Report 2016-126 Recommendation 10 Responses

Report 2016-126: California Department of Social Services: Its Caregiver Background Check Bureau Lacks Criminal History Information It Needs to Protect Vulnerable Populations in Licensed Care Facilities (Release Date: March 2017)

Recommendation #10 To: Social Services, Department of

To ensure that Social Services evaluates the risk individuals may pose to vulnerable populations in its licensed care facilities as quickly as possible, by July 2017 Social Services should establish time frames for staff to evaluate individuals who are present in their facilities and who have received administrative actions from other departments. In addition, it should monitor and follow up with the appropriate staff regarding the status of their assessments of these individuals and their final decisions.

Annual Follow-Up Agency Response From March 2022

Effective January 2021, the Caregiver Background Check Bureau (CBCB) was renamed to Care Provider Management Bureau (CPMB).

Department of Social Services (CDSS), Department of Health Care Services, Emergency Medical Services Authority, Department of Aging, and Department of Public Health are sharing administrative action information by utilizing the Administrative Action Records System (AARS).

CDSS, CPMB contracted with a third party, Innovative Architects LLC to update and implement a National Background Check (NBC) software solution (Guardian) to replace the legacy CBC system. As part of Guardian solution, a bidirectional application programming interface (API) between the new data system and the Administrative Action Records System (AARS) which continually reviews all actions received from other Departments. All new applications in the new data system are checked against AARS and any actions discovered on individuals present in CDSS facilities will be reviewed daily for possible further action by CDSS.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

CDSS has not provided evidence that it is monitoring its administrative action review process to ensure it happens in a timely manner.

Annual Follow-Up Agency Response From November 2020

CDSS, Department of Health Care Services, Emergency Medical Services Authority, Department of Aging, and Department of Public Health are sharing administrative action information by utilizing the Administrative Action Records System (AARS).

However, the ability to use the data electronically is not yet functional. CDSS has contracted with a vendor and is developing a bidirectional application programming interface (API) between a new data system and the Administrative Action Records System (AARS) which will continually review all actions received from other departments. All new applications in the new data system will be checked against AARS and any actions discovered on individuals present in CDSS facilities will be reviewed daily for possible further action by CDSS.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

Annual Follow-Up Agency Response From November 2019

Emailed to CSA.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

The response that Social Services sent to us by email is below verbatim. Our assessment continues to be that this recommendation is partially implemented.

Social Services' Response:

Department of Social Services (CDSS), Department of Health Care Services, Emergency Medical Services Authority, Department of Aging, and Department of Public Health are sharing administrative action information by utilizing the Administrative Action Records System (AARS). When individuals seeking associations to CDSS facilities are identified as having Administrative Actions (AA) with other Departments, the cases are flagged and reviewed by an analyst dedicated solely to this function. All cases identified through AA flags are logged separately in an excel spreadsheet with final decisions on if the individual is eligible or not to go through the CDSS process for requesting an exemption. If they are deemed eligible to go through the process, the case is assigned to an exemption analyst and is processed in the same way as any other exemption case.

Management review and legal consultation are performed and required throughout the process to ensure compliance with applicable processes. Documentation of these reviews and consultations are captured in logs and in Triages stored in the CBC data system. The logs for AAs and petitions for reinstatement are reviewed twice monthly by the manager of the unit as well as the CBC Bureau Chief as part of monthly production meetings. If a case is eligible to seek an exemption, the case is no longer monitored specific to having had an AA. It is considered a standard exemption case and is monitored as such. All case processing is tracked in the CBC data system and analyzed monthly utilizing Power BI software. Case processing metrics are reviewed weekly by Universal Case Processing Managers and monthly with the CBC Bureau Chief as part of the monthly production meetings.

The manual processes for identifying AA's across departments and the manual maintenance of excel logs and spreadsheets for tracking decisions on cases with AA's is targeted to be replaced with a more efficient, timely electronic solution in 2020. CDSS has contracted with a vendor and is developing a bidirectional application programming interface (API) between a new data system and the Administrative Action Records System (AARS) which will continually review all actions received from other departments. Any actions discovered on individuals present in licensed facilities will be reviewed for possible further action by CDSS. All management and Legal reviews will be electronically captured through e-signatures, and data specific to cases with AAs will be able to be generated.

Annual Follow-Up Agency Response From November 2018

CDSS receives a manual log from the Department of Health Care Services, Department of Aging, Department of Public Health, and the Emergency Medical Services Authority. The log contains a listing of administrative actions processed on an individual. A reconciliation is made against the Caregiver Background Check (CBC) System to identify any cases that need action by the California Department of Social Services (CDSS). Cases requiring action are processed by obtaining either conduct or conviction information. Based on the applicant information received from other departments, CDSS performs the appropriate background check process.

A management review and legal consultation is performed and required throughout the process to ensure compliance with applicable processes. Additionally, to ensure timeliness, management and Legal sign-off on the final recommendation. Lastly, to ensure timeliness, management monitors the process.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

Social Services did not provide evidence that it monitors this process to ensure that it is timely.

1-Year Agency Response

The Department has developed a process and updated its procedures to ensure that timelines are being met or, in cases where timelines are exceeded, the cases are prioritized by severity of conduct to eliminate potential risk to the health and safety of clients in care. (Attachment 3)

California State Auditor's Assessment of 1-Year Status: Partially Implemented

Social Services has not yet demonstrated that it is following up with staff about the timeliness of their assessments of individuals who have received administrative actions from other departments.

6-Month Agency Response

The Department has developed a process and tool for monitoring the timeframes set forth in the Interagency Exchange Procedures (see Attachments A and B).

California State Auditor's Assessment of 6-Month Status: Partially Implemented

The documentation Social Services provided to demonstrate that it is monitoring itself against the time frames in its administrative action exchange procedures shows the department is tracking the progress of cases, but not that it is measuring itself against the time frames or that it is following up in cases where it appears the department may have exceeded the time frames.

60-Day Agency Response

These procedures require a review of other departments' administrative actions and request for information from the other departments within five days. Once all information is received, the analyst will conduct a triage and review with Legal, make the determination, and obtain necessary management and Legal review within 20 days. The process and tool for monitoring these cases is included in the response to Recommendation 8 below - monitoring of exemption cases. Additionally, we have identified the recommended changes to be made to the Evaluator Manual. (See Attachment 1.)

California State Auditor's Assessment of 60-Day Status: Partially Implemented

Social Services has established time frames for how quickly staff must review information about administrative actions that is provided by other departments. When such actions are based on conviction information, Social Services' procedures indicate that it will follow its exemption processing time frames. It has also established a time frame for resolving cases that do not involve convictions (conduct related cases). However, it has not demonstrated that it is monitoring conduct related cases to ensure that the time frames it has established are being met.

All Recommendations in 2016-126

Agency responses received are posted verbatim.