Gran Jurado del Condado de Sonoma
2018-2019
From the annual report
The consolidated year-end volume. The individual investigations it contains are listed separately below.
📑 Continuity Report
2018-19 Sonoma County Civil Grand Jury Continuity Report
From the consolidated annual report · 17 páginas
Individual reports (7)
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Recomendaciones adicionales
10
No vinculadas a hallazgos específicos.
R1:
The Sonoma County Board of Supervisors consider recognizing and designating broadband as a "Utility" that needs prioritization by October 31, further follow-up 2021. recommended Current Status: On March 2, 2021, the BOS approved a 5-year strategic plan that includes broadband deployment and access. It does not include designation of broadband service as a utility. Partially, no
R2:
By September 30, 2021, the Sheriff's Office develop a new Partially, no communications model to provide for sufficient telephone kiosks to allow further follow- the inmate population free telephone and video visitation for at least 90 up minutes per week until such time as a new communication contract is in recommended effect. Current Status: According to the Sheriff's Office, inmates are allowed 70 minutes of phone calls per week at a cost to them of $.07 per minute. Prior to Covid, inmates were charged $.21 per minute. There are no additional telephone kiosks in place and there are no video visits.
R4:
The Sheriff's Office and the Board of Supervisors work together to develop a plan by December 31, 2021, to increase the contracted Wellpath resources to fund four additional Wellpath discharge planners for mental health and medical assignment to the Main Adult Detention Facility. Current Status: Wellpath services have increased per 2023-24 Grand Jury report responses. N/A, Resolved
R5:
DHS will continue and expedite the Community Based Organization (CBO) contract evaluation and build performance metrics. Current Status: DHS has stated that it drafted and adopted specific budgetary policies and procedures in the summer of 2019 to address this finding. CAO staff continues to work closely with DHS Finance on budgetary matters— through the normal budget cycle and through board items. Despite this response, from 2022 to the present, DHS contract performance has been problematic, and no performance metrics are being published. Civil Grand Jury Report 2019-2020 Updated All recommendations resolved. Civil Grand Jury Report 2020-2021 Unfulfilled Commitments BROADBAND ACCESS IN SONOMA COUNTY: Broadband IS a Utility; The Quiet Crisis of Availability Implemented Unresolved Recommendations and Current Status Partially, no
R6:
By September 30, 2021, the Sheriff's Office, using the reserve Inmate Partially Welfare Trust funds, resume all inmate programs in existence pre-Covid, complete with funding at the same level once Covid restrictions are lifted. Current Status: According to the Sheriff's Office, inmate programs are being resumed. In-person classes as well as online classes are now offered. Resolved
R7:
The Sheriff's Office restructure the 10-member Inmate Welfare Trust Committee by December 31, 2021, to include more diverse representation, for example, community members, financial analysts, social workers and educators to bring the Committee more in line with the requirements of Penal Code 5006 regarding commission membership standards to State Prisons. Current Status: The jail does not have to abide by the penal code for state prisons. However, according to the Sheriff's Office there are now two civilians on the Inmate Welfare Trust Committee, including one educator. The remaining committee members are composed of Sheriff's Office staff. COVID MITIGATION AND THE COUNTY JAIL And its Unexpected Consequences Unresolved Recommendations and Implemented Current Status
R8:
By December 31, 2022, the Board of Supervisors will consult with the Partially, Human Resources Department to consider establishing an Ombudsperson for survey in progress in County employees to provide a neutral means to voice issues of concern. 2025 Current Status: The Human Resources Department responded that it plans to conduct an employee-engagement survey in 2024 to determine the best path forward.
R13:
By December 31, 2022, the Board of Supervisors and County Partially, no Administrator's Office work with the Department of Health Services executive further leadership team in developing an actionable plan to address work culture follow-up issues, including retaliation, harassment and bullying. recommended Current Status: DHS responded that it hired an equity manager in March of 2022 who was then hired away by Marin County. Recruitment is underway to fill this position. DHS developed an equity plan in December of 2022.
R14:
By December 31, 2022, the Board of Supervisors direct the County Partially, no Administrator's Office to work with the Department of Health Services' further executive leadership team to develop a clearly defined and actionable plan for follow-up internal communication that includes greater transparency and staff recommended participation throughout the department. Current Status: DHS responded that it published an internal newsletter, DHS Connect, in the fall of 2022. Video clips of DHS employees were produced in November of 2023 and used in promotional material to recruit staff. Resolved via
R16:
By March 1, 2023, the Board of Supervisors direct the County Administrator's Office and the County Human Resources Department to County develop a plan for the Board's review and consideration whereby the County organization Human Resources Department has oversight authority over all satellite human restructure resource divisions. with all departments Current Status: The Human Resources Department responded that it will work reporting to with a consultant in 2024 to develop recommendations regarding oversight of County Exec all satellite-department human resources functions. SMART DECISION-MAKING: Citizen Feedback is Critical for Success Implemented Unresolved Recommendations and Current Status
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Hallazgos & Recomendaciones
10 hallazgos
F1:
Deferred maintenance of County buildings and other facilities has become so considerable that it requires extraordinary measures and limits management's ability to plan effectively for future facilities. FZ. Sonoma County Capital Assets Policy FA-l fails to provide sufficient reporting for management to determine the extent to which normal maintenance and repairs of buildings and other County facilities are being deferred.
F3:
There is no formal requirement that County departmental administrators inform the Board of Supervisors iegarding current-year deferred maintenance decisions on capital assets including cost to the County budget.
F4:
Real asset records are scattered over an excessive number ofrecord keeping and asset management sYstems.
F5:
General Services, as well as other departments, have yet to take advantage of integrating with the Enterprise Financial System's Asset Management module which provid"s asset tracking, acquisition, maintenance, inventory, and cost-sharing. 10
F6:
The true cost of maintaining the County's facilities has been substantially understated for over a decade by deferring needed maintenance.
F8:
Deferred maintenance costs are continuing to accumulate to an extent that they constitute a major reduction in asset value not reported in the County's financial statements.
F9:
Deferred maintenance contributes to more rapid deterioration of facilities and therefore, in the long run, to higher facilities costs.
F10:
Public and employee safety are adversely affected by deteriorating building conditions brought about by deferred maintenance.
F11:
The current condition of facilities creates a difficult environment for making future plans and decisions about used and new facilities. Fl2. The County lacks in-house capabilities for determining and setting deferred maintenance valuations. 3. F 1 Capital assets that suffer from significant accumulations of deferred maintenance may be impaired assets for accounting purposes.
F14:
The Board of Supervisors has not been able to fully implement the Capital Improvement Plan due to appropriation of funding to other departments.
Recomendaciones adicionales
6
No vinculadas a hallazgos específicos.
R2:
The County Administrator obtain an independent cost analysis and justification of deferred maintenance on capital assets from each department head and present to the Board of Supervisors by March 2020, and following on an annual basis. [F3]
R3:
The County Administrator work with department heads to evaluate and take advantage of the EFS Capital Asset Management module to avoid duplication, consolidate data, provide cost savings, and report updates to the Board of Supervisors by December 31, 2019. [F4, F5]
R4:
The County Administrator and the Board of Supervisors budget regularly for facility maintenance at levels consistent with recommended industry standards by December 31, 201,9. [F6, F7] 11
R5:
The Director of Health Services reduce employee and public exposure to hazards, minimize risks of OSHA and liability exposure by enforcing a higher level of maintenance by December 31, 2019. [F10]
R6:
The County Administrator and the General Services Director assign resources such as sufficient staffing for determining and setting deferred maintenance valuations by December 31, 2019. lF 12)
R7:
ACTTC review assets with accumulated deferred maintenance and adjust the record of accumulated depreciation if material impairment is found by July I,2020.lFl3l
Hallazgos & Recomendaciones
12 hallazgos
F1:
The Department of Health Services Fiscal Department lacked formal, written policies and procedures congruent with industry-standard budget development.
Recomendaciones relacionadas (1)
R1:
The CAO’s office create and maintain policy and procedure manuals for each DHS department, and desk manuals for all positions in Fiscal and Behavioral Health Divisions by Dec. 31, 2019 [F1]
F2:
BHD failed to establish and audit all CBO performance requirements.
Recomendaciones relacionadas (1)
R2:
DHS prioritize implementation of the Avatar system by Dec. 31, 2019 [F6]
F3:
Projected revenue from anticipated programs and contracts continually failed to materialize, but remained in the budget.
Recomendaciones relacionadas (1)
R3:
BHD include all managers in budget development and review by Dec. 31, 2019. [F8]
F4:
CSU costs exceeded anticipated revenues for those clients staying longer than the time reimbursable (20 hours) from MediCal for CSU services.
Recomendaciones relacionadas (1)
R4:
BHD institute procedures for effective and respectful staff communication and support at all levels by Dec. 31, 2019. [F8, F9]
F5:
Lack of adequate personnel compromised the Compliance Office’s effectiveness. It also posed an independence issue for the Compliance Program staff in any oversight audits. 7
Recomendaciones relacionadas (1)
R5:
DHS continue and expedite the CBO contract evaluation and build performance metrics by Dec. 31, 2019. [F2, F5]
F6:
The failure to fully implement the medical record, claims and billing software, Avatar, continues to result in lost revenues
Recomendaciones relacionadas (1)
R6:
DHS and BHD receive continued training in government finance by Dec. 31, 2019. [F3,
F7:
Although current leadership understands government finance and budgeting process, the Grand Jury found that past BHD and DHS leadership lacked understanding.
Recomendaciones relacionadas (1)
R7:
DHS hire a CFO who is experienced in government finance and systems. [F7, F12]
F8:
Budget development process lacked transparency and staff participation. Section and program managers were not included in budget development.
Recomendaciones relacionadas (1)
R8:
The County Auditor’s Office institute procedures for verifying actual revenue figures, rather than verifying that projected budgets balance, by Dec. 31, 2019. [F12]
F9:
Professional communication was limited by management. This led to a lack of transparency between Fiscal and BHD.
Recomendaciones relacionadas (1)
R9:
The Compliance Program be adequately funded and supported, by Dec. 31, 2019. [F5]
F10:
Inadequate staffing and insufficiently trained staff in DHS Fiscal led to a severely flawed budget for both FY 16-17 and 17-18.
Recomendaciones relacionadas (1)
R10:
We recommend the BOS review its budget oversight responsibilities by Dec. 31, 2019 8
F11:
The budget shortfall caused BHD to reduce vital staffing.
F12:
Auditing procedures designed to detect incorrect revenue information were not evident.
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Hallazgos & Recomendaciones
9 hallazgos
F1:
The Main Adult Detention Facility, through its contractors, is providing quality medical care, drug treatment, dental care, mental health treatment, and adult educational opportunities to its inmates. The Sheriff s Office is to be commended for its management of social services at MADF.
F2:
The Jail Based Competency Restoration program has significantly reduced the time needed to restore inmate competency to stand trial. The Sheriffls Office is to be commended for implementing this program.
F3:
Insufficient nurse staffing in the intake/booking area contributes to delays in the admissions process during evening and night shifts.
F4:
Treatment of communicable diseases at MADF- namely, tuberculosis, HIV/AIDS, syphilis and other STDs - could be improved through broader screening on admissions and more thorough discharge planning.
Recomendaciones relacionadas (1)
R2:
MADF screen all inmates for syphilis at intake by December 31,2019.lF4l
F5:
The lack of a comprehensive vaccination program at MADF is a missed opportunity.
F6:
MADF's current practice of never using maintenance medication to treat opioid addiction is controversial.
Recomendaciones relacionadas (1)
R5:
MADF reevaluate its policy on the use of support medications for opioid abuse reflecting current best practices by December 31, 2019. [F6]
F7:
Inmates admitted on HIV/AIDS medications outside the Wellpath formulary are switched to alternative medications which may not be as effective or well-tolerated.
Recomendaciones relacionadas (1)
R4:
MADF consult with an outside medical specialist to review its HIV/AIDS drug protocols and produce a report by Decemb er 31 , 2019 . lFTl
F8:
The inability for inmates to eam GED certification is a weakness in the MADF education program. 11
F9:
Discharge coordination is insufficient to ensure effective medical hand-offs.
Recomendaciones relacionadas (1)
R3:
MADF add discharge planning hours to strengthen hand-offs to appropriate health care providers by December 31,2019.lF9)
Hallazgos & Recomendaciones
10 hallazgos
F1:
l. Sonoma Water and its water contractors maintain a well-designed system and have made significant progress in mitigating earthquake risks. Ongoing efforts are needed to reduce remaining risks.
F2:
Sonoma County relies primarily on a single wholesale provider for its water. Sonoma Water, which delivers water under contract to cities and water districts.in Sonoma County and northern Marin County, may be without sufficient resources to meet all emergency needs.
F3:
In the event of a major earthquake, water supplies are likely to be significantly disrupted for extended periods of days or weeks, although reduced water supplies may be provided through alternative means. Full recovery of systems could take longer.
F4:
Measures implemented by Sonoma Water to reduce the risk of critical water shortages following a major earthquake have relied heavily upon state and federal grant funds, but implementation has fallen behind the schedules proposed in the LHMP. A more rapid reduction of risks could be achieved through water rate adjustments.
F5:
Consistent with FEMA recommendations, residents need to maintain their own emergency source of water to meet their personal needs for more than the three days frequently stated by officials
Recomendaciones relacionadas (1)
R3:
Sonoma Water and water contractors derive and publicize more realistic outage periods and provide updated information to the public, by December 31, 2019. (F5, F6)
F6:
More public outreach is needed to educate water users to their risks and individual responsibility for earthquake preparedness.
Recomendaciones relacionadas (1)
R3:
Sonoma Water and water contractors derive and publicize more realistic outage periods and provide updated information to the public, by December 31, 2019. (F5, F6)
F7:
Coordination between Sonoma Water and its contractors needs to improve by increasing training exercises, mutual aid training, and systems information exchange. 13
Recomendaciones relacionadas (1)
R4:
Sonoma Water improve coordination with water contractors, including field exercises, by December 31,2019. (F7)
F8:
Because operating pressures must be maintained throughout the system, water contractors have limited ability to curtail non-essential water uses without compromising availability of water for critical applications such as fire suppression and hospital use.
Recomendaciones relacionadas (1)
R5:
Water contractors study options for making local systems more adaptable under emergency conditions - such as dedicated supply loops, digitally monitored metering, or automatic shut-down valves, by December 3 1, 2019. (F8)
F9:
Sonoma Water's planning for earthquake response, supplies, repairs, and restoration of water depends significantly on institutional repair knowledge concentrated in a few long-term employees, but lacks adequate documentation such as manuals for standard operating procedures.
Recomendaciones relacionadas (1)
R6:
Sonoma Water prepare and maintain one or more SOPs (Standard Operating Procedures) for the restoration of water deliveries specifically for an earthquake; SOPs should be updated annually or whenever there are changes to procedures, by December 31,2019. (F9)
F10:
Sonoma Water's estimate of three days to return to service following an earthquake is conditional on the availability of suitable repair parts, aqueduct pipe, joints, pumps and valves. The Grand Jury found the inventory of emergency supplies is sparse and the inventory list is incomplete and out-of-date.
Recomendaciones relacionadas (1)
R2:
Sonoma Water maintain inventory lists with current goals for items, quantities, locations, and sourcing; and improve stockpiling accordingly, by Decembet 31,2079. (Fl0)
Recomendaciones adicionales
8
No vinculadas a hallazgos específicos.
R1:
The Board of Supervisors BOS BOS responds R1 has not been The BOS' directive is to fully (BOS) reassign the Sonoma implemented and may not be operationalize the EOC and make County Emergency implemented. While the Sheriff's improvements in EOC facilities, systems, Operations Center to be Office conducts effective 24/7 procedures and staff development based under the management of a on the EOC After-Action Report. This operations, a major emergency or response entity that disaster will continue to require directive implies that the BOS assumes their review and staff improvements will operates 24 hours a day, their efforts focus on life-safety seven days a week, such as missions in the field. County staff address weaknesses identified in the the Sheriff's Office and that identify emergency response grand jury report based on research and this reassignment be made functions, such as Alert and interviews. The Grand Jury report by Dec. 31, 2018 Warning, to organizations that identified challenges the County EOC maintain a 24/7 operational experienced during the critical initial capability. June 11, 2018 the BOS period in the night of October 8 to October reviewed the EOC After-Action 9. Those challenges led to a lack of Report and directed staff resources communication with/and availability to to fully operationalize the EOC and other local EOCs. make improvements in EOC facilities, systems, procedures and See "Additional Grand Jury Comments" staff development. August 14, 2018 below the County Board of Supervisors directed that the emergency management program report directly to the County Administrator. 2018-2019 Sonoma County Civil Grand Jury Continuity Report RES. RECOMMENDATIONS RESPONSES 2018-2019 GJ OBSERVATIONS
R2:
The County Administrative CAO County staff and stakeholder The CAO responds that R2 has not been Officer (CAO) revise the partners will revise the Emergency implemented but will be implemented in County Emergency Operations Plan in FY2018-2019 FY2018/2019. The Grand Jury identifies Operations Plan in this as a time critical issue and thus it collaboration with all City should meet the target date. The Grand Managers to incorporate Jury acknowledges the CAO commitment lessons learned from this to work closely with stakeholder partners. The grand jury report specifically emergency by 12/31/18 recommends collaboration with City Managers when revising the County Emergency Operations Plan.
R3:
The BOS incorporate BOS County staff and stakeholder The BOS responds that R3 has not been
R4:
The BOS strongly support BOS The County, through the The BOS responds that R4 has been California State Association of implemented. The Grand Jury acknowledges revisions to the State of California Fire Mutual Aid Counties (CSAC), continues to BOS support for the important revisions monitor and supports this item. underway. as cited by the California CSAC includes mutual aid Fire Chiefs Association, by 12/31/18.. funding as a priority and supported the Fire Chiefs' efforts in committee hearings. The BOS adopted a formal resolution of support on Sept. 11, 2018. ADDITIONAL GRAND JURY COMMENTS The grand jury report identifies challenges the County EOC experienced during the critical initial period the night of October 8 to October 9. Those challenges led to a lack of communication with/and availability to other local EOCs. Documents in the public domain, which date from early 2017 through December of 2018, reinforce the findings and recommendations in the 2017-2018 Grand Jury report. Documents of particular interest are: 1. Notes from the Sonoma County Operational Area Emergency Council meetings -- specifically May 10, 2017/Unfinished Business/Item C 2. Wildland Fire Assessment report prepared by the Permit Sonoma and accepted by the BOS in April 2017, indicates underlying weaknesses in emergency preparedness and the high probability of a repeat of the Hanley fire of 1964 2018-2019 Sonoma County Civil Grand Jury Continuity Report 3. Review of the September, 2018 emergency alert system pointed out the remaining weaknesses of the Wireless Emergency Alert/Integrated Public Alert & Warning System (WEA/IPAWS) 4. Public comments from the previous Project Manager of the Sonoma County Public Safety Consortium at the June 11th Special BOS meeting The documents above underscore the fact that the responsible individuals at the executive level were informed of mid-level concerns about of the WEA/IPAWS system. The poor state of staff training and preparedness for an emergency was known to top-level leaders. These deficiencies are still problematic. The Grand Jury determined there is a lack of acceptance of responsibility for response to the fire at the proper executive level. Instead, the Emergency Services Manager who oversaw emergency response was reassigned in March 2018. The 2017/2018 Grand Jury report on the Firestorm describes the lack of information at the critical time the fire crossed into Santa Rosa. The warning and evacuation call from one mid-level City Fire Marshall, in the Fountaingrove area at the time, may have prevented several hundred people from perishing. After the firestorm, a critical communication finding was poor information dissemination from the County EOC to the City EOCs. Since the County EOC is the communications nexus between State and City Emergency Management entities, this function is crucial. With this in mind, the Grand Jury believes the EOC reorganization proposed by both the BOS and the CAO is adequate in addressing the information dissemination problem. However, the reorganization of EOC fails to assign a person or entity with 24/7 notification responsibility to initiate emergency response. 2018-2019 Sonoma County Civil Grand Jury Continuity Report RES = Respondent BOS = Board of Supervisors CAO = County Administrative Officer Dir DHS = Director of Health Services AS Dir = Animal Services Director THE EVACUATION AND SHELTERING OF ANIMALS RECOMMENDATIONS RES RESPONSES 2018-2019 GJ OBSERVATIONS
R5:
The BOS and CAO enter BOS The County of Sonoma through The BOS and CAO respond R5 has not Animal Services, will continue to been implemented and may not be into Memoranda of CAO improve coordination with its non- implemented. The Grand Jury Understandings with non- governmental partners. The need for acknowledges that the Bay Area Urban governmental organizations that play a Memoranda of Understanding will be Area Initiative (UASI) is using the proven Sonoma County Disaster Response Plan role in animal disaster evaluated on a case-by-case basis. The coordinated effort, which does as a template to standardize disaster emergencies by Dec.31, not make use of Memoranda of response plans with governmental and 2018 non-governmental stakeholders. Understanding supports the Therefore this has met the intent of the objective of a regionalized disaster response amongst both Grand Jury recommendation. governmental and non-governmental stakeholders.
R6:
The Director of DHS responds R6 has not Training standards should Dir On August 14, 2018 the BOS approved a resolution mandating the been implemented but will be be enforced by ensuring DHS that the Animal Services creation of a new Emergency Staff implemented in the future. The Grand for AS Development Program to prepare Jury commends that 72% of staff have Director require that all field officers complete County staff to function as completed required online courses as of Dir Incident Command Emergency Workers. This August 20, 2018. The Grand Jury System and fire safety mandatory training will be tailored encourages all staff meet the target date. courses with an emphasis to roles staff are likely to play in an on animal emergencies, emergency. and the Director of DHS ensure that all Department Operation Center members complete the mandatory Incident Command System by December 31, 2018 2018-2019 Sonoma County Civil Grand Jury Continuity Report RECOMMENDATIONS RES RESPONSES 2018-2019 GJ OBSERVATIONS
R7:
The BOS and CAO analyze BOS The BOS and CAO respond R7 has not The CAO will conduct a management the current placement of review of Animal Services, to been implemented but will be CAO evaluate the need for an assignment Animal Services under the implemented in the future. The Grand Department of Health within an agency that operates 24 Jury encourages the CAO conduct a Services (DHS), and hours a day. management review and analyze the determine if Animal need to reassign Animal Services to an agency that operates 24 hours per day by Services should be the recommended target. reassigned to an agency that operates 24 hours per day by Dec.31, 2018 2018-2019 Sonoma County Civil Grand Jury Continuity Report RES = Respondent Dir PS = Director Permit Sonoma OVERALL PROGRESS AT PERMIT SONOMA RECOMMENDATIONS RES RESPONSES 2018-2019 GJ OBSERVATIONS
R9:
Those challenges led to a lack of Report and directed staff resources communication with/and availability to to fully operationalize the EOC and other local EOCs. make improvements in EOC facilities, systems, procedures and See "Additional Grand Jury Comments" staff development. August 14, 2018 below the County Board of Supervisors directed that the emergency management program report directly to the County Administrator. 2018-2019 Sonoma County Civil Grand Jury Continuity Report RES. RECOMMENDATIONS RESPONSES 2018-2019 GJ OBSERVATIONS R2. The County Administrative CAO County staff and stakeholder The CAO responds that R2 has not been Officer (CAO) revise the partners will revise the Emergency implemented but will be implemented in County Emergency Operations Plan in FY2018-2019 FY2018/2019. The Grand Jury identifies Operations Plan in this as a time critical issue and thus it collaboration with all City should meet the target date. The Grand Managers to incorporate Jury acknowledges the CAO commitment lessons learned from this to work closely with stakeholder partners. The grand jury report specifically emergency by 12/31/18 recommends collaboration with City Managers when revising the County Emergency Operations Plan. R3. The BOS incorporate BOS County staff and stakeholder The BOS responds that R3 has not been
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Hallazgos & Recomendaciones
9 hallazgos
F1:
The Main Adult Detention Facility, through its contractors, is providing quality medical care, drug treatment, dental care, mental health treatment, and adult educational opportunities to its inmates. The Sheriff’s Office is to be commended for its management of social services at MADF.
F2:
The Jail Based Competency Restoration program has significantly reduced the time needed to restore inmate competency to stand trial. The Sheriff’s Office is to be commended for implementing this program.
F3:
Insufficient nurse staffing in the intake/booking area contributes to delays in the admissions process during evening and night shifts.
F4:
Treatment of communicable diseases at MADF – namely, tuberculosis, HIV/AIDS, syphilis and other STDs – could be improved through broader screening on admissions and more thorough discharge planning.
F5:
The lack of a comprehensive vaccination program at MADF is a missed opportunity.
F6:
MADF’s current practice of never using maintenance medication to treat opioid addiction is controversial.
F7:
Inmates admitted on HIV/AIDS medications outside the Wellpath formulary are switched to alternative medications which may not be as effective or well-tolerated.
F8:
The inability for inmates to earn GED certification is a weakness in the MADF education program. Final Report 2018-2019
F9:
Discharge coordination is insufficient to ensure effective medical hand-offs.
Recomendaciones adicionales
5
No vinculadas a hallazgos específicos.
R1:
MADF add nurse hours to the booking area during evening and night shifts by December 31, 2019. [F3]
R2:
MADF screen all inmates for syphilis at intake by December 31, 2019. [F4]
R3:
MADF add discharge planning hours to strengthen hand-offs to appropriate health care provid- ers by December 31, 2019. [F9]
R4:
MADF consult with an outside medical specialist to review its HIV/AIDS drug protocols and produce a report by December 31, 2019. [F7]
R5:
MADF reevaluate its policy on the use of support medications for opioid abuse reflecting cur- rent best practices by December 31, 2019. [F6]
* This report's PDF did not contain easily extractable text and required Optical Character Recognition (OCR) for analysis. There may be minor errors in the extracted findings and recommendations due to OCR limitations with scanned documents.