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Sonoma County Grand Jury • 2024-2025

Sonoma County Civil Grand Jury Responses to 2023-24 Civil Grand Jury Reports BOS Response: “We disagree partially with

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Findings and Recommendations 4 findings

F4 Page 116
Inadequate delegation of authority and a toxic work culture inhibits individual decision-making and contributes to DHS’s failure to perform effectively. DHS Response: “We disagree wholly. Staff has daylighted late payments to providers and late behavioral health contracts that seem to have been an issue within the Department of Health Services for 10 plus years. This was feedback received not only from staff, but also from behavioral health providers. We provided a short-term solution with 6-month advance payments in fiscal year 23-24 and called administration staff back into the office who had been working remotely during the COVID pandemic. Staffing vacancies had also been a factor, but in just over one year we have improved staffing vacancies; decreasing our overall department vacancies by 9% (from 23% in July 2023 to 14% in June 2024). Management believes morale has improved as critical vacancies have been filled.”
Related Recommendations (1)
R2
Page 118
By November 1st, 2024, DHS and County Human Resources departments shall submit a recruitment and retention plan The Grand Jury acknowledges to the County Executive to reduce DHS vacancies to no more than 10% of authorized non-field positions. (F3, F4) that this recommendation may be implemented in the future. DHS Response: “This recommendation requires further analysis. We are unclear of the definition of what “non-field” positions is referring to. DHS does not track vacancy rates by whether the position serves in a “field” setting or not. We are, however, happy to report that the DHS HR team now has a regular monthly meeting with the County’s central HR with the goal of improving vacancy rates. We now have two analysts in County HR dedicated to working with DHS on our recruitment and retention goals.” HR RESPONSE: “This recommendation requires further analysis. We are unclear of the definition of what "non-field" positions is referring to. DHS does not track vacancy rates by whether the position serves in a "field" setting or not. Nonetheless, we offer the following information. The challenges the Department of Health Services has faced the last several years to fill healthcare related positions are not unique to Sonoma County. There is a shortage of individuals entering the industry and an insufficient number of qualified individuals interested in changing employers right now to fill vacancies at both private and public employers. This shortage has greatly contributed to the department's inability to quickly fill positions in some job classifications as well as an increased vacancy rate, when coupled with the significant growth the department that has experienced in recent years (the number of allocated positions has increased 37% between the start of Fiscal Years 2019/20 and 2024/25.) The job classifications with the highest number of vacant allocations in the Department of Health Services include Behavioral Health Clinician Intern/Clinician, Alcohol and Other Drug Services Counselor I/II, Senior Client Support Specialist, and Environmental Health Specialist Trainee I/II. Positions in these job classifications require either specific education, work experience, and/or professional licensure, which significantly limits the number of qualified applicants the County receives and subsequently progress through examination and selection processes. As of June 28, 2024, the overall vacancy rate for the Department of Health Services was 14.50%. When excluding positions in the aforementioned four job classifications with the department's highest numbers of vacancies, which are also amongst the County's most difficult to fill, the vacancy rate drops to 10.79%. This rate includes positions that work in administration, clinical, and field settings. Human Resources and the Department of Health Services need further clarification to identify what specific positions are being referred to as "authorized non-field positions" in order for Human Resources to determine what the adjusted vacancy rate with that parameter applied. Central Human Resources and the Health Services Department are and will continue meeting regularly to discuss recruitment needs and remain expeditious in developing and continuing efforts to reduce the department's vacancy rate. The two departments have recently collaborated on a tracking mechanism which allows staff to identify the length of time various recruitment, examination, and selection process steps take to complete, determine if there are any "pain points" or delays at any steps in the process, and implement solutions with the intent to reduce delays for future recruitments. Staff are also currently looking at ways to be more strategic in recruiting, examining, and selecting individuals for hard-to-fill job classifications. Current strategies include evaluating the efficacy of recruitment advertising, examination, department selection, and pre-employment processes to maximize visibility, remove hurdles and/or barriers that may cause qualified individuals from either not applying or opting out of the process, and reduce lengthy/protracted timelines which make the County less competitive compared to private sector employers for similar types of positions. As efforts in these areas progress, both departments anticipate Health Services' vacancy rate will continue to decline. Should that not occur, or should additional attention be warranted, the departments will engage with the County Executive if determined necessary at the time.” HR Update: “DHS has been working both internally within the department and with central HR to evaluate current practices and implement process improvements with the goal to reduce vacancy rates and the time it takes to fill positions across the department, not just those who interact with the public. As of 2/18/25 the vacancy rate was 12.22% (739.83 FTE; 90.42 vacant). The department’s vacancy rate on August 7,2024 was 15.11% (731.83 FTE; 110.56 vacant).”
F5 Page 116
DHS Fiscal and County general accounting process doesn’t require or retain all information needed for post-fact analysis of who is being paid, whether the payment was the result of a no-bid contract, or whether payment documentation matches funding source requirements. ACTTC RESPONSE: “We disagree wholly or partially with this finding. ACTTC fiscal policies RE-2 and RE-3 define department responsibilities and procedures for grant compliance, monitoring, and reporting. All information uploaded to the County financial system is retained pursuant to adopted retention schedules.” SPI Response: “We disagree wholly or partially with this finding. This is an overly broad statement with very vague language. The County, and particularly the Department of Health Services, is a highly regulated agency where federal and state funding sources require this information All information used in federal and state funding is retained pursuant to retention schedules.”
No recommendations for this finding
F6 Page 116
County Purchasing and Internal Audit failed to require that DHS follow mandated procurement policies. BOS Response: “We disagree partially with this finding. We agree with the Sonoma Public Infrastructure’s response to this finding.” ACTTC RESPONSE: “We disagree wholly or partially with this finding. Internal Audit is not responsible for enforcing procurement policies. Internal Audit issued a procurement audit report in August 2023, which Included a DHS procurement related finding. The Procurement Process Audit Report is available on our website under "Fiscal Year End June 30,2022. Please see the link to our website below: https://sonomacounty.ca.gov/auditor-controller-treasurer-tax- collector/audit-reports” SPI Response: “We disagree wholly or partially with this finding. While SPI has developed templates for procurement of goods and services that are generally applicable County-wide, these policies do not displace the specialized procedures that certain departments like DHS must follow. Their practices and procedures are designed to address the mandates of federal and state funding sources. As noted, departments may consult SPI staff for guidance and best practices or may elect to conduct their own processes in accordance with established policies.”
Related Recommendations (1)
R3
Page 118
By December 31, 2025, the Board of Supervisors will request, and County Auditor will complete and publish, a The Grand Jury acknowledges comprehensive audit report on DHS procurement processes and procedures, contract administration oversight and that this recommendation may compliance with County procurement policy and publicly present said report to the Board of Supervisors. (F1, F3, F6, F7) be implemented in the future. BOS Response: “This recommendation has not yet been implemented but will be implemented in the future if warranted. Currently, the County is undergoing a countywide risk assessment which includes DHS contract administration and ACTTC management. Upon conclusion of the assessment, departments will determine the appropriate steps to ensure departmental compliance with County procurement policies. The County Executive will work with departments to evaluate the need for additional resources which will be made through the countywide budget process. This recommendation will be completed as soon as possible; however, it is not currently known if it can be completed and presented to the Board by December 31, 2025.” BOS Update: “No additional internal reports and/or recommendations for improvement have been produced by DHS since the Countywide risk assessment was initiated. Operational processes for initiating, approving, and managing contract payments have been changed since the initial update: 1/12th payment approach recommendation considered and approved by the Board. Approved 10/15/24 - https://sonoma- county.legistar.com/LegislationDetail.aspx?ID=6888956&GUID=682AA542-F038-44FC-9514-AE2E7FD49265 FYE 23/24 expedited payment Approved 10/15/24 - https://sonoma-county.legistar.com/LegislationDetail.aspx?ID=6892948&GUID=BB681D0D-F2A5-402C- 8AC5-4FE4F5FB33A0 On November 22, 2024, we engaged municipal fiscal consultant to provide executive-level project assistance to DHS staff in preparing their Fiscal Year 2025/26 budget, including providing recommendations to department leadership on budget and fiscal best practices. Since October 15, 2024 a retired Human Services contract coordinator has been assisting DHS in reviewing its contract and RFP procedures, templates, annual timelines, and internal processes. Since November 18, 2024, retired Health and Human Services Director from Solano County has been assisting DHS in a variety of operational areas and providing advice and guidance on various fiscal processes and best practices.” 114 June 2025 Sonoma County Civil Grand Jury Responses to 2023-24 Civil Grand Jury Reports ACTTC Response: “This recommendation has not been implemented but will be implemented in the future if warranted. The ACTTC - Internal Audit Division (IA) issued an audit report of the Sonoma County Procurement Process in August 2023. The report includes a finding that Department of Health Services (DHS) contracts are being single or sole sourced without Purchasing Agent approval. This finding was identified as a Risk Classification B: Significant Control Weakness. The report summarizes testing of 23 of 94 DHS contracts, which found that all 23 were not competitively bid for at least ten years. The IA countywide risk assessment includes DHS contract administration. ACTTC management will evaluate the appropriate scope and resources needed to complete an audit of DHS procurement processes and procedures, contract administration oversight and compliance with County procurement policy. The size and scope of the audit and available resources will determine when a DHS contract audit can be included in the annual Audit Plan. This recommendation will be completed as soon as possible; however, it is not currently known if it can be completed and presented to the Board by December 31, 2025. ACTTC management is also aware that the CEO has engaged a procurement consulting firm to review the purchasing lifecycle and grant subaward processes for the seven Safety Net departments including DHS. An initial report for this engagement is expected in September 2024. The findings and recommendations from this report, as well as the time needed to implement accepted recommendations, may also impact the scope and timing of IA's audit of DHS procurement processes, contract administration and compliance with County policies.” ACTTC Update: … “my office has been working on a strategic initiative to enhance the independence and effectiveness of Internal Audit (IA) and ensure that IA operates in compliance with the Institute of Internal Auditors’ Global Audit Standards. This includes updates to the Internal Audit Charter and increased engagement and oversight of the Internal Audit function by the Board of Supervisors. On March 25, 2025, the ACTTC will present our recommendations to the Board of Supervisors and request that the Board approve updates to the Internal Audit Charter and establish an independent Audit Committee, which will include two members of the Board and a member of the public. Additionally, the ACTTC will include a request for two additional audit staff in the FY 2025-26 requested budget. Internal Audit currently has four staff, made up of three Senior Internal Auditors, and one Audit Manager who also serves as the Chief Audit Executive. The FY 2025-26 requested budget also includes $75,000 for professional services, which will allow IA to contract with external firms to perform audits that IA does not have sufficient resources or expertise to perform.” “The FY 25-26 risk assessment is still in development and should be completed later this Spring and will be used to inform the 25-26 Audit Plan. Although the risk assessment is not completed, Internal Audit (IA) anticipates that an audit of DHS contract administration and oversight will be included in the FY2025-26 audit plan. Planning for this audit has not begun and IA has not determined the resource requirements to perform the audit. Separately, the County CEO and HR departments entered into an agreement with a consulting firm (Municipal Resources Group, LLC) to, in part, review and redesign of DHS’s contracting and procurement. To avoid a duplication of effort, IA’s initial audit of DHS will likely focus on contract administration, monitoring, payments and the design of related procedures and controls. IA will consider auditing DHS procurement procedures and purchasing policy compliance in a future engagement. The decision to have the DHS audit performed by staff or an external accounting firm has not been determined.”
F7 Page 116
The BOS failed to require changes to DHS procurement procedures despite published reports that DHS has been violating County procurement policy. BOS Response: “We disagree partially with this finding. The Board of Supervisors called for a new Request for Proposals for homeless services following the issuance of the Pisenti & Brinker, LLC agreed upon procedures report regarding DEMA Consulting & Management.” ACTTC RESPONSE: “We disagree wholly or partially with this finding. The BoS called for DHS to conduct a new competitive Request For Proposal event for homeless services following the issuance of the Pisenti & Brinker, LLC agreed-upon procedures report regarding DEMA Consulting & Management.”
Related Recommendations (1)
R3
Page 118
By December 31, 2025, the Board of Supervisors will request, and County Auditor will complete and publish, a The Grand Jury acknowledges comprehensive audit report on DHS procurement processes and procedures, contract administration oversight and that this recommendation may compliance with County procurement policy and publicly present said report to the Board of Supervisors. (F1, F3, F6, F7) be implemented in the future. BOS Response: “This recommendation has not yet been implemented but will be implemented in the future if warranted. Currently, the County is undergoing a countywide risk assessment which includes DHS contract administration and ACTTC management. Upon conclusion of the assessment, departments will determine the appropriate steps to ensure departmental compliance with County procurement policies. The County Executive will work with departments to evaluate the need for additional resources which will be made through the countywide budget process. This recommendation will be completed as soon as possible; however, it is not currently known if it can be completed and presented to the Board by December 31, 2025.” BOS Update: “No additional internal reports and/or recommendations for improvement have been produced by DHS since the Countywide risk assessment was initiated. Operational processes for initiating, approving, and managing contract payments have been changed since the initial update: 1/12th payment approach recommendation considered and approved by the Board. Approved 10/15/24 - https://sonoma- county.legistar.com/LegislationDetail.aspx?ID=6888956&GUID=682AA542-F038-44FC-9514-AE2E7FD49265 FYE 23/24 expedited payment Approved 10/15/24 - https://sonoma-county.legistar.com/LegislationDetail.aspx?ID=6892948&GUID=BB681D0D-F2A5-402C- 8AC5-4FE4F5FB33A0 On November 22, 2024, we engaged municipal fiscal consultant to provide executive-level project assistance to DHS staff in preparing their Fiscal Year 2025/26 budget, including providing recommendations to department leadership on budget and fiscal best practices. Since October 15, 2024 a retired Human Services contract coordinator has been assisting DHS in reviewing its contract and RFP procedures, templates, annual timelines, and internal processes. Since November 18, 2024, retired Health and Human Services Director from Solano County has been assisting DHS in a variety of operational areas and providing advice and guidance on various fiscal processes and best practices.” 114 June 2025 Sonoma County Civil Grand Jury Responses to 2023-24 Civil Grand Jury Reports ACTTC Response: “This recommendation has not been implemented but will be implemented in the future if warranted. The ACTTC - Internal Audit Division (IA) issued an audit report of the Sonoma County Procurement Process in August 2023. The report includes a finding that Department of Health Services (DHS) contracts are being single or sole sourced without Purchasing Agent approval. This finding was identified as a Risk Classification B: Significant Control Weakness. The report summarizes testing of 23 of 94 DHS contracts, which found that all 23 were not competitively bid for at least ten years. The IA countywide risk assessment includes DHS contract administration. ACTTC management will evaluate the appropriate scope and resources needed to complete an audit of DHS procurement processes and procedures, contract administration oversight and compliance with County procurement policy. The size and scope of the audit and available resources will determine when a DHS contract audit can be included in the annual Audit Plan. This recommendation will be completed as soon as possible; however, it is not currently known if it can be completed and presented to the Board by December 31, 2025. ACTTC management is also aware that the CEO has engaged a procurement consulting firm to review the purchasing lifecycle and grant subaward processes for the seven Safety Net departments including DHS. An initial report for this engagement is expected in September 2024. The findings and recommendations from this report, as well as the time needed to implement accepted recommendations, may also impact the scope and timing of IA's audit of DHS procurement processes, contract administration and compliance with County policies.” ACTTC Update: … “my office has been working on a strategic initiative to enhance the independence and effectiveness of Internal Audit (IA) and ensure that IA operates in compliance with the Institute of Internal Auditors’ Global Audit Standards. This includes updates to the Internal Audit Charter and increased engagement and oversight of the Internal Audit function by the Board of Supervisors. On March 25, 2025, the ACTTC will present our recommendations to the Board of Supervisors and request that the Board approve updates to the Internal Audit Charter and establish an independent Audit Committee, which will include two members of the Board and a member of the public. Additionally, the ACTTC will include a request for two additional audit staff in the FY 2025-26 requested budget. Internal Audit currently has four staff, made up of three Senior Internal Auditors, and one Audit Manager who also serves as the Chief Audit Executive. The FY 2025-26 requested budget also includes $75,000 for professional services, which will allow IA to contract with external firms to perform audits that IA does not have sufficient resources or expertise to perform.” “The FY 25-26 risk assessment is still in development and should be completed later this Spring and will be used to inform the 25-26 Audit Plan. Although the risk assessment is not completed, Internal Audit (IA) anticipates that an audit of DHS contract administration and oversight will be included in the FY2025-26 audit plan. Planning for this audit has not begun and IA has not determined the resource requirements to perform the audit. Separately, the County CEO and HR departments entered into an agreement with a consulting firm (Municipal Resources Group, LLC) to, in part, review and redesign of DHS’s contracting and procurement. To avoid a duplication of effort, IA’s initial audit of DHS will likely focus on contract administration, monitoring, payments and the design of related procedures and controls. IA will consider auditing DHS procurement procedures and purchasing policy compliance in a future engagement. The decision to have the DHS audit performed by staff or an external accounting firm has not been determined.”

Additional Recommendations 8

These recommendations are not explicitly linked to specific findings.