A delayed response?
Grand jury says lack of coordination slowed SJ County’s response to COVID-19
Wes Bowers
Three San Joaquin County departments responsible for disaster relief are being given less than a year to train staff and develop an overall coordination plan to prevent delays in emergency response times in the wake of the COVID-19 pandemic.
The San Joaquin County Civil Grand Jury released a 2021 report this week to the county’s pandemic response, and concluded that national, state, and local incident command policies and procedures, as well as the county’s emergency operations plan, were not working as effectively as they should.
The grand jury attributed this shortfall to a lack of designated leadership for the pandemic response, a lack of definitive policies and procedures, and a lack of adequate training for employees pressed into the roles of disaster service workers.
“The investigation found that dedicated and capable county employees worked tirelessly to contain the virus, but their efforts were hampered and delayed by organizational and policy issues,” the report stated. “The public health needs of the County’s residents were not met in a timely manner during this unprecedented public health emergency.”
Recommendations being made to the San Joaquin County Board of Supervisors include a revision of the county’s Public Health Services organizational structure so that the public health officer report directly to the Director of Health Care Services; written clarification of policies be developed for the placement and recall of personnel deployed as disaster service workers; and the development of written policies with definitive procedures requiring all county employees who may be called upon to perform disaster service work be trained annually on the county’s emergency operation plan.
The grand jury set a deadline of March 1, 2022 for the county’s Public Health Services, Office of Emergency Services, and Office of Emergency Medical Services to comply with the recommendations.
Tiffany Heyer, OES information officer, said all of the departments named in the report are currently reviewing the document.
“The county departments will collaborate on responses in the timeframe designated and present to the Board of Supervisors for approval prior to submitting to the Grand Jury,” she said. “We take this investigation seriously and endeavor to provide the best service to the community and our partners at all times.”
Lack of coordination
The grand jury report stated that while coordination and col
laboration between various county departments had improved over the last couple of months, staff in each agency has been unable to answer who has the overall responsibility for that cohesion with regard to the COVID-19 pandemic.
For the first 10 months of the pandemic, emergency operations procedures were not followed, according to the report, and departments were not sharing information or working together to meet public health needs of in a timely manner.
Shortly after OES declared a local emergency on March 12, 2020, it was determined that the COVID-19 pandemic was really a public health emergency and not an OES natural disaster.
The report said that OES was willing to provide services to support county public health services, which then took over response management of the emergency.
“The overall organizational structure did not lend itself to cooperation between departments at the initial stages of the emergency declaration,” the grand jury said. “When the responsibilities shifted, communication and coordination between departments failed.”
According to the grand jury, the board of supervisors did not recognize how severe the lack of coordination between departments was until vaccine distribution failed to roll out as planned. It was at that time the three agencies began correcting the coordination and collaboration issues and were negotiating a unified response, the report states.
Organizational impediments
Four months prior to the pandemic’s onset, the county reorganized the health department, and the public health officer was required to report to the Public Health Director rather than a Director of Health Care Services, as is done in other California counties.
Once the pandemic began, Dr. Maggie Park was appointed public health officer and became the face of the county’s response, receiving advisories and directives from the State of California while guidelines were constantly changing.
“As state guidelines were constantly changing, the public health officer attempted to communicate with the public and regularly update the Board of Supervisors,” the report said.
“However, the public health services director was hesitant to share pertinent information, thus preventing the public health officer from fulfilling the job of disseminating information to the public and other county departments.”
As a result, supervisors, staff and county residents were often frustrated by the lack of information being provided. Despite the lack of cohesion, the grand jury said Park performed admirably and was commended by peers.
However, the grand jury recommended Park report directly to the director of health care services, rather than the public health director.
Emergency assignments
Under state law, all government employees are declared disaster service workers who can be called upon to perform their regular duties or work in another department during a declared emergency.
The grand jury determined that throughout its investigation, it was evident there was not a clear understanding of how department heads could retain workers assigned to them, and county policy does not detail procedures for how and when those employees are recalled to their home departments.
Issues during the pandemic included a shortage of personnel, departments not making timely requests for personnel, and staff members being prematurely recalled back to their original departments. Some department heads believed employees were assigned until released, and not until recalled, while some department heads recalled employees when they felt it was necessary, regardless of pressing needs of the original department. Several departments had personnel recalled prematurely, which left the emergency response departments short-staffed.
Emergency training
Every year, the Public Health and Emergency Preparedness program created by the Centers for Disease Control and Prevention provides funding to ensure public health departments can effectively deal with disasters.
Funds are used to support appropriate disaster response experts, and require the maintenance of an inventory of personal protective equipment.
The county entered into a $4.2 million, five-year grant agreement with the California Department of Public Health to receive these funds from July 1, 2017 through June 30, 2022.
The grand jury said that just a few months prior to the pandemic, it was determined that PHS staff lacked an overall understanding of the county’s Emergency Operations Plan; the ability to execute the Community Preparedness, Emergency Operations Coordination; and information-sharing capabilities needed to be developed with the use of PHEP funds.
To view the entire grand jury report, visit www.tinyurl.com/2021SJC jury.