County of Los Angeles Civil Grand Jury 222South HillStreet•Sixth Floor•Suite670•LosAngeles,California 90012

Recommendations 16

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  1 Going forward, the city and county should ensure subsidy funding for EHV vouchers. The city agrees in principle, but this finding requires further study. The city aims to ensure that ongoing demand for housing vouchers is met, however it does not have the funds available to directly finance all required operating subsidies. The city continues to lobby state and federal entities to continue or create ongoing funding for housing vouchers, and to ensure that the number of allocated vouchers matches demand. The United to House LA Measure passed in 2022 allocates funding for both rental assistance and operating assistance, and once fullyimplemented can provide assistance directly to renters meeting certain criteria, and to projects to subsidize operations and services for affordable housing. However Measure ULA is currently facing legal challenges, and these funds cannot be fully implemented until the challenges have concluded. The city is also researching alternative financing mechanisms to housing vouchers, in order to maximize the impact of limited subsidies. In addition, as clarified in HUD's PIH Notice 2023-14 issued on June 29, 2023, funding for EHVis not ending in 2023 and leasing of EHVwill continue beyond 2023 for any public housing authority who has available vouchers.
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  Implement the Revised Triage Tool's embedded practices that incorporate race equity and a trauma-informed approach. In addition, the Revised Triage Tool: (a) should not be used as an intake, nor conducted at intake; (b) the Revised Triage should be read word for word to clients, until case managers are comfortable enough to make minor "off script" adjustments; (c) the tool should be administered in a private place whenever possible so as to maximize client comfort in answering personal questions. • LAHSA plans to implement the new revised tool; to implement, LAHSA will hire a consultant to create and implement a training curriculum that will support the execution of this recommendation. 191
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  Use the new scoring system that is anchored in predicting ''adverse events." • LAHSA will implement the new score system, with support from system partners and the CES Policy council.
• R4

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  Prioritize persons scoring above a new threshold or higher on the new scoring system for permanent supportive housing. • LAHSA will implement the new score system, with support from system partners and the CES Policy council.
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  Incorporate additional information with the new scoring system to determine how housing will be allocated (i.e., matching decision) • LAHSA will implement the new score system, with support from system partners and the CES Policy council. Other factors will be included in prioritization as well. LAHSA looks forward to implementing these changes to create a more equitable and fair housing system. RECOMMENDATION NO. 1.24 LAHSA needs to provide adequate housing navigators to assist the 10,000 people currently holding vouchers find rental units. RESPONSE LAHSA agrees with recommendation No. 1.24 and is in the process of being implemented. LAHSA meets with SPA wide community non -profit partners monthly basis to review client level progress and housing connections to ensure 100 percent slots utilization and staffing capacity to carry out the role. Housing Navigation (HN) is offered from one Access Center per SPA to support those participants who do not utilize Interim Housing Resources. HN is offered from Interim Housing (IH) sites throughout the County to support all participants entering interim housing programs to access HN services. LAHSA Technical advisors train interim housing providers on document collection to expedite housing match and connection to HN. LAHSA scheduled a HN Bootcamp for the first week of August to ensure service providers and staff can support their participants fully within the program parameters. LAHSA is hiring recruiters to support service providers hire staffing to support a 1 to 20 caseload ratio. LAHSA is launching five Job Fairs to support service providers in their hiring efforts. These Job Fairs are SPA-wide and located throughout the County of Los Angeles. To support 10,000 people currently holding vouchers, there would need to be sufficient funding for 166 Housing Navigators. In support of this expansive need in the Homeless Services System, LAHSA is creating an Emergency Housing Navigation team, located within the Multi- Department Crisis Response Team Department, that will be nimble and mobile to respond quickly to the needs of service providers while they hire staff. LAHSA also continues to pursue ail funding opportunities to add additional funds to Housing Navigation Programs throughout the program year. In addition, LAHSA will continue to work with service providers to ensure there are ample Housing Navigation staff and support in place to provide services to participants. H AC L A Build HOPE: Investing in People and Place August 30, 2023 Presiding Judge Superior Court of California, County of Los Angeles Clara Shortridge Foltz Criminal Justice Center 210 W.Temple Street, 13^^ Floor,Room13-303 Los Angeles, CA90012 Your Honor: HACLA'S RESPONSE TO THE 2022-2023 LOS ANGELES COUNTY CIVIL GRAND JURY REPORTS: • HOUSING VOUCHERSFOR LOW INCOME AND HOMELESSANGELENOS, and • LACK OF HOUSING: THE SOCIAL INJUSTICE OF THE 21^ CENTURY On June 21, 2023, the Housing Authority of the City of Los Angeles ("HACLA"), received Pre-Release Reports from the 2022-2023 County of Los Angeles Civil Grand Jury (the "Civil Grand Jury"). On or about July 3, 2023, the Civil Grand Jury published its Final Report. HACLA's governing body and agency head are required to provide responses to the findings and recommendations pertaining to matters under their control cited in both reports. See Pen. Code § 933(c). This letter constitutes the response of HACLA's Board of Commissioners and Chief Executive Officer to the reports entitled Housing Vouchers for Low Income and Homeless Angelenos and Lackof Housing: TheSocial Injustice of the 21^* Century. Agency Background HACLA was established in 1938 by the City of Los Angeles Resolution No. 1241. HACLA has grown to become the second largest and leading public housing authority in the nation, providing the largest supply of quality affordable housing to residents of the City. HACLA's annual budget is close to $2 billion and through various resources, including federally-funded public housing and vouchers, houses over 105,000 Angelenos. HACLA administers nearly 60,000 rental assistance vouchers across multiple federal programs including the Housing Choice Vouchers (HCV), Veterans Affairs Supportive Housing Vouchers (VASH), and more recently Emergency Housing Vouchers (EHV). For the last 15 years HACLA's HCV program has been rated as a "High Performer" by the U.S. Department of Housing & Urban Development (HUD) in its annual performance assessment. Additionally, HACLA's public housing program, with 6,393 public housing units, has been rated as a "High Performer" by HUD for 13 years. Through these programs along with its acquisition and development of affordable housing, HACLA is a principal player in providing much needed affordable housing in LosAngeles. From January through June 2023, HACLA's Section 8 Department housed 2,733 new families and is on track to house 6,000 by the end the year. This is the largest number of new families HACLA has housed in a single year. Additionally, HACLA is utilizing 98% of the federal funds it receives for the HCV program. In July 2021, HACLA received 3,365 EHVs, the second largest allocation in the nation. As of the date of this response, 2,601 families have secured housing with an EHV. It has taken an immense effort and significant HACLA's Response to the 2022-23 LA County Civil Grand Jury Reports resources to reach this milestone, and no other housing authority, except for the New York City Housing Authority, has reached this number. HACLA is on track to reach 100 percent utilization of these vouchers by year-end. In furtherance of Los Angeles' housing goals, HUD recently awarded HACLA 250 new VASH vouchers on June 1, 2023, and 377 new Stability Vouchers are expected on August 1, 2023. These recent awards demonstrate HUD's confidence in HACLA. The Section 8 Department is handling a very large volume of applicants and participants. Recognizing its continuing growth and operational complexities, in June 2022 HACLA initiated, with the assistance of Guidehouse, Inc., a consulting firm, an organizational assessment of the Section 8 Department to identify opportunities for operational improvements and streamlining. Since then, HACLA has implemented some quick-wins, and is continuing to identify areas for future, systemic, long-term modernization. HACLA responds below to the findings and recommendations pertaining to matters under the control of HACLA and defers to other agencies to respond to those findings and recommendations pertaining to matters under their control. HOUSING VOUCHERS FOR LOW INCOME AND HOMELESS ANGELENOS
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  Holders of HCVs and EHVs navigate a difficult rental market and are given 180 days to find landlords who will accept their vouchers. HACLA RESPONSE - HACLA partially agrees with this finding. The City of Los Angeles has a difficult rental market with a vacancy rate of less than 3%. Although all voucher holders are usually provided with 180 days to find housing, HACLA modified its policy allowing up to 365 days for EHV participants. HACLA is currently evaluating this policy and will soon make appropriate adjustments to ensure that voucher holders have adequate time but not defer the housing search. HACLA is now providing services to voucher holders from a professional housing location/relocation company in order to assist participants in locating housing as soon as possible.
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  Many HCVs/EHVs go unused because initial inspections and necessary re-inspections are not done in a timely manner. HACLA RESPONSE - HACLA disagrees with this finding. This finding is vague and the Civil Grand Jury did not identify any evidence supporting this finding. Additional information is provided within HACLA's response to Recommendation 1.9 of this report below.
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  Despite HACLA's landlord outreach and incentive programs, many landlords remain reluctant to accept tenants using HCVsand EHVs. HACLA RESPONSE - HACLA agrees with this finding. HACLA is working with Mayor Bass to roll out a communication campaign that will encourage more landlords to accept tenants using vouchers.
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  The CecilHotel in downtown LosAngeles and other SROs have large numbers of vacancies despite readiness and availability to accept HCV and EHV applicants. HACLA RESPONSE - HACLA partially agrees with this finding. HACLA agrees that the Cecil Hotel may have available rental units. However, voucher holders, not HACLA, choose the property and community they live in. HACLA is prohibited by HUD from steering voucher holders to a specific property.
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  HACLA's low Unit Utilization Rate can be attributed in part to HACLA's conservative strategy of issuing no more EHVs than allocated it by HUD. HACLA RESPONSE - HACLA disagrees with this finding. The Civil Grand Jury did not provide evidence that additional issuance of vouchers could increase or expedite utilization. Additional information is provided Housing Authority of the City of Los Angeles 9 2600 Wilshire Blvd., Los Angeles, CA 90057 833-HACLA-4-U ® [email protected] ^ hacla.org HACLA's Response to the 2022-23 LA County Civil Grand Jury Reports in HACLA's response to Recommendation 1.10 of this report below.
• R11

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  Many landlords and tenants, and even quite a few HACLA employees are unaware that FEHA prevents landlordsfrom discriminating against tenants who plan to pay rent using government provided vouchers. HACLA RESPONSE - HACLA partially agrees with this finding. Many landlords and tenants may be unaware that FEHA prevents landlords from discriminating against tenants who plan to pay rent using government provided vouchers. However, HACLA disagrees with the vague finding that "quite a few HACLA employees" are unaware of this. It appears the Civil Grand Jury interviewed approximately/our voucher department employees in preparing its report. HACLA provides annual trainings for its staff, conducts bi monthly landlord orientations, and issues regular reminders via newsletters and forms to both voucher holders and landlords regarding this subject. HACLA willcontinue to issue information and guidance to all stakeholders.
• R12

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  Although FEHA prevents landlordsfrom discriminating against applicants and tenants who plan to pay rent using government provided vouchers, HACLA, and the LosAngeles CityAttorney do little to enforce this law, and referralsfor enforcement are seldom made. HACLA RESPONSE - HACLA partially agrees with this finding. HACLA agrees that some landlords discriminate against voucher holders in violation of the FEHA, but HACLA is not responsible for enforcing the FEHA, nor does it have the authority to do so. When HACLA becomes aware of alleged FEHA violations, it refers those matters to the Housing Rights Center. Additionally, HACLA welcomes enforcement by the City Attorney or other agencies, and we plan to meet with the CityAttorney's Office to discuss whether they may be able to assist in this regard.
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  Having HACLA and LACDA performing the same tasks is an unnecessary duplication ofeffort and results in confusion and numerous inefficiencies. HACLA RESPONSE - HACLA disagrees with this finding. Each public housing authority is responsible for administering its own program and complying with federal regulations. Each public housing authority operates within the limits of specific Jurisdictions authorized by HUD.
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  LACDA has had considerably better results than HACLA in issuing vouchers and moving applicants into homes. HACLA RESPONSE - HACLA disagrees with this finding. This oversimplified comparison ignores the reality that LACDA and HACLA operate in different jurisdictions, serve different populations, encounter different challenges, and have different histories. For instance, while this finding is vague as to which voucher program it is referring to, ifthe reference isto the EHV program, the LACDA began issuing vouchers before HACLA because it already had an established team that transitioned from an expiring program to the new EHV program. HACLA had to hire and train new staff during the COVID-19 pandemic.
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  HACLA's and LACDA's Section 8 HCV and EHV programs could be combined into one agency by agreement among the Board ofSupervisors, the LosAngeles CityCounciland Mayor, HACLA, and LACDA. Already, numerous cities contract with LACDA to manage Section 8 programs. Housing Authority of the City of Los Angeles 9 2600 Wilshire Blvd., Los Angeles, CA 90057 ^ 833-HACLA-4-U ra [email protected] ^ hacla.org HACLA's Response to the 2022-23 LA County Civil Grand Jury Reports HACLA RESPONSE - HACLA disagrees with this finding. Each public housing authority is responsible for administering its own program and complying with federal regulations. Each public housing authority operates within the limits of specific jurisdictions authorized by HUD. RECOMMENDATIONS FOR HACLA 1.1 HACLA should consider adopting LACDA's workflowsfor handling HCVs and EHVs, using specialized teams. HACLA RESPONSE - HACLA implemented this recommendation prior to this report. HACLA already operates in a specialized team model. Staff are responsible for handling specialized tasks such as reviewing applications, conducting housing quality standards inspections, reviewing leases, preparing housing assistance contracts, etc. 1.2 HACLA should consider using temporary workers to perform routine tasks and process paperwork that involve little or not client interface. When hiring, it should also explore recruiting non-traditional employees, such as retired people. HACLA RESPONSE - HACLA implemented this recommendation prior to this report. HACLA is already using temporary employees. With the support of its bargaining units, HACLA has been utilizing temporary workers to assist with various tasks related to issuing vouchers and preparing housing assistance contracts for the past year. Permanent employees are selected through a certified list of candidates who apply through an open and competitive recruitment. HACLA retirees receiving a public employees retirement benefit must comply with the employment restrictions set forth in their retirement plan. Nevertheless, all members of the public who believe they meet the minimum requirements are welcomed to apply. In an effort to further expedite housing, as of February 2023, HACLA is also utilizing a third-party industry administrator. Nan McKay & Associates, to assist with preparing housing contracts for EHV and project- based voucher holders. 1.3 HACLA should develop methods to assure that inquiries and complaints regarding Section 8 vouchers get meaningful responses within two business days. HACLA'S RESPONSE - HACLA implemented this recommendation prior to this report. This is already HACLA's internal response time requirement, whether a question or inquiry comes into the customer contact center or directly by phone or email to a staff person in any unit, including EHV and HCV. Supervisors continuously reinforce this requirement with their staffs and monitor its adherence, taking corrective actions as appropriate. Efforts to ensure full staffing in all units contributes to improvement in this crucial metric. 1.4 HACLA's Section 8 application forms and instructions should be shortened and simplified. HACLA'S RESPONSE - HACLA implemented this recommendation prior to this report. As noted, HACLA is working with consultant Guidehouse and has already identified this as an area of improvement. The collaboration is in the process of shortening and simplifying Section 8 application forms and instructions while still meeting HUD regulations. Housing Authority of the City of Los Angeles 9 2600 Wilshire Blvd., Los Angeles, CA 90057 833-HACLA-4-U ra [email protected] ^ hacla.org HACLA's Response to the 2022-23 LA County Civil Grand Jury Reports 1.5 HACLA should give applicantsforms and instructions, along with appropriate assistance, in time so that the applications can be readyforfiling and review at the earliest possible times well before their names come up for vouchers. HACLA'S RESPONSE - HACLA implemented this recommendation prior to this report. HUD requires that all application income verifications forms and documents be current of voucher issuance. To meet this requirement, applicants are provided application packets with adequate advance notice to complete them timely with assistance available from Los Angeles Homeless Services Authority (LAHSA) supported case managers for special program applicants and HACLA staff for Section 8 waitlist applicants. 1.6 HACLA should partner or leverage outside housing specialists to assist clients in navigating the complex process ofapplying for Section 8 vouchers. HACLA'S RESPONSE - HACLA implemented this recommendation prior to this report. Applicants are already connected with case workers assigned by LAHSA. They are responsible for providing wraparound services which include assistance with completing voucher applications, obtaining required identity and income documents, housing navigation and search, and facilitating move-ins. To further supplement this effort, HACLA now has an internal housing support specialist team and in June contracted with OPC/TranSystems, a relocation expert, to provide housing search assistance. 1.7 HACLA should schedule inspections at the earliest possible time when it appears that they will be necessary, even if applications and other details have not been completed. HACLA'S RESPONSE - HACLA implemented this recommendation prior to this report. HUD requires that the proposed rental unit be inspected within 60 calendar days of the contract date. For this reason, potential rental units cannot be pre-inspected if the owner has not completed a Request for Tenancy Approval for a unit that the tenant has selected. However, HACLA has adjusted its internal process to negotiate the rent immediately upon receipt of the Request for Tenancy Approval, prior to the inspection rather than after, to reduce delays and more efficiently process the work. Prior to this change made in April, rent discussion with the owner took place after the unit was inspected by the inspections team. Many times, the inspection was fruitless because the owner was not in agreement with the rent offer. Or, an additional inspection was warranted to validate additional information provided by the owner, such as additional amenities. Delays in scheduling inspections are generally due to the owner or property manager indicating that unit has not been made ready for a new tenant, the units is not vacant or utilities have not been turned on. Approximately 50% of units fail their first-time inspection because deficiencies are identified in the unit. 1.8 HACLA should creatively use HUD servicefees as landlord incentives, including housing search assistance, application fees, utility hook-ups charges, security deposit assistance and a landlord mitigation fund. HACLA'S RESPONSE - HACLA implemented this recommendation prior to this report. HACLA already provides several landlord incentives to help facilitate the utilization of vouchers for people experiencing homelessness; these incentives are virtually the same as those offered by the LACDA. For EHV applicants, HACLA pays landlords a $2,500 signingon bonus, provides security deposit assistance and up to $5,000 in unit repairs. Funds for paying these incentives are covered with service fees received from HUD. Landlords Housing Authority of the City of Los Angeles 9 2600 Wilshire Blvd., Los Angeles, CA 90057 C 833-HACLA-4-U ® [email protected] ^ hacla.org HACLA's Response to the 2022-23 LA County Civil Grand Jury Reports willing to house an HCV client experiencing homelessness, are also eligible to receive similar incentives which are paid with Los Angeles County Measure Hfunds. Additional information is available on HACLA's website at hacla.org and attached to this response. See Attachments 1 and 2. These incentives have been offered since inception of the EHV program in 2021, and with passing of the County of Los Angeles Measure H in 2017. To further supplement this effort in the EHV program, inJune HACLA contracted with TranSystems Corp., formerly known as Overland, Pacific, and Cutler, a professional housing relocation firm, to provide housing search assistance. HACLA has hired designated housing support specialists to also facilitate housing search assistance. These efforts supplement the work of a real estate broker that HACLA has contracted with since the beginning of the EHV program that does outreach to landlords to secure property listings for applicants. 1.9 HACLA should arrange to have many units in a SRObuilding inspected at one time, so that several units can be leased without inspectors duplicating efforts and making numerous separate trips to the site. HACLA'S RESPONSE - HACLA implemented this recommendation prior to this report. As noted in 1.7 above, HUD requires that the proposed rental unit be inspected within 60 calendar days of the contract date. Forthis reason, potential rental units cannot be pre-inspected ifthe voucher holder and owner have not completed a Request for Tenancy Approval for a unit that the tenant has selected. HACLA attempts to group inspections in the same building wherever possible, but inspecting units that applicants have not selected or may never select is not an efficient use of inspection resources. 1.10 HACLA should consider implementing LACDA's more aggressive method ofover-issuing EHV vouchers. HACLA'S RESPONSE - HACLA implemented this recommendation prior to this report. Although HACLA received 3,365 EHVs, it has issued 4,516 in anticipation that not all voucher holders will be successful. HACLA is closely monitoring the success rate of voucher holders and will issue more vouchers as needed. It is a balancing act to issue the appropriate number of vouchers so that the full allocation is utilized while avoiding: • over-saturation and competition among all voucher holders (as well as renters without vouchers) for the same affordable units; and the problem of overissuing vouchers that later need to be rescinded due to full utilization of the allocation or insufficient funding, as has happened with other housing authorities. HACLA's responsible approach is in line with HUD'sexpectations. 1.11 HACLA should provide easy to read and understand written information about FEHA's antidiscrimination provisions to landlords and tenants, and should schedule seminars and/or webinars to educate the public on this topic. HACLA'S RESPONSE - HACLA implemented this recommendation prior to this report. HACLA already provides every voucher holder and landlord with easy to read and understand information about FEHA anti-discrimination provisions, including local Source of Income ordinances. Information is also provided in landlord and tenant newsletters and on HACLA's website. HACLA provides this information to landlords during HACLA landlord orientation sessions and in partnership with LAHD in their landlord information Housing Authority of the City of Los Angeles 9 2600 Wilshire Blvd., Los Angeles, CA 90057 833-HACLA-4-U ra [email protected] ^ hacla.org HACLA's Response to the 2022-23 lA County Civil Grand Jury Reports sessions as \A/eil. 1.12 HACLA supervisors and caseworkers should be taught about FEHA and related local ordinances and should be trained on how and when to make referrals to the CityAttorney or the HRC. HACLA'S RESPONSE - HACLA implemented this recommendation prior to this report. HACLA staff are already trained on FEHA and related local ordinances at least annually with additional training offered on a bi-monthly basis and assist clients with completing the federal forms. Staff have also been instructed on how to make referrals to HRC regarding local Source of Income discrimination, as HRC is the agency contracted by the City of Los Angeles for Source of Income discrimination enforcement. As noted previously, HACLA welcomes additional enforcement by the CityAttorney or other enforcement agencies, and HACLA plans to discuss whether any such assistance may be available later this calendar year. RECOMMENDATION FOR MORE THAN ONE AGENCY 1.20 HACLA's and LACDA's HCV and EHVprograms should be administered by one agency by agreement among the Board ofSupervisors, the LosAngeles City Council and Mayor, HACLA, and LACDA. This willeliminate unnecessary duplication ofeffort and expense, enable LosAngeles residents to use an agency with a demonstrated excellent track record and promote efficiency. HACLA'S RESPONSE-This recommendation will not be implemented because it is not warranted and is not reasonable. As detailed in the Background section of this response, HACLA has a demonstrated excellent track record as noted by its high performer rating by HUD, near full utilization of budgeted resources; extraordinary leasing efforts this year and continued award of new resources by HUD. Aswith all PHAS, HACLA administers its program and complies with all federal regulations within its significant jurisdiction as authorized by HUD in an effective manner. HACLA and LACDA collaborate, share best practices, and, more importantly, share one common goal - to end homelessness in LosAngeles. LACK OF HOUSING THE SOCIAL INJUSTICE OF THE 21^^ CENTURY
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  There are 10,000 people with vouchers in the City who have been unable to find housing. HACLA'S RESPONSE - HACLA disagrees with this finding. There are approximately 3,100 voucher holders looking for housing at this time. RECOMMENDATIONS 1.7 HACLA must implement procedures to inspect potential voucherfunded units in a timely manner. HACLA'S RESPONSE - HACLA implemented this recommendation prior to this report and will continue to implement procedures to inspect properties in a timely manner. The average time period from receiving an inspection request to scheduling the inspection is three days, with shortest being one day and longest being 12 days. The primary reason for a delay is the inability to reach the owner or property manager to schedule the inspection. The average time from scheduling an inspection to conducting the inspection is four days, with the shortest being two days and the longest being 14 days. The primary reason is for any delay is that the property has not been made ready for a new tenant (the unit is not vacant, housekeeping and maintenance is required, utilities are not turned on, etc.). Almost 50% of units must be re-inspected to correct deficiencies cited in the initial inspection. HACLA conducts over 60,000 inspections every calendar year - a huge undertaking for any organization. As stated above, HACLA is pursuing technological improvements for scheduling and communicating with property owners and managers. Closing Statement HACLA recognizes that all public entities, including HACLA, can and should improve their delivery of services. People experiencing homelessness face many housing barriers, including discrimination, in a challenging LosAngeles rental market of low vacancies and high rents. HACLA leadership wishes to express its sincere appreciation to HACLA staff for their tireless dedication and to property owners for supporting the agency's mission to preserve, enhance, and expand deeply affordable housing opportunities that improve the quality of life for all Angelenos. Housing Authority of the City of Los Angeles 9 2600 Wilshire Blvd., Los Angeles, CA 90057 833-HACLA-4-U ea [email protected] ^ hacla.org HACLA's Response to the 2022-23 LA County Civil Grand Jury Reports Sincerely, Cielo Castro Doug Guthrie Chairperson, Board of Commissioners President and CEO Attachments 1 and 2 Housing Authority of the City of Los Angeles 9 2600 Wilshire Blvd., Los Angeles, CA 90057 833-HACLA-4-U ® [email protected] hacla.org LOS ANGELES COUNTY FIRE DEPARTMENT WORKERS' COMPENSATION T 2022 - 2023 LOS ANGELES COUNTY CIVIL GRAND JURY % T BOARD OF SUPERVISORS Hilda L. Soils First District Chief Executive Office. Holly J. Mitchell Second District LIndsey P. Horvath Third District Janice Hahn Fourth District COUNTY OF LOS ANGELES Kenneth Hahn Hall of Administration 500 West Temple Street, Room 713, Los Angeles, CA90012 (213) 974-1101 ceo.lacounty.gov CHIEF EXECUTIVE OFFICER Fesia A. Davenport August 31,2023 To: From: Supervisor Janice Hahn, Chair Supervisor Hilda L Solis Supervisor Holly J. Mitchell Supervisor Lindsey P. Horvath Supervisor Kathryn Barger Fesia A. Davenport Chief Executive Officer ^ ^ Kathryn Barger Fifth District 2022-2023 LOS ANGELES CIVIL GRAND JURY FINAL REPORT Attached are responses to the 2022*2023 Civil Grand Jury Final Report. We are responding to specific recommendations dealing with the following sections: Aging Out: Transitional Aged Youth All Aboard: Is Metro Rail on Track Civil Grand Jury Compensation Election Operations Have We M.E.T.? Mental Health Evaluation Teams and How They Work Housing Vouchers For Low income and Homeless Angelenos The Inmate Reception Center: An Outdated Process Imperils Staff, Inmates, and the Justice System Juvenile Justice CYA Lack of Housing: The Social Injustice of the 21st Century Los Angeles County Fire Department Workers Compensation Medi-Cal Reimbursement: The Final Resolution of an Ongoing Issue Proposition 19: Implementation and Related Matters Sheriff's Operations: Examining Transparency, Accountability, and Community Policing within the LASD Storm Water Capture and Wastewater Reuse Zero Emissions: Air Quality Monitoring Attachment A represents the Chief Executive Officer's responses; Attachments B through V represent the departments' responses; and Attachment W represents a matrix of the questions and responses from each department. m 'To Enrich LivesThrough Effective And Caring Service" Each Supervisor August 31, 2023 If you have any questions regarding our responses, please contact me, or your staff may contact Cher! Thomas, by phone at (213) 974-1326 or by emaii at [email protected]. FAD:JMN:CT:md Attachments c: Executive Office, Board of Supervisors County Counsel District Attorney Assessor Sheriff Auditor-Controller Children and Family Services Rre Health Services Human Resources Internal Services Mental Health Probation Public Health Public Social Services Public Works Regional Planning Registrar-Recorder/County Clerk Los Angeles County Development Authority Los Angeles County Metropolitan Transportation Authority Los Angeles County Sanitation Districts Los Angeles Homeless Services Authority RESPONSE TO THE CIVIL GRAND JURY FINAL REPORT COUNTY OF LOS ANGELES CHIEF EXECUTIVE OFFICE FOR THE BOARD OF SUPERVISORS 2022-2023 CIVIL GRAND JURY RECOMMENDATIONS FOR LOS ANGELES COUNTY FIRE DEPARTMENT WORKERS^ COMPENSATION RECOMMENDATION NO. l.l.a The CEO should carefully consider its renewal options with Sedgwick as the sole- source contracted Third Party Administrator (TPA) for workers compensation (WC) claims administration by soliciting multiple TPAs and awarding at least two Independent contracts. RESPONSE Agree. This recommendation has been Implemented. The BOS defers to the Chief Executive Office's (CEO) response for further Information on the Implementation. RECOMMENDATION NO. l.l.b LACoFD should be Invited to participate In the development of the renewal of the TPA Unit C contract. RESPONSE Disagree. This recommendation will not be Implemented. The BOS defers to the LACoFD and CEO's response for further Information. RECOMMENDATION NO, 1.2,a LACoFD, working with the CEO and Department of Human Resources (DHR), should amend the existing TPA Unit C contract with Sedgwick to Include detailed Account Service Instructions (ASIs) on preferred methods of claims management for the remainder of the existing contract. Future contracts with any TPA must Include these ASIs. RESPONSE Disagree. This recommendation will not be Implemented. The BOS defers to the LACoFD and CEO's responses for further Information. RECOMMENDATION NO. 1.2.b The Account Service Instructions (ASI) amendments should direct Sedgwick adjusters to provide "point of entry" authorization for all firefighter WC claims for the remainder of the existing contract. Future contracts with any TPA must Include these ASIs. RESPONSE Disagree. This recommendation will not be Implemented. The BOS defers to the LACoFD and CEO's responses for further Information. RECOMMENDATION NO. 1.2.C The ASI amendments should Include penalties for delays In claims caused by Sedgwick's claims handling that result in LACoFD having to use overtime staffing for the remainder of the existing contract. Future contracts with any TPA must Include these ASIs. RESPONSE Disagree. This recommendation will not be Implemented. The BOS defers to the LACoFD and CEO's responses for further Information on the Implementation. RECOMMENDATION NO, 1.2.d LACoFD should consider arranging "ride-alongs" to help claims adjusters better understand the nature of firefighters work by observing their activities. RESPONSE Disagree. This recommendation will not be Implemented. The BOS defers to the LACoFD's response for further Information on the Implementation. RECOMMENDATION NO. 1.3 The ASI amendments should authorize TPA adjusters to pay up to 25 percent more than the Office Medical Fee Schedule (OMFS) standard fees for doctors to treat firefighter patients In order to expedite treatment and recovery for the remainder of the existing contract. Future contracts with any TPA must Include these ASIs. RESPONSE Disagree. This recommendation will not be Implemented. The BOS defers to the LACoFD and the CEO's responses for further information on the Implementation. RECOMMENDATION NO. 1.4 LACoFD should work with DHR to expand the contracted clinic network to expedite treatment for the most common firefighter Injuries, particularly orthopedic Injuries. RESPONSE Partially agree. This recommendation will be implemented. The CEO will Implement this recommendation and provide clarification. The workers' compensation medical provider network (MPN) Is administered by CorVel Corporation (CorVel) under contract with the County. Currently, Local 1014, Fire Management, and CEO staff are discussing the expansion of the prior authorization program. New facilities will be vetted by participating parties (Including CorVel), and after consensus is reached. Included In the prior authorization program. DHR Is not Involved with this process. RECOMMENDATION NO. 1.5 LACoFD should authorize firefighters' WC claims Immediately, and not contest such claims, except where fraud or demonstrable misconduct Is suspected. RESPONSE Disagree. This recommendation will not be Implemented. The BOS defers to the LACoFD and the CEO's responses for further Information on the Implementation. RECOMMENDATION NO, 1.6.a LACoFD should offer financially attractive buy-outs of California Labor Code (LC) 4850 benefits for firefighters who are permanently disabled or forced by Injuries Into retirement. This would allow firefighters to retire and be replaced by permanent hires. RESPONSE Partially disagree. This recommendation requires further analysis. Settlements of LC 4850 benefits may not be supported by existing law and would unlikely be approved by the Workers' Compensation Board. The analysis of all settlements needs to be conducted on a case-by-case basis and subject to review and approval of all parties. The BOS defers to the LACoFD and the CEO's responses for further Information on the Implementation. RECOMMENDATION NO. 1.6.b LACoFD should continue to offer frequent Academy classes In order to hire more recruits. This will reduce reliance on backfill overtime staffing. RESPONSE Agree. This recommendation has been Implemented. The BOS defers to the LACoFD's response for further Information on the Implementation. RECOMMENDATION NO. 1.7.a LACoFD should make full use of CEO Risk Management's Ventiv Claims Enterprise (VCE) to manage WC claims and Its Return-to-Work (RTW) program. RESPONSE Agree. This recommendation will be Implemented. The BOS defers to the LACoFD and the CEO's responses for further Information on the Implementation. RECOMMENDATION NO, l,7,b DHR should assist LACoFD by developing a comprehensive Disability Compliance Record module as part of VCE. RESPONSE Agree. This recommendation will be Implemented. The BOS defers to the LACoFD and the CEO's responses for further Information on the Implementation. RECOMMENDATION NO. 1.8 LACoFD should continue to develop creative RTW strategies, such as remote work by computer, work from home, and community service work. RESPONSE Agree. This recommendation has been implemented. The BOS defers to the LACoFD's response for further information on the implementation. RECOMMENDATION NO. 1.9 LACoFD should continue to emphasize firefighter training and physical and mental fitness programs to control the frequency and severity of injuries/iiinesses. RESPONSE Agree. This recommendation will be implemented. The BOS defers to the LACoFD's response for further information on the implementation. RECOMMENDATION NO. 1,10 LACoFD should continue to reach out to firefighters on disability through frequent personal contact by peers and supervisors as part of its employee weliness programs. RESPONSE Agree. This recommendation has been implemented. The BOS defers to the LACoFD's response for further information on the implementation. RESPONSE TO THE CIVIL GRAND JURY FINAL REPORT COUNTY OF LOS ANGELES CHIEF EXECUTIVE OFFICE 2022-2023 CIVIL GRAND JURY RECOMMENDATIONS FOR LOS ANGELES COUNTY FIRE DEPARTMENT WORKERS' COMPENSATION RECOMMENDATION NO. l.l.a The CEO should carefully consider its renewal options with Sedgwick as the sole-source contracted TPA for WC claims administration by soliciting multiple TPAs and awarding at least two independent contracts. RESPONSE Agree. This recommendation has been implemented. Since 1986, the County has always contracted with more than one TPA to provide workers' compensation claims administration services per workers' compensation claims services solicitation. On March 5, 2019, the CEO recommended the BOS approve contracts with York Risk Services Group (York) and Sedgwick Claims Management, Inc. (Sedgwick). The BOS approved the contracts on March 26, 2019, for the two TPAs; however, Sedgwick subsequently purchased York. The contract with Sedgwick was competitively bid and was not presented or contracted as a ''sole-source" contract. In recent years, the workers' compensation claims administration industry has experienced difficulties in recruiting competent claims staff and an escalation in salaries. Therefore, CEO will perform further analysis with respect to exercising the contract option years. RECOMMENDATION NO. l.l.b RESPONSE Disagree. This recommendation will not be implemented as specified below. Currently, LACoFD and CEO staff meet regularly to discuss workers' compensation claims administration. These meetings address a variety of issues that may be incorporated into future workers' compensation claims administration statement of works. Furthermore, LACoFD and CEO staff regularly work with the TPA to adjust the framework of the administration of workers' compensation claims to accommodate issues as they arise. Under County Code Section 5.31.050, and through delegation, the CEO is mandated to "establish, administer, and operate, as part of the Countywide safety program, a complete self-insured workers' compensation system to ensure the full provision of 50 benefits under the law to employees whose Injuries arise out of and In the course of employment." CEO Risk Management staff are highly specialized personnel with expertise In all facets of Risk Management, Including workers' compensation. While Input from County departments Is vital and encouraged, the final decisions must be made by these Industry professionals In accordance with local and State statutes. RECOMMENDATION NO. 1.2.a LACoFD, working with the CEO and Department of Human Resources (DHR), should amend the existing TPA Unit C contract with Sedgwick to Include detailed ASIs on preferred methods of claims management for the remainder of the existing contract. Future contracts with any TPA must Include these ASIs. RESPONSE Disagree. This recommendation will not be Implemented. The AST model Is already Incorporated within the contract. Currently, workers' compensation claims administration Is performed under client-specific claim handling protocols. Those protocols can be found In the Statement of Work, County of Los Angeles Select Policies and Standards, County of Los Angeles Utilization Review Guidelines, County of Los Angeles Workers' Compensation Audit Manual, and Sedgwick's Claims Administration Procedure Manual. RECOMMENDATION NO. 1.2.b The ASI amendments should direct Sedgwick adjusters to provide "point of entry" authorization for all firefighter WC claims for the remainder of the existing contract. Future contracts with any TPA must include these ASIs. RESPONSE Disagree. This recommendation will not be Implemented. It Is Irresponsible to provide blanket approval of all workers' compensation claims. Currently, Sedgwick claims examiners authorize medical treatment using the County-developed utilization review guidelines. These guidelines were developed with Input from physicians that treat County firefighters and are Intentionally liberal. Overall claims administration Is expected to be advocacy-based and managed as directed under Statement of Work paragraphs 1.5.1 and 1.5.2. RECOMMENDATION NO. 1.2.C The ASI amendments should Include penalties for delays In claims caused by Sedgwick's claims handling that result In LACoFD having to use overtime staffing for the remainder of the existing contract. Future contracts with any TPA must Include these ASIs. RESPONSE Disagree. This recommendation will not be Implemented. This recommendation does not take the LACoFD's return-to-work obligations into account and oversimplifies the complexity of physician, employee, and LACoFD role in overtime usage. Furthermore, CEO staff believe no workers' compensation third party administrator would agree to penalties or excess cost provisions related to an employer's overtime usage. The current Statement of Work requires repayment for the following: • Late payment, inaccurate payments, or nonpayment of any benefit to any applicant or medical provider resulting in penalty, interest, or attorney fees. • Overpayment of any benefit owed to any applicant, lien claimant, or other party in a case due to Contractor's failure to comply with the performance standard set forth in Appendix A, Scope of Work, Paragraph 1.0. • Excess payment of any benefit to any applicant, lien claimant, or other party in a case due to Contractor's failure to comply with the performance standard set forth in Appendix A, Scope of Work, Paragraph 1.0. • Fines and/or administrative penalties assessed against the County due to the Contractor's failure to comply with the performance standard set forth in