Los Angeles County Grand Jury 548 Hall of Justice Los Angeles 12, California*

Recommendations 6

• R1
  Proposed merger of the Human Relations Commission and Community Services Department.
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  Follow-up of the City and County Health Departments' merger.
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  Department 95, Superior Court.
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  Licensing of facilities providing Board and Care to persons between the ages of 16 to 65 years. MERGER OF HUMAN RELATIONS COMMISSION AND COMMUNITY SERVICES DEPARTMENT This Committee recommends the merging of the Community Services De- partment into the Human Relations Commission, the administration of the merged departments to reside with the Human Relations Commission. Following a number of meetings with the principals involved in the pro- posed merger, this committee feels a merger would effect a lessening of services duplication, a duplication which has proved costly and confusing. Although some savings would be effected, the principal benefit to be derived from this consolidation would be a higher level of service. FOLLOW-UP MERGER CITY AND COUNTY HEALTH DEPARTMENTS Meetings were held with the County Health Officer and several District Health Centers were visited. This merger appears to be accomplishing what had been hoped for by its formation. Problems incident to the merger have now been largely overcome. Advantages resulting have been mainly in the adoption of the best programs of each into the merged operation. There has been little reduction in staff-some has been achieved in the administrative function. MENTAL HEALTH DEPARTMENT (Court 95 of the Superior Court) This Court handles juvenile drug addicts, alcoholics, mentally retarded juveniles, the senile and mentally disturbed adults. After a review of the operation of the Court, consultation with psychiatrists, judges and attorneys, this Committee recommended to the Presiding Judge of the Superior Court that a Committee of Judges be appointed with a view toward standardizing the procedures of Court 95 to make possible continuity from year to year. In November, the Presiding Judge informed the Grand Jury such a com- mittee would be appointed early in 1968. SHELTER CARE FACILITIES Visits to approximately 20% of Sheltered Care Facilities for General Relief (GR) and Aid to Totally Disabled (ATD) recipients (selected at random from a list furnished by Central Registry) revealed unbelievably bad conditions, with very few exceptions, from the standpoint of facilities, cleanliness, food, safety and care. The exceptions, which were extremely well run, indicate that reasonably decent accommodations can be furnished at the support level pro- vided by the County. However, for the most part, GR and ATD recipients are living in conditions which are intolerable. According to the Department of Public Social Services, as of June, 1967, there were 75 homes in Los Angeles County listed with Central Registry serving persons between the ages of 16 and 65. In these homes, 406 GR and 300 ATD recipients receive an average grant of $102.70 per month, representing a total County expenditure of $870,000 per year. Granted this represents a small portion of the total County budget, the fact remains that these individ- uals are not receiving even reasonable value for the County's expenditure, and this makes it important. We have strong convictions that the Board of Supervisors should review the intolerable conditions in which these people live, and establish a licensing or permit procedure for these homes, making inspection mandatory on a periodic basis. If a home cannot meet the inspection standards, it should be eliminated from County use. SOCIAL SERVICES COMMITTEE Rita R. Barschak, Chairman Ruth Ellen Stransky, Secretary Anita Gene Chaikin Lesley G. Ericksen Perle B. Smith Edward C. Strandine Lorna Amy Wright SPECIAL REPORT Expenditures for public assistance in Los Angeles County during the last eight years have jumped from $178 million dollars to $382 million dollars an- nually, an increase of 115%. This Grand Jury has extensively examined the Medicare and Medi-Cal pro- grams, and the Aid to Families with Dependent Children Program. Based on our exposure to these segments of the medical aid and welfare system, and our discussions with public assistance officials, it is clear that these programs specifically, and the welfare network generally, require an immediate overhaul of rules, regulations, financial controls and administration at all levels. Despite the existence of many studies and the formulation of numerous welfare recommendations by responsible groups during the past few years, there has been little tangible action to halt the rising costs or to equalize the responsibility for program determinations with the responsibility for program costs. Our study of the AFDC Program, for example, led us to the following concerns and reactions: IT IS INCREDIBLE... . . . that the County could administer — and the State oversee — the Presumptive Eligibility Program ($12,000,000 per year) for more than three years with virtually no controls to insure the reporting of PE payments on Federal reimbursement claims. Presumptive eligibility payments are grants paid to a family apparently in need prior to an actual determination of their eligibility for county money. The Federal Government does not share in the payment of funds under this aspect of the program unless those receiving the aid are determined to be eligi- ble within two months after the first payment is made. . . . that the Federal Government has required a program to allow payments to applicants who are "apparently eligible" and "in immediate need", and yet has made its cost-sharing regulations so restrictive as to effectively negate Federal participation for about 1/3 of PE aid pay- ments. ... that under present permissive eligibility requirements, the County is making approximately $1,350,000 of aid payments each year to "pre- sumptively eligible" recipients who, in fact, are ineligible for AFDC. ... that although the eligiblility requirements for AFDC are generally few and permissive (a property search is not even required) - the County has been unable to accomplish an eligibility confirmation within two months after the month of first payment for cases receiving 23% of all PE payments. IT IS INCONCEIVABLE ... ... that departmental oversights and errors during the past year alone prevented the County and State from reporting for Federal cost reim- bursement approximately $948,000 of aid payments. ... that many of the prior errors will never be found because of the County's procedure of destroying Presumptive Eligibility cards not re- ported for Federal reimbursement. ... that the County has made duplicate payments to AFDC recipients at the rate of almost a quarter of a million dollars per year. ... that Federal regulations forbid the County to recover duplicate pay- ments from recipients unless the error is found within two months. IT IS UNREASONABLE ... ... for the State to require the County to appoint a caretaker for the family of an incompetent mother, require the County to include the in- competent mother in the aid budget, and then refuse to share in the cost of the incompetent mother's budget. ... that Federal and State laws require emergency aid payments, but the Federal and State governments refuse to participate in a major portion of the costs. ... that emergency aid — when deducted from a subsequent month's aid check — is not reimbursable by Federal and State funds. The same total amount is issued in either case, presumably for the same purposes; yet amounts issued by the County through its emergency sources be- come 100% County cost. IT IS ILLOGICAL ... ... for the County to be saddled with carrying out the State's dogmatic and inflexible rules when the State does not participate in the approxi- mately $33,000,000 of annual administrative costs incurred by the County. ... for the County to rely upon the State to audit reimbursement claims when many of the errors found are costing the County money because the State is finding them too late. ... that the State has been as much as four to six months behind in try- ing to find all the reporting errors included in the County's claims for reimbursement. ... to have regulations covering reporting and record keeping require- ments for the preparation of Federal reimbursement claims that are so complicated and massive that County Public Social Services people spend a great share of their administrative, social worker and clerical effort just attempting to accumulate the information for the claims. As this goes to press, the State Administration and the Legislature are struggling with the Medi-Cal Program and the multitude of problems — social, financial, and control — which have mushroomed since its inception 22 months ago. This Grand Jury calls on the administration and the State Legislature to:
• R5
  assign responsibility for straightening out the programs to a limited number of knowledgeable, competent, practical public welfare adminis- trators, with outside professional help, if necessary, and
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  give dollar-conscious legislative support to whatever measures are neces- sary to immediately reform the programs and to frame them into sensi- ble, financible long-range plans. RESOLUTIONS JUDGES The Grand Jury endorsed an increase by 14 the number of Los Angeles County Superior Court Judges. The Resolution was presented to the Board of Supervisors. The Board initiated action at the State level and the Legislature, prior to adjournment, approved the increase. BUILDING PURCHASE Grand Jury opposition to the County's acquisition of a department store building for the Museum of Natural History resulted in the Board of Super- visors subsequently abandoning plans for the purchase. MARSHAL-SHERIFF MERGER After reviewing past Grand Jury recommendations, the County Citizens Economy and Efficiency Committee Report, and its own independent analysis, the Grand Jury approved a Resolution urging the merger of the Marshal's Office into the Sheriff's Department. INSPECTION AND INFORMATION TRIPS The entire Grand Jury made inspection and information trips to the County facilities listed. The trips aided in a more effective approach to both the criminal and committee work of the Jury. Date Place 1/11/67 Sybil Brand Institute for Women 1/18/67 Rancho Los Amigos Hospital 1/24/67 Hall of Justice Jail 1/25/67 MacLaren Hall 2/1/67 Wayside Honor Rancho 2/15/67 California Institution for Men (Chino) 3/1/67 California Rehabilitation Center (Corona) 3/21, 22, 23 Poverty Areas: (Committees of Grand Jury) East Los Angeles South Central Los Angeles Pacoima & City of San Fernando 4/11/67 Preliminary Courts 4/12/67 General Hospital 4/15/67 Los Angeles Police Facility 5/17/67 Descanso Gardens 8/10/67 Marina Del Rey 9/26/67 Music Center 1967 LOS ANGELES COUNTY GRAND JURY Nominating Judge Jurors LYNNE A. FRANTZ, Foreman JUDGE ALLEN MILLER JUDGE ROBERT FEINERMAN RITA R. BARSCHAK, Secretary GEORGE A. CARTER JUDGE ARTHUR K. MARSHALL ANITA GENE CHAIKIN JUDGE RICHARD SCHAUER LESLEY G. ERICKSEN JUDGE JOE RAYCRAFT CLARENCE V. GOFFINET JUDGE JOHN PRESTON C. P. HEBENSTREIT JUDGE BERNARD LAWLER HARRY LEVINSKY JUDGE EUGENE E. SAX C. DREXALL McCULLEY JUDGE BERNARD LAWLER WILLIAM E. PARKER JUDGE JOSEPH A. SPRANKLE WILLIAM RASCH, Jr. JUDGE GEORGE A. DOCKWEILER KATHARINE J. RICHMAN JUDGE LLOYD S. NIX PHYLLIS M. SHERWOOD JUDGE LAURENCE J. RITTENBAND DANA M. SMITH JUDGE CLARKE E. STEPHENS PERLE BRATTON SMITH JUDGE NEWELL BARRETT EDWARD C. STRANDINE JUDGE JOHN F. AISO RUTH ELLEN STRANSKY JUDGE BAYARD RHONE PEARL TAYLOR JUDGE DAVID W. WILLIAMS PATRICK J. THOMPSETT JUDGE CHARLES A. LORING CHARLES F. VAN de WATER JUDGE CHARLES C. STRATTON GEORGE J. WELLINGTON JUDGE WILLIAM H. ROSENTHAL ARTHUR M. WERNER JUDGE GOSCOE O. FARLEY LORNA AMY WRIGHT JUDGE ALLEN MILLER