Contra Costa County Grand Jury
2020-2021
From the annual report
The consolidated year-end volume. The individual investigations it contains are listed separately below.
📑 Year-End Report
The full consolidated volume; individual reports are listed below.
Individual reports (6)
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Findings & Recommendations
10 findings
F1:
Professional crisis team response to mental health calls can de-escalate a crisis and reduce deaths.
F2:
Law enforcement response to mental health calls reduce resources needed for serious crimes.
F3:
Successful pilot programs in other states have earned voter funding support for program expansion.
F4:
Community trust in mental health crisis response teams can only be developed over time.
F5:
Educating the community about mental health crisis response teams is essential for their acceptance and use.
F6:
DHS efforts to educate the community about MCRT services have been ineffective and need improvement.
F7:
Funding is required for all the phases of program development: start-up, pilot, and continuing operations.
F8:
California funding grants, including AB-118, are available for pilot program creation and continuing operations.
F9:
The current MCRT program does not provide standardized responses within the County due to limited hours of service and a single dispatch location.
F10:
The City of Antioch is a suitable community to serve as a pilot city for the MCRT expansion program.
Additional Recommendations
10
Not linked to specific findings.
R1:
By June 30, 2022, the Board of Supervisors approve funding for the expansion of the existing DHS/MCRT program to include a pilot project.
R2:
By June 30, 2022, the Board of Supervisors direct DHS to cooperate with the City of Antioch to develop a pilot project.
R3:
By September 30, 2022, the Antioch City Council collaborate with DHS to establish a pilot project.
R4:
By October 30, 2022, the City of Antioch apply for grants, including AB-118, to fund its participation in the pilot program.
R5:
By June 30, 2022, the Board of Supervisors direct DHS to establish a joint team including representation from community partners for administration of the pilot Contra Costa County 2020-2021 Grand Jury Report 2106 Grand Jury Reports are posted at http://www.cc-courts.org/grandjury project.
R6:
By September 30, 2022, DHS and the City of Antioch begin a comprehensive program to inform and educate the community members about the project and the specific resources that will be available at the outset of the pilot project.
R7:
By December 31, 2022, the Antioch Police Department and its 911 dispatchers augment their training to include the new MCRT alternative response options available.
R8:
By September 30, 2022, DHS apply for all available state, county, and private grants (e.g., AB-118), as well as money available through Measure X, as a source of funding.
R9:
By December 31, 2021, DHS implement ongoing monitoring of the proposed CAHOOTS Act (S.4441) as an additional source of funding.
R10:
By September 30, 2022, if Antioch is not willing to be a pilot program city, DHS identify and approach an alternate city and work with it on the recommendations related to Antioch.
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Findings & Recommendations
17 findings
F1:
Board members are prohibited by WCWD Policies and Procedures from communicating directly with district staff other than the General Manager.
F2:
Therefore, a director cannot obtain non-publicly available information from district staff about district operations without the General Manager’s consent.
F3:
The General Manager determines the agenda for district board meetings in consultation with the Board president.
F4:
Alternatively, a Board member may place an item on the meeting agenda, but only with a Board majority vote.
F5:
The Board has given the General Manager the discretion to spend up to $50,000 (per vendor per fiscal year) of WCWD funds for district maintenance and operations without Board approval.
F6:
Board members can review the check register for the WCWD’s general fund, but the General Manager’s discretionary expenditures are not segregated or identified on the check register. 8The Government Code addresses when claims against employees brought by third parties are paid by the governmental entity. See, e.g., Gov. Code, §§ 995, 995.2 and 995.4 et seq. Contra Costa County 2020-2021 Grand Jury Report 2103 Grand Jury Reports are posted at http://www.cc-courts.org/grandjury
F7:
In the Board’s 2020 investigation of two directors, the Board allocated a $1000 stipend to each to obtain legal advice. In the Board’s most recent investigation of the same directors, no stipends were paid.
F8:
The WCWD has no written policy on when or under what circumstances it will pay for a director’s legal expenses.
F9:
Decentralized IT structures increase vulnerability to cyber-attacks. Contra Costa County 2020-2021 Grand Jury Report 2104 Grand Jury Reports are posted at http://www.cc-courts.org/grandjury
F10:
The County’s IT structure is decentralized.
F11:
Based on interviews, Contra Costa County is at a disadvantage to hire IT staff with cyber security expertise due to increased compensation and perks offered by some private enterprises.
F12:
Measure X funding has not been allocated for CCAS operations.
F13:
The FCC reported 99.2% of Contra Costa County residents have access to internet broadband for greater use of tele-mental health services.
F14:
BHS has not followed the directives of the California Telehealth Advancement Act of 2011 to develop telehealth services to better meet the needs of underserved populations in the community.
F15:
The Congressional Consolidated Appropriations Act of 2021 expands Medicare services to allow tele-mental health services to be integrated with in-person sessions, and to be received by beneficiaries in their home without geographic limitations.
F16:
BHS lacks an adequate electronic data system to evaluate the efficacy of outpatient mental health services provided. Contra Costa County 2020-2021 Civil Grand Jury Report 2102 Grand Jury Reports are posted at http://www.cc-courts.org/grandjury
F17:
BHS does not collect clinical data from network providers, which limits accountability for the outpatient mental health services provided to county residents.
Additional Recommendations
11
Not linked to specific findings.
R1:
EBMUD Board of Directors should consider publishing a cyber policy acknowledging the cyberattack threat and informing the public of its programs to overcome and prevent attacks on the public water supply by December 31, 2020. RESPONDENT RESPONSE EBMUD Board of Directors The recommendation has not yet been implemented, but will be implemented in the future
R2:
EBMUD Board of Directors should consider publishing its conformance with the American Water Infrastructure Act on its public webpage by December 31, 2020. RESPONDENT RESPONSE EBMUD Board of Directors The recommendation has been implemented
R3:
EBMUD Board of Directors should consider applying for a grant to offset new technology costs and strengthen its cybersecurity infrastructure under the Drinking Water Infrastructure Risk and Resilience Program by December 31, 2020. RESPONDENT RESPONSE EBMUD Board of Directors The recommendation has been implemented
R4:
CCWD Board of Directors should consider publishing a cyber policy acknowledging the cyberattack threat and informing the public of its programs to overcome and prevent attacks on the public water supply by December 31, 2020. RESPONDENT RESPONSE CCWD Board of Directors The recommendation has not yet been implemented, but will be implemented in the future Contra Costa County 2020-2021 Civil Grand Jury Grand Jury Reports are posted at http://www.cc-courts.org/grandjury
R5:
CCWD Board of Directors should consider applying for a grant to offset new technology costs and strengthen its cybersecurity infrastructure under the Drinking Water Infrastructure Risk and Resilience Program by December 31, 2020. RESPONDENT RESPONSE CCWD Board of Directors The recommendation has not yet been implemented, but will be implemented in the future The Responses to the 2019-2020 Grand Jury reports are posted on the Contra Costa County Grand Jury Website in their entirety and can be viewed at: http://www.cc-courts.org/civil/grand-jury-reports.aspx Contra Costa County 2020-2021 Civil Grand Jury Grand Jury Reports are posted at http://www.cc-courts.org/grandjury CONTRA COSTA COUNTY CIVIL GRAND JURY REPORT 2003 Contra Costa BART Rider Concerns RECOMMENDATIONS:
R6:
By December 31, 2020, the Board of Supervisors should consider establishing a requirement that a final After-Action Report and a fiscal impact report be completed no later than 60 days after a PSPS event. RESPONDENT RESPONSE Contra Costa County Board of Supervisors The recommendation will not be implemented because it is not warranted or is not reasonable
R7:
The Board of Supervisors should consider developing a plan to take advantage of funding available for PSPS events from various programs at State and Federal levels by December 31, 2020. RESPONDENT RESPONSE Contra Costa County Board of Supervisors The recommendation will not be implemented because it is not warranted or is not reasonable
R8:
By December 31, 2020, The Board of Supervisors should consider tracking and communicating to County departments the status of existing and pending legislation which may mitigate the effects of a PSPS event on the County and its residents. RESPONDENT RESPONSE Contra Costa County Board of Supervisors The recommendation has not yet been implemented, but will be implemented in the future The Responses to the 2019-2020 Grand Jury reports are posted on the Contra Costa County Grand Jury Website in their entirety and can be viewed at: http://www.cc-courts.org/civil/grand-jury-reports.aspx Contra Costa County 2020-2021 Civil Grand Jury Grand Jury Reports are posted at http://www.cc-courts.org/grandjury CONTRA COSTA COUNTY CIVIL GRAND JURY REPORT 2005 Juveniles in Detention RECOMMENDATIONS:
R9:
The Grand Jury recommends that the following be implemented by June 2022:
CCAS management and City Managers pursue customization of the Animal Services contracts to include basic service plus extended services for an additional fee.
R10:
The Grand Jury recommends that the following be implemented by June 2022:
AAS and CCAS explore sharing of resources for low-cost animal care clinics in the eastern part of the County.
R11:
The Grand Jury recommends that the following be implemented by June 2022:
The County Board of Supervisors request that CCAS apply for Measure X funding to lower the projected increased financial cost to CCAS-contracted cities and to support additional low-cost spay and neuter services.
Findings & Recommendations
12 findings
F1:
There is a need for improved animal services throughout the County.
Related Recommendations (1)
R1:
The Grand Jury recommends that the following be implemented by June 2022:
The Antioch City Council allocate funding to fill the staff position of Volunteer Coordinator / Community Outreach at AAS.
F2:
CCAS facilities are concentrated in the northern part of the County.
Related Recommendations (1)
R2:
The Grand Jury recommends that the following be implemented by June 2022:
AAS improve volunteer training.
F3:
AAS volunteers are often not assigned specific tasks and lack direction.
Related Recommendations (1)
R3:
The Grand Jury recommends that the following be implemented by June 2022:
The County Board of Supervisors allocate additional funding to provide outreach to educate residents about available CCAS services.
F4:
AAS does not have funding for a Volunteer Coordinator / Community Outreach staff position.
Related Recommendations (1)
R4:
The Grand Jury recommends that the following be implemented by June 2022:
CCAS explore embedding Animal Control Officers at selected police stations to expand services, such as wildlife retrieval, throughout the county.
F5:
In some of the contracted municipalities, residents are not aware of CCAS- provided services, especially wildlife retrieval.
Related Recommendations (1)
R5:
The Grand Jury recommends that the following be implemented by June 2022:
CCAS engage a consulting firm to obtain guidance on the possible redistribution of animal services within the County.
F6:
Funding reductions to the CCAS budget have hindered live wildlife retrieval and rescue.
Related Recommendations (1)
R6:
The Grand Jury recommends that the following be implemented by June 2022:
CCAS pursue a Memorandum of Understanding with ARF to coordinate resource sharing.
F7:
A satisfaction survey of the 18 CCAS-contracted cities revealed 40% satisfied, 40% somewhat satisfied, and 20% unsatisfied with the quality of overall CCAS services supplied.
Related Recommendations (1)
R7:
The Grand Jury recommends that the following be implemented by June 2022:
CCAS pursue a Memorandum of Understanding with the Milo Foundation to coordinate resource sharing.
F8:
All CCAS contracts with municipalities provide identical services at the same cost per capita.
Related Recommendations (1)
R8:
The Grand Jury recommends that the following be implemented by June 2022:
CCAS pursue a Memorandum of Understanding with East Bay SPCA to coordinate resource sharing.
F9:
Additional vaccination and spay and neuter clinics would reduce the number of homeless and surrendered animals in the shelters.
Related Recommendations (1)
R9:
The Grand Jury recommends that the following be implemented by June 2022:
CCAS management and City Managers pursue customization of the Animal Services contracts to include basic service plus extended services for an additional fee.
F10:
There are private animal shelter facilities, The Milo Foundation and ARF, in the western and central parts of the County, respectively.
Related Recommendations (1)
R10:
The Grand Jury recommends that the following be implemented by June 2022:
AAS and CCAS explore sharing of resources for low-cost animal care clinics in the eastern part of the County.
F11:
A private animal shelter in Alameda County, East Bay SPCA, is located near the southern part of Contra Costa County.
Related Recommendations (1)
R11:
The Grand Jury recommends that the following be implemented by June 2022:
The County Board of Supervisors request that CCAS apply for Measure X funding to lower the projected increased financial cost to CCAS-contracted cities and to support additional low-cost spay and neuter services.
F12:
Measure X funding has not been allocated for CCAS operations.
Findings & Recommendations
11 findings
F1:
County IT Departments are chronically understaffed.
Related Recommendations (1)
R1:
The Board of Supervisors direct the County Chief Information Officer by December 2022 to create a talent pool within DoIT that includes cyber security experts to relieve chronic staffing shortages in all IT departments.
F2:
Obsolete equipment poses a vulnerability threat to County IT security.
Related Recommendations (1)
R7:
The Board of Supervisors direct the County Administrator by December 2022 to have all County departments identify and replace obsolete IT hardware. The Board of Supervisors direct the County Administrator by June 2022 to
F3:
Some County IT departments do not have time to conduct software and hardware updates, and vulnerability scans which are critical for cyber security because of understaffing.
Related Recommendations (3)
R3:
The Board of Supervisors direct the County Administrator by June 2022 to require the installation of software on all County computers that can scan for threats and viruses on any device attached to them.
R4:
The Board of Supervisors direct the County Administrator by June 2022 to authorize DoIT to require system vulnerability testing on all County computer systems.
R6:
The Board of Supervisors direct the County Administrator by June 2022 to have DoIT ensure mandatory updates are performed on all systems for all software applications.
F4:
Some County departments with small IT staffs do not have specialized cyber secu- rity personnel.
F5:
Cyber security training is performed on an inconsistent basis in some County de- partments.
Related Recommendations (1)
R5:
The Board of Supervisors direct the County Administrator by June 2022 to require all county employees to complete annual cyber security awareness training.
F6:
County employees and contractors use personal storage devices (e.g., flash drives) on County computers.
Related Recommendations (1)
R2:
The Board of Supervisors direct the County Administrator by June 2022 to require all IT departments to forbid use of personal devices on and with County computers (e.g., personal thumb drives).
F7:
The use of personal devices makes County computers vulnerable to denial of ser- vice, data breaches or other cyber-attacks.
Related Recommendations (1)
R2:
The Board of Supervisors direct the County Administrator by June 2022 to require all IT departments to forbid use of personal devices on and with County computers (e.g., personal thumb drives).
F8:
IT expenditures and budgets in County departments are not transparently reported so it is difficult to identify redundant and duplicative IT expenditures.
Related Recommendations (1)
R8:
require County departments to identify their planned IT spending in their overall budgets for transparency.
F9:
Decentralized IT structures increase vulnerability to cyber-attacks.
F10:
The County’s IT structure is decentralized.
F11:
Based on interviews, Contra Costa County is at a disadvantage to hire IT staff with cyber security expertise due to increased compensation and perks offered by some private enterprises.
Findings & Recommendations
8 findings
F1:
Board members are prohibited by WCWD Policies and Procedures from communicating directly with district staff other than the General Manager.
Related Recommendations (1)
R1:
The Board adopt procedures by which any Board member can obtain information about WCWD operations without the agreement of the General Manager.
F2:
Therefore, a director cannot obtain non-publicly available information from district staff about district operations without the General Manager’s consent.
Related Recommendations (1)
R1:
The Board adopt procedures by which any Board member can obtain information about WCWD operations without the agreement of the General Manager.
F3:
The General Manager determines the agenda for district board meetings in consultation with the Board president.
Related Recommendations (1)
R2:
The Board adopt procedures by which any Board member can place an item on the meeting agenda without the General Manager’s approval or a Board majority vote.
F4:
Alternatively, a Board member may place an item on the meeting agenda, but only with a Board majority vote.
Related Recommendations (1)
R2:
The Board adopt procedures by which any Board member can place an item on the meeting agenda without the General Manager’s approval or a Board majority vote.
F5:
The Board has given the General Manager the discretion to spend up to $50,000 (per vendor per fiscal year) of WCWD funds for district maintenance and operations without Board approval.
F6:
Board members can review the check register for the WCWD’s general fund, but the General Manager’s discretionary expenditures are not segregated or identified on the check register. 8The Government Code addresses when claims against employees brought by third parties are paid by the governmental entity. See, e.g., Gov. Code, §§ 995, 995.2 and 995.4 et seq.
Related Recommendations (1)
R4:
The Board adopt a procedure that requires the General Manager to identify expenditures made under the authority to make per-vendor payments of less than $50,000 per fiscal year.
F7:
In the Board’s 2020 investigation of two directors, the Board allocated a $1000 stipend to each to obtain legal advice. In the Board’s most recent investigation of the same directors, no stipends were paid.
F8:
The WCWD has no written policy on when or under what circumstances it will pay for a director’s legal expenses.
Related Recommendations (1)
R3:
The Board adopt a written policy on reimbursement of a director’s legal fees for both internal investigations and claims brought against a director by an outside third party.
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Findings & Recommendations
17 findings
F1:
Prior to the Covid-19 pandemic, tele-mental health and audio-only services available through BHS were a small portion of the outpatient services provided (7% in 2018; 8% in 2019).
F2:
During the Covid-19 pandemic, BHS did not offer training to prepare clinicians or clients for effective and confidential use of tele-mental health services.
Related Recommendations (2)
R3:
Develop a training program for BHS clinicians, network providers, and support staff to facilitate the use of tele-mental health.
R4:
Develop a training program for clients to facilitate and provide support for the use of tele-mental health.
F3:
During the Covid-19 pandemic, BHS tele-mental health services continue to be underutilized. While audio-only increased to 52% of all outpatient services, tele-mental health was 18% of outpatient services delivered. Consolidated Appropriations Act (2021): 1775-1776. CCBHS Remote Work Survey (September 2, 2020). CCBHS Contract Providers Remote Work Survey (September 10, 2020).
F4:
At the outset of the Covid-19 pandemic, tele-mental health and audio-only services decreased the number of missed appointments.
F5:
Tele-mental health services are appropriate for clients who are more stable, verbal and insightful.
F6:
Tele-mental health services are appropriate to use with clients displaying symptoms of anxiety and depression.
F7:
The greater use of audio-only services has the limitation of not offering visual cues, which provide clinicians with important clinical information.
F8:
Tele-mental health services are not appropriate for a. Homeless populations b. Patients presenting with chronic schizophrenia with a limited capacity to manage the tasks of daily life c. Patients prescribed controlled substances or injectable medication.
F9:
BHS has not incorporated tele-mental health into a comprehensive service delivery model to offer a broad range of opportunities for underserved populations to receive outpatient mental health services.
Related Recommendations (2)
R1:
Develop a hybrid plan to integrate tele-mental health services with in-person services in their clinics.
R2:
Coordinate with network provider groups to integrate tele-mental health services with in-person services.
F10:
Access to outpatient mental health services in Contra Costa County suffers from difficulties with transportation to clinics, long wait times for appointments, and insufficient availability of after-hours appointments.
F11:
BHS has a limited number of clinicians who can provide culturally and linguistically sensitive services to diverse minority groups.
F12:
Increasing access to mental health services is a priority for Contra Costa County BHS.
F13:
The FCC reported 99.2% of Contra Costa County residents have access to internet broadband for greater use of tele-mental health services.
F14:
BHS has not followed the directives of the California Telehealth Advancement Act of 2011 to develop telehealth services to better meet the needs of underserved populations in the community.
F15:
The Congressional Consolidated Appropriations Act of 2021 expands Medicare services to allow tele-mental health services to be integrated with in-person sessions, and to be received by beneficiaries in their home without geographic limitations.
F16:
BHS lacks an adequate electronic data system to evaluate the efficacy of outpatient mental health services provided.
Related Recommendations (7)
R5:
Collect outcome data from BHS providers and programs to provide feedback to improve mental health services delivered to the community.
R6:
Collect outcome data from network providers to provide feedback to improve mental health services delivered to the community.
R7:
Increase the use of the MyChart health care information system to make clinical information accessible to clients and providers.
R8:
Modernize the electronic data collection capabilities of the quality management program to provide meaningful information about mental health services.
R9:
Develop appropriate clinical metrics to evaluate outcomes that improve the effectiveness of mental health services provided.
R10:
Seek grants and MHSA funding to upgrade the technological resources of the quality management program. By June 30, 2022, it is recommended that Contra Costa Board of Supervisors:
R11:
Allocate funds for BHS to upgrade its quality management program.
F17:
BHS does not collect clinical data from network providers, which limits accountability for the outpatient mental health services provided to county residents.
Related Recommendations (7)
R5:
Collect outcome data from BHS providers and programs to provide feedback to improve mental health services delivered to the community.
R6:
Collect outcome data from network providers to provide feedback to improve mental health services delivered to the community.
R7:
Increase the use of the MyChart health care information system to make clinical information accessible to clients and providers.
R8:
Modernize the electronic data collection capabilities of the quality management program to provide meaningful information about mental health services.
R9:
Develop appropriate clinical metrics to evaluate outcomes that improve the effectiveness of mental health services provided.
R10:
Seek grants and MHSA funding to upgrade the technological resources of the quality management program. By June 30, 2022, it is recommended that Contra Costa Board of Supervisors:
R11:
Allocate funds for BHS to upgrade its quality management program.