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Extracted from Consolidated Report
This investigation was originally published as part of a larger consolidated report containing multiple investigations. View the consolidated PDF for the complete document.
⚠️ Translation Notice: This content has been automatically translated. The original English text is the official version. Translation may contain errors.
⚠️ Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.
Findings 5 findings
F1
Page 23
During FY 2000/2001, with an augmented budget, APS increased its staff and its ability for emergency response, but has not provided enhanced services such as case management as required by SB 2199. APS concurs that there is a need for case management, but attributes its absence to lack of staff and funding.
F2
Page 23
APS administrators were unable to provide members of the Grand Jury with documentation requiring the 90 day cap, and it is unclear whether this is imposed by state regulations or self-imposed by the County.
F3
Page 23
Adult Protective Services has not pursued Targeted Case Management funding. Although TCM provides money at a 50% reimbursement, it is additional funding separate from their current revenue source.
F4
Page 23
There appears to be a philosophy within APS of using crisis intervention and quick closure as the primary remedy. If the cases opened from January 1998 through January 2002, as noted, had been effectively resolved through case management, they would have resulted in savings of approximately $2,700,000 over that four-year period. The savings would be greater if the impact to other systems, such as emergency rooms, law enforcement, etc. were considered. Sacramento County Grand Jury June 30, 2002
F5
Page 24
APS workers and staff of other agencies regularly consult on individual cases for multi-problem individuals which can become time intensive. Sacramento County's Multidisciplinary Team (MDT) with its composition of numerous community agencies, meets one time per month for two hours. Given the number of cases that are processed through APS, the use of the MDT only once a month is not adequate. The Grand Jury determined that Adult Protective Services could expand on its coordination with community agencies, and it could utilize this collaboration and coordination more effectively through an expanded use of the MDT.
Recommendations 5
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R1Page 23Sacramento County APS should immediately implement a pilot program of case management for the identified highest risk cases. APS should implement case management as specified in SB 2199 and the two-year study.
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R2Page 23Adult Protective Services needs to remove the 90-day cap on the amount of time a case can remain open.
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R3Page 23a. Adult Protective Services should explore the possibility of additional funding through Targeted Case Management or MediCal Administrative Assistance. b. If APS no longer maintains an MAA/TCM Coordinator, then it would be advisable for APS to hire a consultant to determine if they qualify for a coordinator and how best to increase reimbursement for services. c. APS should consider the purchase of appropriate software to assist in proper documentation.
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R4Page 24Adult Protective Services should reconfigure its system of triaging/prioritizing cases after the initial response in order to better determine the need for type and length of continued services to reduce re-opening of cases.
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R5Page 24a. The MDT should meet on a weekly basis to alleviate the burden/workload of each individual agency involved in each case by allowing presentation and follow up in less than 30 days as needed. b. APS needs to develop continued and expanded collaboration with social service, health, and criminal justice agencies in order to link clients with necessary services and supports to more effectively create stability. Beyond the scope of referral, APS should collaborate on the cases and follow up on the success of the referral.