Fresno County Grand Jury
• 2024-2025
Fresno County Department of Behavioral Health: Will the Department be able to meet current and future
⚠️ 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 and Recommendations 8 findings
F1
Funding is sensitive as it comes from Federal and State sources (Medi-Cal and grants), yet there is no contingency plan defining how spending will be cut at DBH in the event of funding cuts.
Related Recommendations (1)
R1
The Director of Behavioral Health should create a written contingency plan to define cuts in service in the event there are cuts in funding by January 31, 2026. (F1)
F2
There is no formal system of vertical communication for DBH employees to ask questions or make suggestions and have a guaranteed response from upper management.
Related Recommendations (1)
R2
The Director of Behavioral Health or his/her designee should create a vertical communication system enabling field level staff to communicate concerns and suggestions to the Deputy Director / Director level of management by December 31, 2025. (F2)
F3
The transition to SmartCare Electronic Health Record (EHR) software system has created more issues for DBH than anticipated. 3 https://www.fresnocountyca.gov/Departments/Behavioral-Health/For-Professionals/Quality-Improvement/ Annual-Beneficiary-Grievance-Appeal-Reports 7
Related Recommendations (1)
R3
An employee proficient in SmartCare should be identified by the Director of Behavioral Health as the subject matter expert (SME) to provide as needed training or assistance to all DBH Employees by December 31, 2025. (F3)
F4
DBH Field Clinicians lack sufficient training to enhance their safety and effectiveness.
Related Recommendations (1)
R4
The Director of Behavioral Health or his/her designee should develop a formal training program for all new hires based on their administrative or professional category by March 31, 2026. (F4) 8
F5
DBH’s Field Clinicians have no current information regarding known violent tendencies or criminal history of their patients prior to meeting with them.
Related Recommendations (2)
R5
The Director of Behavioral Health or his/her designee should develop a formal training for all field clinicians, with annual refresher training based on current needs, including a hands-on self defense course and make it available to all field staff who encounter clients by March 31, 2026. ( F4)
R6
The Director of Behavioral Health or his/her designee should create a flag in the Smart Care System which identifies known violent tendencies and criminal history of the clients by March 31, 2026. (F5)
F6
There are insufficient or outdated supplies provided to DBH clinicians working in environments outside of the office including complete first aid kits and Narcan.
Related Recommendations (2)
R7
The Director of Behavioral Health or his/her designee should implement a resupply system that ensures all first aid kits in DBH vehicles are fully stocked and updated by January 31, 2026. (F6)
R8
The Director of Behavioral Health should require that field staff be provided with Narcan, based on the potential Fentanyl and Opioid exposure in the field by January 31, 2026. (F6)
F7
DBH is not maintaining the most current information on its website as reports located on the website are aged and require updating.
Related Recommendations (1)
R9
The Director of Behavioral Health or his/her designee should conduct a yearly audit of each link and button on the DBH website to ensure reports and information contained on the website are up to date by January 31, 2026. (F7)
F8
The Auditor - Controller / Treasurer-Tax Collector’s office and DBH Finance/Accounting division have a different perception as to the timing of reimbursements into the County’s general fund.
Related Recommendations (2)
R10
The Director of Behavioral Health or his/her designee should schedule monthly meetings with the County Auditor/Controller’s Office to timely resolve any accounting issues by December 31, 2025. (F8)
R11
The Director of Behavioral Health should develop a clear written procedure regarding the timing of reimbursement from DBH to the County general fund by December 31, 2025. (F8) 9
Conclusions 1
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CL1 Page 8The Grand Jury recognizes the difficulties DBH faces in accomplishing their mission and generally commends the department in its efforts. The DBH is a large organization filled with compassionate people dedicated to their mission of helping members of the community suffering from mental illness and substance dependency. Our recommendations address specific areas that we believe would improve the organization. It is not our intention, however, to criticize the work ethic, dedication, or intentions of DBH employees. We found most to be sincere people who have a calling to help the community that they serve.
No Responses Found 3
Government entities assigned to respond to this report. No response documents have been linked in our database.
County of Fresno
Agency
Fresno County Board of Supervisors
Elected County Office
Fresno County Treasurer-Tax Collector
Elected County Office