Ventura County Grand Jury • 2011-2012

Public Administrator/Public Guardian Review

Published: May 22, 2012 25 pages
View Original PDF

Findings and Recommendations 28 findings

F01
The internal controls and integration of administrative processes instituted within HSA and PAPG have significantly increased the accountability and fiscal integrity of the PAPG. The PAPG has instituted policy and process changes which mitigate the possibility of future fraud within the department. (FA-08)
No recommendations for this finding
F02
Documentation associated with fiscal control and internal controls has been developed and is being refined. Process mapping has been developed for portions of sub-payee processes but has not yet been refined into desk procedures. Contact forms for client visits have been developed. (FA-08, FA-09) 8 Public Administrator/Public Guardian Review
No recommendations for this finding
F03
All support contract services are acquired through existing contracts by other agencies or are acquired following County procedures. The PAPG is working with the Panoramic software vendor to tailor the software to their needs. (FA-15, FA-18)
No recommendations for this finding
F04
The PAPG has addressed the majority of the May 2010 opened audit action items. The following are notable exceptions: • Development of metrics within the new case management system- Until the processes within the PAPG are stable and documented, the complete application of metrics seems premature. Metrics must necessarily be considered surrogates for the major workload categories of the organization. Only some of these categories relate to data flowing through the case management system. Until proper metrics are articulated outside of the case management system and processes are documented, the developing of metrics within the software would seem premature. The current “Best Practices” policy contains numerous metrics associated with time that address effort rather than outcomes. Considering the size of the organization, regular measurement of these timelines as a basis for evaluating the PAPG does not seem practical. • Criteria for placement of LPS Conservatees should be documented in a Memorandum of Agreement between PAPG and Behavioral Health- Rather than a static criterion for LPS conservatee placement, a joint process has been developed by BH and the PAPG in establishing the Continuity of Care Committee. The Grand Jury considers this a more effective approach. • The PAPG should develop desk procedures for all operational areas- Policies have been developed in a number of areas but not to the level of desk procedures. This issue must remain open. The lack of operational procedures risks instability in the major processes and increases risk to the execution of the five major work categories. (FA-14, FA-16, FA-22) [Ref-05]
No recommendations for this finding
F05
The Panoramic database is central to the operations of the PAPG. The security, administration, and change control of that system is a core element in the protection of client assets. (FA-01–FA-04, FA-06, FA-07) (Att-02)
No recommendations for this finding
F06
The PAPG has been unable to meet its policy goals of visit frequency to conservatees. There has been instability in the PAPG staff. There has been a complete turnover in leadership within the PAPG since July of 2011. There has been a total staff turnover since the Grand Jury Review in 2001. There is no current use of interns to provide on-going staffing needs. Vacancies existed in July 2011 and continue in April 2012. Recruitment of new staff, projected growth in the client base, anticipated changes in the court, and mandated certification requirements Public Administrator/Public Guardian Review 9 necessitate an ongoing process of training and personnel development. (FA-01–FA-13, FA 19–FA-21)
No recommendations for this finding
F07
The large transactional workload and the effects of the work dealing with the mentally ill and the severely disabled seem to have contributed to turnover of PAPG workers. The term for the latter issue is empathy fatigue. (FA-06, FA-07, FA-28) [Ref-13]
No recommendations for this finding
F08
The role of a DPG requires understanding of public administration, property management, trust administration, ability to conduct investigations of assets, and sensitivity to the care and needs of PAPG clients. (FA-01)(Att-01)
No recommendations for this finding
F09
Training of personnel via on-the-job training (OJT) without documented standard practices increases the workload on management and staff which may lead to inconsistent program implementation. This result removes resources from documenting standard practices. Given the anticipated increase in workload for the PAPG there may be further delay in documenting PAPG processes and procedures. (FA-05, FA-06)
No recommendations for this finding
F10
Manual entries are subject to error. The inventory of property at the client’s residence requires handwritten lists prior to data entry into the Panoramic software. (FA-01, FA-15)
Related Recommendations (1)
R02
The PAPG should purchase lap-top or tablet computers with photographic capability for DPGs and CSWs with standard templates for performing inventories in the field, evaluating care facilities, and documenting contacts with conservatees. The templates should allow direct input to the Panoramic software. (FI-10)
F11
The wide geographic distribution of clients and the need for transportation, documentation, and visitation of conservatees consumes a significant portion of the workload of the PAPG. The documentation includes the status of the clients and the clients’ care facilities. Due to the distances traveled, the completion of a handwritten contact visitation form is occasionally completed after a visit. (FA-01, FA-11, FA-12, FA-26) (Att-01)
No recommendations for this finding
F12
The informal Continuity of Care Committee is an excellent example of cross departmental cooperation. (FA-14)
Related Recommendations (1)
R03
The PAPG and Behavioral Health Department should add to their memorandum of agreement the charter and procedures of the Continuity of Care Committee. (FI-12) [Ref-12]
F13
Client valuables are being stored in the cash cart and in the warehouse due to a lack of secure storage in the PAPG office. This is in violation of PAPG policy. There is a need for safe storage of clients’ small-sized assets and papers in a container near the offices of the DPGs. Accessibility to the Treasury vault by the PAPG needs to be based on the variable nature of the PAPG requirements in a timely fashion. In addition, the availability of secure storage must meet the size and quantity needs of the PAPG at various times, rather than an allocation of a fixed set of lock boxes. (FA-24)
Related Recommendations (2)
R04
The PAPG and the Treasurer-Tax Collector should review their current Memorandum of Understanding with respect to the use of the Treasurer- Tax Collector vault to allow more flexible access and storage. (FI-13) [Ref-13] Public Administrator/Public Guardian Review 11
R11
The PAPG should acquire a safe for client assets in the PAPG office. This would provide secure storage during the inventory and assessment process. (FI-13)
F14
The PAPG has no policy in place for liquidating assets after closure of cases. (FA-25)
Related Recommendations (1)
R05
The PAPG should, as part of their policy for closing cases, address the liquidation of assets of clients prior to closure. The policy should address the final distribution of funds to the Treasurer-Tax Collector. (FI-14)
F15
The existing vans for the transportation of conservatees are inappropriate for transporting clients of the PAPG. Transportation of the severely 10 Public Administrator/Public Guardian Review disabled and mentally ill in these vehicles is detrimental to client well- being. (FA-12, FA-13) (Att-02)
Related Recommendations (1)
R06
The Board of Supervisors should allocate a onetime budget increase to the PAPG for completion of documentation of necessary desk procedures, and for procurement of appropriate vehicles for transportation of PAPG clients. (FI-02 – FI-05, FI-15)
F16
The PAPG can anticipate workload changes in the Probate Court process based on further changes in the implementation of the Omnibus Conservatorship and Guardian Act of 2006. (FA-20)
No recommendations for this finding
F17
The present telephonic interactions between PAPG sub-payee processing and Behavioral Health case workers could be improved with Information Technology applications.(FA-09, FA-10)
Related Recommendations (1)
R07
The PAPG and BH should make a shared directory accessible to both the PAPG and BH case workers. The PAPG should export to the shared directory the most current transaction data of sub-payee clients from their local database. BH should export to the shared directory the most current assignment list of Behavioral Health case workers associated with sub-payee clients from their local database. This will reduce the necessity of multiple phone calls between the organizations. (FI-17)
F18
Although very many of the decedent clients are indigent, a number of the decedents are wealthy. The proliferation of e-mail in lieu of the U.S. Postal Service, online banking, and social media, have caused new technical and legal challenges to the PAPG search for assets, liabilities, and heirs. (FA-17)
Related Recommendations (1)
R10
The PAPG should request guidance from County Counsel, the Auditor Controller, and the Information Technology Department on the most appropriate techniques and procedures for acquiring control of and administering the electronic accounts of decedents—guidance to include instituting appropriate internal controls. (FI-18)
F19
The PAPG policy on fiscal operations does not address the frequency of the inventory count associated with all of the following: the vault in the PAPG office, the cash cart, the warehouse, and the Treasury vault. (FA-23)
Related Recommendations (1)
R12
The PAPG should update the fiscal oversight policy to establish the frequency of periodic inventory of client assets in the PAPG office vault, cash cart, warehouse, and the Treasury vault. The inventory should be reconciled to the Panoramic database and other inventory records. This inventory should include all sites yearly on a random basis chosen by the head of the PAPG Office. (FI-19). Public Administrator/Public Guardian Review
F20
GroupWise software system has a potential to exchange data with the Panoramic system to a greater extent than is currently utilized. (FA-27)
Related Recommendations (1)
R09
The PAPG should request the Information Technology Department evaluate the following: • a shared calendar, under GroupWise, to contain the planned activities of PAPG department members including, but not limited to, court appointments, patient transportation, site visits, department and interagency meetings, etc. • the automatic importation of GroupWise data above from Panoramic into the GroupWise shared calendar (FI-20)
F21
The PAPG is responsible for the review of conservatee placement, diagnosis, treatment, and medication and for the appropriate oversight action as conservator. (FA-01) Recommendations
Related Recommendations (1)
R14
The PAPG and the Health Care Agency establish a Memorandum of Understanding delineating joint roles, responsibilities, and reporting requirements for conservatees of the PAPG under treatment in County medical facilities, to assure compliance with existing law. (FI-21) Responses Responses Required From: Board of Supervisors (R-06) Treasurer-Tax Collector (R-04) Responses Requested From: Public Administrator/Public Guardian (FI-01-FI-21) (R-01–R-05, R-07–R-14) Behavioral Health Department (FI-12, FI-17) (R-03, R-07, R-13) Health Care Agency (FI-21) (R-14) Commendations The commitment of PAPG personnel to the health and welfare of their clients and their cooperation with this Grand Jury has been outstanding. References Ref-01. 2001-2002 Ventura County Grand Jury Report. Public Administrator and Public Guardian as Conservator http://portal.countyofventura.org/portal/page/portal/Grand_Jury/Report s/Archived_Reports_2000-2005/TAB4579523/report_af_papgc.pdf (accessed February 24, 2012) Ref-02. Attorney for Plaintiff Superior Court of the State of California. Plaintiff v Juanita Browne A/K/A Juanita Canley, Court No. 20060043109, Peoples Trial Brief and Points and Authorities Regarding Admission of Records, Filed September 10, 2008. Ref-03. County of Ventura Executive Office. Report on Review of Internal Controls and Compliance of the Public Administrator/Public Guardian (PAPG), Submitted by Thompson, Cobb, Bazilo & Associates P.C., February 2007. Ref-04. Ventura County Executive Office. Review of the Public Guardian/Public Administrator Objective 1; Implementation of Corrective Actions, Thompson, Cobb, Bazilo & Associates P.C., March 2007. Ref-05. County of Ventura. Auditor-Controller Follow up audit on the Operations of the Public Administrator/Public Guardian, May 2010, Thompson, Cobb, Bazilo & Associates P.C., May 15, 2010. Public Administrator/Public Guardian Review 13 Ref-06. California State Plan on Aging 2009–2013 http://www.aging.ca.gov/legislation/California_State_Plan_on_Aging_Ao A_2009-2013_06-30-2009.pdf (accessed March 9, 2012) Ref-07. Omnibus Conservatorship and Guardianship Act of 2006. Ref-08. Developing Conservatorship Performance Standards in the California Courts: Preliminary Observations. http://www.courts.ca.gov/documents/senate_paper.pdf (accessed February 27, 2012 ) Ref-09. Judicial Council of California Report. Subject: Probate Conservatorship Task force Recommendations to the Judicial Council, December 9, 2008. http://www.courts.ca.gov/documents/120908item10.pdf (accessed February 27, 2012) Ref-10. Judicial Council of California. Handbook for Conservators. http://www.courts.ca.gov/documents/handbook.pdf (accessed March 12, 2012) Ref-11. Stebnicki, Mark A., Empathy Fatigue, Springer Publishing Co., 2008. Ref-12. “Memorandum of Agreement Between Ventura County Behavioral Health Department and Ventura County Human Services Agency Public Guardian for LPS Conservatorship Services 7/19/11.” Ref-13. “Memorandum of Understanding Between County of Ventura Human Services Agency & Treasurer Tax Collector Oct 21, 2010.” Attachments Att-01. Workload of the Public Administrator/Public Guardian Att-02. Vans for the transportation of Conservatees 14 Public Administrator/Public Guardian Review Glossary TERM DEFINITION BH, Behavioral Health The Behavioral Health Department of Ventura County BOS Board of Supervisors Change Control A formal process of review and sequential change of software and associated documentation County Ventura County CSW Community Service Worker Desk Procedures Also known as Desk-top Procedures. A concise document that describes each work procedure needed to perform a specific job effectively, accurately, and consistently DPG Deputy Public Guardian Empathy Fatigue A state of psychological, emotional, mental, physical, spiritual, and occupational exhaustion brought about by prolonged exposure to emotional situations Grand Jury 2011-2012 Ventura County Grand Jury GroupWise The e-mail and calendaring system of offices of Ventura County HSA Human Services Agency of Ventura County LPS conservatee A conservatee established under the Lanterman- Petris-Short Legislation PA Public Administrator PAPG Public Administrator/Public Guardian PNI Personal Needs and Incidentals account for conservatees Probate conservatee A conservatee established under the Probate code Process Mapping The graphical portrayal of steps used to perform a job Sub-Payee The PAPG is the third party administrator for the assets of a client who is no longer under LPS or probate conservatorship. VISIO Software tool for graphic portrayal of process flows and organization charts Public Administrator/Public Guardian Review 15 This page intentionally blank 16 Public Administrator/Public Guardian Review Attachment 01 Workload of the Public Administrator/Public Guardian Public Administrator/Public Guardian Review 17 This page intentionally blank 18 Public Administrator/Public Guardian Review Responsiveness to the Court a. Transportation of client to the court b. Representation to the Court c. Meeting Court Schedules d. Completion of Inventory and Appraisal e. Provide Care Plan to Court —Level of Care Plan and status reports Protection of Client Welfare f. Referrals of clients i. Hillmont Psychiatric Hospital, Aurora Vista del Mar ii. Adult Protective Services iii. Court g. Search for alternative conservators h. Participation in the Rapid Response Team (Elder Abuse) i. Participation in the placement of clients ( Continuity of Care Committee) j. Reviewing client care plan k. Reviewing client medications l. Transportation of client between care facilities m. Client visitation—in-county monthly, out-of-county quarterly n. Obtaining client benefits o. Contacting client relatives p. Overseeing client burial q. Collecting client funds and paying bills, cash and checks sent to Treasurer, checks paid through Auditor-Controller r. Ensuring personal needs and incidentals of clients s. Paying bills of sub-payees in support of Behavioral Health case workers Protection of Client assets t. Location and identification of assets and liabilities, financial assets, real assets u. Identification and collection from insurance on conservatee and property v. Maintenance of insurance on conservatee and property w. Inventory of client assets x. Liquidation of real and personal property y. Storage of personal property z. Transportation of personal property between care facilities aa. Search for heirs Effective Case Management and administration bb. Case file establishment and maintenance i. Fiscal files ii. Client files cc. Opening cases dd. Closing cases ee. Panoramic software change management Public Administrator/Public Guardian Review 19 ff. Procedural changes for entering data into Panoramic gg. Tracking case status Effective Office Administration hh. Allocation of personnel and responsibilities ii. Vendor Contract Management jj. Collecting client fees kk. Planning, programming and Budgeting ll. Establishing and updating standard practice mm. Policy and procedure review and modification nn. Internal controls establishment and maintenance oo. Personnel recruitment, training, scheduling and evaluation pp. Maintenance and negotiation of organizational relationships i. Behavioral Health Department- MOU ii. Treasurer-Tax Collector MOA iii. County Counsel iv. Adult Protective Services v. Ventura Social Security office vi. Psychiatric Hospitals MOUs vii. Care facilities viii. Auditor-Controller Office 20 Public Administrator/Public Guardian Review Attachment 02 Vans for the transportation of Conservatees Public Administrator/Public Guardian Review 21 This page intentionally blank 22 Public Administrator/Public Guardian Review Public Administrator/Public Guardian Review 23
F22
The PAPG has developed a set of best practices which addresses numerous elements of the PAPG operation.
No recommendations for this finding
F23
Client assets are stored in the treasury vault, warehouse, cash cart, and vault in the PAPG Office.
No recommendations for this finding
F24
Some valuables are stored in the warehouse and cash cart that is, by policy, to be stored in the vault. The reasons given were: (1) appraisal was not done by the County, though appraisal of the material was included in estate files; (2) the bulk of the material could not fit into the drawers allocated to the PAPG by the Treasurer-Tax Collector; (3) inconvenience of using the treasury vault.
No recommendations for this finding
F25
Valuables from two closed cases have remained in the Treasury vault for over five years. There is no policy for disposal of closed case inventory.
No recommendations for this finding
F26
The PAPG policy is to visit clients who reside in the County on a monthly basis and clients residing out of the County every three months. Although the DPGs visit clients from time to time, a majority of client contact is by CSWs. The PAPG has developed a client contact form to document observations of board and care facilities and to document contacts between CSWs and the conservatees.
No recommendations for this finding
F27
The PAPG office utilizes the County-wide Novell GroupWise e-mail software and associated utilities.
No recommendations for this finding
F28
As members of one of the caring professions, DPGs are susceptible to a sense of anxiety, stress, and sense of loss, grief, and over-identification with clients. This can lead to a negative shift in the way these professionals view the people they serve. Sometimes this results in emotional, mental and physical exhaustion. [Ref-11] Findings
No recommendations for this finding

Commendations 2

No Responses Found 3

Government entities assigned to respond to this report. No response documents have been linked in our database.

Camarillo Health Care District Special District
Ventura County Board of Supervisors Elected County Office
Ventura County Treasurer-Tax Collector Elected County Office