Recreation

High turnover results in lower quality patient care. It lowers productivity and quality of service to the community. Response by Department Head: Please refer to response for item #3. We are significantly increasing our level of service. Response by Board of Supervisors: The Board of Supervisors partially agrees in that as a general management theory increased turnover can result in lower productivity and performance. In this situation, however, the Board notes that the only quantifiable factors for department performance provided to the Board are those noted in the Department Head's response to number three which would seemingly indicate that at a minimum productivity has increased at the same time as the increase in turnover.

High turnover contributes to a loss of continuity and interagency cooperation in addressing patient problems. In many cases, the needs of county mental health patients are best served by interagency cooperation and communication. Response by Department Head: We agree that high turnover contributes to a loss of continuity and interagency cooperation. We disagree that we are not involved with persons from other agencies as we continue to participate in interagency meetings and to collaborate with agencies and departments where mental health services are clearly an elemental part of the agenda. In fact, we have a meeting scheduled with representatives from the law enforcement community, the Board of Supervisors, Sutter Amador Hospital, the Mental Health Director and HHS Agency Director on August 25, 2005 to work on improving our communication and better service to our mutual clients. 35 2005/2006 Grand Jury Final Report Verbatim 2004/2005 Grand Jury Report Response by Board of Supervisors: The Board of Supervisors concurs with the Department Head's response.

Since therapists work on-call hours, flextime schedules, and in off- site settings, ,time keeping in ACMH can be complicated. Response by Department Head: We agree that time keeping in the Mental Health Department can be complicated. We continue to look at ways to improve the ways in which we keep track of time, schedule client appointments and cover for staff who are away from the job site for a variety of reasons. Suggestions from staff are encouraged. Response by Board of Supervisors: The Board of Supervisors agrees with this finding.

Team building cannot be accomplished with three sessions if there is no follow-up on a day-to-day basis. This follow-up should be done by ACMH management and emphasized on a daily basis with a plan to foster this "team building" environment. If taxpayer money is going to be spent on workshops, then the results of those workshops need to be implemented and fostered. Response by Department Head: We agree that team building cannot be accomplished with three sessions if there is no follow-up on a day-to-day basis. The workshops that were held were never approached as a series of three disconnected sessions. Following the first training a team building committee, made up of staff from all levels and categories within the department, began to meet weekly to address the day-to-day challenges of developing a sense of team within the department. They are continuing with these meetings, and have even developed a department newsletter. Response by Board of Supervisors: The Board of Supervisors agrees with this finding.

An adverse work environment, such as reported by ACMH employees and former employees, exposes the County to potential litigation and the attendant expenses. Response by Department Head: We agree with this finding, and note that we have addressed any items that are potentially litigious, and continue to address others through contact with the Union, appropriate work place environment trainings and daily monitoring of issues. 36 2005/2006 Grand Jury Final Report Verbatim 2004/2005 Grand Jury Report Response by Board of Supervisors: The Board of Supervisors concurs with the Department Head's response.

The problems encountered in ACMH, have not been addressed by the Director of Health and Human Services. Response by Department Head: We disagree with this finding. Although Fact #17 indicates that five people went to the Director of the Health and Human Services Agency with some of the problems stated above and reported no resolution of the problems. There is not enough information to give a specific response. The Agency Director's records show that when staff has approached her with a problem, it has been investigated and handled. As some complaints have involved personnel issues, they cannot be shared with other staff. The HHS Director has met with Mental Health Department staff in the past and continues to do so. Staff has been advised that they can contact the Director at any time there is a problem to be addressed. Additionally, the Director meets with the Union leadership on a monthly basis and responds to issues for all HHS departments that are raised. Response by Board of Supervisors: The Board of Supervisors disagrees with this finding. The Board recognizes that there are ongoing issues in the Mental Health Department which require resolution. The Board has found the Director of Health and Human Services to be extremely concerned and willing to embrace various techniques to better understand these issues and develop appropriate solutions.