HomeMy WebLinkAboutMINUTES - 07121994 - IO.1 TO: BOARD OF SUPERVISORS5-.--L-
���� Contra
FROM:
Internal Operations Committee ';<_ Costa
-.-• := County
: .�.
DATE: June 27, 1994
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SUBJECT: Proposed Response to 1993-94 Grand Jury Report #9405
"Bureaucratic Child Abuse" -
SPECIFIC REOUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDATION:
Adopt this report of our Committee as the Board of Supervisors '
response to 1993-94 Grand Jury Report #9405 "Bureaucratic Child
Abuse. "
BACKGROUND:
On April 27, 1994 the Grand Jury filed report #9405 which was
reviewed by the Board of Supervisors on May 10, 1994 and referred
to the County Administrator and .Internal Operations Committee. On
June 27 , 1994 our Committee met to discuss the recommendations and
review proposed responses . At the conclusion of those discussions,
we prepared this report utilizing a format, suggested by a former
Grand Jury, which clearly specifies :
a. Whether the recommendation is accepted or adopted;
b. If the recommendation is accepted, a statement as to who will
be responsible for implementation and a definite target date;
C. A delineation of constraints if a recommendation is accepted
but cannot be implemented within the calendar year; and
d. The reason for not adopting a recommendation.
CONTINUED ON ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OFXCOUINISTRTOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE SIGNATURE S : Sll eith Su ervisor .Mark DeSaulnier
ACTION OF BOARD ON VhFi y 12, 1994 APPROVED AS RECOMMENDED --)(— OTHER
The Board discussed the above matter. Shiela Trokey, 3049 Justin Way, Concord and Marlene
York, 1768 Bayo Vista, San Pablo appeared to give testimony on the matter of adoption
procedures in Contra Costa County. Teri Woods had filed a request to speak, but yielded
her time to Shiela Trokey. The Board- APPROVED the above recommendation.
VOTE OF SUPERVISORS
I HEREBY CERTIFY THAT THIS IS A TRUE
41—UNANIMOUS(ABSENT LZZ_ ) AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN,
ATTESTED 1A
Contact: Dean Lucas 646-4077 PHIL BAT ELOR, LERK OF THE BOARD OF
cc: County Administrator SUPERVISORS AND COUNTY ADMINISTRATOR
Presiding Judge of Superior Court
Grand Jury Foreman, 1993-94 Grand Jury
BY ,DEPUTY
(Section I)
RESPONSE TO GRAND JURY RECOMMENDATIONS
RECOMMENDATION A:
The 1993-94 Contra Costa County Grand Jury, because of the urgency of this
matter, recommends that the Board of Supervisors within 30 days initiate and
document in writing a comprehensive program to correct management and adoption
service problems in the Adoption Unit, and to: Appoint an impartial investigator,
reporting to the County Administrator, to correct management and adoption service
problems.
Response:
a. This recommendation is accepted with modifications.
b. The Board of Supervisors agrees with the Grand Jury's recommendation to
appoint an impartial evaluator to identify any management and adoption
services problems that may be present. The Board of Supervisors welcomes
any suggestions the independent evaluator might have to strengthen the
program within the fiscal limitations imposed by the present budget crisis.
This review will be undertaken immediately.
At a presentation to the Internal Operations Committee on May 23, 1994, Mr.
James Brown, Chief of Adoptions, California State Department of Social
Services, suggested that the Family Welfare Research Group of the University
of California, Berkeley, would be a suitable neutral organization to evaluate
adoption services in Contra Costa County. The Board of Supervisors is
prepared to contract with the Family Welfare Research Group to evaluate the
following areas of the Grand Jury's concern:
1. Adoptive parent satisfaction with services, sample to be taken from all
stages of the adoption process; i.e. , application, home study, pre-
placement, post-placement, post-adoption.
2. Outcome evaluation; i.e. , ratings of parents and children of success of
the adoption, sample to be taken from adoptions completed in past 20
years.
3. Evaluation of adoption assessment process:
♦ Adoptive families, sample to be taken from families who adopted
in past five years;
♦ Children who need a permanent placement plan, sample to be
taken from children assessed for adoption in past five years.
4. Agency organization and management practices:
♦ Personnel procedures.
-1-
RECOMMENDATION B:
Instruct the impartial investigator to evaluate the job performance of all directors,
managers, supervisors and social workers responsible for adoption services and
recommend remedial action including reassignment, disciplinary action, dismissal
and, if warranted by the facts, referral to the County District Attorney for criminal
investigation.
Response:
a. This response is accepted with modifications.
b. The Board of Supervisors will be happy to receive any comments the
consultant may wish to make in the course of his review. However, the
Department has in place a performance evaluation program and the County
operates within the structure of the Merit System.
RECOMMENDATION C:
Immediately initiate, and complete within six months, a study to determine the
viability of the County's adoption services being privatized.
Response:
a. This response is accepted.
b. Privatizing adoption services would have the following advantages for the
County:
1. The licensed adoption agency to which a child has been freed for
adoption is responsible for the care of the child (Family Code Section
8704) . This would free the County of fiscal responsibility for the child
at the time of termination of parental rights instead of at the time of
adoption. Since the majority of dependent children freed for adoption
have special needs and thus their caregivers receive an additional
amount of funding called Difficulty-of-Care rate over and above the
basic foster care rate, this could amount to thousands of dollars of
savings. Even if the private agency receiving care and custody of the
child were able to facilitate an immediate adoptive placement, it would
be at least six months before the adoption could be finalized during
which time the responsible agency would pay for care and maintenance
of the child, including medical care costs.
2. Most of the dependent children placed for adoption who are older than
three to four years of age are in therapy. Therapeutic costs are often
not completely covered by Medi-Cal. The Department typically pays for
these services with funds from the state under a category called
"Service Funded Resources." If adoption services were privatized, the
agency receiving a child through relinquishment or termination of
parental rights would thus be responsible for providing therapeutic
services to the child thus freeing up county and state funds for other
dependent children.
-2-
Possible negative consequences for privatizing adoption services might
include:
1. Children not getting the services they need because the private agency
cannot afford them.
2. The number of children becoming legal orphans would increase
significantly because the private agency might not find enough suitable
homes and would then have to use its financial resources to care for the
children to majority.
3. Private agencies might be unwilling to take responsibility for the child
and would be willing only to do the home study. The Social Service
Department would lose control of the adoption process, and it might
take longer to complete than the Social Service Department doing the
home study.
4. The termination of parental rights is determined by the Juvenile Court.
Even under the most favorable circumstances, it is doubtful that a
single private adoption agency could handle the volume of cases
generated by the Juvenile Court in Contra Costa County and still
comply with the time frames demanded by statute and the Court.
RECOMMENDATION D:
Immediately initiate, and complete within six months, a study to determine the
viability of the County's adoption services being transferred to the California State
Department of Social Services.
Response:
A. This recommendation is accepted.
b. Such a transfer would save Contra Costa County in excess of $300,000 in
County overmatch (County General Fund) dollars annually. In the recent
past, due to the need to reduce County budget expenditures, the County
seriously considered returning adoption services to the state. Upon further
analysis, however, it was concluded that the level of services to children and
families would be reduced to an unacceptable level by such an action. Staff
currently employed in the Adoptions program could be deployed to other areas
of Children's Services which are currently understaffed.
The negative impact of transferring adoption services to the state might
include the following:
1. Increased delay in adoption for children currently waiting for adoptive
placement due to anticipated start-up problems for the state because of
the state budget crisis.
-3-
2. Increased inconvenience for adoptive applicants who have started the
adoption process in the County system and will have to switch to the
state system. State staff would probably serve Contra Costa County
clients from the Oakland office, thus increasing travel time for families.
3. Decreased level of services and increase in inconvenience to Contra
Costa County families and dependent children due to the need to
transfer information regarding the child and his/her history to a third
party.
RECOMMENDATION E:
Immediately upon completion, all reports and studies are to be made available to the
general public.
Response:
a. This recommendation is accepted.
Grand Jury Comment
The 1993-94 Contra Costa County Grand Jury Report Nos. 9402 and 9405 are not
meant as an indictment of the entire Social Service Department. The reports were,
however, written and published to identify the gross misconduct of the Adoption
Unit which directly affects vulnerable, adoptable children of Contra Costa County.
Response to the Grand Jury's Comment:
The Board of Supervisors is indeed grateful to the 1993-94 Contra Costa County
Grand Jury for clarifying the fact it is not indicting the entire Social Service
Department with its Report Nos. 9402 and 9405. It is reassuring to know that the
majority of dependent children in Contra Costa County who do not receive adoption
services and return home to their parents are receiving suitable services.
The Department has restated its success in carefully handling a high rate of adoptive
placements while maintaining a very low rate of adoptive disruptions. The Board of
Supervisors continues to promote the philosophy that the total needs of the child are
paramount. Consequently, adoption on the continuum of child welfare services is
one of several avenues to meet those needs.
-4-
(Section I I)
ANALYSIS OF GRAND JURY FINDINGS
Grand Jury Finding No. 1
Due to the Social Service Department's disorganization (Grand Jury Report No. 9402
on Adoptions), the Department lacks focus on its mission to find homes for Contra
Costa children.
Response:
In the reply to Grand Jury Report No. 9402, the Board of Supervisors responded to
the Grand Jury's finding that the Social Service Department is "disorganized" and
"lacks focus." At the Internal Operations Committee meeting on May 23, 1994, Mr.
James Brown, Chief of Adoptions, California State Department of Social Services,
presented statistics indicating that Contra Costa County Social Service Department
was the top producer of completed adoptions per worker of all Bay Area counties and
definitely exceeded the statewide annual average. The likelihood of a child being
adopted in Contra Costa County also exceeded the state average. (An average of 125
dependent children in California out of 1,000 placed in foster care end up being
adopted. In Contra Costa County the average is 133 per 1,000. )
Mr. Brown also noted that:
1. Contra Costa County African-American children were placed for adoption with
two African-American parents 830 of the time. The statewide average is 810.
2. The statewide average amount of time a child spent in foster care was 37
months prior to legal adoption. The Contra Costa County average was 40
months.
3. The statewide average of dependent children adopted by foster parents was
78%. The average in Contra Costa County was 67%, a difference that Mr.
Brown described as "small, but significant."
4. The staff level claimed by Contra Costa County in its fiscal claim to the state
was 6.7 workers, a supervisor and clerical support staff. The Board's
Response to Grand Jury Report No. 9402, reported 5.5 social work FTEs. The
difference is attributed to the election by three MSW social workers to
permanently reduce their hours or to take voluntary time off in 1993 and 1994
as permitted by the Board of Supervisors.
-5-
Grand Jury Finding No. 2
The Social Service Department confirmed that the County will lose state funding if
it refers children to private adoption agencies or to other county agencies.
Response:
The Board of Supervisors' Response to Grand Jury Report No. 9402, discussed this
finding. The amount of revenue lost by the County when making cooperative
placements is insignificant in comparison with the benefit to the children gained in
making cooperative placements. The adoption staffing level is already substantially
supported by a County overmatch of $300,000+ for the 1993-94 fiscal year. It is not
anticipated that further cooperative placements will meaningfully impact on our
adoption staffing level either now or in the future.
Grand Jury Finding No. 3
Many foster parents are routinely threatened with removal of the children from their
foster care home if the foster parents express a desire to adopt them.
Response:
When foster parents express an interest in adopting their foster children, they are
offered an adoption home study. They are required to submit the identical
information and documents that any other adoptive family is required to submit.
Foster parents have a favored position in adopting their foster children as most
foster children are positively bonded to their foster parents. We prefer not to sever
these bonds unless there is clear and convincing evidence that the child is abused
or neglected in the foster placement or the foster family does not meet or complete
adoption requirements as set by state regulation. Sixty-seven percent (67%) of all
children adopted in Contra Costa County in fiscal year 1992-93 were adopted by their
foster parents.
Grand Jury Finding No. 4
Contra Costa County offices create artificial barriers to adoption by repeatedly
citing excuses such as:
a. lack of staff;
b. reduced funding in the Adoption Unit;
c. lack of clerical support;
d. the social worker is on vacation;
e. your file is lost;
f. the social worker is on leave of absence;
g. your social worker took your file home;
h. it can take as long as ten years to complete an adoption.
-6-
Response:
The County can readily document that the following have been barriers to speedy
adoption:
a. lack of Adoption staff because of County fiscal constraints;
b. reduced child welfare funding from the state;
C. lack of adequate clerical support because of County fiscal constraints.
It appears that the following have not generally been realistic or artificial barriers:
a. worker vacations (required by union contract and County personnel rules);
b. lost files (almost no files are permanently lost);
C. worker leave of absence (rare, worker usually seriously ill, or in some
situations workers have voluntarily reduced their work hours because of
County budget constraints) ;
d. workers take files home (against Agency policy, may happen rarely with
supervisory approval) .
We are unable to document that any adoption at this Agency has taken ten years to
complete. Some national studies indicate that Caucasian parents seeking to adopt a
Caucasian infant with no health or history problems may wait as long as ten years for
an agency placement. All the children placed for adoption by Contra Costa County
meet the definition of special needs children.
Grand Jury Finding No. 5
Prospective, qualified adoptive parents, discouraged from adopting children in
Contra Costa County, have frequently finalized adoptions in other counties.
Response:
Adoptive parents legally finalize their adoption in the county where the adoptive
family resides or the county where the child's dependency originates.
Grand Jury Finding No. 6
Social workers use intimidation tactics to dissuade prospective adoptive parents.
This is done by disseminating disinformation that obscures the truth.
Response:
The Board of Supervisors does not tolerate intimidation tactics toward any client of
the County. Quite the opposite, the Board is dedicated to seeing that adoptive
applicants have all the information needed to make sound adoption decisions.
Grand Jury Finding No. 7
The Social Service Department's Adoption Unit threatens prospective adoptive
parents with the loss of the County "safety net" (foster care subsidy and ancillary
services).
-7-
Response:
This is a very vague allegation that is difficult to respond to without specific
examples. It is true that foster parents who adopt do lose their foster care payment.
However, an Aid to Adoption Program (AAP) subsidy is nearly always approved in
its stead. While post-adoption services are not presently available through the
Social Service Department, the Aid to Adoption Program subsidy may be increased
annually to include the cost of therapy and limited residential treatment, if needed,
if the family requests these services. A number of families who have requested and
received the Aid to Adoption Program subsidy to pay for these services can be
identified.
Grand Jury Finding No. 8
The Social Service Department's Adoption Unit negatively exaggerates some
children's limitations by branding them as "ugly" and having few social skills, thus
keeping these adoptable children in the more expensive and less nurturing
environment of foster care limbo.
Response:
The Board of Supervisors believes that no child who is a dependent of Contra Costa
County is denied the benefits of adoption because of his or her physical appearance
or lack of social skills. Some children have fewer adoptive options because of their
sex, appearance, ethnicity, behavioral problems, developmental delays and/or
negative family history. The Social Service Department has shown a commendable
record in recommending for adoption 133 dependent children out of 1,000 in
placement as compared with the state average of 125 dependent children per 1,000
in placement. If a child has been placed with a relative and the relative does not
wish to adopt, the Department usually will not recommend removal of a child to
achieve adoption status with another unrelated family. This decision is unrelated
to the personal characteristics the child may have or not have.
Grand Jury Finding No. 9
Prospective adoptive parents and long-term foster care parents have been
threatened with the institutionalization of their children when they question the
authority of the Social Service Department.
Response:
While we are not aware of the precise source of this information, the only instance
the Department is aware of appears to be a gross distortion of a comment (taken out
of context) made to a prospective adoptive parent by a Department administrator.
During an interview initiated by the Department, representatives were investigating
complaints and allegations of misconduct by a member of the staff. The foster parent
was never threatened with institutionalization of her children. Rather, the manager,
in several attempts to explain the foster care subsidy (Difficulty of Care),
commented that if the children continued to be as damaged as the foster parent
described, they could have qualified for residential treatment.
-8-
Grand Jury Finding No. 10
The Social Service Department staff has demonstrated, and management has
condoned, insensitive and callous behavior toward prospective adoptive parents and
children.
Response:
The Board of Supervisors does not tolerate insensitive and callous behavior toward
adoptive parents or children. The Social Service Department has acknowledged that
there was one worker in the Adoption Unit who displayed "insensitive and callous
behavior" toward adoptive parents. Neither the Board nor Department management
condone nor accept this type of behavior from staff. Appropriate disciplinary steps
are taken to change behavior of staff who do not comply.
Grand Jury Finding No. 11
There is an ongoing practice of complacency by the Social Service Department's
management toward inappropriate and unethical behavior.
Response:
The Board of Supervisors does not believe that this is true. The Department has
always followed up any complaint of inappropriate and/or unethical behavior with a
thorough investigation. The parties making the complaint are not privy to any
personnel actions taken to correct the behavior of individual workers. The
personnel regulation requiring that corrective action taken to improve a worker's
performance is to remain confidential is a common labor rule, supported by findings
in court and in arbitration. The County could be subject to lawsuit if details of
personnel actions were revealed to complainants or the media.
Grand Jury Ending No. 12
The current system lacks a process whereby inequities and/or wrongdoing can be
addressed. Prospective adoptive parents wishing to file a grievance against a social
worker are advised that no formal process exists for grievance resolution in the
Social Service Department, contrary to state law.
Response:
Adoptive applicants who wish to grieve specific decisions of the Social Service
Department have several avenues to proceed with their grievance:
1. They may request a fair hearing before a State Fair Hearing Officer.
2. They may request a grievance hearing before a County Appeals Officer.
3. They may request a juvenile court hearing before the Juvenile Court Referee
or Juvenile Court Judge.
4. They may request a meeting with the worker's Supervisor, Division Manager,
Assistant Director or Director.
-9-
The Department has developed, and is currently in the final stages of review prior
to publication, a written policy entitled "Conflict Resolution" which adds yet another
grievance procedure. This new policy is in addition to, and not a replacement of,
the three grievance procedures already in existence.
Grand Jury Finding No. 13
Every level of management, up to and including the Board of Supervisors, have been
informed of numerous problems with the Social Service Department and have failed
to act.
Response:
Both reports were responded to by the Board of Supervisors well within the
statutory deadline for such purposes. (See also 1.0.-2 on the July 12, 1994 Board
agenda for further follow-up on Grand Jury Report #9402.)
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A NEWSLETTER OF REGION ELEVEN CALIFORNIA NURSES ASSOCIATION
MR )OAYNURSE
VOLUME V,ISSUE 3 ALAD/IMA COUNTY NURSES ASSOCIATION OCTOBER 1990
g
Can You Hear Me C in .
r'Y
Minnie L Stephens-Harper,RN,BSN
The nurses and doctors
WANTED so desperately to live were excellent and took
and I would have, if only you very good care of me and
could have heard me crying. My
life began just as unplanned as my they did hear me crying
death, but my death was preventable, most of the time.
if only you could have heard me
crying.
My birth was a traumatic experi-
ence. You see, 1 was born at 24 weeks The nurses and doctors were ex-
gestation to a mother who had an cellent and took very good care of me
overwhelming craving for Crack. My and they did hear me crying most of
mom began having premature labor the time. I gained weight rapidly and
but her craving for the crack cocaine after four months in the hospital, it
was greater than the love she had for was finally time for me to go home.
me. She could not stop taking the My mom had not visited me very of-
drug and soon I was born in my ten during my four months of hospi-
grandmother's trailer home. she was non-viable but she is showing talization because it was difficult for
I don't know who heard me signs of surviving." I am so glad that her since she did not have a car and I
crying and called for the paramedics. the doctor heard me crying and de- had siblings at home with no one to
The paramedics arrived and dried me cided to.give me a chance. Can you care for them. But I know the real rea-
off. I was so cold, and one of them believe it, only a few hours old and I son for her not visiting was her addic-
wrapped me in a towel and placed have been in two ambulances, two tion to Crack.
me in a tupperware bowl for my trip hospitals, and don't forget my first The doctors, nurses and social
to the hospital. The paramedics didn't isolette, the tupperware bowl. worker are worried about my future
think I had a chance in the world, so At the new hospital, I was taken since I will need to go home on oxy-
they dropped my mom and me off at directly to the Neonatal Intensive Care gen and an apnea monitor. They held
the nearest hospital which did not Unit where the nurses and doctors family conferences with my mom
have a NICU. Well, I thought, I had started inserting tubes everywhere. I whenever she would show up. They
better start crying again so that the was intubated and attached to a respi- told her that they were worried about
right person can hear me and send me rator. An umbilical artery catheter was my future and her ability to care for
to a special nursery. I cried and the inserted into my belly button and then me. They arranged or her to sleep
doctor knew that I wanted to live, so I heard the doctor say, "She's fighting over and take care of me so that the
he arranged a transport to a Level III the respirator, we'll have to paralyze nurses could determine if she was ca-
'Intensive Care Nursery. I overheard her." I thought, "Oh no, please don't pable of caring for me, but she did
him saying, "She's a fighter, I didn't do that! You definitely won't hear me
call earlier because I really thought crying." (continued on page 2)
••• .a ♦ L
Can Yoy, Hear Me... Can You Hear Me...
(continued from front page) (continued from page 2)
not come in. She did show up for the
CPR training but the monitor training After we arrived home, all of my
had to be scheduled twice. The oxy- mom's friends were there to meet me
gen company's representative was ap- and they had a party in my honor. , }`
. v
palled when he delivered the oxygen However, I was not allowed to attends
the party, I was placed in another , r tzabe +
tanks for me at my home. You see, room with the monitor an but no one � a t
about ten of my mom's friends were � f � �•
heard me crying and no one heard the
visiting and they were all smoking,
ry g
The service representative tried to ex- monitor alarming. I was thankful that ryte � �:
the monitor was alarming because it esu �`
F0 s
got my mom's attention, but she was W �. 24�
quite upset when she finally came in
I was placed in another to see if I was okay and found me ; � y
crying and moving around so she =F " ` its,
D room with the monitor on turned the monitor off and it was offMo�yY a
but no one heard me crying most of the time. My mom didn't have
time for me, she missed my doctor
and no one heard the
appointments. My doctor told my �'
monitor alarming. mom that if she missed another ap- d a k
pointment, she was going to report FYItc
her to CPS. My dad and my uncleeste Px
took me to see the doctor. My dad
plain that they could not smoke be- carried me on his bicycle and my
cause of the oxygen. Everyone was so uncle carried the monitor and oxygen
high that the representative was afraid tank on his bicycle while it was con-
to Ieave the oxygen tank. The repre- netted to me. M doctor was shocked ,
sentative reported this incident to the Y
and explained how dangerous that
NICU Social Worker who reported it mode of transportation was and of- fi`'` niemdand
to Child Protective Services (CPS). fered to send us home in a taxi, but
This agency had already been con- get
my dad refused and off we went on
tatted because of my mom's drug ad- the bicycles.
iqMI`'
diction and her failure to visit me and M y doctor was concerned because - Y�" 1'2
keep appointments. Well, the CPS y �
1 had been home for one month and
worker had never heard me crying had not gained any weight. My dad a '•1
and made the decision to send me told the doctor that I was on the
home with my mom. The NICU monitor and oxygen all of the time, m
nurses, doctor and social worker were
but that was not true.
really against this decision.
Mom was so happy on the day ABOUT A WEER later, this special little r: the
that I was discharged from the hospi- baby had died. The coroner reportedi
,al. She 'forgot' to bring clothes for me to the doctor that the body was par- a z. eI
to wear home. So my nurses went tially decomposed when they re-
shopping for me and 1 was dressed in moved it from the home. The doctor
aew clothes from the top of my head reported this to CPS and the other
o the soles of my feet. Finally, it's children were removed from the home t�
ime to leave, the nurses are sad to
and charges were filed against the
>ee me leaving and they are trying to parents for child neglect. j '=
o give mom some last minute instruc- Perhaps this infant would still be
ions, but mom is not listening. I am I alive if only her parents had heard her F'
tfraid to be leavingthe only home 'tg
Y when she stopped crying. ■
hat I have known, so I began to cry d
Tut mom doesn't hear me, she just
hoved a pacifier in my mouth and ,
EJ thartlze to the family of W�� ,
continued her conversation she never =. $ PC
Minnie Stephens-Harper for their « w
-ven looked at me. Well, it is time and ""' D
permission to pant this article. `._.
)ff we go with my monitor and oxy- _.
en tank.
(continued on page 3)