Los Angeles County Grand Jury • 1981-1982

LOS Angeles County Grand Jury of LOS Angel Count*

Published: February 16, 2010 113 pages Consolidated Report

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Note: Missing finding numbers detected: F8

Findings 18 findings

No specific impact studies regarding the consequences of the intended cuts were made prior to the abrupt curtailment of services in July 1981; only broad, descriptive generalizations of services to be cut were provided. The Grand Jury realizes that the Board was responding to abrupt reductions of funding; however, STATE OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE P the Department of Health Services had been warned to prepare projections for various anticipated levels of cutbacks at least six months in advance. A STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE Los Angeles has a large population of immigrants from countries where diseases such as amoebic dysentery, malaria, typhoid and salmonella are endemic. The Jury believes that a curtailment of services could have a serious impact on the . health of the entire community. For example, it should be noted that Los Angeles County is experiencing a rise in the rate of tuberculosis while other major urban areas are experiencing a decrease. The CAO has twice recommended elimination of the requirements of the

Beilenson Act, which calls for a 90-day notice of hearing and 60 days concurrent waiting period prior to closure or reduction of facilities and level of care. The Act gives those who would be adversely affected an opportunity to give vital input about where and how much the level of services would be decreased. The CAO recommended that the County seek repeal of the Act "so that counties can The state of the state of the state of the state of the state of the state of the state of the state of the state of the state of the state of the state of the state of the state of the state of the state of the state of t have needed flexibility in their allocation of limited resources among all service programs," (letter dated December 5, 1980). In another letter dated June 25, 1981, it once again referred to side-stepping the specifics required under the Beilenson notification requirements. The Grand Jury believes the Board must STATE STATE OF fulfill its legal obligation to the community to provide adequate warning and opportunity for review by meeting the Act's requirements. PERSONAL PROPERTY.

The Jury has been unable to obtain an explanation of conflicting budget figures. The final budget adopted by the Board on July 3, 1981, shows a final figure of $4,595,599,459 with 72,300 positions budgeted. Yet in a letter dated July 23, 1981, to Assemblyman Art Torres, the CAO shows 1981-82 adopted figures STATE OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE P totaling $4,717,248,750 with 73,788 positions. This represents an increase of $121,649,291. Considering that the Health Services budget was cut by $56 million, to what extent was this additional amount allocated to restore the . health cuts? A document received from the CAO's Office showed the total number of people A CONTRACTOR on the payroll in September 1981 was 74,432. A second document from the Auditor-Controller showed the County payroll for the October accrual was 77,293. Since we understand a freeze had been put on County hiring, we are puzzled by the addition of 2,861 workers in one month's time. SUPPLY OF STREET Health care is generally considered a right of every citizen, whether privately or

publicly rendered. Medi-Cal was supposed to provide equal access for all; how- 1 ever, many private providers are unwilling to accept Medi-Cal patients because they are considered "unprofitable." In the past, the County has filled the gap for those unserved by the private sector. The current trend is to contract out these services in an effort to save money. The Jury has some serious concerns about the effects of contracting out health services. One university professor of Public Health states, "The history of contracting out has been miserable." He has said the cost of regulating the contract, added to the cost of the contract itself, can cost the County more than providing the services in its facilities. According to him, the cost in California and and a of delivering services at a private hospital is greater than the cost at a County facility. The Jury's fundamental concern is: Who will ensure that the private contractor will provide services to those unable to pay, who receive services in County- operated facilities? The Jury believes contracting out health services might make them financially inaccessible for many, and could result in higher costs to the County. As the professor put it, "The overwhelming motive can't be -- what can we get rid of that no one will see... County facilities were set up to provide services no one else wants to provide. The people provided for in County facili- ties are historically those not profitable for the private providers."

The Jury believes that certain cutbacks in services could be short-sighted, result- ing in increased costs later on. For example, the elimination of health educators, nutritionists and social workers could pose a serious problem. These three occupations are crucial in helping people learn how to take care of their health problems before they become serious. Preventive medicine is the most cost-effective and efficient way of serving the community. Curtailing or eliminating health prevention programs results in hospitalization later, at much greater cost to the County. The Jury finds particularly alarming the elimination of pharmacy services at all but the comprehensive health centers. Almost all out-patient pharmacy services have been eliminated at hospitals, and drug dispensing at health centers is now limited to public health drugs only. Medical facilities and physicians serving the poor find it essential to supply medications. A patient with no definite symp- toms, such as one with hypertension, is not likely to purchase expensive medi- cation until he becomes acutely ill and requires hospitalization. The Grand Jury has learned the County can provide medication at a substantially lower cost than that charged by private pharmacies. Medication has been provided either in a lump sum Medi-Cal billing (under the Los Angeles County waiver which waives the necessity for itemized billing) or is included in the all-inclusive clinic fee. Rather than eliminating the dispensing of medication, the Jury believes the County should explore the feasibility of charging pharmacy fees somewhere between the actual County cost and the much higher fees authorized by Medi-Cal. The result would be a savings for the taxpayer, and the markup could be used to fund medication for those unable to pay and ineligible for entitlement programs. In addition, the Grand Jury has information that a gap in service has resulted because many medications pre- scribed at County facilities are not available in community pharmacies. For example, cancer patients cannot get the narcotics they need in many areas of the County because the pharmacies do not stock them.

Clinic fees as currently structured are exorbitant and unrealistic. Patients have been billed for later collection with extremely low collection rates. The experi- mental program of collecting a $20 up-front cash fee, instituted in April 1981 has reportedly been extremely successful. The vast majority of patients have been willing to pay the fee, and substantially higher revenues are being generated. Therefore, the Grand Jury recommends:

the number of committees to which any member may belong should be restricted so that committee meetings can be scheduled and conducted on a single day as a rule. Response: The Grand Jury agrees.

Recommendation: The Audit Committee should require attendance by the contract auditor at regularly scheduled meetings and other meetings where planned, current or completed reviews are discussed. Response: The Grand Jury agrees. The 1981-82 Grand Jury has been following this practice.

F10

Recommendation: Representatives of the Grand Jury should participate in the early phases of any exami- nation undertaken by the contract auditor in order to gain a first-hand understanding of the issues and the officials involved in the matter being reviewed. Response: The Grand Jury agrees. The 1981-82 Grand Jury has been following this practice.

F11

Recommendation: Representatives of the Grand Jury should communicate with representatives of the CAO Management Services Division, Auditor-Controller's Office and Economy and Efficiency Commission early in the year to discuss the schedules of each organization for reviews and examinations during the year and to establish cooperative arrangements for sharing of information. Response: The Grand Jury agrees. The 1981-82 Grand Jury's Audit Committee took into consideration work recently done or planned by these offices in developing its list of proposed audits, and representatives of the Grand Jury accompanied the contract auditor on interviews of representatives from the Chief Administrative Office and the County Auditor-Controller as one of the early steps in each audit.

F12

Recommendation: The Auditor-Controller's Office and the CAO's Management Services Division should be consulted as one of the first steps in most reviews. Response: The Grand Jury agrees and, as noted in response to Recommendation No. 11, has followed this practice.

F13

Recommendation: Grand Jury examinations should concentrate on the areas outlined in applicable sections of the Penal Code while avoiding detailed department-wide organizational and operational reviews. Response: The Grand Jury agrees. The Grand Jury and its contract auditor have conducted preliminary overviews of departments selected for audit to determine which areas of those departments would be most productive to review, Resources have been concentrated on reviewing those areas. 121

F14

Recommendation: The Grand Jury and its separate committees should focus on areas to be examined and begin work on them as early as possible. Response: The Grand Jury agrees.

F15

Recommendation: The Grand Jury should evaluate the appropriateness of receiving full-time legal advice from a Deputy District Attorney and consider the advisability and feasibility of alternatives. Response: The Grand Jury does not agree. The Jury agrees that full-time services of a Deputy District 200000 Attorney are not now needed, and would point out that at present the Deputy serving the Jury does other work for the District Attorney as well. He estimates that other work has taken approximately 30 percent of his time this year. TO SECTION However, the Jury strongly believes it needs an "on site" legal counsel, i.e., stationed in Grand Jury quarters. Questions involving criminal law do not arise solely in connection with indictment proceed- 47.5 ings. Of the many communications received from the public, most allege some kind of wrongdoing, and require legal advice before reply can be made. The Jury also needs review by counsel of many outgoing communications to make certain they are legally sound, and of almost all press releases. It is true that not all legal questions involve criminal law, and that some information now obtained from the District Attorney could be provided by the CAO or County Counsel. However, the Jury believes its day-to-day work would be greatly impeded if it did not have a single, readily available source of advice. Two advantages in having a Deputy District Attorney as the Jury's counsel are that (1) probably the majority of legal questions which arise involve criminal law and (2) it is logistically more efficient, where counsel does not provide full-time service for the Jury, that he be from a department which is housed in the same building. This facilitates his providing service to both his office and the Jury.

F16

Recommendation: Officials and departments that are the subjects of examinations should be given the opportunity to review draft reports before interim or final reports are issued. Response: The Grand Jury agrees. The 1981-82 Grand Jury has been following this procedure.

F17

Recommendation: Interim reports should be completed and submitted to the Board of Supervisors as early in the Grand Jury's term as possible. Response: The Grand Jury agrees.

F18

Recommendation: The Grand Jury should consider issuing less elaborate final reports than have been prepared in recent years. ì Response: The Grand Jury agrees. The 1981-82 Grand Jury, early in its term adopted a simple, one-color format for the current year's report. In the opinion of the Grand Jury, adoption of a standard format for Grand Jury annual reports would make the reports more identifiable and simpler to prepare.

F19

Recommendation: Near the end of its term each Grand Jury should schedule a meeting with the Board of Supervisors to present the final report. Response: The Grand Jury agrees. DEPARTMENT OF CHIEF MEDICAL EXAMINER-CORONER The Chief Medical Examiner-Coroners Office was established in 1956 as an independent County department, with responsibilities previously performed under the Public Administrator. Its duties are prescribed in the Government Code and the Health and Safety Code. The Coroner determines the circumstances, manner, and causes of all deaths other than natural, and has both mandatory and discretionary powers to perform autopsies. The office is required to perform an autopsy when it is requested and paid for by the next of kin, even though the death was not originally a Coroner's case. The Medical Examiner-Coroner also runs alcohol or drug tests on all traffic deaths where the victim is over 15 years of age and dies within 24 hours of the accident. In all cases, the Medical Examiner-Coroner issues a death certificate as soon as possible after examination of a body. The Department is organized into six separate divisions: Executive Office, Investigations, Forensic Medicine, Forensic Laboratories, Public Services and Inquest. No. The second The Medical Examiner-Coroner's Department had never been the subject of a Grand Jury audit. In 1976 the Department was audited by the Controller's Office and in 1978 its operations were reviewed by the Chief Administrative Officer. On August 31, 1981, the Grand Jury approved the Department of Medical Examiner-Coroner as one of those to be audited. OBJECTIVES STATE OF STATES The objective of this review was to identify areas for overall improvement in departmental operations and to make recommendations necessary for the implementation of improvements. Included was an examination of the general procedures and standards for the investigation of in-custody deaths, the operation of the Coroner's Automated Information System-Data Processing Section (CAIN), and delays in the preparation of transcripts of inquest proceedings which impeded investigations by other County departments and government agencies. STATE OF STREET APPROACH Shortly after finalization of the work plan for a review of the Medical Examiner-Coroner's Office by the Grand Jury's contract auditor in November 1981, the operations of the Department came under increased public scrutiny as a result of a series of articles in the news media. These articles began to appear in December 1981, and focused public attention on the Department. The Board of Supervisors ordered the County's Chief Administrative Officer (CAO) to conduct an in-depth management review of departmental operations. The Grand STATE OF STATE OF Jury's contract auditor (Peat, Marwick, Mitchell, & Co.) and the CAO conducted independent reviews of the Chief Medical Examiner-Coroner's Department but met on several occasions to clarify the scope of the respective reviews and to avoid duplication of effort. The Grand Jury's review was not a result of any adverse publicity about the performance of duties by the Chief Medical Examiner-Coroner or the Department. The Jury did not review A STATE OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE issues relating to allegations of the Chief Medical Examiner's absence from his office or regard- ing his conduct. Nor did the Grand Jury attempt to evaluate his performance as a manager. CANAL STREET

Recommendations 30

R1

The Grand Jury therefore recommends that the Museum Trustees and the County resolve the following issues: 1000 • What is an adequate level of funding for both Museum Associates and Los Angeles County with respect to current operations?
R2

That sufficient funding be restored to the target areas of Pico Rivera, Lynwood, East Los 2000 Angeles, Lennox and Norwalk to allow the addition of 10 deputy district attorneys to Operation Hardcore. A COLUMN
R3

That the Board of Supervisors support legislation which would amend sections of the Welfare and Institutions Code relating to sentencing and court jurisdiction to provide for placement in the state prison system of violent young offenders for whom jurisdiction A STATE OF of the Youth Authority is inappropriate.
R4

That a study be made by a task force appointed by the Board of Supervisors of the Repeat 10000 Offenders Court Program in use in Cook County, Illinois, with the possibility of adopting it in Los Angeles County for prosecution of gang violence cases. Frances Courtney, Chair Mildred Light Rose Black Barbara Lurvey Carmelita West Susan Dixon Pina Fisher James Wilcott Richard Halpin
R5

Conduct a campaign to educate the public to modify its purchasing habits, e.g., avoid buying single-use disposable products, and buy items that are durable, recyclable or repairable.
R6

Adopt as policy that Supervisors will encourage planning commissions, city councils and permit issuing authorities in their districts to facilitate siting of resource recovery and recycling centers through appropriate zoning and special simplified procedures for obtaining conditional use permits.
R7

Encourage the promotion of waste-to-energy projects within the County, and the develop- ment of energy conversion sites wherever feasible.
R8

Encourage recycling centers to expand their drop-off and buy-back programs for news- papers, metals, glass, aluminum and plastics. C. HAZARDOUS WASTE
R9

That DMH work with state hospitals to assist in taking patients for preplacement visits to community care facilities.
R10

That DMH take any additional steps possible to move patients into less restrictive, less i expensive settings whenever therapeutically appropriate. B, CONDITIONS AT THE SUPERIOR COURT'S MENTAL HEALTH DEPARTMENT
R11

That the County Personnel Department conduct an overall review/formal survey of positions and salaries within the Department. Such review should focus on the comparability of wages and duties within the overall County personnel structure and considering similar agencies in surrounding counties. The results of such review should be used in setting wages and salaries in the future.
R12

That the Department establish a specific retention policy for photographs, x-rays, bullets, death instru- ments, personal clothes, inquest reporter notes of inquest hearings, and other data and materials created in daily operations.
R13

That the Department improve storage practices by consolidating all storage areas of vital evidence into one central area. Storage bins should be secured and inventory records maintained.
R14

That the Department develop and submit to the County of Los Angeles Board of Supervisors a request for additional operating space to meet the immediate and long-term requirements.
R15

That the Department develop scheduling and parking arrangements for Coroner's vans and mortuary vehicles to accommodate reasonable peak loads.
R16

That the Department create and maintain a master log report (management information report) that reports the number of deferred certificates and final death certificates issued by examining pathologists and lists pending deferred death certificates and remaining tests and reports ordered by days outstand- ing.
R17

That the Department develop and implement performance standards for completion of internal medical tests (like histopathology) and, when necessary, secure additional support or overtime work to assure timely performance. Such standards should be developed with the help and input of outside agencies (e.g., law enforcement, hospitals, etc.) to develop mutually acceptable time standards for receipt of their respective reports that are critical to the completion of deferred death certificates.
R18

That the Department numerically order death certificates and maintain records to improve internal control procedures.
R19

That pathologists review copies of completed death certificates. If discrepancies are identified in review- STATE OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE P ing the death certificate, an amendment should be issued. That the Department strive to rigidly enforce the requirement for immediate notification of the Coroner. 100000000000000000000000000000000000000
R20

The Department should be requested to report to the 1982-83 Los Angeles County Grand Jury its progress toward implementing the recommendations contained in this report. No. DEPARTMENT OF MENTAL HEALTH 20201000 The County is experiencing major difficulties in maintaining mental health care service levels for its residents under current financial conditions. More than 85 percent of the $142 million Section 1 1981-82 budget administered by the Department of Mental Health comes from revenue sources external to the County, including Federal and non-Federal Medi-Cal, Short-Doyle and State General Fund monies.
R21

That the Department accumulate in a single reference book a Departmental Policy and Procedures Manual; such manual should include tasks and standards for Coroner's Investigators and Senior Coroner's A CONTRACTOR Investigators.
R22

That the Department develop and monitor an evaluation system that tracks and enforces staff investi- gating performance against documented policies, procedures and standards. ACCOUNT. That the Department require payment in full before the preparation of inquest transcripts.
R23

The AAA Advisory Council should more actively seek to inform participants of its role and to improve its communication with them.
R24

That the Auditor-Controller develop a billing rate for first-time requests for inquest transcripts that is 200 consistent with the actual costs of preparation.
R25

That the Department work with other County departments requesting autopsy and transcript reports to determine if the volume of reports is excessive and if such volume cannot reasonably be reduced.
R26

That the Department's request for $85,000 in capital expenditures for the forensic laboratory equipment be approved. Such equipment is necessary to assure accurate and timely toxicology test results.
R27

That the Department develop a plan to implement the recommendations of this report that specifies
R28

That the Coroner's Office continue with the development of the "CAIN" system and the documenta- tion of its internal operating procedures. The detail design phase of "CAIN" development should be scheduled to begin after management changes in operating procedures resulting from this study have been made.
R29

Senior citizens should be provided opportunities for meaningful service commensurate with their skills and 200 experience. Miscellaneous
R30

The Department should consider developing guidelines for its contractors who may be willing to promote shared housing as a means to alleviate the shortage of affordable housing for seniors. The Department should consider requesting each of its contractors to furnish a plan for employing seniors as paid personnel. This review was conducted by Grand Jurors Rebecca Allen, Chair, Patsy Edwards, Mildred Light, and Carmelita ( $ 2 West with the assistance of the contract auditor.) GROUP II - PRELIMINARY REVIEWS DEPARTMENT OF BUILDING SERVICES TOTAL STATE The Department of Building Services (DBS) provides custodial and related services to approximately 400 County-owned facilities, including health care facilities. In 1978 the County electorate passed Proposition A which allowed services being rendered by County personnel to be contracted to private enterprise. It subsequently became the policy of the Board of Supervisors to encourage such contracting. OBJECTIVES The objectives of the Grand Jury were to:

Conclusions 29

CL1

The extent to which the Department has taken action to respond to recommendations made by previous grand juries and the Auditor-Controller to enhance day-to-day operations
CL2

Whether contracts are awarded to outside concerns (for drayage, property management, auctions, estate maintenance, and the like) in an equitable manner
CL3

Whether opportunities exist to contract out services currently provided by the Department at a lower cost to the County without compromising service quality
CL4

Whether adequate management information capabilities exist within the Department .
CL5

Whether the Department is maximizing the revenue it could 100 potentially receive for the services it provides 1000000
CL6

The extent to which the Department monitors its own activities to ensure that estates are closed expeditiously and in keeping with departmental policies and procedures. APPROACH The review was conducted by a two-person team over a period of approximately six weeks. TOTAL STREET The team conducted extensive interviews with numerous officials of the Department as well as representatives of the County Administrative Office, the Purchasing Department, the County Counsel's Office and the Auditor-Controller. The team reviewed numerous previous Grand Jury and Auditor-Controller reports, internal PA-PG reports, case files, budgets, and 7.770 other documents containing information regarding the areas outlined under "Objectives." The team reviewed its findings, conclusions and recommendations with Department officials prior to preparation of the final report.
CL7

While the Department does not appear to be required to follow County purchasing procedures in obtaining outside services for clients, it does have a fiduciary responsibi- lity to those clients to obtain adequate services at reasonable costs. In some aspects and especially with regard to certain services, the Department has not been diligent in assessing the marketplace and establishing adequate contractual arrangements and monitoring procedures. At the same time, it is noted that the current PA-PG has taken several positive steps to improve the performance of some contractors hired to serve the Department's clients. The Department has not been aggressive in identifying and analyzing areas for which
CL8

The existing management information system, while adequate in terms of basic accounting functions, does not provide the Department with a sufficiently useful management tool for workload and performance monitoring, case management and other purposes for which it was designed. Needed changes in programs and files have not been made, with the result that certain system capabilities and reports are not used. Instead, the functions for which those capabilities were designed are accom- plished manually or not at all. The Department's planned approach for developing a new management information system and for financing it through maintenance of compensating balances at a bank which would in turn provide the system, is appro- priate and cost-effective.
CL9

The Department's existing approach to monitoring the workload, performance and productivity of its employees is inadequate. Written policies and procedures in this area are out of date, and there are insufficient reporting mechanisms and performance criteria in place.
CL10

The County would realize substantial savings if the court-related services now provided by both the Marshal's Office and the Sheriff's Office were consolidated into one agency. The Committee makes no recommendation as to whether the services should be delivered by the Marshal or the Sheriff; this decision rests with the Board of Supervisors. AB 2784 gives the Board the authority to act on this important issue that has consumed so much time and effort on the part of prior grand juries, commissions and interested citizens.
CL11

The problems resulting from the County's contracting with a private firm for such an all-encompassing County Solid Waste Management Plan reflect the complexities of Los Angeles County regarding local jurisdictions, special districts and the involvement of the private sector. The staff of the County Engineer, which in the past had prepared the plan, appeared unprepared in their efforts to pass on to the consultant the flow of comments and ideas from those involved in shaping goals, policies and objectives. It appeared that the consultant had not been aware of the complexities of the task and the many voices to be heard until the work was well underway. The Grand Jury, however, recognizes that there is a necessary period of adjustment and learning by County departments contracting for services on complex matters involving detailed inter- action with consulting firms. The process of updating and revising the County Solid Waste Management Plan is in the early stages of its time schedule and it appears that the consultant, County staffs and the advisory committee are adjusting and coordinating their efforts and ideas to reach their objectives.
CL12

A CARLOW In order to achieve an environmental balance we must look to an integrated approach for solutions to our solid waste management problem. This will include social, political, and 2000 economic changes. Just as living organisms have recycled waste - oxygen and carbon dioxide for billions of years so that nothing is lost — so the materials we use must be recycled. No or other Recycling provides a way to dispose of trash while saving valuable materials. Pollution results when resources are withdrawn from the environment and returned as waste, not all of which can be recycled by natural processes. Therefore, people must devise and use additional means of recycling to restore resources and remove pollution as rapidly as possible. This kind of positive action can result in cost savings to consumers and industry, provide alterna- tive energy sources, prolong the life of landfills, and preserve the environmental quality of land and air with concomitant reductions of health hazards. Another benefit is energy saving, since recycling often takes less than one-fifth the energy required to manufacture a product from virgin raw materials. U
CL13

Based upon the number of in-custody deaths or injuries, the Grand Jury concludes there should A .................................... be a posted procedural check-off list in all jails for use of jail personnel as to whom to contact and what to do in case of an inmate death or injury. A COLOR OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF T The Jury also concludes that jail facilities should have portable phones available for use by prisoners. This minimizes physical contact between jailer and prisoner, thus avoiding potential altercations and allowing prisoners to make contact with family, friends and attorneys without being removed from cells.
CL14

To minimize possibilities of jail suicides, bars on cells should be covered with screen or gratings where ventilation permits, and mattresses which do not require removable covers should be A CANADA provided. This Grand Jury became aware of the importance of jail structure and proper procedures in The state of the booking and searching, monitoring arrestees, training and deployment of jail personnel, and availability of portable phones through the extensive investigative hearings surrounding the in- custody death of Reginald Ronnell Settles in the Signal Hill jail. Members of the Grand Jury gained The second additional insight from the management audit commissioned by the Signal Hill City Council and prepared by Management Assessment Centers, Inc., of San Clemente.
CL15

These sources, together with its own inspections, led the Grand Jury to realize that the existing inspection form was not adequate for its purposes; therefore, each juror was asked to submit ideas for its improvement. These suggestions, along with recommendations from the 1981 National
CL16

Study of Jail Suicides of the National Center on Institutions and Alternatives were incorporated into a comprehensive questionnaire. Questions have been organized into areas of jail operations and are intended to be directed to the police administrator or watch commander immediately 0000000 responsible for jail functions. The questionnaire is reproduced on the following pages, and is available to other California grand juries which may wish to have the benefit of this Jury's experience. Copies of the questionnaire
CL17

and of this section of the Jails Committee report are being sent to Police Chiefs and to City Councils of municipalities operating their own jails. 2000000 Barbara Lurvey, Chair Alexander Madrid Warren Bosley, Chair Pro Tem Catherine McAdoo Edmond Desjardins Anita Martinez MODERATE Patsy Edwards Linda Smith Richard Halpin Carmelita West JAIL INSPECTION QUESTIONNAIRE JAIL PROCEDURES AND TRAINING OF JAIL PERSONNEL Have all jail personnel received the minimum 40-hour California P.O.S.T. training in jail procedures? Ask to see confirmation of such training of at least one jail personnel. Is one person with P.O.S.T. training on duty in the jail on each watch? If not, explain. Is there any update on the initial training, or other special training on such subjects as suicide prevention, fire evacuation, first aid? Ask to see the Jail Procedures Manual. Which official(s) has received the 80-hour California P.O.S.T. training in jail management? When? Are translators available for assistance with non-English speaking arrestees? Who are they and where are they located? Upon booking, is the arrestee told by the jailer of the charge and bail against him? Are the bail procedures explained? If not at booking, when? Are phone rights and bail procedures in English and Spanish prominently posted in jail area? If not, explain. Are arrestees offered use of a phone at time of booking? Are the dates and times of the offer and completion of a call recorded on any booking document? Are portable phones available to prisoners in the cell area? If not, ask for the procedures on additional phone calls when requested by prisoners. Are phones operative? MEALS Number of meals per day and what type - frozen dinners, local caterer, hot food from central facility, sack lunches? In Type II and III facilities, ask to see the kitchen and ask number of calories served, menu, and if approved by any dietitian. MAINTENANCE Does this facility use trustees or civilian maintenance personnel? How many? How often is the cell area cleaned, swept, mopped? Is anti-graffiti paint used on the cell walls? If not, is graffiti a problem; how is it handled? If trustees are used, as in most Sheriff's substations, ask to see their accommodations and dayroom HEALTH AND SAFETY At time of booking, is arrestee asked about any health problems such as heart trouble, hepatitis, VD or TB? What is the policy on arrestees with health problems? In Type II and III facilities, is there a dispensary with a doctor or nurse on duty? What is name and address of contract hospital? How far away? The same of A COLORADO What is location of nearest paramedic unit? What are the procedures following discovery of a jail death or suicide? What officials are notified? What reports are written? No. How often does the jailer check the prisoners? Is a record made of each check? What type of check - face- to-face, T.V. monitor? 10022300 Are prisoners isolated for any reason? What are the reasons? Are special precautions made for health and safety of isolated prisoners? Is the facility equipped with a safety/padded cell?
CL18

Are clean blankets, and mattress covers if needed, issued to each prisoner? Are soap and towels available? Are clean jail clothes available? What is procedure on arrestees with unsanitary or contaminated clothes? .... 100000000 1000000
CL19

A STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE STATE OF THE NAME OF THE
CL20

NAME OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE PERSON OF THE 0.04% 1000000 2000
CL21

. A STATE OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE AUDIT COMMITTEE PURPOSE The California Penal Code, Sections 925, 925a and 928, gives the Grand Jury responsibility and authority to investigate and report on the management policies and fiscal needs of County offices and departments, joint powers agencies and special purpose assessment and taxing districts within Los Angeles County, and to make fiscal audits of cities within the County. Until a recent amendment to the Penal Code, the Grand Jury was charged with responsibility to periodically review each County department. Tasks related to the carrying out of these activities have traditionally been delegated by the Grand Jury to the Audit Committee. This work in- cludes: selection of a contract auditor and of departments for review, consultations during the review process, and recommendations for approval by the Grand Jury. However, the Audit Committee acts only with the advice and consent of the Grand Jury as a whole. The Grand Jury is empowered to engage the services of experts to assist it in its investigations. In Los Angeles County, the Grand Jury has annually contracted with a firm of auditors to provide this service. SELECTION OF THE CONTRACT AUDITOR In June of 1981, requests for proposals were sent by the 1980-81 Grand Jury to firms that had expressed an interest in serving the Grand Jury as its contract auditor. The 1981-82 Audit Committee studied the proposals, interviewed representatives from each of the firms submitting proposals, and sought information from previous clients regarding their experience in working with various firms. Concurrently, the Committee was considering potential subjects for audit, with a view to identi- fying which firms had locally-based personnel with specialized experience necessary to expedi- tiously carry out the work of the Grand Jury. On August 10, 1981, Peat, Marwick, Mitchell and Co. was recommended by the Audit Committee, and was selected by the Grand Jury as its contract auditor. SELECTION OF DEPARTMENTS FOR REVIEW The Grand Jury determined that the first County departments to be considered for review should be those which had never been audited by a Grand Jury. The period of time since a previous Grand Jury audit was a second important criterion. Having developed a list of depart- ments using these criteria, the Audit Committee sought information from the Auditor-Controller and the Chief Administrative Officer (CAO) regarding recent reviews of County departments by those offices. In addition, members of the Grand Jury were invited to suggest departments or subjects for audit. The list of tentative audits was reduced to a number which could potentially be completed within the term and fiscal resources of the Jury, and the final list was approved by the Grand Jury August 31, 1981. AUDIT COMMITTEE REVIEW PROCESS At least two members of the Audit Committee were assigned to work with the contract auditor on each audit. Audits were begun by consultation with the Auditor-Controller's Office, staff of the Chief Administrative Office assigned to oversee the department, and an entrance interview No. within the department. The contract auditor then conducted a preliminary review of the depart- ment and reported findings to the Committee. In some cases it was decided that further review should not be conducted by the current Grand Jury. If further review seemed warranted, the . Audit Committee and contract auditor agreed upon the focus of the audit. The contract auditor kept the Committee informed of its studies through progress reports and dialogue at regular committee meetings. Through this process Committee members gained an understanding of the . materials and recommendations being developed and an opportunity to comment on them. When the final draft of an audit was complete, the contract auditor, accompanied by one or more members of the Committee, conducted an exit interview, at which time a department TO STATE OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF THE PARTY OF TH official was able to review and comment on the report. MANNER OF CONDUCTING AUDITS Fiscal realities make it impossible for Grand Juries to conduct full-scale fiscal and/or manage- ment audits of departments of the size of most of those in Los Angeles County. Generally, the 2000 Grand Jury's objective is to review selected aspects of a department's operations to determine whether it has procedures, personnel and equipment to provide an appropriate level and quality of service, is operating in compliance with applicable laws, and has internal control mechanisms NAME OF TAXABLE PARTY. which provide the department's managers with information necessary to identify and correct problems, and to direct and plan so that the department can meet its goals.
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In order to increase the number of departments which could be reviewed within the Grand Jury's audit budget, the contract auditor and the Audit Committee devised innovative methods to carry out this work. The reviews done by the current Grand Jury and/or its contract auditor 10000 have been divided into three sections to reflect the manner in which they were performed: 1) full-scale reviews conducted by the contract auditor (including the Department of Mental Health review in which two Grand Jurors from the Mental Health Subcommittee assisted the No. of Contract of Contract of Contract of Contract of Contract of Contract of Contract of Contract of Contract of Contract of Contract of Contract of Contract of Contract of Contract of Contract of Contract of Contract of contract auditor) and combined reviews conducted by Grand Jurors with the assistance of the contract auditor; 2) limited reviews conducted by the contract auditor; 3) audits begun by the prior Grand Jury which were completed by the current Grand Jury with the 1980-81 contract No. auditor, and a follow-up requested by the prior Grand Jury of an audit made of the Department of Consumer Affairs by the Los Angeles County Auditor-Controller. Audits of the Department of Adoptions and the Department of Purchasing and Stores are those initiated in 1980-81. The second The reviews conducted by the 1981-82 Grand Jury contract auditor are reported in full in a separate volume which is on file at the office of the Grand Jury, the City of Los Angeles Public Library, the Los Angeles County Law Library and various university libraries. The audits begun
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by the 1980-81 Grand Jury and completed by the current Grand Jury in conjunction with the 1980-81 Grand Jury contract auditor are on file at the same locations but each as a separate report. Summaries of all reviews follow. (C) (C) (C) GROUP I - FULL SCALE REVIEWS
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GRAND JURY: Role and Effectiveness THE COLUMN The role of California grand juries in criminal indictments has diminished since the California Supreme Court decision in the case of Hawkins in 1978. Although the civil responsibility of California grand juries has always been equal in importance to their criminal role, this function of grand juries is less understood by the public, press, and even by grand juriors coming into office. Such widespread misconception of the authority and responsibility of the Grand Jury to act in a citizens "watchdog" capacity, combined with changes in use of the Grand Jury in criminal proceedings, appears to have prompted discussion in some quarters as to whether grand juries still perform an important role among government institutions. In fact, the Grand Jury provides a unique service for the citizens of Los Angeles County. Owing no allegiance to any elected or appointed official and having no economic interest in the out- come of its studies, the Grand Jury has credibility as an independent body respected for its independence. However, the size and complexity of departments and governmental units within its jurisdiction led the Grand Jury to conclude that a study should be made to determine the most effective ways of fulfilling its civil role. OBJECTIVES The objective of this review was to identify steps which could be taken to improve the effective- ness and efficiency of the Grand Jury. APPROACH The Grand Jury's contract auditor interviewed more than 25 public officials, present and previous Grand Jury foremen and members, as well as representatives from grand juries in other California counties. Applicable sections of the Penal Code, prior Grand Jury reports and other documents pertaining to the role and functions of California grand juries were studied. Following the document review and interview process, a "discussion matrix" outlining problems and issues was prepared and was used as the basis for discussion involving the contract auditor, the Audit Committee of the Grand Jury and interested members. It was agreed that the review should develop recommendations regarding qualifications for and selection of grand jurors, methods of providing continuity and follow-up, Grand Jury resources, and Grand Jury reports and their implementations.
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The Department appears to be performing well in meeting the requirements set forth in the Older Americans Act and the Older Californians Act. Of necessity those activities to provide communication links with senior organizations and to assure that programs are operated in compliance with State and Federal regulations must take priority in allocation of the Department's resources. The staff of the Department is knowledgeable, dedicated, and has a desire to initiate innovative programs to satisfy the stated but unmet needs of the elderly in the area. However, they are hampered by numerous regulations, budget limitations and, at times, political necessity. Despite the substantial amount of effort on the part of the Department to coordinate with other public and private groups, funding for programs comes mostly from public sources. A STATE Approximately half of the funds allocated under the Older Americans Act must be spent to provide nutrition services. It is, therefore, not surprising that programs which provide meals, either in a congregate setting or via home delivery, are the most widely available programs for . seniors and seem to be most equitably distributed throughout the County. A successful nutri- tion project appears to be the base on which to build a system of additional services for seniors. TOTAL CAR Ideally, a minimum package of other services available daily at each nutrition site should be information and referral, adult education and/or recreation. In addition, health screening and legal services should be provided at each site periodically. Transportation to the site should be available for the frail or disabled as well as in areas where local street conditions warrant.
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Considerable reliance on local organizations and seniors to focus attention on unmet needs in 200 their communities seems to have been intended as part of Federal and State law. The Grand Jury concluded that it is important to seniors' well-being to provide opportunities
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for them to feel needed, useful and capable of handling responsibility, particularly in relation to volunteer service. 2000 The Jury also observed that most seniors need the opportunity to talk and share with others. This need knows no economic or ethnic boundaries. Too much of the publicity surrounding senior programs has tried to justify them as ways to help the elderly poor when, in fact, what they do best is that which such programs were intended to do in the first place - help seniors remain independent and have happier lives.
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The limited review made of the Department of Building Services has indicated that relatively recent changes in County policy, an adverse economic climate, added responsibilities plus 200000000000000000000000000000000000000 additional workloads have provided challenges which must be faced and overcome by manage- ment. However, a properly phased substantial increase in contracting custodial services to competent private contractors should alleviate many of these problems. It is apparent to the Grand Jury that there is a substantial opportunity for cost savings to the County in this area.
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The Department of Consumer Affairs, a relatively new department, has experienced many successes in resolving consumer problems and in developing programs with considerable potential. Most of its problems appear to be due to inexperience in meeting requirements which are necessary in order for governmental units to document and be accountable for their activities, rather than from inadequate performance in actual delivery of service to the public. However, in an era of budget tightening, each government employee must not only be doing a given job but must be able to document that the job is being done in the most efficient manner. The availability of the type of services performed by the Department is an important resource to residents of Los Angeles County and should be continued. The recommendations of the Grand Jury herein are made with a view toward helping the Department and/or its function to survive.

* 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.