Grand Jury Report Response Form Grand Jury Report Title: a Report on Mendocino County Mental Health Branch*

The Mendocino County Board of Supervisors disagrees partially with this finding based on the response by the HHSA Director to this finding, which is incorporated herein, by reference.

The Mendocino County Board of Supervisors disagrees partially with this finding based on the response by the HHSA Director to this finding, which is incorporated herein, by reference.

The Mendocino County Board of Supervisors disagrees with this finding. The opinion expressed is not consistent with actual practice. Several non mandated programs have been restructured or discontinued in response to budgetary constraints, but mandated programs, which are not always self-supporting, are not eliminated for budgetary or for any other reasons. According to the response by the HHSA Director, which is incorporated herein, by reference, General Funds are not used for matching other grant funds.

The Mendocino County Board of Supervisors disagrees partly with this finding. As clarified by the HHSA Director in her response, which is incorporated herein, by reference, the State conducts annual Cost Report Settlement Audits, however, due to staffing shortages at the state level, these audits are conducted six years after the fact. Mistakes do not accrue penalties - it is the audit exceptions themselves that have been a financial drain. MH has made great progress in its most recent audit reports but the failure to do timely audits by the State means that problems may not be identified and corrected in a timely manner, potentially resulting in multi-year audit exceptions.

The Mendocino County Board of Supervisors disagrees partially with this finding. Based on the response by the HHSA Director, which is incorporated herein, by reference, for the past four years, MH has implemented internal audits and training that have consistently reduced billing errors to below 5%. Inability to achieve goals for Medi- Cal billable hours has contributed significantly to past MH deficits, but the Board of Supervisors agrees with the HHSA Director that an average rate that approaches the department standard should be achievable.

The Mendocino County Board of Supervisors partially disagrees with this finding. Based on the response by the HHSA Director to this finding, which is incorporated herein, by reference, the conditions described resulted from construction delays and have been corrected.

The Mendocino County Board of Supervisors partially disagrees with this finding based on the response by the HHSA Director, which is incorporated herein, by reference.

The Mendocino County Board of Supervisors partially disagrees with this finding. Alternatives to hospitalizations (which usually result in out of County placement) often result in treatment that is less traumatizing and more appropriate and therapeutic to the client. See the response to this finding by the HHSA Director, which is incorporated herein, by reference.

The Mendocino County Board of Supervisors partially disagrees with this finding. Mental Health services for Juvenile Hall have not been reduced. Mental Health and other services for the Jail are being restructured so that better all around services can be provided. See the responses to this finding by the Juvenile Hall Manager and HHSA Director and the response to recommendation 9 by the HHSA Director, all of which are incorporated herein, by reference, for more information.

The Mendocino County Board of Supervisors disagrees partially with this finding. Mental Health services have experienced reductions, eliminations and restructuring countywide as staff have struggled to provide the highest level of essential services in the face of shrinking resources, and the coast has been no exception. However, according to the response by the HHSA Director, within the past six months, numerous services and programs on the coast have been enhanced and trainings provided. See the response by the HHSA Director to this finding, which is incorporated herein, by reference, for a detailed explanation of coastal service enhancements.

The Mendocino County Board of Supervisors disagrees with this finding except for the comment regarding high caseloads. It is not true that "two years ago" MH had 125 employees. In March of 2010, two years prior to issuance of the Grand Jury report, MH staffing had already declined to approximately 75 employees. There are now approximately 47 employees with a budgeted staffing level of 53. See the response to this finding by the HHSA Director, which is incorporated herein, by reference, for a detailed explanation of clinician staffing.

The Mendocino County Board of Supervisors disagrees with this finding for the reasons stated by the HHSA Director in her response to this finding, which is incorporated herein, by reference.

The Mendocino County Board of Supervisors disagrees partially with this finding for the reasons stated by the HHSA Director in her response to Finding 14 and this finding, both of which are incorporated herein, by reference. The temporary lack of appropriate check in windows and waiting room space resulted in construction delays and was always intended to be corrected. See the response to this finding by the HHSA Director for more information.