Health & Human Services Committee Health and Human Services

Recommendations 48

• R05-52
  ARMC SECURITY PERSONNEL RECEIVE PROPER TRAINING IN ARREST AND SEARCH AND SEIZURE, AND BE ISSUED AND RECEIVE TRAINING IN THE USE OF PERSONAL DEFENSE ITEMS.
• R05-53
  THE ARMC HEAD OF SECURITY HAVE LAW ENFORCEMENT SUPERVISORY EXPERIENCE AT THE DIVISION LEVEL (LIEUTENANT), AND SUPERVISORS IN FIELD OPERATIONS WILL HAVE EXPERIENCE IN POLICE SUPERVISION AT THE SHIFT LEVEL (SERGEANT). 48
• R05-54
  ALL ARMC PERSONNEL RECEIVE CONTINUING EDUCATION IN ALL ASPECTS OF SECURITY RESPONSIBILITY INCLUDING ADVANCED FIRST-AID, IN ADDITION TO COMPLYING WITH THE COUNTY MANDATED TRAINING AS PER POLICY NO. 09-07 DATED JULY, 1991, ILLNESS/INJURY PREVENTION PROGRAM.
• R05-55
  CONDUCT STUDIES OF THE EFFICIENCY OF THE ARMC PARKING AREA LIGHTING. DO NOT WAIT UNTIL THERE IS A COMPLAINT, AS IS CURRENT POLICY.
• R05-56
  METAL DETECTORS SHOULD BE INSTALLED AND USED ANYWHERE THE PUBLIC CAN GAIN ENTRANCE TO THE ARROWHEAD REGIONAL MEDICAL CENTER.
• R05-57
  MAKE SURE THE LIGHTING SYSTEM IS ADEQUATE TO ENSURE THAT THE SECURITY CAMERA SYSTEM CAN PROPERLY COVER ALL OF THE ARMC PARKING AREAS.
• R05-58
  THE 800 MHZ RADIO SYSTEM CURRENTLY IN PLACE THROUGHOUT THE REST OF THE COUNTY BE IMMEDIATELY PLACED INTO SERVICE AT ARMC.
• R05-59
  INSTITUTE A PRO-ACTIVE LOSS PREVENTION PROGRAM THAT DOES NOT SIMPLY RELY UPON REGULARLY SCHEDULED INVENTORIES OF ARMC PROPERTY.
• R05-60
  REPLACE THE CALL BOXES CURRENTLY IN USE AT ARMC WITH MORE UNITS EQUIPPED WITH TALL MAST-MOUNTED LIGHTS, PLACING THEM THROUGHOUT THE CAMPUS. THESE CALL BOXES SHOULD BE EASILY IDENTIFIABLE.
• R05-61
  PLACE PORTABLE HEART DEFIBRILLATORS THROUGHOUT THE ARMC CAMPUS, OR AT LEAST MOUNT THEM ON THE SECURITY PATROL CARTS. TRAIN SECURITY PERSONNEL IN THE PROPER USE OF THESE DEVICES.
• R05-62
  SECURITY PERSONNEL ASSIGNED TO DETER GANG VIOLENCE IN THE EMERGENCY ROOM OR OTHER PLACES AT ARMC BE PROPERLY TRAINED AND EQUIPPED IN PERSONAL DEFENSE AND IN THE HANDLING OF DIFFICULT PEOPLE.
• R05-63
  ARMC ADMINISTRATION IMMEDIATELY EXAMINE AND ADOPT THE RECOMMENDATIONS CONTAINED IN THE SHERIFF’S FACILITY SECURITY ASSESSMENT DATED MARCH 18, 2002. 49
• R05-64
  POST EMERGENCY EVACUATION SIGNS AT ARMC IN OTHER LANGUAGES BESIDES ENGLISH.
• R05-65
  CHANGE THE COLOR-CODED WRIST BANDS USED BY VISITORS AT ARMD WHO NEED TO BE ON CAMPUS AT OTHER THAN REGULAR BUSINESS HOURS TO A DIFFERENT COLOR EACH DAY, AND CONFISCATE THE BANDS AS THE VISITOR LEAVES THE FACILITY SO AS TO DETER IMPROPER OR UNAUTHORIZED USE.
• R05-66
  SUFFICIENT NUMBERS OF HAZ-MAT SUITS AND PROTECTIVE GEAR SHOULD BE IN PLACE FOR BOTH SECURITY AND MEDICAL PERSONNEL AT ARMC.
• R05-67
  A FULLY DEDICATED CONTAGION ROOM CAPABLE OF CARING FOR MORE THAN A SMALL NUMBER OF PERSONS BE PLACED INTO SERVICE.
• R05-68
  EXPAND HAZ-MAT TRAINING FOR ARMC SECURITY PERSONNEL FROM THE PRESENT SIX EMPLOYEES TO ALL SECURITY PERSONNEL, WITH CONTINUOUS UPDATES.
• R05-69
  SINCE ARMC PRESENTLY HAS NO BACK-UP FOR ITS DOMESTIC WATER SYSTEM, A PLAN TO SAFELY TRUCK NEEDED ADEQUATE SUPPLIES OF WATER TO THE FACILITY BE IMPLEMENTED FOR THOSE TIMES WHEN THE WATER DELIVERY SYSTEM CURRENTLY IN USE IS INTERFERED WITH.
• R05-70
  TEST ARMC’S DOMESTIC WATER WELLS FOR MORE THAN JUST NORMAL BACTERIAL INFESTATION.
• R05-71
  THE WATER WELL SERVING THE ARMC FACILITY BE HARDENED AGAINST TERRORIST ATTACK BEYOND THE CURRENT CHAIN LINK FENCE, AND THE SYSTEM IS ALSO TO BE PROTECTED AGAINST ATTEMPTS TO INTRODUCE CONTAMINANTS INTO THE WATER SYSTEM.
• R05-72
  THE HOSPITAL GENERATOR SYSTEM SHOULD BE HARDENED AGAINST ANY INTRUSION. ACCESS TO THE GENERATOR SYSTEM SHOULD BE AVAILABLE TO FIRE SERVICES.
• R05-73
  VISIBLE GUARD SHANTIES BE PLACED THROUGHOUT THE PARKING LOT AT ARMC TO CONVEY A GOOD SENSE OF SECURITY.
• R05-74
  REINFORCE PRESENT DECORATIVE PLANTERS AT THE MAIN ARMC ENTRANCE, OR REPLACE WITH SOLIDLY PLACED BOLLARDS. Exhibit 1 PC§ 830.7 Non-Peace Officer with Power of Arrest The following persons are not peace officers but may exercise the powers of arrest of a peace officer as specified in Section 836 during the course and within the scope of their employment, if they successfully complete a course in the exercise of those powers pursuant to Section 832: (a) Persons designated by a cemetery authority pursuant to Section 8325 of the Health and Safety Code. (b) Persons regularly employed as security officers for independent institutions of higher education, recognized under subdivision (b) of Section 66010 of the Education Code, if the institution has concluded a memorandum of understanding, permitting the exercise of that authority, with the sheriff or the chief of police within whose jurisdiction the institution lies. (c) Persons regularly employed as security officers for health facilities, as defined in Section 1250 of the Health and Safety Code, that are owned and operated by cities, counties, and cities and counties, if the facility has concluded a memorandum of understanding, permitting the exercise of that authority, with the sheriff or the chief of police within whose jurisdiction the facility lies. (d) Employees or classes of employees of the California Department of Forestry and Fire Protection designated by the Director of Forestry and Fire Protection, provided that the primary duty of the employee shall be the enforcement of the law as that duty is set forth in Section 4156 of the Public Resources Code. (e) Persons regularly employed as inspectors, supervisors, or security officers for transit districts, as defined in Section 99213 of the Public Utilities Code, if the district has concluded a memorandum of understanding permitting the exercise of that authority, with, as applicable, the sheriff, the chief of police, or the Department of the California Highway Patrol within whose jurisdiction the district lies. For the purposes of this subdivision, the exercise of peace officer authority may include the authority to remove a vehicle from a railroad right-of-way as set forth in Section 22656 of the Vehicle Code. (f) Non-peace officers regularly employed as county parole officers pursuant to Section 3089. (g) Persons appointed by the Executive Director of the California Science Center pursuant to Section 4108 of the Food and Agricultural Code. (h) Persons regularly employed as investigators by the Department of Transportation for the City of Los Angeles and designated by local ordinance as public officers, to the extent necessary to enforce laws related to public transportation, and authorized by a memorandum of under- standing with the chief of police, permitting the exercise of that authority. For the purposes of this subdivision, “investigator” means an employee defined in Section 35075.61 of the Government Code authorized by local ordinance to enforce laws related to public transportation. Transportation investigators authorized by this section shall not be deemed “peace officers” for purposes of Sections 241 and 243. Exhibit 2 PC§ 832. POST Training (a) Every person described in this chapter as a peace officer shall satisfactorily complete an introductory course of training prescribed by the Commission on Peace Officer Standards and Training. On or after July 1, 1989, satisfactory completion of the course shall be demonstrated by passage of an appropriate examination developed or approved by the commission. Training in the carrying and use of firearms shall not be required of any peace officer whose employing agency prohibits the use of firearms. (b) (1) Every peace officer described in this chapter, prior to the exercise of the powers of a peace officer, shall have satisfactorily completed the course of training described in subdivision (a). (2) Every peace officer described in Section 13510 or in subdivision (a) of Section 830.2 may satisfactorily complete the training required by this section as part of the training prescribed pursuant to Section 13510. (c) Persons described in this chapter as peace officers who have not satisfactorily completed the course described in subdivision (a), as specified in subdivision (b), shall not have the powers of a peace officer until they satisfactorily complete the course. (d) Any peace officer who, on March 4, 1972, possesses or is qualified to possess the basic certificate as awarded by the Commission on Peace Officer Standards and Training shall be exempted from this section. (e) (1) Any person completing the training described in subdivision (a) who does not become employed as a peace officer within three years from the date of passing the examination described in subdivision (a), or who has a three-year or longer break in service as a peace officer, shall pass the examination described in subdivision (a) prior to the exercise of the powers of a peace officer, except for any person described in paragraph (2). (2) The requirement in paragraph (1) does not apply to any person who meets any of the following requirements: (A) Is returning to a management position that is at the second level of supervision or higher. (B) Has successfully requalified for a basic course through the Commission on Peace Officer Standards and Training. (C) Has maintained proficiency through teaching the course described in subdivision (a). (D) During the break in California service, was continuously employed as a peace officer in another state or at the federal level. (f) The commission may charge appropriate fees for the examination required by subdivision (e), not to exceed actual costs. (g) Notwithstanding any other provision of law, the commission may charge appropriate fees for the examination required by subdivision (a) to each applicant who is not sponsored by a local or other law enforcement agency, or is not a peace officer employed by, or under consideration for employment by, a state or local agency, department, or district, or is not a custodial officer as defined in Sections 831 and 831.5. The fees shall not exceed actual costs. DEPARTMENT OF BEHAVIORAL HEALTH BACKGROUND The County Department of Behavioral Health (DBH) provides mental health and substance abuse treatment services to adults over 18 years of age. DBH oversees County programs, residential treatment services and contract services. The clinic is staffed by clinicians, nurses, social workers and outreach individuals. All personnel are hired through the County Human Resources Department. Most employees are equipped to communicate with diverse cultures and languages. All newly hired personnel go through Cultural Diversity classes. If a language barrier becomes apparent, an AT&T line is available to assist patients and staff with someone that has the required communicative skills. The Arrowhead Behavioral Health Center located at Arrowhead Regional Medical Center (ARMC) includes a specialized inpatient behavioral health facility. It houses four inpatient units that are completely independent of each other. County DBH serves the needs of clients through 25 walk-in clinics and outpatient programs located throughout the County. The Inpatient and Outpatient Departments of Behavioral Health separated five years ago. Funding and resources are handled separately. FINDINGS The County Administrative Office advocates close coordination between both the Inpatient and Outpatient Behavioral Health departments. There is no Outpatient clinic located with the Inpatient clinic at ARMC. The goal of DBH is to bring an Outpatient clinic to the grounds of ARMC. The department has indicated a desire to convert one of the four Inpatient units into an Outpatient clinic. This unit would be based on the Cedar House program, which is an alcohol and drug treatment facility located in Bloomington. The County has a contract for 50 beds at Cedar House and their program is considered a treatment model. Cedar House has a high recovery rate, with only a two percent (2%) recidivism rate. A coordinated effort by both Inpatient and Outpatient Behavioral Health Services is to develop the new unit as an Outpatient treatment program. The goal of this unit will be to treat patients and help them to function in their daily lives. It is estimated that approximately 3,000 patients would utilize this facility annually. The Arrowhead Behavioral Health Center is used for “… admission and detention of mentally disordered persons for evaluation and treatment …” under Welfare & Institutions Code Section 5150. Protocol with these patients begins with voluntary or involuntary admission to one of the four Inpatient units. Efforts are made to calm patients down from a crisis and evaluate their needs. When the crises have abated, patients are then assigned to an Outpatient clinical program. Usual length of stay in the Inpatient Unit is five (5) days. DBH stated that released patients from the Inpatient units in need of Outpatient treatment as advised by the psychiatrist, could obtain mental health, substance abuse and other services within the Arrowhead Behavioral Health Center. They would best be served in a new Outpatient clinic. According to the department, funding solutions for the establishment of an Outpatient Clinic within the existing Inpatient Units at ARMC can be found. RECOMMENDATION
• R05-75
  DEVELOP PLANS TO INTEGRATE AN OUTPATIENT CLINIC WITHIN THE INPATIENT UNITS OF THE ARROWHEAD BEHAVIORAL HEALTH CENTER. PERFORMANCE, EDUCATION AND RESOURCE CENTERS (PERC) BACKGROUND The Performance, Education and Resource Center (PERC) was formed in July of 1999 through the merger of the Department of Public Social Services (DPSS) and Human Resources Department training units. The department offers a wide range of training and development services to public and private sector organizations. On an annual basis, 80 percent of PERC’s training schedule supports Human Services System (HSS) programs, with the Transitional Assistance Department (TAD) as the largest client. The other 20 percent of activities support countywide programs and services determined by the County Administrative Officer and the Human Resources Department. PERC offers more than 600 training classes annually. The classes are developed by the Training and Development supervisor or other training staff. If a County department has a specialized need not covered by PERC, a consultant may be brought in for expert instruction. The decision to use a consultant is made only after a cost benefit analysis is done. In June 2002 the Ethics Resource Office was established. The creation of this office was part of a comprehensive effort to change the ethical climate of the County, and as a direct response to ongoing political scandals. The purpose of the Ethics Resource Office is to provide clear articulation of the laws, rules, regulations and codes of conduct and ethics that govern County employees. The Ethics Resource Officer serves as consultant on ethical issues and dilemmas. The position offers oversight and gives recommendations on policies, procedures, practices and codes that promote or improve the County’s ethical climate. FINDINGS PERC utilizes several methods to check a student’s comprehension of course curriculum, which includes cumulative testing at the end. New employees can be terminated for not mastering required skills for their assigned positions. There is no formal evaluation of the students once they return to their job assignment. If an employee has a problem with job skills, the supervisor will refer them back to PERC for re-training. The Leadership Development Advisory Board, that provides feedback about employee performance, meets once a quarter. No survey or questionnaire is sent to the employees’ supervisors for feedback on performance and training effectiveness. Every new employee at orientation is asked to adopt and make a commitment to standards of behavior. The Code of Ethics (County Personnel Rule #1) is reviewed. There is no mandatory yearly review of the County’s Code of Ethics for current employees. No employee is required to sign the Code of Ethics as an acknowledgement of the review. Department supervisors have mandatory supervision and management classes that include the County Personnel Rules. The Gift Decision Reflection Process was created by the department to provide guidance to County employees in the acceptance of gifts from outside vendors, citizens or co-workers. This process is available to all County employees on the County’s intranet. The Ethics Resource Officer developed a list of 15 questions to guide an employee’s decision to accept a gift. This process is voluntary and the department agrees it is cumbersome. RECOMMENDATIONS
• R05-76
  PROVIDE AN EVALUATION FORM FOR SUPERVISORS TO COMPLETE AFTER EMPLOYEES RETURN TO THEIR JOBS FROM TRAINING. UTILIZE EVALUATIONS TO TRACK JOB PERFORMANCE AND SKILL PROFICIENCY AFTER TRAINING.
• R05-77
  A MANDATORY YEARLY REVIEW OF THE CODE OF ETHICS BE CONDUCTED FOR EVERY EMPLOYEE BY THE EMPLOYEE’S SUPERVISOR. EACH EMPLOYEE SIGN AND DATE THE CODE OF ETHICS AT THE TIME OF REVIEW.
• R05-78
  STREAMLINE THE GIFT DECISION REFLECTION PROCESS. CONSIDER ADVISING THE COUNTY ON A “NO GIFT” POLICY. DEPARTMENT OF PUBLIC HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES AND ANIMAL CARE ANIMAL CARE AND CONTROL BACKGROUND San Bernardino County Animal Care and Control is a program within the Environmental Health Services Division of the Public Health Department. The mission of Animal Care and Control includes prevention of the occurrence of rabies in both humans and domesticated animals, to minimize animal nuisances and hazards, to enforce all State codes and County ordinances, and to enhance public awareness through education. The County operates three shelters: Big Bear, Devore and Rancho Cucamonga. The administrative office, located in San Bernardino, answers all calls from the public, sells dog licenses, rents nuisance animal traps, receives and sends out all mailings for spay and neuter vouchers, and relays all necessary calls to dispatch. The Devore Animal Shelter is a facility operated by the County for the care and boarding of animals. The facility is located on a dead-end roadway that is just west of Cajon Boulevard (Old Route 66) and north of Institution Road. Members of the Grand Jury visited the Animal Care and Control administrative offices and the Devore Animal Shelter. FINDINGS The Animal Care and Control administrative offices located at 606 East Mill Street in San Bernardino, serving the public as well as employees, are inadequate. The waiting area for the public can accommodate only 3-4 chairs. The offices are cluttered and small. The conference room attached to the Program Manager’s office also stores boxes. The outside sign to direct the public to the office is on a single letter-sized paper taped to the front window. This large office building is shared by other tenants. Spay and neutering programs are facilitated by Animal Care and Control. The Board of Supervisors approved $180,000 in the year 2000 to expand spay and neutering operations. Of this, $150,000 is used for vouchers for the public and $30,000 is earmarked for a contract with the Humane Society for mobile spay and neuter clinics. Public awareness for clinics and vouchers is provided through fliers, public service announcements, newspapers, radio, local cable networks and a billboard on Interstate 10. Euthanasia of animals is a high stress job. The employees are allowed flexible scheduling of hours for euthanasia work and are able to ask for relief at any time. An Employee Assistance Program (EAP) is available, but no on-site counseling is offered. Before any animal is euthanized, a double check for microchips, tattoos and physical description is done. Software is used by the County to track animals from field to adoption. In 2003 there were 12,341 animals euthanized at the three County operated shelters. In 2004 there were 12,126 animals euthanized in the same three shelters. Employees who are troubled by the euthanasia process have no stress assistance or counsel available and, therefore, must rely on other employees for help. Citizen complaints regarding Animal Care and Control employees are directed through the main dispatch number. Supervisors handle the complaints. A complaint form is completed and when the complaint has been resolved, the form is filed. No complaints log is maintained for further review with management or employees. RECOMMENDATIONS
• R05-79
  REMOVE BOXES AND CLUTTER FROM THE ANIMAL CARE AND CONTROL ADMINISTRATIVE OFFICE SPACE. CONSIDER RELOCATING TO LARGER OFFICE SPACE.
• R05-80
  PLACE PERMANENT AND OBVIOUS SIGNS FOR THE ANIMAL CARE AND CONTROL ADMINISTRATIVE OFFICE TO FACILITATE PUBLIC ACCESS.
• R05-81
  PROVIDE ON-SITE COUNSELING OR EMPLOYEE ASSISTANCE PROGRAMS (EAP) FOR STRESS, AS NEEDED.
• R05-82
  CREATE AND MAINTAIN A COMPLAINTS LOG FOR PERIODIC REVIEW WITH MANAGEMENT AND EMPLOYEES. DEVORE ANIMAL SHELTER This animal shelter is a very busy place, with as many as 200 animals to be cared for on premises, at any time. While some animals are treated by technicians, others require treatment by a veterinarian. There is no on-premises veterinarian, so animals are required to be transported for treatment. Sick animals are segregated from the rest of the animal population, and seriously ill animals are taken to a local contracted veterinarian. The animals were in clean cages, and plenty of food and water was observed. The shelter has a written policy for animal euthanasia and, while this procedure is done at the facility, it is done after hours. Dead animals are removed from the premises by a commercial disposal firm. Complaint forms, should the public need them, are kept at the facility, but are not on display and must be requested. The office spaces were clean, but somewhat cluttered. The work space was confined. The employees rate security at the Devore Shelter as “poor”. The facility has no security cameras, either where the animals are kept or where people work and equipment is stored. When the shelter is closed, all but the “cat” room and lunch room are locked. The shelter protects areas not open to the public with signage and simple spring- type key locks. There is little or no deterrence to a person with intent to attack. There are no intruder alarms on the premises. Several years ago, on the shelter’s first day of business, a man armed with a knife injured several employees. As a result of that attack, a “panic alarm” was installed that sounds an audible device outside the building. It is not connected to any phone line or to any law enforcement agency. The device can only be heard by someone who may be passing on the dead-end roadway. Relying on a passerby to hear the alarm and recognize its significance and then call police, is ineffective and dangerous. A chain-link perimeter fence is poorly maintained, with several large man-sized holes cut into it. It was stated that there is no razor wire, as the shelter doesn’t wish to make a bad impression to the public. There was a request for repairs to be made to the fence, but employees indicated the fence is breached over and over. The perimeter fence has many crates and boxes stacked against it, allowing for a make-shift step ladder to go over the fence. There is no plan to move these items as the staff feels they are cramped for room. Gates are secured with chains and padlocks. There are no key pads or electronic surveillance to any of the gates or outer doors. The drugs used to treat the animals are stored in a large heavy locked safe. The door to the room is not particularly secure, but the safe within the room is secure. Drugs must be signed for, not so much for drug abuse, but for inventory tracking. Employees do not wear conspicuous name tags, as “everybody knows each other.” The public cannot distinguish an employee from others at the shelter. Sheriff’s work release persons are used at the facility and they, too, are not required to be identified. Visitors’ passes or I.D. tags for visiting persons are not used. Employees park in the general public parking area. A 2004 Sheriff’s Security Assessment found that this is undesirable for employee safety. The public parking area is not adequately lit at night, but electricians were observed in the animal compound installing additional lighting. The parking lots are to be done after the animal areas are done. There are no plans to install protective bollards in front of the facility to deter physical intrusion by a vehicle. There is a protective film placed on the surface of the west facing windows (parking lot). While this protective film is useful in reducing the radiant heat admitted to the building during hot, summer days, it reflects the light back into the building at night, and the employees cannot see into the parking lot. An intruder, or someone wishing to do harm to a person in the parking lot, can see quite well into the building, but people within cannot see out, and are thus at a serious disadvantage. At present, there is no key card system to access the facility, as is being done at other County buildings, but is under consideration. There is one 8" x 11" piece of paper posted on a wall behind the front counter advising of an emergency escape route. There are none in other places within the facility, even though some people on site may not be regular visitors or employees knowing the physical layout of the campus. During a one week period in 2003, 200 animals, including 80 goats, were stolen. Following are the numbers of animals stolen from the shelter since July 1, 2003: 7/1/03 – 6/30/04 7/1/04 – 3/31/05 15 – Dogs 11 - Dogs 1 - Horse 1 – Pot Belly Pig 1 - Duck 1 - Pigeon 3 – Game cocks 1 - Goat Shelter personnel stated that people simply cut the fence and walk in. The only action taken by the shelter to deter these thefts has been to lock the kennel doors. While the building is not equipped with sprinklers for fire protection, the kennels are cooled with a water mist and heated with buried radiant heat coils. Only $200 is ever kept on premises. Any sum over that is dropped in a safe and an armored courier truck makes a pick-up. The shelter has one vehicle available for employee use. Work release persons are not permitted to drive the vehicle and the keys to the vehicle are secured. A fire hydrant is located on the premises next to the public parking lot. The size of the water main or the hydrant capacity is not known by the employees. There are no portable defibrillators on the premises. It is not a requirement to be Cardiopulmonary Resuscitation (CPR) trained, although some of the employees are trained in CPR. The property to the south is County-owned property and staff would expand there if they were allowed to do so. The facility has no back-up generator system. If power fails, the facility is essentially shut down until the electricity is restored. There are no records kept on power outages but, historically, they occur during heavy winter storms. The facility is not serviced by natural gas, but instead has two large propane tanks to the rear of the property. The tanks are vulnerable to attack or product theft. In the room used by the veterinarian there were four hypodermic needles lying out and unattended. Some of the work release persons are in custody for drug or drug related paraphernalia charges. These unattended needles could have been picked up by anyone, especially the work release persons as they are unsupervised. RECOMMENDATIONS
• R05-83
  INSTALL GOOD QUALITY SECURITY CAMERAS TO DETER UNLAWFUL ACTIVITY AND TO ASSIST IN IDENTIFYING THOSE WHO DO COMMIT AN UNLAWFUL ACT AT THE DEVORE ANIMAL SHELTER.
• R05-84
  INSTALL KEY-PAD OR KEY-CARD LOCKS, IN ADDITION TO THE SIGNAGE, TO ENSURE THAT UNAUTHORIZED PERSONS CANNOT GET TO THE STAFF OR OTHERS ON SITE.
• R05-85
  CHANGE THE “PANIC”, AUDIBLE ONLY ALARM, TO ONE MONITORED BY A DISPATCH CENTER, EITHER PRIVATE OR LAW ENFORCEMENT.
• R05-86
  INSTALL INTRUDER ALARMS AT THE FENCE LINE SO THAT LAW ENFORCEMENT WOULD KNOW THAT THERE IS AN UNAUTHORIZED ENTRY ONTO THE PROPERTY.
• R05-87
  PLACE ALARMS ON THE CAGES, STALLS AND MAIN BUILDING SO THAT POLICE WILL KNOW WHERE THE INTRUDERS ARE WHEN THEY ARRIVE ON SCENE.
• R05-88
  INSTALL A MORE SECURE PERIMETER FENCE. CHAIN LINK CAN BE QUICKLY CUT, AND WITHOUT RAZOR WIRE IS EASILY BREACHED.
• R05-89
  EMPLOYEES WEAR CLEARLY VISIBLE IDENTIFYING OFFICIAL NAME TAGS AS IS DONE IN NEARLY ALL OTHER COUNTY BUILDINGS. 61
• R05-90
  IDENTIFICATION TAGS ARE TO BE WORN BY WORK RELEASE PERSONS, IDENTIFYING THEM AS SUCH.
• R05-91
  FOR ANY VISITOR WHO GOES PAST THE FRONT COUNTER, A VISITOR’S TAG IS TO BE WORN WHILE THE PERSON IS ON PREMISES AT THE DEVORE ANIMAL SHELTER.
• R05-92
  SEGREGATE EMPLOYEE PARKING FROM THE PUBLIC PARKING.
• R05-93
  ENSURE THAT THE PARKING LOT(S) BE WELL LIGHTED, WITH NO PLACES FOR AN INTRUDER TO HIDE.
• R05-94
  RESOLVE THE VISION PROBLEM CAUSED BY THE PROTECTIVE FILM PLACED ON THE WINDOWS OF THE MAIN BUILDING.
• R05-95
  CLEARLY POST THROUGHOUT THE FACILITY AN EMERGENCY EVACUATION PLAN WITH PERTINENT TELEPHONE NUMBERS SO THAT TRAPPED, INJURED OR ILL PERSONS CAN CALL FOR HELP.
• R05-96
  ALL EMPLOYEES BE CPR TRAINED AND POSSESS THE ADVANCED FIRST AID CARD AS ISSUED BY THE AMERICAN RED CROSS.
• R05-97
  ENLARGE THE SIZE OF THE DEVORE ANIMAL SHELTER BY USING THE COUNTY-OWNED PROPERTY LYING TO THE SOUTH SO THAT THE FENCE LINE CAN BE CLEARED OF STACKED MATERIALS AND CAGES.
• R05-98
  PUT IN PLACE A BACK-UP ELECTRIC GENERATOR SO THAT EMPLOYEES AND VISITORS WOULD NOT BE LEFT TO TRY TO FIND THEIR WAY OUT OF THE BUILDING IN THE EVENT OF A POWER LOSS.
• R05-99
  MAKE THE PROPANE GAS SYSTEM LESS VULNERABLE TO ATTACK AND PRODUCT THEFT. 05-100 SUPERVISE WORK RELEASE PERSONNEL, AND KEEP HYPODERMIC SYRINGES LOCKED UNTIL THE ACTUAL TIME THEY ARE TO BE USED. 05-101 PUT INTO EFFECT A PLAN TO REDUCE OR ELIMINATE THE THEFT OF ANIMALS FROM THE DEVORE ANIMAL SHELTER. VECTOR CONTROL BACKGROUND West Nile Virus (WNV) has returned and it is early. The record rains and warm weather could accelerate the spread of the West Nile Virus throughout the County, even into areas that largely escaped the disease last year. The virus has already been detected in December 2004 along the Mojave Narrows in the high desert, and in Ontario in January 2005 in sentinel chickens. Environmental Management and Vector Control are functions under Environmental Health Services, a division of the Department of Public Health. Vector Control is responsible for all citizen complaints and requests regarding community control of vectors. Vector-borne diseases are consistently monitored for their presence, including encephalitis, Hantavirus, plague, Lyme disease and West Nile Virus, among others. Inspections and abatement programs are utilized to control vectors that are a nuisance or transmit disease. FINDINGS County Vector Control serves all unincorporated areas, cities with contracts, and cities with emergency contracts. The West Valley Mosquito and Vector Control District that covers Chino, Chino Hills, Ontario, Montclair and Rancho Cucamonga is part of County Vector Control. It is also a member of the Mosquito and Vector Control Association of California. Those areas of the County not covered by Vector Control do not receive services. The County monitors the areas around the non-covered cities and may notify them when a problem is discovered. Emergency contracts have been offered by the County to non- contract cities. These are supported with a detailed Vector Control presentation only when requested by the city. Since the funding of Vector Control is derived from a property tax assessment, cities not currently covered would have to initiate a mail-out ballot for the city’s citizens to approve an assessment. In the event of a major vector borne disease outbreak, all County residents are covered by the Public Health Department. West Nile Virus (WNV) is a mosquito-borne virus that can cause illness and death in humans and horses. San Bernardino County Vector Control has been tracking the westward migration of the disease since 1999, through Arbonet, a program provided by the Center for Disease Control (CDC). The virus was first identified in the County in the fall of 2003. According to the State of California’s website on the West Nile Virus, San Bernardino County was second in the State in 2004 in the number of human infections. There were a total of 197 cases, resulting in five deaths. As of January 2005, the West Nile Virus will enter the third year of a three-year cycle in the County. As of March 1, 2005, news reports indicate West Nile Virus is arriving two months early. Public service announcements (PSAs), newspapers, and the County website are the predominant methods used to alert the public about the transmittal and prevention of this and other vector-borne diseases. West Nile Virus information was added four years ago to the Environmental Health Services fifth grade education program. In September 2004, fliers were distributed to one grocery chain to be included in their shopping bags. There are limited mechanisms in place for the County Public Health Department to disseminate important and timely public health information directly to cities, hospitals, and physicians, including vector control problems. There is no uniform policy to inform contract cities of procedures to respond to reports of dead birds, the disposal of dead birds or precautions to avoid exposure to the virus. Formal exchange of information is lacking between the County and most non-contract cities. Information is provided only upon request. The key to West Nile Virus eradication is individual participation since there is no aerial spraying done in the County. Ninety percent (90%) of the breeding areas for carrying West Nile Virus is in backyard locations such as birdbaths, old tires, children’s toys, animal water dishes and other points of water accumulation. The most vulnerable persons to contract WNV are senior citizens and those with chronic medical conditions. There is no immunization for WNV, but there are behavior modifications that can decrease the exposure of risk. These may include the use of DEET, staying indoors at dusk, wearing long sleeves, and eliminating backyard water sources. RECOMMENDATIONS 05-102 MAKE AVAILABLE CURRENT LISTINGS OF COUNTY VECTOR CONTROL SERVICES TO NON-CONTRACT CITIES. 05-103 BETTER UTILIZE THE CENTER FOR DISEASE CONTROL’S ARBONET TRACKING SYSTEM AS A PRE-EMPTIVE TOOL TO CREATE A PLAN TO DIMINISH ANY EFFECTS OF A VECTOR-BORNE DISEASE BEFORE IT REACHES THE COUNTY. PROVIDE PREVENTION AND CONTROL INFORMATION TO THE PUBLIC, AND AGGRESSIVELY TREAT BREEDING AREAS. 05-104 CREATE A PUBLIC HEALTH E-MAIL DISTRIBUTION LIST TO BROADCAST CURRENT INFORMATION AND ALERTS TO VECTOR CONTROL PERSONNEL IN ALL CITIES. 64 05-105 IMMEDIATELY INFORM EVERY RESIDENT OF THEIR INDIVIDUAL RESPONSIBILITY FOR THE ERADICATION OF VECTOR PROBLEMS. 05-106 MAKE INFORMATIONAL FACT SHEETS CONCERNING WEST NILE VIRUS AVAILABLE TO RESIDENTS OF ALL CITIES TO BE INCLUDED AS UTILITY BILL INSERTS. TRANSITIONAL ASSISTANCE DEPARTMENT BACKGROUND The Transitional Assistance Department (TAD) is responsible for administering the financial support programs to persons in need of financial, nutritional and/or medical assistance. The department also provides welfare-to-work services to CalWORKS recipients. The department’s goal is to meet the basic needs of families and individuals, while working with them to attain self-sufficiency and to promote work and personal responsibility. FINDINGS In September of 2004 the Consortium IV (C-IV) automation system was installed to replace Legacy System, the antiquated computer system used by San Bernardino and other California counties. Several other County departments have access to the C-IV system, namely Arrowhead Regional Medical Center, Behavioral Health, Children’s Services, Aging and Adult Services and Public Health. The departments primarily use the system for Medi-Cal screening. The 1,400 Eligibility Workers (EW) with TAD use the C-IV system to input the information from the client during the interview to complete the application for various benefits offered by the County. The C-IV program has the ability to determine eligibility for one or more programs and calculates benefits for the clients. Every EW was given up to two weeks of classes to provide basic navigational instruction for the C-IV program. Because of the varied computer experiences of each EW, many of them are having a difficult time with the program. The Consortium C-IV is in a fine-tuning period. TAD expects the program should be totally trouble free from installation. Because of the different learning curve of individuals, the ones that were familiar with computers caught on without much difficulty. However, the ones without basic computer skills were slow in learning the system. They had to quickly learn computer basics and learn how to navigate the new computer system at the same time. During the two-week training period, the EW’s stated they were not given time for hands-on training. TAD provided instructional coaches in all the offices. It was apparent that the EW’s who did not have any basic computer skills before the installation of the C-IV had the most difficult time learning the new computer system. The Eligibility Worker series job requirements before the installation of C-IV suited the job, but with the new C-IV system, having basic computer skills enhances the EW’s proficiency stature. Nearly eight months after the installation of the C-IV, the EW’s who became proficient on the C-IV had some suggestions on how the system could be enhanced by revising the procedures. There is a system called Committee on Problem Evaluation (COPE) comprised of EW’s, to look at issues and suggestions of workers. Some EW’s were unaware that suggestions to modify or change the program could be submitted. In some TAD offices, some work stations were configured so that the client would be sitting near the EW who is inputting the answers on the computer monitor. The client can view the information on the monitor quite easily, and this could violate the confidentiality of the client. RECOMMENDATIONS 05-107 RE-EVALUATE THE ELIGIBILITY WORKER JOB REQUIREMENTS TO INCLUDE, BUT NOT LIMITED TO, BASIC COMPUTER KNOWLEDGE. 05-108 MAKE ALL ELIGIBILITY WORKERS AWARE OF THE COMMITTEE ON PROBLEM EVALUATION (COPE) SUGGESTION PROGRAM. 05-109 EVALUATE ELIGIBILITY WORKER WORK STATION LOCATIONS TO REDUCE VISIBILITY OF CONFIDENTIAL INFORMATION ON THE COMPUTER MONITOR WHILE PROCESSING THE CLIENTS’ APPLICATION. VETERANS AFFAIRS DEPARTMENT BACKGROUND The County Veterans Affairs Department serves as an advocate for former members of the U.S. Armed Services, their families and survivors residing in the County of San Bernardino. Established in 1926, the department is the oldest county veterans’ service office in the state. The agency works with veteran’s organizations, community groups, local, state and federal governments to identify and secure all eligible benefits for veterans. The staff of the department works as a liaison between the veteran and the United States Department of Veterans Affairs. In fiscal year 2003/2004 the Department of Veterans Affairs was ranked fifth in the State in veteran population, third in the state for number of claims filed, and first in the State in the number of Medi-Cal Workload Units generated. Over 50 percent of the office workload is claims. The claims filed include survivor benefits, burial claims, appeals, and compensation. The Veterans Affairs staff served over 16,600 veterans during calendar year 2003. FINDINGS When a veteran comes to the department for a request, a full assessment is completed. On this initial visit the veteran is made aware of all eligible benefits and is given assistance in applying for these benefits. All veteran’s claim information is verified for accuracy and monitored as it is processed. A supervisory review of all open cases is done weekly. The State requires that Federal VA claims be processed within ten (10) calendar days. Processing of claims for County veterans has been reduced to less than a day, surpassing the department goal of three days. The New England Journal of Medicine (July 1, 2004) in a study, found that over 15 percent of returning veterans from Iraq suffered from Post Traumatic Stress Disorder. The study also found there were “important barriers” to the veterans receiving treatment. The County Veterans Affairs refers veterans in need of treatment to the VA Medical Center in Loma Linda. At no County cost, there is a contract with the San Bernardino Vet-Center to provide individual and group counseling sessions in the County Department of Veterans Affairs Victorville office in exchange for office space. Counseling services have been proposed for the Chino office in a similar effort to reach more veterans. The Director of Veterans Affairs meets with all Human Services Systems department heads once a month. Currently there is no County database of veterans being served by the various County departments. Preliminary discussions have been held for the creation of a database to better serve veterans who require assistance from other 68 County departments. As the veteran population increases and ages, other County departments will be essential in the overall management of services provided to the veterans. County departments may include, but not be limited to the Department of Aging and Adult Services, Jobs and Employment Services Department, and Behavioral Health. The Director of Veterans Affairs indicated this database would facilitate the pursuit of benefits for veterans and reduce redundant action by other departments. The San Bernardino office has an informational bulletin board and a computer available for use by the veteran. Copies of any information posted on the bulletin board are only made by the office staff if requested by the public. RECOMMENDATIONS 05-110 CREATE A DATABASE OF THE CLIENTS OF VETERANS AFFAIRS THAT CAN BE UTILIZED ACROSS COUNTY AGENCIES. 05-111 EXPAND EFFORTS TO PROVIDE COUNTY VETERANS AFFAIRS OFFICE SPACE TO THE SAN BERNARDINO VET CENTER IN EXCHANGE FOR COUNSELING SESSIONS, TO REACH AS MANY COUNTY VETERANS AS POSSIBLE. 05-112 PROVIDE A RACK IN THE SAN BERNARDINO OFFICE WITH PERTINENT BROCHURES AND PAMPHLETS FOR INTERESTED VETERANS. 69