Santa Clara County Grand Jury • 2001-2002

Review of County Emergency Psychiatric Services Introduction facility are limited to 24 hours or less

Published: December 05, 2001 7 pages
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Note: Missing finding numbers detected: F3, F4, F5, F7, F8, F9, F10, F11, F12, F13, F14, F15, F16, F17, F18, F19, F20, F21, F22, F23, F24, F25, F26, F27, F28, F29, F30, F31, F32, F33, F34, F35, F36, F37, F38, F39, F40, F41, F42, F43, F44, F45, F46, F47, F48, F49, F50, F51, F52, F53, F54, F55, F56, F57, F58, F59, F60, F61, F62, F63, F64, F65, F66, F67, F68, F69, F70, F71, F72, F73, F74, F75, F76, F77, F78, F79, F80, F81, F82, F83, F84, F85, F86, F87, F88, F89, F90, F91, F92, F93, F94, F95, F96, F97, F98, F99, F100, F101, F102, F103, F104, F105, F106, F107, F108, F109, F110, F111, F112, F113, F114, F115, F116, F117, F118, F119, F120, F121, F122, F123, F124, F125, F126, F127, F128, F129, F130, F131, F132, F133, F134, F135, F136, F137, F138, F139, F140, F141, F142, F143, F144, F145, F146, F147, F148, F149, F150, F151, F152, F153, F154, F155, F156, F157, F158, F159, F160, F161, F162, F163, F164, F165, F166, F167, F168, F169, F170, F171, F172, F173, F174, F175, F176, F177, F178, F179, F180, F181, F182, F183, F184, F185, F186, F187, F188, F189, F190, F191, F192, F193, F194, F195, F196, F197, F198, F199, F200, F201, F202, F203, F204, F205, F206, F207, F208, F209, F210, F211, F212, F213, F214, F215, F216, F217, F218, F219, F220, F221, F222, F223, F224, F225, F226, F227, F228, F229, F230, F231, F232, F233, F234, F235, F236, F237, F238, F239, F240, F241, F242, F243, F244, F245, F246, F247, F248, F249, F250, F251, F252, F253, F254, F255, F256, F257, F258, F259, F260, F261, F262, F263, F264, F265, F266, F267, F268, F269, F270, F271, F272, F273, F274, F275, F276, F277, F278, F279, F280, F281, F282, F283, F284, F285, F286, F287, F288, F289, F290, F291, F292, F293, F294, F295, F296, F297, F298, F299, F300, F301, F302, F303, F304, F305, F306, F307, F308, F309, F310, F311, F312, F313, F314, F315, F316, F317, F318, F319, F320, F321, F322, F323, F324, F325, F326, F327, F328, F329, F330, F331, F332, F333, F334, F335, F336, F337, F338, F339, F340, F341, F342, F343, F344, F345, F346, F347, F348, F349, F350, F351, F352, F353, F354, F355, F356, F357, F358, F359, F360, F361, F362, F363, F364, F365, F366, F367, F368, F369, F370, F371, F372, F373, F374, F375, F376, F377, F378, F379, F380, F381, F382, F383, F384, F385, F386, F387, F388, F389, F390, F391, F392, F393, F394, F395, F396, F397, F398, F399, F400, F401, F402, F403, F404, F405, F406, F407, F408, F409, F410, F411, F412, F413, F414, F415, F416, F417, F418, F419, F420, F421, F422, F423, F424, F425, F426, F427, F428, F429, F430, F431, F432, F433, F434, F435, F436, F437, F438, F439, F440, F441, F442, F443, F444, F445, F446, F447, F448, F449, F450, F451, F452, F453, F454, F455, F456, F457, F458, F459, F460, F461, F462, F463, F464, F465, F466, F467, F468, F469, F470, F471, F472, F473, F474, F475, F476, F477, F478, F479, F480, F481, F482, F483, F484, F485, F486, F487, F488, F489, F490, F491, F492, F493, F494, F495, F496, F497, F498, F499, F500, F501, F502, F503, F504, F505, F506, F507, F508, F509, F510, F511, F512, F513, F514, F515, F516, F517, F518, F519, F520, F521, F522, F523, F524, F525, F526, F527, F528, F529, F530, F531, F532, F533, F534, F535, F536, F537, F538, F539, F540, F541, F542, F543, F544, F545, F546, F547, F548, F549, F550, F551, F552, F553, F554, F555, F556, F557, F558, F559, F560, F561, F562, F563, F564, F565, F566, F567, F568, F569, F570, F571, F572, F573, F574, F575, F576, F577, F578, F579, F580, F581, F582, F583, F584, F585, F586, F587, F588, F589, F590, F591, F592, F593, F594, F595, F596, F597, F598, F599, F600, F601, F602, F603, F604, F605, F606, F607, F608, F609, F610, F611, F612, F613, F614, F615, F616, F617, F618, F619, F620, F621, F622, F623, F624, F625, F626, F627, F628, F629, F630, F631, F632, F633, F634, F635, F636, F637, F638, F639, F640, F641, F642, F643, F644, F645, F646, F647, F648, F649, F650, F651, F652, F653, F654, F655, F656, F657, F658, F659, F660, F661, F662, F663, F664, F665, F666, F667, F668, F669, F670, F671, F672, F673, F674, F675, F676, F677, F678, F679, F680, F681, F682, F683, F684, F685, F686, F687, F688, F689, F690, F691, F692, F693, F694, F695, F696, F697, F698, F699, F700, F701, F702, F703, F704, F705, F706, F707, F708, F709, F710, F711, F712, F713, F714, F715, F716, F717, F718, F719, F720, F721, F722, F723, F724, F725, F726, F727, F728, F729, F730, F731, F732, F733, F734, F735, F736, F737, F738, F739, F740, F741, F742, F743, F744, F745, F746, F747, F748, F749, F750, F751, F752, F753, F754, F755, F756, F757, F758, F759, F760, F761, F762, F763, F764, F765, F766, F767, F768, F769, F770, F771, F772, F773, F774, F775, F776, F777, F778, F779, F780, F781, F782, F783, F784, F785, F786, F787, F788, F789, F790, F791, F792, F793, F794, F795, F796, F797, F798, F799, F800, F801, F802, F803, F804, F805, F806, F807, F808, F809, F810, F811, F812, F813, F814, F815, F816, F817, F818, F819, F820, F821, F822, F823, F824, F825, F826, F827, F828, F829, F830, F831, F832, F833, F834, F835, F836, F837, F838, F839, F840, F841, F842, F843, F844, F845, F846, F847, F848, F849, F850, F851, F852, F853, F854, F855, F856, F857, F858, F859, F860, F861, F862, F863, F864, F865, F866, F867, F868, F869, F870, F871, F872, F873, F874, F875, F876, F877, F878, F879, F880, F881, F882, F883, F884, F885, F886, F887, F888, F889, F890, F891, F892, F893, F894, F895, F896, F897, F898, F899, F900, F901, F902, F903, F904, F905, F906, F907, F908, F909, F910, F911, F912, F913, F914, F915, F916, F917, F918, F919, F920, F921, F922, F923, F924, F925, F926, F927, F928, F929, F930, F931, F932, F933, F934, F935, F936, F937, F938, F939, F940, F941, F942, F943, F944, F945, F946, F947, F948, F949, F950, F951, F952, F953, F954, F955, F956, F957, F958, F959, F960, F961, F962, F963, F964, F965, F966, F967, F968, F969, F970, F971, F972, F973, F974, F975, F976, F977, F978, F979, F980, F981, F982, F983, F984, F985, F986, F987, F988, F989, F990, F991, F992, F993, F994, F995, F996, F997, F998, F999, F1000, F1001, F1002, F1003, F1004, F1005, F1006, F1007, F1008, F1009, F1010, F1011, F1012, F1013, F1014, F1015, F1016, F1017, F1018, F1019, F1020, F1021, F1022, F1023, F1024, F1025, F1026, F1027, F1028, F1029, F1030, F1031, F1032, F1033, F1034, F1035, F1036, F1037, F1038, F1039, F1040, F1041, F1042, F1043, F1044, F1045, F1046, F1047, F1048, F1049, F1050, F1051, F1052, F1053, F1054, F1055, F1056, F1057, F1058, F1059, F1060, F1061, F1062, F1063, F1064, F1065, F1066, F1067, F1068, F1069, F1070, F1071, F1072, F1073, F1074, F1075, F1076, F1077, F1078, F1079, F1080, F1081, F1082, F1083, F1084, F1085, F1086, F1087, F1088, F1089, F1090, F1091, F1092, F1093, F1094, F1095, F1096, F1097, F1098, F1099, F1100, F1101, F1102, F1103, F1104, F1105, F1106, F1107, F1108, F1109, F1110, F1111, F1112, F1113, F1114, F1115, F1116, F1117, F1118, F1119, F1120, F1121, F1122, F1123, F1124, F1125, F1126, F1127, F1128, F1129, F1130, F1131, F1132, F1133, F1134, F1135, F1136, F1137, F1138, F1139, F1140, F1141, F1142, F1143, F1144, F1145, F1146, F1147, F1148, F1149, F1150, F1151, F1152, 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F1582, F1583, F1584, F1585, F1586, F1587, F1588, F1589, F1590, F1591, F1592, F1593, F1594, F1595, F1596, F1597, F1598, F1599, F1600, F1601, F1602, F1603, F1604, F1605, F1606, F1607, F1608, F1609, F1610, F1611, F1612, F1613, F1614, F1615, F1616, F1617, F1618, F1619, F1620, F1621, F1622, F1623, F1624, F1625, F1626, F1627, F1628, F1629, F1630, F1631, F1632, F1633, F1634, F1635, F1636, F1637, F1638, F1639, F1640, F1641, F1642, F1643, F1644, F1645, F1646, F1647, F1648, F1649, F1650, F1651, F1652, F1653, F1654, F1655, F1656, F1657, F1658, F1659, F1660, F1661, F1662, F1663, F1664, F1665, F1666, F1667, F1668, F1669, F1670, F1671, F1672, F1673, F1674, F1675, F1676, F1677, F1678, F1679, F1680, F1681, F1682, F1683, F1684, F1685, F1686, F1687, F1688, F1689, F1690, F1691, F1692, F1693, F1694, F1695, F1696, F1697, F1698, F1699, F1700, F1701, F1702, F1703, F1704, F1705, F1706, F1707, F1708, F1709, F1710, F1711, F1712, F1713, F1714, F1715, F1716, F1717, F1718, F1719, F1720, F1721, F1722, F1723, F1724, 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F1868, F1869, F1870, F1871, F1872, F1873, F1874, F1875, F1876, F1877, F1878, F1879, F1880, F1881, F1882, F1883, F1884, F1885, F1886, F1887, F1888, F1889, F1890, F1891, F1892, F1893, F1894, F1895, F1896, F1897, F1898, F1899, F1900, F1901, F1902, F1903, F1904, F1905, F1906, F1907, F1908, F1909, F1910, F1911, F1912, F1913, F1914, F1915, F1916, F1917, F1918, F1919, F1920, F1921, F1922, F1923, F1924, F1925, F1926, F1927, F1928, F1929, F1930, F1931, F1932, F1933, F1934, F1935, F1936, F1937, F1938, F1939, F1940, F1941, F1942, F1943, F1944, F1945, F1946, F1947, F1948, F1949, F1950, F1951, F1952, F1953, F1954, F1955, F1956, F1957, F1958, F1959, F1960, F1961, F1962, F1963, F1964, F1965, F1966, F1967, F1968, F1969, F1970, F1971, F1972, F1973, F1974, F1975, F1976, F1977, F1978, F1979, F1980, F1981, F1982, F1983, F1984, F1985, F1986, F1987, F1988, F1989, F1990, F1991, F1992, F1993, F1994, F1995, F1996, F1997, F1998, F1999, F2000, F2001, F2002, F2003, F2004, F2005, F2006, F2007, F2008, F2009, F2010, F2011, F2012, F2013, F2014, F2015, F2016, F2017, F2018, F2019, F2020, F2021, F2022, F2023, F2024, F2025, F2026, F2027, F2028, F2029, F2030, F2031, F2032, F2033, F2034, F2035, F2036, F2037, F2038, F2039, F2040, F2041, F2042, F2043, F2044, F2045, F2046, F2047, F2048, F2049, F2050, F2051, F2052, F2053, F2054, F2055, F2056, F2057, F2058, F2059, F2060, F2061, F2062, F2063, F2064, F2065, F2066, F2067, F2068, F2069, F2070, F2071, F2072, F2073, F2074, F2075, F2076, F2077, F2078, F2079, F2080, F2081, F2082, F2083, F2084, F2085, F2086, F2087, F2088, F2089, F2090, F2091, F2092, F2093, F2094, F2095, F2096, F2097, F2098, F2099, F2100, F2101, F2102, F2103, F2104, F2105, F2106, F2107, F2108, F2109, F2110, F2111, F2112, F2113, F2114, F2115, F2116, F2117, F2118, F2119, F2120, F2121, F2122, F2123, F2124, F2125, F2126, F2127, F2128, F2129, F2130, F2131, F2132, F2133, F2134, F2135, F2136, F2137, F2138, F2139, F2140, F2141, F2142, F2143, F2144, F2145, F2146, F2147, F2148, F2149, F2150, F2151, F2152, F2153, F2154, F2155, F2156, F2157, F2158, F2159, F2160, F2161, F2162, F2163, F2164, F2165, F2166, F2167, F2168, F2169, F2170, F2171, F2172, F2173, F2174, F2175, F2176, F2177, F2178, F2179, F2180, F2181, F2182, F2183, F2184, F2185, F2186, F2187, F2188, F2189, F2190, F2191, F2192, F2193, F2194, F2195, F2196, F2197, F2198, F2199, F2200, F2201, F2202, F2203, F2204, F2205, F2206, F2207, F2208, F2209, F2210, F2211, F2212, F2213, F2214, F2215, F2216, F2217, F2218, F2219, F2220, F2221, F2222, F2223, F2224, F2225, F2226, F2227, F2228, F2229, F2230, F2231, F2232, F2233, F2234, F2235, F2236, F2237, F2238, F2239, F2240, F2241, F2242, F2243, F2244, F2245, F2246, F2247, F2248, F2249, F2250, F2251, F2252, F2253, F2254, F2255, F2256, F2257, F2258, F2259, F2260, F2261, F2262, F2263, F2264, F2265, F2266, F2267, F2268, F2269, F2270, F2271, F2272, F2273, F2274, F2275, F2276, F2277, F2278, F2279, F2280, F2281, F2282, F2283, F2284, F2285, F2286, F2287, F2288, F2289, F2290, F2291, F2292, F2293, F2294, F2295, F2296, F2297, F2298, F2299, F2300, F2301, F2302, F2303, F2304, F2305, F2306, F2307, F2308, F2309, F2310, F2311, F2312, F2313, F2314, F2315, F2316, F2317, F2318, F2319, F2320, F2321, F2322, F2323, F2324, F2325, F2326, F2327, F2328, F2329, F2330, F2331, F2332, F2333, F2334, F2335, F2336, F2337, F2338, F2339, F2340, F2341, F2342, F2343, F2344, F2345, F2346, F2347, F2348, F2349, F2350, F2351, F2352, F2353, F2354, F2355, F2356, F2357, F2358, F2359, F2360, F2361, F2362, F2363, F2364, F2365, F2366, F2367, F2368, F2369, F2370, F2371, F2372, F2373, F2374, F2375, F2376, F2377, F2378, F2379, F2380, F2381, F2382, F2383, F2384, F2385, F2386, F2387, F2388, F2389, F2390, F2391, F2392, F2393, F2394, F2395, F2396, F2397, F2398, F2399, F2400, F2401, F2402, F2403, F2404, F2405, F2406, F2407, F2408, F2409, F2410, F2411, F2412, F2413, F2414, F2415, F2416, F2417, F2418, F2419, F2420, F2421, F2422, F2423, F2424, F2425, F2426, F2427, F2428, F2429, F2430, F2431, F2432, F2433, F2434, F2435, F2436, F2437, F2438, F2439, F2440, F2441, F2442, F2443, F2444, F2445, F2446, F2447, F2448, F2449, F2450, F2451, F2452, F2453, F2454, F2455, F2456, F2457, F2458, F2459, F2460, F2461, F2462, F2463, F2464, F2465, F2466, F2467, F2468, F2469, F2470, F2471, F2472, F2473, F2474, F2475, F2476, F2477, F2478, F2479, F2480, F2481, F2482, F2483, F2484, F2485, F2486, F2487, F2488, F2489, F2490, F2491, F2492, F2493, F2494, F2495, F2496, F2497, F2498, F2499, F2500, F2501, F2502, F2503, F2504, F2505, F2506, F2507, F2508, F2509, F2510, F2511, F2512, F2513, F2514, F2515, F2516, F2517, F2518, F2519, F2520, F2521, F2522, F2523, F2524, F2525, F2526, F2527, F2528, F2529, F2530, F2531, F2532, F2533, F2534, F2535, F2536, F2537, F2538, F2539, F2540, F2541, F2542, F2543, F2544, F2545, F2546, F2547, F2548, F2549, F2550, F2551, F2552, F2553, F2554, F2555, F2556, F2557, F2558, F2559, F2560, F2561, F2562, F2563, F2564, F2565, F2566, F2567, F2568, F2569, F2570, F2571, F2572, F2573, F2574, F2575, F2576, F2577, F2578, F2579, F2580, F2581, F2582, F2583, F2584, F2585, F2586, F2587, F2588, F2589, F2590, F2591, F2592, F2593, F2594, F2595, F2596, F2597, F2598, F2599, F2600, F2601, F2602, F2603, F2604, F2605, F2606, F2607, F2608, F2609, F2610, F2611, F2612, F2613, F2614, F2615, F2616, F2617, F2618, F2619, F2620, F2621, F2622, F2623, F2624, F2625, F2626, F2627, F2628, F2629, F2630, F2631, F2632, F2633, F2634, F2635, F2636, F2637, F2638, F2639, F2640, F2641, F2642, F2643, F2644, F2645, F2646, F2647, F2648, F2649, F2650, F2651, F2652, F2653, F2654, F2655, F2656, F2657, F2658, F2659, F2660, F2661, F2662, F2663, F2664, F2665, F2666, F2667, F2668, F2669, F2670, F2671, F2672, F2673, F2674, F2675, F2676, F2677, F2678, F2679, F2680, F2681, F2682, F2683, F2684, F2685, F2686, F2687, F2688, F2689, F2690, F2691, F2692, F2693, F2694, F2695, F2696, F2697, F2698, F2699, F2700, F2701, F2702, F2703, F2704, F2705, F2706, F2707, F2708, F2709, F2710, F2711, F2712, F2713, F2714, F2715, F2716, F2717, F2718, F2719, F2720, F2721, F2722, F2723, F2724, F2725, F2726, F2727, F2728, F2729, F2730, F2731, F2732, F2733, F2734, F2735, F2736, F2737, F2738, F2739, F2740, F2741, F2742, F2743, F2744, F2745, F2746, F2747, F2748, F2749, F2750, F2751, F2752, F2753, F2754, F2755, F2756, F2757, F2758, F2759, F2760, F2761, F2762, F2763, F2764, F2765, F2766, F2767, F2768, F2769, F2770, F2771, F2772, F2773, F2774, F2775, F2776, F2777, F2778, F2779, F2780, F2781, F2782, F2783, F2784, F2785, F2786, F2787, F2788, F2789, F2790, F2791, F2792, F2793, F2794, F2795, F2796, F2797, F2798, F2799, F2800, F2801, F2802, F2803, F2804, F2805, F2806, F2807, F2808, F2809, F2810, F2811, F2812, F2813, F2814, F2815, F2816, F2817, F2818, F2819, F2820, F2821, F2822, F2823, F2824, F2825, F2826, F2827, F2828, F2829, F2830, F2831, F2832, F2833, F2834, F2835, F2836, F2837, F2838, F2839, F2840, F2841, F2842, F2843, F2844, F2845, F2846, F2847, F2848, F2849, F2850, F2851, F2852, F2853, F2854, F2855, F2856, F2857, F2858, F2859, F2860, F2861, F2862, F2863, F2864, F2865, F2866, F2867, F2868, F2869, F2870, F2871, F2872, F2873, F2874, F2875, F2876, F2877, F2878, F2879, F2880, F2881, F2882, F2883, F2884, F2885, F2886, F2887, F2888, F2889, F2890, F2891, F2892, F2893, F2894, F2895, F2896, F2897, F2898, F2899, F2900, F2901, F2902, F2903, F2904, F2905, F2906, F2907, F2908, F2909, F2910, F2911, F2912, F2913, F2914, F2915, F2916, F2917, F2918, F2919, F2920, F2921, F2922, F2923, F2924, F2925, F2926, F2927, F2928, F2929, F2930, F2931, F2932, F2933, F2934, F2935, F2936, F2937, F2938, F2939, F2940, F2941, F2942, F2943, F2944, F2945, F2946, F2947, F2948, F2949, F2950, F2951, F2952, F2953, F2954, F2955, F2956, F2957, F2958, F2959, F2960, F2961, F2962, F2963, F2964, F2965, F2966, F2967, F2968, F2969, F2970, F2971, F2972, F2973, F2974, F2975, F2976, F2977, F2978, F2979, F2980, F2981, F2982, F2983, F2984, F2985, F2986, F2987, F2988, F2989, F2990, F2991, F2992, F2993, F2994, F2995, F2996, F2997, F2998, F2999, F3000, F3001, F3002, F3003, F3004, F3005, F3006, F3007, F3008, F3009, F3010, F3011, F3012, F3013, F3014, F3015, F3016, F3017, F3018, F3019, F3020, F3021, F3022, F3023, F3024, F3025, F3026, F3027, F3028, F3029, F3030, F3031, F3032, F3033, F3034, F3035, F3036, F3037, F3038, F3039, F3040, F3041, F3042, F3043, F3044, F3045, F3046, F3047, F3048, F3049, F3050, F3051, F3052, F3053, F3054, F3055, F3056, F3057, F3058, F3059, F3060, F3061, F3062, F3063, F3064, F3065, F3066, F3067, F3068, F3069, F3070, F3071, F3072, F3073, F3074, F3075, F3076, F3077, F3078, F3079, F3080, F3081, F3082, F3083, F3084, F3085, F3086, F3087, F3088, F3089, F3090, F3091, F3092, F3093, F3094, F3095, F3096, F3097, F3098, F3099, F3100, F3101, F3102, F3103, F3104, F3105, F3106, F3107, F3108, F3109, F3110, F3111, F3112, F3113, F3114, F3115, F3116, F3117, F3118, F3119, F3120, F3121, F3122, F3123, F3124, F3125, F3126, F3127, F3128, F3129, F3130, F3131, F3132, F3133, F3134, F3135, F3136, F3137, F3138, F3139, F3140, F3141, F3142, F3143, F3144, F3145, F3146, F3147, F3148, F3149, F3150, F3151, F3152, F3153, F3154, F3155, F3156, F3157, F3158, F3159, F3160, F3161, F3162, F3163, F3164, F3165, F3166, F3167, F3168, F3169, F3170, F3171, F3172, F3173, F3174, F3175, F3176, F3177, F3178, F3179, F3180, F3181, F3182, F3183, F3184, F3185, F3186, F3187, F3188, F3189, F3190, F3191, F3192, F3193, F3194, F3195, F3196, F3197, F3198, F3199, F3200, F3201, F3202, F3203, F3204, F3205, F3206, F3207, F3208, F3209, F3210, F3211, F3212, F3213, F3214, F3215, F3216, F3217, F3218, F3219, F3220, F3221, F3222, F3223, F3224, F3225, F3226, F3227, F3228, F3229, F3230, F3231, F3232, F3233, F3234, F3235, F3236, F3237, F3238, F3239, F3240, F3241, F3242, F3243, F3244, F3245, F3246, F3247, F3248, F3249, F3250, F3251, F3252, F3253, F3254, F3255, F3256, F3257, F3258, F3259, F3260, F3261, F3262, F3263, F3264, F3265, F3266, F3267, F3268, F3269, F3270, F3271, F3272, F3273, F3274, F3275, F3276, F3277, F3278, F3279, F3280, F3281, F3282, F3283, F3284, F3285, F3286, F3287, F3288, F3289, F3290, F3291, F3292, F3293, F3294, F3295, F3296, F3297, F3298, F3299, F3300, F3301, F3302, F3303, F3304, F3305, F3306, F3307, F3308, F3309, F3310, F3311, F3312, F3313, F3314, F3315, F3316, F3317, F3318, F3319, F3320, F3321, F3322, F3323, F3324, F3325, F3326, F3327, F3328, F3329, F3330, F3331, F3332, F3333, F3334, F3335, F3336, F3337, F3338, F3339, F3340, F3341, F3342, F3343, F3344, F3345, F3346, F3347, F3348, F3349, F3350, F3351, F3352, F3353, F3354, F3355, F3356, F3357, F3358, F3359, F3360, F3361, F3362, F3363, F3364, F3365, F3366, F3367, F3368, F3369, F3370, F3371, F3372, F3373, F3374, F3375, F3376, F3377, F3378, F3379, F3380, F3381, F3382, F3383, F3384, F3385, F3386, F3387, F3388, F3389, F3390, F3391, F3392, F3393, F3394, F3395, F3396, F3397, F3398, F3399, F3400, F3401, F3402, F3403, F3404, F3405, F3406, F3407, F3408, F3409, F3410, F3411, F3412, F3413, F3414, F3415, F3416, F3417, F3418, F3419, F3420, F3421, F3422, F3423, F3424, F3425, F3426, F3427, F3428, F3429, F3430, F3431, F3432, F3433, F3434, F3435, F3436, F3437, F3438, F3439, F3440, F3441, F3442, F3443, F3444, F3445, F3446, F3447, F3448, F3449, F3450, F3451, F3452, F3453, F3454, F3455, F3456, F3457, F3458, F3459, F3460, F3461, F3462, F3463, F3464, F3465, F3466, F3467, F3468, F3469, F3470, F3471, F3472, F3473, F3474, F3475, F3476, F3477, F3478, F3479, F3480, F3481, F3482, F3483, F3484, F3485, F3486, F3487, F3488, F3489, F3490, F3491, F3492, F3493, F3494, F3495, F3496, F3497, F3498, F3499, F3500, F3501, F3502, F3503, F3504, F3505, F3506, F3507, F3508, F3509, F3510, F3511, F3512, F3513, F3514, F3515, F3516, F3517, F3518, F3519, F3520, F3521, F3522, F3523, F3524, F3525, F3526, F3527, F3528, F3529, F3530, F3531, F3532, F3533, F3534, F3535, F3536, F3537, F3538, F3539, F3540, F3541, F3542, F3543, F3544, F3545, F3546, F3547, F3548, F3549, F3550, F3551, F3552, F3553, F3554, F3555, F3556, F3557, F3558, F3559, F3560, F3561, F3562, F3563, F3564, F3565, F3566, F3567, F3568, F3569, F3570, F3571, F3572, F3573, F3574, F3575, F3576, F3577, F3578, F3579, F3580, F3581, F3582, F3583, 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Findings 3 findings

F2 Page 3
After reviewing release Due to the shortage of inpatient procedures and interviewing facilities, EPS had recently implemented staff members, the Grand Jury an aggressive strategy to begin found evidence that reasonable placement efforts for the most severely care is taken to alleviate patient ill patients as soon as they have been safety concerns around late-night evaluated by the EPS physician releases. (psychiatrist). One EPS staff member has been assigned full-time to this task. 3. The shortage of adequate acute psychiatric care facilities is a The bed shortage is not unique to Santa serious impediment to the ability Clara County. According to the county of any public organization to mental health director in a report dated provide proper care to this needy December 5, 2001, “The problems of segment of the population. The insufficient public mental health funding Grand Jury acknowledges the and services in general, and the lack of efforts of EPS staff and deep end and residential resources in management to fulfill its mission particular, are statewide concerns that under these difficult conditions. have been documented in a 2000 publication of the Little Hoover 4. The incidence of overstays is Commission, and in a report published lessening month by month, from by the California Institute for Mental 67 in May 2001 to 10 in October Health in August 2001.” 2001. This is partly due to more (See Attachment 2) aggressive efforts to secure placement. The operation of 24-hour public use mental health care facilities in Santa 5. Santa Clara County does not Clara County requires a large subsidy provide an adequate number of from the county coffers. During fiscal acute psychiatric care beds to year 2001, the board of supervisors properly serve its populace. The augmented the department’s operating Santa Clara County Board of 3 Supervisors Health and Hospital and visible. The very existence Committee is clearly aware of of a fire extinguisher cabinet on this shortage, since two reports the patient floor for which no one reviewed by the Grand Jury were has a key creates the potential for written for the specific purpose dangerous confusion and wasted of informing the board. time in the event of an emergency.
F6 Page 4
The need to place acutely ill patients in out-of-county 10. The posted evacuation plan in facilities is onerous to families of EPS is confusing to anyone who the patients. Since the county is not intimately familiar with the system serves mostly public building. None of the Grand patients, families are even less Jurors who viewed the plan could likely to have the financial and/or easily decipher the location of physical resources to travel the emergency exit. This poses significant distance to be near or an unacceptable safety problem visit loved ones. for patients and anyone who might be visiting the facility.
F5150 Page 1
Section 5150 is applicable to of a specially designed security entrance persons who are perceived to be a and holding room. A uniformed security danger to themselves or others. guard is present at all times. Involuntary holds under Section 5150 are limited to 72 hours. Detailed emergency procedures are available on the staff floor. A red phone EPS is a locked facility designed to in the office area provides a direct link to allow evaluation and processing of the sheriff’s dispatch center and other acutely troubled or ill patients. Because emergency personnel. Staff receives EPS is licensed as an ambulatory clinic regular training on procedures covering of Valley Medical Center, stays at the emergencies, such as fire or earthquake. Two problems of note were the lack of Each of these overstays carries the available keys for one locked fire potential for a substantial legal penalty extinguisher cabinet in the patient area, from the state, including a fine of and the lack of understandable detail on $50,000 per incident. EPS has been the posted evacuation plan. Alternative cited twice for this problem, but to date fire extinguishers were available in the the state has not opted to levy any fines. locked kitchen and office areas on the EPS staff stated that all of these staff side of the facility. On both its overstays were attributable to patients visits, Grand Jurors notified the staff of who needed transfer to acute care these insufficiencies. inpatient facilities (psychiatric hospitals). Staff also reported that it is Emergency Psychiatric Services Patients very difficult to place these patients The EPS patient load averages 750-800 within the 24-hour limit because there is per month. Of these, approximately five a shortage of available beds, particularly percent require discharge to an acute for Medi-Cal or uninsured (public) care inpatient facility (psychiatric patients. These types of patients hospital). EPS admits patients of varying comprise the large majority of ages, from children to seniors. Special individuals who pass through EPS. attention is given to juvenile patients, who are kept apart from the general Hospital Bed Shortage patient population under one-on-one A July 2001 survey of psychiatric surveillance. hospitals in the Bay Area showed that Santa Clara County maintains one bed New patients, in particular those brought for each 14,505 county residents, as to the facility by police or ambulance, compared to the Bay Area/Sacramento may arrive at all hours of the day and average of one bed per 6,716 night. Consequently, patients are also individuals. Of the capacity available in released at all hours of the day and night, Santa Clara County, 100 percent of in order to meet the mandated 24-hour public inpatients were in Valley Medical time limit. In the case of late-night Center’s Barbara Arons Pavilion, the releases, staff arranges a taxi or other county’s acute care facility. The other transportation when necessary. In some three Santa Clara County hospitals cases patients are allowed to remain in offering psychiatric beds housed no the secure lobby until daylight. public patients. (See Attachment 2) Although the law states that patients will There are no beds identified for the not remain at EPS longer than 24 hours, treatment of children or adolescent “overstays” are a common occurrence. patients (public or private) within the In the months of May through October county. All juvenile patients are treated 2001, for example, EPS had a total and housed at out-of-county facilities, patient population of 3864. Of this often in Vallejo or Sacramento. Many number, 150 persons (about four adult patients are placed in out-of-county percent) remained beyond the mandated facilities as well, mostly at a contracting 24-hour cutoff. hospital in Fremont or at a state hospital facility. For instance, a survey taken July and September 2001 on behalf of 2 the Greater Bay Area Mental Health budget in the amount of $3.6 million. Directors shows that the county was first During budgeting for fiscal year 2002, among 12 counties in use of out-of- the board approved another $7.6 million county hospital beds. At that time, the infusion. (See Attachment 2) county had placed 18 patients (26 percent) in out-of-county hospitals. FINDINGS EPS staff reported to the Grand Jury that the bed shortage problem is exacerbated 1. The EPS facility is equipped to by an apparent lack of access to three of handle the approximately 800 the four hospitals in the county that patients that pass through its provide psychiatric inpatient service. doors each month. The difficulty They report that the problem relates to comes in finding the appropriate the rates paid by Medi-Cal and the longer-term care for the most degree of acuity of many of these acutely ill patients. severely ill patients.

Recommendations 1

No Responses Found 1

Government entities assigned to respond to this report. No response documents have been linked in our database.

Santa Clara County Board of Supervisors Elected County Office