⚠️ 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.
Note: Missing finding numbers detected: 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, F1153, F1154, F1155, F1156, F1157, F1158, F1159, F1160, F1161, F1162, F1163, F1164, F1165, F1166, F1167, F1168, F1169, F1170, F1171, F1172, F1173, F1174, F1175, F1176, F1177, F1178, F1179, F1180, F1181, F1182, F1183, F1184, F1185, F1186, F1187, F1188, F1189, F1190, F1191, F1192, F1193, F1194, F1195, F1196, F1197, F1198, F1199, F1200, F1201, F1202, F1203, F1204, F1205, F1206, F1207, F1208, F1209, F1210, F1211, F1212, F1213, F1214, F1215, F1216, F1217, F1218, F1219, F1220, F1221, F1222, F1223, F1224, F1225, F1226, F1227, F1228, F1229, F1230, F1231, F1232, F1233, F1234, F1235, F1236, F1237, F1238, F1239, F1240, F1241, F1242, F1243, F1244, F1245, F1246, F1247, F1248, F1249, F1250, F1251, F1252, F1253, F1254, F1255, F1256, F1257, F1258, F1259, F1260, F1261, F1262, F1263, F1264, F1265, F1266, F1267, F1268, F1269, F1270, F1271, F1272, F1273, F1274, F1275, F1276, F1277, F1278, F1279, F1280, F1281, F1282, F1283, F1284, F1285, F1286, F1287, F1288, F1289, F1290, F1291, F1292, F1293, F1294, F1295, F1296, F1297, F1298, F1299, F1300, F1301, F1302, F1303, F1304, F1305, F1306, F1307, F1308, F1309, F1310, F1311, F1312, F1313, F1314, F1315, F1316, F1317, F1318, F1319, F1320, F1321, F1322, F1323, F1324, F1325, F1326, F1327, F1328, F1329, F1330, F1331, F1332, F1333, F1334, F1335, F1336, F1337, F1338, F1339, F1340, F1341, F1342, F1343, F1344, F1345, F1346, F1347, F1348, F1349, F1350, F1351, F1352, F1353, F1354, F1355, F1356, F1357, F1358, F1359, F1360, F1361, F1362, F1363, F1364, F1365, F1366, F1367, F1368, F1369, F1370, F1371, F1372, F1373, F1374, F1375, F1376, F1377, F1378, F1379, F1380, F1381, F1382, F1383, F1384, F1385, F1386, F1387, F1388, F1389, F1390, F1391, F1392, F1393, F1394, F1395, F1396, F1397, F1398, F1399, F1400, F1401, F1402, F1403, F1404, F1405, F1406, F1407, F1408, F1409, F1410, F1411, F1412, F1413, F1414, F1415, F1416, F1417, F1418, F1419, F1420, F1421, F1422, F1423, F1424, F1425, F1426, F1427, F1428, F1429, F1430, F1431, F1432, F1433, F1434, F1435, F1436, F1437, F1438, F1439, F1440, F1441, F1442, F1443, F1444, F1445, F1446, F1447, F1448, F1449, F1450, F1451, F1452, F1453, F1454, F1455, F1456, F1457, F1458, F1459, F1460, F1461, F1462, F1463, F1464, F1465, F1466, F1467, F1468, F1469, F1470, F1471, F1472, F1473, F1474, F1475, F1476, F1477, F1478, F1479, F1480, F1481, F1482, F1483, F1484, F1485, F1486, F1487, F1488, F1489, F1490, F1491, F1492, F1493, F1494, F1495, F1496, F1497, F1498, F1499, F1500, F1501, F1502, F1503, F1504, F1505, F1506, F1507, F1508, F1509, F1510, F1511, F1512, F1513, F1514, F1515, F1516, F1517, F1518, F1519, F1520, F1521, F1522, F1523, F1524, F1525, F1526, F1527, F1528, F1529, F1530, F1531, F1532, F1533, F1534, F1535, F1536, F1537, F1538, F1539, F1540, F1541, F1542, F1543, F1544, F1545, F1546, F1547, F1548, F1549, F1550, F1551, F1552, F1553, F1554, F1555, F1556, F1557, F1558, F1559, F1560, F1561, F1562, F1563, F1564, F1565, F1566, F1567, F1568, F1569, F1570, F1571, F1572, F1573, F1574, F1575, F1576, F1577, F1578, F1579, F1580, F1581, 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, F1725, F1726, F1727, F1728, F1729, F1730, F1731, F1732, F1733, F1734, F1735, F1736, F1737, F1738, F1739, F1740, F1741, F1742, F1743, F1744, F1745, F1746, F1747, F1748, F1749, F1750, F1751, F1752, F1753, F1754, F1755, F1756, F1757, F1758, F1759, F1760, F1761, F1762, F1763, F1764, F1765, F1766, F1767, F1768, F1769, F1770, F1771, F1772, F1773, F1774, F1775, F1776, F1777, F1778, F1779, F1780, F1781, F1782, F1783, F1784, F1785, F1786, F1787, F1788, F1789, F1790, F1791, F1792, F1793, F1794, F1795, F1796, F1797, F1798, F1799, F1800, F1801, F1802, F1803, F1804, F1805, F1806, F1807, F1808, F1809, F1810, F1811, F1812, F1813, F1814, F1815, F1816, F1817, F1818, F1819, F1820, F1821, F1822, F1823, F1824, F1825, F1826, F1827, F1828, F1829, F1830, F1831, F1832, F1833, F1834, F1835, F1836, F1837, F1838, F1839, F1840, F1841, F1842, F1843, F1844, F1845, F1846, F1847, F1848, F1849, F1850, F1851, F1852, F1853, F1854, F1855, F1856, F1857, F1858, F1859, F1860, F1861, F1862, F1863, F1864, F1865, F1866, F1867, 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, F2000
Findings and Recommendations 12 findings
F1
Page 10
Los Angeles Unified School District (LAUSD).
No recommendations for this finding
F2
Page 10
Los Angeles County Sheriff’s Department (LASD).
No recommendations for this finding
F3
Page 10
Department of Health Services (DHS) Public/Private Partnerships.
No recommendations for this finding
F4
Page 10
Hiring practices of the Los Angeles Police Department (LAPD), along with and analysis of the new hiring practices of the Signal Hill Police Department (SHPD).
No recommendations for this finding
F5
Page 10
Department of Public Social Services (DPSS) Quality Control Unit. The Grand Jury approved the following nine subject matters for internal audits: 1. Active Commissions.
No recommendations for this finding
F6
Page 129
Special privileges should be just that, privileges, not rights. These privileges should be severely restricted and line staff should have the authority to suspend what is offered if inmates are being disruptive. The line staff believe that Title 15 requirements should be the only expectations the inmates should have, anything else is a bonus.
No recommendations for this finding
F7
Page 129
Deputies and custody assistants should not be second guessed when it comes to assigning inmate discipline, unless the discipline is totally out of line with the offense or not authorized (e.g., suspending the programs for an entire housing module because one inmate tried to sneak an extra cookie for lunch). Supervisors have to review what the staff under them are doing in regards to discipline but if the line staff has been trained properly in the application of discipline there should be very few reversals. A reversal should be based on an error in judgment on the staff’s part, not an attempt to avoid inmate complaints and litigation.
No recommendations for this finding
F8
Page 129
Deputies and custody assistants should always be consulted on discipline matters at the initial stage after the incident and not in front of inmates. We received many examples of line staff put on an equal playing field with inmates as deputies or custody assistants were asked to justify their actions while the inmate was present. In many cases the line staff was not consulted at all. In the latter situations we heard stories of Sergeants walking directly over to the inmate, listening to the inmates story, then making a decision regarding the situation with little or no consultation with the line staff.
No recommendations for this finding
F9
Page 129
Medication distribution or pill call should be conducted at the door of the inmate housing pod. Inmates should not be let out of their housing area to receive medication unless it is a medical imperative or they need to be escorted to the clinic.
No recommendations for this finding
F10
Page 129
The last change the line staff would like to see occur involves the overall environment of the jail system in which they work. They believe that jail should be just that, jail. We were repeatedly advised that inmates are coddled and given so many privileges that the deterrent effect for someone to not want to come to jail is significantly reduced. This present environment also puts the inmate programs at risk since it blurs the clear channel the Sheriff is hoping to create in regards to reducing recidivism. According to a majority of the line staff, jail should be a place inmates wish to leave and not come back. The programs offered to the inmates should facilitate this desire and assist them in becoming productive citizens. Jail should not be a place anyone would find desirable or a setting where a person could become comfortable. Question Twelve The line staff was asked if they felt the standards set for allowing female inmates into the available programs or work assignments were set high enough. While some of this concern is addressed in the audit portion of this report the following positions were noted. The majority of answers to this question were mixed. There is an acknowledgement that not enough qualified inmates are available for work details. There is tremendous pressure to fill the available positions so unless it is blatantly obvious that an inmate should not be on an inside work crew then that inmate will be given a chance. There appears to be stricter screening for inmates who are assigned to outside work crews. There was also an acknowledgement that inmate workers, particularly the workers who work inside Twin Towers, who are fired by staff often show up again on a work crew, either on a different shift or in a different area. There is a lot of consternation from deputies and custody assistants who fire inmate workers only to see them, sometimes the next day, back on a crew. The line staff believe there is a need for an easy tracking system that staff could utilize. An example of this would be if a deputy fires an inmate worker; that deputy would note the firing in the system and the reasons for the firing. When the fired worker approaches another deputy on a different shift and asks to be placed on a work crew all that deputy would have to do is run the inmate’s name or booking number in the database. In addition, there seems to be a need for a one-strike and your out rule unless a staff member specifically requests that particular worker, after consulting with the staff member who originally fired her. This would allow for a “second chance” without allowing the inmates to manipulate the system. As far as inmate programs available like the anti-drug program or parenting programs there appears to be a low standard regarding these according to the line staff. Many inmates will sign up for a program in order to get special privileges or to get out of a housing area so they can see their friends. These are not good reasons for inmates to be in programs. The line staff believe inmates should be carefully screened for disciplinary problems. If the inmate is a discipline problem she should be excluded from the program. Also, line staff should have the discretion of removing an inmate from a program if the inmate is observed abusing the privilege. An example of this would be if an inmate attending an anti-drug class were observed constantly leaving the class area to roam to other areas of the housing module to see friends. When directed to go back to the class the inmate becomes disrespectful and continues her behavior. Line staff believe they should have the discretion of removing that inmate from the program without having to jump through several levels of bureaucracy. Question Thirteen The line staff was asked if female inmates are treated lightly in matters of security (staff directed not to handcuff potentially violent inmates, inmates roaming in restricted areas of a housing module and not being punished for it, disruptive inmates placed back into their housing areas, contraband not being aggressively searched out and removed etc.) The majority of respondents answered that the female inmates are treated lightly when it comes to security in some instances but that the situation appears to be improving. Line staff reported that inmates are prone to roam when they are let out of their housing areas but this is a combination of medical distribution and inmate programs being held outside the housing pods, lack of staffing, and lack of adequate support from supervisors when deputies seek to apply discipline to the roaming inmate. We were advised that deputies have been directed in the past not to handcuff potentially violent inmates; many of these stories revolved around one particular female sergeant. There was also a consensus among line staff that their supervisors and upper management frown on handcuffing female inmates and consider them to be less dangerous than male inmates despite several instances where line staff have been physically attacked by female inmates. Line staff pointed out that this situation appears to be changing with recent written policy supporting the safety of deputies and staff over the concern for inmate complaints and litigation. It was also pointed out by line staff that more searches need to be done in inmate housing areas and more strip searches need to be conducted on the inmates for weapons or contraband. There are two reasons they listed as to why searches are not done more often. The more significant reason is a lack of staffing to carry out the searches. The other reason is lack of discretion given to line staff. Deputies do not have the discretion to search an entire housing area at random. They need authorization from a supervisor. There is much trepidation about pulling individual inmates out of a housing area on the spot to search for weapons or contraband. Rather than go through the hassle of justifying themselves in order to get authorization from a supervisor and setting themselves up for potential complaints line staff will sometimes let searching go. Question Fourteen The respondents were asked if their line supervision and/or above supported them, if warranted, when inmates have outside relatives or friends call the Watch Commander or above over an issue. About half of the respondents have not dwelt with this issue but believe their supervisors and upper management would support them if an inmate attempted to have outside relatives or friends put pressure on the Watch Commander. The other half who had some experience with this issue had mostly negative comments to make. According to them it depends on who the Watch Commander is for that particular shift on whether you get supported or not. According to the line staff the chief goal of upper management is to make that complaint go away as quickly as possible. Often that means giving in to the inmate. We were told of many instances where staff was overruled by supervision in order to placate a friend or relative of an inmate. In one case an inmate wished to get out of the housing pod and walk around. She stated that she was sick and needed to go to the medical clinic. This particular inmate was sent twice to the clinic and medically cleared. The inmate asked the line staff to send her again to the clinic. After being refused she called a relative who called the Watch Commander and stated that her relative was being denied medical treatment. The Watch Commander immediately directed the inmate be taken to the clinic. The deputies and custody assistants who believe they are not supported also feel as if they were on trial at times. In some instances they are called into a supervisor’s office and grilled about a decision they made regarding an inmate. It bothers the line staff that it is them getting questioned instead of the inmate. Question Fifteen This last question directed towards the respondents asked them if they had anything to add. Not surprisingly, they did. A general theme the line staff spoke of is that deputies and custody assistants are trained to be assertive and proactive in dealing with inmate problems. They are given a tremendous amount of knowledge on how to deal with situations, given a uniform and badge and placed in positions of authority, then their discretion is taken away and given to the Senior Deputies and Sergeants. The majority of the respondents believe this must change if the Department is to be successful in the long run. In addition, many of the female deputies believe they will have to make a radical adjustment when they finally go to patrol. After several years of primarily dealing with female inmates and having their hands tied by management they will suddenly be on patrol and expected to behave proactively and make decisions. They feel that Twin Towers is not preparing them for this eventuality. CONCLUSION In the audit section of this report it is noted there is currently no standards or elements in place to measure how successful the female inmate programs are performing. The Department currently does not have the ability to track inmate progress or to access the recidivism rates of the inmates who participate in the available programs. We believe this is the main reason why many of the line staff have little faith in the very inmate programs for which they are charged with providing a safe environment. Once the Sheriff’s Department gathers the necessary data and provides the line staff with information on what programs are working and which ones are having difficulties, then the overall glum assessment from the line staff should change. Also in the audit section of this report it is noted the Sheriff’s Department modified its established policies and procedures relating to inmate discipline in June of 1999. The Department went from a more “punishment” oriented philosophy to a “counseling and advising” approach in regards to minor inmate violations. This change is consistent with modern correctional philosophy and is considered appropriate for operating a secure facility. This change in philosophy has also been shown, when applied correctly, to reduce inmate complaints and litigation. The days are long gone when a deputy could rely only on his or her authority or force to make inmates respond. So the question is why is there such a significant moral problem with the line staff. The very staff tasked with carrying out the Sheriff’s vision concerning the direction of the Department with regards to female inmates? The audit section of this report details a consistent lack of training afforded to the deputies and support staff tasked with carrying out this change in philosophy. We agree with this assessment. From the perspective of the line staff they have lost a great deal of their discretion in dealing with female inmates, especially problem inmates. They have also not been given the tools to replace what they believe they have lost. Before an inmate becomes enough of a problem to require some form of punishment staff must be aware of the wealth of communication and conflict resolution tools available to de-escalate the situation. If the inmate continues to be a problem and escalates the situation the line staff still have, and must be supported with, the option of applying stronger discipline. Ultimately, it is the line deputies and support staff that carry the bulk of the workload in regards to inmates. Once they have been properly trained they must be fully supported in their decision-making. Once the line staff believe they are being supported once again by their superiors the moral problem as it currently exists should fade away. The line supervisors appear on the surface to support this new approach but it is apparent they also have not been trained in its application. In their view if they support their deputies and staff the way they have in the past they run the risk of hurting their careers and damaging their ability to promote. It appears that a successful supervisor is one who gives in to inmate demands, supports the line staff sporadically, reduces the number of inmate complaints, and whose actions do not incur expensive litigation. A reduction in inmate complaints and litigation should be the result of a well-defined policy that is strongly implemented and supported. Not because supervisors, worried about what upper management will do to their careers, are turning a blind eye to their line staff. In one significant area we found some disagreement with the auditors. The auditors did not find a significant basis for some of the feelings elicited by the line staff concerning the lack of support from supervisors and above and the risk to their safety. The auditors concluded this was primarily a lack of training in the new “advise and counsel” method of interacting with inmates. While there is merit in that conclusion we believe the line staff do have a solid basis for their opinions. The different viewpoint contained in the audit section of this report has mainly to do with the broader mandate the auditors were working with and the fact that we interviewed almost three times the number of people on this issue. We must finally note that we have received extraordinary cooperation from the deputies, custody assistants, and line supervisors at Twin Towers. We found the staff to be people of utmost character who certainly represent the Department’s “Core Values.” With people of such high caliber on the Department the Sheriff’s vision of where law enforcement needs to go in the future can become a reality.
No recommendations for this finding
F1999
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OMC’s audit activity for the other three providers are summarized in the following tables. The following findings are noteworthy: q OMC conducted multiple audits of the same facility in intervals of less than one year q Intervals between OMC audits ranged from one week to 19 months q OMC requested CAPs from 100% of these sites 108 q OMC’s notification to providers that their CAP was approved range from 20 days to 182 days OMC’s management of the audit process is uneven. OMC has scheduled audits with a frequency not allowed for in the PPP Provider Manual. OMC routinely requests CAPs and advises providers when they are past due in providing the CAP. Yet, OMC has taken up to six months to notify the provider of the acceptance of the CAP. Such delays mitigate the value of the audit/CAP process. Based on these findings, the contractors’ frustration with the audit process appears justified. AIA Audit Findings American Insurance Administrators, Inc. (AIA) is the third-party claim administrator (TPA) for the PPP program. AIA’s Procedures Are Logical, Follow Standard Industry Practices And Are Customized to Meet the Needs of the PPP Program, But Some PPP Requirements Delay Finalizing Claims. PPP providers submit claims to AIA either electronically or by mail. AIA then processes the claims following procedures typical of third-party claim payers, i.e., logging in claims, determining patient eligibility, determining eligible expenses and authorizing payment. However, AIA’s claim adjudication process is not as involved as it might otherwise be, because of the reimbursement agreement under the PPP contract. DHS reimburses PPP contractors a flat amount depending on the type of service rendered. The reimbursement for a PPP office visit is currently $83.82 per visit (inclusive of all ancillary services provided in connection with that visit). Where the provider also has contracted with DHS to provide Case Management (CM) services, the provider is also entitled to a flat $27.00 per month (not per visit) for CM services rendered. AIA’s claim adjudication process therefore focuses on four elements of the claim: 1. Patient eligibility for Medi-Cal 2. Condition treated during the billed PPP visit 3. Whether or not CM services were billed 4. Whether or not the provider contracts under the PPP program to provide CM services. AIA does not need to adjudicate the claim in terms of reasonable and customary fees or coordination of benefits (COB), two factors typical of major medical claims processing routines that are both labor and time intensive. These two elements are obviated by the nature of the PPP program’s reimbursement provisions. AIA screens PPP claims for possible Medi-Cal coverage, because Medi-Cal is the State program most likely to provide an alternative source of funding for medical services for the indigent and uninsured population targeted by the PPP program. AIA must deny PPP claims for patients they determine are enrolled in Medi-Cal. Once AIA confirms that the PPP patient is not enrolled in Medi-Cal, AIA’s adjudication process focuses on determining the appropriate level of provider reimbursement. This is first of all a function of the condition treated during the billed PPP visit. Certain kinds of services, or services in connection with certain diagnoses, are not reimbursable under the PPP contract. Mental health services, podiatry services, and chiropractic services are among the services excluded from coverage under the PPP program. Diagnostic codes (ICD-9 codes) are shown on the PPP bill. AIA reviews these diagnostic codes to determine which claims are for treatment of conditions not eligible for reimbursement under the PPP program. Where the ICD-9 codes indicate an ineligible condition, AIA must deny the claim. Once AIA confirms that the condition causing the office visit is eligible for coverage under the PPP program, AIA’s adjudication process then determines the appropriate level of reimbursement for the services provided. If the billing indicates that CM services were provided, AIA then determines: (1) if the provider is contracted to provide CM services; and (2) if the condition treated (ICD-9 code) is eligible for CM services. Where both conditions are satisfied, AIA then reimburses the provider a flat amount of $27.00 for the month for CM services, in addition to the flat PPP program reimbursement amount of $83.82 for the visit. Where either condition is not met, AIA denies the CM reimbursement fee and authorizes only payment of the flat PPP program amount of $83.82 for the billed visit AIA then generates a claim report, which goes to the PPP provider. This report identifies which patients’ claims were denied, with explanatory notes showing the reason for the denial. AIA also generates a Remittance Advice, which goes to OMC where it is processed and forwarded to the Auditor-Controller of DHS to generate a payment warrant for the PPP provider. As indicated above, PPP providers must submit claims to AIA within 45 days of the date of service. AIA must deny claims received after this 45-day window has closed. However, AIA’s ability to process claims in a timely manner does not depend solely on the timeliness of claim submission by the providers. Regardless of when the PPP providers submit claims to AIA, AIA cannot adjudicate the claims until they receive the Medi-Cal eligibility data from DHS. AIA reported during our audit that DHS typically provides the Medi-Cal eligibility data between the 10th and the 20th of the month following the claim cycle. That is, DHS would send AIA the Medi-Cal eligibility data for the month of March 2001 between April 10 and April 20, 2001. During the audit, CGJ asked AIA to provide a report showing the dates AIA received the Medi- Cal eligibility data from DHS for the past year. The data are shown below. Data Received From DHS: February 2001 3/21/01 January 2001 3/15/01 November and December 2000 12/20/00 October 2000 11/17/00 September 2000 11/08/00 August 2000 08/31/00 July 2000 08/10/00 June 2000 07/31/00 May 2000 07/05/00 April 2000 05/04/00 March 2000 04/05/00 February 2000 03/08/00 According to AIA’s data (above), DHS provided the Medi-Cal eligibility data by the 20th of the following month for 6 out of 12 months (50%). DHS provided data beyond the 20th of the following month five times out of 12 (42%). For the month of August, DHS provided the data to AIA at the end of that month. This history indicates that 42% of the time, the providers’ obligation to submit PPP claims to AIA within 45 days of service (as stipulated in the PPP-GRHC Programs Provider Manual) is rendered moot by DHS’s delay in providing the Medi-Cal eligibility data to AIA in a timely manner. For example, a contractor must submit claims for services rendered January 1, 2001 by February 15, 2001 (45 days from the date of service). However, DHS did not provide AIA the Medi-Cal eligibility data for January 2001 until March 15, 30 days after the submission cut-off date. Similarly, claims for services rendered on September 1, 2000, had to be submitted to AIA by October 15, 2000 (45 days). But DHS did not provide AIA the Medi-Cal eligibility data for September 2000 until November 8, 24 days after the submission cut-off date. Contractor File Audit Findings As part of CGJ’s management audit of the PPP program, the contract monitoring files that OMC maintained on 31 PPP contractors were reviewed. These files contained only the most recent OMC audit of the PPP contractor. Thus it was not possible to perform a longitudinal assessment of OMC’s monitoring activities for these contractors. However, these files did furnish a panoramic “snapshot”, as it were, of OMC’s monitoring activities of the contractors involved in the PPP program. OMC’s Monitoring Process Is Primarily Manual. Each monitoring file typically contains the following items: q A “Confirmation Letter” from OMC/Medical Administration. This letter notifies the PPP provider of an upcoming site visit/audit. This letter satisfies the notice requirement to the PPP contractor under the PPP contract (cf. Sec. 31.C of the Contract). This letter also specifies the name of the facility, the facility address, and the date of the scheduled site visit/audit. q A copy of the Monitoring Instrument and related Worksheets, which OMC/Medical Administration will use to evaluate the provider’s facility and operations. q A “Findings Letter” from OMC reporting the results of the site visit/audit to the PPP contractor. In each case, the site visit/audit discovered “deficiencies” sufficient to require that the contractor prepare a “Corrective Action Plan” (CAP) by a due date specified in the “Findings Letter.” q A copy of the OMC’s “Assessment Team Report Summary.” This report summarizes the findings of the site visit/audit, and indicates the magnitude of any deficiencies noted. This report also cross-references the applicable sections in the Monitoring Instrument and related Worksheets used by the audit team in generating the Report Summary. q A copy of the completed Monitoring Instrument and related Worksheets. Part of the instrument is a document that is always a computer-generated; the remainder is completed manually. q A copy of the “Corrective Action Plan” filed by the contractor. q Copies of additional correspondence to or from the contractor regarding the status of the requested CAP or amendments to the CAP. q A copy of the CAP “Acceptance Letter” from OMC to the contractor acknowledging OMC’s approval of the CAP. In addition, contract monitoring files may contain additional supporting documentation regarding facility licenses, insurance policies, certifications, waste management contracts, and copies of the providers’ Articles of Incorporation. Difficulty Accessing Files Limited the Ability to Validate Some of the Work Performed by DHS. OMC would not allow CGJ to review the original contract monitoring files. OMC took the position that the original files contained patient-specific information, which was subject to various confidentiality requirements mandated by state and federal law. Accordingly, OMC devoted staff resources to copying the original files to redact all such patient-specific information. This delayed CGJ’s receipt of the file copies by about two weeks. Similar concerns surfaced during our site visits. OMC personnel accompanied the management audit team on these site visits, to ensure at least in part that patient-specific information was not disclosed to or copied by the CGJ management audit team. This prevented us from conducting any meaningful document review at the provider site. OMC’s Monitoring Files Are Inconsistently Documented And Show Delays in Notifying Providers of CAP Approval. The review of the 31 files identified the following: q Fourteen files had CAPs requested in April 2001; therefore, there had not been time to receive the CAP and processing timelines could not be measured for these files. q Four files lack sufficient documentation to determine the date OMC notified the provider of CAP approval or the elapsed time from OMC’s approving the CAP to OMC notifying the provider of approval. q OMC notified five providers within 30 days of CAP approval. q OMC notified one provider within 60 days of CAP approval. q OMC took from over three months to over five months to notify six providers of CAP approval. These findings indicate that OMC’s management of the CAP approval process is problematic, since in 38% of the cases audited, OMC took more than 90 days to issue an approval. Similar gaps in file documentation and delays in notifying providers of CAP approval were demonstrated during the management audit of the four providers who either became insolvent or whose contracts were terminated within the past two years. Assessment Summaries and Measures Are Inconsistently Applied and Documented In the files reviewed, 31 contract monitoring files contained 25 “Assessment Team Report Summaries.” OMC uses this form to summarize the findings of the Assessment Team Survey after they complete their site audit and review of a PPP contractor’s facility. It provides a concise overview of the findings reported on the more lengthy monitoring instruments and worksheets. These facility site audits were conducted between February 16, 2000, and February 15, 2001. However, over this 12-month period, the Report Summaries used by OMC indicated three different matrices of measurable standards for the facility site review component. These ranged from 10 standards to 12 standards. Of the 31 files audited, five did not contain an assessment team report summary of any kind. Three of the files lacking the summary were for contractors whose contracts had been terminated. In addition, two other files lacked a facility site review, which is to be done annually. The dates of site audits reflected on the 25 Report Summaries also fail to indicate any kind of intentional evolution from a simpler summary to a more complex summary, as shown below: q 12 Standards: site visits between 4-27-2000 and 12-13-2000 q 13 Standards: site visits between 4-25-2000 and 2-15-2001 q 16 Standards: site visits between 2-16-2000 and 2-22-2000 Conclusions, Opportunities For Improvement And Recommendations Although these recommendations may appear simplistic on the surface, they actually represent major structural and process changes that can significantly improve the PPP program. More important, however, is the potential jeopardy to the PPP programs once the 1115 Waiver and associated funding ends. DHS is aware of this problem and is striving to find alternative funding strategies. Although some PPP-funded programs may have had operational, fiscal and health care difficulties, the majority is highly committed to serving low income and indigent populations. If such funding were to be discontinued, the DHS clinics and any surviving non-County clinics would have to absorb these patients currently served by the PPP-funded clinics. These recommendations and the need to pursue replacement funding are critical and will be extremely difficult to achieve. Establish accountability by identifying one organization responsible for the program. Several different offices manage the PPP program. It is incorporated in the operations of functions of several divisions: q The Office of Managed Care/Community Health Plan (OMC/CHP) manages aspects of the PPP program through various internal divisions: ◊ Financial Services is responsible for monitoring financial performance of PPP program contractors. ◊ Medical Administration is responsible for administering the clinical and medical components of the PPP program. ◊ Member Services supports OMC’s product line and provider network expansion efforts for all OMC programs, including the PPP program. ◊ Network Administration (within the Operations Division) administers the PPP program. q The Office of Ambulatory Care (OAC) manages other aspects of the PPP program. The OAC tracks, monitors, analyzes and plans the performance of PPP program contractors in order to meet the Performance Standards established by the 1115 Waiver Office within DHS. Specifically the OAC is responsible for: ◊ Maintaining an ambulatory care visit level under the PPP program of 700,000 visits per year during the five-year life of the 1115 Waiver extension (to June 2005). ◊ Improving the effectiveness of the referral centers. ◊ Seeking Federally Qualified Health Center status for PPP contractors. q The Inspection and Audit Division of DHS oversees the Waiver Office’s quarterly reports on the progress of the 1115 Waiver commitments, some of which involve the PPP program. q The Contracts and Grants Division of DHS provides contract support services to the PPP program by interfacing with OMC and OAC. With this distributed responsibility, a contractor’s history is not available in one place. q OMC maintains one set of contract files and the current year monitoring file on site. q Prior years’ monitoring files are stored, some on-site and some off-site. q No single document captures the general contours of a contractor’s history from entry into the PPP program to the present. Responsibility for the program as a whole should be assigned to one entity or person within DHS. This recommendation does not mean that duplicate processes or structures should be implemented. The role of this person or unit should be the focal point for the program. This function would include coordinating with the persons performing activities related to PPP in other divisions and ensuring that PPP issues are followed to their conclusion. To some extent the Office of Ambulatory Care functions in this role; however, information about the PPP contracts does not reside in this office in its entirety; often one needs to ask in several offices before obtaining the requested information. This also means no one person has a complete understanding of the issues of the program. Evaluate staffing and training needs for ongoing compliance with monitoring requirements. Both Medical Administration and Finance indicated that they did not receive additional resources when responsibility for PPP program monitoring was assigned to OMC. In addition, the processes appear to be primarily manual. Monitoring the PPP contracts is only a part of OMC’s responsibility. At the inception of this management audit, OMC’s inventory of contracts to monitor totaled 264; of these, 74 were PPP primary care contracts. Through its various divisions, OMC is also responsible for monitoring: q Medi-Cal Managed Care enrollment and utilization q Healthy Families Program enrollment and utilization q County Temporary Employees Health Care Program q General Relief Health Care Program q Pharmacy Services q Quality Management q Utilization Management q Case Management q Credentialing/Site Certification. Responsibility for the PPP contracts was transferred to OMC in 1997. Management indicated that this occurred without any additional staffing being allocated to OMC. Currently Medical Administration has eight monitors and the Financial Services Division has two. DHS should evaluate the staffing requirements along with the system support that monitoring requires. This evaluation should include consideration of the training necessary to audit effectively and what is the best model for the staff mix on an audit team Address morale issues arising from the leadership and fiscal instability of DHS. We have already discussed the organizational characteristics that contribute to fragmented management of the PPP program. This fragmentation supports an environment in which everyone is focused on their own narrowly-defined area of responsibility. This is exacerbated in an organization in which leadership is often in flux and everyone fears for the continued existence of their job. Executive leadership at OMC has been unstable. OMC provided a listing of Executive Directors and Medical Directors of the division. This listing showed that: q Eight individuals have served as Executive Director of OMC since 1992. Prior to that, one person served for 11 years. Since then, there have been changes each fiscal year and several of these Executive Directors were on interim status. q The current Interim Director has been in place since October 2000. q Since fiscal year 1995, there has been turnover in the Medical Director position every year. q The current Chief Medical Officer has been in place since February 2000. q The current Chief Financial Officer has been with OMC since September 1998. Moreover, DHS is operating in a financially unstable environment. The County’s financial crisis in 1995 was the impetus for the 1115 Waiver. Funding from this will disappear in three years. DHS is implementing a strategic plan focused on responding to this decrease in revenue. Much of the plan calls for staff reductions. The County should place a high priority on devising ways to creating a work environment that fosters teamwork and shared goals. Coordinate the audit function within the County. DHS’s audit function is not coordinated among County departments or DHS divisions: q Most programs within DHS have their own audit process. q Providers with multiple contracts (for different programs) are subject to multiple audits. As noted earlier in this report, one provider who has several County contracts is frequently subjected to audits by the different offices responsible for the various programs. This is a cost to the provider and the County; the provider repeatedly prepares information, much of which is duplicative, for different auditors and the County uses staff resources on duplicate data collection, analysis and reporting. Therefore, the County should consider centralizing contract monitoring. Centralized contract monitoring will require involvement of each of the programs that have monitoring requirements to ensure that all necessary factors are monitored. Transfer fiscal monitoring from OMC Financial Services to the coordinated function. Fiscal monitoring currently resides with the Financial Services Division of OMC. Financial Services had at most two staff persons dedicated to the PPP program. While the focus is different from the program and clinical monitoring, there are duplicate procedures. Additionally, Finance has indicated that they do not have adequate resources to complete all monitoring within the timeframes required. At the beginning of our management audit, the current year’s goal was to complete monitoring for half the contractors. Since that time, additional staff resources were temporarily provided and the division is currently expecting to complete all monitoring by June 30, 2001. None of the files reviewed included documentation of fiscal monitoring. The County should consider adding fiscal monitoring to the previously recommended central audit function. Articulate the philosophy behind the County’s relationship with the PPP partners. The success of the PPP program depends to some extent on the tone of the relationship with the private partners. DHS does not appear to speak with a single voice about this relationship. Are the providers who have PPP contracts true “partners” in the County’s endeavor to provide care to the target population? True partnership involves collaboration in planning, monitoring, quality improvement processes, etc. Are these providers true partners or contractors who accept the terms of the contract and operate entirely independently of the County? A successful partnership takes time and resources to achieve. Are DHS staff or provider staff able to make this commitment? What are the benefits and drawbacks to each of the relationship models? The program’s operation will improve if all parties understand their respective roles. Providers will not receive conflicting information from different offices and DHS staff will focus their efforts toward one goal. Therefore, DHS should undertake a dialogue, both internally and with community groups, to define the relationship. Review Contract Terms for Take Over Facilities. One of the clinics we visited occupied a portion of a County-owned building. The clinic has a 40-year rent-free lease. The clinic is responsible for property taxes, utilities and any other assessments along with improvements, which will revert to the County at the termination of the lease. This contractor receives the same reimbursement for services that providers who operate in their own space, receive. The County should review these agreements to ensure that they are in the best interests of the County, as well as the PPP program as a whole. Encourage contractors to share best practices such as the decision tree used at one site. Periodic meetings for providers to receive or share information do take place. Provider practices, which are particularly successful, should be shared with the providers in these meetings or by another method. Providers may identify these practices themselves or DHS monitoring staff may identify them in the course of their audit activities. Evaluate ways to improve the impact of the reimbursement process on providers. Several parts of the reimbursement process have a negative impact on providers. The 45-day claim submission window is short of industry standards. One of the main reasons Finance believes this deadline is necessary is that visit levels can be monitored on a timely basis to ensure targets are met. Not only do numbers of visits paid for by the PPP program need to be monitored, but also unused resources need to be allocated to over-performing providers on a timely basis. Finance indicated near the end of the management audit that they allow exceptions to the deadline, but they involve appeals from the providers and staff time at OMC to approve the requests and forward instructions to AIA. Finance was in discussions with provider representatives to evaluate how to best meet everyone’s needs. They should conclude these discussions and implement changes as quickly as possible. Some providers indicated that reimbursement levels are too low for the services they provide to PPP patients. Their perception and OMC’s regarding the level of services, therefore the cost of serving this population, are not congruent. OMC should ask providers to provide OMC with the underlying patient and cost data so that reimbursement levels can be evaluated. H E A L T H FOOD SERVICES I N S P E C T I O N C O M M I T T E E Delores Munoz, Chairperson Robert Bagwell Richard Salazar Victoria Small RESTAURANT AND FOOD MARKET INSPECTIONS INTRODUCTION/OBJECTIVE The purpose of this investigative study is to follow the process of how restaurants and food markets are inspected and graded. The committee felt it would be beneficial to do a follow-up of a prior Grand Jury investigation. Environmental Health, a division of the Los Angeles County Health Services Department was contacted and a meeting was arranged with the staff. The committee members were informed as to the educational criteria that is necessary to qualify as an inspector. Inspector applicants are required to have a Bachelor of Science Degree. Inspectors are routinely rotated every two (2) years. Presently, the Los Angeles Environmental Health Division is budgeted for one hundred and forty-five (145) inspectors. Currently, the Inspector Division is fully staffed. METHODOLOGY The purpose was to familiarize the committee as to the procedures followed during a field inspection and also arrange for ride alongs. The Chief Environmental Specialist explained to the members the procedure they follow at respective locations. Members of the restaurant ratings committee accompanied an inspector on their routine visits. FINDINGS In the state of California there are only three (3) counties that participate in the ratings program. These counties are Los Angeles, San Diego and Riverside. Los Angeles County the largest of the three (3) has sixty-two (62) participating cities. Within Los Angeles County retail food facilities number about thirty-five (35,000) which are serviced by twenty-two (22) regional offices. Each inspector has a caseload of approximately two hundred and twenty (220) food facilities to inspect annually at a ratio of approximately sixty-five (65) routine inspections per month. Los Angeles County adopted Ordinance 97-0071 effective January 14, 1998. This ordinance would require Los Angeles County food facilities to be inspected and rated. It also stated that incorporated municipalities within Los Angeles County may adopt or reject the provisions of this ordinance. At present sixty-two (62) of the eighty-five (85) cities in Los Angeles County are already abiding by the provisions of the ordinance, which require posting of earned letter grade. Inspectors rate retail food establishments on the point system as follows: 100-90 points = “A” rating 89-80 points = “B” rating 79-70 points = “C” rating 69-less points = Is not letter graded Facilities having a score of sixty-nine (69) twice within a twelve-month period are faced with a fourteen-day closure. Restaurants can be closed immediately by an inspector for lack of potable water or sewage back up. This situation is considered an immediate danger to the public health. Facilities can also be closed in cases of numerous and gross violations of the health code. The inspector must confer with his/her supervisor before taking action to close a retail food facility. After closure, a hearing with the area manager is held, whereupon, the operator is informed what requirements must be met in order for the restaurant to be re-opened. The facility is then re-inspected to verify that all requirements have been met before the restaurant can be re-opened. If repeated violations occur, restaurants can face the possibility of charges being filed by the Department of Environmental Services with the City Attorney or District Attorney. The schedule of inspection visits depends on what classification the facility falls under: RA-1 High risk 3 visits per year Restaurants RA-2 Medium risk 2 visits per year 1 item establishments RA-3 Low risk 1 visit per year Gas station/mini-mart RA-4 Any facility that has had bad performance history In addition, food facilities that have shown, through inspection or historical data, to operate substantially below a reasonable compliance levels are placed in category RA-4. After one year the establishment is re-evaluated to determine if its RA category can be decreased. Mobile units, farmers markets and street vendors are not rated. There are three (3) cities that have not adopted the ordinance because they are residential communities. These cities are Bradbury, Hidden Hills and Rolling Hills. Cities that have not adopted the ordinance are Arcadia, Avalon, Azusa, Baldwin Park, Claremont, Compton, Glendora, Industry, La Habra, Lawndale, Monrovia, San Marino, Sierra Madre, Signal Hill, Montebello, Torrance and West Hollywood. The cities of Pasadena, Long Beach and Vernon have their own health department. Cities that have not adopted the County’s grading ordinance are inspected, but are not issued a letter grade.
No recommendations for this finding
F2001
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During the study period the following activities were performed: Entrance Conference: An entrance conference was held with representatives of the Grand Jury and LAUSD supervisory personnel from various divisions. This entrance conference was held to discuss the audit work plan, describe the audit process, establish audit procedures and protocol, and respond to questions involving the audit work plan and time frame. Field Work: Field work started with survey interviews with numerous District staff, including the Chief of Staff, the Associate Superintendent of Planning, Assessment and Research, the Executive Administrator of Business and Finance, three Local District Superintendents, the Controller, the Budget Director, the Director of the Independent Analysis Unit, the Inspector General, the President of the Board of Education, the Chairperson of the Budget Committee of the Board of Education and several support staff. In addition, follow-up interviews were conducted with appropriate supervisory personnel and staff on topics selected for further analysis. Various printed information including, District policies and procedures, background materials, Board of Education minutes and records of actions, State law and regulations, District leases, employment contracts, internal accounting reports, payroll records, budget documents and annual financial reports were also reviewed. Preparation of Findings and the Draft Management Audit Report: Based on the field work and analyses conducted during the audit, findings and recommendations have been prepared for the consideration of the Superintendent and the Board of Education regarding certain aspects of the District’s functions. These recommendations related to the District’s budget system, accounting system, personnel management system, and performance reporting to the Board of Education. Section 1: Analysis and Comparison of LAUSD FY 1999-00 Versus FY 2000-01 Administrative Staffing and Costs: LAUSD Reported FY 2000-01Budgeted Position Reductions and Related Savings On March 14, 2000, at the regular meeting of the Board of Education the Los Angeles Unified School District (LAUSD) Superintendent presented the report entitled Eleven Local Districts, One Mission. This report introduced the proposed plan to reorganize the District. Included in this presentation, the Superintendent stated, “the reconfiguration of the Central Office removes 834 positions from the Central Office and saves over 46 million dollars”. On of the report, it was stated that approximately $10.7 million in General Fund savings would be realized through the restructuring, and approximately $35 million in Special Fund savings would be realized. The total reduction in personnel at the old Central Office structure was reported to be approximately 834 positions. In order to obtain a full and accurate understanding of the reported staff reductions and related savings, we met with LAUSD budget and administrative staff to review and discuss the reported budget savings cited in the Executive Summary of the report on and in a schedule on of the report (Attachment 1.1). Table 1.1 below is a summary of the budget information reported on which shows that a net of 333.11 Central Office positions (not 834 positions) would be eliminated with a savings of $46,102,464. In addition to the 333.11 positions eliminated, 501.42 Central Office positions were reassigned to the new Local Districts or to District schools and remain on the LAUSD payroll. Therefore, although the proposed plan stated in the Executive Summary of the LAUSD submission that the reductions in personnel at the Central Office would be 834 positions (333.11 + 501.42), only 333.11 positions were actually deleted from the Central Office budget. This net reduction of 333.11 positions was accomplished by closing or reducing staff in existing Central Office units and creating new offices and positions as shown in Table 1.1. Further, 35 of the positions included in the net reduction of 333.11 positions from the Central Office budget were added elsewhere in the LAUSD budget. Therefore, the actual net reduction of budgeted positions District-wide was only 298 positions. Table 1.1 Summary of LAUSD Reported Budget Reductions Related to the District Reorganization Positions Cost Closed Offices and Reduced Offices (802.11) ($86,961,693) New Offices/Positions (469.00) (40,859,229) Net Position Reductions/Cost Savings* (333.11) ($46,102,464) * However, approximately 35 of the 333.11 positions were transferred to school budgets. Therefore the actual net reduction of positions District-wide was 298. Grand Jury Audited FY 2000-01Budgeted Position Reductions and Related Savings All of the above data and discussion is based on January and February 2000 budget information included in the “Eleven Local Districts, One Mission” report as supplemental information to document the calculation of position reductions and cost savings. To independently verify the accuracy of the summary position and cost savings cited on pages 5 and 28 of the report, as clarified above to reflect the actual reduction of 298 positions rather than 834 positions, we attempted to reconcile the supplemental budget documentation appended to the report. The results of that analysis showed that the District’s corrected calculation of 298 positions deleted from the budget and $46.1 million of savings was not supported by the supplemental documentation attached to the report. The District reported reduction of 333.11 Central Office positions (excluding the 35 Central Office positions transferred to other LAUSD offices) included the deletion of 73.50 General Fund positions and 259.61 Special Fund positions. Table 1.2 shows the District’s proposed budget reduction of 333.11 positions by funding source, including the Regular funded (General Fund) programs and Special funded programs. After our efforts to reconcile the supplemental budget documentation to the reported position reductions and related savings were unsuccessful, the LAUSD Budget Office assigned staff to disaggregate the supplemental budget documentation in order to perform a detailed reconciliation. LAUSD staff determined that the attached supporting schedules, as formatted, did not reconcile to the reported reorganization savings and resulted in a calculation duplication overstating the position reductions. LAUSD budget staff stated that the current budget system is not organized in a manner that separates administrative and school positions in all cost centers, and the budget system does not have the capability to do so. However, based on the detailed analysis performed by District budget staff to manually exclude positions that were originally included in the Central Office and now are included in LAUSD school budgets, it was determined that only 278.14 positions would be eliminated at a savings of $32,942,571 rather than the 333.11 positions and $46,102,464 reported by the District. Additionally, the LAUSD cost analysis of the proposed restructuring plan did not fully account for other costs that would be incurred by the local districts. The primary cost not accounted for was the cost of each local district administrative office. As part of this review, we requested the lease documents for each of the local district offices. The leases revealed that an estimated $2,987,003 of additional expenses would be incurred for the lease of these facilities. However, these costs were not accounted for in the LAUSD proposed restructuring plan. Therefore, the LAUSD reported budget savings should have shown a net savings of $29,955,568 or 35 percent less than the stated amount of $46,102,464 as shown in Table 1.2 below. Table 1.2 Comparison of LAUSD Reported Position and Budget Cost Savings Versus Grand Jury Audited Position and Budget Cost Savings LAUSD Grand Jury Reported Budget Savings Audited Budget Savings Positions Cost Positions Cost Regular Funded Programs 73.50 $10,643,701 73.50 $10,643,701 Specially Funded Program* 259.61 35,458,763 204.64 22,298,870 Position Reductions/Cost Savings 333.11 $46,102,464 278.14 $32,942,571 Less Cost of Local District Leases (2,987,003) Adjusted Net Cost Savings $29,955,568 * Attachment 1.2 provides the LAUSD worksheet showing the revised position deletions and related savings of $22,298,870. Actual FY 2000-01 Position Reductions and Cost Savings Achieved by LAUSD Based on Payroll Because of the lack of supporting documentation contained in the supplemental budget information and the limitations of the budget system that prevent the separation of administrative from school positions and costs, we concluded that the budget information reported in the “Eleven Local Districts, One Mission” report did not accurately report position and cost savings that would result from the reorganization. Further, even if accurately budgeted and documented, actual savings may not have any relationship to changes in budgeted appropriations from one year to the next. Therefore, we conducted an analysis of actual District staffing and costs based on payroll documents to more accurately determine the approximate number of positions eliminated and cost savings achieved as a result of the restructuring. This analysis was performed based on a special report prepared from District Payrolls showing actual paid hours of all employees in administrative cost centers for FY 1999-00 as of June 30, 2000. A second special report identified actual paid hours of all employees in administrative cost centers for the first eight months of FY 2000-01, based on the payroll ending February 28, 2001. By comparing the final FY 1999-00 actual payroll hours with the FY 2000-01 year-to-date payroll hours through February 28, 2001 annualized through June 30, 2001, the change in actual staffing resulting from the reorganization can by projected. This analysis revealed that there were 5,436 full time equivalent employees in FY 1999-00 and approximately 5,700 full time equivalent employees in FY 2000-01, based on February 2001 payroll. Although the reorganization reportedly eliminated from the budget about 333 position as shown in Table 1.2, actual staffing shows a projected increase of 264 employees following the reorganization. However, because the payroll system is patterned after the budget system organizational structure, school employees and non-school employees are commingled in the payroll system as well. While this somewhat overstates the true number of administrative positions, the overstatement occurs in both years and should be substantially offsetting. As confirmation of this conclusion, the Independent Analysis Unit (IAU) of the LAUSD was consulted. This Unit, which reports directly to the LAUSD Board of Education, had previously performed a similar payroll comparison to determine if administrative staffing had increased or decreased since the reorganization. However, in performing its analysis, the Independent Analysis Unit manually adjusted the actual payroll data to exclude school employees from the comparison in order to isolate administrative positions. The IAU report, which is included as Attachment 1.3, is based on the actual number of employees assigned to non-school locations and compares December 1999 to December 2000. This analysis shows an increase from 5,380 in December 1999 to 5,516 in December 2000, 136 more employees following the reorganization. During the exit conference, LAUSD staff asserted that because the payroll system accounts for all District positions, irrespective of the accounting fund from which they are paid, it is possible that some of the positions included in the administrative cost centers that were analyzed may have been positions funded by capital improvement funds unrelated to school operations. If this occurred, it could have distorted the results of the analysis. Therefore, LAUSD administrative staff has requested its Independent Analysis Unit to reexamine the position detail in the administrative cost centers that were analyzed to ensure that no capital program positions were included. In order to estimate the cost of the additional 136 positions, the Independent Analysis Unit determined the average annual employee cost to be approximately $78,296, including benefits. Therefore, IAU projected the increased cost of these 136 administrative positions to amount to approximately $10,648,256 annually. Table 1.3 compares the results of the payroll analysis conducted by IAU based on December 2000 payroll data to the comparable analysis we performed based on February 2001 data. Table 1.3 Comparison of Actual LAUSD Administrative Staff Based on Payroll Hours Paid in December 2000 and February 2001 Full Time Employees FY FY Net 1999-2000 2000-2001 Change Independent Analysis Unit 5,380 5,516 136 Grand Jury Auditors* 5,436 5,700 264 * The Grand Jury full time equivalent staffing was not adjusted to exclude school employees reported by the payroll system in administrative cost centers. Section 2: Comparison of Organizational Responsibilities of the LAUSD Superintendent for FY 1999-00 and FY 2000-01 The LAUSD reorganization, implemented on July 1, 2000, was intended to accomplish several improvements designed to streamline organizational communication and operational efficiency, facilitate more direct and timely community access, and establish a uniform District-wide goal of improving student achievement. The LAUSD organization that existed in FY 1999-00 was a more vertical organization that reportedly was more bureaucratic and inefficient, and was characterized by untimely decision making and excessive paperwork (Attachment 2.1). At the exit conference, LAUSD staff reported that the actual chain of command also included an associate superintendent and three area superintendents between the cluster administrators and the deputy superintendents. The FY 1999-00 chain of command between the more than 700 schools and the LAUSD Board of Education as shown in the organization chart was as follows: Board of Education Office of Superintendent Chief Operating Officer Deputy Superintendents Cluster Administrators Schools In comparison, the reorganization plan implemented by LAUSD makes significant improvements to enhance organizational access and timeliness by shifting increased responsibility and authority down to local district superintendents. The FY 2000-01 LAUSD organization structure is significantly consolidated as shown in Attachment 2.2. The FY 2000- 01 chain of command between the more than 900 schools and the LAUSD Board of Education is as follows: Board of Education General Superintendent Local District Superintendents Schools Under the FY 1999-00 organizational structure, 700 plus LAUSD schools, more than 700,000 students, and the numerous communities served by the LAUSD, all interacted directly through the Office of the Superintendent of Schools and related Central Office administration. Comparatively, the FY 2000-01 organization divides the reporting relationships of the schools among 11 local districts as follows: Table 2.1 Comparison of the Number of Schools and Students in the LAUSD 11 Local Districts Average Number of Number of Number of District Schools Students Students Per School D 93 59,000 634 C 88 68,000 773 A 85 68,000 800 K 82 67,000 817 G 70 60,000 857 E 71 67,000 924 B 80 77,000 944 I 52 52,000 963 F 66 61,000 1,000 H 66 68,000 1,030 J 41 62,000 1,512 Total 794 709,000 893 The 11 local districts were reportedly determined based on achieving a manageable number of students per district and school, the number of schools and school sites in each district, projected future enrollment growth, the proportion of permanent teachers in each district, existing student matriculation patterns, and other considerations. A description of the communities served by each district is shown in Attachment 2.3. Section 3: LAUSD Local District Superintendent Employment Contracts In order to determine what benefits, perquisites, and special working conditions have been provided to the LAUSD 11 Local District Superintendents, we requested copies of the employment contracts for these positions. The 11 Local District Superintendent contracts are identical, with the exception of salaries, and provide the following employment conditions: • Two year term of each contract from commencing July 1, 2000, and ending June 30, 2002. • Salary set at salary range 04J on the Master Salary Schedule for certificated employees. for Local District Superintendents; one is set at step two. This salary range has three steps. Ten of the 11 Local District Superintendents were appointed at step 1, which amounts to $136,000 annually. One Local District Superintendent salary was set at step 2, which amounts to $143,000 annually. The contract does not specify when promotion to step 3 would occur. Step 3 amounts to $150,007 annually. • The Local District Superintendent shall be entitled to all benefits and rights available to other twelve-month classified executive or administrative employees. These benefits include: - Medical, dental and vision insurance for the employee and qualifying dependents. - Life insurance in the amount of $25,000 - Retirement through the State Teachers Retirement System or Public Employees’ Retirement System - Thirteen (13) days sick leave and 24 days vacation annually. In addition to the benefits specified in the written contract, each Local District Superintendent receives an assigned automobile and a cell phone. Section 4: LAUSD Management System Problems During the course of the audit, we identified and staff reported various weaknesses in important management systems that are critical to the efficient day-to-day functioning of the District. Problem areas include the budget system, the personnel management system, the reporting and monitoring components of the accounting system and the payroll system. These systems are inadequately integrated to ensure cost centers do not exceed budgets and to avoid the overfilling of authorized positions. District staff reported that the District is in the process of replacing its budget and position control systems, and expects this project to be completed during FY 2001- 02. Although the analysis of these problems was outside of the scope of the audit, these issues are reported here in accordance with Section 7.46 of the United States General Accounting Office Auditing Standards. This auditing standard requires the disclosure of issues warranting further analysis and considered significant by the auditor, but the issues are not directly related to the audit and resources were not provided to pursue them. Examples of some of the problems encountered include the following: Budget System: • The existing organization of the budget cost centers does not separate school from non-school costs in all cost centers. Therefore, budget analysis and comparisons between school and non- school costs and staffing is not possible unless manually performed. • Salary and benefit costs are estimated based on broad average cost projections. Neither salary step increases for employees nor salary savings related to vacant positions and attrition are budgeted because these costs reportedly have offset one another in past years. However, the FY 1999-00 LAUSD audited financial statements indicate that actual FY 1999-00 salary and benefit savings amounted to $117.2 million, which amounted to 2.74 percent salary and benefit savings. • The FY 2000-01 CAFR shows that the final General Fund budget included total available resources of $5.279 billion and total authorized expenditures of $5.921 billion for a deficit of $642 million or 12.2 percent of budget. If fully realized, this budget would have reduced the District’s reserves by 98 percent from $655 million to $13 million. • The FY 2000-01 CAFR shows that savings on books and supplies amounted to $295.5 million or 43 percent of the $689 million budget. However, LAUSD staff reported that some of the unexpended amounts related to planned savings by various schools in order to accumulate sufficient funds to make specific large purchases. It was also reported that any teacher who does not have sufficient funds to purchase text books can access a general book purchase account that is available in the central administrative budget. • No budget procedure manual exists and no annual budget instructions are prepared and distributed to organizational units throughout the District to facilitate compilation of the annual budget. Personnel Management System: • There is currently no position control mechanism to ensure that the number of positions authorized in the approved annual budget in any position classification is not exceeded in daily operations. Therefore, it is possible for more persons to be hired in any position classification than are authorized and for which monies have been appropriated. • There is currently no capability to determine the number of budgeted positions that are vacant in any individual position classification or cost center. Payroll System: • The payroll system will accept positions that are not authorized in the adopted budget or which exceed the total number of positions authorized in the position classification or organizational unit. Fiscal and Performance Monitoring and Reporting: • The Board of Education currently receives two budget status reports during the year to exercise its oversight responsibilities related to the $6.0 billion LAUSD budget. These interim financial reports are presented at a highly summarized level and provide minimal narrative explanation of budget variances, corrective actions planned or taken, and other pertinent information. No information is provided regarding staffing, including vacant positions and use of temporary employees to fill permanent positions. • Although the reorganization of the LAUSD was implemented on July 1, 2000, approximately 11 months ago, the LAUSD Board of Education has not established specific quantifiable performance benchmarks and objectives for each of the 11 Local Districts created through the restructuring. Local District Superintendents reported developing such information independently. However, the specific performance measures, objectives and timelines for achievement have not been approved by the LAUSD Board of Education and the Board does not receive periodic performance reports to evaluate the results of the reorganization. The District Executive Administrator reported that such performance based measurement and reporting is planned for the future. • Each employment contract of the 11 Local District Superintendents includes two performance measures that the General Superintendent will use to assess the performance of the Local District Superintendents. However, the Board of Education should receive comprehensive performance information on a periodic basis that is reflective of all of the important programs and objectives of the District. Section 5: Other Issues The LAUSD provides retiree health care benefits for retired employees pursuant to collective bargaining agreements. As of June 30, 2000, 29,916 retired employees met the eligibility requirements for these benefits. The cost of these benefits is funded on a pay-as-you-go basis from the various operating funds of the District. The total cost to the District for this benefit during FY 1999-00 amounted to $101,753,017. The LAUSD Comprehensive Annual Financial Report did not disclose the total estimated amount of this liability. However, the District should obtain an actuarial analysis of this liability, if it has not already done so. The total liability probably amounts to as much as $1 billion. If the District were to fund this liability in a Retiree Health and Welfare Benefits Fund and separately invest these monies in pension fund type investments similar to the investments made by the California State Teachers Retirement System (STRS), the Public Employees Retirement System (PERS), and other city, county and public agency retirement systems, LAUSD could increase its investment earnings substantially. As an example, PERS has earned an average of 12.22% during the past 18 fiscal years since 1983-84 (Attachment 5.1). This return is approximately equal to the median return achieved by the more than 50 defined benefit pension plans administered by the major cities and counties in California. Currently, more than $2.2 billion of LAUSD cash is deposited with the Los Angeles County Treasurer for investment, including over $1 billion of General Fund monies. Because of the restrictions on the investment of local agency surplus monies, the Los Angeles County Treasurer earned only 5.23% in CY 1999 and 6.10% in CY 2000. For each $100 million placed in a Retirees Health and Welfare Benefits Fund and invested on a long term basis consistent with the retirement obligation, LAUSD could earn additional investment income of at least $4 million to $6 million annually, based on achieving a net investment yield of 10.20% to 12.20%. The option to establish a Retirees Health and Welfare Benefits Fund and invest monies in retirement type investments, including corporate bonds, common stock, real estate and other investments, is provided for by Government Code Sections 53620 to 53622 (Attachment 5.2). If the District began a funding plan by setting aside $50 million per year over the next 20 years, once fully funded, the District would realize an annual benefit of $40 million to $60 million per year. Section 6: Conclusions and Recommendations Conclusions: The projected budget savings and reduction in budgeted positions that would result from the restructuring of the LAUSD as reported in the document entitled Eleven Local Districts, One Mission was misleading, inaccurate and substantially overstated. The reported budget reduction of 834 positions and savings of $46.10 million was more accurately only 278 positions deleted from the budget and savings of $29.96 million. Further, the actual change in administrative staffing since the organizational restructuring resulted in an increase of more than 100 positions and an additional cost of over $10 million. During the course of the review of the savings achieved from the reorganization, several needed improvements in management systems and reporting were identified. Budget, personnel, payroll and accounting system improvements, as well as fiscal and performance reporting enhancements, are needed. These improvements would strengthen internal controls, provide staff greater analytical capabilities and provide the members of the Board of Education with increased fiscal and performance information with which to oversee the District’s operations and formulate District policy. Lastly, the LAUSD could generate increased investment income of as much as $4 million to $6 million annually, by implementing alternative investment options for retiree health benefit monies available through Government Code Sections 53620-53622. The benefit from this alternative investment strategy could increase to as much as $60 million annually once LAUSD retiree health benefit liabilities are fully funded.
No recommendations for this finding
Conclusions 27
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CL1 Page 67Modify the budget system to allow the separate budgeting and accounting of school and non- school costs within each organizational unit or cost center.
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CL2 Page 67Develop and document budget estimates of all major revenues and expenditures, including estimated staffing costs related to salary step increases and salary and benefit savings related to vacant positions.
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CL3 Page 67Develop a budget procedure manual and annual budget instructions to distribute to organizational units throughout the District to facilitate compilation of the annual budget and improve budget documentation.
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CL4 Page 67Develop a position control mechanism within the personnel management system to ensure that the number of positions authorized in the approved annual budget in any position classification is not exceeded in daily operations. The District reports that a position control system will be implemented within two years.
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CL5 Page 67Develop a vacant position report within the personnel management system that is linked to the approved positions authorized by the annual budget and the payroll system.
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CL6 Page 67Modify the payroll system to prevent payment for positions that are not authorized in the adopted budget or which exceed the total number of positions authorized in the position classification or organizational unit.
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CL7 Page 67Develop monthly budget status reports for the Board of Education to provide more timely and detailed fiscal information to improve the Board’s ability to oversee the $6.0 billion LAUSD budget.
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CL8 Page 67Develop specific quantifiable performance benchmarks and objectives for each of the 11 Local Districts and provide the Board of Education with quarterly performance reports.
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CL9 Page 67Begin funding retiree health benefits by establishing a Retirees Health and Welfare Benefits Fund and separately invest these monies in pension fund type investments, including corporate bonds, common stock, real estate and other investments, as permitted by Government Code Sections 53620 to 53622. HEALTH CARE DELIVERY SYSTEMS C O M M I T T E E Andrew Bliss Chairperson William Kelley Violet Waldman TABLE OF CONTENTS Introduction................................................................................................................. Objective..................................................................................................................... Methodology.............................................................................................................. Findings.......................................................................................................................
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CL10 Page 74It is questionable that the department will meet the terms and conditions of the 1115 Waiver.
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CL11 Page 74There will be insufficient or no funds to care for the patients receiving services under the provisions of the 1115 waiver when it expires. Furthermore it is not anticipated that the group of patients will be absorbed into the private sector.
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CL12 Page 74The service delivery systems are in need of improvement, especially in providing easy access to primary care physicians, specialists and service facilities.
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CL13 Page 75The department does have excellent service providers, however, they are not easily accessible; in fact the existence of some is not generally known. to the public at large.
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CL14 Page 75The department needs to develop an integrated data collection and management reporting system that allows the client, provider and staff easy access to the data necessary for the care of the client.
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CL15 Page 75The Department of Health Services needs are not being adequately addressed by other County Departments.
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CL16 Page 75The Department of Health Services tends to focus on short-term, crisis- based solutions rather than productive, long-term results.
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CL17 Page 75The Department of Health Services lacks system-wide operational leadership.
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CL18 Page 75There are many providers of health care, both public and private, with some of the private being non-profit and others free. However, availability and access are varied and unknown.
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CL19 Page 75The County lacks a clear written Public Policy on how personal health services are to be provided in this county.
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CL20 Page 132In the audit section of this report it is noted there is currently no standards or elements in place to measure how successful the female inmate programs are performing. The Department currently does not have the ability to track inmate progress or to access the recidivism rates of the inmates who participate in the available programs. We believe this is the main reason why many of the line staff have little faith in the very inmate programs for which they are charged with providing a safe environment. Once the Sheriff’s Department gathers the necessary data and provides the line staff with information on what programs are working and which ones are having difficulties, then the overall glum assessment from the line staff should change. Also in the audit section of this report it is noted the Sheriff’s Department modified its established policies and procedures relating to inmate discipline in June of 1999. The Department went from a more “punishment” oriented philosophy to a “counseling and advising” approach in regards to minor inmate violations. This change is consistent with modern correctional philosophy and is considered appropriate for operating a secure facility. This change in philosophy has also been shown, when applied correctly, to reduce inmate complaints and litigation. The days are long gone when a deputy could rely only on his or her authority or force to make inmates respond. So the question is why is there such a significant moral problem with the line staff. The very staff tasked with carrying out the Sheriff’s vision concerning the direction of the Department with regards to female inmates? The audit section of this report details a consistent lack of training afforded to the deputies and support staff tasked with carrying out this change in philosophy. We agree with this assessment. From the perspective of the line staff they have lost a great deal of their discretion in dealing with female inmates, especially problem inmates. They have also not been given the tools to replace what they believe they have lost. Before an inmate becomes enough of a problem to require some form of punishment staff must be aware of the wealth of communication and conflict resolution tools available to de-escalate the situation. If the inmate continues to be a problem and escalates the situation the line staff still have, and must be supported with, the option of applying stronger discipline. Ultimately, it is the line deputies and support staff that carry the bulk of the workload in regards to inmates. Once they have been properly trained they must be fully supported in their decision-making. Once the line staff believe they are being supported once again by their superiors the moral problem as it currently exists should fade away. The line supervisors appear on the surface to support this new approach but it is apparent they also have not been trained in its application. In their view if they support their deputies and staff the way they have in the past they run the risk of hurting their careers and damaging their ability to promote. It appears that a successful supervisor is one who gives in to inmate demands, supports the line staff sporadically, reduces the number of inmate complaints, and whose actions do not incur expensive litigation. A reduction in inmate complaints and litigation should be the result of a well-defined policy that is strongly implemented and supported. Not because supervisors, worried about what upper management will do to their careers, are turning a blind eye to their line staff. In one significant area we found some disagreement with the auditors. The auditors did not find a significant basis for some of the feelings elicited by the line staff concerning the lack of support from supervisors and above and the risk to their safety. The auditors concluded this was primarily a lack of training in the new “advise and counsel” method of interacting with inmates. While there is merit in that conclusion we believe the line staff do have a solid basis for their opinions. The different viewpoint contained in the audit section of this report has mainly to do with the broader mandate the auditors were working with and the fact that we interviewed almost three times the number of people on this issue. We must finally note that we have received extraordinary cooperation from the deputies, custody assistants, and line supervisors at Twin Towers. We found the staff to be people of utmost character who certainly represent the Department’s “Core Values.” With people of such high caliber on the Department the Sheriff’s vision of where law enforcement needs to go in the future can become a reality.
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CL21 Page 138This survey sought to provide a basic overview of some of the issues that are leading to the racial strife between Black and Hispanic inmates at North County Correctional Facility. While the problem of racial strife and violence between inmates and solutions to that strife will be covered in more detail in the audit section, this survey does achieve its goal of giving the reader a broad perspective on the problem. The effectiveness of inmate programs in reducing the amount of racial violence at North County Correctional Facility and whether the introduction of additional programs, or the expansion of existing ones, would be helpful needs to be examined. The Sheriff’s Department currently has no clear standards or guidelines in which to measure the effectiveness of its inmate programs. As was outlined in the earlier Twin Towers section, this issue needs to be resolved so that line staff and management know what works and what does not work. This recommendation follows the line of logic that a busy inmate focused towards positive goals does not have time to focus animosity towards other inmates, deputies or staff. In the audit section of this report it was recommended that a new classification system be implemented that provides staff with additional information regarding inmate behavior. We hardly agree with this course of action. The current information given to staff is limited and does not provide them with the information necessary to properly assign inmates to housing or programs. In addition, the current classification system does not provide deputies and staff who are directly supervising the inmates with the immediate information needed to assess their behavior potential. Deputies and staff should know what is going on in the housing areas they supervise. Unless it is a direct safety issue or tactical consideration, deputies should be more proactive in dealing with problem inmates and resolving disturbances before they get out of hand. Deputies and staff should be supported by their immediate supervisors and upper management in carrying out this mission. An example of this would be if two inmates in a housing area were moving around each other in a loud and threatening manner. Deputies should not be faulted for proactively entering the housing area and, if conflict resolution methods are not effective, separating and removing the two inmates if necessary. We agree with the auditors’ recommendation that a direct supervision model be implemented and that deputies and staff be trained in its use and supported in its application. Inmates in a housing area should be conditioned to know that a serious violation of the rules like fighting or bringing in dangerous contraband will be dwelt with immediately with severe consequences for the offending party. There should be a clear disincentive for inmates to engage in unruly behavior. There should be no incidents where deputies stand-by, flashing their flashlights and yelling over the intercom, while a situation that could be stopped grows out of control because they are worried about being second-guessed, concerned about their careers, and are waiting for the arrival of a supervisor to make a decision. On another issue, if a deputy is very proactive over the period of a custody career and becomes involved in a number of situations where force is used, as long as there is nothing illegal or unjustified about the force there should be no negative connotations drawn. Under the present system management looks upon the deputy who flashes his flashlight at inmates from a safe distance, who is always the last to show up at a disturbance, who will never take any action unless a supervisor first agrees to it, more favorably because such a deputy will have a clear record. A deputy or custody assistant should never have to worry that if they properly do their job entries will be made to their personnel files that could negatively impact their careers or promotion chances. If the primary focus of management is avoiding complaints and litigation, especially litigation involving force, rather than creating the safest and most beneficial correctional environment for both inmates and staff possible, then reducing the problem of racial strife among inmates will not occur. It is believed that well-trained, proactive deputies and staff members who are fully supported by their immediate supervisors and upper management are a strong deterrent to some of the problems affecting North County Correctional Facility. In addition, this is a positive way to avoid unnecessary and avoidable litigation.
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CL22 Page 145In accordance with Title 15 of the California Code of Regulations, the Sheriff’s Department has established policies and procedures related to inmate discipline. Based on changes to these policies that were adopted in June 1999, the Sheriff is now emphasizing “counseling and advising” as an alternative to discipline and punishment for resolving minor inmate violations of facility rules. While managers and supervisors appear to endorse these revised policies, there are indications that a substantial portion of line staff have some concerns. These concerns include feelings that staff is sacrificing control over the inmates, and are experiencing a lower level of inmate compliance with rules and staff directives. The revised discipline policies adopted by the Sheriff are consistent with modern corrections philosophy, and are appropriate for operating a secure facility. Further, we did not find that this new approach has adversely affected officer or inmate safety. Nonetheless, to effectively operate the Sheriff’s facilities in this manner, line staff must be thoroughly committed to the approach and trained in communication skills and the ability to diffuse tense situations. Our review of Department training records indicates that most line staff have not received appropriate training in this regard. In the basic academy, only 15 hours out of a total of 18 weeks of training are devoted to these skills; of the 56 hours devoted to custody-specific training, only approximately _ hour is spent on these topics; and, less than _ of all deputies and custody assistants in CY 2000 took continuing training in communications and other skills that would be useful when coping with inmate discipline issues. The Sheriff’s Department needs to more aggressively emphasize this change in management philosophy, and establish training policies that will ensure staff receive the skill sets necessary to successfully implement the change. In addition, line supervisors and training officers should be charged with emphasizing the counseling and advising approach to conflict resolution as part of the on-the-job training curriculum.
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CL23 Page 156The Sheriff’s Department is embarking on an effort to expand and enrich program services currently available to inmates. However, the Department has been limited in its ability to accomplish these objectives for female inmates because of physical space limitations at the Twin Towers Correctional Facility. Further, the Sheriff’s Department has not established an internal process for systematically screening inmates for program eligibility, tracking program participation, or measuring program outcomes. Historically, these functions have been delegated to contract program service providers, who have different eligibility criteria, and have not consistently provided data from which program activity or effectiveness can be determined. The lack of a comprehensive programs services approach has contributed to deficiencies in management information from which to measure program participation, eligibility and effectiveness; and, to weak management controls over contractor performance. The Sheriff’s Department should develop a pilot case management model for female inmates, from which a Department-wide system could be developed. This model system should include: (a) a centralized program intake and eligibility process; (b) case planning for each inmate, to include the development of outcome goals; and, (c) a system for measuring program effectiveness. In addition, the Department should develop a more effective monitoring system for contract service providers. By implementing these recommendations, the Sheriff would streamline program screening, obtain better management information, and increase the efficiency and effectiveness of programs services.
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CL24 Page 165The Program Operations Section is currently staffed with sworn staff who are responsible for various functions related to contract management, the oversight of program services, liaison with the community, and various administrative functions. For the most part, these functions and activities could be more effectively provided by civilian staff with the requisite skills and training in contract management and social services delivery systems. In addition, a civilian staff with these skills would be better suited for accomplishing the recommendations made in the previous section of this report, which suggests that the Department transition to a case management system of program service delivery. By accomplishing the conversion from sworn staff to civilian staff, as described in this report, the Sheriff’s Department could realize a net gain of two FTE positions and associated savings of approximately $88,400 per year. In addition, the Department would have the resources to better manage program services, enhance service delivery and monitor program service effectiveness.
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CL25 Page 171Between January 1999 and March 2001, there were 107 riots and major disturbances in the County’s jails. Approximately 30 percent of these occurred at the North County Correctional Facility. These riots and major disturbances seriously threaten the safety and security of inmates, staff and County property, and can be costly. In addition to impacts on operations, litigation exposure alone can amount to millions of dollars. In April 2001, 39 inmates filed claims with the County for approximately $78 million in damages, due to injuries they allegedly received in the April 2000 riots at NCCF. The Sheriff’s Department does not utilize a behavior-based classification system, which employs interviewing and observation techniques to assess anticipated inmate behavior while incarcerated. In the absence of such an assessment, the likelihood that riots and major inmate disturbances will continue in the County’s jails increases since there is not sufficient information available for staff to make informed housing decisions. The Sheriff should modify the current classification plan to require a behavior-based assessment component, and restructure the Classification Unit organization to include staff at each of the outlying facility Inmate Processing Areas who would be responsible for these functions. In addition, the Sheriff should enhance elements of the information contained in the computerized record and on the inmates’ Jail Record Cards, so that housing deputies are more aware of prior disciplinary action taken against inmates. Lastly, the Sheriff should develop a detailed proposal and operational plan for establishing Admission and Orientation Units at six of the jail facilities he operates. The purpose of these units would be to assess inmates for behavioral traits prior to movement into the general population. The County would incur approximately $1.5 million annually in additional personnel costs to implement these recommendations. However, with successful implementation, the incidence of riots and major inmate disturbances would decline and significant operational and litigation costs would be avoided.
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CL26 Page 185The Sheriff’s Department has a system of Indirect Supervision of inmates, where deputy sheriff personnel are physically separate and interact remotely with inmates in dormitory style general housing units. This has resulted in diminished control over inmates, who bind together in racially defined groups to assert dominance over one another, and for mutual protection. This is supported by comments made to us by custody staff, who indicated that “the inmates run the jail, not us,” and “it is unsafe to go into the units alone.” Common knowledge that there are “dorm reps” who represent groups of inmates to one another suggests that the Sheriff’s Department has relinquished some control over inmate interaction in the housing units. The National Institute of Corrections endorses a jail management approach entitled “Direct Supervision.” Under a Direct Supervision model, the jail dorm becomes a patrolman’s beat. The deputy has a constant presence and walks through the dorm frequently, talks to inmates, conducts periodic contraband and weapons checks, and asserts his authority. Under such a system, experts suggest that “violent incidents are reduced 30% to 90%, and homosexual rape virtually disappears.” The American Correctional Association and the American Jail Association endorse the Direct Supervision concept. The Sheriff should implement a Direct Supervision jail management system at the North County Corrections Facility, which experienced 30% of the inmate riots and major disturbances since 1998. The Sheriff should eventually extend this model to other facilities within the Department. In addition, the Sheriff should explore alternatives for creating a career corrections officer classification, which would provide a distinctly different role from deputy sheriff personnel who have a law enforcement career orientation and goals.
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CL27 Page 194The Sheriff’s Department investigates every riot, major disturbance and minor disturbance that occurs in the County’s jail facilities. These investigations provide a very good summary of certain facts related to each incident. However, they do not effectively assess the causes or other important factors that led to the event. A policy should be developed that directs the investigating officer to specifically address causative factors in depth, based on solid investigation processes such as interviews and evidence collection; and, that the cause be reviewed and analyzed by the Captain, who would be required to comment on the cause and preventive measures taken, in a report to the Chief on the matter. By adopting this policy, and enforcing compliance by the investigating team, the Sheriff’s Department would enhance the quality of information available for reducing or eliminating the incidence of disturbances in the County’s jail facilities.
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County of Los Angeles
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Los Angeles County Board of Supervisors
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