Home
California Grand Jury Reports
El Dorado County Grand Jury final report
To link to this object, paste this link in email, IM or document
To embed this object, paste this HTML in website
El Dorado County Grand Jury final report
|
small (250x250 max)
medium (500x500 max)
large ( > 500x500)
Full Resolution
|
|
El Dorado County Grand Jury 2006- 2007
T A B L E O F C O N T E N T S
PREFACE PAGE
Letter to the Honorable Judge Lasarow i
Letter from the Honorable Judge Lasarow iii
Notice to Respondents v
FINAL REPORTS – 2006- 2007 PAGE
GJ06- 023 Countywide Special Revenue Funds 1
GJ06- 033 El Dorado County Advisory Committee to the In- Home
Supportive Services 5
GJ06- 037 Community Service Districts 11
GJ06- 039 El Dorado County Jail, Placerville 13
GJ06- 045 El Dorado County Facilities 17
GJ06- 046 City of Placerville Facilities 25
GJ06- 047 City of South Lake Tahoe Facility Inspection 29
GJ06- 048 El Dorado County Juvenile Hall, Placerville 31
GJ06- 049 Wraparound Program Audit 33
GJ06- 050 El Dorado County Information Technologies 37
GJ06- 053 El Dorado County Juvenile Treatment Center, South Lake Tahoe 41
GJ06- 054 El Dorado County Jail, South Lake Tahoe 43
MID- TERM 2006- 2007 REPORTS PAGE
GJ06- 019 El Dorado County Charter Amendment 45
GJ06- 022 El Dorado County Human Relations Department 57
GJ06- 030 South Lake Tahoe Animal Control 61
APPENDIX PAGE
El Dorado Grand Jury 2006- 2007 ( Photograph) A
El Dorado Grand Jury 2006- 2007 ( Roster) B
Action Request Form ( Rev. 2007) C
El Dorado County Grand Jury 2006- 2007
v
NOTICE TO REPORT RESPONDENTS
Based on Penal Code § 933.05
Response to FINDINGS
The responding person or entity must respond in one ( 1) or two ( 2) ways:
1. Agree with the finding, or
2. Disagree ( all or part) with the finding.
a) Identify the disputed finding ( or portion thereof).
b) Explain the disagreement and include reasons for the dispute.
Response to RECOMMENDATIONS
Recommendations by the Grand Jury require timely action. The responding person or
entity must report their action on all recommendations in one ( 1) of the four ( 4) following ways:
1. The recommendation is implemented. ( Explain how this was accomplished.)
2. The recommendation is not implemented. It will be implemented in the near future.
( Present the plan, including the time- line, for implementation).
3. The recommendation requires further analysis. The explanation requires ( P. C.
§ 933.05) a detailed description of the analysis or study which must be submitted to
the officer, director or governing body of the agency under investigation), or
4. The recommendation will not be implemented because it is not warranted or is not
reasonable. ( Please provide a full explanation about this response.)
Response: TIME, WHERE, and TO WHOM
Penal Code § 933.05 identifies two ( 2) different response times, depending on type of
respondent, and includes where and to whom the response is directed: Day one ( 1) begins with
the date of the report.
1. Public Agency: The governing body of any public agency* must respond within
ninety ( 90) days, to the presiding Judge of the Superior Court. ( Examples:
Governing body of a public agency, Board of Supervisors, Directors of Districts)
2. Elective Officer or Agency Head: All elected officers or heads of agencies* are
required to respond within sixty ( 60) days to the presiding Judge of the Superior
Court, with a copy to the Board of Supervisors. ( Examples: Sheriff,
Auditor/ Controller, Recorder, Surveyor, Tax/ Treasurer)
~ ~ ~
* " agency", also refers to " department"
El DORADO COUNTY GRAND JURY 2006- 2007
Countywide Special Revenue Funds
GJ 06- 023
April 2007
SUMMARY
This El Dorado County Grand Jury report is the result of an investigation into the
management of El Dorado County Countywide Special Revenue Funds. These funds
represent approximately 85% of the special revenue funds managed by the County.
A beginning balance, July 1, 2006 financial report from the El Dorado County Auditor-
Controller’s Office provided data and information related to these funds. One hundred
thirty three ( 133) separate funds were identified having a total balance of $ 95,709,470.17.
The Auditor- Controller’s Mid Year Report 2006- 2007 documented the total Countywide
Special Revenue Funds appropriations at $ 90,937,479.11.
Prior to 2003- 2004, El Dorado County maintained the revenue currently deposited in
Countywide Special Revenue Fund accounts in Trust Fund accounts. Unlike Trust Fund
accounts, the Countywide Special Revenue Fund accounts are subject to budgeting and
reporting requirements.
~ ~ ~
Scope of the Investigation:
Twenty- five ( 25) departments and offices within El Dorado County manage the 133 El
Dorado County Countywide Special Revenue Funds. The Departments of Transportation,
Public Health and General Services were chosen for this investigation due to the number of
funds, the amount of revenue and the range of revenue sources that these departments
manage. These departments manage 63 of the 133 funds, which equates to 47.4% of the
total Countywide Special Revenue Funds. Additionally, they manage 89.9% of the total
revenue in these funds, which is $ 86,019,912.08. Finally, in the case of the Department of
Transportation, multiple revenue sources fund many of the Countywide Special Revenue
Funds.
People Interviewed:
El Dorado County, Auditor- Controller
El Dorado County, Treasurer & Tax Collector
El Dorado County, Director Department of Transportation
El Dorado County, Director Public Health
El Dorado County, Director General Services
El Dorado County, Director Development Services Department
El Dorado County, Deputy Director Development Services Department
1
El Dorado County, Deputy Director Administration Department of Transportation
El Dorado County, Deputy Director Transportation Planning & Land Development
El Dorado County, Senior Traffic Civil Engineer Department of Transportation
Documents Reviewed:
Notice of Availability of the Traffic Impact Mitigation Fee Program, Final
Supplement to the El Dorado County General Plan, Environmental Impact
Report, August 8, 2006
2004 General Plan Traffic Impact Mitigation Fee Program Documents,
August 8, 2006 and provided to the Board of Supervisors on August 22, 2006
Office of Auditor- Controller, Countywide Special Revenue Funds Report,
February 6, 2007
Office of Auditor- Controller, Special Revenue Funds by Department Report,
November 21, 2006
Office of Auditor- Controller, Special Revenue Funds by Fund Type Report,
August 21, 2006
General Services Department, Interdepartmental Memorandum, Additional
Information as Requested – Special Revenue Funds, February 14, 2007
Public Health Department Policy/ Procedure B- 1, Monthly Fiscal Reports,
revised October 1, 2003
Public Health Department Policy/ Procedure B- 2, Current Year Budget
Adjustments, revised January 10, 2007
Public Health Department, Special Revenue Fund Reconciliation Reports,
Balance Detail Reports and Revenue Expenditure Reports, for selected funds
Office of Treasurer & Tax Collector, El Dorado County Pooled Investments,
Statement of Investment Policy
Office of Treasurer & Tax Collector, El Dorado County Treasurers Cash
Balance Report by fund- type, fund and sub- fund, October 27, 2006
Department of Transportation, Impact Fee Program Compliance Reporting
Documents, March 21, 2006
Department of Transportation, Traffic Impact Fee Reports including budgets,
projects for FY 2006- 2007
El Dorado County Grand Jury, Final Report 2003- 2004, Trust Funds
2
1. Fact:
The El Dorado County Board of Supervisors ( BOS) agreed to the recommendations in the
2003- 2004 Grand Jury Report that County departments would conduct annual reviews of
the El Dorado County Trust Funds.
1. Finding:
The BOS indicated that the recommendation pertaining to the maintenance and
reconciliation of funds would result in an annual review of El Dorado County Trust
Funds now maintained as Countywide Special Revenue Funds. A subsequent
inquiry by the 2006- 2007 Grand Jury to the County Administrative Officer ( CAO)
and the Auditor Controllers Office indicated that the BOS did not follow- up on
their commitment to the 2003- 2004 Grand Jury Report.
1a. Recommendation:
The CAO should provide guidelines that will assist County departments in
the management of Special Revenue Funds and in the preparation of
uniform reports.
1b. Recommendation:
The CAO should establish due dates for the Department Special Revenue
Fund Reports.
2. Fact:
Effective management of Countywide Special Revenue Funds involves two major
components associated with each account:
1. the budget component: tracking revenue and expenditures
2. the program or project component: tracking the accomplishment of activities.
Comprehensive and coordinated monitoring of above components is essential to effective
management.
2. Finding:
In some instances current tracking methods are inadequate.
2. Recommendation:
Program management tools should be implemented in those areas where
automation would assist in the management of Countywide Special
Revenue Funds.
3. Fact:
Departmental procedures define how an entity conducts business. Departments cannot
maintain control over how they operate without well- documented procedures that are
followed and routinely reviewed and updated.
3
3a. Finding:
Not all El Dorado County Departments that have oversight responsibility for
Countywide Special Revenue Funds have internal procedures that identify and
define departmental processes and responsibilities as it relates to management and
reporting of these funds.
3b. Finding:
Two of the three departments reviewed, Transportation and General Services, were
found to be deficient in this area.
3. Recommendation:
County departments that do not currently have procedures to manage their
Countywide Special Revenue Funds, should develop and maintain
procedures appropriate to their operations.
4
5
EL DORADO COUNTY GRAND JURY 2006- 2007
El Dorado County Advisory Committee to the In- Home Supportive Services
GJ 06- 033
March 2007
SUMMARY
The El Dorado County Grand Jury received a complaint from a former member of the
Advisory Committee to the In- Home Supportive Services ( IHSS) Public Authority ( PA).
At issue was the lack of orientation, knowledge and overall understanding of the role and
responsibility of the Advisory Committee. Investigation into the administration of the
Advisory Committee manifested inconsistencies between intent and practice.
~ ~ ~
BACKGROUND
The Public Authority is a local agency established by an ordinance enacted by the El
Dorado County Board of Supervisors. It is legally separate from the County and is the
employer of record for IHSS PA care providers for the purpose of collective bargaining.
The IHSS PA is a program under which qualified aged, blind, and disabled persons are
provided with services in order to permit them to remain in their homes and avoid
institutionalization.
The IHSS PA Advisory Committee is appointed by the El Dorado County Board of
Supervisors to provide advice on the In- Home Supportive Services to the Board of
Supervisors and the Public Authority.
SCOPE OF INVESTIGATION
People Interviewed
• El Dorado County Advisory Committee to the In- Home Supportive
Services Public Authority, members, current and past
• El Dorado County IHSS PA, Program Manager
• El Dorado County Human Services, Director
• El Dorado County Human Services, Assistant Director
• El Dorado County Supervisor, District 2
Documents Reviewed
• Assembly Bill 1682
• Interagency agreement between the County of El Dorado and the El
Dorado County IHSS Public Authority, signed August, 2004
• El Dorado County Advisory Committee to the In- Home Support
Services Public Authority minutes, 2006- 2007
6
• El Dorado County In- Home Support Services Public Authority
Organizational Chart, 2006- 2007
• El Dorado County IHSS PA, Advisory Committee web site
• The El Dorado County In- Home Supportive Services Public Authority
Advisory Committee By Laws
1. Fact:
The Advisory Committee should be comprised of no more than eleven individuals. No
less than 50% of membership should be individuals who are current or past recipients of
personal assistance care services, up to two representatives that are current or past
providers of private or IHSS PA homecare services, and up to three community members
as representatives of community based organizations.
1. Finding:
The Advisory Committee is currently composed of four members: three current
and past recipients and one community member.
1a. Recommendation:
Publicize the Advisory Committee in areas of senior assemblage in order
to encourage awareness and participation in the committee.
1b. Recommendation:
Solicit membership through a broader range of notices, e. g. utilize civic
organizations, church groups, local and metropolitan newspapers, public
service announcements via radio and TV, insertion in mailings of public
utilities, etc.
2. Finding:
There is difficulty in recruiting membership in the Advisory Committee.
The work schedule of the providers may not allow sufficient time to
attend meetings, or, respite care is not available to them.
Recipients may not have the resources available to facilitate
attendance at meetings.
Community volunteers have expressed discouragement and confusion
about their role in the Committee and the role of the Committee.
2a. Recommendation:
Provide respite care for providers.
2b. Recommendation:
Provide transportation, as needed, for recipients to participate in Advisory
Committee meetings.
2c. Recommendation:
Hold meetings at locations where eligible recipients/ providers congregate.
2d. Recommendation:
Utilize conference calling for meetings as needed.
7
2e. Recommendation:
Clearly define the role and responsibility of the Advisory Committee to its
members.
3. Finding:
The IHSS PA is responsible for securing membership in the Advisory Committee.
3. Recommendation:
The Board of Supervisors must exercise its responsibility to obtain
appropriate Committee members.
2. Fact:
The Advisory Committee is established to be independent and charged with giving advice
and making recommendations to the Board of Supervisors on the preferred modes of
service to be utilized for in- home supportive service; and to provide advice to the
IHSS PA.
2a. Finding:
The Advisory Committee members are unaware and uninformed regarding the
needs of the population it is supposed to represent.
2a. Recommendation:
The Human Services Department and the Human Resources Department
should furnish to the Advisory Committee all relevant information as
defined in their Interagency Agreement.
2b. Finding:
Pertinent issues of providers/ recipients, labor contracts, etc. are not discussed with
Advisory Committee members.
2b. Recommendation:
The Human Services Department and the Human Resources Department
should furnish to the Advisory Committee all relevant information as
defined in their Interagency Agreement.
2c. Finding:
The El Dorado County Human Services Department and the Human Resources
Department are not providing input to the Advisory Committee as mandated in
the Interagency Agreement between El Dorado County and the El Dorado County
IHSS Public Authority signed August 2004.
2c. Recommendation:
The Human Services Department and the Human Resources Department
should furnish to the Advisory Committee all relevant information as
defined in their Interagency Agreement.
2d. Finding:
The Human Services Department has not facilitated communication between the
Advisory Committee and the Board of Supervisors.
8
2d. Recommendation:
The Human Services Department should develop a mechanism for the
Advisory Committee to communicate directly with the Board of
Supervisors.
2e. Finding:
The Program Manager of the IHSS PA prepares and presents all reports of the
Advisory Committee to the Board of Supervisors.
2e. Recommendation:
The Human Services Department should develop a mechanism for the
Advisory Committee to communicate directly with the Board of
Supervisors.
2f. Finding:
The El Dorado County IHSS PA organizational chart erroneously depicts a direct
line of communication between the Board of Supervisors and the Advisory
Committee.
2f. Recommendation:
The El Dorado County IHSS PA organizational Chart should accurately
reflect the lines of communication that are in place.
2g. Finding:
The Advisory Committee has never met with the full Board of Supervisors.
2g. Recommendation:
The Board of Supervisors should initiate and maintain active involvement
in the functions and responsibilities of the Advisory Committee.
2h. Finding:
The Board of Supervisors has not demonstrated sufficient support or interest in
the Advisory Committee.
2h. Recommendation:
The Board of Supervisors should initiate and maintain active involvement
in the functions and responsibilities of the Advisory Committee.
2i. Finding
There is an awareness of elder abuse, but investigation into this area has been
negligible.
2i ( 1). Recommendation:
Investigation and remedy of evidence of elder abuse must be given high
priority.
2i ( 2). Recommendation: Initiate education and training of providers to
recognize and report physical, emotional, sexual and financial elder abuse.
9
3. Fact:
Meetings should be public and should be held monthly on a regular day at the locations
and times designated by the committee. The IHSS PA Website, Advisory Committees
section, states all efforts are made for transportation accessibility and that meetings may
be offered via conference call.
3a. Finding:
Advisory Committee had ten meetings in 2006.
3a. Recommendation:
Hold meetings as mandated in By- Laws or change the By- Laws.
3b. Finding:
January and February 2007 meetings were canceled due to lack of attendance.
3b. Recommendation:
The Board of Supervisors must exercise their responsibility to obtain
appropriate members.
3c. Finding:
There is no Vice Chair as mandated in the By- Laws.
3c. Recommendation:
Elect a Vice Chair per By- Laws.
3d. Finding:
The agenda and minutes for the Advisory Committee are prepared and written by
IHSS PA staff who also conduct the Advisory Committee meetings
3d. Recommendation:
The Advisory Committee must prepare their own agenda and be
responsible for conducting their own meetings.
4. Fact:
The 2006- 2007 Budget for the Advisory Committee was prepared by the IHSS PA
Program Manager.
4a. Finding
The Advisory Committee budget was included in the budget for IHSS PA.
4a. Recommendation:
The Advisory Committee should prepare its own budget and this should
be kept separate from the budget of the IHSS PA.
4b. Finding:
The Advisory Committee members are uninformed about guidelines for spending
their budget and its potential use.
10
4b. Recommendation:
The Advisory Committee should be provided with all information
necessary to manage their budget.
4c. Finding:
The members are unaware of a method for presenting budgetary requests to the
Board of Supervisors.
4c. Recommendation:
Human Services Department should develop a mechanism for the
Advisory Committee to present budget requests to the Board of
Supervisors independent of the IHSS PA.
EL DORADO COUNTY GRAND JURY 2006- 2007
Community Services Districts
GJ06- 037
March 2007
Reason for the Report
The El Dorado County Grand Jury received a complaint by a citizen and then received
notification of issues from the County Auditor- Controller in regard to bid selection and
approval of agreements for road repair contracted by the Marble Mountain Community
Services District ( Marble Mountain CSD). Upon completion of this investigation, it was
apparent that no oversight exists. The Marble Mountain CSD Board of Directors is
unaware of California Government Codes and ethics training.
Scope of the Investigation
People interviewed:
• Marble Mountain CSD Board of Directors, President
• Marble Mountain CSD Board of Directors, Treasurer
• El Dorado Local Agency Formation Commission ( LAFCO),
Executive Officer
• El Dorado County, Auditor- Controller
• El Dorado County, County Counsel
• El Dorado County, Deputy County Counsel
Documents reviewed:
• California Assembly Bill 1234
• California Government Code Section 1090- 1099
• California Government Code Section 20682.5
• El Dorado LAFCO Memorandum, February 9, 2007
• Marble Mountain Community Services District By- laws
• Mills Construction Proposal, June 20, 2006 – upper section
• Mills Construction Proposal, June 20, 2006 – lower section
• Marble Mountain CSD, meeting minutes, dated:
November 14, 2006 September 12, 2006
August 8, 2006 July 11, 2006
June 13, 2006 May 9, 2006
April 11, 2006
• Construction invoices, 8/ 15/ 2006, August 9, 2006 and July 31, 2006
• Evergreen Turf and Tree Care, Inc., invoice dated November 27, 2006
11
Background
The initial investigation involved whether the Marble Mountain CSD used competitive
bidding in regard to road repair in accordance with California Government Code Section
20682.5. Another issue was if the Board of Directors had a financial interest in contracts
awarded, per California Government Code Section 1090- 1099.
Facts:
1. Marble Mountain CSD Board of Directors did not follow bidding processes as
required by California Government Code Section 20682.5. They did not
advertise to obtain bids and did not receive the three required written bids for
road repair.
2. Interviewed members of the Board of Directors of Marble Mountain CSD are
unaware of the California Government Code Section 1090- 1099 in regard to
awarding contracts.
3. Marble Mountain CSD Board of Directors are not aware of mandated Ethics
Training as required by California AB 1234.
4. The Local Agency Formation Commission ( LAFCO) does not provide
ongoing oversight or support of Community Services Districts.
5. LAFCO responsibility regarding CSDs is limited to formation and/ or
dissolution.
6. The California Special Districts Association ( CSDA) provides training,
information, legal counsel and special risk management information.
Findings/ Recommendations:
1. Finding:
Marble Mountain CSD Board of Directors did not fulfill their fiduciary duty by awarding
contracts according to law, California Government Code Section 20682.5.
1. Recommendation:
The Marble Mountain CSD Board of Directors must educate themselves
regarding the California Codes, statutes and other pertinent ordinances regarding
contracts.
2. Finding:
The Marble Mountain CSD Board of Directors is not aware of the statutes in regard to
ethics as required by California Government Code Section 1090- 1099.
2. Recommendation:
The El Dorado County Auditor- Controller should annually provide notification to
all Community Services Districts of the requirement to maintain necessary
knowledge relevant to government codes and ethics.
12
13
EL DORADO COUNTY GRAND JURY 2006- 2007
El Dorado County Jail, Placerville
GJ 06- 039
March 2007
SUMMARY
Penal Code Section 919( b) mandates that the El Dorado County Grand Jury annually
inspect custodial facilities within the county. The Grand Jury inspection on
October 26, 2006 of the El Dorado County Jail ( the jail) revealed several maintenance
and procedural problems.
~ ~ ~
Reason for the Report
After observing the general condition of the facility and conversing with staff, concerns
regarding the safety and welfare of the staff and inmates arose, requiring further
investigation.
Scope of the Investigation
People Interviewed:
• El Dorado County, Sheriff
• El Dorado County, Undersheriff
• El Dorado County, Division Commander, Jails and Courts
• El Dorado County, Director of General Services
• El Dorado County, General Services, Jail Maintenance staff.
Documents Reviewed:
• El Dorado County Sheriff’s Office, Custody Division, Policy and
Procedures
• California Code of Regulations, Title 15, Sections 1029- 1032, Policy and
Procedures Manual
• California Code of Regulations, Title 15, Section 1280, Facility
Sanitation, Safety and Maintenance.
Background
The Grand Jury, per Penal Code Section 919( b), is responsible for annually inspecting all
jail facilities within the county. After inspecting the jail, significant issues are:
• maintenance of the facility
• jail expansion
• lack of knowledge of the facilities emergency procedures.
14
1. Fact:
The jail lacks proper and timely maintenance.
1. Finding:
The jail is deteriorating due to age and lack of maintenance, including:
• poor condition of the paint throughout the facility
• noticeable water leaks from an upstairs bathroom, onto the first floor hallway,
leading into the kitchen
• antiquated and potentially dangerous kitchen equipment
• standing water in the kitchen
• uncertainty that the water shut- off valves work.
1. Recommendation:
Increase resources to properly maintain the jail and continually document
the maintenance efforts.
2. Fact:
The level of preventive maintenance is insufficient.
2. Finding:
The maintenance person has little or no time for maintenance because he has to
respond to immediate repairs on an event by event basis.
2a. Recommendation:
Establish a comprehensive preventive maintenance schedule that includes
short and long term preventive measures. Maintain maintenance log that
includes the work completed.
2b. Recommendation:
Provide sufficient staff to properly maintain the jail to include preventive
maintenance.
2c. Recommendation:
Increase utilization of inmates in the maintenance and custodial
responsibilities of the facility, under the supervision of the appropriate jail
staff.
3. Fact:
The jail capacity is insufficient to accommodate the current and future inmate population.
3. Finding:
Currently, plans exist to add two hundred ( 200) beds but the plans do not take into
account the impact the new casino may have on the jail facility. The current County
allocation of casino fees for law enforcement may not be adequate to offset the
anticipated increase in demands.
15
3. Recommendation:
Increase the scope of the current jail expansion plans to include the impact
of the impending casino before expanding the facility.
4. Fact:
Emergency preparedness planning in the jail is insufficient.
4. Finding:
Management and staff on duty at the time of the inspection were unaware of
emergency preparedness plans, including an evacuation plan for the jail. This Grand
Jury is unable to ascertain if there are periodic safety drills to safely relocate inmates
in the event of an emergency.
4a. Recommendation:
Review safety policy and procedures, note the date of each review, and
revise policy and procedures if necessary. Ensure all emergency plans meet
or exceed Title 15, Section 1029, Policy and Procedures Manuals and
include:
• fire suppression preplan as required by Section 1032
• escape, disturbances, and the taking of hostages
• civil disturbance
• natural disasters
• periodic testing of emergency equipment storage, issue and use of
weapons, ammunition, chemical agents, and related security
devices.
4b. Recommendation:
Schedule training in emergency procedures including periodic drills. Initiate
and maintain documents that record the date, time, type of training and
names of staff who attend the training and drills.
4c. Recommendation:
Place the emergency preparedness plan in locations easily observed and
accessible to staff. Instruct personnel of its locations upon assignment to the
facility and during training.
16
INTENTIONALLY LEFT BLANK
EL DORADO COUNTY GRAND JURY 2006- 2007
El Dorado County Facilities
GJ 06- 045
April 2007
SUMMARY
The El Dorado County Grand Jury conducts inspections of County, Municipal and Special District
buildings, owned or leased, per Penal Code Sections 888, 914.1, 925, 925( a) and 928. The findings
of these inspections associated with County owned or leased are presented in this report. County
maintenance staff does an excellent job in identifying and addressing maintenance issues
considering they are understaffed and they are working with a marginal budget. These facilities
were chosen based on a number of factors including:
1. the length of time since last inspection
2. the reported condition of a facility
3. findings and deficiencies identified by previous El Dorado County Grand Juries.
~ ~ ~
Facilities Inspected
El Dorado County Government Center
Building A
Building B
South Lake Tahoe
El Dorado Center
Library
Administrative Building
Courthouse
Facility
El Dorado County Government Center, Building A
1. Fact:
A wooden footbridge is the primary entrance to Building A and B of the Government Center.
1. Finding:
The wood decking on the bridge is deteriorating and is slippery when wet.
1. Recommendation:
Correct the deteriorating and slippery conditions.
17
El Dorado County Government Center, Building B
2. Fact:
Stairways that are inadequately lighted are unsafe.
2. Finding:
The stairway from the main entrance leading to the atrium is inadequately lighted.
2. Recommendation:
Add additional lighting to the stairway.
3. Fact:
Buildings A and B are both serviced by the cooling tower adjacent to building B. The cooling
tower provides air conditioning to both buildings.
3. Finding:
The building tower is 34 years old and has deteriorated to the point that failure is imminent.
3. Recommendation:
The cooling tower should be replaced.
South Lake Tahoe, El Dorado Center
4. Fact:
Severely worn carpeting may present a tripping hazard.
4. Finding:
Carpets are worn throughout the building.
4. Recommendation:
Repair or replace worn carpet.
5. Fact:
Mold is a possible health hazard.
5. Finding:
Water stains appear on shingles inside and above entryway of the building. There is grey
mold on bricks leading to the basement.
5. Recommendation:
Take action to eliminate the mold.
6. Fact:
Inoperable toilets present a health hazard.
18
6. Finding:
There is an ongoing problem with a toilet in this facility being stopped- up.
6. Recommendation:
Repair the plumbing.
7. Fact:
Adequate temperature control is essential to a healthy and productive work environment.
7. Finding:
Temperature control throughout the building is inconsistent. The Recorder’s office had the
door to the parking lot wide open for ventilation even though it is not a regular entrance door
and the alarm warning light was flashing.
7. Recommendation:
Correct the deficiency to maintain an acceptable office temperature.
8. Fact:
State and local fire codes call for evacuation signs to be displayed in appropriate areas of the
building so that egress from the building in an emergency can be accomplished in a rapid and
safe time period.
8. Finding:
Emergency evacuation signs are posted in a few offices, most did not have any.
8. Recommendation:
Post emergency evacuation signs in appropriate areas.
9. Fact:
Fire extinguishers require monthly inspections.
9. Finding:
One fire extinguisher has not been checked since September 2006 and others not checked
since January 2007. Fire extinguishers in hallways were locked and could not be checked.
Locked fire extinguishers can not be easily accessed in an emergency.
9. Recommendation:
Ensure that the servicing agent provides monthly inspections and that fire
extinguishers are easily accessed. Fire extinguishers should comply with Cal- OSHA
requirements.
10. Fact:
Uneven floor surfaces are a tripping hazard.
10. Finding:
The entryway floor surface is uneven.
10. Recommendation:
Eliminate the uneven floor surface.
19
11. Fact:
An unlocked door allows unauthorized people to enter.
11. Finding:
There is no lock on the door at the end of the hall leading to an area housing the janitorial
equipment. Additionally, there is no lock on the door leading to an electrical and HVAC
room.
11. Recommendation:
Install locks as needed.
South Lake Tahoe, Library
12. Fact:
Adequate temperature control is essential for a healthy and productive work environment.
12. Finding:
Heating and air conditioning temperatures are maintained at an uncomfortable level.
12. Recommendation:
Correct the deficiency to maintain an acceptable office temperature.
13. Fact:
State and local fire codes call for evacuation signs to be displayed so that egress from the
building in an emergency can be accomplished in a rapid and safe time period.
13. Finding:
Emergency evacuation signs are not prominently posted.
13. Recommendation:
Post emergency evacuation signs in appropriate areas.
14. Fact:
Meeting rooms must have a maximum capacity sign.
14. Finding:
There is no maximum capacity sign posted in the library meeting room.
14. Recommendation:
Post correct maximum capacity sign in the library meeting room.
15. Fact:
Exits from building must be clearly visible.
20
15. Finding:
Exit signs are not clearly visible.
15. Recommendation:
Install exit signs.
South Lake Tahoe, Administration Building
16. Fact:
Adequate temperature control is essential to allow for a healthy and productive work
environment.
16. Finding:
Heat and air conditioning temperatures are maintained at an uncomfortable level.
16. Recommendation:
Correct the deficiency so that is it possible to maintain an acceptable office
temperature.
17. Fact:
Water entering through a leaking roof can destroy the integrity of a building structure.
17. Finding:
There is evidence of water leaking through the roof.
17. Recommendation:
Repair leaks in roof.
18. Fact:
Mice can carry diseases.
18. Finding:
Mice are a periodic problem.
18. Recommendation:
Eliminate the rodent problem.
19. Fact:
Signs are needed to help the public find the building.
19. Finding:
Direction signs to the building are negligible.
19. Recommendation:
Display prominent direction signs.
21
20. Fact:
Noise in the workplace can disrupt productivity.
20. Finding:
A serious noise problem exists in the reception area.
20. Recommendation:
Minimize or eliminate the source of the noise.
South Lake Tahoe, Courthouse
21. Fact:
Walking surfaces should be even and free of defects.
21. Finding:
Carpets on second floor are buckled and duct taped in some areas.
21. Recommendation:
Repair or replace carpet.
22. Fact:
Obnoxious and nauseating odors are unhealthy.
22. Finding:
The mens restroom fan in Department Three is not functioning.
22. Recommendation:
Repair or replace the exhaust fan.
23. Fact:
State and local fire codes require emergency evacuation signs to be displayed.
23. Finding:
No evacuation signs exist.
23. Recommendation:
Post emergency evacuation signs in appropriate areas.
24. Fact:
Signs are necessary to direct people to the closest exit.
24. Finding:
There are no exit signs in the second floor hallway.
24. Recommendation:
Install clearly visible exit signage where needed.
22
25. Fact:
A leaking roof can destroy the integrity of the building structure.
25. Finding:
There is evidence of water leaking through the roof.
25. Recommendation:
Repair leaking roof.
26. Fact:
Public buildings should be wheelchair accessible.
26. Finding:
Courtrooms do not accommodate wheel chairs.
26. Recommendation:
Install wheelchair access where needed.
27. Fact:
Parking lots should be safe.
27a. Finding:
There are a few small lights on the parking lot wall. Lighting is inadequate and there are no
flood lights or security cameras in the Courthouse parking lot. Staff is afraid to go into the
parking area at night.
27b. Finding:
Employees are fearful of being in close proximity to prisoners on a frequent basis in the
parking lot.
27. Recommendation:
Install appropriate lighting, security cameras and provide a secure and safe parking
lot for employees.
28. Fact:
Infectious material is a hazard.
28. Finding:
Infectious materials are frequently found in the Courthouse parking lot.
28. Recommendation:
Investigate and eliminate the source of the health hazard.
29. Fact:
A secure holding cell is required for prisoners prior to court appearance.
23
29. Finding:
There is no secure holding cell.
30. Recommendation:
Provide a secure holding cell.
24
EL DORADO COUNTY GRAND JURY 2006- 2007
City of Placerville Facilities
GJ 06- 046
May 2007
SUMMARY
The El Dorado County Grand Jury conducts inspections of County, Municipal and Special District
buildings, owned or leased, per Penal Code Sections 888, 914.1, 925, 925( a) and 928. The findings
of these inspections associated with the City of Placerville are presented in this report. These
facilities were chosen based on a number of factors including:
1. the length of time since last inspection
2. the reported condition of a facility
3. findings and deficiencies identified by previous El Dorado County Grand Juries.
~ ~ ~
Facilities Inspected
City of Placerville, Police Department
City of Placerville, City Hall
Facility
City of Placerville, Police Department
COMMENDATION
The El Dorado County Grand Jury recognizes the efforts of the City of Placerville, Police
Department to work and function in an outdated and inadequate facility.
1. Fact:
Proper space is necessary for operational efficiency.
1. Finding:
The Police Department does not have a meeting room. Due to the lack of space, a
small squad room is used and it is too small to accommodate staff.
1. Recommendation:
Provide a larger room with a meeting table, hookups for a computer, a
corkboard, a telephone and a map of the jurisdiction.
25
2. Fact:
An eye care station is necessary to treat persons exposed to toxic materials.
2. Finding:
The existing “ eye care station” is deficient because an inadequate water supply and
the space around the eye care station is severely limited.
2. Recommendation:
Correct the water supply problem and provide more space so that emergency
care can be provided.
3. Fact:
Hallways and corridors should be free for passage of people and equipment.
3. Finding:
Furniture is stored in a hallway.
3. Recommendation:
Move the furniture, in the event of an emergency, hallways are exit routes
and must be kept clear.
4. Fact:
Facilities with sprinklers are safer.
4. Finding:
There are areas within the building that are not protected by the fire sprinkler system.
4. Recommendation:
Check with local fire prevention to determine if the fire sprinkler system
meets current building standards and update if necessary.
5. Fact:
Fire extinguishers require servicing according to local code.
5. Finding:
Fire extinguishers have not been serviced in years.
5. Recommendation:
Have fire extinguishers serviced. Also, have fire prevention staff determine
if the existing fire extinguishers are properly located, identified and are of the
proper size and class.
26
6. Fact:
Adequate temperature control is essential to allow for a healthy and productive work
environment.
6. Finding:
The heating, ventilation and air conditioning ( HVAC) system is not working well.
Portable fans are being used to help move air throughout the facility.
6. Recommendation:
Repair or replace the HVAC system.
7. Fact:
Damaged ceiling tiles may present a hazard.
7. Finding:
There are broken or damaged ceiling tiles in a number of locations within the
facility.
7. Recommendation:
Repair or replace as necessary.
8. Fact:
Water pressure should be adequate for proper equipment functioning.
8. Finding:
Water pressure throughout the facility is inadequate.
8. Recommendation:
Repair or replace as necessary.
9. Fact:
Signage must be adequate to give direction to locations.
9. Finding:
The signage identifying the location of the City of Placerville, Police Department is
inadequate.
9. Recommendation:
Provide signage that can be seen both during the day and at night.
27
City of Placerville, City Hall
10. Fact:
State and local fire codes call for evacuation signs to be displayed in appropriate areas of the
building so that building egress in an emergency can be accomplished in a rapid and safe
time period.
10. Finding:
There are no emergency evacuation plans posted in this facility.
10. Recommendation:
Contact local fire authority to obtain information regarding required content
of emergency evacuation plans. Develop the plans and post as recommended
by the fire authority.
28
EL DORADO COUNTY GRAND JURY 2006- 2007
City of South Lake Tahoe Facility Inspection
GJ 06- 047
May 2007
SUMMARY
The El Dorado County Grand Jury conducts inspections of County, Municipal and Special District
owned or leased buildings as per Penal Code Sections 888, 914.1, 925, 925( a) and 928. The
findings of this inspection are presented in this report. This facility was chosen based on a number
of factors including.
1. The length of time since last inspection
2. the reported condition of a facility
3. findings and deficiencies identified by a previous El Dorado County Grand Jury.
~ ~ ~
Scope of the Investigation
South Lake Tahoe Police Department
Commendation
The El Dorado County Grand Jury recognizes the efforts of the City of South Lake Tahoe Police
Department’s efforts to update and modernize their facility.
1. Fact:
Fire codes require fire extinguishers be serviced every two years.
1. Finding:
Fire extinguishers have not been serviced as required.
1. Recommendation:
Have the fire extinguishers serviced. Also, have the local fire authority determine if
the existing fire extinguishers are properly located, identified and are of the proper
size and class.
2. Facts:
Fire codes require posting of Emergency Evacuation Plans.
2. Finding:
There are no Emergency Evacuation Plans posted in this facility.
29
2. Recommendation:
Contact local fire authority to obtain information regarding required content of
Emergency Evacuation Plan. Develop the plan and post as recommended by the
local fire authority.
3. Fact:
Most manufacturers recommend that computer equipment be maintained at a controlled
temperature.
3. Finding:
The Computer Room does not have appropriate temperature control and monitoring
equipment.
3. Recommendation:
Obtain and install temperature control monitoring equipment dedicated to the
computer equipment room.
4. Fact:
For security reasons admittance to the Police Department must be a safe and controlled
environment.
4. Finding:
The location and design of the reception area does not lend itself to these requirements.
4. Recommendation:
Review options for improving the layout of the reception area and make changes
where possible.
5. Fact:
Proper signage facilitate efficiency and a safe environment.
5. Finding:
Departments and Sections within the facility do not have signs that identify their locations.
5. Recommendation:
Develop and place signs throughout the department and sections that will assist in
directing visitors.
30
EL DORADO COUNTY GRAND JURY 2006- 2007
El Dorado County Juvenile Hall, Placerville
COMMENDATION REPORT
GJ 06- 048
March 2007
On Wednesday, January 17, 2007 the Grand Jury visited the
El Dorado County Juvenile Hall, Placerville in compliance with Penal Code
Section 919( b). The visit included housing units, kitchen, sanitation/ shower
facilities, indoor and outdoor exercise areas and schoolrooms.
The residential area is neat and clean. Floors are spotless, beds are
neatly made and bedding is adequate for comfort.
Isolation, medical, behavioral and protective spaces are realistic and
appropriate to individual needs.
There is a central observation room with updated monitoring
equipment in place. Responses to questions and observation indicate
that security is being addressed appropriately.
The kitchen and the food preparation areas are very clean. The food
service staff is experienced and their dedication to providing
nutritious and tasty meals to the wards is obvious.
The classroom area is appropriate for a learning environment. The
teaching staff is comprised of a principal, two teachers and an aide.
The El Dorado County Office of Education provides the program and
materials.
The El Dorado County Juvenile Hall, Placerville staff is commended for
their dedication in providing a safe and secure detention area for juvenile
wards. They conduct their custodial responsibilities with care and
understanding. The focus on redirecting the behavior of their wards is
impressive.
31
INTENETIONALLY LEFT BLANK
32
EL DORADO COUNTY GRAND JURY 2006- 2007
Wraparound Program Audit
GJ 06- 049
May 2007
BACKGROUND
In November 2005, the El Dorado County Department of Mental Health released their
“ Mental Health Service Act” ( MHSA) report ( Proposition 63). This study was conducted
between the months of February 2005 and October of 2005, to identify and prioritize
unmet mental health needs in the County. In total, over 900 community members were
consulted and participated in the study including:
• 82 focus groups and MHSA trainers
• 23 interviews
• 5 written surveys resulting in 545 responses.
In addition, one- hundred four ( 104) community representatives, mental health consumers
and their family members were involved in the workgroup planning process. In this
comprehensive process, members representing a broad range of service providers were
included in the workgroups.
According to the reports, during deliberations several themes became apparent through
the community outreach efforts. These themes included five ( 5) different programs which
were eligible for funding under the newly established “ Mental Health Service Act.”
One ( 1) of the five ( 5) programs identified was “ Wraparound services for uninsured
youth at risk for out of home placement”. The community issue was to reduce out of
home placement for youth and to provide a safe and stable living environment. According
to the program description, the estimated need was for four hundred ( 400) youth per year
as identified in the MHSA study dated November 10, 2005.
The program description was as follows:
“ Wraparound Services is a collaborative, team- based, family- driven service
delivery model which includes clinical case management, an individualized service plan,
and flexible supports and services. Case management and service delivery are
implemented in a convenient and comfortable location for the family who also directs the
use of family, community and system supports”.
The 2004- 2005 Grand Jury initiated a Wraparound Program audit, with the results
published in last year’s 2005- 2006 Grand Jury year end report ( see Grand Jury Year- End
33
report FY 2005- 2006.) The deficiencies in the program as reported last year were subject
to improvement and the 2006- 2007 Grand Jury believed a follow up audit was warranted.
The Consulting Group of Harvey M. Rose Associates, LLC was again retained to conduct
a limited follow up audit of the Wraparound Program for compliance with the
recommendations as reported to the Board of Supervisors.
2006- 2007 LIMITED AUDIT OF WRAPAROUND PROGRAM
The audit report reflects the recent results and status of the progress achieved by
the El Dorado County Human Services and Mental Health Departments. The
2006- 2007 Grand Jury readily acknowledges that the Wraparound Program has
significantly improved since its inception in 2001, and has made major
improvements since the last audit that was completed in January 2006. We
especially acknowledge improvement in the areas of administration and fiscal
responsibility. However, the program has yet to improve on measurement of results
achieved and follow up evaluations on its participants for creating future programs
and funding effectiveness. These areas of concern need to be addressed and should
be in full compliance within the next fiscal year.
In this audit, of special concern is the limited number of youth included in the
Wraparound Program. The Department of Mental Health in 2005 estimated that 400
youth in El Dorado County could benefit from the Wraparound Program. Since 2002 the
County has approved only six ( 6) service allocation slots for funding. That number is
below the median of 7.6 slots per 100,000 populations as compared to some other
counties who have the Wraparound Program. The population in El Dorado County is
slightly over 176,000, per the latest count, as compared to Humboldt County which has a
population of 132,526 and 11.3 slots.
This Grand Jury is concerned that there is a 43.8% “ graduation” rate from the
Wraparound Program in El Dorado County. In essence, “ graduation” means that the
youth has fulfilled all requirements as agreed upon at the start of his/ her and family
involvement in the system. However, there is no follow up after the “ graduation” and
statistics are not available as to the success rate for the “ graduates.” One must ask what
happened to the 56.2 % who did not “ graduate.” Did the program fail them and if so,
why? Again, no follow up data.
As a family based program, families must be thoroughly and frequently informed both in
writing and verbally regarding the number and types of services available to them, both
traditional and non- traditional. Families need to be informed that there are choices
beyond those offered through the County Mental Health Department. If any obtainable
services are unknown to the family then they cannot be utilized, resulting in reduced care
given to those who are most needful.
It becomes apparent by the questions raised in the audit that the results are subject to
interpretation and further study. Both the Director of Human Services and the Director of
Mental Health were interviewed after the audit was finalized and had different opinions
34
of the results of the audit. Both Departments obviously have great responsibility for the
program and need to work closely together.
This Grand Jury finds that much progress has been made by both the Human Services
and Mental Health Departments. However, much more effort needs to be focused on the
follow up of the youth engaged in the program, with funding more rapidly available for
support and payment of services.
This Grand Jury can only report the facts as well as the findings and follow up
recommendations presented in the Harvey M. Rose Associates, LLC audit of May, 2007.
The final decision rests with the Board of Supervisors to read the audit results and make
the necessary decisions for the betterment of the County population and its youth.
It is this Grand Jury’s recommendation that the Board of Supervisors request a major
effort be initiated by the Departments of Human Services and Mental Health to improve
this County’s Wraparound Program to the level where it would become a model for other
counties in the State of California. This Grand Jury believes that this unique program, if
funded and managed properly, will pay for itself in the future with many benefits for the
citizens of the County, such as lessening of the crime rate and a healthy community. The
future of our society rests with its youth.
Findings/ Recommendations:
See attached Audit of Status of Recommendations from January 2006 Audit of El
Dorado County's Wraparound Program prepared by: Harvey M. Rose Associates,
L. L. C., May, 2007 ( pages 1 through 28 to follow).
35
INTENETIONALLY LEFT BLANK
36
Audit of Status of Recommendations
from the January 2006 Audit of
El Dorado County’s
Wraparound Program
Confidential Report
prepared for:
The FY 2006- 07 El Dorado County Grand Jury
Prepared by:
Harvey M. Rose Associates, LLC
May, 2007
May 1, 2007
Mr. Ray Van Asten, Foreman
Members, FY 2006- 07 El Dorado County Grand Jury
P. O. Box 472
Placerville, CA 95667
Dear Mr. Van Asten and Members of the FY 2006- 07 El Dorado County Grand Jury :
Harvey M. Rose Associates, LLC is pleased to submit this Audit of the Status of
Recommendations from the January 2006 Audit of El Dorado County’s Wraparound
Program. This report presents information on each recommendation from the previous
audit, what has been done and what remains to be done for full implementation. New
information and recommendations are also presented to account for changes in conditions
and to provide elaboration of the prior recommendations in some cases.
There has been progress made in the Wraparound program since the previous audit
particularly in the areas of fiscal and administrative management. Some
recommendations still need to be implemented, in particular management needs to
establish annual program goals and objectives and measure program outcomes and
performance in annual evaluations. An assessment is needed of the current number of
program slots relative to the program’s target population.
As discussed in the Executive Summary, the Departments of Mental Health and Human
Services both received a draft version of this report and provided comments and feedback
before it was finalized. The Department of Human Services responded with 104 concerns
about our 28 page report ranging from clarifying information to some broad criticisms of
the report and audit process. Our response to these areas of broad criticism are provided
in the Executive Summary. The Department of Mental Health provided comments and
feedback that have been incorporated where appropriate.
Thank you for this opportunity to serve the El Dorado County Grand Jury. Please feel
free to contact us at any time if you wish further information about this report.
Sincerely,
Fred Brousseau
Principal
Harvey M. Rose Associates, LLC
i
Executive Summary
Harvey M. Rose Associates, LLC was retained by the FY 2006- 07 El Dorado County
Grand Jury to conduct an audit of the status of the County’s implementation of the
January 2006 “ Audit of Claiming and Financial and other Reporting for the Wraparound
Program of El Dorado County” conducted by our firm for the FY 2005- 06 El Dorado
County Grand Jury.
Wraparound is a State authorized program that allows California counties to use State
foster care and Adoption Assistance funds in a flexible manner to provide eligible youth
with services as an alternative to group home care. The program is for youths who are
residing, or are at risk of being placed, in group homes licensed at Rate Classification
Levels 10- 14, the most costly out- of- home facilities designed for youths with severe
emotional disturbances. For each participant assigned to a program slot, the State
provides the County with 40 percent of what their cost would be in a group home and the
County is required to provide 60 percent. The funds can be used flexibly based on what
the youth and their support teams determine to be in their best interest to achieve their
goals. The State requires that counties participating in the program perform certain
planning and program evaluation functions.
To conduct this audit, all recommendations from the January 2006 audit were reviewed
and their status determined. The report presents that information along with updates to
each recommendation such as changes in departmental plans to implement the
recommendations or, in some cases, further information and analysis pertaining to the
original recommendations. New recommendations are presented related to the first audit
recommendations or updated to reflect changes in circumstances since the January 2006
audit was completed.
A summary of the findings and recommendations in each section is presented below.
1. Status of Compliance with Wraparound Program Requirements
Recommendations
Summary of Findings:
Many of the recommendations from the January 2006 Wraparound
program audit pertaining to compliance with Wraparound Program
requirements have been implemented or partially implemented.
Improvements have been achieved in the areas of management oversight
and tracking and reporting of program participants and costs.
Audit recommendations still needing to be implemented are management
establishment of annual program goals, objectives and operational
guidelines and conduct of annual evaluations of program outcomes and
cost- effectiveness. The Department of Human Services has not yet
conducted its first evaluation of the program yet but is planning to conduct
Executive Summary
one at the conclusion of FY 2006- 07 and provide it to the Board of
Supervisors in the first quarter of FY 2007- 08.
As demonstration of the need for program evaluation and Interagency
Advisory Council involvement in setting annual goals, objectives and
operational guidelines, 25 percent of participants exiting the program in
the last year have been placed in group homes and 22 percent left because
the family chose to withdraw. Since these two reasons for departure
account for nearly half the program exits, they should be analyzed by
program staff and used to determine if changes in program protocols are
needed or if this is an acceptable rate of program completion given the
population served.
Graduations from the Wraparound program also need to be more fully
defined and reported on so that County managers and the program’s
Interagency Advisory Council understand the outcomes of the youths who
have participated in the program.
2007 Recommendations
The Board of Supervisors should:
1.1 Direct the Interagency Advisory Council to immediately establish measurable
Wraparound program goals, objectives and outcome measures and methods for
regularly monitoring and evaluating those goals and measures including an
assessment of the reduction in number of group home placements resulting from
the program, to ensure that is operating effectively and cost efficiently and to be
reported annually to the Board of Supervisors.
1.2 Direct the Interagency Advisory Council to conduct some short- term, focused
evaluation as soon as possible requiring staff to report on current program
outcomes including an analysis of the 43.8 percent graduation rate through
January 2007 and to provide details on graduations and other exits by reason such
as group home placements, stabilization of family situation, child arrested, child
terminated from dependency, etc.
1.3 Direct the Interagency Advisory Council to continue current efforts to measure
family satisfaction with the Wraparound program so that these results can be
included in annual program evaluation reports, the first of which will be presented
to the Board of Supervisors by the Department of Human Services in the first
quarter of FY 2007- 08.
1.4 Direct the Interagency Advisory Council to identify specific characteristics about
the Wraparound program target population for internal management purposes and
for inclusion in the first annual evaluation report to be prepared for the Board of
Supervisors in the first quarter of FY 2007- 08.
Harvey M. Rose Associates, LLC
ii
Executive Summary
1.5 Direct the Interagency Advisory Council to prepare an analysis for the Board of
Supervisors regarding why six Wraparound program service allocation slots are
sufficient relative to total need of the program’s target population in the County.
2. Status of Wraparound Program Fiscal Management
Recommendations
Fiscal management and reporting for the Wraparound program has
improved substantially since the January 2006 audit. The Department of
Human Services has assumed the fiscal management role for the program
and maintains an up to date database of expenditures and revenues and
program participants, all of which is reported regularly to the program’s
Interagency Advisory Council. All six service allocation slots have been
close to full for the first half of FY 2006- 07 which maximizes state and
County revenue available for the program. Budgeted and actual
expenditures and revenues for the current fiscal year appear to be more
closely aligned than they were in the years reviewed for the January 2006
audit.
The $ 173,244 in unspent program funds identified in the January 2006
audit is still largely unspent. In fact, the amount has increased to
approximately $ 247,775 due to the collection of subsequent revenues in
excess of expenditures and the discovery of approximately $ 50,000 in
previously unreported revenue by the Department of Mental Health.
Though protocols are now in place for determining how these surplus
funds will be spent, and most of the funds have been committed for
contract services, the rate of expenditure for these services has been slow,
with only $ 15,467 of the $ 247,775 spent. County staff point out that the
County contracting process contributes to the time it has taken to expend
these funds.
Most of the planned uses of program surplus funds are for parent/ staff
trainings and services such as foster parent respite and transitional housing
services that could also be provided directly to program participants if,
consistent with the Wraparound program approach, that is what participant
teams identified as most beneficial to them. But for the most part the
program does not provide services to participants other than those offered
by the Department of Mental Health and its contractors. The availability of
a broader array of services such as tutoring, job training for youth and
parents, substance abuse counseling, private mental health clinicians,
parent coaching and others should be made know to program participants
rather than only services planned and provided by County officials.
Program funding is flexible and can also be used for services provided by
other County departments, the private sector or community organizations.
2007 Recommendations
Harvey M. Rose Associates, LLC
iii
Executive Summary
The Board of Supervisors should:
2.1 Direct the Interagency Advisory Council to consider using a portion of the surplus
program funds available to enhance or replace direct services provided to
participants by the Department of Mental Health and their contractors and to
report back to the Board of Supervisors a timetable regarding planned expenditure
of the surplus funds to ensure that services are provided within the next six
months in a way that is most beneficial to youth at risk of group home placement
as a first priority, and, second, to children’s services in general.
2.2 To ensure that Wraparound program parameters are clearly communicated to
participants, their families and teams, direct the Interagency Advisory Council to
include information in the “ Family Guide to Wraparound Care in El Dorado
County” document that funding is available for emergency support of necessities
and for non- County services such as private clinician services, private lessons and
fees for clubs and extracurricular programs, if determined to be in the best
interests of the child.
3. Status of Wraparound Program Records Recommendations
Accurate staff time records were not in place for a number of the
Wraparound program years reviewed for the January 2006 audit, resulting
in charges to the program funds that were lower than actual costs. There
were no records kept on the basis for which non- revenue generating
children were admitted to the program. These records are now being
maintained by the Departments of Mental Health and Human Services.
The January 2006 audit found that youth participating in the program were
not always receiving the clinical mental health services specified in their
plans and it was recommended that Wraparound program managers
identify program capacity each year to enable the development of realistic
service plans. These comparisons are no longer possible as the Department
of Mental Health has discontinued specifying hours of services to be
provided in their mental health service plans, making it difficult for
program managers to determine staff utilization and to assess if more
children can be accepted in to the program.
The range of services and funding available to children and families
participating in the program are not publicly documented. Since a key
tenet of the Wraparound approach is for participant teams to determine the
services that best meet their needs, written information should be provided
to participants in addition to oral representations at team meetings to
document the flexibility in types of services and funding that can be made
available.
2007 Recommendations
3.1 Direct the Department of Human Services to modify its “ Family Guide to
Wraparound Care in El Dorado County” and other Wraparound program literature
to make clear the wide variety of services available to participants and their
Harvey M. Rose Associates, LLC
iv
Executive Summary
families and that it is the family team’s choice, not that of County officials, about
who provides needed services.
3.2 Direct the Department of Human Services to prepare a Wraparound program
capacity analysis to estimate the level of Wraparound services that can be
provided through the program through County, contractor and community- based
services providers.
3.3 Direct the Department of Human Services to combine the capacity analysis with
the recommended target population analysis to determine if there is a need and
opportunity to expand the program to ensure that services are available for and
accessible to all County youth at risk of group home placement.
Harvey M. Rose Associates, LLC
v
Executive Summary
Feedback from the Departments of Mental Health and
Human Services
Both the Departments of Mental Health and Human Services reviewed and provided
comments and feedback on a draft version of this report. The Department of Mental
Health had several comments, corrections and suggestions for changes. The Department
of Human Services ( DHS) provided a 20 page response with 104 concerns. Some of
those concerns were typographical errors, requests for clarifications or other matters that
have been addressed in this version of the report. A number were of a broader nature and
with which we have some fundamental disagreement, as follows.
1. DHS expressed concern that this report went beyond its scope of
providing an assessment of the status of the January 2006 audit
recommendations.
Response: The scope of this audit remains an assessment of the status of the
January 2006 Grand Jury audit recommendations. It includes a simple
assessment of whether each recommendation is implemented, partially
implemented or not implemented. It also includes discussion of how
recommendations have been implemented or why they are partially or not
implemented. In some cases, discussions are included as to how DHS plans to
address partially or not implemented recommendations.
New recommendations are also included that address the same issues as the
January 2006 audit but with more current information or elaboration on the
basis for the original recommendations.
2. DHS expressed concern that by making recommendations the consultant
and Grand Jury is inappropriately intervening in Board of Supervisors
and Department roles and processes.
Response: This audit was not bound by any plans made by DHS and the
Board of Supervisors, though they were reviewed. The Grand Jury is
authorized by statute to conduct reviews of county operations, functions and
officers. The purpose of this audit was to conduct an independent assessment
of the status of the recommendations from the previous audit. For DHS to
summarily reject recommendations for program performance measures, for
example, because they are from an “ outside party” fails to recognize the role
of the Grand Jury as part of the County structure. To suggest that the Grand
Jury should not comment on how many Wraparound program slots are in
place also reflects a misunderstanding of the role of the Grand Jury. Finally, to
state that the Grand Jury audit is distracting staff from providing important
public services overlooks the fact that the Grand Jury is part of the public
process and has that statutory right to review and make recommendations to
improve those important public services.
Harvey M. Rose Associates, LLC
vi
Executive Summary
3. DHS stated that is has implemented recommendations pertaining to the
need for the Wraparound Program Interagency Advisory Council
establishing annual program goals, objectives and operational guidelines.
Response: The intent of the recommendation in the January 2006 audit was
for the Interagency Advisory Council to set specific program goals and
objectives for the program each year. These are not the same as program
assumptions or general discussions in meetings but would include measurable
outcomes such as the number of participants in the program relative to a
defined population of at- risk youth in the County, the number of participants
kept out of group homes, the number of participating families reporting
satisfaction with the program and others. We have not seen evidence that such
goals and objectives have been established by the Interagency Advisory
Council.
4. DHS states that no evaluation of program outcomes can be expected at
this point because it has developed a plan to conduct an evaluation at the
end of FY 2006- 07 with one years’ worth of data, to be presented to the
Board of Supervisors in the first quarter of FY 2007- 08. The Department
therefore disagrees with the characterization that the recommendation to
evaluate program outcomes has not been implemented.
Response: This recommendation simply has not been implemented. We do
acknowledge the department’s plans to conduct an evaluation at the end of FY
2006- 07 as arranged between the Department and Board of Supervisors. But
the Department could have implemented the recommendation by conducting
an evaluation of FY 2005- 06 results.
The Department also takes exception to program outcome data presented in
the report showing that only 43.8 percent of program participants have
graduated, stating that the auditor does not have sufficient evidence to
conclude that this is a poor outcome. Due to the absence of program
evaluations, the Department has not presented any evidence that this is a
positive outcome.
Harvey M. Rose Associates, LLC
vii
Introduction
Harvey M. Rose Associates, LLC was retained by the FY 2006- 07 El Dorado County
Grand Jury to conduct an audit of the status of the County’s implementation of the
January 2006 “ Audit of Claiming and Financial and other Reporting for the Wraparound
Program of El Dorado County” conducted by our firm for the FY 2005- 06 El Dorado
County Grand Jury.
The Wraparound program is a State- authorized program that allows counties to flexibly
use State and local funds that would otherwise be used for group home placements for
individualized services to prevent at risk youth from being placed in group homes. In El
Dorado County, funding is obtained from the State by the Department of Human
Services, combined with County funds and used to provide services. The County
Department of Mental Health and its contractors provide most of the program’s direct
services through its clinical staff and its Mental Health workers. Three private
organizations contract with the Department of Mental Health to provide additional
resources and services: 1) Sierra Family Services; 2) Summitview; and; 3) Tahoe Youth
and Family Services. The County program was initiated in 2002.
Audit Methods
Methods used to conduct this audit included the following:
Interviews with directors, program managers and key staff at the Department of
Human Services and the Department of Mental Health were conducted.
A follow up assessment on each recommendation from the January 2006 audit report
was conducted through staff interviews and review of program records and
documents such as budget and detailed actual expenditure and revenue, records,
invoices and Foster Care claiming documents, program participant census data and
Department of Mental Health invoices for services.
Detailed program financial records for FY 2005- 06 and part of FY 2006- 07 were
reviewed.
Detailed program participant records was reviewed including details on youth
assigned to the program’s six service allocation slots and those assigned to the non-revenue
generating slots.
A sample of individual case records were reviewed including treatment plans, billing
records and case progress notes.
Governance documents were reviewed including the County’s Wraparound Program
Plan, as amended August 2006, the program’s interagency Memorandum of
Understanding, executed in 2005, and agendas and minutes from meetings of the
program’s Interagency Governing Council, the County’s Cross- Systems Operations
Team and the Placement Committee.
Harvey M. Rose Associates, LLC
1
Introduction
Documentation and budgets regarding programs and services to be funded with
surplus program funds were collected and reviewed.
A draft report was prepared with the results of the audit presented in the same three
finding areas as the January 2006 audit report. The draft report was reviewed by the
Departments of Mental Health and Human Services, some changes were made based on
their input and comments and the final report was transmitted to the FY 2006- 07 El
Dorado County Grand Jury.
Background: Wraparound Program
The Wraparound program was created by State legislation adopted in 19971 that allowed
California counties to use State foster care and Adoption Assistance funds in a flexible
manner to provide eligible youth with services as an alternative to group home care. The
program is for youths who are residing, or are at risk of being placed, in group homes
licensed at Rate Classification Levels 10- 14, the most costly out- of- home facilities
designed for youths with severe emotional disturbances. While behaviors can vary, risk
behaviors include fighting, stealing, vandalism, running away, self- mutilation, cruelty to
animals and others. Under the Wraparound program, qualified youth are provided with
intensive, individualized family- based services designed to keep them with their families,
or to return them to their families if they are already in an out- of- home placement.
Services can be provided, according to the State legislation, to youths living with their
birth parents, relatives, adoptive parents, licensed or certified foster parents, or guardians.
They can include traditional mental health services, therapeutic behavioral services,
recreation program participation, mentoring services, family counseling and others.
Funding for the program consists of State funding at the same rate as would be provided
for group home placements, which vary based on each participant’s Rate Classification
Level ( RCL). The County is required to match the State funds provided at the rate of
approximately 60 percent of the total cost. The funds are provided to the County’s
Department of Human Services in El Dorado County which may enter into interagency
agreements with other County departments for the provision of wraparound services.
The statute requires participating counties, at their option, to develop a plan for
wraparound services and monitor the provision of those services consistent with the plan.
The plan, to be submitted to the State Department of Social Services for informational
purposes, is to include:
A process and protocol for reviewing and determining how children become
eligible for and are admitted to the program.
Processes for developing, modifying and denying individualized services plans
for each youth participant so that the services provided continue to meet the
childrens’ needs as their circumstances change.
1 California Welfare & Institutions Code § 18250 et. seq.
Harvey M. Rose Associates, LLC
2
Introduction
A process for parent support, mentoring, and advocacy to ensure parent
understanding and participation in the program.
A planning and review process to support and facilitate the following program
principles:
o Focus on the individual child through individualized service plans rather
than a formulaic or standardized approach with all services the same for
all participants regardless of their needs or circumstances.
o Providing services geared to enabling the participants to remain in the
least restrictive, most family- like settings possible.
o Developing a close and collaborative relationship with the family.
o Conducting a thorough, strengths- based assessment of each child and
family that serves as the basis of individualized service plans rather than
plans based on all the problems or weaknesses of the participating youth
and their families.
o Designing and delivering services that incorporate the religious customs,
and regional, racial, and ethnic values of the youths and families served.
o Measuring satisfaction of participants and their families with the program
process and services to assess program outcomes.
Written interagency agreements or memorandum of understanding between the
county departments of social services, mental health and probation that specify
jointly provided or integrated services, staff tasks and responsibilities, budget
considerations and related matters.
The statute also requires that each county evaluate its program to determine its cost and
effectiveness in achieving the program’s goals. Each county is to ensure that staff
participating in the project has completed training provided or approved by the California
Department of Social Services.
The Wraparound program in El Dorado County has a net operating expenditure budget of
$ 345,521 for FY 2006- 07 and assumes a monthly average enrollment of 35 youths and
their families. The total actual number of youth served will depend on the length of
participation for each youth served, but between July 2006 and January 2007, a total of
eight youths had participated in the six service allocation slots and 49 youths had
participated in the non- revenue generating slots.
Harvey M. Rose Associates, LLC
3
1. Status of Compliance with Wraparound
Program Requirements Recommendations
1.1 Many of the recommendations from the January 2006 Wraparound
program audit pertaining to compliance with Wraparound Program
requirements have been implemented or partially implemented.
Improvements have been achieved in the areas of management
oversight and tracking and reporting of program participants and
costs.
1.2 Audit recommendations still needing to be implemented are
management establishment of annual program goals, objectives and
operational guidelines and conduct of annual evaluations of
program outcomes and cost- effectiveness. The Department of
Human Services has not yet conducted its first evaluation of the
program but is planning to conduct one at the conclusion of FY
2006- 07 and provide it to the Board of Supervisors in the first
quarter of FY 2007- 08.
1.3 As demonstration of the need for program evaluation and ongoing
Interagency Advisory Council involvement in setting annual goals,
objectives and operational guidelines, 25 percent of participants
exiting the program in the last year have been placed in group
homes and 22 percent left because the family chose to withdraw.
Since these two reasons for departure account for nearly half the
program exits, they should be analyzed by program staff and the
Council and used to determine if changes in program protocols are
needed or if this is an acceptable rate of program completion given
the population served.
1.4 Graduations from the Wraparound program also need to be more
fully defined and reported on so that County managers and the
program’s Interagency Advisory Council understand the outcomes
of the youths who have participated in the program.
The recommendations pertaining to the County’s compliance with Wraparound Program
requirements contained in Section 2 of the FY 2005- 06 El Dorado Grand Jury’s Audit of
Claiming and Financial and Other Reporting for the Wraparound Program of El Dorado
County, published in January 2006, are presented below. The status of each
recommendation is classified as either Implemented, Partially Implemented or Not
Implemented and is accompanied by a brief explanation.
Harvey M. Rose Associates, LLC
4
1. Compliance with Wraparound Program Requirements
Summary of January 2006 audit findings
A summary of the findings in the January 2006 audit pertaining to the County’s
compliance with Wraparound program requirements are as follows:
Wraparound is a State- authorized program that allows counties to flexibly use State
and local funds that would otherwise be used for group home placements to provide
individualized services to prevent at risk children from being placed in group homes.
In El Dorado County, funding is obtained from the State by the Department of
Human Services, combined with County funds and transferred to the Department of
Mental Health which administers the program.
The County is not operating in full compliance with its key governance documents:
State law; the County Wraparound plan; and, a Memorandum of Understanding
between the Departments of Human Services and Mental Health. Key areas of non-compliance
include: the absence of an executive management team assuming
responsibility for planning and monitoring program performance and a lack of
procedures to ensure family understanding of and input to the program. Among other
impacts, the lack of a Wraparound program management structure has resulted in
under- expending available program funds, lower service levels than anticipated and
over- budgeting every year of the program.
State legislation requires that counties providing Wraparound services designate a
number of service allocation slots for participating children. State funding is provided
based on the number of such slots filled each month. The County’s Department of
Mental Health has expanded program participation by including children at risk of
group home placement in addition to those in the authorized service allocation slots.
Services for these other children are provided with funds not spent on the children in
the authorized slots. The methods for determining eligibility and expenditure levels
for these additional children have not been documented in the County’s Wraparound
plan or any other Department documents.
A Memorandum of Understanding between the Departments of Human Services and
Mental Health calls for reinvestment of savings realized in the Wraparound program
to other children’s services. A definition of such savings has not been established nor
has a process for the two departments to determine how funds should be reinvested.
As a result, approximately $ 173,244 in program funding has accumulated over the
last three year fiscal years that could have been reinvested in other services for
children.
Harvey M. Rose Associates, LLC
5
1. Compliance with Wraparound Program Requirements
Status of January 2006 recommendations
The status of the January 2006 recommendations in this area are as follows:
The Board of Supervisors should:
January 2006 Recommendation Status/ Discussion
2.1 Formally delegate management
responsibility for the Wraparound
program to the multi- departmental
Interagency Governing Council* to
continue to be comprised of, at
minimum, the directors of the
Departments of Human Services, Mental
Health and Probation.
Partially implemented:
The Board of Supervisors did not take
formal action to delegate management
responsibility for the Wraparound
Program to the Interagency Advisory
Council. However, the Council has
reconstituted itself comprised of the
Directors of Human Services, Mental
Health, Probation, Public Health, the
Superintendent of the County Office of
Education, a Superior Court
Commissioner, a representative of
Court Appointed Special Advocates
and a dependency attorney. A review of
minutes from their regular meetings
shows that the Council has assumed
management responsibility for the
program through its discussion and
review of matters such as program
participation and expenditures, roles
and responsibilities of all agencies,
reinvesting surplus funds, and related
items.
* The Interagency Governing Council name was used in the January 2006 audit instead of the Interagency
Advisory Council.
Harvey M. Rose Associates, LLC
6
1. Compliance with Wraparound Program Requirements
The Board of Supervisors should:
January 2006 Recommendation Status/ Discussion
2.2 Direct the multi- departmental
Interagency Governing Council*
Wraparound management team to meet
regularly such as quarterly for the
purpose of overseeing the Wraparound
program including setting annual
program goals and objectives,
determining funding and resource
allocations at least once a year as part of
the County budget process, establishing
operational guidelines, receiving and
reviewing regularly produced
management reports on program
outcomes and cost effectiveness, and
making adjustments to program
operations when needed.
Partially implemented:
Interagency Advisory Council records
show that it met monthly between March
and May, 2006 and has met quarterly
since July 2006. The revised County SB
163 Program Plan, approved by the
Council in August 2006, establishes the
role of the Council and other County
stakeholders and includes a statement of
program purpose and objectives.
However, annual program goals and
objectives have not been established by
the Council. Program budgets are
presented but are not formally adopted by
the Council before submission to the
Board of Supervisors. Management
reports such as quarterly data on program
participants are presented regularly to the
Council but evaluations of outcomes and
cost effectiveness are not being produced
for management review. Proposals for use
of surplus SB 163 funds have been
presented to and discussed by the Council.
2.3 Direct the multi- departmental
Interagency Governing Council*
Wraparound management team to
operate in compliance with State
laws governing the Wraparound
program.
Implemented:
The County is operating in compliance
with all State mandates pertaining to the
Wraparound program. Improvements have
been realized since the January 2006 audit
in documenting the strengths and
participation of families in developing
service plans and establishment of a
mechanism for assessing participant
family satisfaction, although results of this
effort to date have been limited. The
County has established a mechanism for
monitoring accessibility and availability
of services to youths residing, or at risk of
placement, in group homes licensed at
Rate Classification Levels 10- 14, as
required by State law.
* The Interagency Governing Council name was used in the January 2006 audit instead of the Interagency
Advisory Council.
Harvey M. Rose Associates, LLC
7
1. Compliance with Wraparound Program Requirements
The Board of Supervisors should:
January 2006 Recommendation Status/ Discussion
2.4 Direct the multi- departmental
Interagency Governing Council*
Wraparound management team to
prepare annual summary evaluations
of program and cost effectiveness for
their own review and transmission to
the Board of Supervisors, to include
documentation of: program
compliance with State law; the
team’s meeting records; achievement
of program goals; staff training
records; accessibility of the program
to the target population; and, program
satisfaction by participating families.
Not implemented:
Annual evaluations of program and
cost effectiveness have not been
prepared yet but the reconstituted
Council has not been functioning for
a full year yet. Department of Human
Services ( DHS) management
representatives report that such
reports will be prepared and
presented to the Council and the
Board of Supervisors after the
completion of FY 2006- 07.
2.5 Direct the inter- departmental
Wraparound management team to
amend the County Wraparound Plan
to include procedures and protocols
for admitting and providing services
to non- revenue generating children in
the program who are not assigned to
authorized service allocation slots.
Implemented:
The County Wraparound Plan has
been amended and approved by the
Council in August 2006 and was
presented to the Board of Supervisors
for approval in September 2006. It
includes procedures for referral and
approval of Program participants with
distinct procedures for slotted and
non revenue- generating participants. 1
2.6 Direct the Wraparound inter-departmental
management team to
amend the program plan to include a
definition of program “ cost savings to
be reinvested in children’s services”
and to establish procedures for how
decisions will be made regarding
expenditure of such funds.
Implemented:
The amended County Wraparound
Plan now includes a definition of
program cost savings and identifies
specific procedures for determining
how those funds will be spent.
* The Interagency Governing Council name was used in the January 2006 audit instead of the Interagency
Advisory Council.
1 Non- revenue generating participants are youths participating in the program who are defined as “ at risk”
of group home placement by the County but either do not meet the State criteria for program participation
that generates State revenue or, if they do, are not able to generate revenue because all of the program slots
are occupied. Because these youth don’t generate program revenue, their services are limited to what can
be provided with surplus funds remaining after the costs of the services provided to revenue generating
youth are paid for. This practice is allowed by the State.
Harvey M. Rose Associates, LLC
8
1. Compliance with Wraparound Program Requirements
January 2006 Recommendation Status/ Discussion
2.7 Direct appropriate County staff to
draft a new Wraparound program
Memorandum of Understanding
( MOU) for execution by the
Departments of Mental Health,
Human Services and Probation to
replace the MOU among these
departments that expired in
September 2005.
Implemented:
A new MOU was executed between
the Departments of Human Services,
Mental Health, Probation, Public
Health, and the County Office of
Education in November 2005.
Improvements have been achieved in the County’s compliance with State and local
program requirements. The executive management team required in the County’s
Wraparound program plan that was inactive in 2005 has been reconstituted and has
assumed responsibility for many key management oversight functions for the Program
that were not being performed during the previous audit review period. The current
County Wraparound program plan calls for the Interagency Advisory Council to advise
on the development of policy pertaining to integrated services, to provide goals and
decision making strategy and to monitor outcomes. The Council’s meeting minutes show
that it is reviewing key program documents and data and has made decisions on program
operations.
The Council has not established annual measurable Wraparound program goals or
established methods for monitoring outcomes and effectiveness as recommended in the
January 2006 audit. A requirement of the interagency Memorandum of Understanding
( MOU), performance monitoring is a key area that should be addressed to ensure
program and cost effectiveness.
The Interagency Advisory Council is now receiving reports at its quarterly meetings that
present snapshots and profiles for each reporting period about program referrals,
participants and exits. Data on “ claiming efficiency” ( percentage of days when revenue
generating program slots were filled2) is also presented to the Council in these reports.
While all of this is useful information and an improvement over 2005 when the
Interagency Advisory Council was not even meeting regularly let alone receiving
program summary information, the data presented does not address the program’s
effectiveness at achieving performance goals. The reports do show improvement in
claiming efficiency to nearly 100 percent since the previous audit.
2 If all of the six program slots are filled every day of the month, the County would achieve 100 percent
claiming efficiency and maximize program revenue. For every day that any of the six slots are vacant,
revenues are reduced accordingly and “ claiming efficiency” drops below 100 percent. Generally, when a
child exits one of the revenue- generating slots, another child is referred in by the program Placement
Committee. Often, eligible children are already receiving services but in the non- revenue generating slots
until a slot becomes vacant.
Harvey M. Rose Associates, LLC
9
1. Compliance with Wraparound Program Requirements
The goal of the Wraparound program is to provide alternatives to group home placements
for at risk youth through collaborative development of family based service programs
using county, private and non- profit service providers. 3 Currently, the program’s success
in meeting this goal is not being measured and reported in a way that allows program
managers and the Interagency Advisory Council to assess overall program effectiveness
and to make changes where needed if program goals are not being achieved.
Data reported to the Interagency Advisory Council at its meetings held between April
2006 and January 2007 are summarized and presented in Table 1.1. Most of the program
participants exiting the program were classified as “ graduates”. The precise nature of
graduation is not defined in the reports. Assumedly this means that their goals were
achieved and it was not considered appropriate to continue with program services. To
measure program effectiveness, further information needs to be reported about each
graduate such as what goals were achieved and how their achievement was measured.
The data in Table 1.1 shows that 25 percent of the participants were placed in group
homes after participating in the program. Another 22 percent withdrew from the program
by family choice. Altogether, this amounts to 47 percent, or nearly half, of the youths
exiting the program. While the explanations for why the youths ended up being placed in
group homes may have been beyond the control of Wraparound program staff, this level
of post- program group home placement combined with the rate of families choosing to
discontinue are factors that should be reviewed by program management to determine if
changes are needed in the way services are currently being delivered to reverse these
trends. It may be that 43.8 percent is an acceptable rate of graduation given the
population served or that a 25 percent group home placement rate is a positive outcome.
Such standards should be established and codified by the Interagency Advisory Council
based on an analysis of these outcomes and the population being served.
Table 1.1
Reported Wraparound Program Outcomes
April 2006 – January 2007
Outcome Number % Total
Graduation 14 43.8%
Placed in GH 8 25.0%
Family choice: discontinue 7 21.9%
Transfer to adult services 1 3.1%
Child in custody 1 3.1%
Runaway 1 3.1%
32 100.0%
Source: DHS reports to Interagency Advisory Council, April 2006 – January 2007
The Department of Human Services reports that it provides information on individual
cases in Interagency Advisory Council and Cross- Systems Operations Team meetings so
3 California Welfare & Institutions Code § 18250
Harvey M. Rose Associates, LLC
10
1. Compliance with Wraparound Program Requirements
that the members have a broader understanding of outcomes. This type of information
should be recorded and incorporated into the official program outcome statistics reported.
The Department also reports that it will be conducting an evaluation of the program after
the conclusion of FY 2006- 07 when it has one year’s worth of data. Given the uncertainty
of the statistics presented in Table 1.1, some focused evaluation seems appropriate before
waiting for year end.
Other performance measures should be established by and regularly reported to the
Interagency Advisory Council based on program goals and objectives that should be set
by the Council annually. Measures of program effectiveness should include at least the
following:
1. Number of group home placements made by the County ( to see if trend is
declining).
2. Number of other out- of- home placements made by the County.
3. Number of Wraparound program graduations/ exits by outcome ( e. g., goals
achieved [ with details on goals and how achievement measured], group home
placements, other out- of- home placements, family reunifications, stabilized
family situation, families choosing to discontinue services, families asked to
discontinue services by County, child taken in to custody)
4. Number of child maltreatment reports for current and past program participants.
5. Number of psychiatric hospital admissions by Wraparound program participants.
6. Number of participating families reporting satisfaction with program and services
received.
7. Measures of performance at school such as attendance.
These measures would allow the Interagency Advisory Council to better assess the
Wraparound program’s overall effectiveness and to assess whether interventions or
program changes are needed in terms of staff training, new procedures or other measures
to achieve other outcomes.
As noted in the discussion of Recommendations 2.3 and 2.4 in the Status of
Recommendations table above, state law calls for counties to assess their Wraparound
program participating families’ satisfaction with the program as well as the program’s
overall accessibility to its target population. The Department of Human Services ( DHS)
has recently developed a Wraparound program family satisfaction questionnaire that,
starting in November 2006, it has been distributing to participant families upon exiting
the program asking them to assess program services and staff. As of the writing of this
report, only nine families have exited the program and returned a completed
questionnaire so it is too early to draw any conclusions about overall family satisfaction
with the program and services provided. DHS staff report that it is not always easy to get
family members to respond to the questionnaires and to provide honest answers or
criticisms to the County when they are in the middle of receiving services. The
Department will need to continue to request families’ responses to these questionnaires
Harvey M. Rose Associates, LLC
11
1. Compliance with Wraparound Program Requirements
and, possibly, use other means to obtain their assessments to ensure compliance with the
state requirement that family satisfaction with Wraparound be measured.
The County monitors access to the program’s target population, as required by state law4,
through its Placement Committee. DHS staff has expanded their program outreach efforts
in the County in recent months by providing presentations to pertinent groups about the
program. While these efforts may raise awareness about the program and increase the
number of participants, the program needs a working definition and data about its target
population of County youth at risk of group home placement, which should include more
than just the number of youth currently in group homes. Such information should be used
as a baseline to compare to the number of program participants and as a guide for future
program outreach efforts to ensure that all segments of the County’s at risk youth and
their families have access to the program.
A County assessment of the Wraparound program target population should also entail
assessing the adequacy of the program’s capacity through its current six program service
allocation slots. Since the program’s inception, the County has had a total of six slots for
the program, which generates State revenue for services to six youth who are at risk of
group home placement and have Rate Classification Levels ( RCLs) of between 10 and
14. Funding is provided for these six slots by the State and County on a formula basis at
the same level as would be provided for group home payments for these youth. To the
extent the funding provided for these six youths exceeds the actual cost of services
provided to them, which so far has always been the case, the remaining funds are used to
provide services to other youth at risk of group home placement but whose risk is
determined by the County to be not as imminent as those assigned to the six County
“ slots”. This arrangement, allowed by the State, enables the County to provide
Wraparound services to more than the six youth in the County’s designated slots. In fact,
there are more youths participating in the program in non- revenue generating slots than in
revenue generating slots. In FY 2006- 07 through mid- January 2007, there were a total of
eight youths assigned to the six service allocation slots and 29 youths had been assigned
to non- revenue generating slots.
While inclusion of youths other than those eligible for the service allocation slots in the
Wraparound program is a good example of the County’s ability to leverage program
funding, it raises the question of the adequacy of the number of County service allocation
slots since some of non- revenue generating children actually meet the slot criteria but
can’t fill a slot until there is a vacancy. Though their situations may be less severe than
those of the youth assigned to the service allocation slots, this indicates that there are
more at- risk youth in the County than those filling the six slots. By increasing the number
of program slots, the County would be eligible for additional funding to use for these and
other at- risk youth. It should be noted that any increase in the number of slots would also
increase County costs as the County is responsible for 60 percent of the revenue per slot
generated by the program; the State pays the other 40 percent.
4 California Welfare & Institutions Code § 18252( a)
Harvey M. Rose Associates, LLC
12
1. Compliance with Wraparound Program Requirements
Not every county in California has implemented a Wraparound program and data is not
centrally collected on the number of participants or service allocation slots in each
county. However, a review of various documents available from some of the counties
with Wraparound programs shows that El Dorado County has a low number of slots
relative to the total county population, measured in terms of slots per 100,000 people.
Table 1.2 shows the number of slots in selected other counties relative to total population.
While there are differences between counties and comparisons always have some
limitations, it can be seen that El Dorado County has the lowest number of slots
compared to the other six counties and is below the median of slots per 100,000
population.
While some of the other counties are very large and urban, at least two are closer in size
to El Dorado County: Santa Cruz and Humboldt and both of those also have more slots
per 100,000 people. Differences in size have been accounted for by measuring the
number of slots for every 100,000 people in all the counties. The other counties were
selected because data was publicly available about the program slots.
Table 1.2
Number of Wraparound Slots
Per 100,000 Population
County # Slots
2005
Population
Slots/
100,000
Alameda 150 1,501,303 10.0
Humboldt 15 132,526 11.3
Kern 40 779,869 5.1
San Bernardino 200 1,991,829 10.0
San Mateo 30 724,104 4.1
Santa Cruz 12 262,351 4.6
Median 35 751,987 7.6
El Dorado 6 173,407 3.5
Sources: 2006 population data from California State Association of Counties.
After assessing the County’s Wraparound program target population, the County should
consider increasing its number of Wraparound program slots. This would provide more
program capacity and could make higher service levels available for all of the County’s
at- risk youth.
The January 2006 audit found that the County Wraparound Program Plan did not address
at risk youths who do not generate program revenues (“ non- slotted” youth) and did not
include eligibility criteria or procedures for how their participation in the program would
be determined. The County Wraparound Plan, as revised in August 2006, addresses the
non- revenue generating population and processes for their referral to and participation in
the Wraparound program. Records were not kept in 2005 about how many non- revenue
generating youth were referred to the program and how many were accepted. Such
records are now maintained.
Harvey M. Rose Associates, LLC
13
1. Compliance with Wraparound Program Requirements
2007 Recommendations
The Board of Supervisors should:
1.1 Direct the Interagency Advisory Council to immediately establish measurable
Wraparound program goals, objectives and outcome measures and methods for
regularly monitoring and evaluating those goals and measures including an
assessment of the reduction in number of group home placements resulting from
the program, to ensure that is operating effectively and cost efficiently and to be
reported annually to the Board of Supervisors.
1.2 Direct the Interagency Advisory Council to conduct some short- term, focused
evaluation as soon as possible requiring staff to report on current program
outcomes including an analysis of the 43.8 percent graduation rate through
January 2007 and to provide details on graduations and other exits by reason such
as group home placements, stabilization of family situation, child arrested, child
terminated from dependency, etc.
1.3 Direct the Interagency Advisory Council to continue current efforts to measure
family satisfaction with the Wraparound program so that these results can be
included in annual program evaluation reports, the first of which will be presented
to the Board of Supervisors by the Department of Human Services in the first
quarter of FY 2007- 08.
1.4 Direct the Interagency Advisory Council to identify specific characteristics about
the Wraparound program target population for internal management purposes and
for inclusion in the first annual evaluation report to be prepared for the Board of
Supervisors in the first quarter of FY 2007- 08.
1.5 Direct the Interagency Advisory Council to prepare an analysis for the Board of
Supervisors regarding why six Wraparound program service allocation slots are
sufficient relative to total need of the program’s target population in the County.
Harvey M. Rose Associates, LLC
14
2. Status of Wraparound Program Fiscal
Management Recommendations
2.1 Fiscal management and reporting for the Wraparound program has
improved substantially since the January 2006 audit. The
Department of Human Services has assumed the fiscal management
role for the program and maintains an up to date database of
expenditures and revenues and program participants, all of which
is reported regularly to the program’s Interagency Advisory
Council. All six service allocation slots have been close to full for the
first half of FY 2006- 07 which maximizes state and County revenue
available for the program. Budgeted and actual expenditures and
revenues for the current fiscal year appear to be more closely
aligned than they were in the years reviewed for the January 2006
audit.
2.2 The $ 173,244 in unspent program funds identified in the January
2006 audit is still largely unspent. In fact, the amount has increased
to approximately $ 247,775 due to the collection of subsequent
revenues in excess of expenditures and the discovery of
approximately $ 50,000 in previously unreported revenue by the
Department of Mental Health. Though protocols are now in place
for determining how these surplus funds will be spent, and most of
the funds have been committed for contract services, the rate of
expenditure for these services has been slow, with only $ 15,467 of
the $ 247,775 spent. County staff point out that the County
contracting process contributes to the time it has taken to expend
these funds.
2.3 Most of the planned uses of program surplus funds are for
parent/ staff trainings and services such as foster parent respite and
transitional housing services that could also be provided directly to
program participants if, consistent with the Wraparound program
approach, that is what participant teams identified as most
beneficial to them. But for the most part the program does not
provide services to participants other than those offered by the
Department of Mental Health and its contractors. The availability of
a broader array of services such as tutoring, job training for youth
and parents, substance abuse counseling, private mental health
clinicians, parent coaching and others should be made know to
program participants rather than only services planned and
provided by County officials. Program funding is flexible and can
also be used for services provided by other County departments, the
private sector or community organizations.
A summary of the findings in the January 2006 audit pertaining to the County’s fiscal
management of the Wraparound Program are as follows:
Harvey M. Rose Associates, LLC
15
2. Wraparound Program Fiscal Management
Harvey M. Rose Associates, LLC
State and local funding is provided to the County’s Wraparound program based on
the number of “ service allocation slots” filled by children participating in the
program. Between its inception in August 2002 and June 2005, the County authorized
six service allocation slots per month but filled an average of only 4.8. As a result, the
County did not collect an estimated $ 182,484 in available program funding that
would have enabled services to an additional 18.7 children.
In addition to under- recovered available revenue, program expenditures were
approximately $ 173,244 less than actual funding received during the three fiscal years
reviewed. These unspent funds have been carried over each year and are still
available for the program, but reflect lower service levels for program participants
and unnecessary encumbrance of County General Fund monies during the review
period. Combined with the $ 182,484 in funds not recovered due to unfilled service
allocation slots, the County did not provide $ 355,728 worth of Wraparound services
that could have been provided during the three fiscal years reviewed.
During the three years reviewed, actual Wraparound program revenues were
$ 327,938 less than budgeted revenues and actual program expenditures were
$ 628,547 less than budgeted. These substantial variances reflect a lack of program
planning and oversight by Mental Health and Human Services Department executive
management.
Total reported Department of Mental Health salary and benefits costs for Wraparound
were only $ 4,775 and $ 10,912 the first two years of the program, respectively, but
increased to $ 304,547 in FY 2004- 05. Department of Mental Health staff report that
staff time sheet and billing records did not capture all staff time dedicated to the
program in its first two fiscal years. If actual staff costs were higher than the amounts
charged to program funds, those program costs were covered by other Department
funding sources, inappropriately curtailing other services.
Though encouraged by the Wraparound program concept, only $ 9,307, or 1.5 percent
of total program expenditures during the three fiscal years reviewed, have been spent
on unique goods and services jointly identified by program participants, their families
and County staff as being in the best interests of the child. Most of the program
funding has been used for traditional County staff- provided services.
16
2. Wraparound Program Fiscal Management
Harvey M. Rose Associates, LLC
The status of the January 2006 recommendations pertaining to the County’s Wraparound
program fiscal management are as follows:
The Board of Supervisors should:
January 2006 Recommendation Status/ Discussion
3.1 Direct the inter- departmental
Wraparound management team and
Chief Administrative Officer to review
the Wraparound program FY 2005- 06
revenue and expenditure budget, its
assumptions about the number of
children to be served, slots to be filled,
actual number of “ slotted” and non-revenue
generating children served and
actual revenues and expenditures year-to-
date and report back to the Board
within six weeks on whether
adjustments should be made to make
the budget more realistic.
Not implemented:
The recommendation called for the
Wraparound management team and
County CAO to prepare an analysis
for the Board of Supervisors
explaining the differences between
FY 2005- 06 budgeted and actual
revenues and expenditures, which
were substantial in the first years of
the program. The analysis was to
include an assessment of the
assumptions used about the number
of slotted and non- slotted children in
the program. While such an analysis
was never delivered to the Board of
Supervisors, DHS is now regularly
tracking and analyzing data about
the number of children being served,
program slots filled and the number
of non- revenue generating children
in the program.
3.2 Direct the inter- departmental
Wraparound management team and
Chief Administrative Officer to prepare
a budget plan each year based on the
actual revenues and expenditures for
the previous year and documented
assumptions about the number of
children to be served, both slotted and
discretionary non- revenue generating,
and the nature of services to be
provided in the budget year.
Implemented:
The FY 2006- 07 program revenue
and expenditure budget is based on
estimates of the number of
individual children that will
participate in the program, both
slotted and non- revenue generating,
and the slotted children’s
reimbursement rates. Actual
revenues and expenditures from FY
2005- 06 were considered in
preparation of the FY 2006- 07
budget, including planned
expenditures of unspent program
funds from previous years.
17
2. Wraparound Program Fiscal Management
Harvey M. Rose Associates, LLC
The Board of Supervisors should:
January 2006 Recommendation Status/ Discussion
3.3 Direct the inter- departmental
Wraparound management team to at
least quarterly monitor actual program
revenues and expenditures and number
of children served for comparison to the
budget.
Implemented:
Department of Human Services staff
and the Interagency Advisory
Council has started monitoring
actual program revenues and
expenditures and number of children
served at its meetings.
3.4 Direct the Chief Administrative Officer
to separately present the Wraparound
program budget each year in the
proposed Department of Mental Health
budget document presented to the
Board of Supervisors and to include
planned and previous year actual
numbers of slotted and discretionary
non- revenue generating children
program participants, hours of staff
service provided, contractor service
hours and expenditures for unique
external goods and services.
Partially implemented:
Due to changes in structure, the FY
2006- 07 budget for the Wraparound
program is presented in the
Department of Human Services
( DHS) budget rather than the
Department of Mental Health
budget. The presentation in the DHS
budget does not show prior year
actual expenditures and revenues or
number of participants, hours of
staff service provided, or
expenditures on unique external
goods and services5. However, as
mentioned above, the budget
document does present estimated
number of participants for the
budget year.
5 DHS has pointed out that it couldn’t provide a full year’s worth of actual expenditures by the time budget
submissions are required in the County. Estimated actual could have been used for the current year as is
common practice in county budgets.
18
2. Wraparound Program Fiscal Management
Harvey M. Rose Associates, LLC
January 2006 Recommendation Status/ Discussion
3.5 Direct the inter- departmental
Wraparound management team and
Chief Administrative Officer to develop
an expenditure plan for the
approximately $ 173,244 Wraparound
program fund balance and transmit the
plan to the Board for review.
Partially implemented:
The Interagency Advisory Council
has established procedures where
proposals for use of these funds are
first considered by the Cross- System
Operations Team, then, if
recommended, forwarded to the
Council for approval. As of April
2007, the Council had approved
$ 220,275 in one- time expenditures
with these funds. Actual expenditure
of these funds was only $ 15,467 as
of April 2007.
As can be seen in the table summarizing the status of January 2006 audit
recommendations pertaining to program fiscal management above, the Department of
Human Services has made progress tracking program expenditure, revenue and
participant data and regularly reporting it to the Interagency Advisory Council. The
number of slotted and non- slotted participants is being monitored and reported and was
used to estimate FY 2006- 07 program expenditures and revenues. This should result in
expenditures more in line with revenues compared to 2005 and service levels more in
keeping with resources available.
A final change of note is that the interagency Memorandum of Understanding ( MOU) in
place at the time of the January 2006 audit called for reinvestment of cost savings in other
services for children and families but cost savings were not defined nor was a process for
determining how they would be spent. A fund balance of approximately $ 173,000 had
accumulated at the time due to a low rate of program expenditure and there was no plan
in place to utilize those monies.
A process has now been defined for determining how surplus Wraparound program
monies should be spent and the Interagency Advisory Council has approved or is
considering a number of one- time expenditures using these funds as of the writing of this
report. The Interagency Advisory Council made the decision to use the funds for one-time
expenditures because the available fund balance is considered a one- time
accumulation and the Council did not want to increase ongoing program services to a
level that would not be sustainable over time.
Though much of the Wraparound Program fund balance has now been earmarked for
expenditure, actual expenditure of nearly all of these funds, which have been
accumulating since the January 2006 audit and before, has still not occurred. Further, the
fund balance has grown because of additional unspent new revenues accumulated since
the audit was issued and the discovery of previously unreported unspent funds by the
19
2. Wraparound Program Fiscal Management
Harvey M. Rose Associates, LLC
Department of Mental Health after the audit was completed. Unspent program funds and
planned expenditures are presented in Table 2.1.
Table 2.1
Approved and Proposed one- time Expenditure of Unspent Wraparound Program
Funds as of April 2007
Expends
Program
$ Amount
Allocated
as of
04/ 07 Balance
Approved:
Foster Parent Respite Care $ 15,000 $ 4,162 $ 10,838
Celebrating Families 1 20,000 0 20,000
Maxim Healthcare Services 20,000 5,880 14,120
Incredible Years Program 2 15,575 5,425 10,150
Foster & Wrap Youth Groups 50,000 0 50,000
Transitional Housing Program + 3 70,000 0 70,000
Foster & FostAdopt Home Recruitmt 29,700 0 29,700
Proposed: TBS Training 2,500 0 2,500
Unallocated 25,000 0 25,000
Total $ 247,775 $ 15,467 $ 232,308
Source: Department of Human Services reports, April 2007
1 This is a training workshop for parents who work with chemically dependent families.
2 This is a training workshop for parents who work with aggressive children.
3 This is a service to assist youth exiting foster care or group home placement that provides
housing assistance and instruction on independent living skills.
As shown in Table 2.1, the surplus funds have been allocated to organizations and not to
individual Wraparound program participants though the organizations and services
funded may indirectly benefit the participants through services such as parent and staff
training, respite care for foster parents, health care services, transitional housing and
others. While it is true that the fund balance money is one time in nature, some or all of
these funds could still be used for individual participants. It is not necessary for the
program to sustain the same level of expenditure per child at all times. In fact, variation
in expenditure levels should be expected as the needs and plans for participants are
supposed to be customized and not based on a formula.
Another issue of concern regarding the unspent monies is that they have remained
unspent since at least 2005, when the first audit field work was conducted although
Department of Mental Health and Human Services staff were aware of the availability of
this money prior to that. While some of the intervening time was spent developing
protocols to determine how decisions should be made to expend the funds, several
months have passed since many of the appropriations have been approved and very little
of the money has actually been spent. The Department of Human Services has pointed
out that there is often a lag between contractor services provided and payment for these
services and that the County’s contracting process can be time consuming.
20
2. Wraparound Program Fiscal Management
Harvey M. Rose Associates, LLC
While it is commendable that the Interagency Advisory Council took time to establish
protocols for systematically deciding how the expenditure of surplus program funds
would be used, the Council and program managers need to create timetables and
management controls to ensure that these expenditures are timely and responsive to need.
For example, the need for parent training or coaching services could have been identified
as a need when the Interagency Advisory Council first reconvened in the spring of 2006
as a service to begin funding immediately with the surplus funds.
A review of DHS records shows that most of the services provided to Wraparound
participants are mental health services provided by either Department of Mental Health
staff or their contractors. While mental health services are a key component of services to
be provided to at risk youth, the fact that they represent the preponderance of services
provided raises the question of the extent to which participant families and teams are
aware of or are being encouraged to request services that will best meet their needs, even
if not provided by traditional government service providers and their contractors.
Wraparound programs in some other jurisdictions provide mental health services as well
as other social services that are identified as most needed by the participants and their
families and support teams. These services can include parent coaching, foster family
care, job training, tutors/ mentors, respite care and case management services as well as
non- traditional assistance in the form of assistance with basic expenses and payment for
extra- curricular activities such as lessons and activities. Paying for these type of services
with Wraparound funds is allowable under state law.
Since the Wraparound program approach is supposed to be flexible and community-based,
services can be provided by County staff or individuals or organizations from the
community. Most of the services paid for with County Wraparound funds are Department
of Mental Health therapy, psychiatric medical services and therapeutic behavioral
services provided by Department staff or Department contractors. The Department of
Mental Health does provide non- clinical services through its Mental Health Workers who
provide in- home assistance to families with basic living skills and needs. An advantage of
using the Department of Mental Health and its contractors for services is that most of
their costs are reimbursed by Medi- Cal. If private providers who don’t accept Medi- Cal
were used, more program funds would be spent on fewer children.
The Wraparound Program’s expenditure trend has begun to change as of FY 2006- 07
with DHS taking greater control of Wraparound program management. This is
demonstrated by DHS’ hiring of a Parent Partner position who provides various support
and advocacy non- clinical services as needed to many of the Wraparound program
participant families. Payment for this position is being made out of the Wraparound
program budget with funds that were previously allocated to Department of Mental
Health staff services. Recently,
Click tabs to swap between content that is broken into logical sections.
Description
| Rating | |
| Title | El Dorado County Grand Jury final report |
| Subject | California. Grand Jury (El Dorado County)--Periodicals.; El Dorado County (Calif.)--Politics and government. |
| Description | Description based on: 2003/2004 ; title from cover.; Harvested from the web on 10/30/07 |
| Creator | California. Grand Jury (El Dorado County) |
| Publisher | El Dorado County Grand Jury] |
| Type | Text |
| Identifier | http://digitalarchive.oclc.org/request?id%3Doclcnum%3A144544458; http://www.co.el-dorado.ca.us/grandjury/index.html |
| Language | eng |
| Relation | http://worldcat.org/oclc/144544458/viewonline |
| Format-Extent | 1 web site : digital, HTML, PDF files. |
| Relation-Requires | System requirements: Adobe Acrobat Reader.; Mode of access: Internet. |
| Transcript | El Dorado County Grand Jury 2006- 2007 T A B L E O F C O N T E N T S PREFACE PAGE Letter to the Honorable Judge Lasarow i Letter from the Honorable Judge Lasarow iii Notice to Respondents v FINAL REPORTS – 2006- 2007 PAGE GJ06- 023 Countywide Special Revenue Funds 1 GJ06- 033 El Dorado County Advisory Committee to the In- Home Supportive Services 5 GJ06- 037 Community Service Districts 11 GJ06- 039 El Dorado County Jail, Placerville 13 GJ06- 045 El Dorado County Facilities 17 GJ06- 046 City of Placerville Facilities 25 GJ06- 047 City of South Lake Tahoe Facility Inspection 29 GJ06- 048 El Dorado County Juvenile Hall, Placerville 31 GJ06- 049 Wraparound Program Audit 33 GJ06- 050 El Dorado County Information Technologies 37 GJ06- 053 El Dorado County Juvenile Treatment Center, South Lake Tahoe 41 GJ06- 054 El Dorado County Jail, South Lake Tahoe 43 MID- TERM 2006- 2007 REPORTS PAGE GJ06- 019 El Dorado County Charter Amendment 45 GJ06- 022 El Dorado County Human Relations Department 57 GJ06- 030 South Lake Tahoe Animal Control 61 APPENDIX PAGE El Dorado Grand Jury 2006- 2007 ( Photograph) A El Dorado Grand Jury 2006- 2007 ( Roster) B Action Request Form ( Rev. 2007) C El Dorado County Grand Jury 2006- 2007 v NOTICE TO REPORT RESPONDENTS Based on Penal Code § 933.05 Response to FINDINGS The responding person or entity must respond in one ( 1) or two ( 2) ways: 1. Agree with the finding, or 2. Disagree ( all or part) with the finding. a) Identify the disputed finding ( or portion thereof). b) Explain the disagreement and include reasons for the dispute. Response to RECOMMENDATIONS Recommendations by the Grand Jury require timely action. The responding person or entity must report their action on all recommendations in one ( 1) of the four ( 4) following ways: 1. The recommendation is implemented. ( Explain how this was accomplished.) 2. The recommendation is not implemented. It will be implemented in the near future. ( Present the plan, including the time- line, for implementation). 3. The recommendation requires further analysis. The explanation requires ( P. C. § 933.05) a detailed description of the analysis or study which must be submitted to the officer, director or governing body of the agency under investigation), or 4. The recommendation will not be implemented because it is not warranted or is not reasonable. ( Please provide a full explanation about this response.) Response: TIME, WHERE, and TO WHOM Penal Code § 933.05 identifies two ( 2) different response times, depending on type of respondent, and includes where and to whom the response is directed: Day one ( 1) begins with the date of the report. 1. Public Agency: The governing body of any public agency* must respond within ninety ( 90) days, to the presiding Judge of the Superior Court. ( Examples: Governing body of a public agency, Board of Supervisors, Directors of Districts) 2. Elective Officer or Agency Head: All elected officers or heads of agencies* are required to respond within sixty ( 60) days to the presiding Judge of the Superior Court, with a copy to the Board of Supervisors. ( Examples: Sheriff, Auditor/ Controller, Recorder, Surveyor, Tax/ Treasurer) ~ ~ ~ * " agency", also refers to " department" El DORADO COUNTY GRAND JURY 2006- 2007 Countywide Special Revenue Funds GJ 06- 023 April 2007 SUMMARY This El Dorado County Grand Jury report is the result of an investigation into the management of El Dorado County Countywide Special Revenue Funds. These funds represent approximately 85% of the special revenue funds managed by the County. A beginning balance, July 1, 2006 financial report from the El Dorado County Auditor- Controller’s Office provided data and information related to these funds. One hundred thirty three ( 133) separate funds were identified having a total balance of $ 95,709,470.17. The Auditor- Controller’s Mid Year Report 2006- 2007 documented the total Countywide Special Revenue Funds appropriations at $ 90,937,479.11. Prior to 2003- 2004, El Dorado County maintained the revenue currently deposited in Countywide Special Revenue Fund accounts in Trust Fund accounts. Unlike Trust Fund accounts, the Countywide Special Revenue Fund accounts are subject to budgeting and reporting requirements. ~ ~ ~ Scope of the Investigation: Twenty- five ( 25) departments and offices within El Dorado County manage the 133 El Dorado County Countywide Special Revenue Funds. The Departments of Transportation, Public Health and General Services were chosen for this investigation due to the number of funds, the amount of revenue and the range of revenue sources that these departments manage. These departments manage 63 of the 133 funds, which equates to 47.4% of the total Countywide Special Revenue Funds. Additionally, they manage 89.9% of the total revenue in these funds, which is $ 86,019,912.08. Finally, in the case of the Department of Transportation, multiple revenue sources fund many of the Countywide Special Revenue Funds. People Interviewed: El Dorado County, Auditor- Controller El Dorado County, Treasurer & Tax Collector El Dorado County, Director Department of Transportation El Dorado County, Director Public Health El Dorado County, Director General Services El Dorado County, Director Development Services Department El Dorado County, Deputy Director Development Services Department 1 El Dorado County, Deputy Director Administration Department of Transportation El Dorado County, Deputy Director Transportation Planning & Land Development El Dorado County, Senior Traffic Civil Engineer Department of Transportation Documents Reviewed: Notice of Availability of the Traffic Impact Mitigation Fee Program, Final Supplement to the El Dorado County General Plan, Environmental Impact Report, August 8, 2006 2004 General Plan Traffic Impact Mitigation Fee Program Documents, August 8, 2006 and provided to the Board of Supervisors on August 22, 2006 Office of Auditor- Controller, Countywide Special Revenue Funds Report, February 6, 2007 Office of Auditor- Controller, Special Revenue Funds by Department Report, November 21, 2006 Office of Auditor- Controller, Special Revenue Funds by Fund Type Report, August 21, 2006 General Services Department, Interdepartmental Memorandum, Additional Information as Requested – Special Revenue Funds, February 14, 2007 Public Health Department Policy/ Procedure B- 1, Monthly Fiscal Reports, revised October 1, 2003 Public Health Department Policy/ Procedure B- 2, Current Year Budget Adjustments, revised January 10, 2007 Public Health Department, Special Revenue Fund Reconciliation Reports, Balance Detail Reports and Revenue Expenditure Reports, for selected funds Office of Treasurer & Tax Collector, El Dorado County Pooled Investments, Statement of Investment Policy Office of Treasurer & Tax Collector, El Dorado County Treasurers Cash Balance Report by fund- type, fund and sub- fund, October 27, 2006 Department of Transportation, Impact Fee Program Compliance Reporting Documents, March 21, 2006 Department of Transportation, Traffic Impact Fee Reports including budgets, projects for FY 2006- 2007 El Dorado County Grand Jury, Final Report 2003- 2004, Trust Funds 2 1. Fact: The El Dorado County Board of Supervisors ( BOS) agreed to the recommendations in the 2003- 2004 Grand Jury Report that County departments would conduct annual reviews of the El Dorado County Trust Funds. 1. Finding: The BOS indicated that the recommendation pertaining to the maintenance and reconciliation of funds would result in an annual review of El Dorado County Trust Funds now maintained as Countywide Special Revenue Funds. A subsequent inquiry by the 2006- 2007 Grand Jury to the County Administrative Officer ( CAO) and the Auditor Controllers Office indicated that the BOS did not follow- up on their commitment to the 2003- 2004 Grand Jury Report. 1a. Recommendation: The CAO should provide guidelines that will assist County departments in the management of Special Revenue Funds and in the preparation of uniform reports. 1b. Recommendation: The CAO should establish due dates for the Department Special Revenue Fund Reports. 2. Fact: Effective management of Countywide Special Revenue Funds involves two major components associated with each account: 1. the budget component: tracking revenue and expenditures 2. the program or project component: tracking the accomplishment of activities. Comprehensive and coordinated monitoring of above components is essential to effective management. 2. Finding: In some instances current tracking methods are inadequate. 2. Recommendation: Program management tools should be implemented in those areas where automation would assist in the management of Countywide Special Revenue Funds. 3. Fact: Departmental procedures define how an entity conducts business. Departments cannot maintain control over how they operate without well- documented procedures that are followed and routinely reviewed and updated. 3 3a. Finding: Not all El Dorado County Departments that have oversight responsibility for Countywide Special Revenue Funds have internal procedures that identify and define departmental processes and responsibilities as it relates to management and reporting of these funds. 3b. Finding: Two of the three departments reviewed, Transportation and General Services, were found to be deficient in this area. 3. Recommendation: County departments that do not currently have procedures to manage their Countywide Special Revenue Funds, should develop and maintain procedures appropriate to their operations. 4 5 EL DORADO COUNTY GRAND JURY 2006- 2007 El Dorado County Advisory Committee to the In- Home Supportive Services GJ 06- 033 March 2007 SUMMARY The El Dorado County Grand Jury received a complaint from a former member of the Advisory Committee to the In- Home Supportive Services ( IHSS) Public Authority ( PA). At issue was the lack of orientation, knowledge and overall understanding of the role and responsibility of the Advisory Committee. Investigation into the administration of the Advisory Committee manifested inconsistencies between intent and practice. ~ ~ ~ BACKGROUND The Public Authority is a local agency established by an ordinance enacted by the El Dorado County Board of Supervisors. It is legally separate from the County and is the employer of record for IHSS PA care providers for the purpose of collective bargaining. The IHSS PA is a program under which qualified aged, blind, and disabled persons are provided with services in order to permit them to remain in their homes and avoid institutionalization. The IHSS PA Advisory Committee is appointed by the El Dorado County Board of Supervisors to provide advice on the In- Home Supportive Services to the Board of Supervisors and the Public Authority. SCOPE OF INVESTIGATION People Interviewed • El Dorado County Advisory Committee to the In- Home Supportive Services Public Authority, members, current and past • El Dorado County IHSS PA, Program Manager • El Dorado County Human Services, Director • El Dorado County Human Services, Assistant Director • El Dorado County Supervisor, District 2 Documents Reviewed • Assembly Bill 1682 • Interagency agreement between the County of El Dorado and the El Dorado County IHSS Public Authority, signed August, 2004 • El Dorado County Advisory Committee to the In- Home Support Services Public Authority minutes, 2006- 2007 6 • El Dorado County In- Home Support Services Public Authority Organizational Chart, 2006- 2007 • El Dorado County IHSS PA, Advisory Committee web site • The El Dorado County In- Home Supportive Services Public Authority Advisory Committee By Laws 1. Fact: The Advisory Committee should be comprised of no more than eleven individuals. No less than 50% of membership should be individuals who are current or past recipients of personal assistance care services, up to two representatives that are current or past providers of private or IHSS PA homecare services, and up to three community members as representatives of community based organizations. 1. Finding: The Advisory Committee is currently composed of four members: three current and past recipients and one community member. 1a. Recommendation: Publicize the Advisory Committee in areas of senior assemblage in order to encourage awareness and participation in the committee. 1b. Recommendation: Solicit membership through a broader range of notices, e. g. utilize civic organizations, church groups, local and metropolitan newspapers, public service announcements via radio and TV, insertion in mailings of public utilities, etc. 2. Finding: There is difficulty in recruiting membership in the Advisory Committee. The work schedule of the providers may not allow sufficient time to attend meetings, or, respite care is not available to them. Recipients may not have the resources available to facilitate attendance at meetings. Community volunteers have expressed discouragement and confusion about their role in the Committee and the role of the Committee. 2a. Recommendation: Provide respite care for providers. 2b. Recommendation: Provide transportation, as needed, for recipients to participate in Advisory Committee meetings. 2c. Recommendation: Hold meetings at locations where eligible recipients/ providers congregate. 2d. Recommendation: Utilize conference calling for meetings as needed. 7 2e. Recommendation: Clearly define the role and responsibility of the Advisory Committee to its members. 3. Finding: The IHSS PA is responsible for securing membership in the Advisory Committee. 3. Recommendation: The Board of Supervisors must exercise its responsibility to obtain appropriate Committee members. 2. Fact: The Advisory Committee is established to be independent and charged with giving advice and making recommendations to the Board of Supervisors on the preferred modes of service to be utilized for in- home supportive service; and to provide advice to the IHSS PA. 2a. Finding: The Advisory Committee members are unaware and uninformed regarding the needs of the population it is supposed to represent. 2a. Recommendation: The Human Services Department and the Human Resources Department should furnish to the Advisory Committee all relevant information as defined in their Interagency Agreement. 2b. Finding: Pertinent issues of providers/ recipients, labor contracts, etc. are not discussed with Advisory Committee members. 2b. Recommendation: The Human Services Department and the Human Resources Department should furnish to the Advisory Committee all relevant information as defined in their Interagency Agreement. 2c. Finding: The El Dorado County Human Services Department and the Human Resources Department are not providing input to the Advisory Committee as mandated in the Interagency Agreement between El Dorado County and the El Dorado County IHSS Public Authority signed August 2004. 2c. Recommendation: The Human Services Department and the Human Resources Department should furnish to the Advisory Committee all relevant information as defined in their Interagency Agreement. 2d. Finding: The Human Services Department has not facilitated communication between the Advisory Committee and the Board of Supervisors. 8 2d. Recommendation: The Human Services Department should develop a mechanism for the Advisory Committee to communicate directly with the Board of Supervisors. 2e. Finding: The Program Manager of the IHSS PA prepares and presents all reports of the Advisory Committee to the Board of Supervisors. 2e. Recommendation: The Human Services Department should develop a mechanism for the Advisory Committee to communicate directly with the Board of Supervisors. 2f. Finding: The El Dorado County IHSS PA organizational chart erroneously depicts a direct line of communication between the Board of Supervisors and the Advisory Committee. 2f. Recommendation: The El Dorado County IHSS PA organizational Chart should accurately reflect the lines of communication that are in place. 2g. Finding: The Advisory Committee has never met with the full Board of Supervisors. 2g. Recommendation: The Board of Supervisors should initiate and maintain active involvement in the functions and responsibilities of the Advisory Committee. 2h. Finding: The Board of Supervisors has not demonstrated sufficient support or interest in the Advisory Committee. 2h. Recommendation: The Board of Supervisors should initiate and maintain active involvement in the functions and responsibilities of the Advisory Committee. 2i. Finding There is an awareness of elder abuse, but investigation into this area has been negligible. 2i ( 1). Recommendation: Investigation and remedy of evidence of elder abuse must be given high priority. 2i ( 2). Recommendation: Initiate education and training of providers to recognize and report physical, emotional, sexual and financial elder abuse. 9 3. Fact: Meetings should be public and should be held monthly on a regular day at the locations and times designated by the committee. The IHSS PA Website, Advisory Committees section, states all efforts are made for transportation accessibility and that meetings may be offered via conference call. 3a. Finding: Advisory Committee had ten meetings in 2006. 3a. Recommendation: Hold meetings as mandated in By- Laws or change the By- Laws. 3b. Finding: January and February 2007 meetings were canceled due to lack of attendance. 3b. Recommendation: The Board of Supervisors must exercise their responsibility to obtain appropriate members. 3c. Finding: There is no Vice Chair as mandated in the By- Laws. 3c. Recommendation: Elect a Vice Chair per By- Laws. 3d. Finding: The agenda and minutes for the Advisory Committee are prepared and written by IHSS PA staff who also conduct the Advisory Committee meetings 3d. Recommendation: The Advisory Committee must prepare their own agenda and be responsible for conducting their own meetings. 4. Fact: The 2006- 2007 Budget for the Advisory Committee was prepared by the IHSS PA Program Manager. 4a. Finding The Advisory Committee budget was included in the budget for IHSS PA. 4a. Recommendation: The Advisory Committee should prepare its own budget and this should be kept separate from the budget of the IHSS PA. 4b. Finding: The Advisory Committee members are uninformed about guidelines for spending their budget and its potential use. 10 4b. Recommendation: The Advisory Committee should be provided with all information necessary to manage their budget. 4c. Finding: The members are unaware of a method for presenting budgetary requests to the Board of Supervisors. 4c. Recommendation: Human Services Department should develop a mechanism for the Advisory Committee to present budget requests to the Board of Supervisors independent of the IHSS PA. EL DORADO COUNTY GRAND JURY 2006- 2007 Community Services Districts GJ06- 037 March 2007 Reason for the Report The El Dorado County Grand Jury received a complaint by a citizen and then received notification of issues from the County Auditor- Controller in regard to bid selection and approval of agreements for road repair contracted by the Marble Mountain Community Services District ( Marble Mountain CSD). Upon completion of this investigation, it was apparent that no oversight exists. The Marble Mountain CSD Board of Directors is unaware of California Government Codes and ethics training. Scope of the Investigation People interviewed: • Marble Mountain CSD Board of Directors, President • Marble Mountain CSD Board of Directors, Treasurer • El Dorado Local Agency Formation Commission ( LAFCO), Executive Officer • El Dorado County, Auditor- Controller • El Dorado County, County Counsel • El Dorado County, Deputy County Counsel Documents reviewed: • California Assembly Bill 1234 • California Government Code Section 1090- 1099 • California Government Code Section 20682.5 • El Dorado LAFCO Memorandum, February 9, 2007 • Marble Mountain Community Services District By- laws • Mills Construction Proposal, June 20, 2006 – upper section • Mills Construction Proposal, June 20, 2006 – lower section • Marble Mountain CSD, meeting minutes, dated: November 14, 2006 September 12, 2006 August 8, 2006 July 11, 2006 June 13, 2006 May 9, 2006 April 11, 2006 • Construction invoices, 8/ 15/ 2006, August 9, 2006 and July 31, 2006 • Evergreen Turf and Tree Care, Inc., invoice dated November 27, 2006 11 Background The initial investigation involved whether the Marble Mountain CSD used competitive bidding in regard to road repair in accordance with California Government Code Section 20682.5. Another issue was if the Board of Directors had a financial interest in contracts awarded, per California Government Code Section 1090- 1099. Facts: 1. Marble Mountain CSD Board of Directors did not follow bidding processes as required by California Government Code Section 20682.5. They did not advertise to obtain bids and did not receive the three required written bids for road repair. 2. Interviewed members of the Board of Directors of Marble Mountain CSD are unaware of the California Government Code Section 1090- 1099 in regard to awarding contracts. 3. Marble Mountain CSD Board of Directors are not aware of mandated Ethics Training as required by California AB 1234. 4. The Local Agency Formation Commission ( LAFCO) does not provide ongoing oversight or support of Community Services Districts. 5. LAFCO responsibility regarding CSDs is limited to formation and/ or dissolution. 6. The California Special Districts Association ( CSDA) provides training, information, legal counsel and special risk management information. Findings/ Recommendations: 1. Finding: Marble Mountain CSD Board of Directors did not fulfill their fiduciary duty by awarding contracts according to law, California Government Code Section 20682.5. 1. Recommendation: The Marble Mountain CSD Board of Directors must educate themselves regarding the California Codes, statutes and other pertinent ordinances regarding contracts. 2. Finding: The Marble Mountain CSD Board of Directors is not aware of the statutes in regard to ethics as required by California Government Code Section 1090- 1099. 2. Recommendation: The El Dorado County Auditor- Controller should annually provide notification to all Community Services Districts of the requirement to maintain necessary knowledge relevant to government codes and ethics. 12 13 EL DORADO COUNTY GRAND JURY 2006- 2007 El Dorado County Jail, Placerville GJ 06- 039 March 2007 SUMMARY Penal Code Section 919( b) mandates that the El Dorado County Grand Jury annually inspect custodial facilities within the county. The Grand Jury inspection on October 26, 2006 of the El Dorado County Jail ( the jail) revealed several maintenance and procedural problems. ~ ~ ~ Reason for the Report After observing the general condition of the facility and conversing with staff, concerns regarding the safety and welfare of the staff and inmates arose, requiring further investigation. Scope of the Investigation People Interviewed: • El Dorado County, Sheriff • El Dorado County, Undersheriff • El Dorado County, Division Commander, Jails and Courts • El Dorado County, Director of General Services • El Dorado County, General Services, Jail Maintenance staff. Documents Reviewed: • El Dorado County Sheriff’s Office, Custody Division, Policy and Procedures • California Code of Regulations, Title 15, Sections 1029- 1032, Policy and Procedures Manual • California Code of Regulations, Title 15, Section 1280, Facility Sanitation, Safety and Maintenance. Background The Grand Jury, per Penal Code Section 919( b), is responsible for annually inspecting all jail facilities within the county. After inspecting the jail, significant issues are: • maintenance of the facility • jail expansion • lack of knowledge of the facilities emergency procedures. 14 1. Fact: The jail lacks proper and timely maintenance. 1. Finding: The jail is deteriorating due to age and lack of maintenance, including: • poor condition of the paint throughout the facility • noticeable water leaks from an upstairs bathroom, onto the first floor hallway, leading into the kitchen • antiquated and potentially dangerous kitchen equipment • standing water in the kitchen • uncertainty that the water shut- off valves work. 1. Recommendation: Increase resources to properly maintain the jail and continually document the maintenance efforts. 2. Fact: The level of preventive maintenance is insufficient. 2. Finding: The maintenance person has little or no time for maintenance because he has to respond to immediate repairs on an event by event basis. 2a. Recommendation: Establish a comprehensive preventive maintenance schedule that includes short and long term preventive measures. Maintain maintenance log that includes the work completed. 2b. Recommendation: Provide sufficient staff to properly maintain the jail to include preventive maintenance. 2c. Recommendation: Increase utilization of inmates in the maintenance and custodial responsibilities of the facility, under the supervision of the appropriate jail staff. 3. Fact: The jail capacity is insufficient to accommodate the current and future inmate population. 3. Finding: Currently, plans exist to add two hundred ( 200) beds but the plans do not take into account the impact the new casino may have on the jail facility. The current County allocation of casino fees for law enforcement may not be adequate to offset the anticipated increase in demands. 15 3. Recommendation: Increase the scope of the current jail expansion plans to include the impact of the impending casino before expanding the facility. 4. Fact: Emergency preparedness planning in the jail is insufficient. 4. Finding: Management and staff on duty at the time of the inspection were unaware of emergency preparedness plans, including an evacuation plan for the jail. This Grand Jury is unable to ascertain if there are periodic safety drills to safely relocate inmates in the event of an emergency. 4a. Recommendation: Review safety policy and procedures, note the date of each review, and revise policy and procedures if necessary. Ensure all emergency plans meet or exceed Title 15, Section 1029, Policy and Procedures Manuals and include: • fire suppression preplan as required by Section 1032 • escape, disturbances, and the taking of hostages • civil disturbance • natural disasters • periodic testing of emergency equipment storage, issue and use of weapons, ammunition, chemical agents, and related security devices. 4b. Recommendation: Schedule training in emergency procedures including periodic drills. Initiate and maintain documents that record the date, time, type of training and names of staff who attend the training and drills. 4c. Recommendation: Place the emergency preparedness plan in locations easily observed and accessible to staff. Instruct personnel of its locations upon assignment to the facility and during training. 16 INTENTIONALLY LEFT BLANK EL DORADO COUNTY GRAND JURY 2006- 2007 El Dorado County Facilities GJ 06- 045 April 2007 SUMMARY The El Dorado County Grand Jury conducts inspections of County, Municipal and Special District buildings, owned or leased, per Penal Code Sections 888, 914.1, 925, 925( a) and 928. The findings of these inspections associated with County owned or leased are presented in this report. County maintenance staff does an excellent job in identifying and addressing maintenance issues considering they are understaffed and they are working with a marginal budget. These facilities were chosen based on a number of factors including: 1. the length of time since last inspection 2. the reported condition of a facility 3. findings and deficiencies identified by previous El Dorado County Grand Juries. ~ ~ ~ Facilities Inspected El Dorado County Government Center Building A Building B South Lake Tahoe El Dorado Center Library Administrative Building Courthouse Facility El Dorado County Government Center, Building A 1. Fact: A wooden footbridge is the primary entrance to Building A and B of the Government Center. 1. Finding: The wood decking on the bridge is deteriorating and is slippery when wet. 1. Recommendation: Correct the deteriorating and slippery conditions. 17 El Dorado County Government Center, Building B 2. Fact: Stairways that are inadequately lighted are unsafe. 2. Finding: The stairway from the main entrance leading to the atrium is inadequately lighted. 2. Recommendation: Add additional lighting to the stairway. 3. Fact: Buildings A and B are both serviced by the cooling tower adjacent to building B. The cooling tower provides air conditioning to both buildings. 3. Finding: The building tower is 34 years old and has deteriorated to the point that failure is imminent. 3. Recommendation: The cooling tower should be replaced. South Lake Tahoe, El Dorado Center 4. Fact: Severely worn carpeting may present a tripping hazard. 4. Finding: Carpets are worn throughout the building. 4. Recommendation: Repair or replace worn carpet. 5. Fact: Mold is a possible health hazard. 5. Finding: Water stains appear on shingles inside and above entryway of the building. There is grey mold on bricks leading to the basement. 5. Recommendation: Take action to eliminate the mold. 6. Fact: Inoperable toilets present a health hazard. 18 6. Finding: There is an ongoing problem with a toilet in this facility being stopped- up. 6. Recommendation: Repair the plumbing. 7. Fact: Adequate temperature control is essential to a healthy and productive work environment. 7. Finding: Temperature control throughout the building is inconsistent. The Recorder’s office had the door to the parking lot wide open for ventilation even though it is not a regular entrance door and the alarm warning light was flashing. 7. Recommendation: Correct the deficiency to maintain an acceptable office temperature. 8. Fact: State and local fire codes call for evacuation signs to be displayed in appropriate areas of the building so that egress from the building in an emergency can be accomplished in a rapid and safe time period. 8. Finding: Emergency evacuation signs are posted in a few offices, most did not have any. 8. Recommendation: Post emergency evacuation signs in appropriate areas. 9. Fact: Fire extinguishers require monthly inspections. 9. Finding: One fire extinguisher has not been checked since September 2006 and others not checked since January 2007. Fire extinguishers in hallways were locked and could not be checked. Locked fire extinguishers can not be easily accessed in an emergency. 9. Recommendation: Ensure that the servicing agent provides monthly inspections and that fire extinguishers are easily accessed. Fire extinguishers should comply with Cal- OSHA requirements. 10. Fact: Uneven floor surfaces are a tripping hazard. 10. Finding: The entryway floor surface is uneven. 10. Recommendation: Eliminate the uneven floor surface. 19 11. Fact: An unlocked door allows unauthorized people to enter. 11. Finding: There is no lock on the door at the end of the hall leading to an area housing the janitorial equipment. Additionally, there is no lock on the door leading to an electrical and HVAC room. 11. Recommendation: Install locks as needed. South Lake Tahoe, Library 12. Fact: Adequate temperature control is essential for a healthy and productive work environment. 12. Finding: Heating and air conditioning temperatures are maintained at an uncomfortable level. 12. Recommendation: Correct the deficiency to maintain an acceptable office temperature. 13. Fact: State and local fire codes call for evacuation signs to be displayed so that egress from the building in an emergency can be accomplished in a rapid and safe time period. 13. Finding: Emergency evacuation signs are not prominently posted. 13. Recommendation: Post emergency evacuation signs in appropriate areas. 14. Fact: Meeting rooms must have a maximum capacity sign. 14. Finding: There is no maximum capacity sign posted in the library meeting room. 14. Recommendation: Post correct maximum capacity sign in the library meeting room. 15. Fact: Exits from building must be clearly visible. 20 15. Finding: Exit signs are not clearly visible. 15. Recommendation: Install exit signs. South Lake Tahoe, Administration Building 16. Fact: Adequate temperature control is essential to allow for a healthy and productive work environment. 16. Finding: Heat and air conditioning temperatures are maintained at an uncomfortable level. 16. Recommendation: Correct the deficiency so that is it possible to maintain an acceptable office temperature. 17. Fact: Water entering through a leaking roof can destroy the integrity of a building structure. 17. Finding: There is evidence of water leaking through the roof. 17. Recommendation: Repair leaks in roof. 18. Fact: Mice can carry diseases. 18. Finding: Mice are a periodic problem. 18. Recommendation: Eliminate the rodent problem. 19. Fact: Signs are needed to help the public find the building. 19. Finding: Direction signs to the building are negligible. 19. Recommendation: Display prominent direction signs. 21 20. Fact: Noise in the workplace can disrupt productivity. 20. Finding: A serious noise problem exists in the reception area. 20. Recommendation: Minimize or eliminate the source of the noise. South Lake Tahoe, Courthouse 21. Fact: Walking surfaces should be even and free of defects. 21. Finding: Carpets on second floor are buckled and duct taped in some areas. 21. Recommendation: Repair or replace carpet. 22. Fact: Obnoxious and nauseating odors are unhealthy. 22. Finding: The mens restroom fan in Department Three is not functioning. 22. Recommendation: Repair or replace the exhaust fan. 23. Fact: State and local fire codes require emergency evacuation signs to be displayed. 23. Finding: No evacuation signs exist. 23. Recommendation: Post emergency evacuation signs in appropriate areas. 24. Fact: Signs are necessary to direct people to the closest exit. 24. Finding: There are no exit signs in the second floor hallway. 24. Recommendation: Install clearly visible exit signage where needed. 22 25. Fact: A leaking roof can destroy the integrity of the building structure. 25. Finding: There is evidence of water leaking through the roof. 25. Recommendation: Repair leaking roof. 26. Fact: Public buildings should be wheelchair accessible. 26. Finding: Courtrooms do not accommodate wheel chairs. 26. Recommendation: Install wheelchair access where needed. 27. Fact: Parking lots should be safe. 27a. Finding: There are a few small lights on the parking lot wall. Lighting is inadequate and there are no flood lights or security cameras in the Courthouse parking lot. Staff is afraid to go into the parking area at night. 27b. Finding: Employees are fearful of being in close proximity to prisoners on a frequent basis in the parking lot. 27. Recommendation: Install appropriate lighting, security cameras and provide a secure and safe parking lot for employees. 28. Fact: Infectious material is a hazard. 28. Finding: Infectious materials are frequently found in the Courthouse parking lot. 28. Recommendation: Investigate and eliminate the source of the health hazard. 29. Fact: A secure holding cell is required for prisoners prior to court appearance. 23 29. Finding: There is no secure holding cell. 30. Recommendation: Provide a secure holding cell. 24 EL DORADO COUNTY GRAND JURY 2006- 2007 City of Placerville Facilities GJ 06- 046 May 2007 SUMMARY The El Dorado County Grand Jury conducts inspections of County, Municipal and Special District buildings, owned or leased, per Penal Code Sections 888, 914.1, 925, 925( a) and 928. The findings of these inspections associated with the City of Placerville are presented in this report. These facilities were chosen based on a number of factors including: 1. the length of time since last inspection 2. the reported condition of a facility 3. findings and deficiencies identified by previous El Dorado County Grand Juries. ~ ~ ~ Facilities Inspected City of Placerville, Police Department City of Placerville, City Hall Facility City of Placerville, Police Department COMMENDATION The El Dorado County Grand Jury recognizes the efforts of the City of Placerville, Police Department to work and function in an outdated and inadequate facility. 1. Fact: Proper space is necessary for operational efficiency. 1. Finding: The Police Department does not have a meeting room. Due to the lack of space, a small squad room is used and it is too small to accommodate staff. 1. Recommendation: Provide a larger room with a meeting table, hookups for a computer, a corkboard, a telephone and a map of the jurisdiction. 25 2. Fact: An eye care station is necessary to treat persons exposed to toxic materials. 2. Finding: The existing “ eye care station” is deficient because an inadequate water supply and the space around the eye care station is severely limited. 2. Recommendation: Correct the water supply problem and provide more space so that emergency care can be provided. 3. Fact: Hallways and corridors should be free for passage of people and equipment. 3. Finding: Furniture is stored in a hallway. 3. Recommendation: Move the furniture, in the event of an emergency, hallways are exit routes and must be kept clear. 4. Fact: Facilities with sprinklers are safer. 4. Finding: There are areas within the building that are not protected by the fire sprinkler system. 4. Recommendation: Check with local fire prevention to determine if the fire sprinkler system meets current building standards and update if necessary. 5. Fact: Fire extinguishers require servicing according to local code. 5. Finding: Fire extinguishers have not been serviced in years. 5. Recommendation: Have fire extinguishers serviced. Also, have fire prevention staff determine if the existing fire extinguishers are properly located, identified and are of the proper size and class. 26 6. Fact: Adequate temperature control is essential to allow for a healthy and productive work environment. 6. Finding: The heating, ventilation and air conditioning ( HVAC) system is not working well. Portable fans are being used to help move air throughout the facility. 6. Recommendation: Repair or replace the HVAC system. 7. Fact: Damaged ceiling tiles may present a hazard. 7. Finding: There are broken or damaged ceiling tiles in a number of locations within the facility. 7. Recommendation: Repair or replace as necessary. 8. Fact: Water pressure should be adequate for proper equipment functioning. 8. Finding: Water pressure throughout the facility is inadequate. 8. Recommendation: Repair or replace as necessary. 9. Fact: Signage must be adequate to give direction to locations. 9. Finding: The signage identifying the location of the City of Placerville, Police Department is inadequate. 9. Recommendation: Provide signage that can be seen both during the day and at night. 27 City of Placerville, City Hall 10. Fact: State and local fire codes call for evacuation signs to be displayed in appropriate areas of the building so that building egress in an emergency can be accomplished in a rapid and safe time period. 10. Finding: There are no emergency evacuation plans posted in this facility. 10. Recommendation: Contact local fire authority to obtain information regarding required content of emergency evacuation plans. Develop the plans and post as recommended by the fire authority. 28 EL DORADO COUNTY GRAND JURY 2006- 2007 City of South Lake Tahoe Facility Inspection GJ 06- 047 May 2007 SUMMARY The El Dorado County Grand Jury conducts inspections of County, Municipal and Special District owned or leased buildings as per Penal Code Sections 888, 914.1, 925, 925( a) and 928. The findings of this inspection are presented in this report. This facility was chosen based on a number of factors including. 1. The length of time since last inspection 2. the reported condition of a facility 3. findings and deficiencies identified by a previous El Dorado County Grand Jury. ~ ~ ~ Scope of the Investigation South Lake Tahoe Police Department Commendation The El Dorado County Grand Jury recognizes the efforts of the City of South Lake Tahoe Police Department’s efforts to update and modernize their facility. 1. Fact: Fire codes require fire extinguishers be serviced every two years. 1. Finding: Fire extinguishers have not been serviced as required. 1. Recommendation: Have the fire extinguishers serviced. Also, have the local fire authority determine if the existing fire extinguishers are properly located, identified and are of the proper size and class. 2. Facts: Fire codes require posting of Emergency Evacuation Plans. 2. Finding: There are no Emergency Evacuation Plans posted in this facility. 29 2. Recommendation: Contact local fire authority to obtain information regarding required content of Emergency Evacuation Plan. Develop the plan and post as recommended by the local fire authority. 3. Fact: Most manufacturers recommend that computer equipment be maintained at a controlled temperature. 3. Finding: The Computer Room does not have appropriate temperature control and monitoring equipment. 3. Recommendation: Obtain and install temperature control monitoring equipment dedicated to the computer equipment room. 4. Fact: For security reasons admittance to the Police Department must be a safe and controlled environment. 4. Finding: The location and design of the reception area does not lend itself to these requirements. 4. Recommendation: Review options for improving the layout of the reception area and make changes where possible. 5. Fact: Proper signage facilitate efficiency and a safe environment. 5. Finding: Departments and Sections within the facility do not have signs that identify their locations. 5. Recommendation: Develop and place signs throughout the department and sections that will assist in directing visitors. 30 EL DORADO COUNTY GRAND JURY 2006- 2007 El Dorado County Juvenile Hall, Placerville COMMENDATION REPORT GJ 06- 048 March 2007 On Wednesday, January 17, 2007 the Grand Jury visited the El Dorado County Juvenile Hall, Placerville in compliance with Penal Code Section 919( b). The visit included housing units, kitchen, sanitation/ shower facilities, indoor and outdoor exercise areas and schoolrooms. The residential area is neat and clean. Floors are spotless, beds are neatly made and bedding is adequate for comfort. Isolation, medical, behavioral and protective spaces are realistic and appropriate to individual needs. There is a central observation room with updated monitoring equipment in place. Responses to questions and observation indicate that security is being addressed appropriately. The kitchen and the food preparation areas are very clean. The food service staff is experienced and their dedication to providing nutritious and tasty meals to the wards is obvious. The classroom area is appropriate for a learning environment. The teaching staff is comprised of a principal, two teachers and an aide. The El Dorado County Office of Education provides the program and materials. The El Dorado County Juvenile Hall, Placerville staff is commended for their dedication in providing a safe and secure detention area for juvenile wards. They conduct their custodial responsibilities with care and understanding. The focus on redirecting the behavior of their wards is impressive. 31 INTENETIONALLY LEFT BLANK 32 EL DORADO COUNTY GRAND JURY 2006- 2007 Wraparound Program Audit GJ 06- 049 May 2007 BACKGROUND In November 2005, the El Dorado County Department of Mental Health released their “ Mental Health Service Act” ( MHSA) report ( Proposition 63). This study was conducted between the months of February 2005 and October of 2005, to identify and prioritize unmet mental health needs in the County. In total, over 900 community members were consulted and participated in the study including: • 82 focus groups and MHSA trainers • 23 interviews • 5 written surveys resulting in 545 responses. In addition, one- hundred four ( 104) community representatives, mental health consumers and their family members were involved in the workgroup planning process. In this comprehensive process, members representing a broad range of service providers were included in the workgroups. According to the reports, during deliberations several themes became apparent through the community outreach efforts. These themes included five ( 5) different programs which were eligible for funding under the newly established “ Mental Health Service Act.” One ( 1) of the five ( 5) programs identified was “ Wraparound services for uninsured youth at risk for out of home placement”. The community issue was to reduce out of home placement for youth and to provide a safe and stable living environment. According to the program description, the estimated need was for four hundred ( 400) youth per year as identified in the MHSA study dated November 10, 2005. The program description was as follows: “ Wraparound Services is a collaborative, team- based, family- driven service delivery model which includes clinical case management, an individualized service plan, and flexible supports and services. Case management and service delivery are implemented in a convenient and comfortable location for the family who also directs the use of family, community and system supports”. The 2004- 2005 Grand Jury initiated a Wraparound Program audit, with the results published in last year’s 2005- 2006 Grand Jury year end report ( see Grand Jury Year- End 33 report FY 2005- 2006.) The deficiencies in the program as reported last year were subject to improvement and the 2006- 2007 Grand Jury believed a follow up audit was warranted. The Consulting Group of Harvey M. Rose Associates, LLC was again retained to conduct a limited follow up audit of the Wraparound Program for compliance with the recommendations as reported to the Board of Supervisors. 2006- 2007 LIMITED AUDIT OF WRAPAROUND PROGRAM The audit report reflects the recent results and status of the progress achieved by the El Dorado County Human Services and Mental Health Departments. The 2006- 2007 Grand Jury readily acknowledges that the Wraparound Program has significantly improved since its inception in 2001, and has made major improvements since the last audit that was completed in January 2006. We especially acknowledge improvement in the areas of administration and fiscal responsibility. However, the program has yet to improve on measurement of results achieved and follow up evaluations on its participants for creating future programs and funding effectiveness. These areas of concern need to be addressed and should be in full compliance within the next fiscal year. In this audit, of special concern is the limited number of youth included in the Wraparound Program. The Department of Mental Health in 2005 estimated that 400 youth in El Dorado County could benefit from the Wraparound Program. Since 2002 the County has approved only six ( 6) service allocation slots for funding. That number is below the median of 7.6 slots per 100,000 populations as compared to some other counties who have the Wraparound Program. The population in El Dorado County is slightly over 176,000, per the latest count, as compared to Humboldt County which has a population of 132,526 and 11.3 slots. This Grand Jury is concerned that there is a 43.8% “ graduation” rate from the Wraparound Program in El Dorado County. In essence, “ graduation” means that the youth has fulfilled all requirements as agreed upon at the start of his/ her and family involvement in the system. However, there is no follow up after the “ graduation” and statistics are not available as to the success rate for the “ graduates.” One must ask what happened to the 56.2 % who did not “ graduate.” Did the program fail them and if so, why? Again, no follow up data. As a family based program, families must be thoroughly and frequently informed both in writing and verbally regarding the number and types of services available to them, both traditional and non- traditional. Families need to be informed that there are choices beyond those offered through the County Mental Health Department. If any obtainable services are unknown to the family then they cannot be utilized, resulting in reduced care given to those who are most needful. It becomes apparent by the questions raised in the audit that the results are subject to interpretation and further study. Both the Director of Human Services and the Director of Mental Health were interviewed after the audit was finalized and had different opinions 34 of the results of the audit. Both Departments obviously have great responsibility for the program and need to work closely together. This Grand Jury finds that much progress has been made by both the Human Services and Mental Health Departments. However, much more effort needs to be focused on the follow up of the youth engaged in the program, with funding more rapidly available for support and payment of services. This Grand Jury can only report the facts as well as the findings and follow up recommendations presented in the Harvey M. Rose Associates, LLC audit of May, 2007. The final decision rests with the Board of Supervisors to read the audit results and make the necessary decisions for the betterment of the County population and its youth. It is this Grand Jury’s recommendation that the Board of Supervisors request a major effort be initiated by the Departments of Human Services and Mental Health to improve this County’s Wraparound Program to the level where it would become a model for other counties in the State of California. This Grand Jury believes that this unique program, if funded and managed properly, will pay for itself in the future with many benefits for the citizens of the County, such as lessening of the crime rate and a healthy community. The future of our society rests with its youth. Findings/ Recommendations: See attached Audit of Status of Recommendations from January 2006 Audit of El Dorado County's Wraparound Program prepared by: Harvey M. Rose Associates, L. L. C., May, 2007 ( pages 1 through 28 to follow). 35 INTENETIONALLY LEFT BLANK 36 Audit of Status of Recommendations from the January 2006 Audit of El Dorado County’s Wraparound Program Confidential Report prepared for: The FY 2006- 07 El Dorado County Grand Jury Prepared by: Harvey M. Rose Associates, LLC May, 2007 May 1, 2007 Mr. Ray Van Asten, Foreman Members, FY 2006- 07 El Dorado County Grand Jury P. O. Box 472 Placerville, CA 95667 Dear Mr. Van Asten and Members of the FY 2006- 07 El Dorado County Grand Jury : Harvey M. Rose Associates, LLC is pleased to submit this Audit of the Status of Recommendations from the January 2006 Audit of El Dorado County’s Wraparound Program. This report presents information on each recommendation from the previous audit, what has been done and what remains to be done for full implementation. New information and recommendations are also presented to account for changes in conditions and to provide elaboration of the prior recommendations in some cases. There has been progress made in the Wraparound program since the previous audit particularly in the areas of fiscal and administrative management. Some recommendations still need to be implemented, in particular management needs to establish annual program goals and objectives and measure program outcomes and performance in annual evaluations. An assessment is needed of the current number of program slots relative to the program’s target population. As discussed in the Executive Summary, the Departments of Mental Health and Human Services both received a draft version of this report and provided comments and feedback before it was finalized. The Department of Human Services responded with 104 concerns about our 28 page report ranging from clarifying information to some broad criticisms of the report and audit process. Our response to these areas of broad criticism are provided in the Executive Summary. The Department of Mental Health provided comments and feedback that have been incorporated where appropriate. Thank you for this opportunity to serve the El Dorado County Grand Jury. Please feel free to contact us at any time if you wish further information about this report. Sincerely, Fred Brousseau Principal Harvey M. Rose Associates, LLC i Executive Summary Harvey M. Rose Associates, LLC was retained by the FY 2006- 07 El Dorado County Grand Jury to conduct an audit of the status of the County’s implementation of the January 2006 “ Audit of Claiming and Financial and other Reporting for the Wraparound Program of El Dorado County” conducted by our firm for the FY 2005- 06 El Dorado County Grand Jury. Wraparound is a State authorized program that allows California counties to use State foster care and Adoption Assistance funds in a flexible manner to provide eligible youth with services as an alternative to group home care. The program is for youths who are residing, or are at risk of being placed, in group homes licensed at Rate Classification Levels 10- 14, the most costly out- of- home facilities designed for youths with severe emotional disturbances. For each participant assigned to a program slot, the State provides the County with 40 percent of what their cost would be in a group home and the County is required to provide 60 percent. The funds can be used flexibly based on what the youth and their support teams determine to be in their best interest to achieve their goals. The State requires that counties participating in the program perform certain planning and program evaluation functions. To conduct this audit, all recommendations from the January 2006 audit were reviewed and their status determined. The report presents that information along with updates to each recommendation such as changes in departmental plans to implement the recommendations or, in some cases, further information and analysis pertaining to the original recommendations. New recommendations are presented related to the first audit recommendations or updated to reflect changes in circumstances since the January 2006 audit was completed. A summary of the findings and recommendations in each section is presented below. 1. Status of Compliance with Wraparound Program Requirements Recommendations Summary of Findings: Many of the recommendations from the January 2006 Wraparound program audit pertaining to compliance with Wraparound Program requirements have been implemented or partially implemented. Improvements have been achieved in the areas of management oversight and tracking and reporting of program participants and costs. Audit recommendations still needing to be implemented are management establishment of annual program goals, objectives and operational guidelines and conduct of annual evaluations of program outcomes and cost- effectiveness. The Department of Human Services has not yet conducted its first evaluation of the program yet but is planning to conduct Executive Summary one at the conclusion of FY 2006- 07 and provide it to the Board of Supervisors in the first quarter of FY 2007- 08. As demonstration of the need for program evaluation and Interagency Advisory Council involvement in setting annual goals, objectives and operational guidelines, 25 percent of participants exiting the program in the last year have been placed in group homes and 22 percent left because the family chose to withdraw. Since these two reasons for departure account for nearly half the program exits, they should be analyzed by program staff and used to determine if changes in program protocols are needed or if this is an acceptable rate of program completion given the population served. Graduations from the Wraparound program also need to be more fully defined and reported on so that County managers and the program’s Interagency Advisory Council understand the outcomes of the youths who have participated in the program. 2007 Recommendations The Board of Supervisors should: 1.1 Direct the Interagency Advisory Council to immediately establish measurable Wraparound program goals, objectives and outcome measures and methods for regularly monitoring and evaluating those goals and measures including an assessment of the reduction in number of group home placements resulting from the program, to ensure that is operating effectively and cost efficiently and to be reported annually to the Board of Supervisors. 1.2 Direct the Interagency Advisory Council to conduct some short- term, focused evaluation as soon as possible requiring staff to report on current program outcomes including an analysis of the 43.8 percent graduation rate through January 2007 and to provide details on graduations and other exits by reason such as group home placements, stabilization of family situation, child arrested, child terminated from dependency, etc. 1.3 Direct the Interagency Advisory Council to continue current efforts to measure family satisfaction with the Wraparound program so that these results can be included in annual program evaluation reports, the first of which will be presented to the Board of Supervisors by the Department of Human Services in the first quarter of FY 2007- 08. 1.4 Direct the Interagency Advisory Council to identify specific characteristics about the Wraparound program target population for internal management purposes and for inclusion in the first annual evaluation report to be prepared for the Board of Supervisors in the first quarter of FY 2007- 08. Harvey M. Rose Associates, LLC ii Executive Summary 1.5 Direct the Interagency Advisory Council to prepare an analysis for the Board of Supervisors regarding why six Wraparound program service allocation slots are sufficient relative to total need of the program’s target population in the County. 2. Status of Wraparound Program Fiscal Management Recommendations Fiscal management and reporting for the Wraparound program has improved substantially since the January 2006 audit. The Department of Human Services has assumed the fiscal management role for the program and maintains an up to date database of expenditures and revenues and program participants, all of which is reported regularly to the program’s Interagency Advisory Council. All six service allocation slots have been close to full for the first half of FY 2006- 07 which maximizes state and County revenue available for the program. Budgeted and actual expenditures and revenues for the current fiscal year appear to be more closely aligned than they were in the years reviewed for the January 2006 audit. The $ 173,244 in unspent program funds identified in the January 2006 audit is still largely unspent. In fact, the amount has increased to approximately $ 247,775 due to the collection of subsequent revenues in excess of expenditures and the discovery of approximately $ 50,000 in previously unreported revenue by the Department of Mental Health. Though protocols are now in place for determining how these surplus funds will be spent, and most of the funds have been committed for contract services, the rate of expenditure for these services has been slow, with only $ 15,467 of the $ 247,775 spent. County staff point out that the County contracting process contributes to the time it has taken to expend these funds. Most of the planned uses of program surplus funds are for parent/ staff trainings and services such as foster parent respite and transitional housing services that could also be provided directly to program participants if, consistent with the Wraparound program approach, that is what participant teams identified as most beneficial to them. But for the most part the program does not provide services to participants other than those offered by the Department of Mental Health and its contractors. The availability of a broader array of services such as tutoring, job training for youth and parents, substance abuse counseling, private mental health clinicians, parent coaching and others should be made know to program participants rather than only services planned and provided by County officials. Program funding is flexible and can also be used for services provided by other County departments, the private sector or community organizations. 2007 Recommendations Harvey M. Rose Associates, LLC iii Executive Summary The Board of Supervisors should: 2.1 Direct the Interagency Advisory Council to consider using a portion of the surplus program funds available to enhance or replace direct services provided to participants by the Department of Mental Health and their contractors and to report back to the Board of Supervisors a timetable regarding planned expenditure of the surplus funds to ensure that services are provided within the next six months in a way that is most beneficial to youth at risk of group home placement as a first priority, and, second, to children’s services in general. 2.2 To ensure that Wraparound program parameters are clearly communicated to participants, their families and teams, direct the Interagency Advisory Council to include information in the “ Family Guide to Wraparound Care in El Dorado County” document that funding is available for emergency support of necessities and for non- County services such as private clinician services, private lessons and fees for clubs and extracurricular programs, if determined to be in the best interests of the child. 3. Status of Wraparound Program Records Recommendations Accurate staff time records were not in place for a number of the Wraparound program years reviewed for the January 2006 audit, resulting in charges to the program funds that were lower than actual costs. There were no records kept on the basis for which non- revenue generating children were admitted to the program. These records are now being maintained by the Departments of Mental Health and Human Services. The January 2006 audit found that youth participating in the program were not always receiving the clinical mental health services specified in their plans and it was recommended that Wraparound program managers identify program capacity each year to enable the development of realistic service plans. These comparisons are no longer possible as the Department of Mental Health has discontinued specifying hours of services to be provided in their mental health service plans, making it difficult for program managers to determine staff utilization and to assess if more children can be accepted in to the program. The range of services and funding available to children and families participating in the program are not publicly documented. Since a key tenet of the Wraparound approach is for participant teams to determine the services that best meet their needs, written information should be provided to participants in addition to oral representations at team meetings to document the flexibility in types of services and funding that can be made available. 2007 Recommendations 3.1 Direct the Department of Human Services to modify its “ Family Guide to Wraparound Care in El Dorado County” and other Wraparound program literature to make clear the wide variety of services available to participants and their Harvey M. Rose Associates, LLC iv Executive Summary families and that it is the family team’s choice, not that of County officials, about who provides needed services. 3.2 Direct the Department of Human Services to prepare a Wraparound program capacity analysis to estimate the level of Wraparound services that can be provided through the program through County, contractor and community- based services providers. 3.3 Direct the Department of Human Services to combine the capacity analysis with the recommended target population analysis to determine if there is a need and opportunity to expand the program to ensure that services are available for and accessible to all County youth at risk of group home placement. Harvey M. Rose Associates, LLC v Executive Summary Feedback from the Departments of Mental Health and Human Services Both the Departments of Mental Health and Human Services reviewed and provided comments and feedback on a draft version of this report. The Department of Mental Health had several comments, corrections and suggestions for changes. The Department of Human Services ( DHS) provided a 20 page response with 104 concerns. Some of those concerns were typographical errors, requests for clarifications or other matters that have been addressed in this version of the report. A number were of a broader nature and with which we have some fundamental disagreement, as follows. 1. DHS expressed concern that this report went beyond its scope of providing an assessment of the status of the January 2006 audit recommendations. Response: The scope of this audit remains an assessment of the status of the January 2006 Grand Jury audit recommendations. It includes a simple assessment of whether each recommendation is implemented, partially implemented or not implemented. It also includes discussion of how recommendations have been implemented or why they are partially or not implemented. In some cases, discussions are included as to how DHS plans to address partially or not implemented recommendations. New recommendations are also included that address the same issues as the January 2006 audit but with more current information or elaboration on the basis for the original recommendations. 2. DHS expressed concern that by making recommendations the consultant and Grand Jury is inappropriately intervening in Board of Supervisors and Department roles and processes. Response: This audit was not bound by any plans made by DHS and the Board of Supervisors, though they were reviewed. The Grand Jury is authorized by statute to conduct reviews of county operations, functions and officers. The purpose of this audit was to conduct an independent assessment of the status of the recommendations from the previous audit. For DHS to summarily reject recommendations for program performance measures, for example, because they are from an “ outside party” fails to recognize the role of the Grand Jury as part of the County structure. To suggest that the Grand Jury should not comment on how many Wraparound program slots are in place also reflects a misunderstanding of the role of the Grand Jury. Finally, to state that the Grand Jury audit is distracting staff from providing important public services overlooks the fact that the Grand Jury is part of the public process and has that statutory right to review and make recommendations to improve those important public services. Harvey M. Rose Associates, LLC vi Executive Summary 3. DHS stated that is has implemented recommendations pertaining to the need for the Wraparound Program Interagency Advisory Council establishing annual program goals, objectives and operational guidelines. Response: The intent of the recommendation in the January 2006 audit was for the Interagency Advisory Council to set specific program goals and objectives for the program each year. These are not the same as program assumptions or general discussions in meetings but would include measurable outcomes such as the number of participants in the program relative to a defined population of at- risk youth in the County, the number of participants kept out of group homes, the number of participating families reporting satisfaction with the program and others. We have not seen evidence that such goals and objectives have been established by the Interagency Advisory Council. 4. DHS states that no evaluation of program outcomes can be expected at this point because it has developed a plan to conduct an evaluation at the end of FY 2006- 07 with one years’ worth of data, to be presented to the Board of Supervisors in the first quarter of FY 2007- 08. The Department therefore disagrees with the characterization that the recommendation to evaluate program outcomes has not been implemented. Response: This recommendation simply has not been implemented. We do acknowledge the department’s plans to conduct an evaluation at the end of FY 2006- 07 as arranged between the Department and Board of Supervisors. But the Department could have implemented the recommendation by conducting an evaluation of FY 2005- 06 results. The Department also takes exception to program outcome data presented in the report showing that only 43.8 percent of program participants have graduated, stating that the auditor does not have sufficient evidence to conclude that this is a poor outcome. Due to the absence of program evaluations, the Department has not presented any evidence that this is a positive outcome. Harvey M. Rose Associates, LLC vii Introduction Harvey M. Rose Associates, LLC was retained by the FY 2006- 07 El Dorado County Grand Jury to conduct an audit of the status of the County’s implementation of the January 2006 “ Audit of Claiming and Financial and other Reporting for the Wraparound Program of El Dorado County” conducted by our firm for the FY 2005- 06 El Dorado County Grand Jury. The Wraparound program is a State- authorized program that allows counties to flexibly use State and local funds that would otherwise be used for group home placements for individualized services to prevent at risk youth from being placed in group homes. In El Dorado County, funding is obtained from the State by the Department of Human Services, combined with County funds and used to provide services. The County Department of Mental Health and its contractors provide most of the program’s direct services through its clinical staff and its Mental Health workers. Three private organizations contract with the Department of Mental Health to provide additional resources and services: 1) Sierra Family Services; 2) Summitview; and; 3) Tahoe Youth and Family Services. The County program was initiated in 2002. Audit Methods Methods used to conduct this audit included the following: Interviews with directors, program managers and key staff at the Department of Human Services and the Department of Mental Health were conducted. A follow up assessment on each recommendation from the January 2006 audit report was conducted through staff interviews and review of program records and documents such as budget and detailed actual expenditure and revenue, records, invoices and Foster Care claiming documents, program participant census data and Department of Mental Health invoices for services. Detailed program financial records for FY 2005- 06 and part of FY 2006- 07 were reviewed. Detailed program participant records was reviewed including details on youth assigned to the program’s six service allocation slots and those assigned to the non-revenue generating slots. A sample of individual case records were reviewed including treatment plans, billing records and case progress notes. Governance documents were reviewed including the County’s Wraparound Program Plan, as amended August 2006, the program’s interagency Memorandum of Understanding, executed in 2005, and agendas and minutes from meetings of the program’s Interagency Governing Council, the County’s Cross- Systems Operations Team and the Placement Committee. Harvey M. Rose Associates, LLC 1 Introduction Documentation and budgets regarding programs and services to be funded with surplus program funds were collected and reviewed. A draft report was prepared with the results of the audit presented in the same three finding areas as the January 2006 audit report. The draft report was reviewed by the Departments of Mental Health and Human Services, some changes were made based on their input and comments and the final report was transmitted to the FY 2006- 07 El Dorado County Grand Jury. Background: Wraparound Program The Wraparound program was created by State legislation adopted in 19971 that allowed California counties to use State foster care and Adoption Assistance funds in a flexible manner to provide eligible youth with services as an alternative to group home care. The program is for youths who are residing, or are at risk of being placed, in group homes licensed at Rate Classification Levels 10- 14, the most costly out- of- home facilities designed for youths with severe emotional disturbances. While behaviors can vary, risk behaviors include fighting, stealing, vandalism, running away, self- mutilation, cruelty to animals and others. Under the Wraparound program, qualified youth are provided with intensive, individualized family- based services designed to keep them with their families, or to return them to their families if they are already in an out- of- home placement. Services can be provided, according to the State legislation, to youths living with their birth parents, relatives, adoptive parents, licensed or certified foster parents, or guardians. They can include traditional mental health services, therapeutic behavioral services, recreation program participation, mentoring services, family counseling and others. Funding for the program consists of State funding at the same rate as would be provided for group home placements, which vary based on each participant’s Rate Classification Level ( RCL). The County is required to match the State funds provided at the rate of approximately 60 percent of the total cost. The funds are provided to the County’s Department of Human Services in El Dorado County which may enter into interagency agreements with other County departments for the provision of wraparound services. The statute requires participating counties, at their option, to develop a plan for wraparound services and monitor the provision of those services consistent with the plan. The plan, to be submitted to the State Department of Social Services for informational purposes, is to include: A process and protocol for reviewing and determining how children become eligible for and are admitted to the program. Processes for developing, modifying and denying individualized services plans for each youth participant so that the services provided continue to meet the childrens’ needs as their circumstances change. 1 California Welfare & Institutions Code § 18250 et. seq. Harvey M. Rose Associates, LLC 2 Introduction A process for parent support, mentoring, and advocacy to ensure parent understanding and participation in the program. A planning and review process to support and facilitate the following program principles: o Focus on the individual child through individualized service plans rather than a formulaic or standardized approach with all services the same for all participants regardless of their needs or circumstances. o Providing services geared to enabling the participants to remain in the least restrictive, most family- like settings possible. o Developing a close and collaborative relationship with the family. o Conducting a thorough, strengths- based assessment of each child and family that serves as the basis of individualized service plans rather than plans based on all the problems or weaknesses of the participating youth and their families. o Designing and delivering services that incorporate the religious customs, and regional, racial, and ethnic values of the youths and families served. o Measuring satisfaction of participants and their families with the program process and services to assess program outcomes. Written interagency agreements or memorandum of understanding between the county departments of social services, mental health and probation that specify jointly provided or integrated services, staff tasks and responsibilities, budget considerations and related matters. The statute also requires that each county evaluate its program to determine its cost and effectiveness in achieving the program’s goals. Each county is to ensure that staff participating in the project has completed training provided or approved by the California Department of Social Services. The Wraparound program in El Dorado County has a net operating expenditure budget of $ 345,521 for FY 2006- 07 and assumes a monthly average enrollment of 35 youths and their families. The total actual number of youth served will depend on the length of participation for each youth served, but between July 2006 and January 2007, a total of eight youths had participated in the six service allocation slots and 49 youths had participated in the non- revenue generating slots. Harvey M. Rose Associates, LLC 3 1. Status of Compliance with Wraparound Program Requirements Recommendations 1.1 Many of the recommendations from the January 2006 Wraparound program audit pertaining to compliance with Wraparound Program requirements have been implemented or partially implemented. Improvements have been achieved in the areas of management oversight and tracking and reporting of program participants and costs. 1.2 Audit recommendations still needing to be implemented are management establishment of annual program goals, objectives and operational guidelines and conduct of annual evaluations of program outcomes and cost- effectiveness. The Department of Human Services has not yet conducted its first evaluation of the program but is planning to conduct one at the conclusion of FY 2006- 07 and provide it to the Board of Supervisors in the first quarter of FY 2007- 08. 1.3 As demonstration of the need for program evaluation and ongoing Interagency Advisory Council involvement in setting annual goals, objectives and operational guidelines, 25 percent of participants exiting the program in the last year have been placed in group homes and 22 percent left because the family chose to withdraw. Since these two reasons for departure account for nearly half the program exits, they should be analyzed by program staff and the Council and used to determine if changes in program protocols are needed or if this is an acceptable rate of program completion given the population served. 1.4 Graduations from the Wraparound program also need to be more fully defined and reported on so that County managers and the program’s Interagency Advisory Council understand the outcomes of the youths who have participated in the program. The recommendations pertaining to the County’s compliance with Wraparound Program requirements contained in Section 2 of the FY 2005- 06 El Dorado Grand Jury’s Audit of Claiming and Financial and Other Reporting for the Wraparound Program of El Dorado County, published in January 2006, are presented below. The status of each recommendation is classified as either Implemented, Partially Implemented or Not Implemented and is accompanied by a brief explanation. Harvey M. Rose Associates, LLC 4 1. Compliance with Wraparound Program Requirements Summary of January 2006 audit findings A summary of the findings in the January 2006 audit pertaining to the County’s compliance with Wraparound program requirements are as follows: Wraparound is a State- authorized program that allows counties to flexibly use State and local funds that would otherwise be used for group home placements to provide individualized services to prevent at risk children from being placed in group homes. In El Dorado County, funding is obtained from the State by the Department of Human Services, combined with County funds and transferred to the Department of Mental Health which administers the program. The County is not operating in full compliance with its key governance documents: State law; the County Wraparound plan; and, a Memorandum of Understanding between the Departments of Human Services and Mental Health. Key areas of non-compliance include: the absence of an executive management team assuming responsibility for planning and monitoring program performance and a lack of procedures to ensure family understanding of and input to the program. Among other impacts, the lack of a Wraparound program management structure has resulted in under- expending available program funds, lower service levels than anticipated and over- budgeting every year of the program. State legislation requires that counties providing Wraparound services designate a number of service allocation slots for participating children. State funding is provided based on the number of such slots filled each month. The County’s Department of Mental Health has expanded program participation by including children at risk of group home placement in addition to those in the authorized service allocation slots. Services for these other children are provided with funds not spent on the children in the authorized slots. The methods for determining eligibility and expenditure levels for these additional children have not been documented in the County’s Wraparound plan or any other Department documents. A Memorandum of Understanding between the Departments of Human Services and Mental Health calls for reinvestment of savings realized in the Wraparound program to other children’s services. A definition of such savings has not been established nor has a process for the two departments to determine how funds should be reinvested. As a result, approximately $ 173,244 in program funding has accumulated over the last three year fiscal years that could have been reinvested in other services for children. Harvey M. Rose Associates, LLC 5 1. Compliance with Wraparound Program Requirements Status of January 2006 recommendations The status of the January 2006 recommendations in this area are as follows: The Board of Supervisors should: January 2006 Recommendation Status/ Discussion 2.1 Formally delegate management responsibility for the Wraparound program to the multi- departmental Interagency Governing Council* to continue to be comprised of, at minimum, the directors of the Departments of Human Services, Mental Health and Probation. Partially implemented: The Board of Supervisors did not take formal action to delegate management responsibility for the Wraparound Program to the Interagency Advisory Council. However, the Council has reconstituted itself comprised of the Directors of Human Services, Mental Health, Probation, Public Health, the Superintendent of the County Office of Education, a Superior Court Commissioner, a representative of Court Appointed Special Advocates and a dependency attorney. A review of minutes from their regular meetings shows that the Council has assumed management responsibility for the program through its discussion and review of matters such as program participation and expenditures, roles and responsibilities of all agencies, reinvesting surplus funds, and related items. * The Interagency Governing Council name was used in the January 2006 audit instead of the Interagency Advisory Council. Harvey M. Rose Associates, LLC 6 1. Compliance with Wraparound Program Requirements The Board of Supervisors should: January 2006 Recommendation Status/ Discussion 2.2 Direct the multi- departmental Interagency Governing Council* Wraparound management team to meet regularly such as quarterly for the purpose of overseeing the Wraparound program including setting annual program goals and objectives, determining funding and resource allocations at least once a year as part of the County budget process, establishing operational guidelines, receiving and reviewing regularly produced management reports on program outcomes and cost effectiveness, and making adjustments to program operations when needed. Partially implemented: Interagency Advisory Council records show that it met monthly between March and May, 2006 and has met quarterly since July 2006. The revised County SB 163 Program Plan, approved by the Council in August 2006, establishes the role of the Council and other County stakeholders and includes a statement of program purpose and objectives. However, annual program goals and objectives have not been established by the Council. Program budgets are presented but are not formally adopted by the Council before submission to the Board of Supervisors. Management reports such as quarterly data on program participants are presented regularly to the Council but evaluations of outcomes and cost effectiveness are not being produced for management review. Proposals for use of surplus SB 163 funds have been presented to and discussed by the Council. 2.3 Direct the multi- departmental Interagency Governing Council* Wraparound management team to operate in compliance with State laws governing the Wraparound program. Implemented: The County is operating in compliance with all State mandates pertaining to the Wraparound program. Improvements have been realized since the January 2006 audit in documenting the strengths and participation of families in developing service plans and establishment of a mechanism for assessing participant family satisfaction, although results of this effort to date have been limited. The County has established a mechanism for monitoring accessibility and availability of services to youths residing, or at risk of placement, in group homes licensed at Rate Classification Levels 10- 14, as required by State law. * The Interagency Governing Council name was used in the January 2006 audit instead of the Interagency Advisory Council. Harvey M. Rose Associates, LLC 7 1. Compliance with Wraparound Program Requirements The Board of Supervisors should: January 2006 Recommendation Status/ Discussion 2.4 Direct the multi- departmental Interagency Governing Council* Wraparound management team to prepare annual summary evaluations of program and cost effectiveness for their own review and transmission to the Board of Supervisors, to include documentation of: program compliance with State law; the team’s meeting records; achievement of program goals; staff training records; accessibility of the program to the target population; and, program satisfaction by participating families. Not implemented: Annual evaluations of program and cost effectiveness have not been prepared yet but the reconstituted Council has not been functioning for a full year yet. Department of Human Services ( DHS) management representatives report that such reports will be prepared and presented to the Council and the Board of Supervisors after the completion of FY 2006- 07. 2.5 Direct the inter- departmental Wraparound management team to amend the County Wraparound Plan to include procedures and protocols for admitting and providing services to non- revenue generating children in the program who are not assigned to authorized service allocation slots. Implemented: The County Wraparound Plan has been amended and approved by the Council in August 2006 and was presented to the Board of Supervisors for approval in September 2006. It includes procedures for referral and approval of Program participants with distinct procedures for slotted and non revenue- generating participants. 1 2.6 Direct the Wraparound inter-departmental management team to amend the program plan to include a definition of program “ cost savings to be reinvested in children’s services” and to establish procedures for how decisions will be made regarding expenditure of such funds. Implemented: The amended County Wraparound Plan now includes a definition of program cost savings and identifies specific procedures for determining how those funds will be spent. * The Interagency Governing Council name was used in the January 2006 audit instead of the Interagency Advisory Council. 1 Non- revenue generating participants are youths participating in the program who are defined as “ at risk” of group home placement by the County but either do not meet the State criteria for program participation that generates State revenue or, if they do, are not able to generate revenue because all of the program slots are occupied. Because these youth don’t generate program revenue, their services are limited to what can be provided with surplus funds remaining after the costs of the services provided to revenue generating youth are paid for. This practice is allowed by the State. Harvey M. Rose Associates, LLC 8 1. Compliance with Wraparound Program Requirements January 2006 Recommendation Status/ Discussion 2.7 Direct appropriate County staff to draft a new Wraparound program Memorandum of Understanding ( MOU) for execution by the Departments of Mental Health, Human Services and Probation to replace the MOU among these departments that expired in September 2005. Implemented: A new MOU was executed between the Departments of Human Services, Mental Health, Probation, Public Health, and the County Office of Education in November 2005. Improvements have been achieved in the County’s compliance with State and local program requirements. The executive management team required in the County’s Wraparound program plan that was inactive in 2005 has been reconstituted and has assumed responsibility for many key management oversight functions for the Program that were not being performed during the previous audit review period. The current County Wraparound program plan calls for the Interagency Advisory Council to advise on the development of policy pertaining to integrated services, to provide goals and decision making strategy and to monitor outcomes. The Council’s meeting minutes show that it is reviewing key program documents and data and has made decisions on program operations. The Council has not established annual measurable Wraparound program goals or established methods for monitoring outcomes and effectiveness as recommended in the January 2006 audit. A requirement of the interagency Memorandum of Understanding ( MOU), performance monitoring is a key area that should be addressed to ensure program and cost effectiveness. The Interagency Advisory Council is now receiving reports at its quarterly meetings that present snapshots and profiles for each reporting period about program referrals, participants and exits. Data on “ claiming efficiency” ( percentage of days when revenue generating program slots were filled2) is also presented to the Council in these reports. While all of this is useful information and an improvement over 2005 when the Interagency Advisory Council was not even meeting regularly let alone receiving program summary information, the data presented does not address the program’s effectiveness at achieving performance goals. The reports do show improvement in claiming efficiency to nearly 100 percent since the previous audit. 2 If all of the six program slots are filled every day of the month, the County would achieve 100 percent claiming efficiency and maximize program revenue. For every day that any of the six slots are vacant, revenues are reduced accordingly and “ claiming efficiency” drops below 100 percent. Generally, when a child exits one of the revenue- generating slots, another child is referred in by the program Placement Committee. Often, eligible children are already receiving services but in the non- revenue generating slots until a slot becomes vacant. Harvey M. Rose Associates, LLC 9 1. Compliance with Wraparound Program Requirements The goal of the Wraparound program is to provide alternatives to group home placements for at risk youth through collaborative development of family based service programs using county, private and non- profit service providers. 3 Currently, the program’s success in meeting this goal is not being measured and reported in a way that allows program managers and the Interagency Advisory Council to assess overall program effectiveness and to make changes where needed if program goals are not being achieved. Data reported to the Interagency Advisory Council at its meetings held between April 2006 and January 2007 are summarized and presented in Table 1.1. Most of the program participants exiting the program were classified as “ graduates”. The precise nature of graduation is not defined in the reports. Assumedly this means that their goals were achieved and it was not considered appropriate to continue with program services. To measure program effectiveness, further information needs to be reported about each graduate such as what goals were achieved and how their achievement was measured. The data in Table 1.1 shows that 25 percent of the participants were placed in group homes after participating in the program. Another 22 percent withdrew from the program by family choice. Altogether, this amounts to 47 percent, or nearly half, of the youths exiting the program. While the explanations for why the youths ended up being placed in group homes may have been beyond the control of Wraparound program staff, this level of post- program group home placement combined with the rate of families choosing to discontinue are factors that should be reviewed by program management to determine if changes are needed in the way services are currently being delivered to reverse these trends. It may be that 43.8 percent is an acceptable rate of graduation given the population served or that a 25 percent group home placement rate is a positive outcome. Such standards should be established and codified by the Interagency Advisory Council based on an analysis of these outcomes and the population being served. Table 1.1 Reported Wraparound Program Outcomes April 2006 – January 2007 Outcome Number % Total Graduation 14 43.8% Placed in GH 8 25.0% Family choice: discontinue 7 21.9% Transfer to adult services 1 3.1% Child in custody 1 3.1% Runaway 1 3.1% 32 100.0% Source: DHS reports to Interagency Advisory Council, April 2006 – January 2007 The Department of Human Services reports that it provides information on individual cases in Interagency Advisory Council and Cross- Systems Operations Team meetings so 3 California Welfare & Institutions Code § 18250 Harvey M. Rose Associates, LLC 10 1. Compliance with Wraparound Program Requirements that the members have a broader understanding of outcomes. This type of information should be recorded and incorporated into the official program outcome statistics reported. The Department also reports that it will be conducting an evaluation of the program after the conclusion of FY 2006- 07 when it has one year’s worth of data. Given the uncertainty of the statistics presented in Table 1.1, some focused evaluation seems appropriate before waiting for year end. Other performance measures should be established by and regularly reported to the Interagency Advisory Council based on program goals and objectives that should be set by the Council annually. Measures of program effectiveness should include at least the following: 1. Number of group home placements made by the County ( to see if trend is declining). 2. Number of other out- of- home placements made by the County. 3. Number of Wraparound program graduations/ exits by outcome ( e. g., goals achieved [ with details on goals and how achievement measured], group home placements, other out- of- home placements, family reunifications, stabilized family situation, families choosing to discontinue services, families asked to discontinue services by County, child taken in to custody) 4. Number of child maltreatment reports for current and past program participants. 5. Number of psychiatric hospital admissions by Wraparound program participants. 6. Number of participating families reporting satisfaction with program and services received. 7. Measures of performance at school such as attendance. These measures would allow the Interagency Advisory Council to better assess the Wraparound program’s overall effectiveness and to assess whether interventions or program changes are needed in terms of staff training, new procedures or other measures to achieve other outcomes. As noted in the discussion of Recommendations 2.3 and 2.4 in the Status of Recommendations table above, state law calls for counties to assess their Wraparound program participating families’ satisfaction with the program as well as the program’s overall accessibility to its target population. The Department of Human Services ( DHS) has recently developed a Wraparound program family satisfaction questionnaire that, starting in November 2006, it has been distributing to participant families upon exiting the program asking them to assess program services and staff. As of the writing of this report, only nine families have exited the program and returned a completed questionnaire so it is too early to draw any conclusions about overall family satisfaction with the program and services provided. DHS staff report that it is not always easy to get family members to respond to the questionnaires and to provide honest answers or criticisms to the County when they are in the middle of receiving services. The Department will need to continue to request families’ responses to these questionnaires Harvey M. Rose Associates, LLC 11 1. Compliance with Wraparound Program Requirements and, possibly, use other means to obtain their assessments to ensure compliance with the state requirement that family satisfaction with Wraparound be measured. The County monitors access to the program’s target population, as required by state law4, through its Placement Committee. DHS staff has expanded their program outreach efforts in the County in recent months by providing presentations to pertinent groups about the program. While these efforts may raise awareness about the program and increase the number of participants, the program needs a working definition and data about its target population of County youth at risk of group home placement, which should include more than just the number of youth currently in group homes. Such information should be used as a baseline to compare to the number of program participants and as a guide for future program outreach efforts to ensure that all segments of the County’s at risk youth and their families have access to the program. A County assessment of the Wraparound program target population should also entail assessing the adequacy of the program’s capacity through its current six program service allocation slots. Since the program’s inception, the County has had a total of six slots for the program, which generates State revenue for services to six youth who are at risk of group home placement and have Rate Classification Levels ( RCLs) of between 10 and 14. Funding is provided for these six slots by the State and County on a formula basis at the same level as would be provided for group home payments for these youth. To the extent the funding provided for these six youths exceeds the actual cost of services provided to them, which so far has always been the case, the remaining funds are used to provide services to other youth at risk of group home placement but whose risk is determined by the County to be not as imminent as those assigned to the six County “ slots”. This arrangement, allowed by the State, enables the County to provide Wraparound services to more than the six youth in the County’s designated slots. In fact, there are more youths participating in the program in non- revenue generating slots than in revenue generating slots. In FY 2006- 07 through mid- January 2007, there were a total of eight youths assigned to the six service allocation slots and 29 youths had been assigned to non- revenue generating slots. While inclusion of youths other than those eligible for the service allocation slots in the Wraparound program is a good example of the County’s ability to leverage program funding, it raises the question of the adequacy of the number of County service allocation slots since some of non- revenue generating children actually meet the slot criteria but can’t fill a slot until there is a vacancy. Though their situations may be less severe than those of the youth assigned to the service allocation slots, this indicates that there are more at- risk youth in the County than those filling the six slots. By increasing the number of program slots, the County would be eligible for additional funding to use for these and other at- risk youth. It should be noted that any increase in the number of slots would also increase County costs as the County is responsible for 60 percent of the revenue per slot generated by the program; the State pays the other 40 percent. 4 California Welfare & Institutions Code § 18252( a) Harvey M. Rose Associates, LLC 12 1. Compliance with Wraparound Program Requirements Not every county in California has implemented a Wraparound program and data is not centrally collected on the number of participants or service allocation slots in each county. However, a review of various documents available from some of the counties with Wraparound programs shows that El Dorado County has a low number of slots relative to the total county population, measured in terms of slots per 100,000 people. Table 1.2 shows the number of slots in selected other counties relative to total population. While there are differences between counties and comparisons always have some limitations, it can be seen that El Dorado County has the lowest number of slots compared to the other six counties and is below the median of slots per 100,000 population. While some of the other counties are very large and urban, at least two are closer in size to El Dorado County: Santa Cruz and Humboldt and both of those also have more slots per 100,000 people. Differences in size have been accounted for by measuring the number of slots for every 100,000 people in all the counties. The other counties were selected because data was publicly available about the program slots. Table 1.2 Number of Wraparound Slots Per 100,000 Population County # Slots 2005 Population Slots/ 100,000 Alameda 150 1,501,303 10.0 Humboldt 15 132,526 11.3 Kern 40 779,869 5.1 San Bernardino 200 1,991,829 10.0 San Mateo 30 724,104 4.1 Santa Cruz 12 262,351 4.6 Median 35 751,987 7.6 El Dorado 6 173,407 3.5 Sources: 2006 population data from California State Association of Counties. After assessing the County’s Wraparound program target population, the County should consider increasing its number of Wraparound program slots. This would provide more program capacity and could make higher service levels available for all of the County’s at- risk youth. The January 2006 audit found that the County Wraparound Program Plan did not address at risk youths who do not generate program revenues (“ non- slotted” youth) and did not include eligibility criteria or procedures for how their participation in the program would be determined. The County Wraparound Plan, as revised in August 2006, addresses the non- revenue generating population and processes for their referral to and participation in the Wraparound program. Records were not kept in 2005 about how many non- revenue generating youth were referred to the program and how many were accepted. Such records are now maintained. Harvey M. Rose Associates, LLC 13 1. Compliance with Wraparound Program Requirements 2007 Recommendations The Board of Supervisors should: 1.1 Direct the Interagency Advisory Council to immediately establish measurable Wraparound program goals, objectives and outcome measures and methods for regularly monitoring and evaluating those goals and measures including an assessment of the reduction in number of group home placements resulting from the program, to ensure that is operating effectively and cost efficiently and to be reported annually to the Board of Supervisors. 1.2 Direct the Interagency Advisory Council to conduct some short- term, focused evaluation as soon as possible requiring staff to report on current program outcomes including an analysis of the 43.8 percent graduation rate through January 2007 and to provide details on graduations and other exits by reason such as group home placements, stabilization of family situation, child arrested, child terminated from dependency, etc. 1.3 Direct the Interagency Advisory Council to continue current efforts to measure family satisfaction with the Wraparound program so that these results can be included in annual program evaluation reports, the first of which will be presented to the Board of Supervisors by the Department of Human Services in the first quarter of FY 2007- 08. 1.4 Direct the Interagency Advisory Council to identify specific characteristics about the Wraparound program target population for internal management purposes and for inclusion in the first annual evaluation report to be prepared for the Board of Supervisors in the first quarter of FY 2007- 08. 1.5 Direct the Interagency Advisory Council to prepare an analysis for the Board of Supervisors regarding why six Wraparound program service allocation slots are sufficient relative to total need of the program’s target population in the County. Harvey M. Rose Associates, LLC 14 2. Status of Wraparound Program Fiscal Management Recommendations 2.1 Fiscal management and reporting for the Wraparound program has improved substantially since the January 2006 audit. The Department of Human Services has assumed the fiscal management role for the program and maintains an up to date database of expenditures and revenues and program participants, all of which is reported regularly to the program’s Interagency Advisory Council. All six service allocation slots have been close to full for the first half of FY 2006- 07 which maximizes state and County revenue available for the program. Budgeted and actual expenditures and revenues for the current fiscal year appear to be more closely aligned than they were in the years reviewed for the January 2006 audit. 2.2 The $ 173,244 in unspent program funds identified in the January 2006 audit is still largely unspent. In fact, the amount has increased to approximately $ 247,775 due to the collection of subsequent revenues in excess of expenditures and the discovery of approximately $ 50,000 in previously unreported revenue by the Department of Mental Health. Though protocols are now in place for determining how these surplus funds will be spent, and most of the funds have been committed for contract services, the rate of expenditure for these services has been slow, with only $ 15,467 of the $ 247,775 spent. County staff point out that the County contracting process contributes to the time it has taken to expend these funds. 2.3 Most of the planned uses of program surplus funds are for parent/ staff trainings and services such as foster parent respite and transitional housing services that could also be provided directly to program participants if, consistent with the Wraparound program approach, that is what participant teams identified as most beneficial to them. But for the most part the program does not provide services to participants other than those offered by the Department of Mental Health and its contractors. The availability of a broader array of services such as tutoring, job training for youth and parents, substance abuse counseling, private mental health clinicians, parent coaching and others should be made know to program participants rather than only services planned and provided by County officials. Program funding is flexible and can also be used for services provided by other County departments, the private sector or community organizations. A summary of the findings in the January 2006 audit pertaining to the County’s fiscal management of the Wraparound Program are as follows: Harvey M. Rose Associates, LLC 15 2. Wraparound Program Fiscal Management Harvey M. Rose Associates, LLC State and local funding is provided to the County’s Wraparound program based on the number of “ service allocation slots” filled by children participating in the program. Between its inception in August 2002 and June 2005, the County authorized six service allocation slots per month but filled an average of only 4.8. As a result, the County did not collect an estimated $ 182,484 in available program funding that would have enabled services to an additional 18.7 children. In addition to under- recovered available revenue, program expenditures were approximately $ 173,244 less than actual funding received during the three fiscal years reviewed. These unspent funds have been carried over each year and are still available for the program, but reflect lower service levels for program participants and unnecessary encumbrance of County General Fund monies during the review period. Combined with the $ 182,484 in funds not recovered due to unfilled service allocation slots, the County did not provide $ 355,728 worth of Wraparound services that could have been provided during the three fiscal years reviewed. During the three years reviewed, actual Wraparound program revenues were $ 327,938 less than budgeted revenues and actual program expenditures were $ 628,547 less than budgeted. These substantial variances reflect a lack of program planning and oversight by Mental Health and Human Services Department executive management. Total reported Department of Mental Health salary and benefits costs for Wraparound were only $ 4,775 and $ 10,912 the first two years of the program, respectively, but increased to $ 304,547 in FY 2004- 05. Department of Mental Health staff report that staff time sheet and billing records did not capture all staff time dedicated to the program in its first two fiscal years. If actual staff costs were higher than the amounts charged to program funds, those program costs were covered by other Department funding sources, inappropriately curtailing other services. Though encouraged by the Wraparound program concept, only $ 9,307, or 1.5 percent of total program expenditures during the three fiscal years reviewed, have been spent on unique goods and services jointly identified by program participants, their families and County staff as being in the best interests of the child. Most of the program funding has been used for traditional County staff- provided services. 16 2. Wraparound Program Fiscal Management Harvey M. Rose Associates, LLC The status of the January 2006 recommendations pertaining to the County’s Wraparound program fiscal management are as follows: The Board of Supervisors should: January 2006 Recommendation Status/ Discussion 3.1 Direct the inter- departmental Wraparound management team and Chief Administrative Officer to review the Wraparound program FY 2005- 06 revenue and expenditure budget, its assumptions about the number of children to be served, slots to be filled, actual number of “ slotted” and non-revenue generating children served and actual revenues and expenditures year-to- date and report back to the Board within six weeks on whether adjustments should be made to make the budget more realistic. Not implemented: The recommendation called for the Wraparound management team and County CAO to prepare an analysis for the Board of Supervisors explaining the differences between FY 2005- 06 budgeted and actual revenues and expenditures, which were substantial in the first years of the program. The analysis was to include an assessment of the assumptions used about the number of slotted and non- slotted children in the program. While such an analysis was never delivered to the Board of Supervisors, DHS is now regularly tracking and analyzing data about the number of children being served, program slots filled and the number of non- revenue generating children in the program. 3.2 Direct the inter- departmental Wraparound management team and Chief Administrative Officer to prepare a budget plan each year based on the actual revenues and expenditures for the previous year and documented assumptions about the number of children to be served, both slotted and discretionary non- revenue generating, and the nature of services to be provided in the budget year. Implemented: The FY 2006- 07 program revenue and expenditure budget is based on estimates of the number of individual children that will participate in the program, both slotted and non- revenue generating, and the slotted children’s reimbursement rates. Actual revenues and expenditures from FY 2005- 06 were considered in preparation of the FY 2006- 07 budget, including planned expenditures of unspent program funds from previous years. 17 2. Wraparound Program Fiscal Management Harvey M. Rose Associates, LLC The Board of Supervisors should: January 2006 Recommendation Status/ Discussion 3.3 Direct the inter- departmental Wraparound management team to at least quarterly monitor actual program revenues and expenditures and number of children served for comparison to the budget. Implemented: Department of Human Services staff and the Interagency Advisory Council has started monitoring actual program revenues and expenditures and number of children served at its meetings. 3.4 Direct the Chief Administrative Officer to separately present the Wraparound program budget each year in the proposed Department of Mental Health budget document presented to the Board of Supervisors and to include planned and previous year actual numbers of slotted and discretionary non- revenue generating children program participants, hours of staff service provided, contractor service hours and expenditures for unique external goods and services. Partially implemented: Due to changes in structure, the FY 2006- 07 budget for the Wraparound program is presented in the Department of Human Services ( DHS) budget rather than the Department of Mental Health budget. The presentation in the DHS budget does not show prior year actual expenditures and revenues or number of participants, hours of staff service provided, or expenditures on unique external goods and services5. However, as mentioned above, the budget document does present estimated number of participants for the budget year. 5 DHS has pointed out that it couldn’t provide a full year’s worth of actual expenditures by the time budget submissions are required in the County. Estimated actual could have been used for the current year as is common practice in county budgets. 18 2. Wraparound Program Fiscal Management Harvey M. Rose Associates, LLC January 2006 Recommendation Status/ Discussion 3.5 Direct the inter- departmental Wraparound management team and Chief Administrative Officer to develop an expenditure plan for the approximately $ 173,244 Wraparound program fund balance and transmit the plan to the Board for review. Partially implemented: The Interagency Advisory Council has established procedures where proposals for use of these funds are first considered by the Cross- System Operations Team, then, if recommended, forwarded to the Council for approval. As of April 2007, the Council had approved $ 220,275 in one- time expenditures with these funds. Actual expenditure of these funds was only $ 15,467 as of April 2007. As can be seen in the table summarizing the status of January 2006 audit recommendations pertaining to program fiscal management above, the Department of Human Services has made progress tracking program expenditure, revenue and participant data and regularly reporting it to the Interagency Advisory Council. The number of slotted and non- slotted participants is being monitored and reported and was used to estimate FY 2006- 07 program expenditures and revenues. This should result in expenditures more in line with revenues compared to 2005 and service levels more in keeping with resources available. A final change of note is that the interagency Memorandum of Understanding ( MOU) in place at the time of the January 2006 audit called for reinvestment of cost savings in other services for children and families but cost savings were not defined nor was a process for determining how they would be spent. A fund balance of approximately $ 173,000 had accumulated at the time due to a low rate of program expenditure and there was no plan in place to utilize those monies. A process has now been defined for determining how surplus Wraparound program monies should be spent and the Interagency Advisory Council has approved or is considering a number of one- time expenditures using these funds as of the writing of this report. The Interagency Advisory Council made the decision to use the funds for one-time expenditures because the available fund balance is considered a one- time accumulation and the Council did not want to increase ongoing program services to a level that would not be sustainable over time. Though much of the Wraparound Program fund balance has now been earmarked for expenditure, actual expenditure of nearly all of these funds, which have been accumulating since the January 2006 audit and before, has still not occurred. Further, the fund balance has grown because of additional unspent new revenues accumulated since the audit was issued and the discovery of previously unreported unspent funds by the 19 2. Wraparound Program Fiscal Management Harvey M. Rose Associates, LLC Department of Mental Health after the audit was completed. Unspent program funds and planned expenditures are presented in Table 2.1. Table 2.1 Approved and Proposed one- time Expenditure of Unspent Wraparound Program Funds as of April 2007 Expends Program $ Amount Allocated as of 04/ 07 Balance Approved: Foster Parent Respite Care $ 15,000 $ 4,162 $ 10,838 Celebrating Families 1 20,000 0 20,000 Maxim Healthcare Services 20,000 5,880 14,120 Incredible Years Program 2 15,575 5,425 10,150 Foster & Wrap Youth Groups 50,000 0 50,000 Transitional Housing Program + 3 70,000 0 70,000 Foster & FostAdopt Home Recruitmt 29,700 0 29,700 Proposed: TBS Training 2,500 0 2,500 Unallocated 25,000 0 25,000 Total $ 247,775 $ 15,467 $ 232,308 Source: Department of Human Services reports, April 2007 1 This is a training workshop for parents who work with chemically dependent families. 2 This is a training workshop for parents who work with aggressive children. 3 This is a service to assist youth exiting foster care or group home placement that provides housing assistance and instruction on independent living skills. As shown in Table 2.1, the surplus funds have been allocated to organizations and not to individual Wraparound program participants though the organizations and services funded may indirectly benefit the participants through services such as parent and staff training, respite care for foster parents, health care services, transitional housing and others. While it is true that the fund balance money is one time in nature, some or all of these funds could still be used for individual participants. It is not necessary for the program to sustain the same level of expenditure per child at all times. In fact, variation in expenditure levels should be expected as the needs and plans for participants are supposed to be customized and not based on a formula. Another issue of concern regarding the unspent monies is that they have remained unspent since at least 2005, when the first audit field work was conducted although Department of Mental Health and Human Services staff were aware of the availability of this money prior to that. While some of the intervening time was spent developing protocols to determine how decisions should be made to expend the funds, several months have passed since many of the appropriations have been approved and very little of the money has actually been spent. The Department of Human Services has pointed out that there is often a lag between contractor services provided and payment for these services and that the County’s contracting process can be time consuming. 20 2. Wraparound Program Fiscal Management Harvey M. Rose Associates, LLC While it is commendable that the Interagency Advisory Council took time to establish protocols for systematically deciding how the expenditure of surplus program funds would be used, the Council and program managers need to create timetables and management controls to ensure that these expenditures are timely and responsive to need. For example, the need for parent training or coaching services could have been identified as a need when the Interagency Advisory Council first reconvened in the spring of 2006 as a service to begin funding immediately with the surplus funds. A review of DHS records shows that most of the services provided to Wraparound participants are mental health services provided by either Department of Mental Health staff or their contractors. While mental health services are a key component of services to be provided to at risk youth, the fact that they represent the preponderance of services provided raises the question of the extent to which participant families and teams are aware of or are being encouraged to request services that will best meet their needs, even if not provided by traditional government service providers and their contractors. Wraparound programs in some other jurisdictions provide mental health services as well as other social services that are identified as most needed by the participants and their families and support teams. These services can include parent coaching, foster family care, job training, tutors/ mentors, respite care and case management services as well as non- traditional assistance in the form of assistance with basic expenses and payment for extra- curricular activities such as lessons and activities. Paying for these type of services with Wraparound funds is allowable under state law. Since the Wraparound program approach is supposed to be flexible and community-based, services can be provided by County staff or individuals or organizations from the community. Most of the services paid for with County Wraparound funds are Department of Mental Health therapy, psychiatric medical services and therapeutic behavioral services provided by Department staff or Department contractors. The Department of Mental Health does provide non- clinical services through its Mental Health Workers who provide in- home assistance to families with basic living skills and needs. An advantage of using the Department of Mental Health and its contractors for services is that most of their costs are reimbursed by Medi- Cal. If private providers who don’t accept Medi- Cal were used, more program funds would be spent on fewer children. The Wraparound Program’s expenditure trend has begun to change as of FY 2006- 07 with DHS taking greater control of Wraparound program management. This is demonstrated by DHS’ hiring of a Parent Partner position who provides various support and advocacy non- clinical services as needed to many of the Wraparound program participant families. Payment for this position is being made out of the Wraparound program budget with funds that were previously allocated to Department of Mental Health staff services. Recently, |
| PDI.Date | 2007 |
| PDI.Date.Issued | 2007 |
| PDI.Title | Final Report. 2006-2007. |
| OCLC number | 144544458 |
Tags
Add tags for El Dorado County Grand Jury final report
Comments
Post a Comment for El Dorado County Grand Jury final report
Your rating was saved.
you wish to report:
Your comment:
Your Name:
|
|
...