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Extracted from Consolidated Report
This investigation was originally published as part of a larger consolidated report containing multiple investigations. View the consolidated PDF for the complete document.
⚠️ Translation Notice: This content has been automatically translated. The original English text is the official version. Translation may contain errors.
⚠️ Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.
Findings 6 findings
F1
The Alcohol and Other Drug entities serving the alcohol and other to F1-F5 and R1-R6 Services Department has a lack of substance abuse population. The monthly sufficient personnel resources to meetings would include a designated point effectively handle case load and public person from the Board of Supervisors, INVITED RESPONSES outreach. Plumas District Hospital, The Sheriff's Office, the Alternative Sentencing Presiding Judge may respond to the entire
F2
While the Alcohol and Other Drug Program, and the Office of Probation. report. Services Department has a good working relationship with the Office of Probation, R4 The Grand Jury recommends that there is insufficient coordination and AOD and Plumas District Hospital Reports issued by the Grand Jury do communication between AOD and other administrators get together and come up not identify individuals interviewed. governing agencies. with a plan to transport intoxicated Penal Code section 929 requires that individuals who are willing to go to a reports of the Grand Jury not contain
F3
Competitive turf wars among medical detoxification facility rather than the name of any person or facts agencies that serve individuals with the County Jail. leading to the identity of any person alcohol and drug issues have created who provides information to the obstacles to creating an integrated R5 The Grand Jury recommends that Grand Jury. behavioral health services model therefore AOD immediately launch a public relations inhibiting their ability to serve these campaign to repair its public image and clients. increase its profile. PLUMAS COUNTY
F4
It is dangerous, and potentially life R6 The Grand Jury recommends that at threatening, to have Correctional Officers least one person be delegated from the MENTAL HEALTH overseeing individuals withdrawing from Board of Supervisors to assist the new SERVICES alcohol and other drugs at the County Jail Director in revamping AOD. rather than in a medical detoxification Challenges and Changes facility. REQUEST FOR RESPONSES
F5
The Grand Jury finds that the SUMMARY Alcohol and Other Drug Services Pursuant to Penal Code section 933.05, the Department closure for three years and Grand Jury requests responses as follows: Plumas County Mental Health Services fluctuating Directors (3 in three years) has (PCMH) had a year of challenges and made it difficult to maintain consistent changes. Multiple changes of Directors and treatment services and thus resulted in a From the following individuals: a community tragedy created some public negative public image. concern over PCMH’s ability to serve The Director of Alcohol and Other Drug Plumas County’s mental health needs. The
F6
The Plumas County Grand Jury In summation, Plumas County Mental finds that the Plumas County Mental Health Services is making a tremendous Health Department has a poor public REQUEST FOR RESPONSES effort to align with the state’s mission that image. not only is treatment available, but full Pursuant to Penal Code section 933.05, the recovery is possible. Today, we are learning Grand Jury requests responses as follows: how to prevent mental illness and promote RECOMMENDATIONS mental wellness with support and From the following individuals: treatment. Between seventy and ninety R1 The Plumas County Grand Jury percent of individuals have a significant recommends that the County hire a Plumas County Sheriff should respond to reduction in symptoms and improved sufficient number of Clinicians and/or F4, R4 quality of life with effective support and Therapists to cover the case load to be The Director of Plumas County Mental treatment. Plumas County Mental Health funded from the current operating budget. Health Services should respond to F1-F6, Services are a vital part of caring for all The county should consider recruiting and R1-R6 Plumas County citizens. The Plumas from the northern California universities County Grand Jury wants the best future and take interns into the system. It is From the following governing bodies: for our county. The results of the work of recommended that there be the this investigation are reflected in the consideration of tiered Therapist salaries The Board of Supervisors should respond following findings and recommendations: to attract job applicants, Therapist 1, to F1-F6 and R1-R6 Therapist 2, and Therapist 3, having the increasing job requirements attached. The governing bodies indicated above FINDINGS R2 The Plumas County Grand Jury should be aware that the comment or recommends Plumas County Mental response of the governing body must be
Recommendations 6
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R1The Grand Jury recommends that the mental health community are the Alcohol and Other Drug Services The Director of the Department of impacting PCMH. The new Affordable Department hire one more Substance Probation should respond to F3, R3, and Care Act was launched January 2014, Abuse Counselor and a Case Manager. The which means more people are now able to money could come from Federal Grants The Director of the Alternative Sentencing access mental health and substance abuse assisting rural counties in substance abuse Program should respond to F3, R3 care because both can be covered by treatment programs. insurance and Medi-Cal. As a result, since Plumas County Sheriff should respond to January, the average weekly new client
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R2The Grand Jury recommends that F4, R3, and R5 numbers have doubled, adding to demands AOD be integrated into a Behavioral on Plumas County Mental Health Services’ Health Services Model. Plumas County District Attorney should already stretched staff and resources. In respond to F3, R3 addition, County Administrators are in
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R3The Grand Jury recommends that discussion about the best way to integrate program Directors meet monthly with the mental health services with other entities AOD Director to come up with a unified From the following governing bodies: Plumas County Grand Jury Report to come into alignment with current that operate as a triage: those with the inadequate time to do much more that California state standards under the highest needs are served, while others wait write prescriptions. Telepsych allows for Behavioral Health Model. for services. There needs to be an increase many more opportunities to interface via a of mental health Therapists and staff to screen with support staff present for Yet another important change and meet the increasing needs of Plumas psychiatric services. At the end of the challenge this year for PCMH is Telepsych, County. session, clients complete a Satisfaction Plumas County Mental Health Services' Survey, which is not specific enough to the new psychiatric care program, where The Grand Jury found that PCMH’s Telepsych user and needs improvement to patients are treated through video greatest weakness is the “siloing” of accurately track satisfaction and recognize conferencing that was introduced in services, a lack of integration of services needed improvements to Telepsych to best August 2013. At the time of this report, the that creates difficulties serving all the serve the client. Telepsych is the new Satisfaction Survey being used to evaluate clients’ needs. In communication with trend for affordable care in small counties Telepsych was too general. An improved other entities, it is very difficult to statewide, and statewide mental health survey is needed to better serve the needs recognize clients with multiple issues, such departments and clients are adjusting to a of users. Last, and far from least, is a deep as alcohol and substance abuse, physical completely different form of psychiatric concern in the established way that PCMH health and mental health issues, and come care. handles 5150 clients—high risk individuals up with common goals and treatment with possible safety risks to themselves or plans. The state of California is making The Plumas County Grand Jury recognizes others in coordination with the Sheriff’s macro changes in the restructuring of that public safety is not an easy task. The Department (PCSD). services in mental health, public health, Plumas County Sheriff’s Department social services, and alcohol and other drug (PCSD) and Plumas County Mental Health The Plumas County 2013/2014 Grand Jury programs. The state is organizing these Services are following proper protocol in wanted to know how well Plumas County services under one umbrella using the the management of 5150s; however, this Mental Health Services serve Plumas Behavioral Health Model. In Plumas protocol doesn’t seem to be taking care of County. At the heart of the matter, is a County, there are multiple stand-alone business. The Plumas County Sheriff’s concern about how well PCMH services operating under new Directors, Department has stated frustration with communicates with their clients, staff, and who are starting to figure out the steps of PCMH’s lack of support in the handling of other department Directors. Another PCMH reorganizing their departments into 5150s. There needs to be a re-evaluation of concern is how they communicate with a Behavioral Health Model. The Plumas the 5150 hospitalization and release outside entities, such as the community, County Grand Jury sees this integrated procedures. PCMH needs to implement other programs, and other departments. approach as essential for these services to measures to improve communication and Given the changes and challenges PCMH is pull together to best serve their clients. trust by creating mental health trainings facing, the Grand Jury wanted to know the for the PCSD. strengths and weaknesses of the Plumas Plumas County Mental Health Services are County Mental Health Services. supervised by the Plumas County Board of Plumas County Mental Health Services is Supervisors (BOS). The Plumas County making a tremendous effort to align with In our investigation of PCMH, we started Grand Jury found lack of structure and California’s state mission of not only to see clear strengths and weaknesses procedure in place for consistent treatment being available for individuals within Plumas County Mental Health communication between PCMH with the with mental health challenges, but full Services. The 2013/14 Plumas County Board of Supervisors. In some cases the recovery. This can only happen by working Grand Jury is impressed with the personal BOS relied on the exchange of emails and well with other entities, identifying level of commitment of the PCMH’s personal relationships for exchange of challenges, and making appropriate employees, who are staunch advocates for a information. The system in place was that changes. population that suffers from PCMH should come to the BOS with any discrimination and are often stigmatized. problems or concerns. The concern of the BACKGROUND PCMH employees demonstrate a profound PCGJ is, is this enough? Is this adequate respect for the individual’s unique supervision and guidance during what The 2013/2014 Plumas County Grand Jury perspectives, problems, and solutions, in appears to be some incredibly challenging Investigations were underway and Plumas spite of being under tremendous pressure times for Plumas County Mental Health County Mental Health Services was not to meet the needs of the mental health Services? one of them. However, the topic of PCMH community with inadequate staff and continued to come up. During the resources. Currently, PCMH is Plumas County Mental Health Services' investigation on the Alcohol and Other experiencing a rising number of people new Telepsych program is a change from Drugs Department the PCGJ kept hearing with mental health-related issues seeking importing a Psychiatrist monthly to come about a lack of coordination with many treatment. There are long waiting lists to the county at high cost and with other departments, including PCMH. Plumas County Grand Jury Report There were newspaper articles on multiple 11-10) Alcohol and other Drug Services – AOD changes of Directors, a heartbreaking tragedy in our community that seemed to (cid:129) Mental Health’s Internal Auditing Plumas County Sheriff’s Office- PCSO have something to do with Plumas County Results Mental Health Services, and a member of Plumas County Sheriff’s Department – the BOS interviewed on television (cid:129) Alzheimer’s Protocol and Community PCSD regarding a teen suicide questioning if Action Plan (1-13-12) PCMH is serving Plumas County with Board of Supervisors – BOS timely service. All of the above demonstrated a need to open an We also reviewed: California Highway Patrol – CHP investigation into how well Plumas County http://sacramento.cbslocal.com/video/9513 Mental Health Services is serving our Electronic Health Records—HER 658-plumas-county’s-mental-health-system- community. faces-major-scrutiny-following-teens- The Plumas County Grand Jury Assembly Bill 1467—AB1467—Assembly suicide/ interviewed members of the Board of Bill 1467 was the omnibus trailer bill that Supervisors, and administration and staff was passed as part of the Governor’s Fiscal The following articles were reviewed from at Plumas County Mental Health Services, Year 2012-13 state budget. AB 1467 made http://www.plumasnews.com: the Sheriff’s Office, Plumas County Jail, additional changes to the Mental Health and Alcohol and Other Drugs Services Service Act (MHSA) in the following areas: Investigation Concludes Deputy Shooting Department. We also toured several funding distributions, submission and was Justified facilities, reviewed many documents, and approval of County MHSA Program Plans, Board Names New Interim Mental Health researched current hot topics for mental Stakeholder Engagement Provisions, and Director health in the state. We wanted to find out state-level education. Family and Friends Sought Help Before how effectively PCMH communicates Teen Suicide within its own organization and with other Assembly Bill 109 – AB109-- This Public County Terminates Contract with Mental entities. Safety Realignment allows non-violent, Health Chief non-serious, and non-sex offenders to serve Therapist Takes Over Mental Health their sentences in county jails instead of Department - Interim Removed from Job METHOD OF APPROACH state prisons. However, counties can Title contract back with the State to house local Documents offenders. Site Tours The Grand Jury reviewed the following Mental Health Services Act Proposition 63– The Plumas County Grand Jury conducted documents from the Mental Health MHSA—Passed by California voters in site tours of the Mental Health Department: November 2004 as Proposition 63, Department, Health and Human Services authorized a tax increase on millionaires Building, the Sierra House, the Drop-In (cid:129) Plumas County Mental Health Service to develop and expand community-based Center, and the Plumas County Jail. Policy and Procedures Manual, (Revised 7- mental health programs, MHSA’s goal is to 17-2013) reduce the long-term impact on individuals (cid:129) State of California – Health and Human and families resulting from untreated Interviews Services Agency Department of Health serious mental illness. Care Services Final Report FY 2012-13 The Plumas County Grand Jury conducted Mental Health and Substance Use 11 interviews. We interviewed members of (cid:129) 2013 Triennial Audit – Plan of Correction Disorders – MHSUD—Mental Health the BOS, PCMH Directors, Administration, problems and substance use disorders Therapists, and staff, concerned citizens, (cid:129) Jail Protocol, Mental Health Notification sometimes occur together. This is because: and the Sheriff’s Department / Response Agreement (11-5-2007) certain illegal drugs can cause people with Administration and Deputies. an addiction to experience one or more (cid:129) Patrol, Memorandum of Understanding symptoms of a mental health problem, between Plumas County Mental Health mental health problems can sometimes
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R4The County should expand the Presiding Judge may respond to the entire maintaining/updating it, and what, if any, inmate work program to provide increased report. value there was in referring to it for any opportunities through implementation. reason. This includes designating more and varied tasks. This program could be used to Our full investigation of county-owned construct/install physical security Reports issued by the Grand Jury do properties was hampered by the measures at the jail to better protect the not identify individuals interviewed. incomplete and outdated information that facility. Penal Code section 929 requires that was available. We were not able to reports of the Grand Jury not contain properly identify, by district, what the
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R5It is recommended that one of these the name of any person or facts county owned, how a building was being expansions of the inmate work program be leading to the identity of any person used, potential environmental hazards, or that there are two inmates at the Animal who provides information to the if buildings were being adequately Shelter 5-7 days a week to 1) clean the Grand Jury. utilized, let alone, if there were buildings facility and 2) spend time with animals to available for potential business use. help socialize dogs and cats, making them more adoptable.
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R6At a minimum, the jail facility PLUMAS COUNTY REAL BACKGROUND should better screen inmates prior to ESTATE ASSETS placing inmates in dormitory cells. The It was considered possible that as county UNCLEAR dormitory rooms should separate the departments relocated or built new sentenced inmates from the non-sentenced facilities, communities could be left with to reduce inmate conflicts and not be several outdated, unusable, and in some