ing healthy habits earlier. These concerns are supported by data, as few high school students reported eating vegetables often.
Finally, residents and stakeholders expressed concerns about mental health, and spe- cifically that of children and adoles


medical offices), first responders, public safety agencies, schools, and health and human services agencies. This chapter describes the types of health care providers serving Prince George’s County, their roles, and the services provided.
   Key data


 More Hispanic adults reported cost as a barrier to medical care than Black adults. Adults with less education were more likely to report cost as a barrier to medical care.
Table 4.2.
Barriers to Health Care Access and Utilization for Adults in Princ


th Resources & Services Administration, 2019b.
NOTES: HPSA, health professional shortage areas. health. HPSAs are identified based geography (e.g., lack of providers nearby) and population (e.g., lack of providers to serve specific populations, such


16
25 25 14 9 28 28 67 62
2017 2018 2019
25 25 25 18 16 10 28 28 32 71 69 67
 SOURCE: Maryland Health Care Commission, 2019a.
NOTES: Data from annual reports on licensed acute care beds by hospital and service. Acute care beds generally accommodate h


.1
58.9 21.2
51.3 54.9
64.7 55.5 47.3
61.4 39.5
62.5 45.3
54.9 47.8
 Sex
Female 68.4
Male Race
White, non-Hispanic Black, non-Hispanic Hispanic
Socioeconomic characteristics
Educational attainment Above high school High school or less
Household incom


visits per 100,000 population to the 16 EDs serving county residents in Maryland and DC. The majority of visits were made to the 11 EDs in Maryland, with fewer visits made to EDs in DC (Table 4.10). More ED visits were made to Doctors Community Hospi


OURCE: Maryland Health Services Cost Review Commission, 2017; DC Hospital Association, 2017.
NOTES: Includes 2017 ED discharges in Maryland and DC for Prince George’s County residents. Children are younger than 18 years. Reasons are CCS codes which g


Figure 4.7.
Rates of ED Visits for Chronic Conditions for Adults per 100,000 Population, by Race and Ethnicity and by Condition, 2017
 ED visits per 100,000
700
600
500
400
300
200
100
-
453 349
577
185
389
224 158
Diabetes
Hispanic
609
Non-Traumatic


r Adults per 100,000 Population, by District and Condition, 2017
County Councilmanic Districts
PG 1 2 3 4 5 6 7 8 9
      All ED visits 32,315
Mental and behavioral
health 1,178
Substance related 194 Diabetes 321 Heart disease 405 Hypertension 464 No


ccess to a usual source of dental care.
Inpatient Hospitals
Inpatient hospital care is defined as involving an overnight stay at the hospital and therefore tends to include more serious and costly care. In fiscal year 2019, there were five hospitals


ated in Lanham, Maryland (Table 4.16). Children had 2,582 hospital discharges per 100,000 population to nine hospital EDs in Maryland and DC. The majority of hospital discharges for children (69 percent) were to Children’s National Medical Center in


ents. Children are younger than 18 years. Reasons are CCS codes which group related diagnoses and procedures into meaningful categories.
Variation in Hospitalization by Race/Ethnicity
During 2017, rates of hospitalizations were highest for Black adul


hildren.
Figure 4.11.
Rates of Inpatient Hospitalizations for Children per 100,000 Population in 2017, by Race and Ethnicity and by Condition
4. Drivers of Health: Health Care Service Environment 81
 Hospitalizations per 100,000
450
400
350
300
250
2


aryland Health Care Commission does not report the number of hospice beds available by county. When examining the number of hospice agencies or organizations, the number in the County in 2018 was similar to nearby counties.
Table 4.21.
Hospices, Hosp


r were considered to be for non-urgent medical services. The percentage of 911 calls for non-urgent medical services varied slightly across districts, ranging from 22.5 percent in District 6 to 26.6 percent in District 7.
Table 4.26.
Emergency Calls


y in Prince George’s County, health care services are primar- ily provided through contracts with local health care providers who come to the correctional facility to provide services. This facility houses inmates who are serving sentences of 18 mont


aryland
conditions. Law enforcement agencies are increasingly working with the health care system and pursuing collaborative community-wide strategies to implement effective policing strategies for people with behavioral health conditions (Council of


ent two school years, the school-based wellness centers have had staffing vacancies for nurse practitioners (NPs). Additionally, it took until the fourth quarter of 2019 to fill all four social worker positions during the 2019 school-year.
Table 4.28


rated Health in All Policies Plan for Prince George’s County, Maryland
or reduced price meals. In Prince George’s County during the 2019-2020 school year, there were 45 schools designated community schools, of which most were elementary schools. Thes


f medical assistance programs that are intended to help families obtain health insurance, reduce barriers to access- ing health care, and promote receipt of needed care. For example, DSS helps residents to sign up for public health insurance programs


mental health screenings, follow-up care, and vaccinations for individuals <18 years.
   94
An Integrated Health in All Policies Plan for Prince George’s County, Maryland
• • •
•
Screening and treatment for sexually transmitted infections.
Testing fo


icare).
The state of Maryland offers crisis lines (phone and text) staffed by specialists for indi- viduals who are experiencing a mental health or substance use concern. Additionally, outpa- tient substance use disorder treatment services and mental


ception that there are few immu- nization clinics in the County and that this limits family’s abilities to obtain neighborhood- based preventive care. School-based screenings were proposed by stakeholders as a potential option for obtaining preventiv


exist- ing health care outreach services and noted that community health workers can help facilitate this connection, but are underutilized.
In focus groups, residents noted their interest in having health care providers who reflect the community’s d


related to the provision of health care, do not have the capacity to bill public insurance.
Mental and Behavioral Health
As noted in the prior chapter, mental and behavioral health was frequently mentioned by stake- holders as an important health nee


on in the school-aged population. Participants expressed the desire for more wellness centers at schools that foster mental health, including staff specially equipped for mental health counseling. One noted,
Our teachers are struggling to manage educ


s tend to focus on sentencing and forensic-related guide- lines, but that it is important for them to also take into consideration health needs, such as access to outpatient primary care and behavioral health services, in the counseling phase.
Stakeh


7, where more than 3 in 4 residents are Black, ED visit rates are high for conditions better managed in primary care settings, like diabetes, heart disease, and hypertension for adults and asthma for children.
• Challenges in obtaining dental care ex


vel and educational attainment. Further, our analyses suggest that many adults lack a usual source of dental care and are using the ED to treat dental conditions best cared for in a dental office. A variety of reasons may lead to inappropriate use of


t also individual-level interventions to educate residents about the role of different types of providers and when to call 911.
Finally, the health care delivery system in Prince George’s County includes more than just hospitals and other traditional


es of home ownership, a key mechanism of building wealth in the United States, have influenced rates of poverty in families and communities for genera- tions. Because the financing of public schools is partially based on local property taxes, ineq- u


 15
2015 16
2016 17
2017 16
2018 16
2019 13
SOURCE: County Health Rankings, 2019b.
NOTES: Possible ranking out of 24 counties in Maryland.
Poverty
Poverty has long been recognized as a contributor to health and disease as it affects a variety of clin


nty residents are uninsured or insured by Medicaid than observed in nearby counties and the state.
Rates of uninsurance are driven by several factors, including income and eligibility requirements for public programs, like Medicaid. In Maryland, adul


district has a sizeable foreign-born population, which may be apprehensive or ineligible for government health insurance programs. These factors may con- tribute to this high rate of uninsurance.
Uninsured 10.8
Has Medicaid
Has Medicare
Has private h


y
Baltimore County Maryland
Howard County
     SOURCE: Annie E. Casey Foundation Kids Count Data Center, 2019.
NOTES: Raw data was obtained from the Maryland State Department of Education School Report Cards, 2000 – 2018. Data not available for Howar


 declined over time, from 8,266 in 2016 to 7,224 in 2019. Similarly, the percentage of new and re-applications approved slightly declined, from 25.6 percent in 2016 to 22.8 percent in 2019.
Table 5.6.
New and Re-Applications Received and Approved for


Data was provided directly from the Office of Special Education and Student Services and are not publicly available. While no denominator was provided for these counts, in 2019 Prince George’s County Public Schools had 208 schools and centers more t


indicator is comprised of two measures of a cohort of ninth grade students grad- uating within four years or five years, respectively. Graduation rates vary widely across race/ ethnicity in the County, with Asians having the highest graduation rate a


udents are
Less than high school education
High school diploma or equivalent
Some college
Bachelor’s degree or higher
4.5 8.7 10.0
14.0 13.3 24.8 20.2 18.9 25.6
61.4 59.0 39.6
Prince George’s Baltimore County County
13.5 8.9
25.7 26.2 28.2 26.3
32.7


n Prince George’s County have a higher median household income than other jurisdictions, excluding Howard County.
Table 5.13.
Median Household Income, by Jurisdiction, Pooled 2014–2018
  Median household income, $
By race/ethnicity, $ White
Black
Ame


percentage of individuals in Prince George’s County con- sidered working poor (5.4 percent) was higher than that of nearby counties and slightly higher than the state (5.2 percent). Additionally, the County unemployment rate was slightly higher than


sed Prince George’s County School Climate Survey discusses parental concern on school safety (Keane & Swinton, 2017). While 91 percent of parents of elementary school students expressed a positive perception of safety and discipline at their child’s


port estimated over 60 percent of the jail mental health population in Los Angeles County jail were likely appropriate candidates for mental health diversion (Holliday et al., 2020). A similar proportion of inmates may benefit from diversion in the C


ing primary data collection as having unique challenges in accessing health and human services. The challenges experienced by noncitizen immigrants were also often mentioned during primary data collection, and this subgroup is described in detail in


ile, 2014–2018.
 122 An Integrated Health in All Policies Plan for Prince George’s County, Maryland
Seniors compose 12.3 percent of the County population, which is less than in nearby counties (Table 5.20). Few County seniors lack health insurance (1


.7 percent of seniors are dually-enrolled in Medicare and Medicaid, a proxy for low-income status.
124 An Integrated Health in All Policies Plan for Prince George’s County, Maryland Table 5.21.
Characteristics of Prince George’s County Residents Aged


ices to enable individuals who meet an institutional level of care or who are chronically ill or disabled remain in their own homes or assisted living facilities. Services include personal assistance, nurse monitoring, home-delivered meals, home adap


rks (4,462 participants), and Yoga in the Parks (3,052 participants).
People Experiencing Homelessness
People experiencing homelessness are those who lack a primary nighttime residence or are living in a shelter. The experiences of people experiencin


ividuals and families experiencing homelessness has declined in Prince George’s County since 2007. In 2018, there were 478 individuals identified as experiencing homelessness in Prince George’s County (Figure 5.5), meaning these individuals did not h


Annual PIT Count of Persons Experiencing Homelessness.
The rate of persons experiencing homelessness within Prince George’s County in 2019 was 0.5 per 1,000 people (Table 5.24). The County’s rate is below the region average without DC’s (0.7 percent)


ts conducted as part of the federally-funded Continuum of Care program and reported in the 2018 Annual Homeless Assessment Report to Congress. Point-in-Time counts provide a count of sheltered and unsheltered persons experiencing homelessness on a si


7 households entered emergency shelters, which was similar to what was observed in June 2017, but much higher than what was observed in June 2018 (327 households). The number of households establishing permanent housing increased from 120 in June 201


rwise meet the PSH or RRH project type descriptions” (Orange County Homeless Management Information System, 2014). *3 permanent supportive housing programs were de-funded by HUD during the FY2016 competition. **Counts of emergency shelter beds provid


at promote employment. As one stakeholder explained, childcare and adequate clothing for an interview are often overlooked as critical human service needs, yet are important for obtaining employ- ment. The County is engaged in positive efforts around


n trafficking and wage theft. One stakeholder noted that the Hispanic population comprises 17 percent of Prince George’s County residents yet makes up 31 percent of sex abuse cases. Stakeholders also mentioned that survivors of domestic violence also


 equipped to handle students and families with English as a Second Language needs. Very few schools equipped for ESL. It impacts their ability to learn and communicate, as well as limits opportunity for parents to get involved.
5. Drivers of Health:


 support to help them stay in their homes, such as real estate tax credits. Assistance to modify their homes to comfortably maintain activities of daily living can support aging in place. Stakeholders shared,
Many seniors are caught in what is called


, a higher percentage of residents remain in poverty and uninsured compared to neighboring counties. Poverty and low educational attainment are clustered in districts (2, 3, 5, 7) that border Washington, DC. Health risks are exacerbated without good


untry has declined over the past ten years. Additionally, more than 80 percent of individuals experienc- ing homelessness were sheltered in 2018. One concerning finding relates to the increasing number of veterans experiencing homelessness. Although


ture have all been associated with greater physical activity in children and adults (Smith et al., 2017). There is also evidence that these features may be associated with lower obesity (Papas et al., 2007), less cardiovascular disease risk factors (


enspace measurements which may affect the quality of pedestrian transit (County Health Rankings, 2019c).
Table 6.1.
County Health Sub-Rankings for the Physical Environment, Prince George’s County 2010–2019
  Year
2010 2011 2012 2013 2014 2015 2016 20


ing overcrowded households across districts in Prince George’s County, overcrowded households is a large problem in Districts 2 and 3, where 16.1 percent and 8.1 percent of households, respectively, are overcrowded or severely overcrowded (Table 6.3)


ty Survey 5-Year Summary File, 2014–2018.
6. Drivers of Health: Built and Natural Environments 143
Neighborhood Design
Neighborhood design plays a strong role in providing a supportive environment for a healthy lifestyle. The idea is that neighborhoo


y food options, we show supermarkets here because of the diversity of food choices they offer.
144 An Integrated Health in All Policies Plan for Prince George’s County, Maryland
There are some limitations to the USDA ERS’s definition of a food desert


nters serving the population of Prince George’s County (6.2 per 100,000) is far lower than the pro- portion in the state of Maryland (11.5 per 100,000), as shown in Table 6.6. Data are available from the U.S. Census County Business Patterns which exc


y to begin and maintain a physically active lifestyle, neighbor- hoods that support walking for commuting and leisure are thought to encourage physical activity and promote a healthy lifestyle (Smith et al., 2017). The term “walkability” is used to d


the risk for obesity and chronic disease (Smith et al., 2017). In addition, parks also provide opportunities for residents to interact with nature and each other, strengthening social capital and sense of place, and improving psychological health. Ta


a higher proportion of impervious surfaces than tree canopy. As noted earlier, these districts have many “walkable” neighborhoods, due to their street connectiv- ity and diversity of residences and businesses. However, the lack of green space may de


bility and Commuting Habit, by Jurisdiction, Pooled 2014–2018
Vehicle availability among working population
One or more vehicles available
No vehicles available
Working population traveling to work by
Driving alone Carpool
Public transportation Walki


ng based on the total number of houses and pro- portion of houses by year of construction. Each era of housing is adjusted with a factor that reflects proportionate risk for that era, according to the prevalence of lead-based paint hazards found in U


In 2017, 1.1 percent of tested children in Prince George’s County had a blood lead level at 5–9 μg/dL and 0.3 percent of children had a blood lead level ≥10 μg/dL (Table 6.13). This proportion was similar to that observed in Mary- land, overall. Alth


are set at the federal level by the EPA and enforced by states. When a water system fails to meet an EPA-mandated drinking water standard, a drinking water violation can be issued, although reductions in enforcement activities have led to estimates


e data collection and understand complicated relationships describing the social and environmental determinants of health.
160 An Integrated Health in All Policies Plan for Prince George’s County, Maryland Figure 6.7.
Social Vulnerability Index for P


lot of the County’s developments now prioritize construction of new roads which encourages movement to remote areas. However, stakeholders thought there should also be a focus on developing older neigh- borhoods and improving land use in these locat


te exercise and outdoor activity. Com- munity centers and parks should be utilized both for exercise and for social engagement and bringing community members together. Residents felt that the County could have a large role in promoting physical activ


nd special transport options, in order to make health care appoint- ments. One stakeholder shared that although, in theory, the County has accessible taxis for seniors who are disabled, many residents do not know how to use this service. Further, som


ousing affordability is a primary concern of residents, which may contribute to overcrowding and have downstream health effects. District 2 has the highest rates of severely overcrowded housing and households paying more than 50 percent of monthly in


: Built and Natural Environments 165
Districts 2 and 7 have a lower proportion of parks per population than other districts. Barriers to transportation (evident in both the quantitative and qualitative analysis) may also contrib- ute to poor access t


o health care services shape long-term outcomes. Many stakeholders mentioned concerns about chil- dren’s mental health and access to health care services in the County.
o Below, we describe linkages between drivers of health and barriers to pediatric


ty, 2018). Because these types of visits are potentially avoidable, they may be indicative of poor health care management or inadequate access to care (Dowd et al., 2014).
Drivers of Potentially Avoidable Health Care Utilization in Children
Although


y Files, 2009–2018.
Health Care Environment: Provider Shortages
Insurance solves only one part of the health care access and health management problem. Other barriers include a shortage of health care providers, not enough providers willing to see ch


k factors.
To overcome this limitation, and to provide a preliminary assessment of barriers to pre- ventative health care for children, we used data from the American Community Survey to better understand the prevalence of drivers for potentially avo


 health care utilization. Many of these communities are in districts that border Washington, DC.
174 An Integrated Health in All Policies Plan for Prince George’s County, Maryland Figure 7.3.
Communities with One or More Determinants of Potentially A


h close to one quarter of Hispanic high school students in the County considered overweight. High school students of other races also have a much higher than average rate of being overweight and non-Hispanic Black high school stu- dents have a slight


3 percent in 2013 to 13.2 percent in 2016 (Table 7.4). During each year of the survey this proportion has been higher than the Maryland-wide average. The group with the highest proportion not eating vegetables in the preceding week were Hispanic stud


kely indicates that there is a complicated relationship between the food environment and childhood obesity, likely influenced by mul- tiple drivers of health.
178 An Integrated Health in All Policies Plan for Prince George’s County, Maryland
Figure 7


ts in Prince George’s County
Research suggests that immigrants encounter more nuanced challenges beyond policy and financial barriers such as discrimination and fear of deportation (Hacker, Anies, Folb, & Zall- man, 2015). Depending on their citizens


% 12% 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
SOURCE: U.S. Census Bureau, 2019a.
NOTES: Data in figure were obtained from the American Community Survey 1-Year Summary Files, 2009–2018.
Across the County, noncitizen immigrants are more likel


 immigrants. Communities with a low percentage of noncitizen immigrants were defined as ZCTAs below the 80th percentile, i.e., having fewer than 21 percent of their popu- lation composed of noncitizen immigrants.
We find that children in communities


ts. Adults are aged 18 years and older. Reasons are Clinical Classifications Software (CCS) codes which group related diagnoses and procedures into meaningful categories. Communities with a high percentage of noncitizen immigrants were defined as ZCT


ities with Fewer Noncitizen Immigrants, %
Other upper respiratory infections 11.2 Viral infection 4.5 Ear infections and related conditions 3.4 Other injuries and conditions due to external causes 4.9 Superficial injury; contusion 4.5 Other gastroint


related diagnoses and procedures into meaningful categories. Communities with a high percentage of noncitizen immigrants were defined as ZCTAs at or above the 80th percentile, i.e., having 21% or more of their population composed of noncitizen immigr


hat noncitizens com- pose the greatest share of the uninsured in Districts 2 and 3 (79.1 percent and 62.5 percent, respectively). Conversely, native-born citizens compose the greatest share of the uninsured in Districts 6 (72.9 percent), 7 (69.3 perc


6.5 20.9
  SOURCE: U.S. Census Bureau, 2018.
NOTES: Data in table were obtained from the American Community Survey One-Year Public Use Microdata Sample (PUMS), 2018.
7. Connecting Drivers of Health with Health Outcomes: Examples for Children and Non


fore, we present county-level information on the housing experiences of noncitizen immigrants and also utilize information from the American Community Survey to better understand the housing experiences of communities with a higher percentage of non-


i- grants and also a high percentage of housing with severe overcrowding. As illustrated by the red, these “hot spots” of communities with high rates of severely overcrowded housing and noncitizen immigrants are primarily in District 2 and primarily


analyses are also intended to spur further thinking and analyses about other subgroups and the drivers of health that may be most salient to them. This chapter also can be used as the County progresses toward Health in All Policies, and must conside


on. When examining common reasons for adult hospitalizations, we found that five of the ten most common reasons for hospitalizations were related to birth and complications of birth for residents of communities with a high percentage of nonciti- zen


 drivers of health described in prior chapters. Where relevant, we pull from prior reports and analyses conducted by the County.
As the data available reflect government spending, the findings noted in this chapter should be interpreted accordingly.


Because that data is not yet available, we offer potential next steps for County action with respect to health budgeting and investment alignment in the final recommendations chapter. We accompany that chapter with a proposed budget template to orie


e total investments directed to health and human services in the County is low (a point raised in the next section about relative County department budget allocations (see Chapter Nine for an associated recommendation).
Figure 8.2.
County Human Servi


ormation has important information on types of ser- vices and specific grant programs, more accurate coding of program documents (objectives, aims, populations served, outcomes) is needed to get this level of specificity.
198 An Integrated Health in


Data was provided in an internal county presentation and conglomerates internal health and human services agencies from FY 2007 to FY 2018.
When looking at spending for populations most in need, Prince George’s County also spends less than nearby cou


d. Also, the accounting of health spending by health and human services departments may not be fully representative of total County health costs. A deeper analysis is important for understanding what types of health funding exist, for what services,


o identify areas of inefficiency. For instance, if there are programs in Human Services that are working to prevent frequent use of 911 or get ahead of chronic disease management for those who are frequent users of emergency departments, those effort


Services*
Community Corrections (e.g., reentry services)
Police
Bureau of Patrol (e.g., community policing)
FY2020 Proposed Budget (General Fund only)
$139,110,500 $21,465,300
$2,291,500 $2,619,000
$182,559,000
8. Exploring Prince George’s County Bud


ose costs. Again, a more detailed coding on direct links to health would be warranted in a health budgeting effort, but this table provides a first place for consideration.
Table 8.2.
Addressing Poverty Efforts with Proximal Links to Health
Departmen


tly focuses on the design and placement of houses, community design, and where food establishments are located and what they serve. For illustration in this driver, we focus on supports for transporta- tion that may influence health (Table 8.4).


onal health care delivery system. The frame- work presented in the first chapter of this report can be used as a way to organize the findings of this report and to also offer a guide to the County when considering future policy and pro- gram decision


ervices are greatly influenced by drivers of health and systemic inequities and these inequities need to be addressed. Inefficient uses of health care services are both magnified and mitigated by greater attention to upstream drivers of health, along


th and human services.
• Residents are often unaware of available services and resources or may not know
how to access or navigate known services and resources.
Low spending on health and human services.
• Estimated County spending on health and huma


apters. We describe the larger, cross-cutting limitations below.
Sub-county data. Prince George’s County is large and diverse. Therefore, data available only at the County-level will not fully capture the experience of all residents. We used several


lar areas where relevant data gaps exist (e.g., oral health, unmet need, health care quality, and broader health and well- being) and discuss ways the County may consider addressing these gaps going forward. Fur- ther, as greater attention is given t


th Health in All Policies. Second, we provide comprehensive recommendations for imple- menting a comprehensive Health in All Policies approach. These recommendations, categorized as (1) creating a Health in All Policies system, (2) aligning investmen


ons as well as to offer suggestions to the County in terms of what may be helpful for monitoring the health and human services ecosystem going for- ward. Where relevant and available, we provide examples from other communities. We note LB where legis


nty reports and policies, relates to the challenge of how departments that serve residents’ health and human services needs are connected and coordinated, mainly in the area of structure and governance across the various sectors that contribute to he


Budget, the body responsible for holding the county accountable for its pro- claimed strategies. Additionally, in 2013, Seattle & King County developed the Health and Human Services Transformation Plan to shift the human services from reactive to pre


ctivities of traditional health and human services to avoid duplication, minimize gaps in services, but also is key as the County moves towards stronger Health in All Policies actions that bring in departments beyond health and human services, such a


ome of these topics were covered in Prince George’s County approved general plan, Plan 2035. Released in 2014, this plan outlines several strategies that align development plans with broader goals of community health and well-being as discussed in th


and recreation, biking, walking, and local cuisine. Another example is the Better Connections Program, which coordinates state and local funding sources to increase transportation options. Local municipalities in Vermont are encouraged to use funds t


rally specific approach “that reflects the needs and experiences of Black women and families” (American Public Health Association, 2015).
Harnessing whole community approaches to place-based investment. Given the role that non- governmental organizat


on, and workforce development in the revitalization of Detroit’s neighborhoods. The City partners with the University of Michi- gan Poverty Solutions Lab to assist in teen pregnancy prevention through increased clini- cian engagement, the expansion o


ered regarding augmenting telemental health, especially for underserved areas, such as District Heights, or for individuals that may feel uncomfortable seeking care in person due to stigma. There was particular interest in enhancing mental health ser


d by a RWJF Data Across Sectors for Health (DASH) grant to integrate affordable housing and health data and can be layered with data on chronic disease to help guide policymakers in resource allocation (DASH Connect, 2019; Eyler et al., 2019).
9. Con


gested that relaunching or reinvigorating such a program could help bring more individuals, particularly youth and seniors, into providing services that support and promote health and well-being. There was also interest raised about helping the most


h literacy integral to its mission, structure, and operations
• Integrates health literacy into planning, evaluation measures, patient safety, and quality
improvement
• Prepares the workforce to be health literate and monitors progress
• Meets the ne


health and human services part of County government, inclusive of the Health Department, Department of Social Services, and Department of Family Services. Further, this is a challenge to broader Health in All Policies budgeting. Stakeholders also que


structure development. Since its establishment, the fund has transitioned to supporting health assessments, developing the Allegheny health improvement plan, and acquiring accreditation (Hacker, Monroe, & Yonas, 2017). Under the grant funds from the


irstly, the fund does not require annual approval through the appropriations committee and instead is a four-year commitment. Second, large hospitals and insurers are the funding source for the fund, rather than relying on taxpayer revenue. Lastly, t


tment submits budgets.
As noted earlier, the County puts forth its actual and anticipated budgets by department each year. These reports include important performance metrics, such as clients served, and some outcomes, such as change in percentage of


 addressing the health outcomes or goals; and (4) using the aforementioned information to budget for the health outcomes or goals.
Examples from the Field: Health Impact Assessments
Although Prince George’s County engages in health impact assessment


such as expanding greenspace and developing more smoke-free sites. The Health in All Policies
9. Conclusions and Recommendations 225
226 An Integrated Health in All Policies Plan for Prince George’s County, Maryland
Task Force has been in the process


tment to identify and apply for funding for initiatives that promote Health in All Policies with nonprofits. Given the broader issue of both coordination and nonprofit capacity building, a few examples from other regions may be worth noting.
Example


es aims to increase access to healthy foods and transportation and support programs for traumatic brain injury, abuse prevention, motor vehicle safety, and falls preven- tion. Another partnership with Tobacco Free Allegheny conducts a week-long campa


ures at a sub-county level would enable the County to identify neighborhood challenges and successes related to health and well-being. To obtain richer sub-county information about these indicators, Prince George’s County could field a similar instru


ts use health care services in Washington, DC. Thus, to accurately measure residents’ use of EDs and hospital services, data are needed from both Maryland and DC. While this assessment uses data from both sources, the most recent health assessment fr


munity-based organizations provide updates and feedback to clinical providers. The communication between the two entities allow for a more holistic integration of the patient. Any clinical-community partnership, in order to be formally recognized by


t the report, but those outcomes are not combined with performance measurement in a way that can be actively and holistically addressed through a common operating and actionable data portal and dash- board. Further, the County Health rankings while u


built, natural, and health ser- vices environments. Further, the study linked key insights from primary and secondary data to recommendations to foster aligned and integrated planning and budgeting across the County to promote health and well-being


 ness, and also to the historical and systemic inequities impacting the health and well-being of many residents.
9. Conclusions and Recommendations 231
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ker, K., Anies, M., Folb, B. L., & Zallman, L. (2015). Barriers to health care for undocumented
immigrants: A literature review. Risk Management and Healthcare Policy, 8, 175-183.
Hacker, K., Monroe, C., & Yonas, M. (2017). Innovative partnerships to


20: https://www.hudexchange.info/resource/5783/2018-ahar-part-1-pit-estimates-of-homelessness-in-the-us/
Human Services Research Institute. (2019). Baltimore public behavioral health system gap analysis. As of January 12, 2020:
https://www.powerdms.c


 p s : / / w w w . h e a l t h a ff a i r s . o r g / d o / 1 0 . 1 3 7 7 / h p b 2 0 1 8 0 8 1 7. 9 0 1 9 3 5 / f u l l /
King County. (2013). Health and human services transformation plan. As of July 22, 2019: https://www.kingcounty.gov/elected/exe


c/live_well_san_diego/indicators/Indicators_Fact_Sheet.pdf
Live Well San Diego. (2018). Live Well San Diego food system initiative encourages residents to prevent food waste. As of September 9, 2019: http://www.livewellsd.org/content/livewell/home/al


coronavirus.maryland.gov
Maryland Department of Health Dataset Query System. (2016). Behavioral Risk Factor Surveillance System. As of January 2020:
https://ibis.health.maryland.gov/query/selection/brfss/BRFSSSelection.html
Maryland Department of Hea


al and emergency department discharges, 2017.
Maryland Institute for Emergency Medical Services Systems. (2018). Mobile integrated health (MIH) programs are growing in Maryland. Maryland EMS News. As of July 23, 2020: http://www.miemss.org/home/Porta


l of Public Health, 41(11), 3-28.
Meltzer, R., & Schwartz, A. (2016). Housing affordability and health: Evidence from New York City. Housing Policy Debate, 26(1), 80-104.
Mensah, G., A., Mokdad, A., H., Ford, E., S., Greenlund, K., J., & Croft, J., B


, 2020: https://www.nihcm.org/categories/hospital-consolidation-trends-impacts-outlook
Nelson, C., Sloan, J., & Chandra, A. (2019). Examining civic engagement links to health: Findings from the literature and implications for a Culture of Health. Ret


ysis, FY2008 - 2018. Information shared by Prince George’s County Council Budget and Policy Analysis Team.
Prince George’s County Department of Family Services. (2019). Department of Family Services 2019 Fiscal Year Approved Budget. As of January 15,


etwork. (2019). Prince George’s County senior resource guide. As of February 3, 2020:
https://www.princegeorgescountymd.gov/DocumentCenter/ View/24613/2019-Prince-Georges-Senior-Resource-Guide
Regional Primary Care Coalition. (2018). The healthcare l


n and Physical Activity, 14(1), 158.
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Substance Abuse and Mental Health Services Administration.


 54-62.
University of Maryland School of Public Health. (2012). Transforming health in Prince George’s County, Maryland: A public health impact study. As of October 1, 2019: https://sph.umd.edu/sites/default/files/files/TransformingHealth.pdf
Urban H


The health and health care of U.S. prisoners: Results of a nationwide survey. American Journal of Public Health, 99(4), 666-672.
Young, R., F., & Severson, R., K. (2005). Breast cancer screening barriers and mammography completion in older minority w


sagree, strongly disagree, don’t know) and used an online polling system, which enabled attendees to immediately see aggregated responses as part of the discussion. Prompts included the following:
• There is good health care in my community (26 perce


esidents were conducted to obtain information about residents’ opinions and experiences regarding health and human services in the County. The focus groups were conducted in English. The composition of these focus groups is described in Table A.1. Th


 Health Department
252 An Integrated Health in All Policies Plan for Prince George’s County, Maryland
• Prince George’s County Department of Housing and Community Development
• Prince George’s County Department of Parks and Recreation
• Prince George


with the best efforts (e.g., individuals experiencing homelessness and undocumented immigrants). Relatedly, the individuals who attend focus groups and town hall meetings may represent more engaged residents who may or may not share the same opin- i


e end of the study we will destroy the tapes. Is it all right if we audiotape this focus group? If you have questions about your rights as a research participant or need to report a research-related injury or concern, you can contact RAND’s Human Sub


ife
i. Let’s start by thinking about a few questions that offer an indication of quality of life. For example, is my community a good place to raise children? A good place to grow old? Are there policies and laws that protect my health and the health


y can do to improve health in the County and to better serve the needs of residents.
In this discussion, we want to get your perspective on priority health issues in the County – and, importantly, your thoughts on the program and policy solutions to


e been the biggest barriers faced by your agency in improving these human
service needs? Probe – funding streams, resource allocation, political biases, county
norms
5. Are there particular targeted populations that have been most challenging?
6. Con


ry File
American Community Survey 1-Year Summary File
American Community Survey 1-Year Public Use Microdata Sample
American Lung Association, State of the Air
Behavioral Risk Factor Surveillance System
CDC National Center for Health Statistics, CDC W


r extreme heat days
and number of extreme precipitation days. Available at https://ephtracking.cdc.gov/DataExplorer. Extreme heat days are days in which the daily maximum temperature exceeded the 90th percentile of the range of daily maximum temperat


County by the total number of children tested in the County. These data were obtained from the Childhood Blood Lead Surveillance In Maryland Annual Reports for each year, 2009 – 2018. Reports are found on the Maryland Department of the Environment we


dexchange.info/resource/5783/2018-ahar-part-1-pit- estimates-of-homelessness-in-the-us/. Available December 2018. Accessed September 19, 2019.
The Pregnancy Risk Assessment Monitoring System (PRAMS) data are limited only to births within Maryland and


groups were placed into 20 quantiles by variable value. The block groups were then assigned a rank from 1 to 20 depending upon their quantile position. A ranked score of 1 was assigned to the block groups with the lowest relative values influencing w


uction, each of block is contained uniquely in a tract and in a ZCTA. To add district information to this block level file, we used a spatial join in ESRI ArcMap 10.7 between blocks and councilmanic districts.1 Almost all census blocks are uniquely c


 downloaded from Prince George’s Planning Department GIS Open Data Portal.
Appendix B 263
     264 An Integrated Health in All Policies Plan for Prince George’s County, Maryland
Statistics, CDC WONDER is a comprehensive database designed to promote i


I11
I13 I20-I25 I26-I28
I30-I51
I10 I11 I12 I13 I15 I16
K08.81 K08.82 K08.89
Code Description
Diabetes mellitus due to underlying condition Drug or chemical induced diabetes mellitus Type 1 diabetes mellitus
Type 2 diabetes mellitus
Other specified


Behavioral Health Conditions per 100,000 Population in 2017, by ZIP Code
SOURCE: 2017 Maryland data was obtained from the Maryland Health Services Cost Review Commission. 2017 DC data was obtained from the DC Hospital Association.
NOTES: Includes 201


des 2017 inpatient hospital discharges in Maryland and DC for Prince George’s County residents aged 18 years and older. Non-traumatic dental care identifies conditions that can be prevented or best treated in a traditional dental office. It is an ind


ell-
being outcome
of interest (e.g.,
either outcome
goal to achieve)
      health services get
Decrease in unmet
who need mental
need (i.e., those
mental health
services without
delay or other
barrier)
   county plans are organized. A similar approa


r)
get services
Step 3: Given Steps 1, 1a, and 2, consider what programs and policies you would rate as most critical for addressing the outcome of
interest. Consider rating against three dimensions:
• Interoperability - Can be executed with coordina


rden, including mental and behavioral health conditions
• Desire to focus on health equity and address the role of systemic factors in influencing health
• Increasing interest in health promotion policies, social determinants of health,
and investmen


ing these services (in order to measure and reduce inequities).
• Align information about what is being spent on these health services and information on reach, effectiveness, and impact on reducing inequities.
• Require all nongovernmental organizat


er communities to situate recommendations in a Health in All Policies framework to foster aligned and integrated planning and budgeting across the county to promote health and well-being. Findings from the assessment indicate a shared interest among


  Research Report
SAMUEL PETERSON, DIONNE BARNES-PROBY, KATHRYN E. BOUSKILL, LOIS M. DAVIS, MATTHEW L. MIZEL, BEVERLY A. WEIDMER, ISABEL LEAMON, ALEXANDRA MENDOZA-GRAF, MATT STRAWN, JOSHUA SNOKE, THOMAS EDWARD GOODE
Understanding
Subgroups Within the


les County Counsel commissioned the RAND Corporation to conduct an independent research study on deputy subgroups within LASD. The study was commissioned to help the county and LASD learn more about how subgroups have affected community per- ceptions


ups Within the Los Angeles County Sheriff’s Department
Recommendations Related to Subgroups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 Conclusion.........


puty . . . . . . . . . . . . . . . . . . . . . . . . . . . Midlevel Managers’ Versus Deputies’ Views Regarding the Impact of Subgroups on the
Department and Individuals and Their Suggestions as to What LASD Can Do About
Subgroups.....................


Cliques on the Workplace and LASD as a Whole . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8.5. Survey Respondents’ Views About What LASD Should Do, if Anything, About
Deputy Subgroups or Cliques . . . . . . .


to Join a Deputy Subgroup, Overall and by Tenure. . . . . . . 125
8.4. At What Stage in Their Career Are Most Deputies First Invited to Join a Deputy Subgroup?......................................................................................... 1


estigations (not just those associated with subgroups), the
1 In February 2020, LASD implemented a new policy, “3-01/050.83: Employee Groups Which Violate Rights of Other Employees or Members of the Public” (Los Angeles County Sheriff’s Department Ma


station areas;3 interview data from 57 individuals, including members of LASD and other county stakeholders; and 1,608 survey participants. To preserve confidentiality and promote honest responding, surveys were conducted anonymously, and no informat


differential treatment by race, socioeconomic status, physical appear- ance, and other factors. Community members from the Central and North Patrol Division areas overall reported less-positive views of LASD. Stakeholders also pointed to the ways de


of deputy subgroups in media reports, legal claims, state- ments by public officials, and some of our interviews with LASD personnel and community members are that they are gangs that glorify violence and recruit only hard-charging crime fighters, es


ledge of and assessments of subgroups’ characteristics and conduct.
 What Purpose Do Subgroups Serve?
Subgroups vary significantly. Some are drinking groups. Others are closer to cliques or, as one respondent called them, “popular kids.” And some enc


ime—is a point of pride and means that one is competent enough to work anywhere in the department. Deputies at fast stations might be perceived as hard chargers, although deputies might choose slow stations for practical reasons, such as proximity to


often discussed as a potential reason for why people form subgroups or get invited to join subgroups, but some interviewees challenged this characterization. It is not clear why hard work and humility could not be recognized and rewarded through ord


 supervision. Proper supervision was identified by LASD interviewees as critical for managing subgroups.
Another key role in the formation of subgroups identified by LASD personnel and in research literature is that of the frontline supervisor. This


this leading to adverse behavior. For example, deputies might use unnecessary force to show how aggressive they are in an effort to be invited to join a subgroup. Thus, how a subgroup defines competence has implications for what behavior is valued by


they were asked to join a subgroup on the basis of their performance and declined without professional repercussions. In interviews, those who opted out mentioned some form of work-life balance, and command staff speculated that deputies working tow


this behavior could include efforts to get people to act in certain ways (e.g., make certain arrests) or to transfer out of the station. Many of the internal problems that can develop with subgroups involve pat- terns of disrespectful behavior toward


ups are accused of misconduct is too great a risk for the county and its residents. Efforts should be made to intervene early to prevent problems from escalating or occurring in the first place. Research on change management suggests that a critical


perceptions of problematic behaviors associated with subgroups are not universal among LASD respondents and tend to change over time given a set of con- ditions (e.g., poor supervision, subgroup leadership). Although LASD personnel perceive the more


nts and independence of the various units across LASD, chiefs and commanders should work with unit commanders to develop strategic plans for managing known subgroups.
• Ensure that those in key roles are aware and accountable. Unit commanders are dir


disabilities, and building skills for interacting with people and displaying empathy. Some training recommendations were specifically about the practice of deputies starting their careers in the jails instead of in patrol stations, which community s


reimbursement).
• Improve relationships with external oversight. This includes establishing community advisory councils, soliciting feedback on policies from the Los Angeles County Sheriff Civilian Oversight Commission, and building a productive work


ty of Los Angeles
California Commission on Peace Officer Standards and Training Performance Reporting and Monitoring System
Project Active Bystandership for Law Enforcement
xxvii
xxviii Understanding Subgroups Within the Los Angeles County Sheriff’s


ke those described above damage public trust. Moreover, as indicated by allega- tions of community mistreatment (e.g., excessive force), the risk of harm to the community is a key reason why this issue is a matter of public discussion. This risk make


public demonstrations against police brutality, as well as several high- profile shootings committed by deputies that have contributed to tension with some com- munity members. These tensions also manifested in attacks on deputies, the most notable o


intent and reach of this policy, ongo- ing conflict with civilian oversight bodies regarding the department’s approach to subgroups, and post-policy allegations of ongoing subgroup activity provide reasons to be wary. Addition- ally, recent depositi


ions of LASD personnel and community members. This framework recognizes that subgroups and issues surrounding them exist within a broader context, which could have implications for group formation, group features, group member characteristics, and be


 this case, interviewees, focus group participants, and survey respondents.4 Surveys were conducted anonymously; RAND does not have any information that could be linked to an individual.
Additionally, we present many of our qualitative findings with


ers relevant inquiries and lawsuits into LASD subgroups over several decades and analyzes media coverage to see how frequently and in what context subgroups have been mentioned (primarily in the Los Angeles Times). The Kolts Commission provided the f


 Los Angeles County Sheriff’s Department
Media Coverage of LASD Deputy Subgroups
Web searches for “deputy cliques,” “deputy gangs,” and “deputy subgroups” reveal cover- age from local, national (e.g., New York Times), and international (e.g., The Gua


bgroup), statements by county officials (e.g., the Sheriff, the Board of Supervisors), and potential investigations into deputy subgroups (e.g., by the FBI or the OIG). Researchers also analyzed the set of articles using RAND-Lex, a cloud-based text


ent is formally organized into many workplace groups of various sizes—across units, shifts, and areas of responsibility, and this structure can create a sense of isolation and localized patterns of behavior (Klinger, 1997; Hassell, 2007), which occas


s unclear; however, the NOPD at the time was mired in scandals related to various forms of corruption and outright criminal conduct (Frontline, 2009).
Other groups have been identified following whistleblower accusations about pressure to use lethal


Two Internal Affairs undercover investigators originally assigned to investigate were reportedly removed from the case after two and a half years; claiming they were reassigned and ostracized, the investigators filed a whistleblower retaliation laws


ding Subgroups Within the Los Angeles County Sheriff’s Department
Operation Pandora’s Box
More recently, the 2011 Operation Pandora’s Box scandal resulted in federal charges and con- victions for former Sheriff Baca and Undersheriff Tanaka (Grad and


mbers of individuals who were killed in shootings committed by deputies. Community members’ claims typically cite unreasonable search and seizure; unreasonable or excessive force; failure to train, supervise, and discipline; and munici- pal liability


behavior (e.g., Rathbun & Sexton v. County of Los Angeles).
Together, such complaints and lawsuits provide ample examples of subgroup members’ alleged misconduct against both county residents and other deputies. However, the resolu- tion of these cas


ly affecting these out- comes, such as supervision, discipline, and community engagement, among others. Here, we review key findings from these reports as they relate to subgroups or cliques and LASD culture generally and for recommendations related


community policing. Regarding the subgroups, the report recommended that LASD eradicate offensive station mascots and conduct an immediate internal affairs investiga- tion to identify and punish gang-like behavior. It recommended breaking up deputy


rengths and weaknesses of management, knowing what training had been received or is needed, and knowing whether subgroups are forming and what assistance has been given to the captain. This assistance included developing working plans with captains t


2011; Liebowitz et al., 2012). These reports
Prior Reports and Media Coverage of LASD Subgroups 17
identified deficiencies in LASD’s use-of-force policy; its training; and its reporting, investiga- tion, and discipline for excessive force and noted a


rom this report, one can infer that cliques were emblematic of a culture or subculture within the department that supported the use of force as a tool. The CCJV advocated culture change, noting that it would require committed supervisors, strong and


The agreement includes a vari- ety of recommendations related to stops, seizures, and searches; bias-free policing; community engagement; Section 8 enforcement; data collection; use of force; personnel complaints; and accountability. These recommenda


past investigations on deputy subgroups (Loyola Law School Center for Juvenile Law and Policy, 2021). The report distin- guishes between deputy subgroups or cliques and deputy gangs based on whether the group has engaged in gang-like behaviors, defin


o them, instead focusing on disciplinary and other departmental processes. The OIG’s recent report on the Banditos criminal investigation (OIG, 2020a) and the Loyola Law School Center for Juvenile Law and Policy report (Loyola Law School Center for J


eractions, and not condoning allegiances to sub- parts of the department.
LASD disagreed with some of the findings and recommendations, typically noting their points of disagreement in response letters. LASD has, however, implemented several of the r


tting (e.g., “tattoos associated with deputy cliques . . . have also in some instances been used as a reward for aggressive behav- ior”; CCJV, 2012, p. 115). What has been missing in prior accounts of deputy subgroups is an explanation of why these g


ture is emergent—that is, it is part of a creative process that is influenced by social action and group interactions and conflict. This includes the broader social context, and deputies bring their own beliefs, values, and worldviews to the job.
Pol


, which reflects an occupational culture within law enforce- ment. In relation, an organizational perspective posits that unique features within a particular agency lead to unique cultural adaptations that vary across agencies (Paoline and Terrill, 2


ilence is important for the mutual trust needed to perform well. In research surveys on this topic, officers tend to overwhelmingly endorse physical protection and emotional protection or the camaraderie/bond features of loyalty, while between 12 and


y themselves as a distinct group within the organiza- tion . . . and routinely take action on the basis of collective understandings unique to the group” (Van Maanen and Barley, 1984, p. 38). The extent to which subcultures reflect other subcultures


evel of danger), (4) preferences and ideologies of command structures, and (5) types of crimes and legal authority commonly used (e.g., stops and searches for weapons). Both formal and infor- mal processes shape subunit culture and officer behavior.


ypical members are negative outliers (or “free riders”) and “high-flyers.” Rejecting the free riders is important for solidifying the ingroup prototype, while high-flyers can be tolerated as long as the group can take some ownership of their behavior


r police to avoid external scrutiny). In addition to the impact of peer groups, a key consideration for research in this area involves group processes. The idea of emergence—how elemental content (e.g., individual orientations to aspects of police cu


, views about use of force (Oberfield, 2012; Roithmayr, 2016), misconduct (Chappell and Piquero, 2004; Ouellet et al., 2019; Quispe-Torreblanca and Stewart, 2019; Wood, Roith- mayr, and Papachristos, 2019), ethical decisionmaking (Blumberg, Papazoglo


of these effects occur because of selection (i.e., “birds of a
Relevant Research 29
30 Understanding Subgroups Within the Los Angeles County Sheriff’s Department
feather flock together”) or influence. Thus, research on social identity, self-categoriz


es or the extent to which workgroups share similar outlooks. However, other research has shown that fairness perceptions are associated with observed treatment of peers, and particularly more similar peers (Huang, Ryan, and Mujtaba, 2015). As mention


recognizes that the way an organization treats employees also can affect attitudes and behaviors and has implications for reforming LASD and implementing new policies. These concepts also have relevance for understanding orientations toward and inter


ess, LASD provided contact information for command staff in the custody1 and patrol divisions. We developed our survey approach through feedback from LASD stakehold- ers, which informed our decision to conduct a paper survey. LASD and ALADS also assi


using referrals and independent searches to ensure that a variety of perspectives were represented. Ultimately, 46 community stakeholders agreed to participate, yielding a 45-percent response rate. For the focus groups, we recruited 95 English- or Sp


operates, awareness of deputy subgroups, impacts of deputy subgroups, and perspectives on how to address deputy subgroups.
Recruitment
In October 2019, LASD sent out an email announcement giving personnel an overview of the various components of the


where subgroups are typically found within LASD
– advantages of belonging to a subgroup
– conduct, attitudes, and behavior of deputies who belong to a deputy subgroup – impact of subgroups on the workplace
– supervisors’ approach to subgroups
– views


tment, and community levels.
To pretest the survey, we recruited 12 LASD personnel of varying ranks to partici- pate in cognitive interviews. Cognitive interviewing, which involves administering a survey while asking a respondent to elaborate on the


ntities investigating LASD, and would not provide confidential information to any outside entity, including the county. Infor- mation gathered as part of the survey would only be used for research purposes and would not be shared with anyone outside


or had been asked within the past five years to join a subgroup. We felt that the analyses that compared subgroup invitees with those had never been invited to join a subgroup were informative as to these respondents’ knowledge of and assessments of


l. First, we used benchmarking to identify units that had signifi- cantly lower or higher levels of reported subgroup activity than we would expect, given the demographics of the individuals who responded. We compared these results with external
Meth


ty for the department to change in response to public outrage or pressure from other county stakeholders. Therefore, we sought to understand community perceptions on this issue, as well as how those perceptions are related to views of LASD overall.
T


es, station personnel, and leadership through their involvement in citizens groups and advisory panels. In addition, stakeholders in the North and Central divisions more frequently offered negative perceptions of LASD than community representatives i


ing with the commu- nity; and (3) community partnership, which varies from collaborating to address public
 Chapter Five Methods: Interviews and Focus Groups with Community Stakeholders
• Our method is based on interviews and focus groups conducted w


nd-highest numbers of calls for service; Figure 5.1).1
Community leaders and members offered several different perspectives on and experi- ences with department personnel and subgroups. The aim of this chapter is to present this information as it was


the people, not to the Board, but they control his budget, so they went after him [through the] budget. . . . The Board should drop their lawsuit and let [the Sheriff] do what he was elected to do.
Funding
Some participants expressed concern about th


es 45
46 Understanding Subgroups Within the Los Angeles County Sheriff’s Department
Compton Station to describe the present relationship between Compton and LASD. Commu- nity leaders in the North Division frequently mentioned the 2015 Antelope Valley


ASD programs, such as the Youth Activi-
2 In 2011, the DOJ, Civil Rights Division, initiated an investigation of LASD to evaluate allegations of violations of the Fair Housing Act. DOJ found that LASD’s Palmdale and Lancaster stations “had engaged in


research suggests that supervisor expectations can affect whether officers engage in community policing or problem- solving (Engel and Worden, 2003), but much more research is needed to understand the opti- mal conditions for high-fidelity implementa


ture in nearly every focus group or interview in every division. However, community leaders’ perceptions were more varied, with negative culture mentioned in a fourth of interviews in the South Division, approximately two thirds of interviews in the


vested in the community. Others described problems emerging when the majority of deputies do not represent the community culturally or demographically. A community leader noted that having stations represent the racial and ethnic composition of the c


was failing to provide necessary services for the community. This theme was especially prominent in the North and East divisions, with approximately half of discussions of those divisions describing inadequate service. This topic was raised far less


e
community. More community stakeholders from the North and South divisions mentioned having opportunities to interact with deputies than did those in the other divisions.
Despite the importance of community interaction, some participants noted that


ness, some people felt unsafe so LASD ensured they had more presence with deputies. There is also a roving COPS [Com- munity Oriented Policing Services] team that comes to the community. It is proactive policing. They are very actively involved if th


fety decisions. Attempts to partner with the community might not be successful if station personnel have not engaged in relationship-building through community interaction. A community leader mentioned that the local station’s attempts to solicit fee


ders reported experiencing mistreat- ment by deputies—including harassment, retaliation, and excessive force—as well as differ- ential treatment. Community members described mistreatment in every interview and focus group, which was more often than i


d Central divisions.
The majority of the comments suggested that differential treatment was based on race (i.e., primarily Black and Hispanic individuals). A community member described the relation- ship between the Hispanic community and deputies th


 leader attributed lower crime rates to successful partnerships between the deputies and the community and added that:
it takes the community working with the sheriffs. Now, if the community doesn’t care or isn’t working with the sheriffs [you won’t


ity. For example, a com- munity leader said:
There were more programs in the community which made it more comfortable for them to understand who the community is. Now, it’s “I’m going to shoot you, I’m going to beat you.” . . . I asked [deputies] to


ory good where I could really hear everything about that. It was just in a walk-by way, if that makes sense—it wasn’t the main point in the conversation, so I
hadn’t really thought about it. But I could believe it. I could believe it just based on th


ne community leader explained,
I have seen those cliques make the community safer because they don’t tolerate the things that are going on, so the crime rate has significantly reduced. These cliques are not out to hurt people. When I was in the servi


l Division (with only one additional comment from a community member in the East Division) and from community leaders in the South and North divisions.
Subgroup Behavior
Patrol Deputies’ Behavior
Community leaders and members gave examples of how pat


anguage of rival gangs.
In addition, some participants were reticent to file complaints about subgroup behavior because they said that the complaints would just go through fellow LASD personnel and would likely never be heard. Comments about the beha


that is because I was part of the military and I know how these rank-and-file companies are and how they are run. If you have a bad person running that company . . . when I think of the sheriff rank-and-file group, they teach the same kind of trainin


and kept the community safe, and a few said that there really was no impact on the community. In general, however, the predominant sentiment was that subgroups have a negative impact on the community. As we note later, this sentiment aligns with that


ors indicated the existence of and participation in subgroups.
Illicit Behavior
Community members and leaders described illicit behavior that they associated with sub- groups. One common and unlawful practice that participants discussed was dropping


e LA Times article came out last year, they did a good job communicating that the cliques aren’t there now, so from my perspective and my neighbors’ perspective, we don’t really have a sense of that being there anymore. It might be more of a sense of


d for training to focus more on building skills for interacting with people (e.g., procedural justice) and display- ing empathy. One community member said:
[They need p]eople skills, because you’re dealing with people. You’re dealing with the com- mu


responsible for the entire community.
In a similar vein, participants recommended that LASD overall engage in more community-oriented policing (COP).4 Participants described COP as working with the com- munity to advance public safety, engaging with


ment
Recommendations for Internal Activities
Improve Hiring and Training Practices
Both community leaders and community members had suggestions about improving hiring and training practices as a way of addressing issues of subgroups within the depart


 was likely to be ineffective. A community member’s comment underscored this point:
There needs to be investigations by independent bodies within the department of any sus- picions. I have doubts about any internal committees to be unbiased—I don’t t


groups; federal agencies, through consent decrees or federal injunctions, to keep the pressure on the department to do something about sub- groups; the Board of Supervisors and the COC exercising their power over the department to dismantle these gro


eaders were also more likely to highlight the need for residents to be more involved in efforts to improve LASD community relations. Conversely, community members typically offered a less favorable assessment of LASD culture, station personnel behavi


and survey questions were aimed at helping us understand whether complexity (or lack of it) at LASD is a factor in deputy subgroups forming. RAND research- ers with expertise in qualitative data collection interviewed a total of 57 individuals, inclu


ly, patrol tends to be a more valued assignment than other assignments like custody and courts, and special assignments (Special Enforcement Bureau, Homicide Bureau) tend to be the most highly valued assignments.
• Core organizational processes. The


who was ambushed and killed in the line of duty—states: “My goals are simple, I will always be painfully honest, work as hard as I can, learn as much as I can and hopefully make a differ- ence in people’s lives.” We highlight these values and mottos


ge from urban areas to suburbs and from high-crime areas to low-crime areas. These differences contribute to deputies’ perception of the experience to be gained by working at some stations (e.g., deputies in high-crime areas will be more likely to wo


 earning the reputation of having favored assignments within LASD. According to one retired department member,
Working in [other areas], you were nothing. You weren’t worthy of promotion. [One region] had the stigma of being the cowboy country. I was


on, this idea that certain assignments are more favorable feeds into department members’ understanding of what leadership values. It is not clear how perva- sive these perceptions are today, as some interviewees reported that there is currently no cl


e there is a higher volume of serious crime, this could result in a trade-off in quality when it comes to writing reports, can hinder the development of skills to deal with less serious crimes or provide service, and can result in less diverse experi


rate as independent police departments.
This statement also recognizes that, rather than operating as districts or precincts within the same department, LASD stations are more like completely separate departments (Meyer and Rowan, 1977; Pfeffer and S


2000/3000 to build your reputation as a hard charger and can handle ghetto. Those floors are associated with the station you want to go to. 3000 go to Compton. In patrol, they ask where did this guy work? Which floor? 2000 go to Century. NCCF [North


g., being close to home, a regular schedule).
Key Organizational Processes
Although a full examination of organizational processes is beyond the scope of this project, several of these processes were frequently mentioned in relation to both subgroups


ld also contribute to making the department “too young” because they could lead to people leaving custody too soon and being unprepared for patrol training. Conversely, contingent on county funding, if a hiring spree is followed by a hiring freeze, p


we need them to know. We have the field operations school for sergeants that’s supposed to be had within a year [of promoting to sergeant], but 90 percent of the typical class has at least 3 years [on the job]. We have no training for sergeants or li


s a ringer in there. There would be a county rep or a city manager or someone that you’d interview with, and they would tell the Sheriff who they wanted. And the Sheriff would ignore that and pick the person they actually wanted.
There is now apparen


pline varies across the department, and historical perspectives on discipline under different sheriffs.
Historically, several command staff noted a pattern of lax discipline during Sheriff Baca’s tenure, primarily attributed to favoritism on the part


at we’re trying to get our younger personnel to understand. Consistency is a good thing, but every situation should be looked at differ- ently. There should be minimum standards, but everything needs to be evaluated. If you’re not going to own the mi


all, building trust, and ensuring that everyone is on the same page. The simplest aspect of this is walking around the station or facility and talking to people where they work rather than in an office. Captains deemed this to be critical for unders


he importance of deputy leaders and TOs for implement- ing the goals of the department. Sergeants are also in important leadership positions, but as a supervisor, their role is slightly different in that they need to guide and monitor behavior withou


n important requirement because their deeper experience and knowledge of assign- ments in these areas will likely make them better leaders. However, “if they make exceptions, then it’s a huge drawback . . . people lose respect for leadership.”
Front-


ing or controlling activity, which could set LASD apart from other law enforce- ment agencies. This approach can present a tension with supervision, however, as people could feel that if a supervisor does “roll” on a call (accompany the deputy when r


 staff
LASD Organizational Context 85
86 Understanding Subgroups Within the Los Angeles County Sheriff’s Department
member noted, “Years of service is more important than rank. On the surface, we’re very com- pliant with the hierarchy. You have to se


geant’s background could poten- tially inhibit his or her effectiveness when dealing with subgroup members.
Promote and Remain
On the flip side of “back-dooring” is the idea of “promote and remain,” or promoting from within the same station where one


nvestigation. Once that investigation starts, the deputy could be blacklisted or worse. Policy dictates the way the supervisor will supervise. . . . Even guiding someone, it affects the sergeant-deputy relationship. I can see these things being good


everything is education. If it is correctible, then education can be more effective than discipline. Discipline can make some depu- ties ineffective. But if the offense is bad enough, there’s no problem firing the deputy. For instance, if a deputy ne


very station. They control how [the] deputy will go.” Another outlined the characteristics of a good TO this way:
Good TOs recognize what works with the trainees. There is no “one size fits all.” You have to be dedicated and willing to put in the hou


ted to take the position. If you as a supervisor are going to be respon- sible for managing the person, you should at least be able to weigh in on who gets the job.
Peer Leaders
Informal peer leaders were mentioned as having an important role in help


es are also expected to listen and learn, or, as one command staff put it:
7 To “roll up” means to leave patrol training before completing it and returning back to custody or another nonpatrol assignment.
 Trainees don’t talk unless they have to talk


own approach to the job. Being labeled a hard worker could help a deputy advance or maybe even get one out of trouble. Some interviewees noted that deputies can occasionally be hard working to a fault, as in being too defined by work and having a wo


a sheriff, I thought, okay, I’m going to do law enforcement—I wasn’t thinking, okay, I’m going to help this person find a home, okay, I’m going to help this person get into foster care. And they don’t give people enough training to deal with that. It


uits is the question.
Conclusion
LASD is a large and fragmented law enforcement agency, with each patrol station operating largely as an independent police department. Despite the size and fragmentation, individual reputation matters. A variety of fa


extent to which expectations for serving the community are embedded into key organizational processes is worthy of further exploration.
CHAPTER SEVEN
LASD Views on Subgroups
Among LASD staff, there is little agreement about the degree to which subgro


, and focusing on their personal lives or having family obligations that prevented socializing with colleagues above and beyond regular work interactions.
 95
96
Understanding Subgroups Within the Los Angeles County Sheriff’s Department
• What are th


humiliating, or intimidating behavior might try to deal with these behaviors on their own or put up with them until they become very serious. Many noted that the risks of more serious or criminal behavior are rare but can occur. Finally, some noted t


 that is known to group members, but they are not officially recognized by LASD. Deputies typically join the subgroup by invitation only and may have to meet certain requirements for subgroup membership.”
Organizational research on other professions


k ethic, the indi- viduals joining the group, the nature of the group, and the individual’s own feelings about tat- toos, and unit-based versus LASD pride. The groups often form based on shared work experi- ence; as another interviewee explained, the


ains. They are elected by peers. They communicate information from the coaches. That’s how I view subgroups. Subgroups are people of like minds. A true friend will communicate to you if you’ve screwed up. The department needs more mentor- ing to help


and peer motivation fill in the gaps where supervision and formalized performance evalu- ations cannot. For instance, we repeatedly heard that the “county only requires people to be competent and not good.” There are five levels to the performance r


es a clear example of how groups that get too big lose their ability to provide distinctiveness to their members, which motivates people to find other ways to be distinctive
(Hogg and Terry, 2000). Tension can also arise across groups or between memb


get involved in a shooting or a fight, that’s it. You’re in. [In custody], if a deputy was involved in a physical fight with an inmate, that was huge [for getting asked to join a sub- group]—even though you could have de-escalated the situation! I’v


be better. Show- boating is not cool, especially in this crowd.” Some groups are noted for this. Being reserved about one’s status in a subgroup could contribute to the secrecy and the allure of the subgroups. Notably, one LASD interviewee explained


ing reports), and providing off-duty favors (such as hosting parties) or obliging egregious demands (such as “paying rent to work at a station”). Some line-level and midlevel representatives were adamant that membership in some subgroups is contingen


ed that these individuals want to ensure that “there is no dirt on them, ever.” This attitude toward subgroups stands in contrast to historical examples in which one’s mem- bership in a subgroup, especially at specific stations, might have contribute


saw subgroups as a means of reinforcing the standards of being a top-performing deputy, which raises the question of how similar subgroup standards are to LASD standards. A command-level staff member explained:
You’re not going to get any points for


y to destress and decompress from all of this.
Interviewees across ranks echoed the sense that subgroups “are just the way to decom- press” and not an avenue for adverse actions.
A command-level representative spoke about the role of healthy competit


gs because they have
a tattoo while others are not. To others, the divisiveness comes from the exclusivity associated with certain tattoos, which conflicts with the idea that the tattoos are supposed to represent unit pride. It also could contribute


 workers was a common explanation for asking someone to get a tattoo, and the offer was often made by respected deputies at the station. As one respondent said:
When you get to patrol, the cool group are the two-stripes deputies (Bonus Deputies). Sub


ls of Visibility
Secrecy, exclusion, alternative hierarchy
Encouraging adverse behaviors such as ostracism and disrespect, overemphasis on aggressive policing, promoting unhealthy coping mechanisms, workaholism
LASD Views on Subgroups 109
      Low v


erned that subgroups are by nature exclusionary. As one command-level representative said, “The tattoos are by invitation—this is divisive because it’s not all inclusive. This creates a wedge between the partners. Even though it’s not a problem, it j


 also report on a deputy’s performance, and interviewees said that they felt pressure “to please the TO.” A line-level representative described training as follows:
You’re put in this spot where you have to do whatever you have to do to get off train


hey have the brass thinking they’re squared away and let them do anything they want. They tried to get him to sign off that he was failing patrol. I got him transferred.
This quote describes how subgroup members have reportedly tried to “roll up” tra


pervised. . . . The two or three [bullies] who were extremely loud and powerful, they created chaos.
This interviewee noted that the individuals in question were also perceived to be hard workers, so other aspects of their job performance were not an


across staff levels described the intrinsic role of supervision as being either complacent or complicit in the formation and persistence of subgroups. A midlevel rep- resentative stated, “The slippage happens when supervisors start to turn a blind ey


ing contrast to the reports from some other interviewees that subgroup members are seen as the do-gooders who are unwilling to go against policy to accomplish their work. One interviewee recounted a past example of having to supervise deputies who ha


avor of saying [subgroups in gen- eral] are a problem” but still acknowledged the risk of the separate codes of conduct that cer- tain subgroups have orchestrated. “Any group that sets separate rules should not be allowed,” he said. “The job isn’t ab


get their hands dirty without disgrace, dishonor, or hesitation” meant working late and not complaining, according to members of the group. The department did not agree that this creed reflected the values of the department, and several members or as


thout necessarily being overly aggressive. Additionally, a command-level representative spoke about subgroups as an isolated, historical issue:
The Viking5 issue was an anomaly. I’m unsure how that occurred, but I haven’t seen that type of non-commun


 have protection. . . . It’s no wonder they’re drinking so much and their divorce and suicide rates are so high.
The previous quote and the next quote both highlight how the solidarity and support provided by being in a subgroup can contribute to soc


of camaraderie to one of problematic behavior. “Subgroups open up the department to risk. If there’s enough smoke there’s probably fire,” a command-level staff member stated succinctly. The running thread throughout interviews is that subgroups allo


ically (and as was detailed in Chapter Four), the survey focused on survey respondents’ experiences with deputy subgroups, including
• who gets invited to join these subgroups and the criteria for being invited
• where within LASD these subgroups are


aking arrests) as a criterion.
• Where within LASD are deputy subgroups or cliques typically found? Two-thirds of subgroup invitees and two-thirds of midlevel managers agreed that deputy subgroups exist in some, but not all, LASD stations. Half of ea


nd 30 percent of midlevel managers and 20 percent of invitees agreed with the statement that deputies
Los Angeles County Sheriff’s Department Survey Results 121
in subgroups bully or harass nonmembers. Roughly one out of five midlevel managers agreed


em out to be.
• What are their views regarding supervisors’ approach to deputy subgroups or cliques? Half of midlevel managers and two-thirds of subgroup invitees agreed that supervisors were aware of subgroups’ conduct. One out of four midlevel mana


ly, to report on survey respondents’ assessment of the impact of subgroups on LASD and individuals, as well as their recommendations for what (if anything) LASD should do about subgroups, we first compare those who had ever been invited to join a sub


ed because they are more likely to be familiar with subgroups. This is underscored by the fact that the percentage of respondents who indicated “don’t know” for a particular response category was much higher for those who had never been invited. Depu


p or clique?
  Q4 and Q5. Have you ever been invited to join a deputy subgroup or clique? In the last five years, have you been invited to join a deputy subgroup or clique? For each question, survey respondents were asked to check either “Yes” or “No


ubgroup invitees reported that these subgroups exist in some, but not all, LASD stations (Table 8.5). Only 24.7 percent responded that deputy subgroups exist in all LASD stations. In addition, 55.6 percent reported that these sub- groups are common a


dback from several interviewees who commented that subgroups often can serve to motivate other members to be proactive about making arrests.
130 Understanding Subgroups Within the Los Angeles County Sheriff’s Department
Figure 8.2
What Are the Percei


4%
7.1%
8.3% 11.7% 11.2%
26.0% 19.3% 20.4%
10.2%
6.3%
 Q11 (a, b, c). The following statements to a deputy subgroup or clique. Please statements. (Survey respondents were Agree,” plus a “Don’t Know” option.)
are about the
indicate how strongly you ag


ndicated that not belong- ing to a subgroup had no negative impact (Table 8.9). Specifically, about two-thirds of these respondents
• disagreed that not belonging limits a deputy’s training opportunities
134 Understanding Subgroups Within the Los Ang


ther two-thirds indicated that deputy subgroups help motivate others within the station or unit (e.g., make more arrests, maintain better order of custody inmates).
Still, some subgroup invitees noted a negative impact of these groups. A quarter indi


iques hurts morale within the station/unit.
The presence of deputy subgroups or cliques makes non-members want to leave or avoid certain stations/units.
Deputy subgroups’ or cliques’ behavior has negatively impacted community perceptions of LASD.
Dep


deputies indicated that the invitation had occurred prior to the past five years (Table 8.11).
At What Point in Their Career Are Most Deputies First Invited to Join a Subgroup?
Just under half of midlevel managers and nearly one-fourth of deputies in


38%
32%
  23%
  29%
49%
 49%
140 Understanding Subgroups Within the Los Angeles County Sheriff’s Department
Table 8.11
Whether a Respondent Had Ever Been Invited to Join a Subgroup or Had Been Invited Within the Last Five Years (Midlevel Managers Ver


re likely than deputies to agree that deputy subgroups exist in some, but not all, LASD stations and are common at LASD stations in high-crime areas. Specifically, nearly three-fifths of midlevel managers either somewhat or strongly agreed that these


ist in some, but not all, LASD stations, and 13.8 percent responded that subgroups exist in all LASD stations (Table 8.13). More than a third of deputies agreed that these subgroups are common at LASD stations in high-crime areas. Note the higher per


her Agree nor Disagree" and "Don't Know."
41%
 40%
23%
 23%
 38%
21%
12%
17% 51%
5% 4%
39%
38%
55%
   48%
 72%
Respondent Strongly Somewhat Neither Agree Somewhat Strongly
Type Disagree Disagree nor Disagree Agree Agree Don’t Know
Row Total
394
100%


bgroups have their own code of conduct (Table 8.15). One out of five midlevel managers also agreed that subgroups encourage members to work outside the chain of command in situations that normally require supervisor involvement (e.g., use- of-force i


 Respondent Strongly Somewhat Neither Agree Type Disagree Disagree nor Disagree
Subgroups or cliques have their own code of conduct
Somewhat Agree
Strongly Agree
15.3% 12.8% 13.5%
33.0% 17.1% 21.3%
10.4% 6.7% 7.7%
Don’t Know
33.3% 50.2% 45.8%
26.6%


ongly Agree" and "Agree" responses, while the "Disagree" category represents "Strongly Disagree" and "Disagree." Respondents also had the option of "Neither Agree nor Disagree" and "Don't Know."
of deputies about the impact of subgroups and suggestio


half of deputies indicated that these subgroups have no effect on the daily operations of their station or unit (Figure 8.9). Nearly two-
150 Understanding Subgroups Within the Los Angeles County Sheriff’s Department
Figure 8.9
Midlevel Managers’ Ver


el managers to report that they did not know what impact subgroups had on community perceptions of LASD.
With respect to the media’s portrayal of subgroups, there was a large percentage of respondents who agreed that subgroups were not as harmful as


,104 100% 1,498 100%
394
100% 1,107 100% 1,501 100%
  Midlevel managers
Deputies
Overall
4.3% 7.4%
2.4% 2.7%
2.9% 3.9%
12.9% 28.2%
9.8% 18.8%
10.7% 21.2%
Supervisors formally discipline improper or unethical behavior by subgroup or clique members
Mid


at subgroups are a way to recognize high-performing deputies, that the formal performance evaluation process was lacking in terms of being able to properly reward positive performance or correct poor perfor- mance, and that evaluations were not used


were in similar agreement about whether promotions are handled fairly (40 to 49 percent agreement), while invitees and midlevel managers were more likely to disagree (41 and 37 percent, respectively). On the consistency of disciplinary action, 44 per


e who had not been invited to join a subgroup were more positive about executive leadership. Subgroup invitees were the least positive about leadership, with 41 percent disagreeing that executive leadership represents high ethical stan- dards. Midlev


analyses supported insights from the interviews that, according to survey respondents, those who were invited to join subgroups were typically deputies who are known as hard workers, are willing to work challenging assignments, and, in some cases, s


nagers and those who had not been invited to join a subgroup agreed that LASD should discourage deputies from joining subgroups or cliques and/or prohibit subgroups alto- gether. Among subgroup invitees, one-third agreed with discouraging deputies fr


dividual groups and individuals within those groups should be accountable for their own behavior and that it was unfair to label all groups or all people within a group based on the actions of others. This parallels some of the history and heterogene


a collection, so we also identify the findings that most prominently informed our recommendations after Table 9.1. This is then followed by a discussion of the main limitations of this study.
We base our recommendations on the following key findings:


cent of those invited agreed;
62 percent of midlevel management agreed)
• Subgroups engage in behavior that may offend intimidate or endanger community members (15 percent overall agreed; 16 percent of those invited agreed)
LASD is fragmented, and un


In custody], if a deputy was involved in a physical fight with an inmate, that was huge [for getting asked to join a subgroup]—even though you could have de-escalated the situation!” (line-level interview)
What do subgroups do? What is their impact o


ercent overall agreed; 23 percent of those invited agreed)
• limit opportunities for career advancement or promotion (22 percent overall agreed; 25 percent of those invited agreed)
Subgroups might start out with honorable intentions, but there is a r


sivity, or problematic actions (Carton and Cummings, 2012). Secrecy is another form of control that enhances group cohesion and group identity (Costas and Grey, 2014). Problematic behaviors iden- tified by interviewees often target select individuals


ey would advocate for telling deputies to not join subgroups. Many survey respondents recognized the negative com- munity perceptions associated with subgroups. Lastly, survey respondents tended to indi- cate that something should be done, with 37 pe


ommendations
LASD is not the only law enforcement agency that has been confronted with reexamining its policies and practices in the wake of scandal, nor is it alone in its need to show that it can be accountable to the public and acknowledge negativ


te responses. Some captains have responded by developing their own approaches to addressing issues with sub- groups, emphasizing direct communication and setting expectations. Although this approach could ameliorate problems in particular places, it


they are not aligned with cultural values and practices or if amending these values and practices does not make sense to the population that must adhere to them. Any strategy that does not recognize the significance of subgroups to a significant pro


hat even the best supervision can be circumvented if there is motivation to do so.
Although it is worthwhile to uphold and enforce policies prohibiting subgroups, it is also important to consider that doing so could have unintended consequences. Proh


olicy as it currently exists, and consider potential negative unintended consequences and efforts that could mitigate or pre- vent them. Next, we focus on other ways that LASD could use a holistic approach to promote cultural change. This approach in


ty. In the longer term, collaboration, stakeholders, training and resources will be important for driving lasting, sustainable change.
Implementing the Policy on Employee Groups Which Violate the Rights of Other Employees or Members of the Public
She


ambiguous language that employees are “advised to avoid joining” these groups. Being firm in setting and enforcing standards will be critical for this issue and has been identified elsewhere as being essential when implementing programs to enhance e


s do come to light, it is critical that they are investigated thoroughly and swiftly. However, secrecy also makes these investigations challenging because information can be limited to insiders. Internal Affairs investigators should receive guidance


with LASD mission and values) and the desired cultural change that the department is heading toward, which could include acknowledging and com- municating a desire to separate the department from the past. A cultural stance on subgroups would convey


eriff’s Department
behavior of deputies, and they must denounce retaliation (Mesmer-Magnus and Viswesvaran, 2005). Leadership must also clearly explain that retaliation will not be tolerated. For example, a recent anonymous report to Internal Affairs


rganizational identification, unit commanders should emphasize the common identity of working in a particular unit.5 In-group
4 Recently, two deputies at the Compton station filed lawsuits against LASD with allegations that a subgroup allegedly named


ive conduct or bullying. Supervisors should understand and know to look for these behaviors and signs of conflict.
• Supervisorsshouldalsobemadeawarethattheircurrentorpriormembershipinadeputy subgroup is a reportable conflict of interest should they


ntoring programs for sergeants to enhance supervisory behavior in general was recommended by several inter- viewees, although, again, research evidence is limited (Herrington and Schafer, 2019; Pearson- Goff and Herrington, 2014). Lastly, LASD should


t at the time, who mentioned efforts to get ahead of problems associated with cliques, although the article did not discuss what those were (Avins, 2000).
84 percent of those at all ranks support a requirement to intervene if another officer is about


most critical factor is that depu- ties know they will be supported if they intervene, which is the responsibility of leadership (Mesmer-Magnus and Viswesvaran, 2005). Additionally, the goals of Project ABLE include redefining various features of la


 departmental members (e.g., peer intervention requires that anyone can intervene with anyone else, regardless of rank or status).
Transform How the Department Shares and Generates Information
Lessons Learned
From our interviews and survey findings,


stances of subgroups pressuring individuals to leave a unit, this procedure could identify issues early. Information from these interviews should be reviewed regularly.
Devote Resources to Enhancing Support for Employees
Lastly, ongoing devotion of r


 improving respectful interactions with community members or inmates.
Recommendations 179
 180 Understanding Subgroups Within the Los Angeles County Sheriff’s Department
with higher workload, more serious crime, and/or subgroups that prioritize aggre


 “Guardians” Starting in the Academy
As noted above, organizational and cultural change needs to be built into organizational pro- cesses where possible. Rahr and Rice, 2015, contend that shifting to more of a guardian mind- set and recommitting to d


al justice components to the officer. This approach has the added benefit of creating interactions between supervisors and subordinates that are positive (i.e., nondisciplinary) while also training to reinforce procedural justice and positive behavio


al contacts with citizens and document the con- tact in the MDC [mobile data computer] system with a clearance code of 755 (community relations).” The order instructed deputies to provide contact cards and instructed sergeants to brief and review dep


ed by community members (Fielding and Innes, 2006). Such mea- sures consist of key activities and outcomes identified as relevant to the given problem and solution (Alpert, Flynn, and Piquero, 2001). Common measures and methods for assessing communit