Report 2012-107 Recommendation 18 Responses

Report 2012-107: Developmental Centers: Poor-Quality Investigations, Outdated Policies, Leadership and Staffing Problems, and Untimely Licensing Reviews Put Residents at Risk (Release Date: July 2013)

Recommendation #18 To: Public Health, Department of

To improve its enforcement, each year Public Health should evaluate the effectiveness of its enforcement system across all types of health facilities, including those in developmental centers, prepare the required annual report, and, if called for, recommend legislation to improve the enforcement system and enhance the quality of care.

Annual Follow-Up Agency Response From July 2017

Public Health is moving forward with efforts to determine a methodology to comply with the reporting requirement in Health and Safety Code section 1438 to address the effectiveness of the enforcement system in maintaining and improving the quality of care provided by long-term health care facilities. This will include an internal review of staff capacity/skills within CDPH to frame the methodology for the program evaluation and may include a Request for Offer to further define the methodology and/or conduct the assessment.

Additionally, Public Health completed two quality improvement projects which resulted in the development of periodic metrics under SB75 to track complaint investigations and post the results to the CDPH website. Citation processing improvement was achieved and ongoing monitoring efforts include quality and process measurements to ensure the current capacity will meet the mandatory requirements established in the legislation as well as produce reports for the legislature.

  • Estimated Completion Date: June 2019

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


Annual Follow-Up Agency Response From August 2016

Public Health is exploring funding to support ongoing research and reporting on effectiveness of the enforcement system in maintaining the quality of care provided by long-term health care facilities.

Additionally, Public Health initiated two quality improvement projects that evaluate complaint investigations and citation processes for long-term health care facilities. The projects focused on the Public Health District Offices success in completing investigations and if applicable, issuing citations, in a specified timeframe. The two projects resulted in new procedures that are in the pilot phase for the testing for eventual statewide implementation.

  • Estimated Completion Date: June 2018

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented


Annual Follow-Up Agency Response From October 2015

The status of this recommendation is unchanged.

  • Estimated Completion Date: 10/2015

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented


Annual Follow-Up Agency Response From October 2014

The status of this recommendation is unchanged.

  • Estimated Completion Date: 9/2015

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented


1-Year Agency Response

CDPH expanded its fiscal year (FY) 2014-15 Annual Fee Report to include additional enforcement related information than we reported in previous years. See pages 17 and 18 of the FY 2014-15 fee report at http://www.cdph.ca.gov/pubsforms/fiscalrep/Documents/LicCertAnnualReport2014.pdf.

In addition, SB 857 (Chapter 31, Statutes of 2014) requires CDPH to post performance and enforcement metrics on its website. CDPH will begin posting these metrics by October 30, 2014.

  • Estimated Completion Date: October 30, 2014
  • Response Date: October 2014

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


6-Month Agency Response

CDPH, through Hubbert Systems Consulting, will identify appropriate enforcement metrics to be evaluated for inclusion in the 2015 annual fee report, which CDPH submits to the Legislature on or before February 1 of each year.

  • Estimated Completion Date: February 2015
  • Response Date: January 2014

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


60-Day Agency Response

CDPH has partially implemented this recommendation. CDPH is engaged in a continuous process of building its quality improvement program which empowers and trains its staff to effectively enforce state and federal requirements. Additionally, CDPH is in the process of refining its quality improvement program to enhance the skill, knowledge and ability of its staff in evaluating the effectiveness of its enforcement system across all types of health facilities, particularly developmental centers.

CDPH will incorporate additional workload and enforcement activity information into the Health Facility License Fees Annual Report that CDPH submits to the Legislature on or before February 1st of each year.

In addition, we anticipate the recommendations from Hubbert Systems Consulting Group will identify additional reporting opportunities and identify opportunities to further improve the effectiveness of enforcement activities.

  • Estimated Completion Date: June 30, 2014
  • Response Date: August 2013

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


All Recommendations in 2012-107

Agency responses received are posted verbatim.


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