San Joaquin County Grand Jury • 2006-2007

2006/07 San Joaquin County Civil Grand Jury Final Report*

Published: November 30, 2007 104 pages Consolidated Report

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⚠️ 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.

Note: Missing finding numbers detected: F44, F50, F51, F52, F53, F54, F55, F56, F57, F58, F59, F60, F61, F62, F63, F64, F65, F66, F67, F68, F69, F70, F71, F72, F73, F74, F75, F76, F77, F78, F79, F80, F81, F82, F83, F84, F85, F86, F87, F88, F89, F90, F91, F92, F93, F94, F95, F96, F97, F98, F99, F100, F101, F102, F103, F104, F105, F106, F107, F108, F109, F110, F111, F112, F113, F114, F115, F116, F117, F118, F119, F120, F121, F122, F123, F124, F125, F126, F127, F128, F129, F130, F131, F132, F133, F134, F135, F136, F137, F138, F139, F140, F141, F142, F143, F144, F145, F146, F147, F148, F149, F150, F151, F152, F153, F154, F155, F156, F157, F158, F159, F160, F161, F162, F163, F164, F165, F166, F167, F168, F169, F170, F171, F172, F173, F174, F175, F176, F177, F178, F179, F180, F181, F182, F183, F184, F185, F186, F187, F188, F189, F190, F191, F192, F193, F194, F195, F196, F197, F198, F199, F200, F201, F202, F203, F204, F205, F206, F207, F208, F209, F210, F211, F212, F213, F214, F215, F216, 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F715, F716, F717, F718, F719, F720, F721, F722, F723, F724, F725, F726, F727, F728, F729, F730, F731, F732, F733, F734, F735, F736, F737, F738, F739, F740, F741, F742, F743, F744, F745, F746, F747, F748, F749, F750, F751, F752, F753, F754, F755, F756, F757, F758, F759, F760, F761, F762, F763, F764, F765, F766, F767, F768, F769, F770, F771, F772, F773, F774, F775, F776, F777, F778, F779, F780, F781, F782, F783, F784, F785, F786, F787, F788, F789, F790, F791, F792, F793, F794, F795, F796, F797, F798, F799, F800, F801, F802, F803, F804, F805, F806, F807, F808, F809, F810, F811, F812, F813, F814, F815, F816, F817, F818, F819, F820, F821, F822, F823, F824, F825, F826, F827, F828, F829, F830, F831, F832, F833, F834, F835, F836, F837, F838, F839, F840, F841, F842, F843, F844, F845, F846, F847, F848, F849, F850, F851, F852, F853, F854, F855, F856, F857, F858, F859, F860, F861, F862, F863, F864, F865, F866, F867, F868, F869, F870, F871, F872, F873, F874, F875, F876, F877, F878, F879, F880, F881, F882, F883, F884, F885, F886, F887, F888, F889, F890, F891, F892, F893, F894, F895, F896, F897, F898, F899, F900, F901, F902, F903, F904, F905, F906, F907, F908, F909, F910, F911, F912, F913, F914, F915, F916, F917, F918, F919, F920, F921, F922, F923, F924, F925, F926, F927, F928, F929, F930, F931, F932, F933, F934, F935, F936, F937, F938, F939, F940, F941, F942, F943, F944, F945, F946, F947, F948, F949, F950, F951, F952, F953, F954, F955, F956, F957, F958, F959, F960, F961, F962, F963, F964, F965, F966, F967, F968, F969, F970, F971, F972, F973, F974, F975, F976, F977, F978, F979, F980, F981, F982, F983, F984, F985, F986, F987, F988, F989, F990, F991, F992, F993, F994, F995, F996, F997, F998, F999, F1000, F1001, F1002, F1003, F1004, F1005, F1006, F1007, F1008, F1009, F1010, F1011, F1012, F1013, F1014, F1015, F1016, F1017, F1018, F1019, F1020, F1021, F1022, F1023, F1024, F1025, F1026, F1027, F1028, F1029, F1030, F1031, F1032, F1033, F1034, F1035, F1036, F1037, F1038, F1039, F1040, 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F1899, F1900, F1901, F1902, F1903, F1904, F1905, F1906, F1907, F1908, F1909, F1910, F1911, F1912, F1913, F1914, F1915, F1916, F1917, F1918, F1919, F1920, F1921, F1922, F1923, F1924, F1925, F1926, F1927, F1928, F1929, F1930, F1931, F1932, F1933, F1934, F1935, F1936, F1937, F1938, F1939, F1940, F1941, F1942, F1943, F1944, F1945, F1946, F1947, F1948, F1949, F1950, F1951, F1952, F1953, F1954, F1955, F1956, F1957, F1958, F1959, F1960, F1961, F1962, F1963, F1964, F1965, F1966, F1967, F1968, F1969, F1970, F1971, F1972, F1973, F1974, F1975, F1976, F1977, F1978, F1979, F1980, F1981, F1982, F1983, F1984, F1985, F1986, F1987, F1988, F1989, F1990, F1991, F1992, F1993, F1994, F1995, F1996, F1997, F1998, F1999, F2000, F2001, F2002, F2003, F2004

Findings 49 findings

F1 Page 1

The building permit fees charged by the Community Development Department remained unchanged from 1992 to 2001. In 2001 a City analyst in the department determined that the plan check fee was not currently being included in the permit calculation. An adjustment was made by the department to include the plan check fees, which effectively more than doubled the fees. Within four months, the department staff determined that the plan check fee had already been included in the permit fees and discussed the matter with the City Manager's Office. The City Manager's Office decided to maintain the increased fee despite the discovery of the error. The increase was later approved by the City Council (in July 2002) as a budget line item. California Government Code Section 66014 provides that building permit fees may be charged at a rate which coincides with the cost the municipal department incurs to process the permits. Section 66014 (a) says that "notwithstanding any other provision of law, when a local agency charges fees for zoning variances; zoning changes; use permits; building inspections; building permits; filing and processing applications and petitions filed with the local agency formation commission or conducting preliminary proceedings...those fees may not exceed the estimated reasonable cost of providing the service for which the fee is charged, unless a question regarding the amount of the fee charged in excess of the estimated reasonable cost of providing the services or materials is submitted to, and approved by, a popular vote of two-thirds of those electors voting on the issue." Section 66014 (b) adds "The fees charged pursuant to subdivision (a) may include the costs reasonably necessary to prepare and revise the plans and policies that a local agency is required to adopt before it can make any necessary findings and determinations." No evidence has been found by the Grand Jury to prove that the fees were increased based on an assessment of the costs of the service. Up to the present, the City has not provided to the Grand Jury a comprehensive analysis of the direct and indirect costs of providing the building permit service in order to justify the fee level. Code Section 66016 also requires a public hearing when fees are raised.

F2 Page 1

The City of Stockton, at the time of a resolution changing permit fees, must inform the public ahead of time and conduct a public meeting which meets the test of full disclosure. A full and complete cost analysis must be presented and discussed with the public being given the opportunity to provide comment on the proposed change. The Community Development Department should be audited on a mandatory basis every two (2) years. Based on the findings of the audit, the department should adjust fees according to the law.

F3 Page 1

Sections 66016 (a) says "Prior to levying a new fee or service charge, or prior to approving an increase in an existing fee or service charge, a local agency shall hold at least one open and public meeting, at which oral or written presentations can be made, as part of a regularly scheduled meeting. Notice of the time and place of the meeting, including a general explanation of the matter to be considered, and a statement that the data required by this section is available, shall be mailed at least 14 days prior to the meeting to any interested party who files a written request with the local agency for mail notice of the meeting on new or increased fees or service charges. At least 10 days prior to the meeting, the local agency shall make available to the public data indicating the amount of cost, or estimated cost, required to provide the service for which the fee or service charge is levied and the revenue sources anticipated to provide the service, including General Fund revenues. Unless there has been voter approval, as prescribed by Section 66013 or 66014, no local agency shall levy a new fee or service charge or increase an existing fee or service charge to an amount which exceeds the estimated amount required to prove the service for which the fee or service charge is levied. If, however, the fees or service charges create revenues in excess of actual cost, those revenues shall be used to reduce the fee or service charge creating the excess." In 2002, the Stockton City Council approved the City's budget for fiscal year 2002/03, with the amount of the fee increase contained as a budget line item. It is the Grand Jury's opinion that this mechanism does not satisfy full disclosure to the public and therefore does not meet the minimum requirement of a public meeting set forth in California Government Code Section 66016. The budget line item approval did not allow sufficient information to provide interested parties an explanation of the justification for the increased fees, as provided for in Code Section 66016. According to Government Code Section 66022, an increase in building permit fees requires a 120-day period during which persons may file a legal action. Section 66022 (a) says "Any judicial action or proceeding to attack, review, set aside, void, or annul an ordinance, resolution, or motion adopting a new fee or service charge, or modifying or amending an existing fee or service charge, adopted by a local agency, and defined in Section 66000, shall be commenced within 120 days of the effective date of the ordinance, resolution, or motion." Because of the lack of information provided to the public when the fees were initially raised in 2001 and when the resolution was passed in 2002, the City of Stockton effectively precluded legal action by persons affected by this change.

F4 Page 1

Based on the outcome of the cost study by Muni Financial, due on July 1, 2007, the Community Development Department should carefully review fee levels to ensure that revenue matches cost and take steps to adjust, if necessary.

F5 Page 1

The City maintains that the fee increase was necessary in order to cover ten years of deficit spending by the Community Development Department, which was covered by monies from the City's General Fund. No precedent in law allows for an increase in building permit fees to repay monies transferred from a General Fund to cover deficit spending in a department. Legal opinions provided to the Stockton City Council in 2003 and 2005 found that the increase in fees was in compliance with all laws. The 2003 opinion by an interim City Attorney was reviewed by the City Council during a presentation regarding the Stockton Events Center. That opinion stated that the increase in fees was based on the cost of providing the services of the Development Department and that the transfer of the funds from the Development Services Fund to the Infrastructure Reinvestment Fund was appropriate. The 2005 opinion by the same attorney, who was then functioning as Special Counsel to the City of Stockton, reaffirms the first opinion and states that the "current building permit fees are actually below the full cost to the City of the building permit program." The Grand Jury has not been presented sufficient information from the City to verify that the cost of providing the building permit services is equal to the amount of the fees.

F6 Page 1

The City of Tracy produced no code enforcement policies and procedures for Grand Jury review. Regarding Individual Properties Referenced:

F7 Page 1

The City of Stockton does not audit this department on a regularly-scheduled basis. The Grand Jury was provided a copy of a "draft" internal audit report of the Community Development Department regarding fees, which was written in 2002. This audit was "conducted in response to a request from the City Manager's Office to address service fees charged for building permits." The audit report states, "...in the process a clerical error occurred. In July 2001, the Community Development Department implemented what was perceived to be a correction to the Combination Permit fee schedule, and increased the rates to match the schedule approved by the Council. However, the Community Development Department did not take into account the processing adjustments related to the plan check fee made in 1987. The department continued the practice of calculating a separate Plan Check fee and adding it to the permit fee charged. This caused a double assessment of the Plan Because the Council had not authorized a fee increase, the Check Fee. department's adjustment resulted in a significantly higher Combination Building Permit fee. Between July 1, 2001 and April 5, 2002, the Community Development Department issued 1,805 Combination Permits, and building permit and plan check revenues were 67 percent above budgeted figures." However, when the final audit by the City Auditor was submitted to the Stockton City Council on January 3, 2003, a different finding appeared. This audit states, "Based on the results of our work, we conclude that the City is charging fees in compliance with the annual citywide fee schedule approved by the Council." There appears to be a major discrepancy between the "draft" and the "final" audit, which raises a question about the validity of the final audit.

F8 Page 1

Finally, in 2007 the City has hired a firm, Muni Financial, to conduct a cost study of the Community Department's direct and indirect expenses in order to determine the allowable expenses against which to measure the permit fee level.

F9 Page 1

Incidents List, Detailed from the EMS Incident Reporting System for 01/01/2007- 01/31/2007

F10 Page 1

Incident Detail Report, Incident number: 06082553, Incident Date: 10/07/2003, 23:54:12

F11 Page 1

EMS Agency Report on the Exclusive Emergency Ambulance Provider Contract Compliance for AMR for the months of May and June, dated August 13, 2006

F12 Page 1

EMS Agency Report on the Exclusive Emergency Ambulance Provider Contract Compliance for American Medial Response for the months of July and August 2006, dated November 9, 2006

F13 Page 1

EMS Agency Report on the Exclusive Emergency Ambulance Provider Contract Compliance for American Medial Response for the months of September and October 2006

F14 Page 1

EMS Agency Report on the Exclusive Emergency Ambulance Provider Contract Compliance for AMR for November and December 2006

F15 Page 1

Letter to EMS from Stockton Fire Department Consultant/Investigator re: Medical Dispatch-Keyser Drive dated November 8, 2006

F16 Page 1

Letter to the Chairman of the San Joaquin County Board of Supervisors from the Mayor of Stockton dated July 27, 2006

F17 Page 1

Tritech CAD-to-CAD (Computer Assisted Dispatch) Functional Specification Documents

F18 Page 1

Logisys CAD-to-CAD Functional Specifications Documents

F19 Page 1

Unusual Occurrences Filed by the Stockton Fire Department with Delayed Calls Highlighted.

F20 Page 1

CAD-to-CAD Links report (Computer Assisted Dispatch) from AMR/LifeCom to the Stockton Fire Department from September 9, 2006 to March 19, 2007 of responses that were two minutes or longer.

F21 Page 1

Structure Fire Call Times submitted by AMR/LifeCom to EMS that conflict with the times AMR/LifeCom submitted to the Stockton Fire Department.

F22 Page 1

Series of Letters (May 1 and May 2, 2006) from Chief Hittle, Stockton Fire Department to Kenneth Cohen, Director, San Joaquin County Health Care Services, detailing perceived dispatch and communication problems.

F23 Page 1

May 3rd Letter from Kenneth Cohen to Chief Hittle responding to Chief Hittle's letters of May 1 and May 2.

F24 Page 1

Series of Letters (May 5, May 9) from Chief Hittle to Kenneth Cohen detailing perceived EMS system failures.

F25 Page 1

Memorandum dated December 19, 2003 from the San Joaquin County Fire Chiefs Association to Chico Research Foundation with a subject of Redesign of County EMS System.

F26 Page 1

San Joaquin County EMS Agency Continuous Quality Improvement Meeting Rules

F27 Page 1

Letter from the Chief of the Tracy Fire Department, dated February 13, 2007, to the Director of the Administrative Services Department for the City of Stockton concerning the issue of public safety radio frequencies

F28 Page 1

Letter from Chief Hittle of the Stockton Fired Department, dated February 26, 2007, to Chief Bosch of the Tracy Fire Department concerning the Public Safety Radio Frequencies.

F29 Page 1

Report to the Board of Supervisors by the Fire Chief, Ripon Fire District, Chairman, San Joaquin County Joint Radio Users Group (SJCJRUG)

F30 Page 1

March 29 communication from the Stockton Fire Department to EMS, Re: Information Exchange.

F31 Page 1

Unusual Occurrence Case #06489, Public Report, January 29, 2007 Relevant Law and Regulations:

F32 Page 1

Health and Safety Code, Division 2.5, Section 1797.200

F33 Page 1

Health and Safety Code, Division 2.5, Section 1797,204

F34 Page 1

Health and Safety Code, Division 2.5, Section 1798

F35 Page 1

California Code of Regulations, Title 11, Division 9, Chapter 12, EMS System Quality Improvement Relevant San Joaquin County EMS Agency Policy and Procedures:

F36 Page 1

San Joaquin County EMS Policy No. 540.01 Unusual Occurrence

F37 Page 1

San Joaquin County EMS Agency No. 3001, Guidelines for EMS Call Screening by Primary Public Safety Answering Points

F38 Page 1

San Joaquin County EMS Agency No. 3001A, PSAP Call type Flow Sheet

F39 Page 1

San Joaquin County EMS Agency No. 3101, Emergency Ambulance Service Provider Dispatch Requirements

F40 Page 1

San Joaquin County EMS Agency No. 6620, Continuous Quality Improvement Process

F41 Page 1

EMS Form #6002, Unusual Occurrence Report, August 16, 2006 Relevant LifeCom EMS and Fire Dispatch Policies and Procedures:

F42 Page 1

MPDS Implementation and EMD Call Processing Emergency Call Taking and Law Enforcement/Fire/First Responder Call

F43 Page 1

Notification GIS/GEO File Troubleshoot Procedure

F45 Page 1

Sentinel Event Notification Matrix

F46 Page 1

Letter from EMS to Stockton Fire Department dated November 22, 2006, Re: Unusual Occurrence Report, SJCEMSA Case #6459

F47 Page 1

Letter from EMS to Stockton Fire Department dated November 22, 2006 Re: Unusual Occurrence Report, SJCEMSA Case #6443

F48 Page 1

Data Reduction Methodology used by Inspironics for January 2007 Listing of Unusual Occurrence Reports Categorized by Type for EMS

F49 Page 1

Continuous Quality Improvement Meeting of March 15, 2007 FINDINGS: The current method of dispatch has land line 911 calls going to primary Public

F2005 Page 1

4. Work with the state leadership and the Department of Juvenile Justice to improve overall conditions in the operation of this facility and implement a plan to increase the potential ability of wards to re-enter society successfully. 2006/07 Finding: The number of wards in each unit has been decreased. A Ward Grievance Program was established, as well as a Ward Incentive Program. The school is also working with juvenile justice experts to prepare wards for re-entry into the community.

Recommendations 48

R1

This complaint is against: Include the name of the individual or organization the complaint is against. Insure correct spellings. If the complaint is against an individual in an organization, include the individual's title or position in the organization. Provide the street address (not a P.O. Box), city, and zip code. The telephone number of the organization or individual cited should include the area code.
R2

My complaint against the above-named person or agency is: Describe the problem in your own words. Be as concise as possible, providing dates, times, and names of individuals involved. Cite specific instances as opposed to broad generalizations. Attach any available photographs, correspondence, or documentation that supports the complaint. If more room is required, attach extra sheets, and include their number on the last line of the first sheet — for example: "three (3) additional sheets are attached."
R3

Complainant: Include your name, street address, city, zip code, telephone number and area code. Your name will be held in strictest confidence. All grand jury documents are secret and cannot be subpoenaed in court or revealed to the public. Mail this complaint form to the address shown on the front. Please sign your complaint. You may file an anonymous complaint if you wish; but the grand jury is less likely to investigate anonymous complaints — and also less likely to get to the truth of the matter if it does. The grand jury will respond to your complaint and advise you whether or not an III. investigation will be undertaken. The grand jury may contact you directly during its inquiries.
R4

2 East Weber Avenue — Room 303 Stockton, California 95202 209-468-3855 CITIZEN COMPLAINT FORM Date: _____ This complaint is against: Name: Title: Agency: Address: Phone: My complaint against the above-named person or agency is: ______________________________________ (Use and attach extra sheets if necessary.) Complainant: Name (printed): Address: Telephone: Signature: All communications to the grand jury are confidential. HOW TO CONTACT THE GRAND JURY Residents are encouraged to write or contact the San Joaquin County Civil Grand Jury by the following methods: East Weber Avenue, Room 303 Stockton, CA 95202 Internet site: www.stocktoncourt.org/courts/grandjury Telephone inquiries may be made at (209) 468-3855 during normal business hours. Leave your name and address and a representative of the Grand Jury will contact you. 2006/07 SAN JOAQUIN COUNTY CIVIL GRAND JURY COMPLAINT STATISTICS A cornerstone of the Grand Jury process is to receive and review citizen complaints which concerned persons direct to the Grand Jury members as a mechanism to expose issues within governmental agencies which affect all citizens. Because the Grand Jury is vested with certain powers to gather information, the members are able to review and investigate issues thoroughly as they represent all persons in the community Through review of documents and interview of witnesses, the Grand Jury process holds a strong light up to agencies to determine whether there appear to be any inefficiencies, mismanagement, or even corruption. The Grand Jury relies to a great extent on those persons who have the courage and the determination to suggest issues which may need to be investigated. The citizen complaint is a valuable tool. The 2006/07 San Joaquin County Civil Grand Jury received a total of sixty-seven (67) complaints this year, on a variety of subjects and agencies. As each complaint is received, the members review the document and any accompanying materials to determine first of all whether this body has jurisdiction over the agency cited and the issue described. If a decision is made that the issue is not within the scope of the Grand Jury, the complainant is sent a letter indicating that determination and suggesting, when possible, other avenues the writer may wish to take. If the issue falls with the Grand Jury's jurisdiction, then the complaint is assigned to a preliminary committee first, in order to determine whether the complaint has merit. After a thorough initial investigation, the committee presents its findings to the whole body, with recommendations for action. The entire membership then votes on the matter, with continuing investigation of those approved. After the investigation is complete, a final report is generated which reveals the findings and any recommendations the Grand Jury has in the matter. As each complaint is received, it is categorized by the members as to the nature of the issue. Based on that assessment, the following distribution resulted from this year's complaints: Government Malfeasance 40 21 Government Mismanagement 6 Law Enforcement 2 Fraud 1 Personal Dispute Note: Some complaints have more than one issue and thus may be assigned to more than one category. Also, twenty-four (24) of the complaints in the "Government Malfeasance" category were submitted on the same matter. All investigations of complaints involve a combination of investigative techniques, including interviews of the complainant and others with knowledge about the matter; review and comparison of documents; research; discussion; and summarization of the findings. The Grand Jury also assigned a subcommittee of members to conduct follow-up to the 2005/06 Civil Grand Jury Final Report to ensure that necessary steps had been taken by the agencies, with the findings and any new recommendations included in the 2006/07 Final Report. This process is an important one to ensure that agencies complete the work begun in response to Grand Jury recommendations. Grand Jury 2006/07 Complaint Log Monthly Totals through May 2007 28 24 Number of Complaints 20 16 12 8 4 0 05/06 J s 0 N D M М Α J F Α Months 24 of 26 November complaints were the same subject Grand Jury 2006/07 Complaint Types 2006/07 through May 2007 40 35 30 Number of Complaints 25 20 15 10 5 0 Govt Law Fraud Govt Pers Enforcement Malfeas Dispute Mismgmt Complaint Type Complaint Determinations 2006/07 through May 2007 50 40 Number of Complaints 30 20 10 0 No Pending Assigned Prelim# Inv ClosedClosed--FinClosed Rpt after Jurisdiction Info Case Prelim Determination Grand Jury County of San Joaquin Courthouse 222 East Weber Avenue-Room 303 Stockton, California 95202 (209)468-3855 CASE #01-06(A) FOLLOW-UP REPORT: SAN JOAQUIN COUNTY REGISTRAR OF VOTERS REASON FOR INVESTIGATION: This report is a follow-up to an investigation begun by the 2004/05 Grand Jury concerning the department's inability to use the Diebold TSX Touch Screen Voting Machines because of the lack of certification of the devices by the California Secretary of State. During the investigation, the members also identified problems related to a lack of space in the department to accommodate operations. The 2006/07 Grand Jury conducted a follow-up (case #04-05A), noting that the voting machines had been certified and were used in the 2006 elections.
R5

below.) Include in the Policy and Procedures that the residential facility keep 4. comprehensive records of clients they serve. It would serve the community and Mental Health to have records that are concise and verified regarding the patient visits, doctor appointments, and substance abuse counseling. A verbal report back to Mental Health is inefficient when working with Mental Health felons, particularly when reports are made only once a month. Any issues of non-compliance need to be reported to CONREP immediately for appropriate follow-up by CONREP staff. Incidents such as the Osborg case are rare, but with better record keeping the potential for violent criminal behavior might have been recognized earlier. 2006/07 Grand Jury Finding: A policy covering care and records from residential facilities of CONREP clients (Policy #0612.3004.0 Community Placement) was implemented December 1, 2006. The purpose of this policy is to assure adequate clinical supervision and support to maintain the forensic client in a community setting while assuring the safety of the community. The policy also covers the placement of clients in a Board and Care Facility and includes training of Board and Care staff. 5. A policy regarding the requirements of Collateral Contacts needs to be established, for both residential facilities which house CONREP clients and for persons who are the subject of visitation or other interaction regarding the client. CONREP staff should consider establishing a "contract" form, which would lay out the expectations of Collateral Contacts to provide information. 2006/07 Grand Jury Finding: In its response, CONREP program staff indicated that the state's guidelines will be adhered to in regards to collateral contacts of clients in the program. Staff will assess the appropriateness of collateral contacts, with a written agreement developed, signed, and provided to persons who serve as collateral contacts. CONREP staff indicate that this process is part of the "core service" required by the State. However, written materials provided at the time of this report do not verify the existence of this "contract." 6. Weekly/Bi-weekly meetings need to be transcribed and entered into the client's file; the current process is problematic because the writing is illegible and incomplete. 2006/07 Grand Jury Finding: A Policy (#0612-2004.0 Staff Meetings) was implemented on December 1, 2006. The purpose of this policy is to establish a teamwork approach and to provide quality treatment to CONREP clients. This activity is to assure the safety of the community and the effectiveness of outpatient treatment. Meetings will be conducted with CONREP staff and Community Re-entry Program staff, and then it will be recorded in the client's The weekly meetings will provide a forum to ensure that record. communication is complete, with a typed summary placed in the client's file. When participants in the CONREP program fail to comply with their treatment 7. plan, CONREP program staff must take quicker action when areas of non-compliance include missed meetings, substance abuse, and missed medications, all serious signs of problem behavior. They should immediately request an Order to Show Cause hearing to discuss this change of behavior and to determine whether the patient should be kept in or removed from the program. Pending the outcome of the hearing, additional restrictions or monitoring should be applied. 2006/07 Grand Jury Finding: The policy (#0612.3007.0 Non-Compliance) was revised as of December 1, 2006. The purpose of this policy is to provide twenty- four hours of coverage and supervision for CONREP clients and to address all issues of non-compliance quickly and thoroughly. They are expected to follow the CONREP Terms and Conditions Agreement and any Treatment Plan that has been established. Issues of non-compliance will subject the clients to possible revocation of their status in the program and possible placement in a state hospital. CONREP staff will notify the Court immediately of any serious non- compliance. Mental Health staff must ensure that law enforcement has direct contact with 8. appropriate CONREP staff if a client is detained and noted by law enforcement to be in the CONREP program. At a minimum, the client should not be released until a knowledgeable CONREP person has made an informed decision about the client and the current situation. 2006/07 Grand Jury Finding: A Policy (#0612.2003.0, Staff Coverage and Backup) was implemented on December 6, 2006. The purpose of this policy is to provide twenty-four hours of coverage and supervision for CONREP clients, as well as scheduling of CONREP staff to cover after-hours, weekends, and holidays. The policy outlines a process by which knowledgeable staff will address any concerns from local law enforcement regarding clients in the program. 9. The CONREP Director should reduce the client load to the required maximum level per staff member or increase staff to match the client load. 2006/07 Grand Jury Finding: The State mandates a ratio of one staff to ten clients. At the time of the Grand Jury review of the program in December 2006, CONREP had thirty-six clients and a staff of two and one half. In May 2007, thirty-four clients were in the program, with three full-time staff assigned to the program. However, one staff member has been out on medical leave and will remain so until July 2007. CONREP is in the process of hiring additional staff, but at present they have not been able to keep up with the Court's mandated placements in the program. The CONREP Program should be in compliance with the state's mandated ratio of one staff member to ten clients. 10. The CONREP Program Manual for Mental Health Services must be brought up to date, and include policies for "non-compliance" and "special incident reports" at a minimum. In general, the Manual contains brief policies, some of which rely on
R6

Computerize the Inventory List of clients' personal property to allow reporting, viewing, and changes when property is added or removed from the list. The computer should trace all entries by date, indicating when property is added or removed and to whom the property was released. 2006/07 Grand Jury Finding: The Storekeeper position has been filled, with an inventory tracking system in place. The staff person in this position provided a tour and demonstration of the safeguards for the property of conservatees. The Public Guardian/Conservator's Office has also set up a criteria for which items will be collected and stored, resulting in a reduction in overall volume of storage and a simpler process to enter and track the information. ADDITIONAL FINDINGS BY THE 2006/07 GRAND JURY: The previous warehouse problem had caused more damage to clients' property than was known earlier. Almost everything that was stored there had water damage or mildew damage from the initial water damage. Only a few boxes that were cleaned passed the final inspection to be removed and taken to the new Union Street warehouse. Thus, at the time of our visit the warehouse was clean, maintained, individual possessions were in labeled boxes or on labeled pallets with plastic wrapping. RECOMMENDATIONS OF THE 2006/07 GRAND JURY: No additional recommendations are made at this time. The Grand Jury commends the Public Guardian/Conservator's Office for continuing to work diligently to improve the efficiency and effectiveness of the services it provides to its clients.
R7

Reviewed Event Permit Application forms
R8

Reviewed the final approved Special Events Ordinance RECOMMENDATIONS FROM THE 2005/06 GRAND JURY:
R9

The CONREP Director should reduce the client load to the required maximum level per staff member or increase staff to match the client load. 2006/07 Grand Jury Finding: The State mandates a ratio of one staff to ten clients. At the time of the Grand Jury review of the program in December 2006, CONREP had thirty-six clients and a staff of two and one half. In May 2007, thirty-four clients were in the program, with three full-time staff assigned to the program. However, one staff member has been out on medical leave and will remain so until July 2007. CONREP is in the process of hiring additional staff, but at present they have not been able to keep up with the Court's mandated placements in the program. The CONREP Program should be in compliance with the state's mandated ratio of one staff member to ten clients.
R10

The CONREP Program Manual for Mental Health Services must be brought up to date, and include policies for "non-compliance" and "special incident reports" at a minimum. In general, the Manual contains brief policies, some of which rely on
R11

EMS Agency Report on the Exclusive Emergency Ambulance Provider Contract Compliance for AMR for the months of May and June, dated August 13, 2006
R12

EMS Agency Report on the Exclusive Emergency Ambulance Provider Contract Compliance for American Medial Response for the months of July and August 2006, dated November 9, 2006
R13

EMS Agency Report on the Exclusive Emergency Ambulance Provider Contract Compliance for American Medial Response for the months of September and October 2006
R14

EMS Agency Report on the Exclusive Emergency Ambulance Provider Contract Compliance for AMR for November and December 2006
R15

Letter to EMS from Stockton Fire Department Consultant/Investigator re: Medical Dispatch-Keyser Drive dated November 8, 2006
R16

Letter to the Chairman of the San Joaquin County Board of Supervisors from the Mayor of Stockton dated July 27, 2006
R17

Tritech CAD-to-CAD (Computer Assisted Dispatch) Functional Specification Documents
R18

Logisys CAD-to-CAD Functional Specifications Documents
R19

Unusual Occurrences Filed by the Stockton Fire Department with Delayed Calls Highlighted.
R20

CAD-to-CAD Links report (Computer Assisted Dispatch) from AMR/LifeCom to the Stockton Fire Department from September 9, 2006 to March 19, 2007 of responses that were two minutes or longer.
R21

Structure Fire Call Times submitted by AMR/LifeCom to EMS that conflict with the times AMR/LifeCom submitted to the Stockton Fire Department.
R22

Series of Letters (May 1 and May 2, 2006) from Chief Hittle, Stockton Fire Department to Kenneth Cohen, Director, San Joaquin County Health Care Services, detailing perceived dispatch and communication problems.
R23

May 3rd Letter from Kenneth Cohen to Chief Hittle responding to Chief Hittle's letters of May 1 and May 2.
R24

Series of Letters (May 5, May 9) from Chief Hittle to Kenneth Cohen detailing perceived EMS system failures.
R25

Memorandum dated December 19, 2003 from the San Joaquin County Fire Chiefs Association to Chico Research Foundation with a subject of Redesign of County EMS System.
R26

San Joaquin County EMS Agency Continuous Quality Improvement Meeting Rules
R27

Letter from the Chief of the Tracy Fire Department, dated February 13, 2007, to the Director of the Administrative Services Department for the City of Stockton concerning the issue of public safety radio frequencies
R28

Letter from Chief Hittle of the Stockton Fired Department, dated February 26, 2007, to Chief Bosch of the Tracy Fire Department concerning the Public Safety Radio Frequencies.
R29

Report to the Board of Supervisors by the Fire Chief, Ripon Fire District, Chairman, San Joaquin County Joint Radio Users Group (SJCJRUG)
R30

March 29 communication from the Stockton Fire Department to EMS, Re: Information Exchange.
R31

Unusual Occurrence Case #06489, Public Report, January 29, 2007 Relevant Law and Regulations:
R32

Health and Safety Code, Division 2.5, Section 1797.200
R33

Health and Safety Code, Division 2.5, Section 1797,204
R34

Health and Safety Code, Division 2.5, Section 1798
R35

California Code of Regulations, Title 11, Division 9, Chapter 12, EMS System Quality Improvement Relevant San Joaquin County EMS Agency Policy and Procedures:
R36

San Joaquin County EMS Policy No. 540.01 Unusual Occurrence
R37

San Joaquin County EMS Agency No. 3001, Guidelines for EMS Call Screening by Primary Public Safety Answering Points
R38

San Joaquin County EMS Agency No. 3001A, PSAP Call type Flow Sheet
R39

San Joaquin County EMS Agency No. 3101, Emergency Ambulance Service Provider Dispatch Requirements
R40

San Joaquin County EMS Agency No. 6620, Continuous Quality Improvement Process
R41

EMS Form #6002, Unusual Occurrence Report, August 16, 2006 Relevant LifeCom EMS and Fire Dispatch Policies and Procedures:
R42

MPDS Implementation and EMD Call Processing Emergency Call Taking and Law Enforcement/Fire/First Responder Call
R43

Notification GIS/GEO File Troubleshoot Procedure
R45

Sentinel Event Notification Matrix
R46

Letter from EMS to Stockton Fire Department dated November 22, 2006, Re: Unusual Occurrence Report, SJCEMSA Case #6459
R47

Letter from EMS to Stockton Fire Department dated November 22, 2006 Re: Unusual Occurrence Report, SJCEMSA Case #6443
R48

Data Reduction Methodology used by Inspironics for January 2007 Listing of Unusual Occurrence Reports Categorized by Type for EMS
R49

Continuous Quality Improvement Meeting of March 15, 2007

* This report's PDF did not contain easily extractable text and required Optical Character Recognition (OCR) for analysis. There may be minor errors in the extracted findings and recommendations due to OCR limitations with scanned documents.