5. There are no written bylaws to govern the District. There are several policy manuals which overlap, and are not

Recommendations 7

• R1

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  The 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.
• R2

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  A 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.
• R3

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  HSS 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.
• R4

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  The 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
• R5

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  The 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
• R6

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  Marshall 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
• R7

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  El 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