EL Dorado County

The Wraparound program is not operating in full compliance with its key governance documents: State legislation; the County Wraparound program plan; and, a Memorandum of Understanding between the Departments of Mental Health and Human Services. The State requirement for parent and family involvement in planning and assessing the program and for evaluation of the program are two key areas with which El Dorado County is not in compliance. County compliance with the State’s requirement for thorough strengths-based assessments of each participating child and family are not documented. The inter-departmental management structure called for in the program plan has not been implemented. This appears to be one of the key factors explaining under-expenditures of available program funding, lower service levels than anticipated, program budgets that have consistently been in excess of actual revenues and expenses and the absence of program evaluations. The Department of Mental Health has admitted 48 children, at an average of 9.1 per month, to the Wraparound program in addition to those assigned to the County’s six authorized service allocation slots. There are no official procedures for how these children are admitted to the program, how resource allocation decisions are made for these children and there is no program documentation about how they were selected and who was considered but not selected for this type of program participation. The Wraparound program under-spent available funding by approximately $173,244 between its inception in August 2002 and June 2005. The Memorandum of Understanding between the Departments of Mental Health and Human Services calls for reinvesting program savings in children’s services. These terms have not been defined and procedures have not been established for how funds such as these will be spent. If such procedures were in place, the $173,244 surplus could have been used for other services for the County’s children over the last three fiscal years.

The County has not consistently filled all of its six authorized Wraparound program service allocation slots since the program was implemented in August 2002. Since State and local program funding is directly related to the number of slots filled, the County has not collected the maximum amount of funding that it could have had all slots been filled. Lost program funding between FYs 2002-03 and 2004-05 was approximately $182,484 that could have provided services to an estimated additional 18.7 children over the life of the program through June 2005. The County has significantly over-budgeted revenues and expenditures for the program, indicating that fiscal management oversight has not been adequate. Actual program funding and service levels have been substantially less than anticipated in the annual program budgets since FY 2002-03. Besides recovering less Wraparound program funding than anticipated, the County did not expend $173,244 over the life of the program in funding that was available for the program and could have been used to provide services. The funds are in reserve and can still be used for the program but it is not clear why the funding has not been used to provide services as it was received. Combined with the $182,484 in funds not recovered due to unfilled service allocation slots, the County forewent $355,728 worth of services that could have been provided to children at risk of group home placement during the three years reviewed.

The County obtains State funding for the Wraparound program as part of the Department of Human Services’ monthly claims for foster care reimbursement submitted to the State. A review of a sample of claims and supporting documents conducted for this audit showed that the Department has sufficient documentation about the program participants to justify the amounts claimed. Department of Mental Health time sheet and cost records are not adequate to determine actual program costs and services provided prior to February 2005 when a new time and cost tracking system was implemented. While the new system is an improvement, other Wraparound program records are not being maintained to adequately document program costs, services and eligibility and admissions procedures. Records are not maintained of the number of children eligible for the program who were not admitted. No records are maintained regarding which children are admitted to the program but not assigned to service allocation slots or children considered but not admitted to the program. Program participant mental health treatment plans are not consistent with actual services delivered in many instances, possibly indicating a lower level of service than planned. Plans should be updated to reflect changes in prescribed services as conditions change and prepared in conjunction with an inventory of available service provider resources. Harvey M. Rose Accountancy Corporation 33 Section 4: Wraparound Program Records

District Attorney Personnel

Court Executive Officer

Court Operations Managers

Administrative Personnel

General Services Personnel Documents Reviewed:

Prior Grand Jury Reports regarding the District Attorney’s Office Building

Letters between the Grand Jury and CAL OSHA regarding the condition of the District Attorney’s Office Building

General Service’s Interdepartmental Memo

Board of Supervisor’s Agendas, May 22 and June 12, 2001 regarding the District Attorney's Office Building

That you agree with the finding.

Proposed expenditures for Program Development (PO) and Coordination (C) must be discussed at a public hearing. Did the AAA discuss PO and C activities at a public hearing? [ ] Yes [X] Not Applicable (check only if PO and C funding is not being used) [ ] No If No, Explain:

Summarize the comments received concerning proposed expenditures for PO and C, if applicable.

Were all interested parties in the PSA notified of the public hearing and provided the opportunity to testify regarding setting of minimum percentages of Title" I B program funds to meet the adequate proportion funding for Priority Services? (See Appendix V) [X]Yes [ ] No If No, Explain:

Summarize the comments received concerning minimum percentages of Title III B funds to meet the adequate proportion funding for priority services. (See Appendix V) No comments

Summarize other major issues discussed or raised at the public hearings. Translator is not required unless the AAA determines that a significant number of attendees require translation services. AAAs are encouraged to include individuals in LTC facilities in the planning process, but hearings are not required to be held in facilities 110 In summary, the major issues raised included: • Approximately twenty people commented on the Brown Bag Program. Primarily, concern was expressed about the impacts of discontinuance of funding and the importance of food services. Some expressed the opinion that Brown Bag activities were more important than services to persons with Alzheimer's. Concern was expressed on the amount of food being distributed. There appeared to be some confusion over the difference between Brown Bag and other food assistance programs, as well as the source of Brown Bag funding. However, for the most part comments emphasized the importance of food assistance and an interest in having Brown Bag continue.

List major changes in the Area Plan resulting from input by attendees at the hearings. No changes are proposed to the Area Plan. However, the Commission on Aging, in adopting the Area Plan, voted to revisit the Brown Bag funding issue. Should any changes develop out of those discussions, they would be proposed in the form of a future plan amendment. • Concern was expressed that senior services be countywide and not focused on or limited to one location. • Individual comments were received on Medicare drug benefits, public notice of the Area Plan and county employee salaries. 111 Cal Wel & Inst Code § 9535 DEERING'S CAUFORNIA CODES ANNOTATED Copyright (c) 2006 by Matthew Bender & Company, Inc. a member of the LexisNexis Group. All rights reserved. *** THIS DOCUMENT REFLECTS ALL URGENCY *** LEGISLATION ENACTED *** *** THROUGH 2006 CH. 21, APPROVED 4/24/06 WELFARE AND INSTITUTIONS CODE DIVISION 8.5. Mello-Grandlund Older Californians Act CHAPTER 7. Community-Based Services Network GO TQ CALIFORNIA CODES ARCHIVE DIRECTORY Cal Wel & Inst Code § 9535 (2006) § 9535. Area agencies responsibility Area agencies on aging shall be responsible for, but not limited to, all of the following: (a) Contracting with the department to locally manage the community-based programs specified in and in accordance with the requirements of this chapter and Chapter 7.5 (commencing with Section 9540). (b) Integrating the community-based services programs contracted under this chapter into the local area plan development process. . (c) Where the area agency on aging proposes to redirect funding under this chapter, the area agency shall ensure that it has submitted its recommendations to a locally formed advisory committee, that shall include consumers of long-term care services, representatives of local organizations of seniors, functionally impaired adults, representatives of employees who deliver direct long-term care services, and representatives of organizations that provide long-term care services. At least one-half of the members of the advisory committee shall be consumers of services provided under this chapter or their representatives. (d) In addition, where the area agency on aging proposes to redirect funding under this chapter, an administrative action plan shall be developed and shall receive the approval of the area agency's governing board, which shall consider the input received pursuant to subdivision (c). The administrative action plan shall receive the governing board's approval prior to submission to the department for final state approval. The administrative action plan shall be an update to the area plan. (e) Effective in the 1999-2000 fiscal year, and except for the health insurance counseling and advocacy program, determining which of the community-based services programs specified in Chapter 7.5 (commencing with Section 9540) and contracted under the authority in this chapter will continue to be funded and the amount of funding to be allocated for that purpose. (f) Subject to Section 9534, providing directly, through contracts with other local governmental entities, or through competitively procured contracts, the community- based services programs. (g) When required pursuant to Chapter 875 of the Statutes of 1995, and subject to the annual Budget Act, relinquishing funding originally contracted under this chapter and the associated local management of the community-based services programs, and except for the health insurance counseling and advocacy program, to the long-term care integration pilot program. (h) Monitoring direct services contract performance and ensuring compliance with the requirements of this chapter and any other relevant state or federal laws or regulations and the nondiscrimination requirements set forth under Article 9.5 (commencing with Section 4135) of Chapter 1 of Part 1 of Division 3 of Title 2 of the Government Code. (i) Appropriately expending and accounting for all funds associated with this chapter and providing access to all program books of account and other records to state auditors. j) Maintaining a systematic means of capturing and reporting to the department all required community-based services program data, specified in paragraph (5) of subdivision (a) of Section 9102. (k) The governing body of each participating area agency shall establish a process within its area plan for requesting and providing a hearing for the programs specified under this chapter and Chapter 7.5 (commencing with Section 9540). A hearing shall be provided upon the. request of either provider whose existing direct services contract is either terminated prior to its expiration date or reduced in scope outside of the state or federal budget process, or any applicant that is not selected in a direct service contract procurement process due to the alleged presence of a conflict of interest, procedural error or omission in solicitation request, or the lack of substantial evidence to support the award. NOTICE TO RESPONDENTS For the assistance of all Respondents, Penal Code Section 933.05 is summarized as follows: How to Respond to Findings The responding person or entity must respond in one of two ways:

The Grand Jury wishes to thank the Board of Supervisors and the CAO for their help in initiating this Reports & Response Review tracking system. Future Grand Juries will continue to track the necessary responses to insure the proper responses as per the penal code. 3

EL DORADO IRRIGATION DISTRICT HIRING PROCESS GJ 05-029 Reason for the Report The 2005/2006 Grand Jury received a complaint regarding the hiring, by the El Dorado Irrigation District (EID), of a high level employee with an alleged criminal background. This matter was reported locally in the newspaper.