Marin County Grand Jury
2017-2018
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Findings & Recommendations
4 findings
F1:
Alternatives to juvenile detention continue to produce positive results in Marin.
Related Recommendations (1)
R1:
The Board of Supervisors should solicit input from the public regarding the future of Marin’s juvenile detention services and the Juvenile Hall property within three months of receipt of this report.
F2:
The average census at Marin Juvenile Hall has remained low.
Related Recommendations (1)
R2:
The Board of Supervisors should conduct a formal Request for Proposal (RFP) process with all neighboring counties to determine interest in sharing juvenile detention services and facilities within six months of receipt of this report.
F3:
Marin Juvenile Hall is an aging facility.
Related Recommendations (1)
R3:
The Board of Supervisors should commission a study to determine the highest and best use of the entire Juvenile Hall property within three months of the conclusion of the RFP process.
F4:
Marin spends between $600 and $800 per day, per incarcerated youth.
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Findings & Recommendations
8 findings
F1:
Traffic congestion is consistently cited as the number one problem in the county and school-related traffic is a significant contributor.
Related Recommendations (1)
R1:
The Marin County Board of Supervisors should work with Marin Transit to secure ample locations for bus parking and a location for bus maintenance by the end of 2018.
F2:
School buses have been shown to reduce traffic congestion.
Related Recommendations (1)
R2:
All municipalities should work with Marin Transit to secure ample locations for bus parking and a location for bus maintenance by the end of 2018.
F3:
There are school districts with no bus service and others with varying levels of service. The lack of coordination results in inefficiencies.
Related Recommendations (1)
R3:
Marin Transit should produce and make public a list of possible sites for bus parking and maintenance and the barriers to purchasing and utilizing each site by October 2018.
F4:
Current school bus funding includes bus pass sales and various municipality and county contributions. The municipal and county contributions are temporary and inconsistent.
Related Recommendations (1)
R4:
Marin Transit should facilitate negotiations for a financial arrangement across the full group of participants that would distribute any tax revenue lost by a municipality or the County for providing a parking or maintenance facility.
F5:
There is demand to establish and/or expand YSB programs in the County.
Related Recommendations (1)
R5:
The Marin County Board of Supervisors should direct Marin Transit to establish a new standing YSB committee by September 2018.
F6:
Securing dedicated YSB bus parking and a maintenance facility is essential for expansion of a countywide YSB program.
Related Recommendations (1)
R6:
Marin Transit should establish a new standing YSB committee that would provide guidance on YSB issues to include representatives from the County, Marin County Office of Education, and each school district and municipality in the urbanized areas of Marin. The initial meeting should be held by October of 2018.
F7:
The YSB programs in Marin face many challenges, including dependable funding sources, bus drivers and coordinated school bell times.
Related Recommendations (1)
R7:
School districts (with or without existing YSB programs) and municipalities within the urbanized area of the County should join and actively participate in the YSB committee providing guidance to Marin Transit on YSB issues, such as cost allocations, bell times and routes. The initial meeting should be held by October of 2018.
F8:
Marin Transit is the appropriate entity to efficiently manage a coordinated YSB program.
Related Recommendations (1)
R8:
The YSB committee should work toward the establishment of a coordinated YSB for K-8 program for the urbanized areas of Marin with the goal of beginning the coordinated program by the 2019-2020 school year.
Additional Recommendations
2
Not linked to specific findings.
R9:
Marin Transit should manage the development and operations of the coordinated YSB program beginning immediately, with the goal of initiating operations by the 2019-2020 school year.
R10:
The County and municipalities of the urbanized corridor should make financial support of all YSB programs a part of each year’s budgeting process.
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Findings & Recommendations
9 findings
F1:
With the exception of Sausalito, all Marin County law enforcement agencies are now following the 2013-14 Marin Civil Grand Jury’s recommendation that body-worn cameras be used.
F2:
Video camera policies published on law enforcement agency websites enhance transparency and help gain public trust.
F3:
Although all agencies have policies regarding police video technology, not all agencies have posted policies on a public website.
Related Recommendations (2)
R1:
Sausalito should implement body-worn cameras as recommended by the 2013-14 Marin County Civil Grand Jury and by this Grand Jury.
R2:
Marin law enforcement agencies that have not posted their body-worn camera policies to their websites should do so by October 1, 2018.
F4:
Automatically activated body-worn cameras reduce the occurrence of failure to capture critical events when compared with manually activated cameras.
Related Recommendations (1)
R3:
All Marin law enforcement agencies should seek to employ automated activation of body-worn cameras based on that agency’s choice of activation modes.
F5:
Data storage and data management costs are often many times the cost of the cameras themselves with the newer camera systems.
Related Recommendations (2)
R4:
All Marin law enforcement agencies pursuing new or improved video technology should explore cooperative negotiating and resource sharing with other agencies to reduce costs.
R5:
The County of Marin should work with the law enforcement agencies to form a county- wide buying group to reduce the costs of video technology.
F6:
Platforms that allow sharing of information technology resources exist and can lower individual agencies’ costs.
Related Recommendations (2)
R4:
All Marin law enforcement agencies pursuing new or improved video technology should explore cooperative negotiating and resource sharing with other agencies to reduce costs.
R5:
The County of Marin should work with the law enforcement agencies to form a county- wide buying group to reduce the costs of video technology.
F7:
Half of the reporting agencies in Marin have experienced a decrease in citizen complaints against officers since deploying body-worn cameras.
F8:
No Marin agency has reported an increase in citizen complaints.
F9:
Agencies have reported that the time required to investigate citizen complaints has decreased with the use of BWCs.
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Findings & Recommendations
13 findings
F1:
The buildings at GGV have suffered from a severe accumulation of deferred maintenance due to lack of sufficient funding from HUD for decades.
Related Recommendations (1)
R1:
Within 90 days, the Marin Housing Authority should create and communicate an accelerated timeline, against which progress can be measured, for the rehabilitation of GGV based upon approved Scenario B. This timeline should include milestones for the selection of a developer, the completion of a development plan, a plan for funding, the submission of a RAD application, and the beginning of construction.
F2:
The buildings and systems are deteriorating and may eventually require wholesale replacement if there is no intervention.
Related Recommendations (1)
R1:
Within 90 days, the Marin Housing Authority should create and communicate an accelerated timeline, against which progress can be measured, for the rehabilitation of GGV based upon approved Scenario B. This timeline should include milestones for the selection of a developer, the completion of a development plan, a plan for funding, the submission of a RAD application, and the beginning of construction.
F3:
A scenario for development (Scenario B) has been created by CVR Associates and approved by the Marin Housing Authority Board of Commissioners.
F4:
The CVR scenario relies upon a RAD conversion, which is a competitive application, for which the likelihood of success is unknown and with current planned budget cuts likely to be highly sought after by many public housing agencies.
Related Recommendations (1)
R3:
The Marin Housing Authority should proceed to develop alternative financial plans, as the RAD conversion and other aspects of the plan envisioned by the consultants carries great risk in terms of financial execution.
F5:
The CVR Associates scenario has substantial financial uncertainties and identifies at least a $19M gap even if successful.
Related Recommendations (1)
R3:
The Marin Housing Authority should proceed to develop alternative financial plans, as the RAD conversion and other aspects of the plan envisioned by the consultants carries great risk in terms of financial execution.
F6:
GGV is vital to Marin County based upon historical significance and the fact that it is the only family public housing in Marin.
F7:
Marin has been declared the least racially diverse county in the State.
F8:
GGV is part of Marin City, one of the more racially diverse areas in Marin.
F9:
Given current housing trends in Marin it is unlikely that residents would be able to relocate in the County if GGV is gone.
F10:
There is a fear of displacement by some residents of GGV stemming from a mistrust of public programs and a history of failure in other communities for public housing.
Related Recommendations (4)
R4:
The Marin County Board of Supervisors should proceed immediately to engage an established firm with experience in resolving mistrust issues who can work to create an atmosphere of trust between the residents of GGV and the Marin Housing Authority.
R5:
The Marin County Board of Supervisors, in conjunction with the Marin Housing Authority and GGV residents, should develop high priority programs that go beyond the housing needs of the community. These include job programs, a strong commitment to youth in the area, and help in establishing local leadership on issues that involve the GGV community.
R6:
Although there are provisions in the law, and assurances in the plan to provide certain rights to tenants, the Marin Housing Authority should pass a binding resolution addressing GGV tenants’ rights to remain in GGV during and after renovation and what it means to be a tenant in “good standing.”
R7:
MHA should develop HUD compliant but compassionate best practice programs to assist residents in resolving the issues such as being over-housed, off-lease, or in rent arrears to minimize displacement as GGV residents transition to new housing.
F11:
The efforts of SF Hope provide a model for a successful revitalization that Marin can use in its own efforts.
F12:
The success of SF Hope was based on the establishment of a mayoral office appointee to work in concert with the San Francisco Housing Authority in order to coordinate rehabilitation of these communities.
F13:
The County’s leadership has shown a lack of urgency as regards the deteriorating property at GGV.
Related Recommendations (2)
R1:
Within 90 days, the Marin Housing Authority should create and communicate an accelerated timeline, against which progress can be measured, for the rehabilitation of GGV based upon approved Scenario B. This timeline should include milestones for the selection of a developer, the completion of a development plan, a plan for funding, the submission of a RAD application, and the beginning of construction.
R2:
Within six months, the Marin County Board of Supervisors should appoint and empower a coordinator independent of the Marin Housing Authority to lead the efforts to improve GGV in conjunction with the Marin Housing Authority and other agencies. These would include the physical construction and social programs at GGV as well as the coordination of public and private resources.
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Findings & Recommendations
10 findings
F1:
The nonprofit and faith-based groups that have provided emergency shelter under the REST program for the past ten years will no longer continue to do so. The REST program ended in April 2018.
Related Recommendations (1)
R3:
The County of Marin should create additional emergency shelter capacity to replace the services lost by the end of the REST program.
F2:
The Housing First philosophy espouses housing-focused shelter, including services for the homeless and case management.
F3:
Housing First is dependent upon the availability of housing. The very limited supply of rental housing makes this a challenge in Marin County.
F4:
Nonprofits provide most services and shelter to the homeless in Marin County; some of them receive funds from the County, the State, and the Federal Government in addition to fundraising from private sources.
F5:
Collaboration between the County and the nonprofit service providers has improved. The coalition of Ritter Center/St. Vincent de Paul Society/Marin Housing authority providing assistance under the Whole Person Care program is a notable example.
F6:
At least 400 units for the chronically homeless must be added to the existing housing stock to achieve functional zero homelessness.23 This can be accomplished by new construction as well as repurposing existing housing, motels, churches/convents, and office/retail.
Related Recommendations (2)
R1:
The County of Marin should provide capital funding for up to 400 units of additional housing for the chronically homeless.
R5:
The County of Marin and each city and town should actively seek developers to create housing for the homeless within their jurisdictions.
F7:
Federal funding for the WPC and HHP programs ends in 2020. New funding sources must be created to continue the benefits of these programs.
Related Recommendations (1)
R4:
The County of Marin should create a local housing voucher program to supplement Federal funding.
F8:
The cost of chronic homelessness in Marin in terms of emergency room visits, hospital stays, police services, jail and the negative impacts of living on the streets has been documented to be approximately $60,000 per person per year. By contrast, the cost of a person in supportive housing has been documented to be approximately $34,000. Thus, housing is actually less expensive than abandoning the homeless to the streets.24
F9:
Homeward Bound’s Mill Street facility does not have staffing during the day. As a result everyone who stays there is turned out at 8:00 AM and cannot return until 5:00 PM. With additional funding, this facility could provide intensive housing-focused support throughout the day.
Related Recommendations (1)
R2:
The County of Marin should fund Homeward Bound’s Mill Street facility to provide 24/7 staffing with housing-focused case managers.
F10:
The State of California has millions of dollars allocated to serve the homeless that have not yet been released. Marin’s collaborative homeless advocates are well positioned to put additional funds to immediate use in ending homelessness in Marin.25 23 “New Approaches to Homelessness in Marin.” [Video.] Marin Coalition. March 2018. 24 “Marin Chronic Alcohol with Justice Involvement Project Business Plan June 2013.” Marin Department of Health & Human Services. 25 “Billions of Dollars to Help California’s Homeless Population are Piling Up.” Los Angeles Times, 25 March 2018.
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Findings & Recommendations
17 findings
F1:
The average number of reported rapes (per 1,000 population) in Marin County for 2011- 2016 is lower than all other counties in the Bay Area.
F2:
The low numbers of these assaults is equated with low numbers of SART exams (less than 29 per year average), which are insufficient to support a local program.
F3:
Having an in-county SART exam facility would not reduce the impact to the victims or the county agencies.
F4:
SANE nurse proficiency is maintained and enhanced by sufficient experience and caseload.
F5:
Identifying, training and retaining qualified SANE nurses in the North Bay represent challenges to the program.
F6:
Kaiser Permanente Vallejo Medical Center is a central location with good access for the counties it serves. It is an efficient operation where approximately 200 examinations per year are performed.
F7:
Marin County’s contract with Napa Solano SANE SART expires on July 2, 2018 and a renewal of the contract offers an opportunity to optimize the support to Marin and the SANE SART program.
Related Recommendations (1)
R1:
The County’s contract with the Napa Solano SANE SART should be renewed.
F8:
The geography and small number of rapes relative to the size of the counties that Napa Solano SANE SART serves creates challenges to resourcing and funding the program.
Related Recommendations (1)
R2:
The County should investigate alternative financing in collaboration with Napa Solano SANE SART to address funding variations resulting from the number of rapes per capita and large geography serviced, as directed in California Penal Code Section 13898.2 (c).
F9:
Funding based on actual examinations performed results in inconsistent revenue for an operation that must pay SANE nurses to be available 24 hours a day all year.
Related Recommendations (1)
R2:
The County should investigate alternative financing in collaboration with Napa Solano SANE SART to address funding variations resulting from the number of rapes per capita and large geography serviced, as directed in California Penal Code Section 13898.2 (c).
F10:
The Grand Jury finds no evidence of a testing backlog after the new RADS process was implemented in 2011.
F11:
The Grand Jury found unprocessed rape kits for years prior to 2011.
Related Recommendations (1)
R3:
Each law enforcement agency should complete an inventory of rape kits in their evidence lockers, and identify kits that have not been submitted to the California Department of Justice Crime Laboratory for DNA analysis.
F12:
Some kits obtained prior to 2011 were not analyzed due to perceived non-prosecutory value.
Related Recommendations (1)
R4:
Kits that have not been DNA tested should be sent to the California Department of Justice Crime Laboratory for processing, regardless of statute of limitations or prosecutorial value.
F13:
The exact number of unprocessed rape kits before 2011 remains unknown due to prior database procedures that did not identify the status of DNA testing of rape kits in evidence logs.
Related Recommendations (1)
R3:
Each law enforcement agency should complete an inventory of rape kits in their evidence lockers, and identify kits that have not been submitted to the California Department of Justice Crime Laboratory for DNA analysis.
F14:
The evidence databases in some agencies are incomplete.
Related Recommendations (1)
R3:
Each law enforcement agency should complete an inventory of rape kits in their evidence lockers, and identify kits that have not been submitted to the California Department of Justice Crime Laboratory for DNA analysis.
F15:
DNA testing of unprocessed rape kits nationwide, including other Bay Area counties, has led to the discovery of serial rapists and links to other crimes.
F16:
Policies for retention of rape kits vary among agencies.
Related Recommendations (1)
R5:
Law enforcement agencies should have a clearly defined policy regarding retention of kits.
F17:
The process for victims to learn the status of the results of their rape kit analysis is dependent on procedures of each department and varies throughout the County.
Related Recommendations (1)
R6:
Each law enforcement agency should have a clear, publicly available policy for keeping victims updated on the status of their rape kit processing and results.
Findings & Recommendations
5 findings
F1:
Marin County is very progressive in providing information and support for elders.
Related Recommendations (1)
R1:
The Board of Supervisors should request that HHS include information about how to register cell phones and Voice Over Internet Protocol (VOIP) phones for emergency alerts as part of community outreach.
F2:
Marin County and many of its cities are actively working to make Marin a more age- friendly county.
Related Recommendations (1)
R2:
The District Attorney should include registration of VOIP and cell phones in the DA’s outreach program.
F3:
Marin County’s first responders are exceptionally well-trained in providing help to elders.
Related Recommendations (1)
R3:
Marin County should develop a plan for a designated elder shelter.
F4:
Marin County does not have adequate shelter facilities for seniors in crisis.
Related Recommendations (1)
R4:
The Board of Supervisors should actively lobby State Legislators to allow MHSA funds to be used to help elders with mental illness and co-occurring dementia or Alzheimer’s disease.
F5:
Many Marin County seniors are not technologically savvy, and therefore may not have their phones properly registered for emergency services.
Additional Recommendations
7
Not linked to specific findings.
R65-69:
18,817 18,963 18,670 18,061 18,177 17,065 14,568 13,549 12,956
R70-74:
13,694 17,896 18,253 18,070 17,579 17,768 16,766 14,342 13,383
R75-79:
8,537 12,563 16,686 17,192 17,155 16,785 17,082 16,212 13,922
R80-84:
5,963 7,429 11,124 14,969 15,633 15,767 15,615 15,970 15,350
R85-89:
4,492 4,865 6,126 9,239 12,648 13,432 13,778 13,769 14,264
R90-94:
2,105 2,530 2,776 3,654 5,698 7,943 8,570 9,063 9,074
R95-99:
514 681 813 991 1,364 2,165 3,053 3,319 3,573 100+ 37 93 117 172 217 345 578 871 1,018 73,899 84,372 93,184 100,990 105,943 106,177 103,870 100,331 98,248 Total 65+ (28%) (32%) (34%) (37%) (38%) (38%) (37%) (36%) (36%) Total 262,105 267,020 270,747 274,243 277,316 278,955 278,811 277,335 275,223 Population 2 “Total Estimated and Projected Population for California Counties: July 1, 2010 to July 1, 2060 in 5-year Increments.” Accessed on December 19, 2017. APPROACH The Grand Jury originally focused on the problem of elder abuse, but found it most instructive to put that examination into the context of Marin’s overall preparedness for a rapidly-aging population. The Jury studied programs addressing aging worldwide, nationwide, in California, and in Marin County itself. In researching elder issues, the Grand Jury: ■ Examined extensive professional research reports as well as articles in the general media. ■ Consulted with individuals and agencies involved with elder issues in Marin and other northern California counties, including experts in dementia, shelters for abused victims, elected officials, and legal experts. ■ Interviewed first responders from Marin County police and fire departments. ■ Interviewed a community religious leader. ■ Examined legal issues relating to elder abuse and elder care. DISCUSSION Preparing for an Aging Population — Worldwide Communities around the world are preparing for an aging population by taking the guidance of the World Health Organization (WHO) and creating age-friendly cities, towns and counties that: ■ Recognize the wide range of capacities and resources among older people. ■ Anticipate and respond flexibly to aging-related needs and preferences. ■ Respect older people’s decisions and lifestyle choices. ■ Protect those who are most vulnerable. ■ Promote older people’s inclusion in and contribution to all areas of community life.3 The WHO initiative proposes eight age-friendly topics for inclusion:4 ■ Housing ■ Social participation ■ Respect and social inclusion ■ Civic participation and employment ■ Communication and information ■ Community support and health services ■ Outdoor spaces and buildings ■ Transportation Preparing for an Aging Population — The Federal Government Federal law provides for adult protective services and grant programs. “The Secretary shall ensure that the Department of Health and Human Services … provides funding authorized by this part to State and local adult protective services offices that investigate reports of the abuse, neglect, and exploitation of elders...”5 The National Center on Elder Abuse (NCEA) serves as a national resource center dedicated to the prevention of elder mistreatment. First established by the U.S. Administration on Aging (AoA) in 1988 as a national elder abuse resource center, the NCEA was granted a permanent home at AoA in the 1992 amendments made to Title II of the Older Americans Act.6 The Elder Justice Act was signed into law by President Obama on March 23, 2010, as part of the Patient Protection and Affordable Care Act.7 It provides federal resources to “prevent, detect, treat, understand, intervene in and, where appropriate, prosecute elder abuse, neglect and exploitation.” The text above refers to just some of the laws and programs in place to help and protect seniors. 3 “Age Friendly Practices.” World Health Organization. 4 “Global Age-Friendly Cities, a Guide.” World Health Organization. 5 “Federal Law 42 U.S Code § 139m-1.” US Government Publishing Office. 6 “What We Do.” National Center On Elder Abuse. 7 “Elder Justice Act.” Oklahoma Department of Human Services. Preparing for an Aging Population — State of California The State of California appears to be actively supporting elders through state laws, initiatives and agencies with the assistance of nonprofits. California Commission on Aging The California Commission on Aging serves as the state’s principal advocate for older adults. Its primary purpose is to advance issues fundamental to ensuring healthy, purposeful and dignified longevity for all Californians. The Commission on Aging advises the state’s Governor and Legislature, along with federal, state, and local agencies, on programs and services that affect older adults. Additionally, the Commission works closely with public, nonprofit, and private-sector institutions to address emerging challenges and opportunities. Established in 1973 by a California government mandate and confirmed in the Older Californians Act, the Commission is comprised of 23 volunteer commissioners (a majority of whom are over 60 years old) representing diverse fields related to aging. Commissioners serve three-year terms and are appointed by the Governor, the Speaker of the Assembly, or by the Senate Rules Committee.8 California Department of Aging The California Department of Aging (CDA) administers programs that serve older adults. The Department contracts with the network of Area Agencies on Aging, which directly manages a wide array of federal-and state-funded services that help older adults find employment, support older and disabled individuals to live as independently as possible in the community, promote healthy aging and community involvement, and assist family members in their vital caregiving role. Elder Abuse In California, elders are defined as persons 65 years and older. Under California law, elder abuse can be both criminal and civil. As far back as 2002 the California Department of Justice partnered with AARP to develop a guide to preventing and reporting elder abuse.9 8 “Your Advocate.” California Commission on Aging. 9 “A Citizen's Guide to Preventing and Reporting Elder Abuse.” California Department of Justice. Preparing for an Aging Population — Marin County Year of the Older Adult In January, the Marin County Board of Supervisors proclaimed 2018 as the “Year of the Older Adult.” The stated goals of this project are to: ■ Promote Marin as a great place to age. ■ Bring all ages together to understand and celebrate the social, cultural, and economic contributions of Marin’s older adults. ■ Raise community awareness of ageism affecting the opportunities that an older population brings to Marin. ■ Align and showcase collaborations between and among neighbors, businesses, government, education, and community organizations to expand opportunities for older adults. ■ Identify new strategies, programs, and resources to support and address the needs of Marin’s older population.10 The Board of Supervisors has published a 2018 calendar of events that will take place at least monthly to bring attention to these goals. Age-Friendly Communities AARP has an initiative affiliated with WHO with the same objective of identifying age-friendly communities. Marin County has an age-friendly planning committee aimed at guiding cities and towns through the process. Currently, five communities in Marin have received the Age-Friendly designation from both WHO and AARP: Sausalito (2013), Corte Madera (2015), Fairfax (2015), San Rafael (2017), and Novato (2017). Mill Valley, Larkspur, San Anselmo, Tiburon, and the district of Tam Valley are currently working toward this designation. 10 “Year of the Older Adult.” Marin County Board of Supervisors. Programs for Elders Provided by Nonprofits Homeward Bound Homeward Bound of Marin is the primary provider of Marin County homeless shelters and services for homeless families and individuals. Homeward Bound also has a program that is currently providing permanent supportive housing to 60 homeless seniors (62+) in Novato11 and eight in Mill Valley. Another program, which will serve an additional 11 homeless seniors, has passed the first stages of an approval process in Larkspur. The residents in the new program will be referred by the Marin Housing Authority from a list of seniors eligible for “housing choice”, also called Section 8, subsidies that allow them to pay 30% of their income in rent.12 Marin Villages The “Village” concept, born in Boston in 2001, is designed to give elders the ability to continue living at home by providing basic services, such as transportation and assistance with home maintenance, as well as providing social, cultural, and educational opportunities in the community. In response to a 2007 Grand Jury Report on aging in Marin, Marin Villages was formed as a nonprofit umbrella for individual “Villages” in the County. Currently, Homestead Valley, Mill Valley, San Rafael, Novato, Ross Valley, Tiburon Peninsula, and Twin Cities participate in Marin Villages, and Sausalito Village operates independently.13 Members pay a modest annual fee and can request services as needed. Volunteers are vetted and sign up for services they would like to provide. An efficient online dashboard coordinates requests with volunteers. Many participants are both members and volunteers who can provide and receive services. “Villages” are growing and changing with the needs of the community and are a vital part of the age-friendly movement. 11 “Warner Creek Senior Housing.” Eden Housing. 12 “Larkspur Partnership Offers Senior Housing.” Homeward Bound of Marin. 13 “Welcome to Marin Villages.” Marin Villages. Whistlestop “Founded in 1954 as Marin Senior Coordinating Council, Whistlestop promotes the independence, well-being and quality of life for older adults and people living with disabilities in Marin County. Whistlestop’s Active Aging Center provides nutritious meals, educational classes, multicultural gatherings and helpful information and referral services. Whistlestop also provides special needs transportation services through Marin Access, a partnership of Whistlestop, Marin Transit and Golden Gate Transit.”14 Senior Access Senior Access provides day activity programs for elders with memory loss that benefit both the elder and the family members who care for them. Their services include: an adult day program with therapeutic exercise, art and other activities; memory screenings; and day excursions for those with early-stage memory loss. It also provides respite, support groups, and educational workshops for family caregivers.15 Alzheimer’s Association The Alzheimer’s Association of Northern California and Northern Nevada has an office in San Rafael that provides information, education, and support groups for people with dementia, their families and caregivers. The 24/7 helpline can match the needs of dementia sufferers with various services meant to smooth the way. The Alzheimer’s Association also has a training program for professionals who work with people with dementia.16 Services for Elders Provided by the County of Marin Marin Aging and Adult Services, a division of Health and Human Services (HHS), provides an information telephone line (415-457-4636) that is answered by a person (not a recording) who can direct elders to appropriate services throughout the County. Someone is always available during regular business hours.17 Area Agency on Aging (AAA) is set up to administer federal dollars that come to the County for elder services. Most of these funds are contracted out to nonprofits in the community. The AAA is the leading administrator and funder of services for persons over 60 and family caregivers in Marin County.18 Adult Protective Services (APS) provides an array of services for elders that will be discussed later under the topic of elder abuse. 14 “Welcome to Whistlestop.” whistlestop.org. 15 “Senior Access.” senioraccess.org. 16 “Alzheimer’s Association.” alz.org. 17 “Aging and Adult Services.” Marin Health & Human Services. 18 “Area Agency on Aging.” Marin Health & Human Services. First Responders Marin’s law enforcement and fire departments’ training goes beyond minimum requirements for
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Findings & Recommendations
10 findings
F1:
Marin County has a large number of sanitary districts.
F2:
Independent sanitary districts are accountable only to district voters.
F3:
The public is not greatly involved in local sanitary district governance.
F4:
The public is not well informed about funding schemes or governance of sanitary districts.
F5:
Marin County’s current system of sanitary districts is not cost-efficient.
Related Recommendations (3)
R1:
Marin LAFCO should complete the planned reorganization of Murray Park Sewer Maintenance District and San Quentin Village Sewer Maintenance District with Ross Valley Sanitary District.
R2:
Central Marin Sanitation Agency (JPA), Sanitary District #1 (Ross Valley), Sanitary District #2 (Corte Madera), and the San Rafael Sanitary District should reorganize into a single sanitary/sanitation district. Each entity should complete a reorganization application with Marin LAFCO by 9/30/2018 and announce this action on the agenda of the next board meeting for public involvement.
R3:
Sewerage Agency of Southern Marin (JPA), Almonte Sanitary District, Alto Sanitary District, Richardson Bay Sanitary District, Homestead Valley Sanitary District, Public Works Department of the City of Mill Valley, and Tamalpais Community Services District should reorganize into a single sanitary/sanitation district. Each entity should initiate a reorganization application with Marin LAFCO and announce this action on the agenda of the next board meeting for public involvement.
F6:
Consolidation of sanitary districts in Marin has been recommended multiple times by governmental and non-governmental agencies.
F7:
Well-executed consolidations of sanitary districts will reduce administrative and operating costs.
Related Recommendations (3)
R1:
Marin LAFCO should complete the planned reorganization of Murray Park Sewer Maintenance District and San Quentin Village Sewer Maintenance District with Ross Valley Sanitary District.
R2:
Central Marin Sanitation Agency (JPA), Sanitary District #1 (Ross Valley), Sanitary District #2 (Corte Madera), and the San Rafael Sanitary District should reorganize into a single sanitary/sanitation district. Each entity should complete a reorganization application with Marin LAFCO by 9/30/2018 and announce this action on the agenda of the next board meeting for public involvement.
R3:
Sewerage Agency of Southern Marin (JPA), Almonte Sanitary District, Alto Sanitary District, Richardson Bay Sanitary District, Homestead Valley Sanitary District, Public Works Department of the City of Mill Valley, and Tamalpais Community Services District should reorganize into a single sanitary/sanitation district. Each entity should initiate a reorganization application with Marin LAFCO and announce this action on the agenda of the next board meeting for public involvement.
F8:
Well-executed consolidations of sanitary districts will improve service.
Related Recommendations (3)
R1:
Marin LAFCO should complete the planned reorganization of Murray Park Sewer Maintenance District and San Quentin Village Sewer Maintenance District with Ross Valley Sanitary District.
R2:
Central Marin Sanitation Agency (JPA), Sanitary District #1 (Ross Valley), Sanitary District #2 (Corte Madera), and the San Rafael Sanitary District should reorganize into a single sanitary/sanitation district. Each entity should complete a reorganization application with Marin LAFCO by 9/30/2018 and announce this action on the agenda of the next board meeting for public involvement.
R3:
Sewerage Agency of Southern Marin (JPA), Almonte Sanitary District, Alto Sanitary District, Richardson Bay Sanitary District, Homestead Valley Sanitary District, Public Works Department of the City of Mill Valley, and Tamalpais Community Services District should reorganize into a single sanitary/sanitation district. Each entity should initiate a reorganization application with Marin LAFCO and announce this action on the agenda of the next board meeting for public involvement.
F9:
Sanitation districts need to prepare for sea level rise.
F10:
Marin LAFCO is underfunded and understaffed.
Related Recommendations (1)
R4:
The County of Marin should allocate additional funds to Marin LAFCO.
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Findings & Recommendations
5 findings
F1:
No consistent concussion protocol is used across the County.
Related Recommendations (1)
R1:
The Marin County Office of Education should provide state-of-the-art head injury protocols and make them available for use at all schools.
F2:
Policies for testing for concussion are applied inconsistently across the County.
Related Recommendations (1)
R2:
School districts should provide head injury data to the Marin County Office of Education.
F3:
Return-to-Play and Return-to-Learn protocols are available to all student athletes.
Related Recommendations (1)
R3:
The Marin County Office of Education should maintain a database of head injuries provided by the school districts.
F4:
Lack of available head injury data at the schools prevents analysis of the effectiveness of current head injury practices and procedures.
Related Recommendations (1)
R4:
Novato School District should require mandatory annual neurocognitive testing of all high school athletes in high-risk sports and mandatory post-injury testing.
F5:
Not all school districts have added the costs of post-injury neurocognitive testing to their budgets.
Related Recommendations (1)
R5:
Tamalpais Union School District should require mandatory annual neurocognitive testing of all high school athletes and mandatory post-injury testing.
Additional Recommendations
5
Not linked to specific findings.
R6:
Novato School District should add the cost of neurocognitive testing to their annual budget.
R7:
Tamalpais Union School District should add the cost of neurocognitive testing to their annual budget.
R8:
A certified athletic trainer should be present at all high-risk sporting events.
R9:
Novato School District should provide mandatory concussion education for student athletes and parents.
R10:
Tamalpais Union School District should provide mandatory concussion education for student athletes and parents.
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Findings & Recommendations
3 findings
F1:
Lack of full compliance by the Sheriff and the Board of Supervisors with the
Related Recommendations (1)
R1:
The Marin County Jail, together with the Board of Supervisors and the Department of Health and Human Services, should ensure that mentally ill inmates are not kept in a safety cell longer than 24 consecutive hours unless the Jail psychiatrist certifies that no other remedy is available to prevent the inmate from harming themselves or others.
F2:
Lack of full compliance by the Sheriff and the Board of Supervisors with the
Related Recommendations (1)
R2:
Safety cells should never be used for mentally ill inmates as a substitute for adequate medication and/or other psychiatric treatment.
F3:
HHS is not timely updating the HHS Detention Medical and Mental Health Services Marin County Jail Policy and Procedures Manual.
Related Recommendations (1)
R3:
Any inmate placed in a safety cell should be evaluated by mental health staff within four hours for the appropriateness of the placement and the evaluation of possible alternative placements.
Additional Recommendations
10
Not linked to specific findings.
R4:
The Board of Supervisors should, within 6 months, establish or contract with a local facility where sentenced inmates can receive involuntary administration of psychiatric medication.
R5:
As provided in the joint settlement agreement regarding the Los Angeles County Jails, the Marin County Jail should identify and adopt, within 6 months, policies that ensure mentally ill inmates are provided with 10 hours of unstructured out-of-cell time as well as 10 hours of structured therapeutic or programmatic time per week.
R6:
The Marin County Jail, together with the Board of Supervisors and the Department of Health and Human Services, should ensure that a psychiatrist be available at the Jail 8 hours per day, 5 days per week, and be available by telephone 24 hours per day, 7 days per week.
R7:
The Marin County Jail, together with the Board of Supervisors and the Department of Health and Human Services, should ensure that a Mental Health Crisis Specialist or a psychiatric nurse be available at the Jail 24 hours per day, 7 days per week.
R8:
The Marin County Jail, together with the Board of Supervisors and the Department of Health and Human Services, should immediately institute programs to provide appropriate professional (non-pharmacological) mental health therapy to all mentally ill inmates, particularly those incarcerated for longer than 7 days.
R9:
The Marin County Jail, together with the Board of Supervisors and the Department of Health and Human Services, should ensure that classification of inmates as mentally ill be reviewed by a member of the mental health staff within four hours of booking.
R10:
All policies and procedures in the Sheriff’s Manual related to the care of inmates should be reviewed and updated within the next 6 months. As required by law, they should be reviewed and updated biennially thereafter. An immediate review should take place whenever code changes are made.
R11:
The County should provide adequate funding to implement these recommendations.
R12:
The Jail should inform HHS of procedural changes that affect HHS policies and procedures in the Jail.
R13:
The County should provide adequate funding to implement these recommendations. Sheriff’s response: The Sheriff was not required to respond to this recommendation. Board of Supervisors’ response: “This recommendation requires further analysis. The County spends approximately $1.3 million annually to provide adequate behavioral health consistent with state and federal health and safety standards. In addition, the County spends additional state realignment funds to provide transitional services to inmates, including those inmates with mental health needs. Over the next few months, we will be considering proposals to enhance mental health services and potential funding sources. As part of the Stepping Up initiative the Board of Supervisors has asked HHS to bring recommendations for expanding services. These proposals are being developed and will be brought to the Board for funding consideration.” Analysis: As discussed in relation to other recommendations above, the courts have repeatedly found that a failure to provide adequate mental health care cannot be excused by a lack of facilities, personnel or funding.