HomeMy WebLinkAboutMINUTES - 08072001 - C.125 �.s_._.L _°� • Contra
TO: BOARD OF SUPERVISORS
Costa
FROM: JOHN SWEETEN, County Administrator .s
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DATE: AUGUST 7, 2001 County s�A-�ao��`�
SUBJECT: RESPONSE TO GRAND JURY REPORT NO. 0108 ENTITLED
"GROUP HOMES"
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDATION:
ADOPT report as the Board of Supervisors' response to Grand Jury Report No. 0108
entitled, "Group Homes".
BACKGROUND:
The 2000-2001 Grand Jury filed the above-referenced report on June 19, 2001, which
was reviewed by the Board of Supervisors on July 10 and subsequently referred to
the County Administrator, Employment and Human Services Director, and Children &
Family Services Director, who prepared the attached response that clearly specifies:
A. Whether the finding or recommendation is accepted or will be implemented;
B. If a recommendation is accepted, a statement as to who will be responsible
for implementation and a definite target date;
C. A delineation of the constraints if a recommendation is accepted but cannot
be implemented within a six-month period; and
D. The reason for not accepting or adopting a finding or recommendation.
CONTINUED ON ATTACHMENT: YES SIGNATURE:
'T-COMMENDATION OF COUNTY ADMINISTRATOR RECOMME TION OF BOARD COMMITTEE
✓✓APPROVE OTHER
SIGNATURE(S):——-Q
r
ACTION OF BOAR _&, s t 7, 2001 APPROVE AS RECOMMENDED XXX OTHER
VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE
AND CORRECT COPY OF AN ACTION TAKEN
XX UNANIMOUS(ABSENT ------ ) AND ENTERED ON THE MINUTES OF THE
BOARD OF SUPERVISORS ON THE DATE
AYES: NOES: SHOWN.
ABSENT: ABSTAIN:
ATTESTED August 7, 2001
CONTACT: DANNA FABELLA(925)313-1583 JOHN SWEETEN,
CLERK OF THE BOARD OF SUPERVISORS
AND COUNTY ADMINISTRATOR
CC: PRESIDING JUDGE OF THE SUPERIOR COURT
COUNTY ADMINISTRATOR
EMPLOYMENT AND HUMAN SERVICES DIRECTOR
CONTRA COSTA FIRE PROTECTION DISTRICT CHIEF /
BY (, ,DEPUTY
Group Homes August 7, 2001
County Response to Grand Jury Report No. 0108 Page 1
RESPONSE TO GRAND JURY REPORT NO. 0108
GROUP HOMES
.:..:.....:
FIND
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1. There are 37 group homes in Contra Costa County with licenses issued by the State
of California Community Care Licensing (California Community Care Licensing
Division) Division. These group homes provide housing and special services for
juveniles 2 through 17 year of age.
Response: Partially disagree. Residential programs licensed as group homes do not
provide care for children under the age of 6.
2. Juveniles are placed in the group homes by court order. Some have been abused
(dependency) and some have committed crimes (delinquency).
Response: Partially disagree. Minors are not generally placed in group homes by
court order. However, the Juvenile Court determines whether placement out of the
family home is appropriate. In the case of children who have been victimized by abuse,
neglect or molestation, the Juvenile Court then entrusts placement authority with the
Children & Family Services Bureau of the Employment and Human Services
Department. Social Workers determine the level of care the children need, and select
the appropriate placement resource. Similarly, in the case of delinquent children, if they
are not incarcerated but are to receive residential care in the community, the Probation
Department is entrusted with placement authority and decision making responsibility.
3. There is a position designated as County Group Home Developer. This position is
staffed by a County Social Casework Specialist, with experience as a Case
Manager. This person has the responsibility of evaluating the level of service
provided by all in-county Group Home providers, and attending California
Community Care Licensing Division orientations to advise aspiring Group Home
providers of expectations and program needs.
Response: Agree, with the clarification that the finding does not represent an all-
inclusive list of the Group Home Developer's responsibilities.
4. The owners of Group Homes are compensated with Federal, State, and County
funds. In some Group Homes the owners are on site administrators. In others, the
owners hire an administrator/provider to handle the day-to-day operations. Each
Group Home has a Relative Care Level (RCL) assignment. RCL refers to the
physical facilities, the qualifications of the staff and staff number. The base rate is
$3,890 per child per month. With additional care requirements, the rate can rise as
much as $11,000 per child per month.
Response: Partially disagree. RCL refers to the "Rate Classification Level'
established through the California Department of Social Services Foster Care Rates
Bureau. The group home relative care level is based on the type of services available
to the child in the facility, the staffing ratio and staff qualifications.
There are 14 relative care levels established by the State. A program with a relative
care level of 1 would receive $1,387 per child per month in foster care payment. We
are not aware of any programs within Contra Costa County below a relative care level
of 6. A Relative Care Level 6 program would receive $3,189 and would be expected to
have a staffing ratio of 1 staff to 6 children with night staff being permitted to sleep on
the premises.
Comparatively, a Relative Care Level 14 program would receive $6,076 per child per
month in foster care funding, would be expected to maintain a high level of professional
staffing and to meet the needs of extremely psychiatrically disturbed children, e.g. those
Group Homes August 7, 2001
County Response to Grand Jury Report No. 0108 Page 2
exhibiting schizophrenic, suicidal, or assaultive behaviors. They would be expected to
have a high staff-to-child ratio with awake staff 24 hours/day. In order to maintain and
meet the needs of this very difficult population, most Relative Care Level 14 programs
operate day treatment programs funded through County Mental Health Departments.
They generally also operate on-ground non-public schools, as the children in their
programs cannot be contained in regular public schools. The school system funds
these programs on a per-child basis. The combination of funding per child of foster
care, mental health funds and education funds could reach the $11,0001child/month
rate cited by the Grand Jury.
5. Gross negligent conditions were found in some Group Homes. One Group Home in
West County was in despicable condition. Fire, Health and Safety code violations
were visible. Bathrooms were filthy with an accumulation of mold around the
shower and floors were not clean. There were non-working smoke detectors, bare
light fixtures, and lack of illuminated exit signs. There was evidence of cigarette
butts that had been extinguished in drawers. There were no rope or ladder escape
routes from the second floor. In general, the Group Home provided a totally
unhealthy and unsafe environment.
Response: Agree, with the clarification that the finding refers to only one group home
in our County. The owner of the group home was admonished regarding maintaining a
safe and sanitary environment for children. Children & Family Services staff reported
these deficiencies to the California Community Care Licensing Division.
6. Some Group Homes were austere; beds without frames, mattresses on bare floors,
and walls without pictures. In others there was no extra supply of stocked food in
evidence and children complained of insufficient variety and quantity of food.
Response: Partially disagree. We accept the finding that some group homes are
austere, but note that Children & Families Services staff did not see mattresses on bare
floors or beds without frames when accompanying the Grand Jury members on site
visits to in-County group homes.
7. School attendance and progress were not sufficiently monitored for some residents.
Children were at the Group Home during school hours without sufficient reasons.
The only incentive given to children for attending classes were merit points required
to maintain Group Home privileges. Records of school progress and attendance
were not available.
Response: Agree, with the clarification that the finding refers to only one group home
in the County. The owner of the group home identified by the Grand Jury has been
admonished regarding school attendance being critical for residents. This particular
group home is only used in emergencies for teens who are difficult to place because of
habitual and extreme oppositional or defiant behaviors.
8. Some Group Home owners are not accounting for the monies paid to provide the
services that have been ordered. Group Home owners determine how and where
funds received each month are spent. California Community Care Licensing
Division is responsible for auditing expenditures at the Group Homes.
Response: Partially disagree. The Foster Care Rates Bureau of the California
Department of Social Services is responsible for ensuring that programs provide the
services required for them to receive payment at their established relative care levels.
Group homes do have discretion in allocating their resources.
9. Group Home owners determine the quantity and qualifications of their staff. Group
Home owners are not required to live in the Group Homes. However, 24 hour
staffing is required. One Group Home was cited 4 times in 1997 for having no staff
on the premises.
• Group Homes August 7, 2001
County Response to Grand Jury Report No. 0108 Page 3
Response: Partially disagree. Group home operators must maintain the quantity and
qualifications of staff required to maintain their relative care levels or risk State
sanctions, such as having their program relative care levels downgraded or having their
program closed by the State. We are not aware of any program used by the County
being cited four times for having no staff on the premises when children were present.
10. In one Group Home, 8 juvenile females were being supervised by 3 male staff
members. There was no female staff present.
Response: Agree. There are no State regulations requiring same gender supervision.
However, Children & Family Services staff has sternly counseled the group home
operator about the inappropriateness of this staffing pattern and, as noted in the
County's response to Finding No. 7, this program is used only in an emergency.
11. A County Social Worker (SSW) is assigned to each juvenile living in a Group Home.
SSWs are required to make monthly visits to each assigned child and submit written
reports regarding the juvenile visited. They also prepare for the Court, a semi-
annual status report which covers all areas of the child's permanent and confidential
records.
Response: Agree, pertaining to dependent children of the Juvenile Court.
12. SSWs are not required to conduct the interview of the juveniles inside the Group
Home, nor are they required to assess or report on the conditions that exist in the
Group Home.
Response: Agree, with the clarification that while State regulations do not mandate
interviewing the minor within the group home, agency policy mandates seeing the
home/placement environment of any child in out-of-family care on at least a quarterly
basis, since this provides important information in assessing the child's well-being.
13. State Fire Marshall regulations require that all Group Homes be initially inspected.
However, local fire departments have no authority to inspect Group Homes
thereafter on a continuing basis.
Response: Partially disagree. The Contra Costa County Fire Protection District
informs us that it performs an inspection of a group home as part of the licensing
process mandated by California Community Care Licensing Division. While it is true
that an annual fire inspection is not required, the Fire District has the authority to and
will, with sufficient cause or upon request by the California Community Care Licensing
Division, inspect a group home.
14. The Contra Costa County fire departments do not make safety inspections of Group
Homes unless requested by California Community Care Licensing Division, through
the State Fire Marshall. To make an appointment for inspection, the local fire
department inspector will first call the Group Home owner. If personal contact is not
made at this time and the owner does not return the call, no inspection is made. A
Group Home may operate for years without a fire inspection.
Response: Disagree. The Contra Costa County Fire Protection District, for example,
informs us that upon request by the California Community Care Licensing Division, the
Fire District sends an information packet request to the affected group home asking for
a response from the owner in order to schedule an inspection. If the Fire District does
not hear from the owner within six weeks, the Fire District sends a 30-day notice to the
group home owner. If the Fire District still receives no response within that 30 days, the
Fire District responds back to the California Community Care Licensing Division (with a
copy to the group home owner) stating that there has been no response, that the Fire
District is closing its file, and notifies the California Community Care Licensing Division
that fire safety clearance has been denied. Lacking fire safety clearance, the California
Community Care Licensing Division will not grant a license to operate a group.home.
• Group Homes August 7, 2001
County Response to Grand Jury Report No. 0108 Page 4
home.
15. Not all Group Homes have problems such as have been mentioned. Some have
established excellent training programs for their staff and require their attendance.
Some post extra activity opportunities and conduct regular outings for the juveniles.
Superior conditions were found in the more newly established Group Homes (1999
— 2000). Their refrigerators and food cupboards were well stocked. All the
juveniles could sit for meals at the same time in a family atmosphere. Recreation
areas within these Group Homes were equipped with pool tables and other games.
Mission statements and menus for the week were posted in view.
Response: Agree, with the note that the programs identified by the Grand Jury as
providing quality services were developed since the creation of the Group Home
Developer role. This employee worked closely with these new programs as they were
being designed.
REEND MM ATI
C NS
O O
1. Ensure that juveniles living in Group Homes in the County have a safe place to live.
Establish a schedule and a reporting for the Group Home Developer to inspect all
Group Homes on an annual basis, and to evaluate their physical and procedural
conditions (such as juveniles rights and responsibilities, menus and recreational
activities).
Response: Will be implemented, except with regard to annual inspections. Inspection
of facilities, by State law, is the responsibility of the California Community Care
Licensing Division. The responsibility of Children & Family Services staff is to ensure
safety and well being of dependent children in their care. With respect to all in-County
group homes used by Children & Family Services for placement, the Division Manager
responsible for children placed in group homes will develop a written policy regarding
group home visits by the Group Home Developer along with a complaint procedure that
will include reporting facility deficiencies to the California Community Care Licensing
Division. This policy will be published and distributed within 90 days.
2. Ensure that Group Home owners keep the Group Homes clean. Support staff
should do regular, thorough cleaning of all areas of the Group Homes, particularly
where mold and bacteria are most likely to grow. (Reference, Group Homes
Manual, Title 22, Division 6, Chapter 5, Paragraph 84065.2 d/e).
Response: Has not yet been implemented, but will be within 90 days. Dependent
children in out-of-home care are entitled to safe, sanitary living conditions. The written
policy to be developed will include the reporting of unsanitary conditions to the
California Community Care Licensing Division.
3. Clarify the requirements as to who is responsible for inspecting and reporting the
existence of unsafe or unhealthy conditions in the Group Home and establish
procedures and follow-up inspections to make certain problems are corrected.
Response: Has not yet been implemented, but will be, as noted in the County's
response to Recommendation Nos. 1 and 2.
4. Order that Group Home owner/administrators require students to maintain
acceptable school attendance and progress. School records should be included in
the monthly visit reports of the County Social Services Workers and this information
brought to the attention of the County Group Homes Developer.
Response: Has not yet been implemented, but will be. The Division Manager within
the department responsible for Policy has been working on the full implementation of a
Health and Education Passport for every child in out-of-home care. To this end, the
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Group Homes August 7, 2001
County Response to Grand Jury Report No. 0108 Page 5
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department has collaborated with other agencies to hire both Public Health Nurses and
Educational Liaisons to closely I track and monitor health and education issues for all
children for whom Children & Family Services is responsible, with group home children
being the first target population.
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5. Direct its Children and Family Services Bureau to conduct unannounced quarterly
inspections and identify deficiencies of each of the 37 Group Homes in the County.
A Social Service Caseworker Specialist, other than the Group Homes Developer
should conduct these inspections.
Response: Will not be implemented because it is not reasonable. State law places
the responsibility for inspection of licensed facilities with the California Community Care
Licensing Division. As stated in the County's response to Recommendation No. 1,
Children & Family Services will ensure that the Group Home Developer completes
assessments of group homes it uses, to ensure the safety and well being of its
dependent children. Children i & Family Services staff will meet with the California
Community Care Licensing Division to discuss its regulatory role and responsibilities.
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6. Require that the SSW, as part of their job responsibility, report any observations of
existing hazardous conditions, or conditions that have the potential to jeopardize the
safety of the residents. This could take place during their monthly visits. A
procedure should be established to correct deficiencies that have been reported.
Response: Has not yet been implemented, but will be, as noted in the County's
response to Recommendation No. 1.
7. Coordinate with the Community Care Licensing Division and the County Board of
Supervisors to enact or create legislation that would allow fire districts to conduct
annual inspections of Group Homes as a preventive measure in contrast to
responding to emergencies,
Response: Will not be implemented because it is not warranted. Fire Departments are
currently allowed, but not required, to conduct inspections. Staff will, however, stress
with the California Community Care Licensing Division the importance of annual fire
inspections for group homes.
8. Require each SSW to document observed Group Home violations and juvenile
complaints on a monthly basis. A complaint file should be maintained for each
Group Home.
Response: Has not yet been implemented, but will be, as noted in the County's
response to Recommendation Nos. 1 and 2.
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9. Enforce adherence to the audit requirements established by California Community
Care Licensing Division Division.
Response: Will not be implemented, as the County has no regulatory authority in the
licensing relationship between group homes and the California Community Care
Licensing Division. Staff will, however, meet with the California Community Care
Licensing Division and discuss its regulatory role with respect to State audits.
10. Recommend to Community Care Licensing Division, closure of Group Homes that
consistently fall below established standards.
Response: Has not yet been implemented, but will be incorporated into the
forthcoming policy described in the County's response to Recommendation No. 1.
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