Score: +5 (5/10/0)

Monterey County Grand Jury • 2022-2023

Public Guardian the Final Helping Hand: a Mandate to Care Stock photo from Microsoft 365*

Published: May 19, 2023 16 pages

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⚠️ 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 and Recommendations 8 findings

Adult Protective Services does not have sufficient access to professional Capacity Determinations for potentially-eligible clients to be referred to the Public Guardian.

Related Recommendations (1)

Adult and Aging Services engage a licensed professional to provide all necessary Capacity Declarations for Adult Protective Services' clients and/or collaborate with existing professional resources in other County Departments to fill this need

Written policies and procedures exist, but it does not appear that they are fully utilized by staff.

Related Recommendations (1)

The Public Guardian Bureau adopt an approved and accessible policies and procedures manual to standardize operations and assure that staff is fully aware of and compliant with the stated policies and procedures

The Civil Grand Jury was unable to determine whether all staff interacting directly with clients with mental health diagnoses and medication needs were provided specific training to ensure their personal safety and build effective relationships.

Related Recommendations (1)

The Public Guardian Bureau initiate on-going mandatory training for staff on best practices for working with clients with mental illness

The Civil Grand Jury was unable to determine whether all staff interacting with clients from the criminal justice system or with incarcerated individuals have been provided with training on how best to ensure their safety and build effective relationships.

Related Recommendations (1)

The Public Guardian Bureau initiate on-going mandatory training for staff on best practices for working with criminally charged clients

Related Recommendations (1)

The Public Guardian Bureau update its website and brochure to include information about Capacity Declarations, referral procedures, self-determination, and family as first option

There is no locked Institution for Mental Disease facility in Monterey County, requiring LPS conservatees to be placed out-of-county, resulting in hardship for families, PG staff and for conservatees to re-integrate into their community.

Related Recommendations (1)

The Public Guardian Bureau evaluate the benefits of specialized caseload assignments versus mixed caseload assignments

A preference for Deputy PA/PGs to each specialize in a specific type of case was stated. They currently all do all types of cases.

Related Recommendations (1)

The Monterey County Health Department pursue mechanisms and options to have LPS conservatees housed within Monterey County to enable more family support, efficient use of staff time, and easier transition to lower level of care within the County

The Monterey County Health Department is commended for its commitment and work with the LPS, Probate and Representative Payee population.

No recommendations for this finding

Agency Responses 5

Government agencies' official responses to this report's findings and recommendations. Click on a response to see the structured breakdown.

County of Monterey's Health Director's Response to Public Guardian The Final Helping Hand: A Mandate

February 14, 2024 • 2 pages View Details ▾

PDF

County of Monterey's Response to Public Guardian The Final Helping Hand: A Mandate to Care

September 30, 2023 • 6 pages • 7 responses • Score: 0 (+0, 7, 0) View Details ▾

PDF

7 responses to findings and recommendations

HCD extend the hours of the noise complaint hotline beyond 10 p.m. on weekends to accommodate the extended hours of special events

Response: Implemented

Score: 0

R2, R3, R4, R5, R6-R7 RECOMMENDATIONS: Response With respect to each recommendation, pursuant to Penal Code, section 933 (c), the Department shall indicate one of the following: 1) That the recommendation has been implemented, with a swnmary regarding the implemented action; 2) That the recommendation has not yet been implemented, but will be implemented in the future, with a timeframe for implementation; or 3) That the recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a timeframe for the matter to be prepared for discussion...

HCD require code enforcement officers to consistently patrol areas known for noise complaints and unpermitted events

Response: Implemented

Score: 0

R3, R4, R5, R6-R7 RECOMMENDATIONS: Response With respect to each recommendation, pursuant to Penal Code, section 933 (c), the Department shall indicate one of the following: 1) That the recommendation has been implemented, with a swnmary regarding the implemented action; 2) That the recommendation has not yet been implemented, but will be implemented in the future, with a timeframe for implementation; or 3) That the recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a timeframe for the matter to be prepared for discussion by ...

Monterey County Sheriff prioritize filling currently budgeted sworn peace officer positions available for patrol in the Monterey County Sheriff’s Office

Response: Implemented

Score: 0

R4, R5, R6-R7 RECOMMENDATIONS: Response With respect to each recommendation, pursuant to Penal Code, section 933 (c), the Department shall indicate one of the following: 1) That the recommendation has been implemented, with a swnmary regarding the implemented action; 2) That the recommendation has not yet been implemented, but will be implemented in the future, with a timeframe for implementation; or 3) That the recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a timeframe for the matter to be prepared for discussion by the ...

HCD community outreach regarding permit requirements is insufficient to reach those who may be unaware of the need for special event permits.

Response: Disagree Partially Score: 0

There is a lack of information for the public to assess eligibility for a conservatorship and understand the referral process, confidentiality rules, and the limitations of the Public Guardian Bureau. F5 Response: The Board agrees with this finding. F6 There is no locked Institution for Mental Disease facility in Monterey County, requiring LPS conservatees to be placed out-of-county, resulting in hardship for families, PG staff and for conservatees to re-integrate into their community. F6 Response: The Board agrees with this finding. F7 A preference for Deputy P A/PGs to each specialize in a s...

HCD develop an outreach program to encourage residents to report any advertisements of planned special events and to call the hotline

Response: Implemented

Score: 0

R5, R6-R7 RECOMMENDATIONS: Response With respect to each recommendation, pursuant to Penal Code, section 933 (c), the Department shall indicate one of the following: 1) That the recommendation has been implemented, with a swnmary regarding the implemented action; 2) That the recommendation has not yet been implemented, but will be implemented in the future, with a timeframe for implementation; or 3) That the recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a timeframe for the matter to be prepared for discussion by the Boar...

MCSO develop a protocol with CHP to share information about large, possibly unpermitted events, to increase safe driving conditions in the area of the event, to be completed

Response: Implemented

Score: 0

R6-R7 RECOMMENDATIONS: Response With respect to each recommendation, pursuant to Penal Code, section 933 (c), the Department shall indicate one of the following: 1) That the recommendation has been implemented, with a swnmary regarding the implemented action; 2) That the recommendation has not yet been implemented, but will be implemented in the future, with a timeframe for implementation; or 3) That the recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a timeframe for the matter to be prepared for discussion by the Board (t...

HCD develop a public outreach program to inform residents of permit requirements for special events by December 31, 2023. 11

Response: Implemented

Score: 0

R7 RECOMMENDATIONS: Response With respect to each recommendation, pursuant to Penal Code, section 933 (c), the Department shall indicate one of the following: 1) That the recommendation has been implemented, with a swnmary regarding the implemented action; 2) That the recommendation has not yet been implemented, but will be implemented in the future, with a timeframe for implementation; or 3) That the recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a timeframe for the matter to be prepared for discussion by the Board (this...

Monterey County Department of Social Services Additional Response to Public Guardian, The Final Help

March 26, 2024 • 3 pages • 7 responses • Score: +3 (+3, 3, 0) View Details ▾

PDF

7 responses to findings and recommendations

Response: Unknown

Score: 0

The Board agrees with this recommendation. Department of Social Services (DSS)/ Adult Protective Services (APS) will pursue engaging with and procuring a qualified licensed provider to provide the necessary and complete Capacity Declarations by December 31, 2023. Update: DSS began the process for procuring a qualified licensed provider last year in July 2023. Since that time, they have obtained quotes from multiple providers. A scope of service has been developed, terms negotiated, and an agreement is being finalized. It is anticipated that the finalized agreement will be in place by the end o...

Response: Implemented

Score: 0

The recommendation has been implemented, All PGO policies are accessible. Staff will be reminded where to access policies and that polices must be consistently followed. The review of polices will occur during mandatory, biweekly staff meetings by December 31, 2023. Update: Completed. Public Guardian Bureau staff were reminded that policies must be followed and where to access such policies on the Public Guardian's shared document drive. Continuous review of existing and new policies occurs during mandatory bi-weekly staff meetings. R3. The Public Guardian Bureau initiate on-going mandatory tr...

The Public Guardian Bureau initiate on-going mandatory training for staff on best practices for working with clients with mental illness

Response: Will Implement

Score: +1

The recommendation will be implemented by September 30, 2023. Update: Ongoing. During the month of December, all PGB deputy staff became members of NAMI, National Alliance of Mental Illness to facilitate access to training, resources, and information on mental illnesses. Appropriate PGB staff will be attending NAMI's conference in June 2024. R4. The Public Guardian Bureau initiate on-going mandatory training for staff on best practices for working with criminally charged clients by September 30, 2023. 2egaP

The Public Guardian Bureau initiate on-going mandatory training for staff on best practices for working with criminally charged clients

Response: Will Implement

Score: +1

The recommendation will be implemented. PGO will develop a written policy and seek training resources related to best practices in working with criminally charged clients by September 30, 2023. Update: On-going trainings for criminally charged clients are presented by County Counsel to Deputy staff as needed during their mandatory bi-weekly meetings. A recent training was provided on March 11, 2024. R5. The Public Guardian Bureau update its website and brochure to include information about Capacity Declarations, referral procedures, self-determination, and family as first option by December 31...

The Public Guardian Bureau update its website and brochure to include information about Capacity Declarations, referral procedures, self-determination, and family as first option

Response: Will Implement

Score: +1

The recommendation will be implemented by December 31, 2023. The PGO will work with Health Department, Information Technology and Communications staff to update the website and brochure, providing a user-friendly overview of the referral process, legal process and what a conservatorship can or cannot do. Update: In progress. PGB staff has been working with Health Information Technology staff to update its webpages and brochure. The PGB expects to have these activities completed by March 31, 2024. R6. The Public Guardian Bureau evaluate the benefits of specialized caseload assignments versus mi...

The Public Guardian Bureau evaluate the benefits of specialized caseload assignments versus mixed caseload assignments

Response: Implemented

Score: 0

The recommendation has been implemented. It was determined that mixed caseloads are in the best interest of the public. The PGO has a relatively small staff with many senior deputies close to retirement. It is critical that staff are knowledgeable, trained and work a mixed assigned caseload. Lastly, the Class Specifications clearly indicates a deputy shall work a varying caseload. Update: Completed. After review and discussion with staff and County Public Conservator/Guardian, it was determined that mixed caseloads are in the best interest of the public and the clients we serve. R7. The Monter...

Response: Requires Analysis

Score: 0

The recommendation requires further analysis and discussions with Behavioral Health Bureau Placement team members and other stakeholders regarding viability of establishing additional capacity for varying levels of care needed to support our LPS conservatees in Monterey County. Discussions will be held by March 31, 2024. Update: In progress. The Department received State funds to invest in Bridge Housing and a Mental Health Rehabilitation Facility (MHRF). About 110 units will become available under Bridge Housing by early 2025 and about 100 beds will become available at the MHRF in 2027.

Monterey County Department of Social Services Director's Response to Public Guardian, The Final Help

February 14, 2024 • 2 pages • 2 responses • Score: +1 (+1, 0, 0) View Details ▾

PDF

2 responses to findings and recommendations

Adult Protective Services does not have sufficient access to professional Capacity Determinations for potentially-eligible clients to be referred to the Public Guardian.

Response: Agree Score: +1

</b> We agree that APS needs a consistent physician or psychologist to provide capacity determinations, particularly in-person and in client homes. Capacity determinations are needed to pursue conservatorships, as a last resort for clients who are no longer able to take care of themselves or arrange for their own care. Finding a licensed professional is critical at this time because the current neuropsychologist will be retiring this year. R1 of the Report is that Adult and Aging Services engage a licensed professional to provide all necessary Capacity Declarations for Adult Protective Service...

Response: Unknown

Score: 0

Monterey County Department of Social Services Response to Public Guardian, The Final Helping Hand: A

June 20, 2023 • 1 pages • 2 responses • Score: +1 (+1, 0, 0) View Details ▾

PDF

2 responses to findings and recommendations

Adult Protective Services does not have sufficient access to professional Capacity Determinations for potentially-eligible clients to be referred to the Public Guardian.

Response: Agree Score: +1

Response: Unknown

Score: 0

</b> DSS/APS agrees with Recommendation1. DSS/APS will pursue engaging with and procuring a qualified licensed provider to provide the necessary and complete Capacity Declarations by December 31, 2023. Thank you again for your report and recommendations that will help us better serve our vulnerable seniors and people with disabilities. Sincerely, in of Medine Lori A. Medina, MSW Director County of Monterey Department of Social Services mcdss.co.monterey.ca.us

No Responses Found 1

Government entities assigned to respond to this report. No response documents have been linked in our database.

Monterey County Board of Supervisors Elected County Office

* 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.