T A B L E O F C O N T E N T S

PAGE

County SUMMARY 4

HEALTHY COMMUNITY 8

HEALTH SYSTEM – HEALTH DEPARTMENT 8

Health Administration 9

Health Policy and Planning 10

Aging and Adult Services 10

Behavioral Health and Recovery Services 12

Community Health 14

Agricultural Commissioner/Sealer 16

Family Health Services 16

Correctional Services 17

SAN MATEO MEDICAL CENTER 18

Administrative and Quality Management 19

Patient Care Services 19

Ancillary and Support Services 20

Long-Term Care Services 20

Ambulatory and Medical Staff Services 20

SHERIFF’S OFFICE 21

Administrative and Support Services 22

Professional Standards Bureau 22

Forensic Laboratory 23

Patrol Bureau 23

Investigations Bureau 24

Office of Emergency Services 24

Maguire Correctional Facility 24

Custody Programs 25

Court and Security Services 25

PROBATION DEPARTMENT 26

Administrative Services 27

Adult Supervision and Court Services 27

Juvenile Supervision and Court Services 27

Institutions Services 28

DISTRICT ATTORNEY’S OFFICE 28

CORONER’S OFFICE 29

PUBLIC SAFETY COMMUNICATIONS 30

FIRE PROTECTION SERVICES 31

COUNTY SERVICE AREA #1 32

PROSPEROUS COMMUNITY 35

HUMAN SERVICES AGENCY 35

Office of the Agency Director 36

Program Support 36

Economic Self-Sufficiency 36

Child Welfare Services 37

Prevention and Early Intervention 37

DEPARTMENT OF CHILD SUPPORT SERVICES 38

HUMAN RESOURCES DEPARTMENT 39

LIVABLE COMMUNITY 42

PLANNING AND BUILDING DEPARTMENT 42

Program Performance Measures 42

Administration and Support 42

Long Range Planning Services 43

Development Review Services 43

DEPARTMENT OF HOUSING 43

Housing and Community Development 44

Housing Authority 45

ENVIRONMENTALLY CONSCIOUS COMMUNITY 47

DEPARTMENT OF PUBLIC WORKS 47

Administrative Services 49

Engineering Services 49

Facilities Maintenance and Operations 49

Road Construction and Operations 50

Construction Services 51

Vehicle and Equipment Services 51

Waste Management and Environmental Services 51

Transportation Services 52

Utilities, Flood Control and Natural Resources 52

Airports 53

PARKS 53

Administration and Support 54

Operations and Maintenance 54

Coyote Point Marina 55

COLLABORATIVE COMMUNITY 57

COUNTY MANAGER / CLERK OF THE BOARD 57

County Management 58

Intergovernmental and Public Affairs Unit (IGPA) 58

Clerk of the Board 59

Shared Services 59

REAL PROPERTY SERVICES 60

ASSESSOR-COUNTY CLERK-RECORDER 60

ACR Administration and Support 61

Appraisal Services 62

County Clerk-Recorder 62

Elections 62

CONTROLLER’S OFFICE 63

Administration 64

Controller Information Systems (CIS) 64

General Accounting 64

Internal Audit 65

Payroll Services 65

Property Tax/Special Accounting 65

TREASURER-TAX COLLECTOR 66

Tax Collector 67

Treasurer 67

Revenue Services 68

COUNTY COUNSEL 68

INFORMATION SERVICES DEPARTMENT 69

Information Technology Availability 69

Project Management 70

FY 2008-09 YEAR-END SUMMARY

Overview

Countywide implementation of Outcome-Based Management (OBM) began in 1999 during the Shared Vision 2010 community process. OBM is the performance management system that was implemented to track the performance of all County programs toward achieving Shared Vision 2010 commitments and goals. OBM will continue to be used but in a more integrated and systematic way to plan and manage employee and organizational performance, and to measure client and customer outcomes that contribute to achieving Shared Vision 2025 community outcomes.

Significant efforts have been made by departments since 1999 to align programs and existing planning processes to the community’s Shared Vision. Performance measures have been developed and refined during this time, and data reporting capabilities have been enhanced so that better decisions can be made toward improved program outcomes and goal achievement. Ongoing training on the preparation of program plans and budgets and the development and use of performance measures continues to be offered annually to managers through the County’s Management Development Program (MDP). OBM performance planning training was provided for the first time this year to supervisors through the First Line Supervisors Academy (FLSA).

This FY 2008-09 Year-End Performance Report highlights, for the first time, progress toward performance targets, organized by the five Shared Vision 2025 community outcomes:

• Healthy Community

• Prosperous Community

• Livable Community

• Environmentally Conscious Community

• Collaborative Community

Performance reports are prepared to communicate mid-year and year-end progress of programs toward achieving performance targets established during budget development. Each program has Headline Measures selected from measures of Quality (How Well We Do It) and Outcomes (Is Anyone Better Off?). These Headline Measures are the most important indicators of program success, and serve to provide the reader with a quick assessment of progress toward performance targets and goals. This year-end report contains two years of historical data and year-end actuals for the current year for each Headline Measure, along with a ü indicating when performance targets have been met or exceeded. A brief discussion is also included on trends and factors affecting performance.

Vision Alignment

The Mid-Year and Year-End County Performance Reports provide information on the progress for all County programs and services in the current fiscal year, and therefore contributes to all Shared Vision 2025 Community Outcomes. Training new and current managers and supervisors on using OBM and specifically on measuring performance directly contributes to creating a Collaborative Community: by forging partnerships, promoting regional solutions, with informed and engaged residents, and approaching issues with fiscal accountability and concern for future impacts.

Fiscal Impact

There is no fiscal impact related to acceptance of this report.

County Summary – Overall Customer Satisfaction Results

County programs ended FY 2008-09 with 93% of survey respondents rating overall satisfaction as good or better, which exceeds the Countywide target of 90%. Approved by the Board of Supervisors in 1999, the standard CARES survey is used by most departments to capture and report on customer satisfaction results. The CARES survey includes eight core questions focusing on response time, courtesy of staff, knowledge of staff, helpfulness of information, staff availability, information about the process, appropriate follow-up, and overall satisfaction with the service. Surveys are distributed by mail, available at public counters, on the Internet, or conducted by phone. Only the results for overall customer satisfaction are included in the Year-End Performance Report.

For FY 2008-09, 15 of 22 departments met or exceeded the 90% target of survey respondents rating overall satisfaction as good or better and 2 of the 22 did not conduct surveys in FY 2008-09 but will complete surveys in FY 2009-10. The table below highlights customer satisfaction results at the department and agency level. A summary and discussion of customer satisfaction results for each department / division is included in this report.

OVERALL CUSTOMER SATISFACTION RESULTS by Community Outcome	2006 Actual	2007 Actual	2008 Actual	2009 Actual	Achieved 90% Target
Health System – Health Department	91%	90%	89%	95%	ü
Health System – San Mateo Medical Center	91%	91%	83%	91%	ü
Sheriff's Office	99%	100%	98%	97%	ü
Probation Department	N/A	89%	95%	89%
District Attorney / Public Administrator	100%	100%	N/A	83%
Coroner's Office	95%	92%	97%	93%	ü
Public Safety Communications	N/A	N/A	100%	100%	ü
Fire Protection Services	N/A	100	N/A	N/A	N/A
Healthy Community	N/A	N/A	N/A	93%	ü
Human Services Agency	94%	93%	95%	92%	ü
Department of Child Support Services	79%	79%	81%	80%
Human Resources Department	95%	96%	95%	95%	ü
Prosperous Community	N/A	N/A	N/A	94%	ü
Planning and Building	79%	92%	61%	81%
Department of Housing	97%	98%	83%	83%
Livable Community	N/A	N/A	N/A	83%
Department of Public Works	95%	96%	95%	95%	ü
Parks Department	94%	94%	91%	94%	ü
Environmentally Conscious Community	N/A	N/A	N/A	95%	ü
County Manager / Clerk of the Board	99%	100%	100%	100%	ü
Real Property Services	N/A	90%	89%	96%	ü
Assessor-County Clerk-Recorder	91%	90%	89%	90%	ü
Controller's Office	96%	95%	93%	95%	ü
Treasurer-Tax Collector	100%	98%	89%	96%	ü
County Counsel	94%	N/A	98%	N/A	N/A
Employee and Public Services (no longer a department)	75%	N/A	N/A	N/A	N/A
Information Services Department	97%	100%	82%	100%	ü
Collaborative Community	N/A	N/A	N/A	96%	ü
Total County	93%	92%	90%	93%	ü

County Summary – Quality and Outcomes Measures Meeting Performance Targets

Of all program Quality and Outcomes measures, 72% met current year performance targets, which is below the Countywide target of 75% and about the same level as the last two years. Ten of the County’s 22 departments/budget units met or exceeded the 75% target; two improved from the prior year; and the remaining 10 performed at the same or lower level than the prior year. The results for this Countywide measure can vary from department to department for a number of reasons. Some departments tend to be more ambitious about setting performance targets. Approaches to setting performance targets vary by the types of services provided and among managers who set data collection methodologies. While managers are expected to plan for performance improvement over time, it is understood that performance can be affected by factors outside their influence or control. Managers are encouraged to use a combination of past experience; industry standards or benchmarks; factors that can affect future performance, such as the economy and budget reductions, new regulations or changes in client demographics; results expected from high-priority program initiatives; and realistic stretch goals, to set their performance targets. Targets are also developed with the involvement of staff that perform the work as part of the program’s plan and priorities for the following year.

The table below highlights department performance toward meeting targets for at least 75% of Quality and Outcomes measures. A summary of department performance as well as a discussion of Headline Measures for each program is included in the attached report.

HEALTHY COMMUNITY

Our neighborhoods are safe and provide residents with access to quality health care and seamless services.

Healthy Community includes the following departments:

• Health System

• Sheriff’s Office

• Probation Department

• District Attorney / Public Administrator

• Coroner’s Office

• Public Safety Communications

• County Fire

• County Service Area #1

HEALTH SYSTEM – HEALTH DEPARTMENT

Customer Satisfaction Results

Customer satisfaction results are displayed by Division in the pages that follow.

Performance Measure Results

Department Performance Measures Health System – Health Department	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Quality and Outcomes measures meeting performance targets	72%	81%	79%	75%	ü
Health cost per capita	$286	$327	$327	$339	ü
Percent of county residents who exhibit healthy behaviors	N/A	8.5%	N/A	N/A	N/A

The Health Department met current year performance targets for 79% of its Quality and Outcomes measures. Health’s cost per capita came in 4% under target, mostly due to savings from holding positions vacant. The trend for percent of residents who exhibit healthy behaviors has remained relatively flat, however the racial and ethnic disparity continues. Residents are surveyed on their behaviors every four years; therefore, this measure will be replaced in FY 2009-10 with the measure of years of potential life lost. Measuring the years of potential life lost was previously reported by Health every 3 years. Methodology has been improved to enable the department to report on potential life lost every year by using a three-year moving average.

The Health System – Health Department includes the following divisions:

• Health Administration

• Health Policy and Planning

• Aging and Adult Services

• Behavioral Health and Recovery Services

• Community Health

• Family Health Services

• Correctional Services

HEALTH ADMINISTRATION

Customer Satisfaction Results

Health Administration surveyed internal Health Department customers using a web-based survey tool. Of the 22 responses received, 91% of customers rated overall satisfaction with service as good or better. Seven staff were recognized for their high quality service and support. Areas for improvement noted by the survey included customer service and improvement with contract support and feedback. Health Administration is engaging in training opportunities to address these issues to continue their improvement from prior years.

Performance Measure Results

Division Performance Measures Health Administration	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Percent of business questions able to be answered through the Health Client database	3%	3%	0%	8%	No
Percent of stakeholder survey respondents rating services good or better	92%	94%	91%	90%	ü

Health Administration met current year performance targets for one of two Headline Measures. The Health Client Data Store Project merges various databases and information throughout the Health System into a common system that would allow for reporting across divisions and programs on the people we serve. This information is to be used to obtain grants, program planning, and evaluation to ensure that we are meeting the needs of the community. During the implementation phase, approximately 200 business questions were identified. It was also learned during this process that some key programs lacked the required data systems or data extraction was difficult, slowing the rate of business questions that could be answered. As a result, this project is under review due to budget constraints. Customer satisfaction ratings came in above target.

HEALTH POLICY AND PLANNING

Customer Satisfaction Results

Health Policy and Planning surveyed internal Health System customers, with responses submitted via a web-based survey tool. Overall, 100% reported their overall satisfaction of services as good or better with special consideration to the technical assistance provided to the divisions. Efforts will be made during the next reporting cycle to improve survey response rates by sending more frequent email reminders.

Performance Measure Results

Health Policy and Planning (HPP) met current year performance targets for three of its five Headline Measures. Overall enrollment in low-income children’s insurance programs continues to demonstrate strong performance. However, given that the trend in uninsured children continues to improve, Healthy Kids is more driven by trends in the larger economy (jobs, immigration), which may contribute to lower numbers of children who would fall into the Healthy Kids eligibility levels. Enrollment of children into other programs supported by federal and state funding enables maximum leverage of local dollars. HPP exceeded targets by 6% for strategic initiative partner confidence ratings for both internal and external partners.

AGING AND ADULT SERVICES

The division includes the following programs:

• Conservatorship Program

• Community-Based Programs

• IHSS Public Authority

Customer Satisfaction Results

Aging and Adult Services (AAS) and its contracted community based organizations distributed a total of 9,981 Care surveys and 14% were returned. Specifically, AAS distributed 1,374 and 20% were returned. Continuing the high performance level of recent years, 95% of respondents rating overall satisfaction as good or better. In AAS’s Case Management program, survey responses acknowledged staff, staff assistance, and appreciation of accurate translations and interpretations. There were a few complaints over the limitations of the In-Home Supportive Services program; clients wanted more hours than could be assessed under the Hourly Time for Task guidelines. AAS staff will direct themselves and work with contract service providers to address the relatively few areas for improvement cited by some survey respondents.

Performance Measure Results

Program Performance Measures Conservatorship Program	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Percent of cases managed by the Public Guardian in which no fiduciary claims were filed against the Division	100%	100%	100%	99%	ü
Percent of probate conservatees for whom the Conservator-ship Program has medical consent authorization	79%	81%	82%	80%	ü

The Conservatorship Program met current year performance targets for both Headline Measures. The total amount of client assets managed by the Conservatorship Program decreased from approximately $68 million to $63 million due to the downturn of the economy. The Conservatorship Program continues to have no fiduciary claims against the cases being managed. Securing medical consent authorization enables program staff to make medical treatment decisions on behalf of conservatees who cannot make such decisions independently, thus increasing the level of patient care.

Community-Based Programs did not meet current year performance targets for either Headline Measure. Adult Protective Services experienced a slight decrease in the percent of cases effectively resolved and stabilized for at least twelve months due to reductions in resources, which has necessitated cases being closed more expediently following client stabilization. The practice of closing cases soon after client stabilization may create more cases being re-opened within a twelve-month period. The percent of at-risk individuals maintained in a least restrictive setting through case management did not meet target, although they were able to come within 1% of the target through a collaborative work effort toward enhancing the continuum of care to better meet the needs of seniors and adults with disabilities. Programs include other County programs such as Behavioral Health and Recovery Services, Ron Robinson Senior Care Center, and Environmental Health; the County’s Commissions on Aging and Disabilities; and community providers. In addition, the Network of Care continues to assist in the dissemination of information regarding available services throughout the community.

Program Performance Measures IHSS Public Authority	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Percent of consumers without caregiver resources who find an IHSS provider through the Public Authority registry	100%	76%	74%	80%	No
Percent of caregiver survey respondents rating services good or better	97%	98%	98%	90%	ü

The Public Authority (PA) met current year performance targets for one of two Headline Measures. The data collection methodology for assessing PA Registry success in assisting consumers to find an IHSS worker changed in FY 2007-08. The percent now indicates any consumer who requested Registry services, including those who chose a family member or friend. This increases the number of customers served, but decreases the percentage of consumers who find an IHSS provider through the Registry service. In the past, the PA has typically received over 100 surveys annually, and has used the findings to improve services, thus maintaining a high level of satisfaction in services.

BEHAVIORAL HEALTH AND RECOVERY SERVICES

The division includes the following programs:

• Behavioral Health and Recovery Administration

• Mental Health Youth Services

• Mental Health Adult Services

• Alcohol and Other Drug Services

Customer Satisfaction Results

The Mental Health Services Division is mandated to adhere to specific reporting requirements set forth by the State Department of Mental Health. Therefore, Mental Health survey results do not match directly with questions on the San Mateo County Cares survey instrument. For example, in addition to asking different questions, these surveys give the option of “neutral,” “undecided,” and “not applicable” responses. These additional response options affect the number of respondents rating services as excellent, good, fair, or poor. Mental Health administers surveys to three groups of consumers: adults that receive mental health services; youth that receive services; and family members of youth that receive services. Overall satisfaction with Mental Health services continues to be high in all groups. For the adult population, the overall positive endorsement rate was 95%, which is consistent with other measures of satisfaction observed in public mental health systems. The positive endorsement ratings were 85% from youth who receive services and 71% from their families. In recent years, BHRS has implemented community based intensive services for the most at-risk youth in order to decrease out of home placements. This shift may have had a negative impact on parent satisfaction for some programs. BHRS will be working closely with parents and providers of the program that experience the most significant decreases to understand the source of dissatisfaction.

Performance Measure Results

Behavioral Health and Recovery Administration met current year performance targets for all Headline Measures. Success of recent staff development activities, such as trainings, is reflected in high percentages of staff satisfaction and familiarity with mission / initiatives. The survey is measured once a year via staff survey. Third party revenue is composed of billing revenue generated from Medi-Cal, Medicare, Healthy Families, and other public and private health insurers.

Program Performance Measures Mental Health Youth Services	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Average monthly census of out-of-home placements at the countywide group home level by Mental Health, Probation, and Human Services Agency	110	84	71	105	ü
Percent of survey respondents who agree or strongly agree that they are satisfied with services received: Parents	90%	73%	72%	90%	No
Percent of survey respondents who agree or strongly agree that they are satisfied with services received: Youth	88%	89%	91%	90%	ü

Mental Health Youth Services met current year performance targets for two of three Headline Measures. A decrease in out-of-home placements at the group home level (fewer out-of-home placements are better) to 71 represents continuing achievement that is partly attributable to the recently opened Canyon Oaks facility; full implementation of the Partners for Safe and Healthy Children initiative and the San Mateo Child Abuse Treatment Collaborative; and interagency success in meeting the treatment needs of younger, more severely disturbed children entering the system who often require the more restrictive setting of a group home placement. The State-mandated customer satisfaction instrument is in its fourth year of use, with performance achieved exceeding target for both youth and adults. Mental Health Youth Services will address satisfaction outcomes with those providers who have had decreased in satisfaction in order to determine how improvement can be made. Some of these providers serve the most acute clients. Families dealing with the onset of severe clinical issues may not be disposed to high levels of satisfaction. The goal over the next two years is to maintain or improve upon these results with expanded levels of service funded by the Mental Health Services Act.

Mental Health Adult Services met current year performance targets for all Headline Measures. The first two measures track the average usage per client per year of Psychiatric Emergency Services (PES) and hospitalization. In tandem, these rates provide an accurate reflection of system effectiveness at the client level. The implementation of a centralized placement and review team to assist PES and acute units with more efficient discharge planning and linkage to outpatient resources contributed to improved performance. Tracking of trends in meeting customer satisfaction is difficult due to the biannual point-in-time data collection methodology employed by the State. To meet customer needs, the program has implemented the findings of recently conducted consumer and family focus groups that resulted in wellness and recovery enhancements including increased employment of consumers; creation of the Financial Empowerment Pilot Project to increase personal financial responsibility; and implementation of a contracted peer support services program. Improvement of these consumer outcome measure results is expected to continue with implementation of expanded levels of service funded by the MHSA.

Program Performance Measures Alcohol and Other Drug Services	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Percent of clients who successfully complete alcohol and drug treatment services	60%	59%	60%	60%	ü
Number of selected communities participating in environmental community-based prevention strategy	N/A	N/A	4	4	ü

Alcohol and Other Drug Services (AOD) met current year performance targets for all Headline Measures. Efforts to redesign the system are continuing, including the identification and implementation of standards of care inclusive of evidence-based and promising practices. The plan is to implement the standards of care in FY 2009-10. During the implementation, it is anticipated the percentage of clients successfully completing primary treatment may remain relatively flat. The number of selected communities participating in environmental community-based prevention strategy is a new performance measure for FY 2008-09. Prevention strategies that focus on community norms and laws, organizational practices, and the physical environment are evidence-based practices for alcohol and other drug prevention. State prevention policy and the San Mateo County Alcohol and Other Drug Strategic Plan specifies the development of community partnerships as an effective means to impact those areas identified above.

COMMUNITY HEALTH

The division includes the following programs:

• Chronic Disease and Injury Prevention (CDIP)

• Public Health Programs

• Environmental Health Services (EHS)

• Emergency Medical Services (EMS)

• Agricultural Commissioner / Sealer

Customer Satisfaction Results

Community Health received 536 Cares survey responses, with 94% of respondents rating overall satisfaction as good or better, continuing the high ratings received over the past three years and exceeding the County standard of 90%. Throughout all programs, comments received were very complimentary of staff and program services; clients felt comfortable getting the services and believe they were better off because of the services received from these programs. While most comments were complimentary of Community Health, there were suggestions to have more flexible hours and shorter wait times in clinics for Public Health Programs. There were also comments to further develop the Environmental Health website. The main Health System website is undergoing major web design and content updates, which include Environmental Health.

Performance Measure Results

Chronic Disease and Injury Prevention (CDIP) met current year performance targets for one of two Headline Measures. Starting in FY 2008-09, data are being collected on the number of community members who benefit from the implementation of new policies related to chronic disease prevention. When a policy is implemented in a community, a calculation of the number of community members impacted by the specific policy is conducted. For example, when a tobacco retailer license (TRL) ordinance was implemented in Brisbane, it was estimated that there were 637 people under 18 years of age in Brisbane were impacted by the policy, as the TRL is intended to limit youth access to tobacco products. Similarly, community events that implement a smoke-free policy will benefit the number of people who attend that event. CDIP is utilizing program-specific tools that measure the change in participants knowledge, attitudes, and behavior (KAB) changes as a result of our educational efforts. Because CDIP's focus is on policy advocacy, there were no community educational presentations during April 2009, when KAB surveys were to be implemented. The measure reported here is from the Community Health educational presentation on the Ten Essential Public Health Services. This presentation was provided during the all-staff Community Health meeting and represented the first opportunity for over 90% of our staff to hear about the Ten Essential Services and their role in providing those services in the community. This specific outcome measured staff's evaluation of whether the educational presentation advanced their understanding of the essential public health services and functions.

Public Health Programs, which includes the STD / HIV Program, met current year performance targets for both Headline Measures. Customer satisfaction ratings have consistently been 90% or above for the past three years as a result of focusing on the survey responses as we implement improvements to our services. The KAB survey instruments are primarily distributed during group presentations in the adult and juvenile correction facilities, alcohol and drug programs, and schools. Since the program does these on a regular basis, each group can include persons hearing the information for the first time as well as those who have heard it a number of times. Given the issues confronting these persons, some in the group may be ready to make a change in their risky behaviors while others are not. Therefore, the results can vary from year to year.

Environmental Health Services did not meet current year performance targets for both Headline Measures. Annual inspections of permitted facilities remain a priority, as a means of educating clients and ensuring that businesses pose little risk to the public’s health. Most individual programs met or exceeded the goal; however, two sub-programs significantly reduced the overall percentage. These programs will be prioritized in this next fiscal year. The ultimate goal of the Household Hazardous Waste (HHW) program is to educate individuals to buy what they need and for manufacturers to begin producing products that are not hazardous at the end of their useful life, thus collection of a lesser amount than predicted is a step in the right direction. While the program is serving an increasing number of households, from 11,000 to 42,000, the amount of waste received is trending downward, which could be attributed to consumers purchasing more accurate quantities, therefore producing less waste for disposal.

Emergency Medical Services met current year performance targets for all Headline Measures. On-time response rates for both paramedic and ambulance responses met targets due to continuous work on quality improvement and performance, and proximity to small geographic service areas. Recent efforts to improve the patient care record increased access to data and contributed to EMS exceeding their target by 25%.

Agricultural Commissioner / Sealer met current year performance targets for both Headline Measures. The variation in the number of harmful pest interceptions, such as magnolia white scale, is related to the fluctuation over time in the number of plant and produce shipments with multiple pests and the expansion of state-funded staff time expended on pest prevention inspections. There are 1,770 businesses regulated for weights and measures requirements in the county. Program staff work to keep compliance rates high by following inspection plans that include multiple visits to businesses with a history of non- compliance, responding promptly to consumer complaints, and leveling administrative civil penalties for violations when warranted.

FAMILY HEALTH SERVICES

Customer Satisfaction Results

Family Health Services received 543 survey responses, with 99% of respondents rating overall satisfaction as good or better, and more than 95% of customers reporting positive responses on every indicator. Approximately 80 staff were individually recognized for excellence; comments suggest that staff are helpful, friendly, and go above and beyond expectations. There were relatively few areas for improvement. There were a few comments for the WIC program regarding limited food choices and quantity, and needing additional venues for exchanging food voucher.

Performance Measure Results

Family Health Services (FHS) met current year performance targets for both Headline Measures, as well as exceeding the national Healthy People 2010 benchmark standards for both breastfeeding and immunization of low-income children. Trained WIC (Women, Infants, and Children) staff and Breastfeeding Peer Counselors provide increased support for new mothers, and contribute to the improvement in the breastfeeding rate. FHS also leads the Breastfeeding Advisory Committee, which aims to increase breastfeeding levels in San Mateo County. According to the U.S. Department of Health and Human Services, babies who are not breastfed are sick more often and have more doctor visits. Breast milk provides infants with the most complete form of nutrition, babies tend to be their appropriate weight, and breastfed children tend to score slightly higher on IQ tests. For the mom, breastfeeding reduces the risk of breast and ovarian cancer and can help her bond with her baby. Breastfeeding impacts the community by reducing healthcare costs, increasing the mother’s work productivity, and reducing waste related to bottles and formula. There is consensus in the health community that immunizations are extremely effective at decreasing childhood mortality. The American Academy of Pediatrics suggests that the completeness of a child’s immunizations is a crucial element in preventive health services. FHS staff conduct regular community immunization clinics and provide both administrative and technical support to other immunization providers.

CORRECTIONAL HEALTH SERVICES

Performance Measure Results

Division Performance Measures Correctional Health Services	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Percent of mentally ill inmates engaging in treatment by receiving medications	37%	62%	40%	40%	ü
Percent of offenders receiving timely histories and physicals: Juveniles	100%	100%	99%	95%	ü
Percent of offenders receiving timely histories and physicals: Adults	100%	98%	95%	95%	ü

Correctional Health Services met current year performance targets for all Headline Measures. Increased inmate compliance to receiving medications has recently resulted in improved performance. Clinical staff continue to provide encouragement and education to inmates and address issues of medication side effects to maintain and increase compliance. Completion of timely histories and physicals for both juveniles and adults continues at a high level of achievement.

HEALTH SYSTEM – SAN MATEO MEDICAL CENTER

Customer Satisfaction Results

Department Customer Satisfaction Health System – San Mateo Medical Center	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Overall satisfaction rated good or better	91%	83%	91%	90%	ü
Number of customer survey responses	4,283	2,531	8,000	N/A	N/A

San Mateo Medical Center uses several different divisional surveys to measure patient satisfaction. A new Centralized Patient Satisfaction Database was developed to collate the various patient satisfaction forms and relate each specific division measure to a County Cares general category. In addition, the Medical Surgical Unit subscribes to a third party vendor, Press Ganey, in order to meet regulatory requirements that mandate the reporting of specific satisfaction measures to the Joint Commission and the Centers for Medicare and Medicaid Services.

Approximately 8,000 surveys were received from both the Press Ganey Corporation and the various divisions for FY 2008-09. Overall Satisfaction is rated as “Excellent” (63%) or “Good” (28%) in 91% of surveys, which is a strong improvement over last fiscal year’s 83% rating for “Good” and “Excellent”. The very large sample size of FY 2008-09 is in contrast to the smaller sample size in FY 2007-08. Surveys from the Clinics system revealed excellent and consistent courtesy of staff, which is impressive in the face of lengthening wait times due to increasing patient population. The bulk of surveys were filled out in the Clinics system, which also has the overwhelming majority of patient contact throughout the Health System.

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Performance Measure Results

The San Mateo Medical Center (SMMC) has 32 quality and outcome measures and 11 of these are data development measures. Of the remaining 21 measures, 11 met target. Five of the 10 measures that did not meet target were related to payor mix breakdown. The continuing economic recession and increasing unemployment rate has caused the percentage of patients with third party insurance to decrease. The decrease in other third party payor source has caused an increase in both the County and Medi-Cal payor sources, which adversely affected financial performance. In addition, three of the measures that did not meet target were related to Long-Term Care surveys. Survey responses expressed concerns specifically with dietary and nutrition. Many residents on special diets were not satisfied with the food provided to them. Typically, however, the blandness of the diet is inherent to their clinical condition and related dietary restrictions. Several strategies are being developed such as the introduction of diet holiday waivers wherein patients will be allowed to go off their dietary restrictions for a temporary period, which can increase satisfaction as well as improve adherence to their dietary restrictions in the long-term. Other initiatives include the installation of more equipment for the cook-chill system, which will increase food preparation capacity, which can lead to increased tray accuracy. The last measure was for the number of Quality Improvement Plans meeting target. This number is low because many departments set very aggressive targets and these became increasingly difficult to achieve in light of the hiring freeze and flat staffing resources coupled with increased demand for services caused by the recession.

SMMC met current year performance targets for 52% of its Quality and Outcomes measures. The cost per adjusted patient day came in below target as the reliance on premium pay, overtime and registry staff has been reduced. The number of inpatient days is expected to be lower than projected due to the ongoing efforts of management to reduce administrative days and effectively manage census and staffing. The number of outpatient visits also met target due to the various initiatives aimed at improving clinic volumes and productivity.

The department includes the following programs:

• Administrative and Quality Management

• Patient Care Services

• Ancillary and Support Services

• Long-Term Care Services

• Ambulatory and Medical Staff Services

Administrative and Quality Management met current year performance targets for one Headline Measure. However, despite actual improvement in margins, the hospital faces increasing costs. Net margins are defined as net profit divided by net revenues and are often expressed as a percentage. Many departments set very aggressive targets and these became difficult to achieve in the face of rising demand for services due to the economic recession. For example, wait times have increased across most divisions as units attempt to meet rapidly increasing demand for services with flat staffing resources. As a result, the percent of Quality Assessment / Improvement Plans meeting targets fell short of its goal. However, documentation improvement initiatives, ongoing staff education, and committee discussions have all served to improve performance on the core measures, from the previous year.

Program Performance Measures Patient Care Services	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Nursing Vacancy Rate	14%	9%	7%	12%	ü
Percent of customer survey respondents rating services good or better	91%	82%	90%	90%	ü

Patient Care Services met current year performance targets for both Headline Measures. Although the target for the nursing vacancy rate will be met, SMMC continues to face the challenge of a nationwide shortage of nurses, which is compounded in California which has a stricter nurse-to-patient staffing ratio requirement. Customer satisfaction feedback improved due to ongoing patient experience projects, such as the implementation of regular comfort rounds during which nursing staff proactively check on patients’ comfort needs and requirements. The enhancement of the patient experience has been set as a core institutional goal with each program required to develop specific projects designed to improve the overall experience of care at SMMC. Despite the effects of the increased demand especially on the Operating and Emergency Departments, customer satisfaction remains high.

Program Performance Measures Ancillary and Support Services	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Number of retail outpatient prescriptions	173,389	214,362	235,379	218,000	ü
Percent of survey respondents rating services good or better: Patients	97%	80%	93%	90%	ü
Percent of survey respondents rating services good or better: Employees	N/A	73%	75%	90%	No

Ancillary and Support Services met current year performance targets for two Headline Measures. The need for prescriptions is driven by patient acuity and a projected increase was seen in clinic visits. Customer surveys are made available at front desk reception areas where patients usually check-in. While the overall ratings are positive, the majority of complaints appear to relate to wait times for services. The customer satisfaction rating for employees is compiled by a peer department satisfaction survey. The decline in peer department satisfaction appears to be related to delays in service delivery as a result of recent staffing shortages and reductions. Ancillary and Support Services continues to look at new initiatives to improve service and efficiency within current financial limitations.

Program Performance Measures Long-Term Care Services	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Percent of customer survey respondents rating services good or better: Burlingame Long Term Care	92%	66%	66%	85%	No
Percent of customer survey respondents rating services good or better: Main Campus Long Term Care	92%	87%	83%	90%	No
Number of patient falls per 1000 patient days	2.49	3.55	3.4	2.2	No

Long Term Care (LTC) Services did not meet current year performance targets for any of its Headline Measures. Burlingame Long Term Care only conducts patient satisfaction once a year and one specific issue that weighed heavily on overall satisfaction was the quality of food. Several strategies are being developed such as the introduction of diet holiday waivers wherein patients will be allowed to go off their dietary restrictions for a temporary period, which can increase satisfaction as well as improve adherence to their dietary restrictions in the long-term. Other initiatives include the installation of additional equipment for the cook-chill system, which will increase food preparation capacity and can lead to increased preparation accuracy. Ongoing improvements and focus on patient experience initiatives has resulted in a higher customer rating for the Main Campus Long Term Care Unit. A significant percentage of the number of patient falls can be attributed to just one patient who suffered from a neurological disorder that resulted in frequent falls while refusing or failing all interventions to reduce his risk for falling. If, however, this patient is subtracted out, the fall rate is substantially lower at 2.7 falls per 1000 patient days.

Program Performance Measures Ambulatory and Medical Staff Services	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Percent of clinic patients who have been assigned a Primary Care Provider	70%	77%	N/A	N/A	N/A
Percent of clinic outpatient visits by payor: County	21%	26%	34%	28%	No
Percent of clinic outpatient visits by payor: Medi-Cal / Medicare	48%	49%	51%	48%	ü
Percent of clinic outpatient visits by payor: Other Payor Sources	31%	25%	15%	24%	No

Ambulatory and Medical Staff Services met current year performance targets for one of four Headline Measures. The methodology to calculate the percent of clinic patients who have been assigned a Primary Care Provider is in the process of being revised due to data inconsistencies introduced in part by provider shortages and staff turnover. The percent of clinic outpatient visits by payor source for the County has increased largely due to the implementation of the Access and Care for Everyone (ACE) initiative, which is an expansion of healthcare programs for uninsured and underinsured county residents. However, the continuing economic recession and increasing unemployment rate has caused the percentage of patients with third party insurance to decrease over the last several months as more and more patients are losing their insurance. The decrease in other third party payor source has caused an increase in both the County and Medi-Cal payor sources.

SHERIFF’S OFFICE

Customer Satisfaction Results

The Sheriff’s Office received 74 surveys with 97% of respondents rating overall satisfaction as good or excellent. Compared to the prior year, overall satisfaction decreased slightly and the number of survey responses also decreased. Many of the community policing programs, such as bicycle safety, car seat inspections, Sheriff’s Activities League (SAL), and the school resource officers received the most written comments. Overall, customer feedback was positive with a number of responses recognizing staff as being knowledgeable, helpful, detailed, kindness, thorough, informative, polite, dedicated, friendly, professional, and courteous.

Performance Measure Results

The Sheriff’s Office met current year performance targets for 65% of its Quality and Outcome measures, which is short of the countywide standard of 75%. The number of dispatched calls for service for FY 2008-09 increased by 985 or 1%; however, the average cost per dispatched call for service decreased. This decrease is primarily due to the increase in total calls while maintaining existing staffing levels. While both the Maguire Correctional Facility and the Women’s Correctional Center remain severely overcrowded with an average of 301 inmates over the State Board of Corrections rated capacity for these two facilities, Sheriff’s Office staff and County partners in the Health System and Probation Department continue to make progress in modifying inmates eligible for out-of-custody treatment programs in order to keep the average daily population from growing.

The Sheriff’s Office includes the following programs:

• Administration and Support Services

• Professional Standards Bureau

• Sheriff’s Forensic Laboratory

• Patrol Bureau

• Investigations Bureau

• Office of Emergency Services

• Maguire Correctional Facility

• Custody Programs

• Court and Security Services

Administrative and Support Services met current year performance targets for both Headline Measures. Customer satisfaction with the department exceeded the countywide standard of 90% with the majority of the responses from the Community Policing Program and the North Fair Oaks sub-station. The percent of department budget devoted to administrative cost came in under target while the administrative cost per department employee decreased slightly and came in under target. The Program had six major projects or initiatives identified in the budget and completed five or 83% of those projects on schedule

Program Performance Measures Professional Standards Bureau	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Percent of new hires / promotions (Deputy / Correctional Officer) successfully completing probationary period	90%	91%	85%	95%	No
Percent of citizen complaints that are sustained at some level	19%	38%	27%	23%	No

Professional Standards Bureau did not meet current year performance targets for both Headline Measures. Performance in the Bureau is primarily driven by recruitment and training activities for new hires. The percent of new hires in the Deputy Sheriff and Correctional Officer classifications that successfully completed probation did not meet target primarily due to the fact that sworn personnel are required to complete a six-month police academy, complete a jail operations training program, and successfully complete a field training program. The number of citizen complaints processed increased from 48 in the prior year to 61 in the current year and 17, or 27%, of the complaints were sustained at some level. The increase in complaints and increase in complaints sustained is primarily due to a rise in complaints from the Maguire Correctional Facility.

Program Performance Measures Forensic Laboratory	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Percent of Major Cases completed in less than 30 days	23%	30%	20%	25%	No
Percent of Major Cases completed in less than 60 days	38%	45%	38%	55%	No
Percent of customers rating turnaround time as good or better	100%	98%	90%	90%	ü

The Forensic Laboratory met current year performance targets for one of three Headline Measures. The percent of major cases completed in less than 30 and 60 days did not meet target primarily due to a change in methodology from counting the number of major crimes to counting the number of major case items processed, an increase in the number of major case items, and a large number of laboratory staff in training. The change in methodology was made because it more accurately reflects the workload due to the fact that one case may have just one item to process while another case may have one hundred items to process. To reduce backlog, the Laboratory has increased staff and training in the forensic biology, latent print, and firearms units; contracted with a private laboratory to test toxicology samples; and increased outreach to client agencies in order to streamline and prioritize casework. Customer satisfaction with the Laboratory continues to remain high with 90% of customers rating turnaround times as good or better. The Laboratory will continue to focus on timely processing and analysis of submitted evidence while maintaining a high level of customer satisfaction.

Program Performance Measures Patrol Bureau	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Annual Part I crimes per capita: San Mateo County	.028	.024	.026	.030	ü
Annual Part I crimes per capita: Bay Area Counties	.037	.035	.033	.037	Benchmark
Annual Part 1 crimes per capita: Statewide	.036	.035	.034	.038	Benchmark
Average cost per dispatched call	$539	$534	$492	$545	ü

The Patrol Bureau met current year performance targets for both Headline Measures. The annual Part I crimes per capita met target and consistently remains lower than in neighboring counties and statewide. However, the Bureau did see an increase in the number of crimes in early 2009 and indicators show the number may continue to climb both locally and statewide, which may be related to a down economy. Part I crimes are separated into two categories: violent and property crimes. Violent crimes include aggravated assault, forcible rape, murder, and robbery. Property crimes include arson, burglary, larceny-theft, and motor vehicle theft.

The cost per dispatched call for service came in under target this year primarily due to the number of calls increasing by 1,000 while staffing has remained static or slightly lower than the prior year. In addition, the Bureau has made some significant efforts in reducing staff costs by not filling all vacant posts when it is appropriate and does not compromise public safety. Response times for priority emergency services calls in urban areas has increased from 4:44 minutes in the prior year to 5:07 minutes in FY 2008-09 and did not meet target. This increase in urban response times is primarily due to increasing traffic congestion and static or reduced staffing levels. Coastside and rural response times vary by location and have decreased by over one minute from the prior year primarily due to stabilized staffing levels as a result of the addition of the Relief Staffing Unit positions to ensure beat coverage.

Program Performance Measures Investigations Bureau	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Percent of cases submitted to the District Attorney’s Office	31%	34%	38%	31%	ü
Percent of first time offenders successfully completing the Juvenile Diversion Program	85%	90%	87%	85%	ü
Percent of youth re-offending within 12 months after completing Diversion Program	15%	10%	13%	15%	ü

The Investigations Bureau met current year performance targets for all Headline Measures. Total cases reviewed for investigation in FY 2008-09 is 9,248, an increase of 449 cases, or 5%. The number of investigations performed increased from 5,891 in FY 2007-08 to 6,368 in FY 2008-09. In addition, investigations performed by the various task forces, such as the Countywide Narcotics Task Force (CNTF), the Vehicle Theft Task Force (VTTF), the Northern California High Intensity Drug Trafficking Area (NC / HIDTA) and the Regional Terrorist Threat Assessment Center (RTTAC), have become more complex with more co-conspirators, reflecting organized gang consolidation in narcotics.

The Juvenile Diversion Program continues to offer After-Care, which provides ongoing support and access to counseling services for program attendees and in FY 2008-09 the Program serviced 42 minors. This is a decrease from the prior year primarily due to the loss of the Temporary Assistance for Needy Families (TANF) grant; a loss of Juvenile Justice Crime Prevention Act (JJCPA) funding that was received from the Probation Department, and a lack of referrals from schools. The overall recidivism rate, the percentage of participants entering or re-entering the criminal justice system, increased slightly from the prior year, but still met target. This percentage includes beneficiaries of both Diversion and Intervention services. Due to reduced staffing levels, program completion by participants has decreased slightly, from 90% in the prior year to 87% in FY 2008-09.

The Office of Emergency Services (OES) met current year performance targets for one of two Headline Measures. OES has remained steady with hazmat, bomb, and general mutual aid calls, however, the annual calls for service did not meet target primarily due to a significant drop in the number of mutual aid fire call outs, a decline in search and rescue call outs, and a decline in storm related calls. Generally, OES is busy with storm related calls from mid November through February; however, OES received 9 storm related calls in FY 2008-09, which may be attributed to a more mild winter that in the prior years.

The OES remains positioned to respond to an increase in calls should new domestic security crises arise. OES responded to 39 emergencies in FY 2008-09, which may range from serious fires to SWAT incidents to national security alerts. Victim assistance remains a high priority for both OES and the first responder agencies that OES supports. In FY 2008-09, volunteers contributed 12,169 hours to the Emergency Services program, which represents a savings to the County of $647,768.

Program Performance Measures Maguire Correctional Facility	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Percent of ADP classified as At-Risk	76%	79%	87%	74%	ü
Average daily population managed at the Maguire Correctional Facility	982	979	968	990	ü
Total In-custody assaults	121	100	73	115	ü

The Maguire Correctional Facility met current year performance targets for all Headline Measures. The average daily population (ADP) for FY 2008-09 is 968, which is a slight decrease from the prior year but still considerably higher than the California State Corrections Standard Authority rated capacity of 688. This overcrowding can be attributed to closure of alternative low-risk inmate custodial facilities including the Men’s and Women’s Honor Camps, increased gang enforcement, and an increased in the average length of stay for inmates. Although the percentage of inmate population that is classified as at-risk, gang affiliated, and / or suicidal has stabilized, due to the rising ADP, the number of inmates classified as at-risk has increased from the prior fiscal year. The total number of in-custody assaults decreased by 42 in FY 2008-09. This decrease is primarily due to improved staff training and inmate management, including the addition of a second Choices Pod and the Administrative Segregation Pod.

Program Performance Measures Custody Programs	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Jail beds saved by using custody alternatives programs	29,009	30,785	28,342	32,000	No
Annual value of community service work provided by work crews	$2,310,840	$2,538,720	$2,380,680	$2,800,000	No

Custody Programs did not meet current year performance targets for both Headline Measures. Custody alternative programs include the Sheriff’s Work Program (SWP), Electronic Monitoring Program (EMP), and Work Furlough. These programs assist in managing the jail population and incarceration costs by providing sentencing alternatives to low-risk, minimum-security offenders. In FY 2008-09, the average daily number of SWP and EMP participants decreased primarily due to successful efforts by the Courts and Probation on sentencing alternatives for low offenders; the success of the Reentry Workgroup to modify low offender sentenced inmates out of the Sheriff’s custody facilities and into community based programs, which are not counted in the measures; and a higher severity of crimes being committed by felony offenders, which are ineligible for SWP and EMP. The number of hours of community services worked by alternative custody inmates in FY 2008-09 is 317,424, which represents an annual value of 2.3 million dollars.

Program Performance Measures Court and Security Services	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Percent of Temporary Restraining Orders Filed that are Served	75%	75%	73%	78%	No
Number of inmates transported per Deputy	1,598	1,888	1,763	1,900	No

Court and Security Services did not meet current year performance targets for both Headline Measures. In FY 2008-09, the Bureau transported 29,983 and had only one injury during transportation, which was a self-inflicted injury by an inmate. Civil enforcement services, including serving temporary retraining orders (TROs), are mandated and follow strict procedures. The civil enforcement services served 73% of TROs that are filed, which is slight below target. This decrease can be attributed to the Deputy not being able to find or locate the subject. Efforts are made to serve all TROs, including up to three service attempts at various times and days of the week, with state law requiring a minimum of two attempts, however, the number served is affected by availability and schedules of those being served.

PROBATION DEPARTMENT

Customer Satisfaction Results

The Probation Department received ten survey responses with 89% of respondents rating overall satisfaction as good or better coming in just under the County standard of 90%. Overall, customer feedback was positive with a number of responses recognizing staff as being warm hearted, helpful, kind, exceptional, excellent, empathetic, understanding, knowledgeable, and courteous regardless of the fact that the majority of the people who enter the offices where the surveys are located are significantly stressed, angry, and / or embarrassed. Some areas of improvement and enhancement of customer service were identified with regards to communication with parents of children in custody.

Performance Measure Results

The Probation Department met current year performance targets for 63% of its Quality and Outcomes measures. The Department has reviewed performance measures methodology and made revisions in FY 2008-09. The average annual service cost for juveniles exceeds target primarily due to the exclusion of appropriate juvenile supervision costs that are state funded. The exclusion of these costs reflects a more accurate overall service cost. The total number of youth formally supervised does not include youth who are assessed and receive less formal, shorter, and more targeted interventions by the Assessment Center. The average annual service cost for adult exceeds target due to a decrease in cases, which were shifted to a banked caseload and not included in the case cost calculation in addition to the proper inclusion of unit expenditures that had been omitted from previous year methodology.

The Probation Department includes the following programs:

• Administrative Services

• Adult Supervision and Court Services

• Juvenile Supervision and Court Services

• Institutions Services

Administrative Services met current year performance targets for both Headline Measures. The percent of department budget allocated to Administrative services came in under target primarily due to positions held vacant in the division resulting in salary and benefits savings. Administration Services is responsible for the collection and reporting of customer CARE surveys for all divisions within the Department. The percent of customer survey respondents rating services good or better met the current year performance target. The Department has noticed that the number of customer survey responses increases when a client received direct person-to-person service from a Probation Officer or from a member of the support staff. In an effort to improve future performance, the Department shares the survey comments with all staff.

Adult Supervision and Court Services did not meet current year performance targets for both Headline Measures. With the advent of a new information management system, the Division can establish its targets with more precision than in previous fiscal years. Though the Division missed its first headline measure by 2%, we maintain that the year-end actual is a reflection of having better IT tools to capture and report this data more accurately than in the past rather than a reflection of poor staff and client performance. In FY 09-10, the Division will institute new treatment program tracking processes to augment current IT reporting tools. In doing so, the Division will collect the data it needs to understand variation in treatment performance measures.

Juvenile Supervision and Court Services met current year performance target for one of two Headline Measures. The percent of probationers successfully completing probation without a new law violation did not meet target due to a number of programmatic circumstances which limited resources used for high-risk youth with a variety of specialized needs. The percent of youth diverted from the Juvenile Justice system exceeded the target. Juvenile Probation Services strives to serve lower risk youth with shorter, more targeted interventions. Success in the area of formally and informally diverting lower risk juveniles, as well as uncontrollable, case specific variables, has resulted in an increasing number and percent of formal juvenile probation wards who have significant mental health issues, past trauma, and gang influences, which adversely impacts the successful completion of probation requirements.

Program Performance Measures Institutions Services	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Number of serious behavioral incidents (per thousand detention bed days)	1.2	1.1	1.3	1.0	No
Monetary value of Community Care Program (weekend work)	$1,020,272	$1,167,538	$1,525,403	$1,202,614	ü

Institutions Services met current year performance targets for one of two Headline Measures. The number of serious behavioral incidents did not meet target primarily due to an increase in gang activity and an increase in the average daily population in Juvenile Hall. The Program is developing a new gang classification system in order to decrease the number of incidents and the population increase can be attributed to youth who would have traditionally been sent to Camp Glenwood, the state Department of Justice, or the Rites of Passage placement program have been serving their time in Juvenile Hall. The monetary value of the Community Care Program exceeded target by $322,789, or 26%. This increase is primarily due to the rising cost of detention bed space.

DISTRICT ATTORNEY’S OFFICE

Customer Satisfaction Results

The District Attorney’s Office (Public Administrator) received six surveys with 83% of respondents rating overall satisfaction as excellent or good. Customer surveys are mailed to all heirs in the estates the Office administers; attorneys representing heirs; and all stakeholders involved with the administration of an estate including the auctioneer service provider, certified public accounting firm, funeral homes, cemeteries, real estate agents, probate referees, and jewelry and art appraisers. Overall, customer feedback was positive with a number of responses recognizing staff as being helpful, knowledgeable, kind, friendly, and accommodating. Some areas of improvement and enhancement of customer service were identified and the Office with regards to communication with an individual. The Office routinely reviews all surveys and will follow up on specific cases if the customer comments were negative and / or the ratings were poor.

Performance Measure Results

The District Attorney’s Office met performance targets for 60% of its Quality and Outcomes measures. After a slight decrease in cost per case in FY 2007-08, the cost per case increased in FY 2008-09. This increase is primarily due to the reduction of state and federal revenues as a result of the current economic conditions. The percent of Public Administrator cases closed within 12 months came in slightly under target primarily due to the transition to a new accounting firm that files the final taxes for the estates and staff turnover within the Office. In general, cases that are opened for longer than 12 months may require the need for tenant evictions, involve incidents of theft and vandalism, or have difficulties with heirs in the disposition of assets. A trend in emerging where more estates have established will, trusts, and executors, who are able to provide adequate oversight, which has decreased the number of estates referred to the Public Administrator. In addition, there are a number of cases that are opened and closed quickly due to a lack of response from the referral source, next-of-kin refusing services, and a high number of indigent cases that require little administration due to lack of assets.

CORONER’S OFFICE

Customer Satisfaction Results

Department Customer Satisfaction Coroner’s Office	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Overall satisfaction rated excellent or good	92%	97%	93%	90%	ü
Number of customer survey responses	57	66	68	N/A	N/A

The Coroner’s Office received 68 surveys with 93% of respondents rating overall satisfaction as excellent or good. The percent of respondents rating services as excellent or good experienced a slight decrease from the prior year and is primarily due to extended response times for our removals, which has been resolved for FY 2009-10. Overall, customer feedback was positive with a number of responses recognizing staff as being helpful, courteous, knowledgeable, empathetic, sensitive, and considerate during a difficult time. However, some areas for improvement or enhancement of customer service were identified and the Office will be implementing a number of process changes with regards to contacting families and communicating the services offered by the Office. The number of survey responses has increased slightly this year. Surveys are available in the lobby area and are also distributed to the families of the deceased where the Office performs autopsy investigations or are within jurisdiction rights. Cares surveys are not mailed to families of homicide victims or cases involving a child’s death.

Performance Measure Results

Department Performance Measures Coroner’s Office	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Quality and Outcomes measures meeting performance targets	83%	83%	100%	75%	ü
Cost per Investigation	$1,085	$912	$815	$1,150	ü
Percent of Cases Closed within 30 Days	88%	92%	94%	94%	ü
Percent of Customer Survey Respondents Rating Investigative Services Good or Better	92%	97%	93%	90%	ü

The Coroner’s Office met current year performance targets for 100% of its Quality and Outcomes measures. The cost per investigation has decreased slightly primarily due to vacancies within the Office. In FY 2008-09, the Office implemented a new method of determining the manner of death that takes additional time but is more accurate. Regardless of the additional time, the Office continues to exceed the target of the percent of cases closed within 30 days. The number deaths reported to the Office has increased even though, as of January 1, 2009, Hospice cases are not required to be reported to the Office. The Office continues to prioritize timeliness in assisting clients and families by responding to calls within 15 minutes 98% of the time and closing cases within 30 days 94% of the time.

PUBLIC SAFETY COMMUNICATIONS

Customer Satisfaction Results

Public Safety Communications (PSC) received 210 surveys with 100% of respondents rating overall satisfaction as excellent or good. PSC’s high customer satisfaction rating is primarily due to the high quality of training provided to Dispatchers and professional staff. In addition, excellent customer service ratings are due to PSC’s ability to simultaneously dispatch fire, police, and medical calls to a single incident resulting in real-time coordination of all resources from the time of dispatch through the end of the incident. This is particularly important during multi-causality incidents, large-scale incidents and violent or serious injury calls warranting multiple resources as ordered by a single Incident Commander in charge of all disciplines of public safety at the incident. Individual employees were recognized by callers for their exceptional service.

Performance Measure Results

Program Performance Measures Public Safety Communications	2007 Actual	2008 Actual	2009 Actual	2009 Target	Target Met
Quality and Outcomes measures meeting performance targets	80%	80%	57%	75%	No
Percent of 9-1-1 callers rating overall satisfaction with services good or better	100%	100%	100%	90%	ü
Percent of high priority calls dispatched within established time frames – Police	88%	87%	84%	82%	ü
Percent of high priority calls dispatched within established time frames – Fire	94%	94%	93%	94%	No
Percent of high priority calls dispatched within established time frames – medical	91%	92%	92%	94%	No

Public Safety Communications met current year performance targets for 57% for its Quality and Outcomes measures. Customer satisfaction continues to remain high, with 100% of 9-1-1 customer survey respondents rating services good or better. Call volumes are decreasing for the first time in recent years. Many factors affect call volumes, including increasing use of web-based tools to determine the need for emergency services. The Department continues to dispatch high priority calls in all categories at a high level, all of which are higher than industry standards, even as overall call volumes had, until recently, increased by 10% over the past three years. Police dispatch is at a lower percentage than other types of calls as police dispatches require additional types of information provided by the caller. Both Fire and Emergency Medical Services call dispatch percentages were below the target, but only by a slight percentage. However, average call times for EMS calls at 30 seconds and Fire calls at 26 seconds continue to remain well-established industry standards at 60 seconds for both. According to the data, a handful of challenging calls impacted the overall percentage data. The Department is examining data regarding the average amount of time spent on subcategories of calls (robberies, traffic incidences, etc) to better understand which types of calls take a dispatcher the most time to complete.

FIRE AND COUNTY SERVICE AREA #1

Performance Measure Results