Report 2009-107.2 All Recommendation Responses

Report 2009-107.2: California Department of Corrections and Rehabilitation: Inmates Sentenced Under the Three Strikes Law and a Small Number of Inmates Receiving Specialty Health Care Represent Significant Costs (Release Date: May 2010)

Recommendation #1 To: Corrections and Rehabilitation, Department of

To address the erroneous sentencing information and inappropriately assigned convictions in its data system, Corrections should complete its cleanup of data that will be transferred into the new system, ensuring that this review includes a detailed evaluation of convictions that have been assigned outdated sentencing information as well as deleting erroneous sentencing information, before it begins using its new data system.

Annual Follow-Up Agency Response From October 2016

The Division of Adult Institutions Case Records staff have completed the review and made corrections that were identified by EIS/SOMS from the time of OBIS conversion to SOMS back in 2014. EIS/SOMS completed their portion of the action plan in August 2013. This recommendation has been fully implemented and no further corrective action is necessary.

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

Annual Follow-Up Agency Response From September 2015

As reported in October 2013, the EIS/SOMS portion of the action plan has been complete since August 2013. Efforts are continuing by the Division of Adult Institutions (DAI) Case Records staff to work through data identified as needing review and correct.

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

Although Corrections indicates its status as fully implemented its response indicates that efforts are continuing by case records to work through data identified as needing review and correction.

Annual Follow-Up Agency Response From October 2014

As reported in October 2013, the EIS/SOMS Sentence Calculation module and SOMS statute table has been complete since August 2013. Efforts are continuing by the Division of Adult Institutions' (DAI) Case Records staff to work through data identified as needing review and to correct during conversion.

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

Corrections response indicates that efforts are continuing by its case records staff to work through data identified as needing review and to correct during conversion.

Annual Follow-Up Agency Response From October 2013

SOMS Update - The SOMS statute table, formerly known as the OBIS Offense Edit Table, has been updated by correcting outdated information and adding new statute codes that were missing. As a result, CDCR can now enter offenses and enhancements into SOMS that were previously placed in the comments field in OBIS.

The Sentence Calculation module of the SOMS project was implemented in August 2013. The module includes an automated sentence calculator which reduces human error and provides uniformity of sentencing and crediting and loss of credit business rules.

Before and during the Sentence Calculation deployment, legacy system data continues to be reviewed and compared to the calculator for accuracy.

As part of the data conversion process, inaccurate data was identified and corrected prior to loading OBIS data into SOMS. Reports of identified problems were generated and sent out to institution Records offices for cleanup.

A tremendous amount of testing was completed over a period of approximately six months by a team of seven full time staff using the cleansed data to ensure results of the application were correct and could be relied upon.

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

Annual Follow-Up Agency Response From September 2012

The EIS/SOMS team will continue to perform data analysis and assist in correcting data issues identified and approved by the Case Records Unit. Several clean-up activities are in process including, a complete review and update of the Offense Edit Table, removal of offense codes with no inmate data and clean up of codes that we placed in comment fields and now are available in data fields. The Sentence Calculation module of the SOMS project is currently scheduled for deployment in the Spring of 2013.

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

Recommendation #2 To: Corrections and Rehabilitation, Department of

To address the erroneous sentencing information and inappropriately assigned convictions in its data system, Corrections should create a schedule for regular checks of the accuracy of existing sentencing information, as well as the accuracy with which sentencing information has been assigned to convictions.

Annual Follow-Up Agency Response From September 2015

The Case Records Administrator worked with SOMS to implement changes to the second striker credit earning formulas to address new statue rules. This is an ongoing maintenance activity that will be needed whenever statue or codes are revised to ensure the ongoing accuracy of sentencing information.This most recent example was completed in May 2014. Additionally, each offender is received into CDCR with a Commitment (Legal documents such as Abstract of Judgment, Minute Order, and/or Felony Compliant) at the time they are admitted. The first check is completed by a Case Records Analyst to ensure the sentencing information is accurate for the conviction. Each offender will have regular checks at specific audit time frames, which include transfer audits, 60-day audits, and parole audits. If a sentence is found to be inaccurate for a type of conviction, CDCR continues to refer those cases to the presiding court/judge for clarification.

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

Corrections provided documentation of the review it references in its update. It states that it will need to complete this activity whenever statute or codes are revised to ensure ongoing accuracy of sentencing information.

Annual Follow-Up Agency Response From October 2014

The Case Records Administrator worked with SOMS to implement changes to the second striker credit earning formulas to address new statue rules. This is an ongoing maintenance activity that will be needed whenever statue or codes are revised to ensure the ongoing accuracy of sentencing information. This most recent example was completed in May 2014.

Additionally, each offender is received into CDCR with a Commitment (Legal documents such as Abstract of Judgment, Minute Order, and/or Felony Compliant) at the time they are admitted. The first check is completed by a Case Records Analyst to ensure the sentencing information is accurate for the conviction. Each offender will have regular checks at specific audit time frames, which include transfer audits, 60-day audits, and parole audits.

If a sentence is found to be inaccurate for a type of conviction, we continue to refer those cases to the presiding court/judge for clarification.

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

Corrections states that the case records administrator worked with SOMS to implement changes to the second striker credit earning formulas to address new statute rules and that this is an ongoing maintenance activity that will be needed whenever statute or codes are revised to ensure the ongoing accuracy of sentencing information. Corrections indicates the most recent example was completed in May 2014. However, Corrections did not provide any documentation to substantiate its ongoing checks and reviews of the accuracy of existing sentencing information and reviews of the accuracy with which sentencing information has been assigned to convictions.

Annual Follow-Up Agency Response From October 2013

The OBIS Edit table has been replaced with the SOMS statute table; the table has been updated by correcting outdated information and adding new statute codes that were missing from the OBIS Edit table.

As part of the data conversion process, inaccurate data was identified and corrected prior to loading OBIS data into SOMS. A tremendous amount of testing was completed over a period of approximately six months to ensure results of the application were correct and could be relied upon.

Going forward, a Case Records Administrator has been assigned to complete at least an annual update to the statute table. The Case Records Administrator will be working with the SOMS team to add any new statute codes or amended statutes to the SOMS statute table.

Sentencing data continues to be checked on a regular basis during case records audits that occur throughout an offender's incarceration period (i.e., Intake, Transfer, 60-Day 10-Day prior to release). Additionally, monthly data quality reports will be generated on an ongoing basis for cleanup as needed in order to maintain the integrity of the offender sentencing data in the SOMS system.

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

Corrections states that it has corrected the sentencing data and continues to check the accuracy on a regular basis during case records audits. It also states that monthly data quality reports will be generated on an ongoing basis to maintain the integrity of the sentencing data. However, Corrections did not provide documentation demonstrating that it has a schedule for regular checks of the accuracy of existing sentencing information and reviews of the accuracy with which sentencing information has been assigned to convictions.

Annual Follow-Up Agency Response From September 2012

The recommendation was fully implemented in May 2011. A copy of our revised “OBIS Offense Edit Table Update Procedures were provided as an attachment to BSA in (Month/Year) and can be provided again upon request. The task of updating the offenses in our OBIS system was reassigned from the Legal Processing Unit Case Records Manager to a Case Records Administrator during that time. The system is updated at minimum twice a year. In addition, Case Records receives, on a regular basis, the Chaptered Legislative Report from CDCR's Office of Legal Affairs. This report is a tool to assist us in identifying new or amended statues that require an update to our OBIS Offense Edit Table

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

Recommendation #3 To: Correctional Health Care Services, California

Health Care Services should continue to explore methods of reducing the costs of medical care to the State, including those of inmates with high medical costs. These efforts could include proposing a review of the program that allows for the early release of terminally ill or medically incapacitated inmates, and other possible means of altering the ways in which inmates are housed without unduly increasing the risk to the public.

1-Year Agency Response

Health Care Services provided a copy of the emergency regulations for the new medical parole process, which were approved and adopted in April 2011. According to Health Care Services, as of April 2011, it had identified 38 potential candidates for medical parole and reported that it was working to provide these cases to the Board of Parole Hearings for consideration. (See 2012-406, p. 172)

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

Recommendation #4 To: Correctional Health Care Services, California

To improve its ability to analyze and demonstrate the effectiveness of current and future utilization management efforts in containing health care costs, Health Care Services should identify a method to associate cost information with utilization management data.

1-Year Agency Response

Health Care Services stated that it has developed various reports that link volume data with paid claims so that high volume and high cost specialty and hospital data can be analyzed. Health Care Services provided copies of a sample from these reports and provided its Utilization Management Monthly Cost Report for February 2011. (See 2012-406, p. 172)

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

Recommendation #5 To: Correctional Health Care Services, California

To determine whether the additional expansion of telemedicine is cost-effective within the California correctional system, Prison Health Care Services should identify and collect the data it needs to estimate the savings of additional telemedicine through an analysis of the cost of specialty care visits currently provided outside of the institution that could be replaced with telemedicine.

Annual Follow-Up Agency Response From August 2017

This recommendation has been fully implemented. CCHCS has implemented improved methodologies for determining cost avoidance for specialty telemedicine services. In October of 2016, CCHCS reported an estimated cost avoidance of $7,100,000 for fiscal year 13/14 and $8,900,000 for fiscal year 14/15. Upon further analysis and refinement of CCHCS Telemedicine Services data on cost avoidance of medical guarding and transportation cost for specialty services, the reported totals for fiscal year 13/14 and fiscal year 14/15 reflected a higher amount of savings for each fiscal year than previously reported. In addition, the medical guarding and transportation cost avoidance has steadily increased through fiscal year 15/16. The updated figures indicate a cost avoidance of $9,934,188.87 for fiscal year 13/14, $11,722, 315.34 for fiscal year 14/15, and $12,315,298.36 for fiscal year 15/16.

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

Annual Follow-Up Agency Response From October 2016

During fiscal year 2015-16, the specialty care telemedicine program resulted in estimated medical guarding and transportation cost avoidance of $12,300,000. The cost avoidance figures have increased from $8,900,000 in fiscal year 2014-15 and $7,100,000 in fiscal year 2013-14. This increase mirrors ongoing growth in telemedicine specialty encounters which have increased from 20,452 in fiscal year 2013-14 to 25,590 in fiscal year 2015-16.

Additional claims data analysis reveals no difference in specialty service reimbursement between telemedicine and non-telemedicine providers as they share the same fee schedule.

The implementation of the statewide electronic medical record is expected to be completed in fiscal year 2017-18. Successful implementation may result in undetermined additional medical guarding and transportation cost avoidance.

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

Annual Follow-Up Agency Response From October 2015

CCHCS has partially implemented this recommendation with full implementation anticipated in fiscal year 2016/2017.

All 35 prisons have telemedicine capability and access to telemedicine specialists. For telemedical appropriate encounters, telemedicine services specialty claims data indicate that Telemedicine is utilized statewide at 64 percent in 2015 for an estimated medical guarding and transportation cost avoidance of $8,915,000 at fiscal year-end (June 2015). This is up from 48 percent in 2011, 55 percent in 2012, 59 percent in 2013, and 61 percent in 2014. This data indicates that those specialty services that could be accomplished via telemedicine (non-procedural office visits in specialties Telemedicine Services offers) have shown a steady increase in the last five years.

Achieving the remaining 36 percent is estimated to potentially save an additional $4,977,000 in medical guarding and transportation cost avoidance. The telemedicine specialty network continues to expand around the needs of the institutions; however, the expansion of the telemedicine specialty network in some areas (e.g., Pelican Bay State Prison) remain challenging for those surgical specialties and subspecialties that may eventually require a "hands on" visit, thus making a 100 percent capture rate more difficult to attain.

The ability to further analyze telemedicine specialty care data within CCHCS will be realized with the completed roll out of the statewide electronic medical record currently in deployment. Additionally, with the implementation of the electronic health record system, CCHCS will employ a complete care model that will allow for a higher level of care coordination and is expected to result in an increase in specialty referrals routed for telemedicine services versus offsite services. For this reason, CCHCS targets full completion of this recommendation by December 2016.

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

Annual Follow-Up Agency Response From November 2013

CCHCS has implemented this recommendation to the extent possible. We are unable to assess further due to lack of staffing and data resources.

CCHCS has determined that Telemedicine appointments are billed at the same Medicare rates as in-person office visits and, therefore, do not reflect cost savings over traditional specialty service appointments. The primary goal of Telemedicine Services is to provide timely access to medically necessary care. In addition to increasing access to specialty care, CCHCS developed and implemented Primary Care Telemedicine in 2010. Primary Care Telemedicine utilizes civil-service CCHCS physicians to provide needed patient care to those remote locations that have had difficulty recruiting and/or retaining physicians and has improved access to primary care in mulitiple institutions statewide.

Telemedicine Services provide increased access to care, particularly in those remote locations where local medical facilities do not provide all the needed services to support the patient-inmate population. Expansion of Telemedicine Services shall primarily be based on efficacy and efficiency of patient care, as well as the needs of each individual institution, rather than cost effectiveness. Additionally, the use of telemedicine reduces transport of inmates into communities for healthcare through remote management, increasing public safety.

California State Auditor's Assessment of Annual Follow-Up Status: Will Not Implement

Annual Follow-Up Agency Response From September 2012

In the past, Telemedicine Services did not secure claims data or have technical expertise to perform cost-center analyses. Telemedicine Services is now accessing all specialty claims data on an ongoing basis. Telemedicine Services is developing a methodology to accurately identify specialty referrals seen off-site in providers' facilities that could appropriately be seen via telemedicine (e.g., eligible examination/consultation Current Procedural Terminology (CPT) codes without accompanying procedural CPTs for the same patient, provider, date and time). In addition, Telemedicine Services is investigating ways to measure cost elements for telemedicine that are difficult to estimate/quantify such as the value of increased community safety, improved patient access to specialty care, access-to-care litigation costs avoided, and others.

The future implementation of an enterprise electronic medical record system creates the opportunity to follow patient-inmates receiving telemedicine care to review health outcomes and subsequent utilization as compared with similar patient-inmates receiving care that is not delivered through telemedicine, to refine comparative cost analyses.

Telemedicine Services has gained access to specialties claims data and is starting analyses relating those data to telemedicine scheduling system data. Telemedicine Services is investigating cost analyses methods used by other government and non-governmental agencies that may be usable in trying to quantify some of these intangible variables to inform a cost comparison model. Systems to collect these sorts of data in a standardized way have not been identified or implemented to date. Once improved data and staff expertise to perform analyses are developed, more detailed comparisons will be done on an ongoing basis to inform policy decisions.

The insufficiency of cost center data and inadequate cost analysis methodology and technical analysis expertise have delayed implementing this recommendation. CCHCS is trying to address both of these deficiencies in order to improve efficacy and quality assessments for telemedicine services to inform policy decisions.

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

Recommendation #6 To: Correctional Health Care Services, California

To determine whether the additional expansion of telemedicine is cost-effective within the California correctional system, Prison Health Care Services should further analyze the cost-effectiveness of telemedicine through a more robust estimate of savings, including considering factors such as the percent of telemedicine consultations that required subsequent in-person visits because the issue could not be addressed through telemedicine.

Annual Follow-Up Agency Response From November 2015

The institution utilization management teams follow a standardized process to approve referrals and determine appropriateness of telemedicine services before the consultation. The cost effectiveness of telemedicine in prison health care has been shown through an analysis of medical guarding and transportation costs from 2013-2014. The analysis showed a cost avoidance of $7,222,574 based on 19,351 telemedicine encounters. For 2014-15 the figure is closer to $8.9 million in cost avoidance based on 23,900 specialty encounters, which reflects a 64 percent statewide utilization of Telemedicine. (see attachments)

An analysis looking at the percent of telemedicine consultations requiring subsequent in-person visits because the issue could not be addressed through telemedicine is not applicable as a traditional, in-person visit may still be needed for a specific physical examination, diagnostic studies or procedure. These visits can then be followed by a telemedicine visit for follow up. For example, a patient may be followed in Telemedicine by dermatology for a full year before the dermatologist decides, based upon a morphological change observed on a dermatology camera, that a wide-margin excision of a lesion is indicated. The telemedicine cost savings for that entire year remain actual savings and are unchanged based on the later surgical excision.

There are also times where the specialist prefers to see the patient face-to-face initially, which are then followed by telemedicine visits. The cost savings for the telemedicine follow-ups is unaltered by face-to-face visit. In addition, specialty encounters may be scheduled offsite due to the unavailability of a specialty provider network, or compliance date requirements. According to the American College of Physicians, Policy Recommendations to Guide the Use of Telemedicine physicians should use their professional judgment about whether the use of telemedicine is appropriate for a patient.

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

Corrections' Health Care Services stated that an analysis considering the percent of telemedicine consultations requiring subsequent in-person visits that could not be addressed through telemedicine is not applicable as an in-person visit may still be needed for a specific physical examination, diagnostic studies or procedure. However, Health Care Services has established a standardized process to approve referrals and determine the appropriateness of telemedicine services before the consultation. This process includes specific documented policies and procedures, updated in May 2015, which provide guidance to the field when utilizing telemedicine services for medical specialty and primary care.

Annual Follow-Up Agency Response From November 2013

CCHCS cannot fully implement this recommendation because the needed IT and personnel resources are not currently available to provide this level of in-depth data analysis.

Within Telemedicine Services' current resources, implementation of this recommendation would yield unreliable data. For example, the current system does not distinguish whether a follow-up encounter is scheduled in accordance with the patient's routine conservative plan of care or of the efficacy of a previous telemedicine encounter. Needed IT and personnel resources are not currently available to provide this level of in-depth analysis.

Rather than rely on retrospective data to determine efficacy of telemedicine encounters, Institutional utilization management teams follow a standardized process to approve referrals (Attachment 6) and determine appropriateness for telemedicine services before the consultations. Those referrals deemed not appropriate for telemedicine are routed for in-person office visits.

California State Auditor's Assessment of Annual Follow-Up Status: Will Not Implement

Annual Follow-Up Agency Response From September 2012

Please see response to 2009-107.1 Recommendation 2. Although some telemedicine cost center information (e.g., claims payments; equipment costs, service, and depreciation; IT connectivity costs) is available, other cost elements such as the value of increased community safety, improved patient access to specialty care, access-to-care litigation costs avoided, and others are difficult to estimate/quantify.

The future implementation of an enterprise electronic medical record system creates the opportunity to follow patient-inmates receiving telemedicine specialty and primary care to review health outcomes and subsequent utilization as compared with similar patient-inmates receiving specialty and primary care that is not delivered through telemedicine, to refine comparative cost analyses.

Telemedicine Services is investigating cost analyses methods used by other government and non-governmental agencies that may be usable in trying to quantify some of these intangible variables to inform a cost comparison model. Systems to collect these sorts of data in a standardized way have not been identified or implemented to date. Once cost center modeling, improved data, and staff expertise to perform analyses are developed, more detailed comparisons will be done on an ongoing basis to inform policy decisions.

The insufficiency of cost center data and inadequate cost analysis methodology and technical analysis expertise have delayed implementing this recommendation. CCHCS is trying to address both of these deficiencies in order to improve efficacy and quality assessments for telemedicine services to inform policy decisions.

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

Recommendation #7 To: Corrections and Rehabilitation, Department of

To ensure that the State Controller's Office has accurate information on the number of authorized and filled positions, Corrections should determine why the number of positions the State Controllers' Office indicates are vacant is higher than the number of vacant positions it is aware of, and submit information to the State Controller's Office to correct this situation as necessary.

1-Year Agency Response

Corrections stated that it completed the design and development of all Human Resource functions in its Enterprise Resource Solution, the same system as the State Controller's Office uses and that this automated system includes a strong position maintenance module that will improve the accuracy of position information. Corrections also stated that it has completed various efforts to improve its position data, including reconciling position data with the State Controller's Office data, completing data cleansing activities, establishing a baseline position data set, and developing processes to ensure ongoing maintenance of position data. Corrections also stated that it is monitoring compliance and these efforts are ongoing. In August 2011 Corrections provided its monthly discrepancy summary for the months of February through August 2011 demonstrating its efforts to correct and reduce the number of discrepancies and continuous effort to reconcile budget information with the State Controller's Office. (See 2012-406, p. 173)

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

Recommendation #8 To: Correctional Health Care Services, California

To ensure that the total amount of overtime worked by custody staff does not unduly reduce their effectiveness and result in unsafe operations, Prison Health Care Services should monitor overtime closely. If its efforts to reduce the number of referrals of inmates to outside specialty services do not reduce the amount of overtime worked by custody staff for the purpose of medical guarding and transportation, Prison Health Care Services should explore other methods of reducing the total amount of overtime worked by custody staff.

Annual Follow-Up Agency Response From November 2013

Implementation of the CDCR staffing model for community hospital guarding details, combined with the CCHCS Utilization Management Unit implementing an additional review step within the Referral for Services process, has resulted in a reduction of offsite specialty provider referrals, overtime hours and overtime dollars. The total number of CCHCS statewide referrals for offsite provider services in Fiscal Year 2010/2011 equated to 118,910 and have declined to 78,990 in Fiscal Year 2012/2013. Medical Transportation overtime hours for the same time period has been reduced from 451,066 to 377,646. Likewise, hospital guarding overtime hours were reduced from 740,989 to 645,456.

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

Annual Follow-Up Agency Response From September 2012

Implementation of this recommendation is contingent upon transition of Health Care Access Units (HCAU) to CDCR and completion of assessment of utilization. The plan for implementing this recommendation is as follows. In order to gain efficiencies in utilization while reducing medical guarding and transportation overtime, CDCR has completed the reassessment and finalization of a policy specific to staffing efficiencies. Given this update in policy, CCHCS in coordination with CDCR, plans to assess utilization of Medical Guarding and Transportation resources this fiscal year with a view towards efficient utilization and reduction of overtime, while exploring options for reducing the total amount of overtime worked by custody staff if deemed necessary. The reason CCHCS has not implemented this recommendation is as follows. The assessment was pending on the completion of the CDCR policy specific to staffing efficiency, prior to assessing the medical guarding and transportation utilization to reduce overtime.

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

Recommendation #9 To: Corrections and Rehabilitation, Department of

To ensure that custody staffing meets institutional needs, and to provide staff the opportunity to use the amount of leave that they earn in the future, Corrections should update its staffing formulas to accurately represent each of the factors for which custody staff are unavailable to work, such as vacation or sick leave. Corrections should attend to this project before implementing its new business information system to ensure the updated formulas can be used as soon as practical. In addition, Corrections should create a policy for regularly scheduled reviews of the data used in the staffing formulas and update the formulas as necessary.

Annual Follow-Up Agency Response From September 2012

Effective July 23, 2012, the Division of Adult Institutions of the California Department of Corrections (CDCR) implemented the Blueprint, The Future of California Corrections. This implementation established uniform, standardized staffing at the institutions that will enable the department to operate more efficiently and safely. This model replaced the previous 6 to1 ratio-driven staffing model. This implementation is considered complete, with some minor necessary adjustments at specific institutions based on further reviews.

CDCR also obtained additional relief funding based on accruals to assist in covering the significant scheduled and unscheduled absences to include Vacation, Holiday, Sick, Family Leave Act (FMLA), Jury Duty, Bereavement, Military leaves, etc. Accruals and usage will be reviewed and evaluated for any necessary relief updates.

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

Recommendation #10 To: Corrections and Rehabilitation, Department of

To better communicate to policy makers the annual cost of incarceration, and to provide a more accurate estimate of expenditures associated with changes in the large leave balances of custody staff—many of whom require relief coverage when they are absent—Corrections should provide a calculation of the annual increase or decrease in its liability for the leave balances of custody staff to better explain the cause of changes in expenditures to the relevant legislative policy and fiscal committees.

Annual Follow-Up Agency Response From November 2015

Each year, CDCR's Budgets Management Branch must submit its overall budget projections to both the Legislative Finance Committee and the Department of Finance for review and approval before including into the final annual Governor's Budget. For these expenditure projections, CDCR's Budgets Management Branch completes detailed calculations including vacant position coverage and custody leave coverage, and associated salary increases as part of the overall Salaries and Wages line item category. The Salaries and Wages projections are part of the overall CDCR budget projections submitted for approval into the final annual Governor's Budget. The attached spreadsheet outlines the detailed calculations supporting the summary line items on the Governor's Budget submittal.

Overall, for FY 14-15, leave liability for all "custody classifications", which we interpreted as BU6 staff, decreased by $70.2 million or 9.1% from June 30, 2014 to June 30, 2015. (detail by month attached)

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

Annual Follow-Up Agency Response From October 2014

Overall, leave liability for all "custody classifications", which we interpreted as BU6 staff, decreased by $64.7 million or 7.7% from June 30, 2013 to June 30, 2014. (detail by month attached via email)

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

Corrections does not indicate whether it plans to provide the estimate to the relevant legislative policy and fiscal committees.

Annual Follow-Up Agency Response From October 2013

CDCR's Budget Management Branch is currently relying on monthly MIRS reports to track leave balance liability by Classification. An annual MIRS report of accumulated leave balances for custody staff will be submitted in October 2013 and for the period ending June 30 every year thereafter beginning in 2014.

Further, the relief formula approved through CDCR's Blueprint is based off of a blend of leave usage and accrual. CDCR's Division of Adult Institutions has submitted a relief increase Budget Concept Proposal for Fiscal Year 14/15 for Relief factor that is based solely on leave usage. Our intent is to continue to track the leave usage and accruals of CDCR custody staff to determine the most effective means of controlling future liabilities while maintaining institution security and fiscal responsibility.

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

Corrections states that its budget management branch is relying on monthly reports to track leave balance liability and will submit an annual report of accumulated leave balances for custody staff in October 2013 and for the period ending June 30 every year thereafter beginning in 2014. Corrections also states that their intent is to continue to track the leave usage and accruals of custody staff to determine the most effective means of controlling future liabilities while maintaining institution security and fiscal responsibility. When asked for evidence to substantiate its claim of full implementation of the recommendation, Corrections provided support showing that it is capturing monthly leave data totals for the entire department. However, its support did not separate leave balances for custody staff and Corrections did not provide the annual report it references in its update. Additionally, Corrections did not address whether it plans to provide a calculation of the annual increase or decrease in its liability for the leave balances of custody staff to better explain the cause of changes in expenditures to the relevant legislative policy and fiscal committees.

Annual Follow-Up Agency Response From September 2012

Through the Management Information Retrieval System (MIRS), the CDCR has the ability to calculate accumulated leave balances of custody staff. The department is currently producing monthly reports of current leave balances. However, projecting how or when leave balances are used or compensated is very challenging.

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

Recommendation #11 To: Corrections and Rehabilitation, Department of

To better communicate to policy makers the annual cost of incarceration, and to provide a more accurate estimate of expenditures associated with changes in the large leave balances of custody staff—many of whom require relief coverage when they are absent—Corrections should provide an estimate of the annual cost of leave balances likely to be paid for retiring custody staff to the relevant legislative policy and fiscal committees.

Annual Follow-Up Agency Response From November 2015

As part of the annual projections for the Governor's Budget, CDCR's Budgets Management Branch completes detailed lump sum calculations for possible employee separations to include in the overall Salaries and Wages projections. The Salaries and Wages category includes possible salary increases, temporary help and overtime as part of the Vacant Position coverage to fill behind those separations. The Salaries and Wages projections are part of the overall CDCR budget projections submitted to both the Department of Finance and the Legislative Finance Committee for approval into the final annual Governor's Budget. The attached spreadsheet outlines the detailed calculations supporting the summary line items on the Governor's Budget submittal.

Based on historical trends and current staff for FY 2015-16, lump sum for custody positions, again interpreted to mean BU 6 staff, is estimated to be approximately $103 million. (details attached)

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

Annual Follow-Up Agency Response From October 2014

CDCR's Budget Management Branch estimates from historical trends and current staff, FY 2014-15 projected separation payment (lump sum) to be approximately $90 million for custody positions, interpreted as BU6 staff. (details attached via email)

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

Corrections does not indicate whether it plans to provide the estimate to the relevant legislative policy and fiscal committees.

Annual Follow-Up Agency Response From October 2013

CDCR's Budget Management Branch will calculate an annual projected separation payment (lump sum) figures based on actual prior year expenditures and taking into account all factors unique to the coming year, in October 2013 and for the period ending June 30 every year thereafter beginning in 2014.

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

Corrections states that its budget management branch will calculate an annual projection in October 2013 and for the period ending June 30 every year thereafter beginning in 2014. Corrections did not provide any documentation--such as the initial annual projection and a policy and procedures requiring an annual calculation for each period ending June 30--to substantiate its claim of fully implemented.

Annual Follow-Up Agency Response From September 2012

Given the amount of change associated with Public Safety Realignment and the CDCR Blueprint, we are not able to estimate with any real precision the annual cost of leave balances likely to be paid for retiring custody staff. There are simply too many factors currently in flux to reasonably estimate the number of potential lump sum payouts relative to custody staff.

California State Auditor's Assessment of Annual Follow-Up Status: Will Not Implement

All Recommendations in 2009-107.2

Agency responses received after June 2013 are posted verbatim.