29 responses to findings and recommendations
F1
Butte County government showed support for the grand jury system with its on-time and on-point responses, even as county officials disagreed as often as not with the findings and recommendations of the 2011-12 report.
Response: Disagree Partially
Score: 0
The respondent agrees with the finding. It should be noted, however, that this is Response: not unique to the Behavioral Health Department. Most County departments operate on a severely restricted budget. Recent Management changes have had a positive impact on operational problems.
F2:
Response: The respondent agrees with the finding. The DBH fund deficit has been eliminated and the fund now carries a positive balance.
F3:
The respondent partially disagrees with the finding. The Behavioral Health Response: Fund had a positive balance at the end of fiscal year 2010-2011 (June 30, 2011). How...
R1
Develop and implement an outreach program to raise awareness of Adult Protective Services in order to educate the public about programs.
Response: Implemented
Scheduled: fiscal year 2010-2011
Score: 0
The respondent agrees with the finding. It should be noted, however, that this is Response: not unique to the Behavioral Health Department. Most County departments operate on a severely restricted budget. Recent Management changes have had a positive impact on operational problems.
F2:
Response: The respondent agrees with the finding. The DBH fund deficit has been eliminated and the fund now carries a positive balance.
F3:
The respondent partially disagrees with the finding. The Behavioral Health Response: Fund had a positive balance at the end of fiscal year 2010-2011 (June 30, 2011). How...
F2
The Feather River Recreation and Park District explained all of its positions in considerable detail and in conformance with state law. In contrast, three recreation and park districts - Durham, Paradise and Richvale - failed to meet their legal requirements even after a reminder letter from the 2012 - 13 Grand Jury.
Response: Disagree Partially
Score: 0
Fund had a positive balance at the end of fiscal year 2010-2011 (June 30, 2011). However, it is projected to have a negative balance at the end of fiscal year 2011-2012 (June 30, 2012). The negative cash flow problem has not improved in the last three years and will present
F4:
a challenge to the department for an undetermined number of years to come under the current strategy. The respondent disagrees with the finding. The negative cash flow problem has Response: gradually improved during the last three years due to: 1) increased productivity, 2) budgeting lower expenditures than anticipate...
R2
Hire additional public health nurses to evaluate and assist with APS and IHSS clients.
Response: Will Not Implement
Scheduled: fiscal year 2012-13
Score: -1
addressed through temporary borrowing from other funds without any disruption to services. As noted in response to F4, the department continues to improve its cash flow.
R3:
No further transfers from the Mental Health Trust Fund to DESS should be made until the staff levels necessary to provide core services within DBH have been met. The recommendation will not be implemented because it is not reasonable. Response: Pursuant to law, the Board of Supervisors must consider the County budget on an annual basis. During the budget process, the Board considers spending priorities in the context of ...
F3
The two cities that were the subjects of reports, Gridley and Oroville, both agreed overwhelmingly with the 2011-12 Grand Jury’s findings and
Response: Disagree Partially
Score: 0
Fund had a positive balance at the end of fiscal year 2010-2011 (June 30, 2011). However, it is projected to have a negative balance at the end of fiscal year 2011-2012 (June 30, 2012). The negative cash flow problem has not improved in the last three years and will present
F4:
a challenge to the department for an undetermined number of years to come under the current strategy. The respondent disagrees with the finding. The negative cash flow problem has Response: gradually improved during the last three years due to: 1) increased productivity, 2) budgeting lower expenditures than anticipate...
R3
Continue to investigate and assist in prosecuting IHSS fraud cases and seek ways to reduce recurrences of fraud.
Response: Will Implement
Scheduled: fiscal year 2012-13
Score: +1
Pursuant to law, the Board of Supervisors must consider the County budget on an annual basis. During the budget process, the Board considers spending priorities in the context of overall County needs and not just behavioral health services. The Board will continue to consider how realignment funding transfers will impact health, social and safety services before making these critical funding decisions. It should be noted that the 1991 realignment legislation specifically allowed for these transfers recognizing that each county had unique needs. By transferring realignment revenues from the Pub...
F4
Larger local government agencies, which commonly have more personnel and more experience dealing with grand jury reports, generally did better than smaller agencies in providing legally adequate responses to reports. xvi
Response: Unknown
Score: 0
, the department continues to improve its cash flow.
R3:
No further transfers from the Mental Health Trust Fund to DESS should be made until the staff levels necessary to provide core services within DBH have been met. The recommendation will not be implemented because it is not reasonable. Response: Pursuant to law, the Board of Supervisors must consider the County budget on an annual basis. During the budget process, the Board considers spending priorities in the context of overall County needs and not just behavioral health services. The Board will continue to consider how realignment fun...
R4
Hire additional social workers to better manage the caseload for the IHSS program.
Response: Will Implement
Scheduled: fiscal year 2012-13
Score: +1
implemented by the end of the fiscal year. However, this will be an on-going effort. The Board has charged the director to work with individuals, departments, hospitals, and non-profit organizations to optimize behavioral
health services within available resources by the end of the current fiscal year. The Board and the CAO have taken leadership to bring stability to the budget of the Behavioral Health Department and appointed an able director. The Board of Supervisor continues to provide leadership by establishing broad policies for the County and appointing department heads to execute them....
F5
The caseloads of IHSS social workers are significantly large.
Response: Disagree Partially
Score: 0
above, the wall does not constitute a dangerous condition.
The state of the state of the state of the state of the state of the state of the state of the state of the state of the state of the state of the state of the state of the state of the state of the state of the state of t This concludes my response to the 2011-2012 Grand Jury report. Once again, I appreciate all the recommendations made by the Grand Jury, and remain convinced that this type of citizen participation in the operations of gove Sincerely, 一門 中部部 Jerry W. Smith Sheriff-Coroner Board of Supervisors CC: Steve Lambert Bill C...
R5
Work with social workers in Adult Services to equip them with whatever resources are available that they would need to insure their safety. 13
Response: Will Not Implement
Scheduled: fiscal year 2012-13
Score: -1
Hall facility. The recommendation will not be implemented because it is not reasonable. An Response: additional exterior fence surrounding the current climb-resistant razor-wired fence could still not prevent contraband thrown over it. Staff checks the outdoor exercise field prior to use, is always present during use and can direct youth back into the building if suspicious activity outside the fence is observed. Seek funding for and install security fencing and a remotely operated security gate to the
R6:
detainee reception area. The recommendation has been partially implemented. A security...
F6
Staff in Adult Services feels communication with their supervisors is good, that they can voice concerns and that those concerns are heard.
Response: Unknown
Score: 0
All audio-visual recording of persons detained by law enforcement under the provisions of
R8:
Section 5150 should be shared with responding DBH mental health evaluators and with appropriate hospital personnel who care for the 5150 detainees. Response: This recommendation will not be implemented because it is not warranted as stated in the
R6
Due to increased incarceration time, expand medical and dental care to cover the longer-term needs of inmates.
Response: Will Implement
Scheduled: fiscal year 2010-2011
Score: +1
that will allow emergency department physicians to release 5150 holds. <b>Response:</b> This recommendation has not yet been implemented but will be implemented in the future. A new policy will be completed before December 31, 2012. and the second of the second of the second of the second
BUTTE COUNTY DEPARTMENT OF BEHAVIORAL HEALTH FINANCIAL CHALLENGES REQUEST FOR RESPONSES Pursuant to Penal Code sections 933 and 933.05, the Grand Jury request responses are as follows: The Butte County Board of Supervisors FINDINGS DBH is operating on a severely restricted budget.
F1:
The respondent agrees...
F7
There are safety concerns for Adult Services workers when doing field visits.
Response: Disagree Partially
Score: 0
is needed before a detainee can have a mental status evaluation, which is done at emergency departments. RECOMMENDATIONS The Board of Supervisors was not requested to respond to Recommendations R2 through R3 and R5 through R9 Law enforcement agencies and DBH should work together with area hospitals to develop
R1:
coordinated policies and procedures, to be utilized and followed by all organizations involved (law enforcement, DBH, and EDs) in detaining, evaluating, and treating those persons in mental health crisis in accordance with California Welfare and Institutions Code section 5150 et seq...
R7
Look for evidence-based methods of dealing with mental health disorders and formulate a plan for implementation at the County Jail.
Response: Implemented
Scheduled: fiscal year 2012-13
Score: 0
facility. This recommendation has been implemented and will continue to be Response: implemented whenever repairs are necessary. The cameras on the exterior of the building and the camera in the exercise area field rarely fail, and it has been 41, 41, nearly two years since one was replaced or repaired. Repairs have been made without undue delay when necessary. . .
<b>EXHIBIT A</b> Elected Department Head Response
BUTTE COUNTY OFFICE OF THE SHER JERRY W. SMITH SHERIFF-CORONER CONTRACTOR STATES August 20, 2012 Honorable Stephen E. Benson, Presiding Judge Superior Court of California, County o...
F8
There are some concerns among the correctional deputies due to the stress of managing security issues in an overcrowded jail.
Response: Disagree Partially
Score: 0
Supervisors is not involved in the day-to-day operations of the jail, the Board has received information from staff that a safety cell would not offer any particular advantage over what is currently in place. The installation of a safety cell would reduce the use of the restraint chair.
F3:
The respondent does not agree with the finding. Although the Board of Response: Supervisors is not involved in the day-to-day operations of the jail, the Board has received information from staff that a safety cell is not an effective substitute or alternative for a restraint chair.
RECOMMENDATIONS <b>BU...
R8
Conduct an anonymous survey of the correctional deputies for any possible concerns. Formulate a plan to address any issues and provide feedback to the deputies.
Response: Will Not Implement
Scheduled: fiscal year 2012-13
Score: -1
Section 5150 should be shared with responding DBH mental health evaluators and with appropriate hospital personnel who care for the 5150 detainees. This recommendation will not be implemented. For the reasons stated above, video recording of individuals in crisis would not be advisable and would have little to no practical value to mental health professionals during assessment. CIT training for all law enforcement and emergency response personnel, DBH personnel
R9:
and hospital personnel who have responsibility for response to and management of 5150 cases should be an ongoing priority. This ...
F9
Having only seven female deputies is insufficient for a 24/7 operation.
Response: Disagree Partially
Score: 0
The respondent agrees with the finding. The department is currently evaluating both new mortality review tools and procedures. The relationships with all area hospitals, especially with Enloe Hospital, are dysfunctional
F10:
and have a negative impact on the delivery of mental health services to consumers. This situation does not adequately serve the best interest of the community. Response: The respondent partially disagrees with the finding. The relationship with Enloe Hospital varies from department to department and staff to staff. The administrators of both the department and the hospit...
R9
Recruit additional female correctional deputies.
Response: Implemented
Score: 0
R9:
Response: This recommendation has been implemented.
F10
Knowledge of the proposed security system upgrade was varied among the staff counselors.
Response: Disagree Partially
Score: 0
Supervisors is not involved in the day-to-day operations of the jail, the Board has received information from staff that a safety cell would not offer any particular advantage over what is currently in place. The installation of a safety cell would reduce the use of the restraint chair.
F3:
The respondent does not agree with the finding. Although the Board of Response: Supervisors is not involved in the day-to-day operations of the jail, the Board has received information from staff that a safety cell is not an effective substitute or alternative for a restraint chair.
RECOMMENDATIONS <b>BU...
R10
Better communicate details and updates about the security system upgrade to the staff.
Response: Will Implement
Scheduled: fiscal year 2012-13
Score: +1
procedures to insure that those being released from incarceration are connected with outpatient mental health services in a timely manner. The recommendation will be implemented. As discussed in the response to F14, Behavioral Health has a new position, called a Forensic Clinician. Our jail release planner will work with Behavioral Health's Forensic Clinician to coordinate placements pursuant to both 4011.6 PC and 5150 W&I. Behavioral Health representatives attend our quarterly medical care "Quality Assurance" meetings to address any concerns or issues. The Butte County Sheriff's Corrections D...
F11
The City of Oroville, under contract with DWR, is the Fund Administrator for the Project Supplemental Benefits Fund and will be disbursing grants to the community to stimulate recreation, tourism and economic development.
Response: Disagree Partially
Score: 0
practices concerning the application of Section 5150 are appropriate. This recommendation has been implemented. The Sheriff's Office has in the past, interacted with the DBH regarding the application of 5150 W&I, and will continue to do so The second second and the second second second second second second second second second second second second second second second second second second second second second second second second second second second second in the future. ang pang akan andalah kecamatan di 200 INVESTIGATION INTO THE UTILIZATION OF INVOLUNTARY DETENTION UNDER CALIFORNIA WELFARE...
F12
The City Council’s adoption of a new Facility and Park Fee Waiver Policy will bring consistency to this process.
Response: Disagree Partially
Score: 0
even for those determined not to need immediate treatment, could be at least partially solved if Emergency Department Physicians were authorized to release such holds. <b>Response:</b> The respondent agrees with the finding. RECOMMENDATIONS The Board of Supervisors was not requested to respond to Recommendations R1 through R5 and R7 through R15. That DBH, together with area hospitals and the Board of Supervisors, develop a policy
R6:
that will allow emergency department physicians to release 5150 holds. <b>Response:</b> This recommendation has not yet been implemented but will be implemented...
F13
Although the City of Oroville has a shortfall in its annual operating expenditures as compared to its revenues, City management is transparent about their steps to correct the situation.
Response: Disagree Partially
Score: 0
Department to meet the demand for such services. Response: The respondent partially disagrees with the finding. The department does not have evidence that the demand for services exceeds the department's target population needs. The department is required to provide substance use disorder services for those individuals who meet medical necessity. The state and federal definition of medical necessity is not currently well defined. However, the department is the "safety net" service provider for individuals who are indigent or Medi-
cal eligible. The department is not geared nor mandated to pro...
F14
The City of Oroville balanced its operating budget by using its Contingency Fund. Paradise
Response: Disagree Partially
Score: 0
, Behavioral Health has a new position, called a Forensic Clinician. Our jail release planner will work with Behavioral Health's Forensic Clinician to coordinate placements pursuant to both 4011.6 PC and 5150 W&I. Behavioral Health representatives attend our quarterly medical care "Quality Assurance" meetings to address any concerns or issues. The Butte County Sheriff's Corrections Division has policies regarding transfers to Behavioral Health facilities as outlined by Departmental Orders 5026 - Mentally Disordered inmates and 5035 - Transfer to Mental Health.
That DBH and all area law enforc...
F15
The Town of Paradise is primarily a residential community with minimal retail and commercial businesses. Therefore, Paradise residents often work and shop elsewhere, leaving their sales tax dollars in other jurisdictions.
Response: Disagree Partially
Score: 0
to section 5150. The presently dysfunctional working relationships between DBH and area hospitals, as well as in some cases questionable application of the 5150 provisions by law enforcement, are not serving the best interests of either the community or mental health consumers. The respondent disagrees in part with the finding. The respondent does not agree that there is "questionable application of the 5150 provisions by law enforcement." Deputies make on scene decisions regarding the criteria present to assess an individual STATE STATES in crisis to determine if they are a danger to themselv...
F16
The Town of Paradise has experienced revenue challenges for many years, which impact town services.
Response: Disagree Partially
Score: 0
The respondent partially disagrees with the finding. While the implementation appears to be slow, Butte County is actually is ahead in the overall implementation compared to other counties who have chosen the AVATAR system. As staff has grown more accustomed to the software program, they have become more accepting and cognizant of its value to both consumer care and operational efficiency. The implementation is not impacting the ability to provide and bill for necessary services at this time. The lack of County in-patient mental health facilities for youth leads to expensive out-of-
F17:
cou...
F17
The Town of Paradise carefully planned for the transition to a new town manager.
Response: Disagree Partially
Score: 0
The respondent agrees with the finding. Adult consumers are being placed in out-of county facilities when at times the in-county
F18:
facilities, such as Enloe Behavioral Health, are not fully utilized.
Response: The respondent agrees with the finding. Enloe Hospital is a private corporation, and the department cannot dictate how to use its facilities. The department continues to encourage Enloe Hospital to evaluate its business model to include both involuntary admissions and to accept medi-cal payments. DBH does not effectively utilize resources that can increase public awareness and
F19...
F18
The Town of Paradise’s lack of a sewer system has been a barrier in attracting significant new retail and commercial businesses. 67
Response: Disagree Partially
Score: 0
The respondent agrees with the finding. Enloe Hospital is a private corporation, and the department cannot dictate how to use its facilities. The department continues to encourage Enloe Hospital to evaluate its business model to include both involuntary admissions and to accept medi-cal payments. DBH does not effectively utilize resources that can increase public awareness and
F19:
ţ understanding of its programs in order to encourage and cultivate community support. Response: The respondent partially disagrees with the finding. While more can be done, the department continues to reach out t...
F19
A sewer system for the residential districts is impractical due to the Town of Paradise’s topography.
Response: Disagree Partially
Score: 0
The respondent partially disagrees with the finding. While more can be done, the department continues to reach out to the community to increase public awareness and understanding. For example, the department has developed better content on the DBH website, published a new service guide, and had several articles printed in local media over the past year. The Director has been on several radio shows to discuss services. A new social media and stigma and discrimination reduction program will be rolled out over the coming year through our regional and statewide prevention and early intervention (P...
