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Extraído del Informe Consolidado
Esta investigación fue publicada originalmente como parte de un informe consolidado más amplio que contiene múltiples investigaciones. Consulte el PDF consolidado para ver el documento completo.
⚠️ Aviso de traducción: Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.
⚠️ Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.
Findings 16 findings
F1
Page 20
The MHD stands alone as a county department. The MHD has been split from the Department of Alcohol and Drugs. The MHD is not linked to the Plumas County Health Department.
F2
Page 20
There is inadequate interaction between the MHD and the Department of Alcohol and Drugs. The relations between the two county agencies have been acrimonious for a number of years. Relations have improved slightly in the last few months.
F3
Page 20
There is no Memorandum of Understanding (MOU) between the MHD and the Department of Alcohol and Drugs outlining a protocol for the needed interaction between the two departments. 17
F4
Page 21
The communication between the MHD and the Sheriff’s Department is minimal. One aspect of the problem that contributes to the lack of communication is complicated by patients’ confidentiality rights. The MHD clinicians cannot divulge information about a client and therefore are unwilling to release information about treatment and follow-up of that client. The perception sometimes is that “nothing is being done”. This appears to be one cause for misunderstandings between the MHD and the Sheriff’s Department.
F5
Page 21
There is no civil (non-criminal) protective locked facility for members of the community who may be a danger to themselves or to others. Currently, the MHD does not see such individuals that are considered “under the influence”. As a consequence, these people remain untreated and unprotected or are taken to jail. A locked civil protective custody facility is mandated by law (Welfare and Institution Code 5170), but one does not exist in Plumas County.
F6
Page 21
There have been issues raised that on occasion the MHD is slow to respond to crisis intervention situations and the law enforcement officer who should be in the field is taken out of service to care for an individual during a possible mental health situation until the clinician arrives.
F7
Page 21
There is an MOU between the MHD and the Sheriff’s Department that outlines mutual areas of coordination and responsibilities for emergency evaluations and hospitalizations.
F8
Page 21
As mandated by the State of California, Plumas County has a Mental Health Commission separate from the MHD. The Commission acts in an “Advise and Recommend” capacity to the Board of Supervisors on MHD issues and on the policies of the MHD. The Commission also acts in an advisory capacity directly to the MHD, as well as participates in the budgeting and planning agenda of the MHD. The Chair of the Mental Health Commission meets with the director of MHD on a regular basis and has an excellent working relationship. However, the Mental Health Commission meets with the Board of Supervisors only once a year. A Board of Supervisors member attends the Mental Health Commission’s meetings irregularly.
F9
Page 21
There are issues of coordination within the MHD staff about clients and their treatment that may put clients at risk.
F10
Page 21
The MHD staff meets on a weekly basis. It was reported to the Grand Jury that communication within the staff is excellent and supportive.
F11
Page 21
The MHD provided a budget that indicates that the Department is efficiently run and is fiscally responsible.
F12
Page 21
The MHD operates a number of quality programs within its area of practice. The MHD is to be commended for the hard work of its employees and for the implementation of innovative and supportive programs. Notable, are Sierra House, the Respite Program, and the Wilderness Program.
F13
Page 21
The recently passed California Proposition 63 should increase revenue for the MHD.
F14
Page 21
The MHD staff meets face-to-face once a week for four hours. Otherwise, the small staff is spread out in the various communities it serves and rarely comes together 18 except for the weekly staff meetings. Most communication among staff is done by phone, a highly inefficient method for a task that requires communication and relay of client information. As a result, there have been errors.
F15
Page 22
MHD knowledge of Grand Jury investigations caused the stoppage of all quality control with Plumas District Hospital.
F16
Page 22
An administrator of MHD violated the admonition of the Grand Jury to keep discussion with the Grand Jury confidential.
Recommendations 8
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R1Page 20The MHD and the Department of Alcohol and Drugs develop an MOU that outlines mutual areas of coordination and responsibilities. It is crucial that there be communication and support between the two agencies, in particular to prevent those individuals with co-occurring disorders of both mental illness and substance abuse from “falling through the cracks” between the agencies. In most counties in California, mental health departments and alcohol and drugs departments are closely linked. The division in Plumas County between these two departments has been going on for years. The Board of Supervisors, as the governing body of these two departments, must take a proactive stance in facilitating cooperation.
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R2Page 20The MHD develops a position in which an employee acts as a liaison between the MHD and the Sheriff’s Department. This employee would be approved by both departments and would be in daily contact with both departments and would address problems with communications, protocol, and allegations of misconduct.
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R3Page 20As mandated by the State of California, Board of Supervisors must act to provide a civil protective custody facility for Plumas County in which to house those individuals who need protection but should not be arrested. This facility will allow law enforcement personnel to safely place individuals into protective custody and then return to law enforcement duties in the community with expediency. This will alleviate the problem of the MHD’s position of not seeing an individual for assessment until the individual is free from alcohol and/or substances.
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R4Page 20It is time to computerize the MHD. The staff is dispersed and timely communication is essential. The MHD and community safety would benefit greatly with a wireless computer that would allow clinicians to submit and read records and information quickly and confidentially. New data would be available instantly assuring that every staff member would be apprised of the history of client contact or client crisis in a timely manner.
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R5Page 20A Board of Supervisor’s member regularly attends the Mental Health Commission’s meetings and report back to the Board of Supervisors
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R6Page 20The Mental Health Commission publish a periodic newsletter of statistical information in order to keep the public informed of its activities.
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R7Page 20Training on Grand Jury interaction and scope of Grand Jury authority be performed. 19
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R8Page 20This ongoing review of the MHD be referred to the 2005-2006 Grand Jury for further investigation. PLUMAS COUNTY BOARD OF SUPERVISORS
Conclusions 1
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CL1In the course of our investigation, this Grand Jury became informed of numerous allegations of impropriety by staff members. The Grand Jury has worked diligently to not only verify each allegation, but also attempted to categorize them in an effort to keep our focus on the Department as a whole, not on an individual mistake. Put succinctly, we feel many of this department’s problems are heightened by (if not a result of) interpersonal relationship conflicts. There were several seemingly improper actions by staff members that the Grand Jury felt were a result of the antagonism that is so pervasive throughout the Department. The Grand Jury’s findings were focused on the core issues and not the small details. The Grand Jury did its best to focus on areas that may help to make this department more productive. It is the Grand Jury’s hope that with consistent management and increased oversight, this department will again be one upon which our citizens may rely. 16 PLUMAS COUNTY MENTAL HEALTH DEPARTMENT Function The Plumas County Mental Health Department (MHD) is an outpatient service providing a full range of outpatient, case management and socialization services. More intensive services such as acute hospitalization, long-term intensive residential and state hospital services are provided by contracting with the appropriate agencies in question. The services includes: emergency assessments, outpatient services, inpatient services, case management, day treatment programs, medication support and therapeutic behavioral services. The MHD is the managed care provider for all MediCal mental health services in the county.
Commendations 4
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CM1The main electrical breakers are now secured with fencing and locks. However, not only does the chain link structure need to be enlarged to adhere to PG & E's equipment clearance guidelines, but also the roof of the chain link structure has collapsed under the weight of snow requiring the need to redesign the structure as a whole.
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CM2Negotiations with the Public Works Department are underway for installation of food slots in the maximum security cell doors.
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CM3A full-time employee of the Facility Services Department is now assigned, specifically, to maintain the Jail. PLUMAS COUNTY ALCOHOL AND DRUG DEPARTMENT Function The mission of the Plumas County Alcohol and Drug Department (A&D) is to improve the quality of life in the County through lowering the impact and incidence of alcohol and other drugs of abuse. The State requires five (5) primary divisions of the A&D Department. • The Prevention Program includes educational youth programs such as Friday Night Live. • The Drug Courts include an adult division that entails such services as drug testing and counseling. • The Treatment Services include outpatient and residential services. • The Driving Under the Influence (DUI) Program is a drunk driving school. • The Perinatal Program helps pregnant women, women with children and their families with recovery from substance abuse. The A&D Department is funded by State and Federal dollars as well as funds from legal fines and client payments for certain services. Therefore, it is imperative for the A&D Department to collaborate with many other County departments including the Mental Health Department and the District Attorney’s Office. The State and Federal funds are closely monitored by State and Federal agencies. Client fees are set by the Plumas County Board of Supervisors.
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CM4In spite of the problems facing the fire departments, there is a good esprit de corps among the fire fighters. They willingly assist other departments and agencies and respond to emergencies without regard to funding and the quality of their equipment. 25 PLUMAS COUNTY FACILITIES SERVICES DEPARTMENT Function The Facilities Services Department (FSD) is charged with providing and maintaining acceptable environments in which all county employees are able to comfortably carry out their individual duties. The FSD maintains over thirty (30) facilities and real properties owned and/or operated by the county.