Final Report 1976-1977*

Recommendations 9

• R1
  Child Support An audit of this program is mandated by Section 10602.5 of the Collection Welfare and Institutions Code. Program The Contract Auditor concluded that: · Certain organizational improvements have been made within the last year. · Work methods and procedures, and related staffing levels, are not adequate in all areas to effectively process the current case load on a timely basis, resulting in a significant backlog of partially processed cases. · Management Reports are generally inadequate and do not provide accurate information regarding the effectiveness of the program. · All delinquent payments are not identified and collected on a systematic and timely basis. · The County is presently in technical violation of Federal IV-D regulations in several areas. SUMMARY OF MAJOR RECOMMENDATIONS Case processing — Regional Office (No. 1-1) Improve the quality and accuracy of reported statistical information. (No. 1-2) Systems and procedures should be developed and standard- ized for all the Regional Offices. (No. 1-3) Establish and implement guidelines and procedures for closing and purging cases at the Regional Offices. (No. 1-4) Develop a pre-interview questionnaire to be filled out by the complaining witness to shorten interview time; and, separate the interview function from the case follow-up and investigation function. (No. 1-5) Mail should be processed on a timely basis at the Regional Offices. (No. 1-6) Replace the Investigator-in-Charge at each Regional Office with a qualified and experienced administrative office manager. (No. 1-7) Implement improved case review procedures at Regional Offices experiencing a high rate of returned cases. (No. 1-8) Undertake a major method and work measurment program designed to develop revised standards for staff planning and performance evaluation. (No. 1-9) Review the Regional Offices for possible improvements to office layout and determine need for additional office space. (No. 1-10) Develop and implement a reorganized case filing system at all Regional Offices. (No. 1-11) Case control cards should be typed and filed on a timely basis after the initial interview with the complaining witness. (No. 1-12) The supervising child support investigator should be made responsible for insuring that all cases are reviewed every ninety days. Case Processing — Central Office (No. 1-17) The District Attorney should give the highest priority to the conversion of existing cases in accordance with the require- ments of Title IV-D. (No. 1-18) Carefully consider increasing available manpower resources in order to process additional child support cases. (No. 1-19) Establish procedures within the Civil Process Section which will insure the timely serving of all court processes. (No. 1-20) Controls over the physical movement of cases should be strengthened. (No. 1-21) Mail received for cases "out of file" should be filed in a separate file by defendant name. Payment Collection and Distribution (No. 1-24) The Court Trustee should enforce additional output controls in the Input/Output Control Unit. (No. 1-25) The Court Trustee should institute better controls over funds released from the suspense account. (No. 1-26) The Court Trustee in conjunction with the clerk of the court and the Bureau of Child Support Operations office should initiate additional controls to insure that all data is properly entered into the Court Trustee System. (No. 1-27) The Court Trustee should develop formal written procedures for follow-up of suspense items. (No. 1-28) The Court Trustee should maintain follow-up documentation for each suspense account case. (No. 1-29) The Court Trustee in conjunction with the Bureau of Child Support Operations, should evaluate the feasibility of instituting a central case numbering system. (No. 1-32) The Court Trustee should enforce procedures to insure that all returned warrants are entered into the suspense account immediately after they are received. Delinquency Identification and Processing (No. 1-33) The Court Trustee in conjunction with the Bureau of Child Support Operations and the Data Processing Department should initiate action to comply with federal regulation P.L. 93-647, Section 303.6. (No. 1-34) The Court Trustee in conjunction with the Data Processing Department should evaluate the cost effectiveness and feasi- bility of more effective use of the existing automated system in converting Family Law cases, established prior to May 1, 1976, to the new delinquency identification system. Automated Child Support Enforcement System (ACSES) (No. 1-35) Continue the implementation of the ACSES project according to the System Implementation Work Plan. (No. 1-36) Consideration should be given to restricting and monitoring access to ACSES information through both physical and programmed controls over CRT terminals.
• R2
  County Budgetary This function within County government was reviewed because of Process the major role it plays in the allocation of resources to governmental programs and activities and the overall County management process. The Contract Auditor concluded that:
• R3
  a. Personnel This Personnel System review was conducted because of the cost Organization, impact and budgetary considerations of personnel salaries, benefits, Policies and and other personnel programs in the County. There has not been a Practices previous Grand Jury review of this area. The Contract Auditor concluded that: The task of administering personnel programs for some 80,000
• R4
  Review of the Los of the size and complexity of the County's health care system and Angeles County because of the magnitude of escalating costs to the County taxpayers Hospitals associated with providing medical care to County patients. The Contract Auditor concluded that: · The Los Angeles County Department of Health Services, as its primary concern, provides a full range of quality medical services to the medically indigent patient of the County and views its role as the "hospital of last resort." Unfortunately, the Department has given insufficient attention to financial matters, particularly in the areas of financial screening, billing and management of ac- counts receivable. In our opinion, there appears to be significant room for improvement in these areas. · The Board of Supervisors should consider placing in the position of Director of Health Services, currently vacated, an administrator with a strong financial background. · The total cost to the County taxpayers for providing health care through the eight County hospitals was approximately $169 million in 1975 and $211 million in 1976, which represented a cost per capita in Los Angeles County of $24 and $30, respectively. Additionally, in 1975, operating costs per in-patient day and 6% 16%, and visit were approximately out-patient respectively, higher than the same costs incurred by the non- county hospitals they selected for comparisons. · Sufficient patient financial information, such as correct name, address and party responsible for payment, is not always obtained from patients prior to their leaving the facilities. Additionally, Medi-Cal patient claims are not being submitted on a timely basis, resulting in an excess unbilled claim backlog. Also, private insurance companies are often not billed for services rendered to their enrollees or subscribers. Many financial patient records in the billing departments at County
• R5
  County Data This review of the County Data Processing Department (DPD) was con- Processing ducted because of the major role it plays in the formidable and complex Department task of providing County management with proper and adequate data processing support. The Contract Auditor concluded that: · The centralization of County-wide data processing activities is being conducted without an overall master plan. · The present controls over the DPD "Billing System" should be improved to better monitor development and maintenance expen- ditures.
• R6
  The schools or districts should develop systems of receiving and dis- tributing appropriate current research and legislative data.
• R7
  The experience of the mature teacher could be harnessed to develop new training courses. In Long Beach this system is called "mid-career incentive" and is used to renew teacher interest as well as to give sal- ary credits to the participants.
• R8
  Teachers could be taught to teach each other. Principals would act as management-advisors, directing programs. Edu- cational leadership would come from their guidance and direction, and through consultation and coordination with the staff. This leads to the indication that principals, too, require in-service programs. We suggest the development of courses to give principals training in (1) instructional leadership; (2) defining problems and making decisions; and (3) accep- tance of accountability to both the superintendent and the public. Finally, there is a need for improving the preparation of teachers before they enter the education system. We urge consideration of two concepts:
• R9
  The appointment would not necessarily eliminate the need for the services of a full-time deputy district attorney as advisor. The present advisor assists in the preparation and presentation of criminal cases to the full Grand Jury. He also assists in the prep- aration and screening of cases for the Criminal Complaints Committee. Additionally, he serves as a liaison between the Grand Jury and the District Attorney. As a result, the proposed legal advisor would be able to assume only a portion of the pre- sent advisor's duties, and would represent an additional cost to the taxpayers. RECOMMENDATION The Grand Jury recommends that the present method of selecting advi- sory counsel for the Grand Jury from the District Attorney's staff be retained. I-B. Separate Civil The Grand Jury's findings regarding the division of the Jury into two and Criminal separate bodies are: Grand Juries