Score: +37
(39/7/2)
Sonoma County Grand Jury
• 2018-2019
Sonoma County Civil Grand Jury 2018-2019 Final Report
⚠️ Translation Notice: This content has been automatically translated. The original English text is the official version. Translation may contain errors.
⚠️ Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.
Findings 14 findings
F1
Sonoma County relies primarily on the Russian River for drinking water which may be disrupted in the event of a major earthquake.
F2
Sonoma County relies primarily on a single wholesale provider for its water. Sonoma Water, which delivers water under contract to cities and water districts in Sonoma County and northern Marin County, may be without sufficient resources to meet all emergency needs.
F3
In the event of a major earthquake, water supplies are likely to be significantly disrupted for extended periods of days or weeks, although reduced water supplies may be provided through alternative means. Full recovery of systems could take longer.
F4
Measures implemented by Sonoma Water to reduce the risk of critical water shortages following a major earthquake have relied heavily upon state and federal grant funds, but implementation has fallen behind the schedules proposed in the LHMP. A more rapid reduction of risks could be achieved through water rate adjustments.
F5
Consistent with FEMA recommendations, residents need to maintain their own emergency source of water to meet their personal needs for more than the three days frequently stated by officials.
F6
More public outreach is needed to educate water users to their risks and individual responsibility for earthquake preparedness.
F7
Coordination between Sonoma Water and its contractors needs to improve by increasing training exercises, mutual aid training, and systems information exchange.
F8
Because operating pressures must be maintained throughout the system, water contractors have limited ability to curtail non-essential water uses without compromising availability of water for critical applications such as fire suppression and hospital use.
F9
Sonoma Water’s planning for earthquake response, supplies, repairs, and restoration of water depends significantly on institutional repair knowledge concentrated in a few long- term employees, but lacks adequate documentation such as manuals for standard operating procedures.
F10
Sonoma Water’s estimate of three days to return to service following an earthquake is conditional on the availability of suitable repair parts, aqueduct pipe, joints, pumps and valves. The Grand Jury found the inventory of emergency supplies is sparse and the inventory list is incomplete and out-of-date. 18
F11
Sonoma Water and its water contractors maintain a well-designed system and have made significant progress in mitigating earthquake risks. Ongoing efforts are needed to reduce remaining risks.
F12
Auditing procedures designed to detect incorrect revenue information were not evident.
F13
Capital assets that suffer from significant accumulations of deferred maintenance may be impaired assets for accounting purposes.
F14
The Board of Supervisors has not been able to fully implement the Capital Improvement Plan due to appropriation of funding to other departments.
Recommendations 11
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R1Sonoma Water review and establish viable options for accelerating how rapidly the highest-priority mitigation measures are being funded and implemented by December 31, 2019. [F3, F4]
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R2Sonoma Water maintain inventory lists with current goals for items, quantities, locations, and sourcing; and improve stockpiling accordingly by December 31, 2019. [F10]
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R3Sonoma Water and water contractors derive and publicize more realistic outage periods and provide updated information to the public by December 31, 2019. [F5, F6]
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R4Sonoma Water improve coordination with water contractors, including field exercises by December 31, 2019. [F7]
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R5Water contractors study options for making local systems more adaptable under emergency conditions - such as dedicated supply loops, digitally monitored metering, or automatic shut-down valves, by December 31, 2019. [F8]
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R6Sonoma Water prepare and maintain one or more SOPs (Standard Operating Procedures) for the restoration of water deliveries specifically for an earthquake; SOPs should be updated annually or whenever there are changes to procedures, by December 31, 2019. [F9]
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R7DHS hire a CFO who is experienced in government finance and systems. [F7, F12]
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R8The County Auditor’s Office institute procedures for verifying actual revenue figures, rather than verifying that projected budgets balance, by Dec. 31, 2019. [F12]
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R9The Compliance Program be adequately funded and supported, by Dec. 31, 2019. [F5]
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R10We recommend the BOS review its budget oversight responsibilities by Dec. 31, 2019 [F3,
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R51-41YF several projects had already been completed. To date, Sonoma Water has completed more than 32 projects ranging in cost from $71,000 to 12.7 million dollars. Some of the completed projects include: providing 14 isolation valves to over 90 miles of transmission pipeline for seismic mitigation implementing Mirabel site seismic improvements mitigating Santa Rosa Aqueduct seismic hazards over Rogers Creek Fault Crossing procuring large diameter flexible hose to deploy for emergency use procuring stockpile material for use in emergency developing a dedicated Emergency Operations Center installing additional UPS (uninterrupted power supply) units at each facility to prolong communications. The total cost for the 32 projects was greater than 63.28 million dollars; additional projects are in progress at this time. Hazard Risks and Water Shortage Sonoma Water estimates that after a 7.0+ Water Sources: earthquake, potential damages to aqueducts and/or On average, Sonoma Water supplies 90- pumping stations would be restored within three 95% of the water required by the nine days. Sonoma Water projects it has a day and a contracting cities and local water agencies; half of stored water available during the repair the rest of the water, supplied from local period. The contracting cities have similar water wells, is not sufficient to sustain full flow storage and well capacity to cover needs during needs. repairs. Three days is an optimistic estimate. Other factors and experience point to more extended water outages. Sonoma Water recently estimated that if emergency repairs to their River Diversion System (RDS) were needed, the restoration could take 2-3 Russian River Other weeks. According to FEMA, “People have been encouraged to maintain an emergency supply of water. This has been widely interpreted as a recommendation to keep a three –day supply of water on hand. However, after a major earthquake that probably will not be enough. FEMA is recommending that you have enough water for each member of your family, to meet their needs for two weeks.” Emergency relations officers within the county recommend that every household keep enough water for a week, and even that amount might not be enough. The East Bay MUD projects repair estimates of 1-2 weeks, and a significant period of water shortage. Estimates from the Los 14 Angeles basin noted that it might take months to complete repairs to their three main aqueducts. They added that that shortfall could become a major issue for potable water, reduction of fire protection and sanitation operations with public health consequences. In 2015, Southern California’s Shakeout 2 Scenario, an earthquake practice drill, showed a “significant vulnerability in the conveyance system where pipes and other components cross or are located close to the San Andreas Fault. Major damage to the water system could leave the most affected areas without running water for up to 6 months.” Sonoma Water’s optimistic estimate of three days is conditional on the availability of suitable repair parts, aqueduct pipe, joints, pumps and valves. The Grand Jury has surveyed the supply of repair parts around the aqueduct and found the inventory of emergency supplies is sparse and the inventory list is incomplete and out-of-date. The 2018 California State Hazard Mitigation Plan noted that “based on the most recent earthquake forecast model for California, the USGS and other scientists estimate a 72% probability that at least one earthquake of magnitude 6.7 or greater, capable of causing widespread damage, will strike the San Francisco Bay Area before 2044.” While damage from an earthquake varies considerably from one scenario to another, people need to maintain personal emergency water supplies for substantially more than 3 days. “Despite the County efforts to reduce risks, no amount of planning or mitigation can prevent disasters from occurring or eliminate the risks of such events all together. The County’s actions may help to reduce the risks and impacts these hazards pose to life, property and the economy. While the Hazard Mitigation Plan seeks to identify opportunities for reasonable mitigation actions, each individual has a responsibility to be aware of the potential hazards where they live and to minimize their own household’s vulnerability.” (Sonoma County Hazard Mitigation Plan, October 2016) Emergency Policies, Systems, and Program Weaknesses In the event of an emergency, Sonoma Water activates an Emergency Operations Center (EOC) subordinate to the Sonoma County EOC. Sonoma Water serves the interests of citizens, drawing water from about 60 small, independent water systems scattered throughout the County. Sonoma Water EOC maintains contact with its operations through a Supervisory Control and Data Acquisition (SCADA), with the ability to dispatch corrective action if the water supply is disrupted. Procuring a mobile operations center with full SCADA capabilities is listed on the 2018 mitigation action sheet, but has not been implemented. Improvements in the SCADA system have been discussed but not implemented. The ability of Sonoma Water and any utility to respond to failures depends on the rapid availability of qualified repair personnel, either on-staff or from mutual aid support. To be successful, advanced training and coordination is necessary. For several years Sonoma Water has been working on their Emergency Plans, and completed the Continuity of Operations Plan (COOP) in June 2018. The COOP is a plan to continue essential governmental functions across a wide range of emergencies. The Emergency Response Plan has been replaced by the Sonoma Water Emergency Operations Plan, completed in 2017. Water Agency Contractors’ Emergency Actions The Civil Grand Jury researched two cities to inform the public regarding the emergency response on the part of a sample of city water contractors, one with a large population and one with a smaller population. City of Santa Rosa The City has developed their own LHMP, Emergency Operations Plan Annex, and Urban Water Management Plan. Santa Rosa takes delivery from Sonoma Water at 60 psi (pounds per square inch). The water transmission system operates within zones and sectionalizing valves to permit failure isolation. If needed, a City well on Farmers Lane and Sonoma Avenue could provide water. The main water line down Sonoma Avenue was installed with flex couplings to allow for movement during earthquakes. Restoration of water deliveries in Santa Rosa after an earthquake requires operating personnel to drive along the major pipelines, identify failures and fix them, or call a team for repairs. The Santa Rosa Water Department Operations Center (DOC), and The City of Santa Rosa Emergency Operations Center locate and acquire additional resources as necessary. Water emergencies might be addressed by third party contractors to import water or obtain bottled water, and then distribute the water through point of dispensing centers (PODs). Health and safety, as well as fire protection are prioritized. Santa Rosa water workers (cross trained and certified in water and wastewater operations) are on mandated duty during emergencies. Most of the City workers live locally, with some living as far away as Ukiah. The standard work mode is for a two-person field crew team to follow water supply routes and report leaks to the DOC/EOC. At the DOC/EOC, the operations are logged on in conjunction with Geographic Information System (GIS) displays and hard copy map books. The City of Santa Rosa Water and Wastewater group conducted earthquake drills from 1984 onward, believing earthquakes posed the most extreme risk. Those drills helped with the fires of October 2017, even though the drills were for an earthquake. In the past, none of the simulation drills were jointly done with Sonoma Water. The Santa Rosa Emergency Operations Plan lacks coordination with the other water contractors. In Santa Rosa, if there were a sustained water shortage following an earthquake, people would be urged to shelter in place if possible, or relocate to one of the emergency centers such as Finley Park or a Place to Play, where tent camping might be an option. Back-up water delivery modes for Santa Rosa City include POD hose taps, milk trucks, bottled water, private wells, and additional wells for use during emergencies. Santa Rosa Water has had no cross training with other organizations, although it does anticipate mutual aid through the California Master Mutual Aid Agreement. The City of Santa Rosa participates in Sonoma Water’s Water Advisory Committee (WAC) and Technical Advisory Committee (TAC) meetings with other contractors to share information. City of Sonoma Water supplies in the City of Sonoma rely on Sonoma Water, supplemented by city wells especially during peak periods, drought, and emergencies. The City’s water operations could get by for about two weeks if cut off entirely from Sonoma Water. They would rely on conservation, rationing, city well water, and whatever water remained in the city water tanks. This may require a work-around of any break in the line, using what is available, including hoses. Data from the City’s water management plan suggests there is an expectation that consumers could get by on a 15-20% reduction of normal water flows for a limited time. The City has backup materials on hand in their corporate yards for emergency repairs. The water supply line diameters are smaller than the Sonoma Water aqueduct. The smaller diameter pipes are more readily available. The water supply depends on electricity for pumping capacity, so the City of Sonoma has back-up emergency generators if needed. The City of Sonoma has no LHMP, but is considering other funding options. They have an updated EOP available on-line. The City is seeking a contract with a consulting engineering firm to conduct a risk assessment based on an emergency involving water. The City does outreach to their customers through their web site under Emergency Preparedness. The City of Sonoma participates in mutual aid contracts under the California Master Mutual Aid Agreement developed under the California Emergency Services Act. The City of Sonoma, along with the other eight contractors, participates with Sonoma Water’s WAC and TAC advisory committees. Sonoma Water System - Actions during an Emergency Sonoma Water has a direct-to-consumer public information program aimed at water conservation, and is proud that their efforts have reduced average per-capita water consumption. In the absence of a similar campaign to bolster earthquake awareness and preparation, that responsibility is currently assumed unevenly by the retailing contractors/utilities. Sonoma Water holds periodic coordination meetings with the nine water contractors, through the WAC and TAC committees. Sonoma Water does not conduct joint emergency training sessions with these contractors, but may contact them for help if needed. Sonoma Water has larger diameter transmission pipes that the water retailers, and skilled personnel versed in handling them. Due to the larger diameter pipeline sizes, Sonoma Water staff would be the most available and best qualified to take care of most issues. Joint exercises would provide specialized training to the nine water contractors. Emergency preparations include stockpiling spare pipe and valves at scattered corporate yards, including those at Wohler Bridge and Mirabel. Sonoma Water relies on good vendor relations to fill emergency needs if their inventory is not already on hand. Portable, flexible 12” hose line is available to bypass water outages. Problems with collector wells could create a special issue needing expert help from outside of Sonoma Water. In addition to seismic events, the Local Hazard Mitigation Plan continues to address floods, droughts, wildfires, and sea-level changes - all exacerbated by climate change. Throughout this investigation, the Civil Grand Jury has been impressed with the expertise, education and dedication of the staff at Sonoma Water and its contractors. FINDINGS F1. Sonoma County relies primarily on the Russian River for drinking water which may be disrupted in the event of a major earthquake. F2. Sonoma County relies primarily on a single wholesale provider for its water. Sonoma Water, which delivers water under contract to cities and water districts in Sonoma County and northern Marin County, may be without sufficient resources to meet all emergency needs. F3. In the event of a major earthquake, water supplies are likely to be significantly disrupted for extended periods of days or weeks, although reduced water supplies may be provided through alternative means. Full recovery of systems could take longer. F4. Measures implemented by Sonoma Water to reduce the risk of critical water shortages following a major earthquake have relied heavily upon state and federal grant funds, but implementation has fallen behind the schedules proposed in the LHMP. A more rapid reduction of risks could be achieved through water rate adjustments. F5. Consistent with FEMA recommendations, residents need to maintain their own emergency source of water to meet their personal needs for more than the three days frequently stated by officials. F6. More public outreach is needed to educate water users to their risks and individual responsibility for earthquake preparedness. F7. Coordination between Sonoma Water and its contractors needs to improve by increasing training exercises, mutual aid training, and systems information exchange. F8. Because operating pressures must be maintained throughout the system, water contractors have limited ability to curtail non-essential water uses without compromising availability of water for critical applications such as fire suppression and hospital use. F9. Sonoma Water’s planning for earthquake response, supplies, repairs, and restoration of water depends significantly on institutional repair knowledge concentrated in a few long- term employees, but lacks adequate documentation such as manuals for standard operating procedures. F10. Sonoma Water’s estimate of three days to return to service following an earthquake is conditional on the availability of suitable repair parts, aqueduct pipe, joints, pumps and valves. The Grand Jury found the inventory of emergency supplies is sparse and the inventory list is incomplete and out-of-date. F11. Sonoma Water and its water contractors maintain a well-designed system and have made significant progress in mitigating earthquake risks. Ongoing efforts are needed to reduce remaining risks. RECOMMENDATIONS The Sonoma County Civil Grand Jury recommends that: R1. Sonoma Water review and establish viable options for accelerating how rapidly the highest-priority mitigation measures are being funded and implemented by December 31, 2019. [F3, F4] R2. Sonoma Water maintain inventory lists with current goals for items, quantities, locations, and sourcing; and improve stockpiling accordingly by December 31, 2019. [F10] R3. Sonoma Water and water contractors derive and publicize more realistic outage periods and provide updated information to the public by December 31, 2019. [F5, F6] R4. Sonoma Water improve coordination with water contractors, including field exercises by December 31, 2019. [F7] R5. Water contractors study options for making local systems more adaptable under emergency conditions - such as dedicated supply loops, digitally monitored metering, or automatic shut-down valves, by December 31, 2019. [F8] R6. Sonoma Water prepare and maintain one or more SOPs (Standard Operating Procedures) for the restoration of water deliveries specifically for an earthquake; SOPs should be updated annually or whenever there are changes to procedures, by December 31, 2019. [F9] REQUIRED RESPONSES Pursuant to Penal Code sections 933 and 933.05, the Grand Jury requires responses as follows: Sonoma Water [R1, R2, R3, R4, R6] Water Contractors: Santa Rosa, Rohnert Park, Cotati, Petaluma, Sonoma, Windsor, Valley of the Moon Water District, Marin Municipal Water District, and North Marin Water District [R5] GGLLOOSSSSAARRYY AABBAAGG – Assoc iation o f Bay AArsesaoGcioavtieornn mofe Bntasy Area Governments CCAALL--OOEESS –Ca lifornia OfficeC oafl iEfomrenriga eOncffiyc See orvf iEcmesergency Services DDOOCC – Departm ent Op erationDs Cepeanrttemrent Operations Center EEOOCC – Emerge ncyOp erationsE Cmeenrtgeern, c y Operations Center, EEOOPP -E mergen cy Oper ations PElmanergency Operations Plan FFEEMMAA –Feder al Emer gency MFeadneargael mEemnet rAgegnecnyc yManagement Agency LLHHMMPP – Local Hazard MitigaLtioocna Pl lHanazard Mitigation Plan 19 PG&E Pacific Gas and Electric POD Point of Dispensing site, for water SCWA Sonoma County Water Agency/ Sonoma Water/SW SCADA Supervisory Control and Data Acquisition SOP Standard Operating Procedure TAC Sonoma Water’s Technical Advisory Board USGS United States Geological Survey WAC Sonoma Water’s Water Advisory Board BIBLIOGRAPHY Water and Earthquake “Best Management Practices Framework in California.” California Department Water Resources. 10/2016. “Biological Opinion.” Environmental Species Act. September 2008. “Federal Grant for Water System Disaster Preparedness.” Sonoma County Gazette. 12/17/18. FEMA emergency water recommendations: https://www.fema.gov/txt/library/f&web.tx “Final Memorandum of Understanding Regarding Water Transmission System Capacity Allocation during a Temporary Impairment.” SCWA and Distributors. 10/16/06. “Global Risks 2018: Fractures, Fears and Failures.” The Global Risks Report. 2018 “New Map of Rodgers Creek Fault in Sonoma County, California.” USGS. 7/2018. “Practical Lessons from Loma Prieta Earthquake – 1994.” National Academies Press. 10766 “Proposal for Emergency Water Supply Memo.” GHD report. 11/5/18. Number 11177640. “Reassessing the Effectiveness of All-Hazards Planning.” Inquiries. 2015. “Restructured Agreement for Water Supply.” SCWA and Distributors. 6/23/06. “Rodgers Creek and Hayward Faults are revealed to be one Fault, capable of a Magnitude – 7.4 Earthquake.” Science Advances. Temblor. 1/6/2017. “Scientists Discover Sonoma County Earthquake Fault connected to Hayward Fault.” Press Democrat. Net. 2/21/2018. “Sonoma County Hazard Mitigation Plan.” SCHMP. Chapter 1. 2016. “Sonoma County Hazard Mitigation Plan.” SCHMP. Seismic Hazards. 2017. “Sonoma County Operational Area – Emergency Operations Plan.” Threat Summary and Assessments. October 2014. “Southern California Water Supplies Vulnerable to big Earthquake.” UC Regents. Chakrabarty. 2016. State of California Multi-Hazard Mitigation Plan 2018. CA Governor’s Office of Emergency Services. 4/2018. Sonoma County Water District SCWA Current Budget, FY 2018-2019, SCWA – Emergency Operations Plan, Earthquake plan. Doc.159969. Wyatt. 2017. SCWA Emergency Operations Plan, Earthquake Plan. Doc 159969. Wyatt. 2017 SCWA Frequently Asked Questions, sonomawater.org SCWA Local Hazard Mitigation Plan. 2018 SCWA Russian River System, July 2001 SCWA 10 year Summary of Planned Water Supply and Reliability Projects, 2012- 2013. SCWA Urban Water Management Plan 2015. 2016. SCWA Water Billing History, 1995-2019 City of Santa Rosa and City of Sonoma “Capital Improvement Projects List.” City of Santa Rosa. “City of Santa Rosa 2017 Local Hazard Mitigation Plan” “Emergency Operations Plan.” City of Sonoma. November 2015 “Emergency Operations Plan.” Part II: Hazard Annexes Earthquake. City of Santa Rosa. 6/2017 “2015 Urban Water Management Plan.” City of Santa Rosa. 2015 The Jailhouse Rocks Main Adult Detention Facility Inspection May 7, 2019 SUMMARY Our jail has changed. It is no longer a short-term holding facility for people awaiting trial and those serving sentences of one year or less. Due primarily to the Public Safety Realignment Bill of 2011, the average length of detention in our jail dramatically increased from days to years. Longer incarceration times have resulted in inmates who are likely to be older, sicker, and/or more mentally disturbed. In addition, the increase in the homeless population generally has resulted in an increase in the number of homeless within our jails. Just as in the community at large, their social service needs are great. Some have described our federal government as “an insurance company with an army,” so too, our jail might now be called “a health clinic with guards.” The Sonoma County Civil Grand Jury wanted to know how our Sheriff and the Detention Division have responded to the increased social service challenges of medical, dental, and psychiatric care (including substance abuse treatment), as well as more extensive adult education. The Grand Jury discovered a mix of surprises, challenges, concerns, and reassurances in this complex entity. Our jail does a good job doing jobs a jail is not designed to do. The Main Adult Detention Facility (MADF) in Santa Rosa is competently managing the challenge of its growing role. The current provider (Wellpath) appears to be delivering medical, dental, mental health and substance abuse treatments at a level at least equal to those formerly provided by the county Department of Health Services. Dental care has improved. The Sheriff’s Office has shown commitment to education through the steady improvement in the range of courses and learning opportunities. A new approach to treating inmates incompetent to stand trial is yielding dramatic results. GLOSSARY CDCR California Department of Corrections and Rehabilitation CFMG California Forensic Medical Group GED General Education Development JBCR Jail-based Competency Restoration MADF Sonoma County Main Adult Detention Facility Cognitive Behavior Therapy (CBT): A talk therapy based on the assumption that a person's mood is directly related to his or her patterns of thought or behavior. Negative thinking affects a person's mood, sense of self, behavior, and even physical state. The goal of CBT is to help a person learn to recognize negative patterns of thought, evaluate their validity, and replace them with healthier ways of thinking. CBT is an effective treatment for depression, PTSD, and many anxiety disorders. Moral Reconation Therapy (MRT): A therapy similar to CBT developed specifically for an offender population. “Reconation” means an act of conscious decision making that includes the moral impact of 22 Moral Reconation Therapy (MRT): A therapy similar to CBT developed specifically for an offender population. “Reconation” means an act of conscious decision making that includes the moral impact of one’s choices. Unlike CBT, MRT seeks to change a person’s personality as it relates to moral development. Realignment: California’s Public Safety and Realignment Act (Penal Code Section 11709(h), 2011). This act mandates that counties, rather than state prisons, house felons who have never been convicted of serious, violent or sexual offenses (low-risk felons).
Conclusions 5
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CL1 Page 24Our jail does a good job doing jobs a jail is not designed to do. While the Grand Jury anticipated that the Detention Division would oversee MADF competently, we were pleased how well it appears to be meeting the challenges of its outsized role. The decrease in inmate complaints over the last two years, while not fully understood, may indirectly reflect how well the Sheriff’s Office is providing these additional medical and social services. Wellpath appears to be delivering medical, dental, mental health and substance abuse care at levels at least equal to those formerly provided by DHS. Several areas, most notably dental care and the Jail Based Competency Restoration program, show distinct improvements. The new dedicated mental health unit, projected for completion in 2020, will allow the jail to go further in providing specialized care to individuals who would struggle in a general correctional population. The Sheriff’s Office has shown commitment to education through the steady improvement in the range of courses and learning opportunities. The adoption of Five Keys, a provider that understands the unique challenges of the correctional environment, should further enhance opportunities. The Grand Jury was impressed with the professionalism and dedication of those working at the jails, both managerial as well as line staff. For example, when the dental clinic was closed for remodeling, the dentist and her assistant responded by creating a dental hygiene program which they taught to the inmates. Whether speaking with staff in their work areas, or formally interviewing managers, the Grand Jury found people were enthusiastic about sharing their accomplishments and forthcoming in identifying remaining challenges. They were, on the whole, positive and proud of their contributions to improving MADF. Many made clear their commitment to working in the detention environment. 30
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CL2 Page 33While most of the challenges identified in this report have been adequately met, some concerns were identified. Many sources told us that additional nurse hours dedicated to the booking area would significantly streamline the booking process during the evening and night shifts. Sonoma County Public Health desires a tighter working relationship with Wellpath to increase screenings for STDs (especially syphilis), to improve the hand-off process for inmates with reportable cases, and to initiate a comprehensive vaccination program. Wellpath’s practice of changing successful HIV/AIDs medication regimens on admission is problematic. Two outside sources asserted that changing the drug protocols of HIV/AIDS patients on admission was driven by cost containment at the expense of therapeutic considerations. The jail’s current practice of routinely stopping all support medication for opioid addicts should be examined. This practice was questioned by at least two sources and deserves reassessment. Wellpath’s reliance on Moral Reconation Therapy as the core of its therapy and substance abuse treatment is perhaps outdated. A few outside sources told us that Cognitive Behavior Therapy is more effective and addresses a wider range of therapeutic goals.
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CL3 Page 40Behavioral Health Division has a history of annual budget shortfalls. Starting with Fiscal Year (FY) 14/15 the budget deficit was $8.09 million, FY 15/16 was $5.0 million, FY 16/17 was 39
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CL4 Page 41$11.0 million and FY 17/18 was $10 million. Current estimates for FY 19/20 indicate an approx- imate 8.5 million dollar shortfall. In earlier years, the shortfall was mitigated by revenue from fund balances. In FY 17-18, fund balances were insufficient to meet revenue shortfalls. The Civil Grand Jury consistently and repeatedly requested fiscal policies and procedures within BHD. None were forthcoming. Leadership’s lack of knowledge and understanding of government finance systems contribut- ed to inaccurate forecasts of revenues and expenditures. Significant turnover in Fiscal Service employees in key positions, without replacing them with persons with equivalent knowledge, experience and training, contributed to lack of understanding of vital budget and accounting processes. Section and program managers were excluded from budget development, contribut- ing to inaccurate projections of service needs. This exclusion also led to the inability to control program expenditures. Professional communication was stifled by a culture of retribution and neglect which impacted the free flow of information. This led to an egregious lack of transparen- cy.
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CL5 Page 52The history and present moment of managing public property in Sonoma County has led to uncoordinated decisions and neglected assets. County administrators and employees have been stymied by economic realities, shifting state resources, a fragmented data system, catastrophic fires and floods. These public property issues are formidable and County administrators are tasked with difficult decisions. The Sonoma County Civil Grand Jury hopes that this report will assist county administrators and the public in understanding how we got here, where things stand presently, and create an interest and involvement in civic decisions regarding public property as we go forward.
Commendations 1
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CM1 Page 41The Grand Jury commends the Department of Health Services leadership in addressing the struc- tural problems of past budget development methods and instituting robust and timely changes to ensure that this process remains transparent, accurate and responsive to change. The new cash-based accounting system adopted by Sonoma County in FY 17-18 requires that revenue only be recorded when received. We acknowledge the employees of the BHD who work in a difficult situation and continue to provide quality services to the residents of Sonoma County.
Agency Responses 7
Government agencies' official responses to this report's findings and recommendations. Click on a response to see the structured breakdown.