Response from Sacramento County Board of Supervisors re Child Protective Services, Probation, Sheriff's and County Executive

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Adopt this report as Sacramento County’s response to recommendations contained in the 2009-2010 Grand Jury Final Report. 2. Direct the Clerk of the Board to forward a copy of this report to the Presiding Judge of the Superior Court and the Grand Jury Foreman. Measures/Evaluation Not applicable. Fiscal Impact The cost of responding to this report is approximately $3,000. Staff from CPS, the Probation Department, the Sheriff Department and the County Executive Office contributed to this report. These costs were absorbed within each department. — BACKGROUND Each year the Sacramento County Grand Jury concludes its work and releases its Final Report, typically the last week in June. The report, which can address a variety of activities, functions, and responsibilities of government, typically contains findings and recommendations with a response specifically directed to the Presiding Judge of the Superior Court. This response is required by October 1, 2010. The form of the County’s responses as required by law is as follows: Response To The 2009-2010 Grand Jury Final Report As to each Grand Jury finding, the responding person or entity shall indicate one of the following: 1. The respondent agrees with the finding. 2. The respondent disagrees wholly or partially with the finding in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons. As to each Grand Jury recommendation, the responding person or entity shall report one of the following actions: 1. The recommendation has been implemented, with a summary regarding the implemented action. 2. The recommendation has not yet been implemented, but will be implemented in the future, with a timeframe for implementation. 3. 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 officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency when applicable. This timeframe shall not exceed six months from the date of the publication of the Grand Jury report. 4. The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation. DISCUSSION The 2009-2010 Grand Jury Final Report required several responses from Sacramento County’s Child Protective Services, Probation Department and Sheriff Department. Child Protective Services In the chapter entitled The State of Foster Care in Sacramento County the report focused on Child Protective Services (CPS) and its ability to adequately provide for the safety and well- being of children in foster care. The report identified the following concerns: e Too many placements per child; e Too many social worker changes per child; e Inadequate social worker visits; e Lack of accurate health records; e CPS social workers and supervisors not following policies and procedures; e No database for available foster homes; and e Other problems identified by former foster youth and foster parents. In its report, the Grand Jury concludes there is no clear answer regarding CPS’s ability to ensure the safety and well-being of children in out-of-home placement. The report emphasizes that children do not thrive in unstable environments and acknowledges CPS’s efforts to restructure its Response To The 2009-2010 Grand Jury Final Report operations to provide more stability for children in care. Attachment | outlines the findings and recommendations. Probation Department In the chapter entitled Probation and Education at Juvenile Hall the report addressed issues relating to the provision of educational services within the Juvenile Hall which are provided by the Sacramento County Office of Education (SCOE). Findings and recommendations were addressed to both SCOE and the Probation Department. Attachment 2 provides responses to recommendations and Attachment 2A provides additional policy information as it relates to the Probation Department. SCOE will respond independently. Sheriff Department In the chapter entitled Rio Cosumnes Correctional Center (RCCC) the report addresses issues related to staffing levels, and safety of both inmates and staff in the aging facility. Attachment 3 provides responses to the findings and recommendations from the Sheriff and the Board of Supervisors. MEASURES/EVALUATION Not applicable. FINANCIAL ANALYSIS The cost of responding to this report is approximately $3,000. Staff from CPS, the Probation Department, the Sheriff Department and the County Executive Office contributed to this report. These costs were absorbed within each department. Respectfully submitted, STEVEN C. SZALAY Interim County Executive Attachments: Attachment | — Child Protective Services Responses Attachment 2 — Probation Department Responses Attachment 2A — Probation Policy Documents Attachment 3 — Sheriff Department Responses REVISED Attachment 1 COUNTY OF SACRAMENTO CALIFORNIA Response To 2009-2010 Grand Jury Final Report Department of Health and Human Services-Child Protective Services

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1 CPS should continue with the implementation of the change to the operational structure to have a single social worker follow a child throughout the CPS system. CPS has already implemented the first phase of the reorganization which reduced the number of social workers involved with a child when he/she first comes into care from four to one. The next phase involves restructuring the services provided to children from the time they are placed in out-of-home care until they exit the system or are placed in a permanent home. This restructuring will result in a child having one ongoing social worker during the time they are in foster care. These changes will be fully implemented by March 2011.

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1 Children in long-term placement who have a placement change should be visited by their social worker at the same frequency as that on initial placement. CPS believes that best practice calls for more frequent contact with children who are in out-of- home placement. In addition, beginning in 2011, State regulation will require that all waivers be eliminated and children be visited monthly by the county social worker. The only exception to this rule will be children who are placed in Foster Family Agencies (FFAs), since they do receive ongoing monthly visits by the FFA social worker. Best practice policies are being developed to determine when the FFA waiver exceptions can be used, as it may not be appropriate for some Child Protective Services Response To The 2010 Grand J ury Report children. CPS program managers and supervisors will continue to monitor the frequency of visits via the SafeMeasures database. In addition, the Systems Improvement Plan (SIP) goal for timely social worker visits is 95%.

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1 CPS should require each social worker to maintain a growth chart on each child in their care to help identify medical conditions or possible abuse or neglect. Any irregularities should be referred to the Public Health Nurses for review. Though CPS supports the principle of this recommendation, reductions in foster care social workers may prohibit implementation exactly as suggested. CPS is committed to developing a mechanism for monitoring children’s growth and reviewing irregularities with the Child Health and Disability Prevention Program (CHDP) nurses. This review is currently under way.

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1 CPS social workers should hold the foster parents accountable for taking the HEP with them for all medical, dental, counseling, and educational visits for the child, and having the provider update and correct it as required. Social workers will hold foster parents accountable for complying with medical, dental and mental health treatment plans. Foster parents who fail to comply will be reported to the appropriate licensing agency. In addition, social workers will utilize an interview template to obtain important child-related information including health information from foster parents during the required monthly contact. The interview template is currently under development with full implementation targeted for October 1, 2010. The HEP policy and procedure is being revised to ensure that medical and dental information received from the foster parent and medical provider is included in an updated HEP.

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1 When there are repeated allegations against a foster parent, a social worker from the CPS Foster Home Licensing Program should make an unannounced visit to the home to check on the welfare of the child and conditions in the home. CPS and Community Care Licensing (CCL) are developing protocols for a joint response and multi-agency review when two or more complaints are received against a foster home. These protocols will ensure coordinated early intervention to increase child safety as well as compliance with licensing regulations. The multi-agency review process is scheduled to launch on August 5". Target date for completion of the joint response protocol is August 20, 2010 and will include unannounced home visits.

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1 CPS should apply this six-child limit to all new placements in FFA foster homes. CPS is meeting with the FFAs on this issue and will be implementing the six-child limit for FFA foster homes

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1 In all cases CPS should, prior to placement, fully disclose all known medical, behavioral, educational and special needs of foster children to foster parents. CPS agrees that full disclosure is necessary to ensure the best possible placement match occurs, and that caregivers are prepared to meet the needs of the children entering their care. The processes for obtaining medical, behavioral, educational and special needs information at time of removal and communicating directly to the prospective care provider prior to placement is under review and will be revised to close existing gaps. Target date for full implementation of the improved processes is October 1, 2010. The process for children ages 0-5 will see immediate improvement when the Health Education, Assessments, Referrals and Treatment Services (HEARTS) for Kids program, funded by the First 5 Sacramento Commission is implemented this summer. The HEARTS for Kids program includes medical clearance exams as well as dental and developmental screenings for children ages 0-5 entering care. Information gathered during the medical clearance exam and dental and developmental screenings will be provided to the Child Protective Services Response To The 2010 Grand Jury Report social worker and the caregiver. Furthermore, the program includes home visits by a public health nurse and a mental health early intervention clinician to help the caregiver better understand the needs of the child and help the child adjust better to the new placement.

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1 CPS should survey foster parents to determine the topics in which they need additional training in caring for special needs children. Currently, CPS collaborates with American River College (ARC) to provide a “Medically Fragile” course for foster parents who care for children with severe medical needs. ARC is developing a survey to be distributed to foster parents in the fall of 2010 to assess their training needs and interests.

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1 All CCL or FFA reported violations should be sent to CPS and entered into the Child Welfare Services/Case Management System (CWS/CMS) file. CCL will be submitting to CPS reports of violations or other concerns involving foster homes. These reports will be screened and, if appropriate, sent to the social worker for information and/or follow-up. This new process will be included in the policy and procedure for placing a Child Protective Services Response To The 2010 Grand Jury Report hold on a county foster home and an alert on a certified foster family agency home. This policy and procedure will be finalized by September 1.

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1 CPS should develop a database that contains all the data needed to determine the best available foster home for each foster child. This can be developed in-house, contracted from another county, or a software developer. As stated under Finding 11.0 above, CPS is working collaboratively with foster families agencies and SCOE to develop a database to assist in finding appropriate foster homes within the school districts that serve foster youth. A Memorandum of Understanding has been executed between Sacramento County and SCOE to collaborate on this project. All foster family agency and county foster homes will be included in the database. Foster family agencies will be able to input information about their certified foster homes on the database for use by the CPSU. The database is scheduled to be ready for use by September 1, 2010..

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1 CPS management should require and enforce that all data concerning each foster child be entered into CWS/CMS as it becomes available. Child Protective Services Response To The 2010 Grand Jury Report The required content, processes, and timelines for entering information into the electronic data base, including health and education data, are under review. Clerical resources are being redistributed to support timely data entry of health information. Implementation of improved documentation standards will also include quality assurance processes to ensure compliance with the requirements. Full implementation is scheduled for October 1, 2010.

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1 CPS management should require and enforce greater utilization of SafeMeasures® and evaluate supervisors and managers on their use of the program. CPS program managers and supervisors are reviewing SafeMeasures® data at every supervision session. In addition, CPS leadership reviews SafeMeasures® data during weekly phone conferences to make sure all relevant safety, permanency and accountability indicators are being appropriately monitored. To ensure utilization of SafeMeasures®, CPS division and program managers receive a periodic report detailing staff's usage of SafeMeasures®. The latest report, issued in June 2010, analyzed the use of SafeMeasures® by supervisors in all CPS programs and identified those supervisors who did not meet required usage during the chosen month. The CPS performance evaluation tool includes an expectation that supervisors will use SafeMeasures® to monitor caseload activities and outcome compliance.

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1 CPS management should accelerate the effort to complete all sections of the CPS Policies and Procedures Manual. Due to the reorganization currently underway and the need to maximize efficiency, CPS will synchronize the remaining revision process with the different phases of the reorganization. Therefore, policies and procedures pertaining to the permanency phase will be updated as that phase is completed. This also allows for newly assigned policy and procedure staff to receive training in Information Mapping, as several of the staff previously trained are no longer with CPS due to budget cuts. The exception to this approach are policies and procedures related to health documentation and interview templates previously discussed. Guideline revisions related to these foster care areas are being prioritized. REVISED Attachment 1 COUNTY OF SACRAMENTO CALIFORNIA Response To 2009-2010 Grand Jury Final Report Department of Health and Human Services-Child Protective Services