San Benito County Grand Jury • 2015-2016

The Property of Flora Ave Rosebud Av Galfodii Dr*

Published: March 16, 2023 124 pages Consolidated Report

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⚠️ 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.

Note: Missing finding numbers detected: F16, F17, F18, F19, F20, F21, F22, F23, F24, F25, F26, F27, F28, F29, F30, F31, F32, F33, F34

Findings 18 findings

presenting higher risk of vehicular pedestrian injury. The speed limit on Memorial Drive does not reflect the use of existing speed risk

data or any risk analysis. Perception by some residents is that local government is either unaware of the

risks to pedestrians on Memorial Drive or is unconcerned. There is a lack of vehicle calming methods to assist pedestrian safety.

The number of injuries to children from gopher damage is underreported to the schools.

Follow up regarding the effectiveness or ineffectiveness of current measures in place for gopher abatement/control is not being tracked.

Long term plans to abate gophers from school fields and prevent persistent mounds in newer fields is needed.

General communication between departments, agencies and districts are lacking.

Negotiated Memorandums of Understanding (MOUs) do not exist for providing mental health care in SBC and between agencies under different boards, county, or state authority.

The time between initial custodial hold and admission as an inpatient for a person in an involuntary hold under WIC often exceeds 72 hours in SBC, and not infrequently goes beyond a week. Reports indicate that patients are being held waiting in the HHH ED for as long as 14 days for further mental health evaluation and treatment.

F10

The SBC Behavioral Health Department is writing consecutive WIC 5150s.

F11

Patients on a temporary involuntary hold in SBC hold may not know their legal rights under the CA WIC laws of civil commitment.

F12

There is a possible violation of Patient's Rights when under a temporary involuntary hold in SBC being violated, under the CA WIC laws of civil commitment.

F13

The HHH ED staff is using a pamphlet derived from Santa Cruz County to distribute to patients on WIC 5150 holds about their civil rights.

F14

The HHH ED staff may be releasing WIC 5150 hold patients that exceed 72 hours due to concerns about violations of patient's rights.

F15

BH does not have official authorization or paperwork from any authority to support the claim that they may stack 5150s. F 16. There is a lack of adequate county psychiatric health facilities, crisis centers, and/or inpatient psychiatric beds based upon the previous, current, and the rapidly growing SBC population. F 17. Mental health patients may have to wait a long time to be medically cleared. F 18. Mental health patients who come in, or are brought in, consecutively to the HHH ED may 'backup' in the ED while waiting for medical clearance and assessment. F 19. Healthcare and security manpower requirements at HHH increase when monitoring and holding an individual on a WIC 5150 involuntary hold, and increase at a more rapid rate when exceeding the allowed 72 hours. F 20. A backlog of individuals on a WIC 5150 involuntary hold results in mental health patients in the ED with no place to wait creates general HHH ED crowding, financial, and security risks. F 21. The ED can be holding multiple psychiatric patients in ED beds, creating a longer wait time for medical treatment for other types of ED patients. F 22. HHH or the HHH Emergency Department or does not have a psychiatrist on staff. F 23. The San Benito Health Care District, Board of Directors, is not involved enough in the oversight and disposition of HHH ED individuals in a WIC 5150 temporary involuntary hold and persons needing mental health care assessment, evaluation, and treatment or transfer. F 24. The Mayor of Hollister and City Council of Hollister are not systematically involved in the impact Hollister residents experience from alimited mental health program and dysfunction of the communications and protocols among the agencies. F 25. Jail psychiatric support is lacking. F 26. Correctly updated written SBC Jail policies and procedures in Section 609 are not possible in the current climate of a broken mental health care program in SBC. F 27. BH providing one-way directives to the Jail or other agencies such as LE or HHH ED that significantly impact the other's resources is not appropriate nor in the best interest of the SBC mental health care system. F 28. The current BH policy incurring significant limits to the Jail staff in making calls to clinicians AND the expanded timeframe the Jail staff endures while waiting for clinicians to arrive at the Jail for assessment has had a substantially negative impact on the Jail. F 29. Our local government is not considering the strain placed on County Jail Correctional Officers at the SBC Jail due to BH policies, and HHH limitations or as part of a comprehensive SBC mental health care program. F 30. Inmates are waiting in a safety cell for a mental health assessment for too long. F 31. Requiring Jail Corrections Officers to conduct 15-minute checks to the Jail's Safety Cell on an extended basis while waiting for mental health clinicians to perform a mental health assessment is unacceptable. F 32. Transportation logistics are inadequate. Obtaining and funding the appropriate type of transportation for mental health patients to other facilities with an available bed is problematic. F 34. Inmates are not provided with an adequate facility per Title 15 to accommodate psychiatric evaluation and treatment. F 33. There is no established, dedicated, and collaborative committee to confer and effect solutions under BOS oversight to remedy current mental health care problems and to explore the future mental healthcare needs of the county.

F35

SBC Law Enforcement and HPD LE are out of compliance with WIC 5150 by not transporting persons placed under involuntary hold to a facility where the person may receive a mental health evaluation.

F36

SBC government does not have an area set aside to construct the augmented infrastructure needed for a psychiatric treatment facility.

F37

COG has not considered SBC LTA as an option for transportation in a comprehensive mental health care program nor a temporary solution in the shortfall of transportation logistics in SBC for mental health care patients.

Recommendations 18

R1

to the park to a speed based on a combination of studies and surveys, not just the speed summary.
R2

The Grand Jury found no evidence of any kind to suggest that anyone had been the subject of discrimination. This determination would be more transparent and easier to make had the Districts kept the electronic records suggested in
R3

bumps and/or advisory signs, paint the speed limit on the asphalt, yellow flashing lights during events.
R4

conditions while driving on Memorial Drive given the presence of events and pedestrians
R5

fatality occurs on the Memorial Drive segment adjacent to Veterans Park before addressing the speed issue. Local government should acknowledge and further evaluate safety and the speed to prevent and not wait to react to accidents. Local government should decide if conditions warrant another E&TS be done before 2017.
R6

typical event and on a regular day. Count the traffic during a typical event and on a regular day. Research the risk of injury based on the number of pedestrians in proximity to the number of cars. Determine if any benefits exist in a speed limit of 40mph.
R7

F6, All new school fields built should include wire mesh in the cost of construction.
R8

F4, F6, F7, F23. The LE, ED and BH Departments and the Jail are key relationships to one another. Policies and procedures between these agencies should be made with particular attention and supported with a close oversight of the BOS that reflects these dependencies to ensure mental health care program efficiency and success.
R9

F1, F4, F5, F6, F7, F23. Collaborative effort should begin immediately from all parties for the health and welfare of SBC.
R10

F4, F7, F8, F23. SBC BOS establish clear Memorandums of Understanding (MOUs) written by and for the involved agencies, districts that have a separate board, and counties, (i.e. those not operating under the SBC BOS direct authority) to determine and establish agreement upon, and compliance with, local protocol. Also, that the BOS effect policy to maintain these MOUs until superseded by subsequently negotiated agreements.
R11

F1, F4, F10, F11, F12, F14, F23. "Stacking" 5150 holds is bad practice, and may be in violation of CA law. SBC should cease taking liberties with CA legislation concerning persons placed on 5150 holds. All methods available to agencies and departments should be implemented to attempt not to exceed the 72-hour maximum elapsed time from when the hold is initiated by LE, or otherwise, until the point of completed disposition of the patient.
R12

F1, F4, F10, F11, F12, F14. F15. BH should not look for, or be compelled to find, creative ways to circumvent the law to extend the 5150 72-hour hold due to SBC's lack of psychiatric treatment resources. BH should not "fudge the start time of the 5150 hold" nor argue that the start time or "hold lift time" is ambiguous. BH's good intention is clear, but working with the BOS to gain the facilities for an outstanding mental health program is optimal. Anything else may be counterproductive to achieving a long-term viable and quality program in SBC. If SBC BH does obtain written official temporary authorization to stack 5150s from the state, SBC should still employ a more strict 5150 72 hold time, and county agencies work together to increase our quality of mental health care under this time constraint. If BH obtains formal approval to stack 5150s given our dire lack of resources, BH's use of the temporary waiver should be done so understanding that it to be used in parallel to a dedicated lobby for establishment and implementation of permanent solutions for SBC.
R13

F9, F10. Recommended that SBC adopt a model such as Monterey County to consider weekends and holidays as part of the 72-hour period of a 5150 hold regardless of SEIU bargaining demands.
R14

F1, F4, F10, F12, F23, F32. Both the ED and BH should be responsible for researching and locate bed availability to transfer 5150 persons who cannot receive needed care in SBC. Both departments should be held equally accountable for delays or wait time in the 72 hours to research and find a bed. This policy should be written in a formalized protocol and enforced by the BOS in oversight of the county mental health care program.
R15

F1, F10, F11, F12, F14, F15, F23. If individuals object to being involuntarily held during or beyond the 72 hours on a 5150 hold, then the use of the patient's legal rights to judicial review (filing a writ of habeas corpus) process should be brought (again) to the patient's attention by the ED staff. In particular, when medical clearance has processed but a BH assessment is not complete. That is, according to WIC the patient may be reminded that: "If held longer than 72 hours, you have the right to a lawyer and a qualified interpreter and a hearing before a judge. If you are unable to pay for the lawyer, then one will be provided to you free of charge." Notification by the individual to the County Public Defenders office or any other attorney should not be interfered with or discouraged. The individual may also be reminded that if demanding a writ of habeas corpus, the decision whether to file it lies solely with the SBC Public Defender.
R35

F33, F34 Is it recommended that the BOS have research continued to help determine the concerns of the SBC Juvenile Hall (JH) and the SBC Probation Department policies and procedures in mental health care. Both departments should be consulted and interviewed by independent, nonaligned researchers. Both departments should also participate in future collaboration and planning. The mandates and policies for the mental health care for minors held in detention and parolees stayed outside the scope of this report only due to time constraints. Members of the SBC Grand Jury 2015-16 working on this research have volunteered to assist with further impartial research and reporting on the needs and impact on these departments if requested. The SBC Grand Jury Foreperson has 2015-16 has contact information.
R36

F36. Recommend that due to the inherent delays associated with the construction of a Homeless Facility that SBC local government together identify and the BOS approve an area and property ready to allow the building of a psychiatric treatment facility as soon as state assistance is secured.
R37

The Grand Jury recommends that the BOS, in conjunction with the Council Of Government, evaluate the use of LTA to assist SBC in transportation as part of a temporary or permanent solution to the inherent and problematic logistics of a Mental Healthcare Program in SBC.

* This report's PDF did not contain easily extractable text and required Optical Character Recognition (OCR) for analysis. There may be minor errors in the extracted findings and recommendations due to OCR limitations with scanned documents.