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Extracted from Consolidated Report
This investigation was originally published as part of a larger consolidated report containing multiple investigations. View the consolidated PDF for the complete document.
⚠️ 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.
Recommendations 12
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R1Page 54State of California Review of Amador County Mental Health Plan.
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R2Page 54Require the Director to supply his superior and the County a written plan to improve the working environment and effectiveness of ACMH. The plan should include how to implement the team building recommendations from the workshops into the day-to-day functioning of the Department. It should include a timeline and measurable goals. The plan should also be a part of the performance evaluation of the Director and be reviewed by his supervisor and the County Administration, and be included in the response to the Grand Jury. Response by Department Head: The recommendation has not yet been implemented, but will be implemented by December 31, 2005. Although we have begun utilizing the recommendations from the workshops within the department, the director will be asked to expand on these efforts in a written plan of implementation. This plan will be given to his supervisor and County Administration and will be used to monitor progress toward improving the working environment within the department. Response by Board of Supervisors: This recommendation has not yet been implemented; however, County Administration is currently working with the Director of Health and Human Services to effectively transition to a Behavioral Health Agency. As part of this transition, Administration fully expects to seek the development of a strategic plan which would include the Mental Health Department. Development of this plan will commence once the new Behavioral Health Director position is filled which may be as early as Fall 05. 38 2005/2006 Grand Jury Final Report Verbatim 2004/2005 Grand Jury Report Addendum response by Health and Human Services Agency Director: Refer to the attached improvement plan submitted by the Mental Health. This plan is now in effect and will be used as a benchmark for current and future performance evaluations.
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R3Page 55Such a plan should include, but not be limited to, quarterly meetings of ACMH employees (management and staff) with staff input into a published agenda. These meetings should address current issues and problems, problem solving, suggestions and/or exercises, goal-setting for the next time period, and recognition of good performances and successes from the previous time period. Response by Department Head: This recommendation has been implemented. All committees and meetings within the Mental Health Department have agendas and minutes and continue to meet on a regularly scheduled basis. These meetings do address current issues/problems, problem solving, suggestions, etc. Additionally, the HHS Director has conducted a SWOT analysis with all staff to look at the strengths, weaknesses, opportunities and threats for the department. A follow-up meeting will be held with staff by December 31, 2005 to determine our progress and challenges still facing us. We are currently working on placing all minutes of the committees and meetings in e-files available to all departmental staff. Successes are celebrated in addition to dealing with issues and/or problem solving. Additionally, a monthly newsletter is being published with input from all staff. This newsletter recognizes successes and achievements and serves to improve communication within the department and with the Agency Director. Response by Board of Supervisors: The Board of Supervisors concurs with the Department Head's response.
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R4Page 55If the goals in the plan are not being met, this should be reflected in the Director's performance evaluation. There should be a specific structure for ongoing evaluation, of the ACMH Director's management of the staff, by the Health and Human Services Agency and the County Administrative Office. 39 2005/2006 Grand Jury Final Report Verbatim 2004/2005 Grand Jury Report Response by Department Head: The recommendation has not been implemented, but will be completed no later than December 31, 2005. The Health and Human Services Agency Director and the Deputy CAO are currently conducting interviews with staff of the Mental Health Department to address issues, concerns and suggestions. Findings will be compiled into a report that will assist in establishing goals for the department and the Mental Health Director. Performance Evaluations are a tool utilized to monitor an individual's ongoing ability to perform his/her essential job functions. As required, the HHS Agency Director will continue to monitor the performance of the Mental Health Director, and will set expectations, goals, and corrective actions to be performed as deemed appropriate and as approved by the County Administrative Office. Response by Board of Supervisors: The Board of Supervisors has implemented this recommendation across the organization. All departments are required to annually submit goals and conduct evaluations. Addendum response by Health and Human Services Agency Director: The HHS Agency Director and Deputy County Administrative Officer conducted interviews with a majority of staff from the Mental Health Department to determine how we are currently functioning and meeting their needs. Part of this process was to look at employee morale as well as how the Director is performing the essential functions of the job. A report was then prepared based upon these interviews and was given to the Board of Supervisors in Closed Session (because it dealt with personnel issues). The conclusions reached were shared with the Director only to the extent that they will be used to set over-all department as well as specific performance goals.
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R5Page 56Supervisors should be responsible for keeping track of employee time and ensuring that rules regarding timekeeping are applied evenly to all staff. If supervisors cannot manage the appropriate monitoring of employees' work hours, ACMH should install and use a time-recording device to standardize the record keeping of employees' work time arrival and departure. Also this device should be used to record employee breaks, lunchtime, and other office departures. 40 2005/2006 Grand Jury Final Report Verbatim 2004/2005 Grand Jury Report Response by Department Head: This recommendation has been implemented. Keeping track of employee time was addressed in memos to all staff on October 8 and 28, 2004.The first memo was asking for cooperation from staff, and the second memo spelled out that we must be open and available for clients during clinic hours. Additionally, the subject of time was addressed at a staff meeting on October 28th, and supervisors are now managing and monitoring employees' work hours. Since the issuance of the second memo, tracking of time has not been an issue within the department. Response by Board of Supervisors: The Board of Supervisors concurs with the Department Head's response.
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R6Page 57Develop an informal grievance procedure for ACMH. The procedure should include, guidelines for how the grievances would be handled by the receiving person and what sort of response is required when an employee uses the informal process. Orient ACMH staff at all levels to this policy. Response by Department Head: This recommendation has not been implemented, but will be process for conflict resolution that could also be used as an informal grievance procedure. As the process is completed, it will be presented for discussion/comment in an all-staff meeting as well as in the department newsletter. Recommendations will then be put into place in a plan that will be covered with all staff. Response by Board of Supervisors: The Board of Supervisors concurs with the Department Head's response Addendum Response by Health and Human Services Agency Director; Teach Team Building Committee has begun working on this item. However, the team invited the Deputy CAO to participate in our efforts and we are working on this for all county employees. There is a grievance procedure in the current MOU so we are now developing a “Conflict Resolution” process/procedure. As this will go beyond the department, it has not yet been completed. We anticipate that such a process/procedure will be in place by March, 2006 at the latest.
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R7Page 57Identify a management team, to clarify supervisory roles, responsibilities and lines of communication. Publish this information for all staff and schedule management team meetings on a regular basis. Members of the management team should be chosen by position in the department. 41 2005/2006 Grand Jury Final Report Verbatim 2004/2005 Grand Jury Report Response by Department Head: This recommendation has not been completed, but will be in place by December 31, 2005. The Mental Health Department is merging with the Alcohol/Drug Prevention Department to become the Behavioral Health Services Division within the Health and Human Services Agency. A recruitment process is currently underway to hire a new Behavioral Health Director. Once this process is completed a management team will be established based upon job specifications. An organizational chart will then be published and presented to all staff with roles and responsibilities defined. The management team will meet on a regular basis, no less frequently than monthly, but more often if needed. Response by Board of Supervisors: The Board of Supervisors concurs with the Department Head's response. Addendum response by Health and Human Services Agency Director: This recommendation has been completed in part (see attached information from the ACMH Director). Additionally, Social Entrepreneurs, Inc. has received a contract with the County to undertake a structural analysis of both the Mental Health and Alcohol/Drug Prevention Departments. This analysis will allow us to move towards combining the two departments into a Behavioral Health Division and will look at current job descriptions as well as make recommendations for changes in descriptions/duties. Once this is completed (March 2006) we will identify an ongoing Management Team, define their roles/responsibilities and publish this for all the staff.
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R8Page 58Where appropriate, staff input should be solicited and considered when developing new policies and procedures. Response by Department Head: This recommendation has been implemented. The Mental Health Department utilizes a committee structure to develop new policies and procedures as appropriate unless they are a direct result of a change in Federal or State regulation. When these policies and/or procedures are completed, they are then presented at the next all-staff meeting after being distributed to all staff for preview. Staff then has the opportunity to express comments and/or concerns. Response by Board of Supervisors: The Board of Supervisors concurs with the Department Head's response. 42 2005/2006 Grand Jury Final Report Verbatim 2004/2005 Grand Jury Report
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R9Page 59Adhere to the personnel guidelines of the County and to County policy and the expectations (both the letter and the spirit of the law) of the Department regarding sexual harassment, ethnic, racial and religious tolerance, understanding and sensitivity, and workplace dress code and behavior (Review , MOU and County of Amador Policies and Procedures Manual-number 2-100 and 2-900 (see Appendices C & D) Note: these policies are currently being updated by County Administration). All employees must review the policies and expectations on a yearly (or sooner, if needed) basis and sign an agreement stating that they know the policies and will comply with them. This documentation should be placed in an employees' personnel files. Response by Department Head: This recommendation has not been implemented, but will be implemented by December 31.2005. Mental Health Departmental staff is expected to adhere to all County Policies and Procedures, and are further expected to review them yearly. We will implement a system by December 31, 2005 to ensure that this is completed in keeping with County policy and will place documentation in the employees' personnel files. Response by Board of Supervisors: While the Board concurs with the Department Head's response the Board adds the following. First, the Board notes that all new employees are required to review the County's anti-harassment policy, which is then acknowledged in writing. Secondly, County Administration currently provides harassment training on an annual basis. Each employee's participation is tracked and employees are required to attend trainings on a schedule that is determined by their job duties. Addendum response by Health and Human Services Agency Director: Please refer to the attached Policies/Procedures Follow-up with Employees and Review Affidavits. These were developed by our Compliance/Utilization Review staff and are being shared with all department employees. In accordance with the Grand Jury recommendations, a copy will be kept in each personnel file.
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R10Page 59Management should foster an atmosphere of cultural sensitivity. Respect for diverse populations and cultures is important in the work place. The environment of the work place must be free of any intimidation, influence or distraction that interrupts the delivery and quality of the services provided to the citizens of Amador County. 43 2005/2006 Grand Jury Final Report Verbatim 2004/2005 Grand Jury Report Response by Department Head: This recommendation has been implemented. The Mental Health Department has an active Cultural Competency Committee whose charge it is to oversee that cultural diversity is acknowledged and respected. This committee meets no less than monthly. Issues then are brought up to the committee that indicates that something needs to be done to improve in this area can be brought up to the Agency Director and County Administration to ensure compliance. Response by Board of Supervisors: The Board of Supervisors concurs with the Department Head's response.
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R11Page 60Remove all posters, flyers, jokes, stories or other items that are inappropriate to be displayed or said in the workplace. Management must enforce this and set an example for employees to follow. Response by Department Head: This recommendation has been implemented. Management has taken action to see the workplace is free of all posters, flyers, jokes, stories or other materials that may foster ill will, distractions to completion of job tasks or an otherwise hostile work environment. Management does not condone inappropriate jokes, comments, mannerisms or behaviors. Management began to oversee all reading materials placed in the department for appropriateness and relevancy as soon as it was discovered that inappropriate materials were in the workplace. This is an important recommendation and is taken very seriously by department management. We will continue to enforce this area on an ongoing basis. Response by Board of Supervisors: The Board of Supervisors concurs with the Department Head's response.
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R12Page 60The Director of Health and Human Services should become more involved in ACMH, both on a regular basis and especially when there are unresolved personnel issues affecting morale and quality of service to the community. 44 2005/2006 Grand Jury Final Report Verbatim 2004/2005 Grand Jury Report Response by Department Head: This recommendation is implemented. The Health and Human Services Agency Director is more involved in the Mental Health Department, both on a regular basis and when there are unresolved issues that effect employee morale and services to the community. The HHS Director has begun attending all-staff meetings as well as some Team Building meetings and recently facilitated a SWOT analysis with staff for the needs and strengths of the department. See item #4 for additional involvement. The Mental Health Department is an integral piece of the Health and Human Services Agency, and the HHS Director will continue with her involvement on an ongoing basis. Response by Board of Supervisors: The Board of Supervisors both concurs with the Department Head's response and also notes that County Administration finds it important to seek additional opportunities to communicate with Health and Human Services Agency departments. The County Administrative Officer is working with the Health and Human Services Agency Director to identify staff meeting opportunities for County Administration participation. These meetings are expected to commence in Fall 05. End: Verbatim 2004/2005 Grand Jury Report 45 2005/2006 Grand Jury Final Report 6.3.3 Responsible Agency, City, County Department or Special District Amador County Health and Human Services Agency Amador County Board of Supervisors 6.3.4 Jurisdiction, Justification, Penal Codes and or Laws California Penal Code Section 925, 933(c), 933.05 6.3.5 Findings of the 2005/2006 Grand Jury 1. The Amador County Grand Jury of 2005/2006 reports that interviews have been conducted with the Amador County Mental Health Department. Questions covered procedures; policies; cultural, ethnic, morale issues; and general requirements mandated by the County. Eighteen (18) current employees were interviewed with the only exceptions being personnel out on leave. 2. Since publication of the 2004/2005 Grand Jury Report, employee retention has increased from sixty-two (62) percent to ninety-five (95) percent. 3. Amador County Mental Health Department was ranked number two (2) out of fifty-eight (58) counties in the State, as reported by the State Managed Care Review Audit. This audit was performed by the California Department of Mental Health. Two hundred nine (209) of two hundred thirteen (213) items audited were in compliance. Many of the issues found by the 2004/2005 Grand Jury appear to no longer exist and the others are in the process of being corrected. 4. The 2005/2006 Grand Jury finds that issues reported have been satisfactorily resolved. The 2005/2006 Grand Jury commends the employees and management for their achievements. 6.3.6 Recommendations No further actions or recommendations required. 6.3.7 Pertinent References, Documents and Materials 1. State of California Review of Amador County Mental Health Plan. 2. Interviews with Staff and Management. 3. Web Site www.co.amador.ca.us/depts/mental 46 2005/2006 Grand Jury Final Report 6.4 City Of Plymouth 6.4.1 Introduction The 2004/2005 Amador Grand Jury elected to investigate a number of citizen complaints. Following is a synopsis of the actions taken and the responses from the City. 6.4.2 Background See the following 2004/2005 Grand Jury report sections referring to City of Plymouth. 47 2005/2006 Grand Jury Final Report Verbatim 2004/2005 Grand Jury Report