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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.
El Dorado County Grand Jury
• 2010-2011
5. There are no written bylaws to govern the District. There are several policy manuals which overlap, and are not
⚠️ 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 9 findings
F1
Page 70
Agencies which have signaled an interest in participating in joint efforts to improve prevention and response to mental health crises include: El Dorado County Sheriff’s Office, EDC Mental Health, Placerville Police Department, EDC District Attorney, National Alliance on Mental Illness, EDC Emergency Services Authority, EDC Mental Health Commission EDC Probation Department and Marshall Hospital.
F2
Page 70
This commitment to move forward resulted in written agreements, augmented participation in training programs, and expanded use of the Sheriff’s Department sponsored Multi-Disciplinary Team.
F3
Page 70
There is a lack of leadership structure supported by agency heads and the Board of Supervisors. This deficiency could make the joint effort less effective and subject to collapse should interagency conflict arise or public interest wane.
F4
Page 70
The potential for continued or increased encounters with persons in crisis is apparent according to available data. There is a significant increase in the at-risk population. For example, in El Dorado County there are 521 veterans who have been diagnosed with Post Traumatic Stress Disorder and 681 veterans receiving care for other mental health disorders. This group represents a small portion of the at-risk population in the county. 6 4
F5
Page 71
Declining revenues limit the ability of organizations to commit resources to these mental health incidents.
F6
Page 78
Hospital security failed to document important events and information from their shifts.
F7
Page 78
The video camera system is inadequate. There are areas in the Marshall Emergency Department that are not covered by cameras. The video recordings are retained for one week. AMBULANCE
F8
Page 78
As of October 25, 2010, revisions to the ambulance policy have been under discussion. Proposed changes would require that all 5150 patients riding in El Dorado County Emergency Service Authority vehicles be secured. Gravely disabled and incapacitated patients would be secured with gurney straps. Patients, who have a history of violence or are violent, agitated or angry, 7 2 coupled with the physical capability of inflicting harm and endangering themselves, would be placed in a four-point restraint. MULTI-DISCIPLINARY TEAM
F9
Page 79
Marshall Medical Center, Healthcare Security Services officers, Director of the Emergency Services Authority, and the USDA Forest Service Law Enforcement has expressed an interest in participating in the MDT.
Recommendations 7
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R1Page 67The urgent need for bylaws demands the immediate attention of the District. LAFCO should be consulted for assistance. The bylaws should include a process for the removal of a Board Member from office.
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R2Page 67A grievance procedure and grievance form should be developed without delay and be made available to all employees. RESPONSES Responses to both numbered findings and recommendations in this report are required in accordance with California Penal Code §933 and §933.05. Address responses to: The Honorable Suzanne N. Kingsbury, Presiding Judge of the El Dorado County Superior Court, 1354 Johnson Blvd., South Lake Tahoe, CA 96150. Report provided to PFPD BOD Chairperson for response. Elected officials under statute are given 60 days to respond, and non-elected officials are provided a 90-day response period from the release date of this report. 6 1 -007 REASON FOR REPORT The El Dorado County Grand Jury (EDCGJ) learned that a number of recent encounters between law enforcement and persons in emotional crisis have resulted in confrontations leading to injury or even death. An investigation was initiated to develop workable recommendations for interagency collaboration that would reduce risks to officers, subjects and citizens.
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R3Page 67HSS security staff needs training in documenting important events that occur on their shifts related to the monitoring of 5150 patients. All daily security notes regarding 5150 patients should be provided to the Charge Nurse.
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R4Page 67The purpose, current usage and configuration of the video monitoring system should be re-evaluated. The current system must be upgraded if it is going to be of any use in preventing another incident. 7 3 AMBULANCE
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R5Page 68The Executive Director of the El Dorado County Emergency Medical Authority has proposed changes to the Ambulance 5150 policy that are intended to reduce the likelihood that a patient would harm themselves or others. The proposed changes should be reviewed by other agencies; especially Marshall Medical Center, which has policies and procedures for transporting persons with mental health issues. MULTI-DISCIPLINARY TEAM
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R6Page 68Marshall Medical Center, Healthcare Security Services officers, Director of the Emergency Services Authority, and USDA Forest Service Law Enforcement should be included in MDT training. EL DORADO COUNTY
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R7Page 68El Dorado County should have a designated health facility where 5150 patients and others with mental health impairments would be evaluated and treated in a safe, secured environment. RESPONSES Responses to findings and recommendations in this report are required in accordance with the California Penal Code §933 and §933.05. Address responses to: The Honorable Suzanne N. Kingsbury, Presiding Judge of the El Dorado County Superior Court, 1354 Johnson Blvd., South Lake Tahoe, CA 96150. This report has been provided for a response to the following agencies: Director, Health Services Department, 670 Placerville Drive Suite 1B, Placerville, CA 95667 Chief Executive Officer, Marshall Medical Center, 1100 Marshall Way, Placerville, CA 95667 Healthcare Security Services Supervisor, Marshall Medical Center, 1100 Marshall Way, Placerville, CA 95667 Executive Director, Emergency Services Authority, 480 Locust Road, Diamond Springs, CA, 956667 El Dorado County Sheriff, 300 Fair Lane, Placerville, CA 95667 Chief, Placerville Police Department, 730 Main Street, Placerville, CA 95667 7 4 Chairperson, El Dorado County Board of Supervisors, 330 Fair Lane, Placerville, CA 95667 Patrol Captain, El Dorado National Forest, 100 Forni Road, Placerville, CA, 95667 Elected officials under statute are given 60 days to respond, and non-elected officials are provided a 90-day response period from the release date of this report. 7 5 - 2011 OPERATIONS REVIEWS AND THE POTENTIAL FOR PUBLIC/PRIVATE PARTNERSHIPS Case Number GJ010-018 REASON FOR REPORT Grand Jury investigations and reports on El Dorado County government have produced a recurring picture. Though there is an increasing need for government to become more efficient and effective at less cost, there has been a lack of initiative and due diligence in assessing and evaluating the operations and performance of county government. The functions and operations of county government, the mechanics of actual governance, have not been reviewed or updated, to the point where it is now out-of-step with the need and demand for change. The County should show a willingness to utilize relevant experience and expertise from outside county government…from the various sectors of business, education, professional services, non-profits, even the general public…to participate in much needed operations reviews of departments, functions, systems, operations and processes. Such an outreach effort could provide valuable perspectives and relevant knowledge when properly focused. This investigation reveals that relevant and needed experience and expertise exists in abundance among the citizenry of El Dorado County, and is just waiting to be tapped and incorporated in long overdue operations reviews of county government. 76