Orange County Grand Jury
• 2006-2007
The Mental Health Services Act in Orange County:
⚠️ Translation Notice: This content has been automatically translated. The original English text is the official version. Translation may contain errors.
⚠️ Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.
Findings and Recommendations 7 findings
F1
HCA makes extensive use of contractors to implement Proposition 63. Eleven of sixteen services in the CSS Plan are provided by contractors as of March, 2007, with several other contractors pending approval.
Related Recommendations (1)
R1
Ensure that adequate resources are in place at HCA to audit contractor outcomes.
F2
HCA staff monitors contractor activities extensively; however, HCA has little or no direct contact with SMI/SED clients. HCA Staff relies on information recorded on charts/logs by the Care Coordinators.
Related Recommendations (1)
R2
HCA staff should conduct ride-alongs with the contractors’ care coordinators to develop a better understanding of the daily activities of the contractors’ personnel.
F3
Training by HCA staff and training contractors of County employees and contractors providing MHSA services appears to be behind the schedule implied in the CSS plan.
Related Recommendations (1)
R3
Devote more resources to training of County employees and contractors delivering actual MHSA services to clients.
F4
A training contractor’s records of what training has been delivered do not match HCA’s CSS Plan implementation status reports. HCA’s status reports indicate that more training has been given than the contractor indicates.
Related Recommendations (1)
R4
Clearly identify what training has actually been given and adjust CSS plan implementation status reporting to more accurately reflect the facts.
F5
Multiple programs/contractors may cause overlap in service.
Related Recommendations (1)
R5
A program performance audit of MHSA programs should be conducted by an internal or external auditor at the end of each CSS Plan cycle to ensure that services are not duplicated.
F6
HCA’s management requires contractors/providers to contact HCA before scheduling meetings with the Grand Jury.
Related Recommendations (1)
R6
HCA should allow and not impede the ability of contractors and providers to communicate with the Grand Jury, if the contractors and providers so choose.
F7
HCA has two CAT/PERT programs in place; Garden Grove and Westminster police department. Responses to Findings F-1 through F-7 are requested from the Health Care Agency. A Response to Finding F-1 is required from the Board of Supervisors. RECOMMENDATIONS In accordance with the California Penal Code sections 933 and 933.05, each recommendation will be responded to by the government entity to which it is addressed. The responses are to be submitted to the Presiding Judge of the Superior Court. Based on the findings of this report, the 2006-2007 Orange County Grand Jury makes the following recommendations:
Related Recommendations (1)
R7
HCA should collaborate with law enforcement in Orange County cities to expand the CAT/PERT program as additional Proposition 63 funds become available. Responses to Recommendations R-1 through R-7 are requested from the Health Care Agency. Responses to Recommendations R-1, R-5, R-6 and R-7 are required from the Board of Supervisors. REQUIRED RESPONSES The California Penal Code specifies the required permissible responses to the findings and recommendations contained in this report. The specific sections are quoted below: §933.05(a) For purposes of subdivision (b) of Section 933, as to each grand jury finding, the responding person or entity shall indicate one of the following: (1) The respondent agrees with the finding. (2) The respondent disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefor. (b) For purposes of subdivision (b) of Section 933, as to each grand jury recommendation, the responding person or entity shall report one of the following actions: (1) The recommendation has been implemented, with a summary regarding the implemented action. (2) The recommendation has not yet been implemented, but will be implemented in the future, with a timeframe for implementation. (3) The recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a timeframe for the matter to be prepared 12 for discussion by the officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency when applicable. This timeframe shall not exceed six months from the date of publication of the grand jury report. (4) The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation therefor. 13
Conclusions 1
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CL1On November 2, 2004, the voters of California passed Proposition 63, the MHSA. This Act proposes to expand mental health services in California and pay for it by taxing residents who have a taxable income of more than one million dollars. Under Proposition 63, counties are required to develop and implement programs and services for children, adults, and seniors who are seriously mentally ill and are unserved or underserved. The Orange County HCA is responsible for implementing these programs. There are sixteen programs outlined in the County’s CSS Plan. Of these, eleven are implemented by contractors. All of these programs outlined in the CSS Plan use the principles of FSP. The MHSOAC stated in its quarterly review that: “It was evident throughout Orange County Community Services and Supports plan that they sought to truly implement the intent of the Act and to transform mental health services in their county.” The Grand Jury agrees with this statement. However, regarding the FSPs, the Commission wrote, “The fact that most of the services are going to be contracted out raises the issue of how well the county’s commitment will translate to the day- to-day operations of a contractor.” The Orange County Grand Jury visited program sites and interviewed HCA staff assigned to work with contractors, and found that HCA staff use most of their time performing administrative responsibilities (managing the contractor) while little or no time is spent with clients that are served. The CSS Plan is well written; however, the County should evaluate the strategies for implementing the MHSA programs, including a contractor oversight process having direct HCA staff involvement with the SMI/SED individuals and families living in Orange County who are underserved and unserved.
Agency Responses 1
Government agencies' official responses to this report's findings and recommendations. Click on a response to see the structured breakdown.