First audit report on Multnomah County's response to the COVID-19 pandemic

Report Highlights

Why we did this audit

The COVID-19 pandemic has presented significant challenges to Multnomah County. We conducted this audit to support transparent and accountable government operations during this unprecedented time. We focused our work on determining steps the county took to ensure that vital services could continue safely and equitably during the pandemic; whether those steps were in line with guidance from the Centers for Disease Control and Prevention and other health authorities to reduce health risks; and what improvements can be made moving forward.

Our focus on equitable service delivery led us to center our work on congregate settings, where people are housed together. People who work and live in these settings may face particular challenges with social distancing to prevent the spread of COVID-19. People living in congregate settings also tend to represent vulnerable populations in our county, including elders, people who have disabilities, people who are experiencing houselessness, and people who are in adult or juvenile custody. We also examined operations that affect the county’s ability to provide vital services: countywide guidance and support to departments and employees, physical changes to county buildings, and teleworking.

We focused our work on the guidance and practices in place as of June 1, 2020, and which continued to evolve through December 18, 2020. This audit report provides a snapshot of some county preparations and operations during that time. Due to the volatile nature of the pandemic, some county practices may have changed since we concluded our work. COVID-19's prevalence at the county is also likely to change. For example, our office learned about an outbreak at the Multnomah County Detention Center after we completed audit fieldwork. The tenacity of COVID-19 underscores the importance of implementing the recommendations we have noted in this audit.

What we found

The Joint Office of Homeless Services made several changes in the shelter system in response to COVID-19. It added shelter sites to allow for physical distancing, including motel shelters to house the most vulnerable guests. The Joint Office and Public Health provided COVID-19 safety guidance to shelter providers. Moving forward, funding will be a concern, staffing will be challenging, and the need for supplies will continue. Additionally, there could be a substantial increase in homelessness because of economic conditions.

The Sheriff’s Office worked closely with the Health Department to develop policies, plans, and processes that were consistent with CDC, state and local guidelines. However, getting Sheriff’s Office staff to follow the guidelines regarding face coverings has been challenging.

The management of the juvenile detention center responded quickly to the pandemic by updating policies and practices and ordering face coverings and PPE. Fewer youths are in custody, which makes is easier to maintain physical spacing. However, the employee survey found that employees and youth in detention could improve their use of face coverings.

We found that the county’s Adult Care Home Program (ACH Program) had pivoted quickly to remote working conditions for the ACH Program licensers and support staff to monitor adult care homes (ACHs) during the pandemic. We conducted a survey of ACHs to help substantiate the ACH Program’s efforts and assess ACH compliance with federal, state, and local guidelines and recommendations related to the pandemic. Overall, we found the results to be positive. However, we also noted an opportunity for the ACH Program to increase their communications with ACHs to help ensure compliance with federal, state, and local requirements to support the health and safety of vulnerable residents in the ACH as well as staff working in the homes.

The safety guidance that the county provides to departments and employees was thorough. It covered most of the topics addressed in federal and state guidance. New requirements from Oregon Occupational Safety and Health (OSHA) address items that were missing. We surveyed county employees to learn about their experiences. According to employees, county departments are implementing safety steps in line with guidance. However, there are still gaps, and many employees expressed workplace safety concerns in the survey.

The county has generally followed authoritative guidance to modify Heating, Ventilation, and Air Conditioning systems (HVAC), make physical distancing modifications, and install signage at county buildings. Areas of concern include whether contractors can meet the cleaning and disinfecting needs, and if Facilities and Property Management (FPM) has staff capacity to complete modifications before more buildings substantially open to employees and service users.

In response to the pandemic, the county had to rapidly change how it accomplishes a large portion of its responsibilities from working on-site in county buildings to teleworking from employee’s homes. With this change, the county was challenged to make sure telework agreements were in place and employees had proper equipment. These tasks should be done to help ensure secure use of county information systems, and employee worksite safety.

What we recommend

Recommendations for Shelters

Upon issuance of report, county Public Health officials should revise guidance on the public facing website for nonprofit shelter providers within county boundaries to improve clarity, in line with state requirements.
Joint Office of Homeless Services management should include clauses to follow Public Health guidelines in new contracts with shelter providers and in new amendments to contracts with shelter providers.

Recommendations to Sheriff’s Office

To be consistent with CDC guidelines, MCSO should begin exchanging the cloth masks of adults in custody on a daily basis if they are used upon issuance of this report.
With normal no-cost visiting options suspended because of COVID-19 precautions, MCSO should either expand the use of free-phone calls or modify lobby video visit operations to allow for safe use as soon as possible and no later than 90 days within issuance of this report.

Recommendation to the Department of Community Justice

Immediately upon the issuance of this report, we recommend that managers consistently enforce face covering policies with their staff.

Recommendation to the Adult Care Home Program

The ACH Program should perform a review of all recent communication with each ACH and ensure that each ACH has received sufficient information and is aware of requirements and guidelines pertaining to the pandemic. A particular focus is needed in the areas of exposure, infection control, physical distancing and reporting. A review should be performed as soon as possible and no later than 30 days from issuance of this report. If contact is needed the contact should be made within at least 90 days from the issuance of this report.

Recommendations for Guidance section

As soon as possible, the OR OSHA COVID-19 temporary rule implementation committee should complete all new OSHA requirements:
1. Risk assessment, infection control plan, protocols for potential exposure, and employee training.

Note: management reports that substantial work toward this recommendation has been completed. This work occurred between the time the report was written and when it was issued. We acknowledge that work has been done, but we did not audit that work. We are leaving the recommendation in the report, so we can follow up on the recommendation thoroughly.

By March 2021, Central Human Resources should develop a method for employees to provide COVID-19 related feedback anonymously.
By March 2021, the Chair or her designee should provide employees with a point of contact for COVID-19 safety coordination.
Based on responses to our office’s employee survey, it appears that applying policies is an ongoing challenge. Upon issuance of the report and periodically thereafter, the Chair or her designee should reiterate to managers and employees her expectations that safety policies and recommendations are followed, including the requirement that employees telework as much as possible.

Recommendations for Facilities

Prior to adding in-person capacity at county locations, we recommend that FPM ensure that necessary building modifications, including the installation of partitions, and filter upgrades in HVAC systems have been completed.
Prior to adding in-person capacity at county locations, we recommend that FPM work with its janitorial contractors to ensure that each location has sufficient staffing capacity to ensure the enhanced cleaning recommended by the CDC.
We are told that the county is currently in the process of adding COVID-19 specific cleaning and disinfecting requirements into its contracts with janitorial providers. We recommend that FPM complete these contractual requirements prior to programs adding substantial in-person capacity at county locations.

Recommendations for Teleworking

By July 2021, department directors should provide county-owned computers to employees who frequently telework and should emphasize using county-owned computers for employees who occasionally telework. The county should also provide employees with any other equipment typically used by one person to telework effectively, such as computer mice, computer monitors, and headsets. These examples are meant to be descriptive, not exhaustive.
By February 2022, Central Human Resources should ensure the maintenance of telework information electronically, preferably in Workday to allow:
1. Accessibility to approved or denied telework agreements at the employee, supervisory, departmental and central levels.
2. Electronic approvals and updating for better efficiency.
3. Monitoring of teleworking performance and equity.
4. Documentation of specific details, such as computer ID numbers, of all county equipment used to telework.
To help ensure fairness among employees, by February 2022, Central Human Resources should indicate potential telework eligibility in county job descriptions.