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Extraído del Informe Consolidado
Esta investigación fue publicada originalmente como parte de un informe consolidado más amplio que contiene múltiples investigaciones. Consulte el PDF consolidado para ver el documento completo.
⚠️ 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 9 findings
F1
Page 279
There will be no risk that they become lost.
F2
Page 281
1 Although sharing information for youth under County care is beneficial, electronic links between certain County systems are legally prohibited.
F3
Page 282
1 The Center under development at Magnolia Place is a community-based facility that offers services and support to local residents in a nurturing and welcoming manner.
F4
Page 283
1 The CGJ understands that the CEO has directed staff to evaluate the role of the CIO. This evaluation highlights the need for the role of the County CIO to be expanded and enhanced to provide a coordination point for all IT needs within the County. However, the recommendation does not include giving the County CIO the responsibility for con- ducting procurements of sophisticated information systems County-wide in conjunction with the departments which will be utilizing the systems. Procurement of sophisticated information systems requires the application of highly technical skills including: • writing functional specifications for systems • defining the skills and experience that bidding contractors must possess • drafting contracts that specify required results and threaten penalties for failures • defining how the procurement process will run • overseeing contractors’ work during the development phase • establishing and supervising acceptance criteria for the new system These skills are gained only through professional training and experience.
F5
Page 283
1 The DCEO of the Children and Families Well-Being Cluster has been tasked with spearheading the CCMS effort. The results have not yet been presented to the Board of Supervisors for approval and subsequent implementation.
F6
Page 283
1 Differing views concerning the protection of individuals’ healthcare privacy rights and sharing information openly between agencies have been voiced. Information technology can offer a solution to this dilemma. 2008-2009 Los Angeles County Civil Grand Jury Report 265
F7
Page 284
1 The Katie A. case demonstrates how the inability or unwillingness to share vital information between departments, and bureaucratic reluctance to accept and respond to serious complaints of inadequate care-giving, can prove damaging and expensive to the County. The State’s resistance to settling their case with the plaintiff class, and to assist in seeking solutions to the information-sharing dilemma, presents unnecessary barriers to the performance of the County’s goals.
F8
Page 278
5 Full cross-departmental cooperation regarding the intended creation, implementation, and employment of EMPI has occurred. However, full County funding for EMPI development (estimated at $5.46 million) has not yet been approved, although County approval of $1.8 million for DHS’s initial EMPI work is adequate for the current state of implementation. Full and complete implementation of EMPI is not expected until June 2013. A sign of optimism regarding the expected greater utility and sophistication to become available under EMPI is that DMH is already seeking software contractor bids for the development of its new Integrated Behavioral Health Information System (IBHIS), which will be linked to EMPI. Magnolia Place is intended to be the County’s test bed for putting EMPI into use. This testing, under the auspices of the Comprehensive Case Management group named in section 5.0, will identify all County services (and others for which the client may qualify) being provided. EMPI will be a very effective tool for improving cross-departmental information-sharing. To date, the County CIO has not been involved in this critical electronic system acquisition.
F9
Page 279
1 SCAN reports at HUBs are not kept in an automated database, so, as paper documents, they are subject to being misplaced or lost when sent out to a requestor.
Recommendations 9
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R1Page 284There will be no risk that they become lost.
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R2Page 2811 – DCFS and DHS As direct electronic links between mHUB and myCSW software programs would violate the Statewide Automated Child Welfare Information System (SACWIS) regulations, DCFS and DHS should set up non-electronic processes for information-sharing (See
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R3Page 2821 – DCEO of Children and Families Well-Being Cluster The Deputy Chief Executive Officer (DCEO) of the Children and Families Well-Being Cluster should take immediate action to extend the agency cooperation concept of Magnolia Place.
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R4Page 2831 – The County Chief Executive Officer and Chief Information Officer The CEO should mandate that the County CIO be included from the beginning in the development and procurement of all sophisticated IT systems, utilizing the CIO’s professional expertise with extensive cooperation from each user organization. There should only be very limited and specific instances, mandated by the County CIO’s office, in which user organizations may bypass CIO procurement services. The County CIO should work with the user organization at the beginning of the project development cycle to identify the respective roles and responsibilities to be assumed by the CIO and the user department staff.
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R5Page 2831 – DCEO of Children and Families Well-Being Cluster The DCEO should present the results of the coordinated CCMS effort to the Board of Supervisors as quickly as feasible for approval and implementation.
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R6Page 2841 – DCFS, DHS, DMH and DPH To the extent permitted by law, DCFS, DHS, DMH, and DPH should provide skilled healthcare professionals access to a youth’s healthcare information regardless of the department in which the information was originally obtained. However, such access should be limited to those personnel who have been provided confidential user names and passwords. Requiring the use of user names and passwords for maintaining information privacy is a proven tool which makes the control of such access safe and feasible.
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R7Page 2841.1 – The County Chief Executive Officer The CEO should caucus with DCFS and DMH, as well as with the DCEO of the Children and Families Well-being Cluster and the County Counsel, to develop strategies for implementation of standards, remedies, and legislative changes at both County, State and Federal levels that will enable continuing improvement of healthcare delivery to County residents, consistent with the improvements which have been achieved as a result of Katie A. Court and Advisory Panel supervision.
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R8Page 2785.1 – The Board of Supervisors The Board of Supervisors should fully fund EMPI development with all possible speed and direct DHS to complete implementation no later than the end of 2010.
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R9Page 2791 - DHS DHS should direct that SCAN reports (officially entitled “California Office of Emergency Services – Medical Report: Suspected Child Physical Abuse and Neglect Examination – OES 900 form) be entered electronically at HUBs by the end of September 2009 so that: 1. There will be no risk that they become lost. 2. DCFS office personnel are not obliged to decode someone else’s handwriting in taking the data from the SCAN reports. 10. Conclusion Through this CGJ’s “follow-on” investigation, we documented a number of issues related to information-sharing. Of those issues, there are several that the CGJ intends should be given the highest priority on the County’s “to do” list. These are: 1. Implementation of EMPI and expanding its scope to other departmental services. 2. Strategizing for and meeting with State officials to work for legislative amendments to key state statutes itemized in this report which inhibit information-sharing on healthcare issues. 3. Redefining the responsibilities of the County CIO to include, for all major departmental information system acquisitions, active participation in: • implementation planning, • preparation of functional specifications, • definition of contractor skill and experience specifications, and • system selection process and issue resolution; 4. All departments which share responsibilities for providing essential services to County citizens should caucus and appoint cross-departmental coordination 2008-2009 Los Angeles County Civil Grand Jury Report 261 committees with principal responsibility for investigating problems in, and facilitating solutions of, information-sharing issues. 262 2008-2009 Los Angeles County Civil Grand Jury Report HEALTH INFORMATION-SHARING FOR AT-RISK YOUTH Overcoming Obstacles