnel and Mental Health staff. The

Compendium states that clients “ Must meet Mental Health requirements of

DSM IV diagnosis.” Most of the reviewed IEPs for children receiving services

lacked a DSM IV diagnosis.

Response ( Mental Health): Disagree. Every child who has an IEP that is served

by the Mental Health Department has a DSM IV diagnosis. The diagnosis is not

2000- 2001 Mendocino County Grand Jury Final Report 14

kept in the school file but rather in the confidential Mental Health Chart. These

charts were not reviewed by the Grand Jury.

Response ( Board of Supervisors): The Board disagrees with this finding. The

Board agrees with the response presented by the Department of Mental Health.

13. Mental Health has not provided school districts with consistent written

information regarding services available through Mental Health. The

Compendium is not specific in listing services provided or how a district can

obtain those services.

Response ( Mental Health): Disagree. A letter was sent out to every District in

1999 explaining the services of the Mental Health Department. Each year since

then a Mental Health Clinician has made a presentation to the local SELPA

Policy Council which includes the Special Education Directors from each district

explaining in detail the services of the Department.

Response ( Board of Supervisors): The Board disagrees with this finding. The

Board agrees with the response presented by the Department of Mental Health.

14. Mental Health reported: “ Services to the schools are provided through

contracts with local districts. The opportunity to purchase those services was

made known to the SELPA ( Special Education Local Plan Area) and through

the Superintendent’s Council, as well as informal contacts by us to Principals

and Special Education Directors.”

Response ( Mental Health): Agree.

Response ( Board of Supervisors): The Board agrees with this finding.

15. Mental Health provided three contracts with school districts to the Grand

Jury. Contracts do not specify the programs to be provided or the evaluation

of their outcomes.

Response ( Mental Health): Agree in part. Contracts do not describe services.

Attachments to the contracts spell out all services. Attachments do not speak

about outcomes.

Response ( Board of Supervisors): The Board agrees in part with this finding.

While the Board agrees with the response presented by the Department of

Mental Health, it is unfortunate that the Grand Jury did not review the “ Scope

of Work” which is customarily included as an attachment to County contracts.

The Board is also concerned about outcomes and will ask the Department for

clarification on how the school- based contracts are evaluated.

2000- 2001 Mendocino County Grand Jury Final Report 15

16. Some high school counselors testified that they were unaware other districts

were receiving Mental Health Clinician services at high school sites.

Response ( Mental Health): The Mental Health Department does not know

what was said to the Grand Jury.

Response ( Board of Supervisors): The Board was not given sufficient

information by the Grand Jury to either agree or disagree with this finding.

17. Mental Health services are not provided in an equitable manner to the 12

school districts throughout the County. Some district superintendents

informed the Grand Jury that even though Clinicians were in their areas and

the students in their schools experienced the need for services they have never

had a Clinician available to them for mental health services in the schools.

Response ( Mental Health): Disagree. Superintendents always have the right to

refer a child to the Mental Health Clinic for services. The family of the child

must fill out a sliding scale financial assessment. If the District wants the Mental

Health Department on their school site, they must assist with one half of the

costs associated with the delivery of services. When a District has a contract

with Mental Health, the Department does not discriminate against children who

do not have resources and everyone who has mental illness is served at no cost

to the family of the child. If a District does not have a contract with Mental

Health, a child who is eligible will receive AB3632 services regardless.

Response ( Board of Supervisors): The provision of services to children is a

collaborative effort between the schools, the Mental Health Department, and

other agencies. The County has always been supportive of requests from school

districts to implement collaborative programs to the extent resources are

available.

18. Contracts are not monetarily equitable throughout the County. Some districts

pay Mental Health for services, Mental Health reimburses some districts for

staff and facilities, while other districts provide space and receive service.

Services are billed to Medi- Cal whenever possible.

Response ( Mental Health): Disagree in part. Contracts are entirely equitable.

Every District pays exactly the same. If there is a Day treatment program on site,

the Mental Health Department may purchase the services of a para- professional

to assist in the staffing pattern required by the State of California. All districts

that have purchased clinical services are required to provide space for those

services to occur. Every year the Department receives a greater number of

requests for school site services.

2000- 2001 Mendocino County Grand Jury Final Report 16

Response ( Board of Supervisors): The Board disagrees with this finding. The

Board agrees with the response prepared by the Mental Health Department. As

previously stated, the provision of services to children is a collaborative effort

between the schools, the Mental Health Department, and other agencies. The

County has always been supportive of requests from school districts to

implement collaborative programs which meet the needs of that particular

district.

19. School districts receive Mental Health services in convoluted ways as follows:

Response ( Mental Health): Disagree. Services are tailored to meet the needs of

each school site. There is confusion between the Department contracting with

the districts to provide services to students at the district’s request and the

provision of mental health services to individual students at the school sites.

The Department does not contract for day treatment programs. Day treatment

programs are provided on school sites whenever the school agrees to provide

the educational components. Because there is no exchange of funds, the

Department enters into MOU’s, not contracts, for Day treatment services.

Contracts are made between schools and Mental Health to provide counseling

services, including attendance at care- team meetings, holding socialization

groups, and consulting with teachers of students served by the Mental Health

Department at the school’s request.

The Department does not provide services to districts. It provides services to

students.

Response ( Board of Supervisors): The Board disagrees with this finding. The

Board agrees with the response prepared by the Mental Health Department. As

previously stated, the provision of services to children is a collaborative effort

between the schools, the Mental Health Department, and other agencies. The

County has always been supportive of requests from school districts to

implement collaborative programs which meet the needs of that particular

district.

a) Willits Unified School District ( Willits) pays Mental Health $ 47,000 per

year and has the most comprehensive Mental Health support. Willits

contracts with Mental Health for Day Treatment Programs and Clinician

counseling services for elementary through high school.

Response ( Mental Health): Disagree in part. The Department has a contract for

$ 47,000 to provide counseling services on behalf of Willits Unified for

elementary through high school students. The Department is also expanding the

PACE program to Willits this year, which will provide a 10 seat Day Treatment

program for students on probation. Family Strengths wrap around services to

2000- 2001 Mendocino County Grand Jury Final Report 17

provide services to students returning from out of home placements are also

being expanded, as well as TBS services to students to prevent placement and

avoid hospitalizations.

Response ( Board of Supervisors): The Board disagrees in part with this

finding. The Board agrees with the response presented by the Department of

Mental Health.

b) Mendocino Unified School District contracts with Mental Health for the

operation of a Day Treatment Program, but no other services.

Response ( Mental Health): Disagree. Mental Health runs a Day Treatment

program on a school site with the collaboration of the District. There is also a

$ 12,000 contract for Mental Health to provide counseling services 2 days per

week. The Department just received Board of Supervisors authorization to

implement TBS on the Coast, which will be an additional service for MUSD

students who qualify under Medi- Cal regulations.

Response ( Board of Supervisors): The Board disagrees with this finding. The

Board agrees with the response presented by the Department of Mental Health.

c) Under contract, Mendocino County Office of Education ( MCOE) and

Mental Health participate in operating the Probation Alternative in a

Community Environment ( PACE) Day Treatment Program. Mental Health

pays MCOE approximately $ 40,000 per year. The only other reported

Mental Health service for MCOE is to provide a representative on the

Early Start Team that meets twice a month.

Response ( Mental Health): Disagree. MCOE and Mental Health are also full

partners in the Children’s System of Care.

Response ( Board of Supervisors): The Board disagrees in part with this

finding. The Board agrees with the response presented by the Mental Health

Department.

d) The Ukiah Unified School District ( Ukiah) and Mental Health have had a

draft unsigned contract for over a year. The terms of the contract require

Mental Health to pay Ukiah approximately $ 30,000. District officials and

Mental Health employees for the Inland Valley Day Treatment Program

have signed a memo of understanding, but the memo has not been

approved by the Board of Supervisors or County Counsel.

Mental Health provides 1.5 Full- time equivalent Clinicians at Oak Manor

School for a Day- Treatment program that can have a maximum of ten

2000- 2001 Mendocino County Grand Jury Final Report 18

students, and three days of counseling services at two Ukiah elementary

schools. ( Ukiah also hires its own district staff to provide counseling

services.)

Response ( Mental Health): Agree. At the time the Grand Jury requested

information the contract was not signed. The MOU is now signed by all

necessary parties.

Response ( Board of Supervisors): The Board agrees in part with this finding.

The Board agrees with the response presented by the Mental Health

Department.

e) Fort Bragg Unified School District receives services of two Clinicians who

have assigned times at all Fort Bragg schools and other times dependent

on client’s needs.

Response ( Mental Health): Disagree. There never has been a contract with Ft

Bragg schools. Mental Health Children’s Services provides services on the

school campus on an as- needed basis.

Response ( Board of Supervisors): The Board disagrees in part with this

finding. The Board agrees with the response presented by the Mental Health

Department. However, it also notes that new positions recently approved by

the Board will enhance Children’s Services on the coast.

f) Laytonville Unified School District receives services on Mondays from one

Clinician. The CSOC 2001- 2002 Budget Year Position Requests states that

Mental Health entered a contract during the past year with Laytonville

Elementary to provide school- based services; however, Mental Health did

not provide the Grand Jury with a contract,

Response ( Mental Health): Agree. Services were provided to students in

Laytonville. A contract is now signed and in place. Relationships between

schools and Mental Health historically have not been driven by written contracts

but rather by good will. Mental Health is increasingly being asked to enter into

contracts as the value of school- based services is demonstrated.

Response ( Board of Supervisors): The Board agrees with this finding. The

Board agrees with the response presented by the Mental Health Department.

g) Anderson Valley Unified School District receives Clinician services one

morning per week.

Response ( Mental Health): Agree. There never has been a contract with

Anderson Valley School District. Mental Health has provided services to

2000- 2001 Mendocino County Grand Jury Final Report 19

children attending school in the district one morning a week, but only to those

IEP children for whom Mental Health is legally obligated.

Response ( Board of Supervisors): The Board agrees with this finding. The

Board agrees with the response presented by the Mental Health Department.

h) Round Valley Unified School District received no services, but Mental

Health reports the district is now requesting services.

Response ( Mental Health): Agree. The plan is to begin to provide services in

Fall 2001.

Response ( Board of Supervisors): The Board agrees with this finding. The

Board agrees with the response presented by the Mental Health Department.

The Board recently approved the new positions to provide this service.

i) Arena Elementary, Point Arena High School, Leggett, Manchester, and

Potter Valley School Districts receive no services.

Response ( Mental Health): Disagree in part. Services are delivered to students

in Pt. Arena Elementary and Manchester, both on the school sites and in a

satellite clinic in downtown Pt. Arena. Students in Leggett receive services from

clinicians located in Willits. Potter Valley School District students receive

services from clinicians based in Ukiah.

Response ( Board of Supervisors): The Board disagrees in part with this

finding. The Board agrees with the response presented by the Mental Health

Department.

j) Cornerstone School, a privately owned non- public school for children who

have not been able to succeed in a public school setting, is scheduled to

have a Mental Health operated day treatment program although no

contract exists stating what the private school will pay for Mental Health

services. The past school year, the school has had one Mental Health

Clinician Monday morning for counseling and another Clinician Monday

afternoon for group therapy.

Response ( Mental Health): Agree. Cornerstone School is a private non- profit

entity that provides educational opportunities for students who would

otherwise have to seek an out- of- county setting for their education and

treatment. The Board of Supervisors has just authorized Mental Health to begin

to provide Day Treatment at this site, as well as wraparound and TBS to these

students, when necessary. No contract will exist because no money will be

exchanged between these two agencies. An MOU will be created to operate the

2000- 2001 Mendocino County Grand Jury Final Report 20

intended Day Treatment program in 2001/ 2002. The Department’s legal

mandate is to provide services to eligible students wherever they attend school.

Response ( Board of Supervisors): The Board agrees with this finding. The

Board agrees with the response presented by the Mental Health Department.

k) North Haven School, a privately owned non- public school at the Trinity

residential facility in Ukiah, receives no Mental Health services.

Response ( Mental Health): Agree. No services have been requested.

Response ( Board of Supervisors): The Board agrees with this finding. The

Board agrees with the response presented by the Mental Health Department.

20. In violation of the Education Code, positive interventions for behaviors that

interfere with learning are not being used consistently. When Mental Health

provides services to children with IEPs, Mental Health becomes subject to the

regulations of the Education Code. When Mental Health workers participate

in the development of a Behavior Plan, they must recommend positive

interventions for behaviors that interfere with learning. [ Ed. Code 56523

( b)( 1)].

Response ( Mental Health): Agree in part. This law indicates that “ behavior

intervention plans” must be developed by behavior specialists in compliance

with special education law prior to suspension or expulsion. These behavior

intervention plans are the responsibility of education. Mental Health is not

subject to the Education Code regarding " behavior intervention plans." Mental

Health is available for consultation to the behavior specialist upon request.

Response ( Board of Supervisors): The Board disagrees in part with this

finding. The Board agrees with the response presented by the Mental Health

Department.

21. The Grand Jury visited a Day Treatment Program operated by Ukiah Unified

School District and Mental Health and found that a child was being isolated,

without visual or personal supervision in violation of California Code of

Regulations, Title V 3052 ( l)( 7) p. A- 41. That Day Treatment Program had a

schedule of general behavior interventions posted on the wall and the final

consequence on the list was isolation in a closed room. State law requires

individual interventions for individual students. Classroom rules would be

appropriate for posting, but general punishments are not.

Response ( Mental Health): Disagree. The Ukiah Unified School site that was

visited does contain a quiet room that is included in the classroom, and is part of

the teacher’s office. This room is under constant observation by staff. It contains

2000- 2001 Mendocino County Grand Jury Final Report 21

a large window that views the outdoors. This quiet room has no lock on the

door and has a window in the door so staff can observe the child in question.

The design of the room meets educational code. The licensed psychologist that

consults with the program assisted in training the staff about the appropriate

use of the room. This is a room that contains a beanbag chair where children

often go voluntarily when they need to relax and regroup. Children can go there

when they are experiencing side effects to medication or if they were unable to

sleep the night before and want to rest. Children often see this as a resource. If a

child has a “ timeout” in the room it is under strict provisions: 1) it is part of a

behavior plan produced by a licensed psychologist; 2) logged for staff review 3)

time limited and 4) under staff observation.

The child in question was in the room voluntarily, and thus did not need to be

supervised intensely, as he could come out of the room whenever he chose. The

room has been very useful and has allowed children to stay in school who might

otherwise have to go home. Many positive incentives currently exist in this

program.

Response ( Board of Supervisors): The Board disagrees with this finding. The

Board agrees with the response presented by the Mental Health Department.

22. A review of IEPs of children in the Day Treatment Program found that none

of the IEPs reviewed contained Behavior Intervention Plans ( which would

identify positive individual interventions) as required by law.

Response ( Mental Health): Disagree. Behavior plans are generally not part of

an IEP. They may or may not be attached to an IEP. Many children in this

program not only have behavior plans for school, but also for home. These

plans may be revised based on how the child responds, and always identify

positive and strength- based interventions.

Response ( Board of Supervisors): The Board disagrees with this finding. The

Board agrees with the response presented by the Mental Health Department.

23. Mental Health Day Treatment Programs have no method of tracking children

when they move from elementary school to middle school or when they

return to regular classrooms to measure the success of the program provided.

Response ( Mental Health): Disagree. The Day Treatment programs contain an

aftercare component that includes outpatient services for a minimum of 6

months after the student leaves the program. Frequently, outpatient services

continue for longer than 6 months, as the criteria for closure is successful

transition into an appropriate educational and community setting. This option is

available to all former Day Treatment students regardless of what new school

they enter.

2000- 2001 Mendocino County Grand Jury Final Report 22

Response ( Board of Supervisors): The Board disagrees with this finding. The

Board agrees with the response presented by the Mental Health Department.

24. Supervision and management of school programs is sporadic. School districts

do not supervise the Mental Health workers who are on the school sites.

Clinicians report their work hours with time sheets to direct supervisors who

in turn certify the hours and turn the time sheets in to the payroll department.

Until March 2001, the Mental Health did not have a written list of locations of

Clinicians and their work sites. Mental Health provided the Grand Jury a list

of Clinician information that sometimes conflicts with information provided

by the school districts.

Response ( Mental Health): Disagree in part. When Mental Health staff is out-stationed

on school sites, they are provided clinical supervision for their entire

caseload. There are four clinical supervisors. Each Day Treatment program has

a clinical supervisor assigned to address administrative and clinical issues. In

addition to time sheets, clinicians turn in daily records that indicate all of their

work activities for each day.

Response ( Board of Supervisors): The Board disagrees in part with this

finding. The Board agrees with the response presented by the Mental Health

Department.

Recommendations

A. Mental Health focus on the needs of all children, rather than those that can

generate Medi- Cal dollars to increase funding. ( Findings 1- 24)

Response ( Mental Health): Already implemented. Title XXII, section 5600.2

states “ public mental health services in this state should be provided to priority

target populations.” This is further defined as including “ children and youth

with serious emotional disturbances.” No financial limitations are imposed

families under these mandates.

Subsequent case law found that children with Medi- Cal were typically

underserved in California’s mental health system, and as a result, restorative

settlements have been ordered by the courts. For this reason, children in

California with Medi- Cal have special entitlements for services, which are

currently fully reimbursed by the State. Mendocino County has been aggressive

in seeking these resources for children in this county. It is important to note that

Medi- Cal dollars are generated only in response to billing for specific services

delivered. There is no “ new money” without “ new services.”

The Department also welcomes children into its many school- based services

without regard for income, and at no cost to the families of these children.

2000- 2001 Mendocino County Grand Jury Final Report 23

Children and families without Medi- Cal may be served by the county on a

sliding- scale basis, depending on therapeutic need.

Response ( Board of Supervisors): The Board agrees with the Mental health

Department that this recommendation has already been implemented. Further,

the Board commends the Department and its collaborative partners for making

the best use of local dollars to serve the most children.

B. Mental Health provide the services as specified in Welfare and Institutions

§ 5600.5. ( Finding 1)

Response ( Mental Health): Implemented to the degree resources are available.

W& I Section 5600.5 refers to the minimum array of services that should be

delivered to the target population “ in every geographical area to the extent

resources are available.” Mendocino County Mental Health Children’s Services

has made remarkable progress in getting assessment and case management

services to outlying areas. The addition of telepsychiatry services to Ft. Bragg

and Willits in the past year has greatly expanded access to pediatric psychiatry

in these areas. However, access to crisis and 24- hour services will continue to

center on Ukiah, and to a lesser degree, the Coast. Thus the full “ minimum

array” of services will likely never be achieved throughout “ every geographical

area.”

Response ( Board of Supervisors): The Board believes that this

recommendation is also being implemented. The Board recently approved 18

new positions to complete the final step of implementation for CSOC, including

expansion of services on the coast, as well as in Willits, Round Valley, and

Laytonville.

C. For the first contact with the family, Mental Health assign their most

competent licensed children’s Clinician to assess the urgency of the situation.

Response ( Mental Health): The Department agrees with this recommendation.

To be implemented this fiscal year ( budget item approved by the Board of

Supervisors 7/ 24/ 01).

Response ( Board of Supervisors): Already implemented. The Board approved

5 new clinicians for the Crisis Division, with one being designated as a

Children’s Services specialist.

D. Mental Health staff provide medication information or a staff person to

discuss with each client medications and interactions. ( Finding 1c)

2000- 2001 Mendocino County Grand Jury Final Report 24

Response ( Mental Health): Implemented. This is the responsibility of medical

staff, which is the only Mental Health staff capable of providing this service

within their scope of practice. If the Grand Jury is suggesting that clinical staff

also perform this function, it will not be implemented, as these duties fall

outside the scope of practice as defined by their education and licensure.

Response ( Board of Supervisors): The Board agrees with the response of the

Mental Health Department.

E. Mental Health research the possibility of coordinating with other County

agencies to hire a staff psychiatrist for children who would assess children,

create treatment plans, and evaluate therapeutic interventions, as well as

monitor medications. ( Finding 2)

Response ( Mental Health): Will not be implemented because it is unfeasible.

As indicated earlier, pediatric psychiatrists are among the most rare of

practicing physicians, and the chances of attracting a qualified practitioner to

Mendocino County are extremely remote.

Response ( Board of Supervisors): The Board agrees with the response

presented by the Mental Health Department. Ideally, our community would

have a full array of specialists for all medical needs. However, this is not likely

to happen in rural areas. Therefore, the Board commends the Mental health

Department for its implementation of telepsychiatry as a creative model for our

community.

F. Mental Health provide programs for identification and services for pre- school

children who are experiencing psychosocial problems. ( Finding 3)

Response ( Mental Health): Agree – The Mental Health Department is working

with an inter- agency collaborative to bring these services to children ages 0- 5

within the next year. ( Proposition 10 is seen as a potential source of funding

such a program.)

Response ( Board of Supervisors): The Board agrees with this recommendation.

As previously mentioned, the Board supports the efforts of Mental Health staff

to participate in collaborative teams serving children under 5.

G. Mental Health hire a children’s Patient Right’s Advocate with special training

in child development, behavior, and family systems. ( Finding 4)

Response ( Mental Health): The Department disagrees with this

recommendation. The Department already has a full time Patients’ Rights

Advocate and three other parent partners. Mendocino County is regarded by

2000- 2001 Mendocino County Grand Jury Final Report 25

the State Department of Mental Health as a model County in this regard. A

review of the duties of the PRA under Title XXII, section 5500 et seq. gives no

instance where specialized training in child development, behavior and/ or

family systems would be useful.

Response ( Board of Supervisors): The Board agrees with the response

presented by the Mental Health Department and agrees that the Parent

Advocates, along with the Patients’ Rights Advocate, can represent the interests

of consumers.

H. Mental Health develop a means of evaluating their service delivery outcomes.

( Findings 5, 23)

Response ( Mental Health): Already implemented. As indicated in the

“ findings” section, the State Department of Mental Health has standardized

requirements of the Mental Health Department to report client outcomes. These

requirements are extensive and complex, involving the use of 5 standardized

instruments.

Response ( Board of Supervisors): The Board agrees with the response

presented by the Mental Health Department. If the Department wishes to

implement additional means of self- evaluation, the Board is willing to hear their

suggestions.

I. Mental Health develop a continuum of services that provides early

intervention to address the mental health needs of all children experiencing

psychosocial problems and prevent the later need for out- of- home placement.

( Findings 6- 10)

Response ( Mental Health): To be implemented. The Mental Health

Department and Children’s System of Care were given the mission of

addressing the needs of children with the most sever problems in high level

( level 12 or above) placement. This effort has been successful, and in the past

year the CSOC has begun to target all children in level 10 placements and

children at risk of placement. In addition, this year’s budget included funding

for the MHD to do assessments for all children being seen by the Department of

Social Services. The Department will continue to move in this direction,

depending on availability of resources ( human as well as monetary.)

Response ( Board of Supervisors): The Board agrees with the response

presented by the Mental Health Department.

2000- 2001 Mendocino County Grand Jury Final Report 26

J. Children’s Mental Health develop and distribute to all school districts a

specific written notice of services available to school districts and the

procedures for obtaining those services. ( Findings 11- 19)

Response ( Mental Health): Already implemented. The SELPA already has a

system in place, and the Mental Health Department provides information

annually to SELPAS, which is then distributed by SELPA to all jurisdictions.

Response ( Board of Supervisors): The Board agrees with the response

presented by the Mental Health Department. It is recommended that the Grand

Jury obtain information from the SELPAs to ascertain how this information is

distributed.

K. Mental Health develop guidelines that are in accordance with the Education

Code for positive behavioral interventions. ( Findings 20- 22)

Response ( Mental Health): Implemented. The Department worked with a

consulting psychologist to assure that the guidelines already developed by

education are suitable in a Mental Health context. The Department has been

assured that their protocols meet all standards for both psychological and

educational practices.

Response ( Board of Supervisors): The Board agrees with the response

presented by the Mental Health Department.

L. Children’s Mental Health revise the Compendium of Services to be a

readable, easily understood document that accurately provides a detailed list

of services available. ( Findings 1- 24)

Response ( Mental Health): To be implemented in the next fiscal year. The

compendium is updated annually.

Response ( Board of Supervisors): The Board agrees with the response

presented by the Mental Health Department.

M. The Board of Supervisors contract to conduct a program management audit of

Children’s Services. ( Findings 1- 24)

Response ( Board of Supervisors): The Board disagrees with this

recommendation at this time. The Grand Jury has not presented a

compelling argument for a management audit. The Mental Health

Department and County Administrative Office recently completed a major

review of Mental Health Services, and 18 new positions were approved by

the Board to enhance Children’s Services. These new programs should be

2000- 2001 Mendocino County Grand Jury Final Report 27

given a chance to mature before any conclusions are drawn regarding the

effectiveness of Children’s Services.

Response Required

Mendocino County Board of Supervisors

Response Requested

Mendocino County Department of Mental Health

2000- 2001 Mendocino County Grand Jury Final Report 29

Mendocino County Mental Health

Patients’ Rights Advocate

A Patients’ Rights Advocate ( PRA) is the single strongest protection for assuring

appropriate services and treatment for those with mental disabilities. This position

in the County Department of Mental Health Services is currently ineffective. This

ineffectiveness endangers clients. This problem can be corrected.

Method of Investigation

The Grand Jury reviewed the California Department of Justice “ Legal Rights of

Persons With Disabilities,” 1975. ( 42 U. S. C. 6000 et seq.); Welfare and Institution

Code. ( Sec. 4500- 5699.99); “ Consumer Rights and Complaint Process,” Mendocino

County Mental Health; Office of Patients’ Rights Advocacy, Inc., “ Patients’ Rights

Program Review”; “ Finding Our Way Home,” Stories from the AB34 projects”;

Mental Health Services Compendium of Services; List of Duties of Patients’ Rights

Advocate; Mendocino County Mental Health Board Annual Report, 1999 and 2000;

Grand Jury Final Report 1998- 99, “ Investigation of Suicide at Mendocino County

Adult Detention Facility”; and Rights to Treatment Case Law of Wyatt v Stickney,

1971.

The Grand Jury interviewed clients, family members, members of the Mental

Health Board ( past and present), the PRA, and the Director of Mental Health.

Grand Jury members attended the Mendocino County Mental Health Forum, and

contacted Protection and Advocacy in Sacramento.

Background Information

Bronzan- McCorquodale Act of 1986 provides for authorization and financing of

county community mental health services for the mentally disordered through

locally administered and locally controlled community mental health programs.

Both the Welfare and Institutions Code and the California Code of Regulations

specify the County’s responsibility and the role of the PRA.

When a mental health client has a problem with the system, the PRA should be the

person’s defender. Also, the PRA assists with educating staff about clients’ rights

and informs families of their own, as well as clients’ rights. This position is a liaison

between clients, Mental Health, and the State Department of Mental Health ( State).

The PRA advises a client when to pursue a complaint to the State, and additionally

may pursue it alone. A PRA is never intimidated or held back from duties by fear of

staff or managers within the mental health system.

2000- 2001 Mendocino County Grand Jury Final Report 30

Findings

1. Mental Health complaints are not resolved in a timely manner, contrary to the

two- day “ Patients’ Rights Program Review,” May 25 and 26, 2000, which

stated,

Our review indicated that Mendocino County has an adequate process and

procedure in place. The PRA informs clients of the complaint process on a

regular basis through individual meetings and educational training.

Complaint forms are also available in several locations for use of clients. A

standard form is available to all clients for writing and submitting their

complaints to the advocate. The advocate has a computerized system for

tracking of all complaints. The complaint process however does not inform

clients of the complaint appeal process if they remain dissatisfied.

One complaint reviewed by the Grand Jury was unresolved after a year’s

time, with no resolution or written response.

Another complaint took eight months for response, but when the client

reported the same incident to the State six months into the complaint

process, the State’s formal, written response was received in six weeks.

Response ( Mental Health): The Department disagrees with this finding. The

Grand Jury cited two examples of complaints that had not been resolved within

the 30- day timeframe required by the State. Since 1998, only 10% of complaints

took more than 30 days to resolve. The Department does not know which two

complaints were reviewed by the Grand Jury, but reasons for complaints to take

more than 30 days to resolve include the following: 1) consumer not responding

to requests for follow- up information 2) limited availability of staff time for

interviews ( there may be multiple staff to interview, and one PRA to conduct the

interviews) 3) consumer deciding to pursue a higher level of review ( the

complaint remains open pending final resolution) 4) delay in receiving signed

release of information when complaint is filed by a consumer’s representative or

5) client leaving the area before investigation is completed. The Patient Rights

Advocate is now sending follow- up letters asking consumers to confirm that

they want to continue with the complaint process when she has been unable to

reach them by telephone.

The report cited by the Grand Jury, above, was from an independent assessment

of Mendocino County’s PRA program by Protection and Advocacy,

Incorporated, which has a contract with the State Department of Mental Health

to review all Patients’ Rights Advocacy programs for conformance with State

standards. Protection and Advocacy has a long history of challenging the

practices of County Mental Health Departments. This report, mailed January 8,

2001, summarized: “ The Mendocino County Patients’ Rights program is a well-developed

and run program. The relationship of the advocates to the clients is

an excellent one. The relationship between the advocate and the Mental Health

2000- 2001 Mendocino County Grand Jury Final Report 31

Director is one of good communication, great trust and cooperation.” The

Mental Health Director delivered the full report to the Grand Jury, which chose

not to report the overwhelmingly positive comments of this review.

Response ( Board of Supervisors): The Board disagrees with this finding and

supports the response of the Mental Health Department.

2. Clients and family members stated that the staff intimidates the PRA,

therefore destroying the clients’ confidence in the effectiveness of the PRA.

Response ( Mental Health): The Department disagrees with this finding. The

Patients’ Rights Advocate has the full support of the Mental Health Director in

her role, and staff is directed to be fully cooperative with any investigations

conducted by the PRA. Under Welfare & Institutions Code 5530, the PRA also

has the ability to bring any issues directly to the State, bypassing the Mental

Health Director if she believes that issues are not being addressed appropriately

by staff.

Response ( Board of Supervisors): The Board disagrees with this finding and

supports the response of the Mental Health Department.

3. Under previous Mental Health administration direction, the keys to the

Psychiatric Health Facility were taken from the PRA. The PRA did not appeal

this action in accordance with Welfare & Institutions Code § 5530 ( a).

Response ( Mental Health): The Department agrees with this finding. While the

keys were taken for security reasons, the PRA was not denied access to the unit

during the time she was without keys, so no appeal was deemed necessary.

Response ( Board of Supervisors): The Board agrees with this finding and

supports the response of the Mental Health Department.

4. The PRA’s office is located in the Mental Health building. According to the

Mental Health Board Annual Report, 1999- 2000, clients intimidated by staff

are less likely to file a formal complaint at the current location.

Response ( Mental Health): The Department partially agrees with this finding.

The PRA’s office is located in the Mental Health Building. The Mental Health

Board Annual Report from 1999- 2000 was a collection of committee reports from

the Mental Health Board, not a statement from the full Board, so these

comments were actually written by one person. The Patients’ Rights Advocate

selected her current office, which had been formerly occupied by the prior

Mental Health Director, because of consumer ease of access to her services. The

office is directly adjacent to the Mental Health Department lobby, and

consumers can access The PRA without having to check in with the receptionist.

There is a seeming trade- off of closeness to Departmental functions (“ that’s

2000- 2001 Mendocino County Grand Jury Final Report 32

where the clients are”) and entirely independent operations (“ more confidential

access”).

The Department is open to suggestions about other locations for the Patients’

Rights Advocate office, and has submitted this question to the current Mental

Health Board for their review and comments. It is expected that any

recommendations will come from the full Board.

Response ( Board of Supervisors): The Board agrees with this finding in part

and supports the response of the Mental Health Department.

5. The Director of Mental Health hires, evaluates, and oversees the PRA.

Response ( Mental Health): The Department agrees with this finding. Chapter

6.2 of the Welfare & Institutions Code, Section 5520 states “ Each local mental

health director shall appoint or contract for the services of one or more county

patient’s rights advocates.”

Response ( Board of Supervisors): The Board agrees with this finding and

supports the response of the Mental Health Department.

6. Public awareness of the PRA and/ or complaint process is lacking. Families

entering the mental health system in crisis are not fully informed verbally of

these services. During a crisis, families do not read pamphlets or posters. The

PRA represents all clients of Mental Health; however, parents, school

counselors, and parent/ advocates within Mental Health all testified that they

were unaware of a PRA for children.

Response ( Mental Health): The Department agrees in part with this finding.

There will always be consumers who are unaware of the availability of the PRA.

It is the duty of the Department to inform all consumers of their rights, and to

disseminate information on how to access the PRA’s services as widely as

possible. Staff is informed of the PRA and access thereto and are expected to

relay this information to all clients and coordinating agencies.

Response ( Board of Supervisors): The Board agrees in part with this finding

and supports the response of the Mental Health Department.

Recommendations

A. Mental Health establish a policy and procedure for complaints with strict

timelines and frequent notations made on notifying the complainant.

( Finding l)

Response ( Mental Health): This recommendation will be implemented in

September of 2001.

2000- 2001 Mendocino County Grand Jury Final Report 33

Response ( Board of Supervisors): The Board supports this recommendation

and the timeline proposed by the Mental Health Department.

B. Develop a memo of understanding between Mental Health and the PRA to

explicitly define PRA access to clients and Mental Health facilities. ( Finding

3)

Response ( Mental Health): This recommendation will not be implemented

because the law ( W& I Code 5530 & 5550) is clear that the PRA has unlimited and

unrestricted access to clients and Mental Health facilities. No MOU is required

because the law supercedes any possible MOU. There was only one unit that

needed keyed access, the Psychiatric Health Facility. This unit is now closed.

The PRA determines all her own contacts with clients, and has full access to

records as allowed by law.

Response ( Board of Supervisors): The Board agrees with the response

prepared by the Mental health Department and will not recommend

implementation of this recommendation. Patients Rights Advocate access issues

are covered in State law.

C. To eliminate any client discomfort about visiting the PRA, the PRA relocate to

a site other than the Mental Health buildings. ( Finding 4)

Response ( Mental Health): This recommendation requires further study and

has been referred to the Mental Health Board for their comments. The

Department will include their comments in the review of Departmental space

needs which is currently underway with the architectural firm of Ross- Drulis

Associates.

Response ( Board of Supervisors): The Board supports the response of the

Mental Health Department and would like the input of the Mental health

Advisory Board regarding location of the PRA office. The current location is

right in the lobby and is easily accessible at this time.

D. Mental Health develop a procedure to inform all parents, staff, school

counselors, that there is a PRA for children. ( Finding 6)

Response ( Mental Health): The Department agrees to implement this to the

degree practicable. Children’s Services staff will meet with the Patients’ Rights

Advocate no later than October 31 to receive information of PRA services. They

will be given supplies of brochures and posters to distribute to school sites and

to each family they work with. Mailings of these materials will be made to each

school in the County, no later than January 1, 2002. School sites are not under

2000- 2001 Mendocino County Grand Jury Final Report 34

the jurisdiction of the Mental Health Department, and each school site principal

will individually determine appropriate distribution of this information.

Response ( Board of Supervisors): The Board agrees with this recommendation

and supports the response and timeline presented by the Mental health

Department.

E. Mental Health design a better system to inform verbally of the PRA services,

location, and phone number. Pamphlets and posters alone are not adequate.

( Finding 6)

Response ( Mental Health): This recommendation is in the process of being

implemented. The Mental Health Director will remind staff that they should

speak to consumers about the availability of PRA services at the Department

All- Staff meeting August 10, 2001. In addition, the Department has produced

an audiotape outlining all services provided by the Department, including the

availability of the Patients’ Rights Advocate. The tape is currently being

translated into Spanish, and will be mass- produced with English on one side

and Spanish on the reverse. These will be distributed to all clinic sites and to all

providers on contract to the Department by January 1, 2002.

Response ( Board of Supervisors): The Board supports this recommendation

and the implementation timeline as presented by the Mental Health

Department.

Response required

Mendocino County Board of Supervisors

Response requested

Mendocino County Mental Health Services Director

Mendocino County Patients Rights Advocate

2000- 2001 Mendocino County Grand Jury Final Report 35

Juvenile Hall Update

The Mendocino County Juvenile Hall ( Hall) has implemented several

recommendations from Grand Jury Final Reports for the two previous years;

however, the Hall still needs additional mental health staff support, action on

various maintenance deficiencies, completion of the recreation yard, and more

planning and programs to prevent recidivism.

Method of Investigation

The Grand Jury inspected the Hall in October 2000. In April 2001, the Grand Jury

visited again and spoke with incarcerated youth during lunch. The Grand Jury

interviewed the Hall Superintendent and Assistant Superintendent and reviewed

written information given to parents of incarcerated youth, the Hall’s daily

schedule, and the public Juvenile Justice Delinquency and Prevention Commission

( Commission) annual Facility Inspection Report ( Facility Inspection Report).

Background Information

The Hall, under the direction of the Department of Probation, provides for the

physical and emotional care of incarcerated youth in the County pursuant to the

California Code of Regulations, Juvenile Facilities, Title 15, and Building Standards,

Title 24.

All incarcerated youth attend West Hills School, a Court School provided by the

Mendocino County Office of Education.

The 1997- 98, 1998- 99, and 1999- 2000 Grand Juries reported violations of the State

regulations for juvenile halls regarding lack of recreation time and lack of hair care.

Recommendations included developing unused space next to the Hall for

additional recreation activities, implementing additional programs to promote

social awareness and reduce recidivism, and notifying parents of the high cost of

collect calls from the Hall.

In May 2000, a new wing that houses intake and youth accused of violent offenses

( Code 3 youth) was completed. With the new intake facilities, youth can be

admitted to the Hall without locking all youths in cells as previously was necessary.

The general Hall population and Code 3 youth are now separated for all activities,

including school, eating, and recreation. Code 3 youth use outdoor recreation

facilities when not in use by the general population and have a separate classroom

and common room.

Findings

1. The Hall is run in an orderly manner.

2000- 2001 Mendocino County Grand Jury Final Report 36

Response ( Probation): We agree with this finding.

Response ( Board of Supervisors): The Board agrees with this finding.

2. The Superintendent’s response to the 1999- 2000 Grand Jury report indicated

that he was seeking program providers to implement programs designed to

promote social awareness and reduce recidivism. Programs now provided:

a. Narcotics Anonymous and Alcoholics Anonymous conduct programs on

Monday and Thursday evenings.

b. The County Department of Mental Health Services ( Mental Health)

worker provides an evening meditation group.

No other new programs were reported.

Response ( Probation): We agree in part with this finding. The Juvenile Staff is

always seeking new and different programs to promote healthier children. In

addition to the programs mentioned in the Grand Jury report, we have Alcohol

and Other Drugs programs, Reality Awareness, Aerobics, and Project Sanctuary

Battered Women’s programs.

Response ( Mental Health): Mental Health agrees with this finding.

Response ( Board of Supervisors): The Board agrees with the response

provided by the Chief Probation Officer. Juvenile Hall has added to the

programs outlined by the Grand Jury to promote social awareness and reduce

recidivism.

3. A gardening area is available for youth. A volunteer helps with gardening

efforts. In October the area was not being used. In April, youth reported that

onions are now growing in one of the raised beds. The area is underused.

Response ( Probation): We disagree with this finding. The Grand Jury visited

between garden seasons. Presently the garden is flourishing and the vegetables

are being served in the Hall kitchen. We hope to expand the garden area next

year.

Response ( Board of Supervisors): The Board agrees with the response

provided by the Chief Probation Officer. The garden is well used and provided

fresh vegetables to the youth.

4. The Facility Inspection Report notes the need for additional treatment

planning for incarcerated youth:

Because time in the hall gives agencies the time and opportunity to

intensively address the needs of these youth, an effort to coordinate

interagency evaluation of the individuals educational, emotional, physical,

2000- 2001 Mendocino County Grand Jury Final Report 37

and social needs and the concomitant development of a treatment and

discharge plan.

Agencies that have the opportunity to evaluate incarcerated youth and

provide services are the Department of Probation, Mental Health, Alcohol and

other Drugs Program, and the Mendocino County Office of Education.

Response ( Probation): We agree with this finding. Treatment planning is a

multi- agency function.

Response ( Board of Supervisors): The Board agrees with this finding.

5. The Facility Inspection Report states that “ although the school staff and the

juvenile hall staff serve the same population and face many of the same

challenges, there have been no cross training opportunities.” The Commission

recommended that “ the Juvenile Hall Administration and the principal of

Juvenile Hall high school hold joint training” for Hall staff and the West Hills

School staff.

Response ( Probation): We agree with this finding.

Response ( Board of Supervisors): The Board agrees with this finding.

6. Mental Health provides a one- half time Clinician daily, Monday to Friday.

The Clinician sees individuals and conducts group therapy. The

Superintendent states that during times when the Hall is at or near capacity,

additional Mental Health services, approximately 10 hours per week are

needed.

Response ( Probation): We agree with this finding.

Response ( Mental Health): Juvenile Hall contracts with the Mental Health

Department to provide these clinical services. Back up staff is available to

substitute if the regular clinician is not available. Psychiatric services are also

provided under this contract. As Juvenile Hall contracts and pays for Mental

Health services as they deem necessary, Mental Health is always open to

negotiating the terms of contracts to add services.

Response ( Board of Supervisors): The Board agrees with this finding.

7. If requested by youths, haircuts are now provided. A staff person is a licensed

cosmetologist and provides the services every two weeks. Youth reported that

the system is working and that those who request haircuts get them in a

timely manner.

No evidence of a hair care procedure was presented if a licensed

cosmetologist staff person is not available to provide hair care.

2000- 2001 Mendocino County Grand Jury Final Report 38

Response ( Probation): With the exception of informing the Grand Jury that we

have a licensed cosmetologist on staff that performs hair care, it is unclear what

is missing from our hair care program.

Response ( Board of Supervisors): The Board agrees with the response

provided by the Chief Probation Officer.

8. Previous inspections reported the need for lights in an outside caged

recreation area. The Superintendent reported that lights have been installed,

allowing youths to exercise in the evenings.

Response ( Probation): We agree with this finding.

Response ( Board of Supervisors): The Board agrees with this finding.

9. The Superintendent’s response to the 1999- 2000 Grand Jury report states,

“ Recreation area is being developed, using the labor and energy of

incarcerated and work program youth.”

a. In October, the Superintendent testified that the fenced area South of the

Hall was scheduled for completion by summer 2001 as a recreation area,

but as of May 2001, site work had not started.

b. In April, the Superintendent reported that completed plans include paved

and grassy exercise areas, a gravel perimeter track, and restroom. Because

of drainage problems. additional grading, fill dirt, and topsoil were

required, changing the estimated cost from $ 10,000 to $ 32,000.

c. The Superintendent has had difficulty getting bids from contractors for

the work; only one was received.

d. Funds are available from the Criminal Justice Improvement Fund this year

and next year, which will pay for the recreation improvements. One local

service organization has offered to help.

Response ( Probation): We agree with this finding.

Response ( General Services): The Department agrees with this finding ( a, b,

and d).

Response ( Board of Supervisors): The Board agrees with this finding. The area

is scheduled to be completed this Fiscal Year.

10. In October, the Grand Jury observed that the cafeteria needed painting and

had worn and discolored drapes. The Superintendent reported that he had

requested painting and blinds to replace the drapes. In April, these items

were not completed.

Response ( Probation): We agree with this finding.

2000- 2001 Mendocino County Grand Jury Final Report 39

Response ( General Services): The Department disagrees in part with this

finding because the Buildings and Grounds Division had not received a formal

request, in the form of a Work Order, from the Juvenile Hall Superintendent for

these projects.

Response ( Board of Supervisors): The Board agrees with this finding. The area

is scheduled to be completed this Fiscal Year.

11. Previously, weekly parent visits were in the boys’ recreation room. They are

now held in the dreary cafeteria. The boys’ recreation room is equipped with

couch- like plastic seats, television, books, magazines, and two vending

machines.

Response ( Probation): We agree with this finding.

Response ( Board of Supervisors): The Board agrees with this finding.

12. When visits were in the boys’ recreation room, parents could purchase items

from vending machines for themselves or their children. With a move to the

cafeteria those machines are not available.

a. Youth suggested that the vending machines should be moved either to the

cafeteria or outside the cafeteria so parents could once again purchase

items during visits.

b. Youth reported they are not allowed to use the vending machines located

in the recreation room; they are now used for staff only.

Response ( Probation): We agree with this finding.

Response ( General Services): The Department agrees with this finding.

Response ( Board of Supervisors): The Board agrees with this finding.

13. Parents are now informed in an informational pamphlet that calls made from

youth at the Hall “ are ‘ collect’ and charged at a premium rate.” “ Premium

rate” does not clearly state the actual cost of the calls. Youth from Fort Bragg

reported that calls to home cost parents $ 3.00 per minute. Ukiah youth

reported that the charges are not as high for their parents. A private

communications provider provides services.

Response ( Probation): We agree with this finding.

Response ( Board of Supervisors): The Board agrees with this finding.

2000- 2001 Mendocino County Grand Jury Final Report 40

Recommendations

A. Hall administration continue to seek additional programs that promote social

awareness and reduce recidivism, such as victim awareness, conflict

resolution, and self- esteem building. ( Finding 2)

Response ( Probation): Already implemented, in that this is a continuous

process of programming.

Response ( Board of Supervisors): The Board agrees with the response

provided by the Chief Probation Officer.

B. Hall administration make more use of the gardening area and contact

community gardening groups for assistance. ( Finding 3)

Response ( Probation): Already implemented, in that the garden is being used

regularly during growing seasons.

Response ( Board of Supervisors): The Board agrees with the response

provided by the Chief Probation Officer.

C. The Department of Probation, Mental Health, Alcohol and other Drugs

Program, and the Mendocino County Office of Education develop a plan to

provide social- emotional programs and discharge planning for incarcerated

youth. ( Finding 5)

Response ( Probation): Already implemented, in that such programs are a

continuous part of the Hall program.

Response ( Mental Health): Agree. Within the next year MHD will review this

recommendation with these agencies.

Response ( Board of Supervisors): The Board agrees with the response

provided by the Chief Probation Officer.

Response ( Mendocino County Office of Education Board of Trustees): No

legal response received by deadline.

Response ( Mendocino County Superintendent of Schools): No legal response

received by deadline.

D. Mendocino County Office of Education and the Department of Probation

sponsor coordinated training for West Hills School staff and the Hall staff to

ensure social- emotional educational services are provided. ( Finding 2, 4, 5)

2000- 2001 Mendocino County Grand Jury Final Report 41

Response ( Probation): Already implemented, in that Juvenile Hall and MCOE

staff meet weekly to discuss the socio- emotional and educational, and share

practices and developmental concepts that cross train each to the needs of the

other. This has been a practice for several years.

Response ( Board of Supervisors): The Board agrees with the response

provided by the Chief Probation Officer. This recommendation has already

been implemented.

Response ( Mendocino County Office of Education Board of Trustees): No

legal response received by deadline.

Response ( Mendocino County Superintendent of Schools): No legal response

received by deadline.

E. Hall administration and Mental Health assess the need for more Clinician

services at peak times of need and reassign Mental Health staff to the Hall as

needed. ( Finding 4, 6)

Response ( Probation): Already implemented, in that this is recognized and

dealt with at the times most needed.

Response ( Mental Health): Disagree. Juvenile Hall purchases services from the

Mental Health Department. Mental Health will work cooperatively with Hall

administration to evaluate their need for additional services and amend contract

provisions and payment terms to add new clinical services to the Hall. Mental

Health staff cannot be removed from current duties and reassigned to the Hall,

as this would create lack of services elsewhere in the County.

Response ( Board of Supervisors): The Board agrees with the response

provided by the Chief Probation Officer. Mental Health staff is available for

Juvenile Hall when needed.

F. Hall administration develop a written policy for providing hair care. ( Finding

7)

Response ( Probation): Already implemented, in that we have a cosmetologist

on staff. It is unclear what is missing from our hair care program.

Response ( Board of Supervisors): The Board agrees with the response

provided by the Chief Probation Officer.

G. The Board of Supervisors direct General Services to help the Hall complete

the recreation area as soon as possible so that it can be used this summer. The

2000- 2001 Mendocino County Grand Jury Final Report 42

Superintendent extend outreach to other community service groups for

possible support in developing this area. ( Finding 9)

Response ( Probation): Already implemented. General Services has been

responsive to our needs. Each year money is set aside for the development of

the recreation yard. The Superintendent has approached local services for

assistance, and will continue to do so. Manpower has been more available than

monetary contributions.

Response ( General Services): The Department agrees with this

recommendation, and has requested $ 13,000 in BU 1710 ( Capital Improvements)

in the Fiscal Year 2001- 2002 Proposed Budget from the Criminal Justice

Improvement Fund for completion of the project. As soon as the final budget

has been approved by the Board of Supervisors, Buildings and Grounds will

coordinate with the Juvenile Hall Superintendent to complete the project.

Response ( Board of Supervisors): The Board agrees with the response

provided by the Chief Probation Officer. Juvenile Hall staff works closely with

Buildings and Grounds on the recreational yard project and has approached the

local community for assistance.

H. General Services order blinds for the cafeteria and paint the cafeteria.

( Finding 10)

Response ( Probation): Already implemented. General Services has work orders

for blinds and painting.

Response ( General Services): The Department agrees with this

recommendation, and intends to paint the cafeteria and replace the blinds in the

cafeteria expeditiously upon receipt of a formal Work Order for these projects

from the Juvenile Hall Superintendent.

Response ( Board of Supervisors): The Board agrees with the response

provided by the Chief Probation Officer. Buildings and Grounds has placed this

project on the list for completion this Fiscal Year.

I. If the Hall staff decision remains to disallow use of vending machines for

parent visits, and youth are not allowed to use the machines, remove or

relocate the machines to a staff room. ( Finding 12)

Response ( Probation): Requires further study. Juvenile Hall agrees that having

the vending machines on the Boy’s Unit serves no good purpose. It is the

intention to relocate the machines to an area they can be utilized so that parents

may purchase goods for the youth. Relocating the vending machines has been

explored, but logistical issues need to be worked out.

2000- 2001 Mendocino County Grand Jury Final Report 43

Response ( General Services): The Department agrees with this

recommendation, subject to the decision of the Juvenile Hall Superintendent.

Upon the request of the Juvenile Hall Superintendent, General Services will

work expeditiously with the vending machine contractor to ensure that the

vending machines are relocated.

Response ( Board of Supervisors): The Board agrees with the response

provided by the Chief Probation Officer. Relocation of the vending machines

needs further study.

J. Hall staff renegotiate the contract with the private communications provider

to ensure that calling costs from youth to parents are the same throughout the

County and inform parents of actual costs. ( Finding 13)

Response ( Probation): Requires further study. Recently the private

communications provider has sent notice that the current agreement is being

reviewed. Juvenile Hall and the Jail have invited other providers to

demonstrate their products. Hopefully, we can find a provider that better

serves our needs.

Response ( Board of Supervisors): The Board agrees with the response provided

by the Chief Probation Officer. Further study is necessary to find other

providers to lower the cost.

Response Required

Mendocino County Board of Supervisors ( Recommendations A– J)

Mendocino County Office of Education Board of Trustees ( Recommendations C, D)

Mendocino County Superintendent of Schools ( Recommendations C, D)

Response Requested

Mendocino County Department of Probation ( Recommendations A - J)

Mendocino County Department of Mental Health Services ( Recommendations C, E)

Mendocino County General Services ( Recommendations G, H, I)

2000- 2001 Mendocino County Grand Jury Final Report 45

Mendocino County Jail

Understaffing in the Mendocino County Jail ( Jail) as well as the continuous cleaning

and maintenance problems of the facility, referred to in past Grand Jury reports

( 1997– 2000), are an ongoing concern and are being resolved. Two recommendations

from the 1999– 2000 Final Report have not yet been implemented.

Method of Investigation

The Grand Jury reviewed 1997– 2000 Grand Jury reports, recommendations and

County and Sheriff responses, citizens’ complaints, the Board of Corrections’ ( BOC)

Biennial Inspection for September 2000 and the Sheriff’s response, Jail and

Rehabilitation Center Report 2510, and Sheriff’s Office Termination Analysis—

January 1990 through February 2000. The Grand Jury toured the Jail and

interviewed Jail classroom and kitchen staff, Jail inmates, Sheriff, Jail Commander,

Buildings and Grounds Department ( Buildings and Grounds) Supervisor, and

citizens with law enforcement experience. The Grand Jury reviewed Penal Code

§ 4000 et seq. and California Code of Regulations § 1027.

Background Information

The Grand Jury is charged with the responsibility of conducting an oversight of the

Jail annually ( California Penal Code § 919 ( b)). The Jail, operated by the Sheriff,

holds a maximum of 296 inmates.

The 1999– 2000 Grand Jury Final Report had ten recommendations for the Jail. The

Sheriff’s response to the Grand Jury Report stated that eight had already been

implemented. Two recommendations and responses are as follows:

 “ Maintenance Recommendation” number 3 stated: “ Inmate Welfare Trust

Fund should be used for Jail maintenance when the Sheriff deems it

appropriate.”

The Sheriff responded: “ This recommendation requires further analysis,

including a formal legal opinion from County Counsel. A request for an

opinion will be submitted within the next 30 days. A fiscal analysis is also

needed to identify how much of the inmate welfare fund can be identified as

‘… not needed for the welfare of the inmates…’ ( Penal Code § 4025( e)). No

policy changes are needed to allow Buildings and Grounds to bill the Sheriff’s

Office for maintenance services.”

The Board of Supervisors ( Board) deferred to the Sheriff for examination of the

matter.

 “ Staffing Recommendation” number 3 stated: “ The Grand Jury continues to

insist that the County provide adequate private space for attorney/ inmate

interviews at the Courthouse.”

2000- 2001 Mendocino County Grand Jury Final Report 46

The Sheriff responded: “ This recommendation has not yet been implemented,

but work is underway to implement it in the near future. Discussions are

underway with Buildings & Grounds and the department that vacated the

office space next to the courthouse holding cells. If the space can be secured, I

will be requesting that work commence immediately to reconfigure the space

for attorney/ client interviews.

The Board stated: “ The Board agrees with this recommendation. Buildings and

Grounds is examining the facility to determine if the recently vacated office

space can be used as an attorney/ inmate interview room.”

Findings

1. The Grand Jury determined that the Jail and Jail facilities are operating

effectively. The implementation of eight of the 10 recommendations of the

1999- 2000 Final Report shows that the Sheriff has made substantial

improvements in the conditions of the Jail.

Response ( Sheriff): I agree with this finding.

Response ( Board of Supervisors): The Board agrees with this finding. The

Sheriff has worked hard in complying with the recommendations of the Grand

Jury.

2. Jail improvements implemented following Grand Jury recommendations

include:

a. Previous Grand Juries recommended that staffing be brought to full

complement. Pursuant to the BOC Biennial Inspection of September 12,

2000, the optimum number of Correctional Deputies ( line staff) is 54.

Currently the Board is funding only 44 line staff positions, 43 of which

have been filled, versus 34 filled positions one year ago. The Board still

has not funded a full staff at the Jail.

Response ( Sheriff): I disagree with this finding only insofar as the staffing level

required by the Board of Corrections. The Grand Jury apparently misinterpreted a

statement included in the September 2000 inspection report, which noted that the

jail has a complement of 44 line staff and 10 vacancies. At the time of the BOC

inspection, 57 Corrections Deputy positions were allocated, 44 were funded, but

only 34 were filled. According to a staffing analysis prepared by the Board of

Corrections in 1995, the Mendocino County Jail requires 57 Corrections Deputies

to support all jail functions within the existing physical plant.

Response ( Board of Supervisors): The Board agrees with the response provided

by the Sheriff. The Board has allocated the 57 deputies required by the Board of

Corrections. Our goal, within our fiscal constraints, is to fund all 57 deputies. The

2000- 2001 Mendocino County Grand Jury Final Report 47

Board has also taken steps to retain existing staff by implementing the recent class

and compensation study.

b. Continuous cleaning and maintenance are ongoing necessities in the Jail,

and improvement has been accomplished by the assignment of one full-time

maintenance position. Communications with the Buildings and

Grounds has improved and ongoing supplies for parts and repairs are

stocked. Repairs are being done in a timely manner and active logs are

being kept.

Response ( Sheriff): I agree with this finding.

Response ( General Services): The Department agrees with this finding.

Response ( Board of Supervisors): The Board agrees with this finding. Along

with the Sheriff, Buildings and Grounds has worked hard to keep the Jail clean

and keep repairs timely.

3. As of May 28, 2001, the Sheriff has not requested a legal opinion from County

Counsel about using the Inmate Welfare Trust Fund for Jail maintenance,

even though his response was that he would request it within 30 days. In the

meantime, the Sheriff is interpreting Penal Code § 4025 to not use the funds

for Jail maintenance. There is no evidence that the Sheriff has conducted a

fiscal analysis of the $ 140,000 balance to identify possible funds available.

Response ( Sheriff): I agree with this finding. Due to an oversight by a member

of my staff, the opinion was not requested. On July 26, 2001, my office sent a

formal request for opinion to County Counsel. I received the opinion on August

1, 2001. It states that inmate welfare funds may be used for jail maintenance

“… so long as the funds truly are not needed for the welfare of the inmates.” A

copy of the complete opinion is attached. Staff has begun a fiscal analysis to

identify what portion of the fund is not needed for inmate welfare programs.

Response ( Board of Supervisors): The Board agrees with this finding and the

response provided by the Sheriff.

4. There is still no private space set aside at the Courthouse for attorney- inmate

interviews; however, since the 1999– 2000 Grand Jury Final Report was

published the Jail has established three rooms at the Jail for attorney– inmate

interviews. The Sheriff’s Office is continuing to work with Buildings and

Grounds to establish this private space in the Courthouse.

Response ( Sheriff): I agree with this finding. Space has been secured on the

ground floor of the courthouse immediately adjacent to the courthouse holding

cells. Renovation of the existing space is scheduled to begin in August 2001.

2000- 2001 Mendocino County Grand Jury Final Report 48

Response ( General Services): The Department agrees with this finding.

Response ( Board of Supervisors): The Board agrees with this finding and the

response provided by the Sheriff. Renovation of space adjacent to the holding

cells for attorney- client interviews in the basement of the Courthouse is

scheduled for this summer.

Recommendations

A. The Sheriff immediately request County Counsel opinion directly on the

question, may the Welfare Trust Fund be used for Jail maintenance? ( Finding

3)

Response ( Sheriff): The recommendation has been implemented. On July 26,

2001, my office sent a formal request for opinion to County Counsel. On August

1, 2001, I received opinion # 01- 614, which states that inmate welfare funds may

be used for jail maintenance “… so long as the funds truly are not needed for the

welfare of the inmates. A copy of the opinion is attached.

Response ( Board of Supervisors): The Board agrees with the response

provided by the Sheriff. The inmate welfare fund may be used for jail

maintenance under certain circumstances.

B. Sheriff conduct the fiscal analysis he referred to in his response. ( Finding 3)

Response ( Sheriff): The recommendation has been implemented. My staff is

currently analyzing the inmate welfare fund to identify what portion of the fund

is “… not needed for the welfare of the inmates.” ( Penal Code § 4025( e). This is

not a simple analysis. It must consider inmate welfare programs currently in

place, programs in development and programs identified as desirable but not

immediately deliverable given existing constraints on staffing, facilities or

equipment. If and when excess funds are identified, I believe the first priority for

expenditure should be for the repair of intentional damage to the jail caused by

inmates. Taxpayers should not have to bear this cost.

Response ( Board of Supervisors): The Board agrees with the response provided

by the Sheriff. The Board welcomes the findings from the Sheriff on the uses of

the Welfare Trust Fund.

C. The County implement the recommendation from the 1999– 2000 report to

provide a private room at the Courthouse for attorney/ inmate interviews.

( Finding 4)

2000- 2001 Mendocino County Grand Jury Final Report 49

Response ( Sheriff): The recommendation has not yet been implemented but

will be in the future. Renovation of an existing space adjacent to the courthouse

holding facility will begin in August 2001.

Response ( General Services): The Department agrees with this

recommendation. Buildings and Grounds is currently working with the Sheriff,

the District Attorney, and Courts to rearrange space in the Courthouse to allow

for the development of a private attorney/ inmate interview area adjacent to the

inmate holding cells on the ground floor of the Courthouse. We expect the

project to be completed by October 31, 2001.

Response ( Board of Supervisors): The Board agrees with the response

provided by the Sheriff. Renovation of space in the basement of the

Courthouse for attorney- client interviews will begin this summer.

Response Required

Mendocino County Board of Supervisors ( Recommendation C)

Mendocino County Sheriff ( Recommendations A– C)

2000- 2001 Mendocino County Grand Jury Final Report 51

Chamberlain Creek and Parlin Fork

Conservation Camps

Chamberlain Creek and Parlin Fork Conservation Camps are highly functional,

well- organized facilities that provide beneficial programs for the County and State.

The inmates must maintain a level of physical fitness necessary for strenuous fire

fighting and emergency services.

Method of Investigation

The Grand Jury visited Chamberlain Creek and Parlin Fork facilities, interviewed

California Department of Corrections ( CDC) Officers, California Department of

Forestry ( CDF) Officials, on site instructors, and made contact with inmates. The

Grand Jury reviewed CDC and CDF publications and web sites. The Grand Jury

reviewed publications on the benefits of correct weight training. The Grand Jury

reviewed newspaper articles and letters of commendation regarding community

services projects.

Background

Chamberlain Creek and Parlin Fork are two of 38 conservation camps in California

that are operated by the CDC and the CDF, housing a combined total of 212

minimum- security inmates. The inmates provide emergency fire fighting, flood

control, forest and park maintenance, rescue work, and community services

projects.

Assignment to a conservation camp is a hard- won privilege. Inmates are screened

carefully using a sophisticated system to identify and weigh personal aspects of

their background to determine a potential for camp placement. To qualify they

must be minimum security risks, physically fit, and have no history of violent

crimes. After being accepted for camp, inmates undergo a vigorous two- week

physical fitness training program and they are trained in fire safety and suppression

techniques. During the training, they are also evaluated for overall suitability to

continue the program. The average sentence in the camps is one year. Inmates who

are screened out are sent back to State prison.

Each fire crew has 17 inmates supervised by a CDF Captain and a CDC Correctional

Officer. Inmates work 12- hour shifts, often under extreme conditions and in steep

terrain, hauling 30 pounds of materials. A trained inmate earns $ 1 per hour while

fighting fires.

Grand Jury oversight of prisons in Mendocino County is a Grand Jury

responsibility per California Penal Code § 919.

2000- 2001 Mendocino County Grand Jury Final Report 52

Findings

1. Inmates have contributed to the community through volunteer work that

includes preparing food for those in need, donating handmade woodwork

items to charity organizations, and speaking to high school students about the

dangers of drinking and driving.

Response ( California Department of Corrections): No legal response received by

deadline.

Response ( California Department of Forestry): No legal response received by

deadline.

2. The Conservation Camps stress racial harmony, carefully integrating work

crews, recreation teams, and living arrangements in order to combat ethnic

tensions. According to a CDC Correctional Officer, this results in a dramatic

difference between the attitude of inmates at the camps and those in the

prison systems.

3. Firefighting crews can be mobilized quickly during emergencies.

4. A proper level of physical fitness must be maintained in order to be prepared

for the strenuous working conditions encountered when responding to

emergencies. Firefighters often haul heavy equipment while clad in

suffocating, insulated clothing and then they are required to perform at full

capacity enduring high heat and oxygen deficient environments.

5. Weight training equipment has been eliminated by Corrections mandate for

all prisons statewide, regardless of the type of facility. Penal Code § 5010

governs access to Weights and Weight Lifting Equipment.

Comment

Penal Code § 5010( a) states: “ The Legislature hereby finds and declares that the

predominant purpose of exercise in corre