racist portland police murder cover up

7/31/2019 Racist Portland Police Murder Cover Up

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PORTLAND POLICE BUREAU LEARNING:Improvements needed to strengthen

existing processes

May 0

LaVonne Grif n-ValadeCity Auditor

Drummond KahnDirector o Audit Services

Ken GavettePrincipal Management Auditor

Kristine Adams-WannbergSenior Management Auditor

Of ce o the City Auditor

Portland, Oregon


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Production / Design

Robert Cowan

Public Inormation Coordinator

PORTLAND POLICE BUREAU LEARNING:

Improvements needed to strengthenexisting processes

May 0

LaVonne Grif n-ValadeCity Auditor

Drummond KahnDirectoro AuditServices

KenGavettePrincipalManagementAuditor

KristineAdams-WannbergSeniorManagementAuditor

Of ce otheCity Auditor

Portland,Oregon


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CITY OF PORTLAND

Office of City Auditor LaVonne Griffin-Valade

Audit Services DivisionDrummond Kahn, Director

1221 S.W. 4th Avenue, Room 310, Portland, Oregon 97204

phone: (503) 823-4005

web: www.portlandoregon.gov/auditor/auditservices

May , 0

TO: Mayor Sam Adams

Commissioner Nick Fish

Commissioner Amanda Fritz

Commissioner Randy Leonard

Commissioner Dan Saltzman

Michael Reese, Chie o Police

SUBJECT: Audit Report Portland Police Bureau Learning: Improvements needed to strengthen

existing processes (Report #)

The attached audit looked at the Police Bureaus eorts to improve operations through the

collection, assessment and eective use o inormation gleaned rom experience and external

reviews. There can be ew organizational goals more important than continually improving

service delivery. This is especially critical or the Police Bureaus ,000 sworn employees who are

responsible or enorcing the law, are sometimes in potentially dangerous situations, and are given

the authority to use orce i appropriate. Mistakes can mean the dierence between lie and death

or an of cer or a community member.

We ound the Bureau has made determined eorts in the past twenty years to improve its processes

or collecting inormation and making organizational improvements. External experts have alsocome to this conclusion. However, we ound several areas that require increased eort and change,

including improving the timeliness o investigations o major incidents, initiating procedures to

strengthen of cer accountability, and reducing employee turnover in key positions.

We believe these improvements, in concert with the positive changes in the learning processes

noted in the report, will enable the Bureau to make substantial progress toward continually

improving services to the Portland community.

As a ollow-up to our report, we ask the Police Bureau to provide us with a status report in one year

detailing steps taken to address the recommendations in this report.

We appreciate the cooperation and assistance we received rom Portland Police Bureau sta as we

conducted this audit.

LaVonne Grif n-Valade Audit Team: Drummond Kahn

City Auditor Ken Gavette

Kristine Adams-Wannberg

Attachment


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Table o Contents

Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Chapter 1

Background. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Chapter 2

Structural and technological processes are in

place to oster organizational learning . . . . . . . . . . . . . . . . . . . . . . . . . 13

Chapter 3

Learning aspects o police culture need to be addressed . . . 23

Chapter 4

Improving the eectiveness o learning processes . . . . . . . . . . . 31

Chapter 5

Recommendations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

Chapter 6

Objectives, scope and methodology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

Appendix A Employee Inormation System Review . . . . . . . . . . 47

Appendix B Status o select recommendations . . . . . . . . . . . . . . . 53

Appendix C Employee Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

Appendix D Discipline matrix examples. . . . . . . . . . . . . . . . . . . . . . . . 69

Responses to the Audit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85


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Summary

Is the Portland Police Bureau a learning organization? Does it learn

rom its mistakes? With a orce o ,000 sworn of cers who must

periodically use judgment in lie-threatening circumstances some

mistakes seem inevitable, and they will sometimes appear to be

repeated. We believe the important questions are:

. Does the Bureau make attempts to improve its operations

by collecting and assessing inormation, accepting outside

expertise, and implementing improved polices and

procedures?

. Can the Bureau do better?

Our report nds the answer to both those questions is yes.

We studied the Police Bureau rom three key organizational learningperspectives: ) structural including the systems and processes used

to review incidents; ) technological which included an in-depth

review o the Bureaus system or identiying of cers who may need

help and mentoring; and ) cultural including an employee survey

about how Bureau leadership values and reinorces learning in the

lives o its employees. We ocused our work primarily on the Opera-

tions Branch, where police and residents come into contact hundreds

o thousands o times each year.

We ound the Portland Police Bureau exhibits many o the character-

istics o organizational learning. In the Operations Branch, the Bureau

gathers inormation rom street level events, reviews that inormation

at many dierent organizational levels, and attempts to incorporate

lessons learned into its policies, procedures and training practices.


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Portland Police Bureau Learning

We ound there is no shortage o review processes in place, both

internal and external, to review police actions and to recommend

improvements. We also ound the Bureau has made signicant

improvements in review and assessment systems over the past ew

years. The Bureau has been responsive to recommendations o out-side experts and to ones made by internal review panels. The Bureau

has also recently implemented a system using real-time inormation

to ag employee behavior that may indicate a need or extra supervi-

sion and mentoring. This system incorporates industry best practices.

However, of cers who responded to our survey and in interviews

reported that improvements could be made to some aspects o the

Bureaus learning process.

We also believe a number o issues negatively aect the Bureaus

eorts to collect inormation and achieve better results rom its learn-ing eorts: loss o experience in key positions because o excessive

turnover; a lack o timeliness in investigating cases o alleged of cer

misconduct and in implementing important personnel accountability

systems; a need or an easily understood, accepted ramework, such

as a matrix, to provide guidance to help consistently apply discipline;

and a need or regular employee perormance reviews. We believe

these issues hinder the Bureau rom taking ull advantage o the

learning processes already in place.

We make several recommendations or improvements which, in con-

cert with eorts already underway, will enable the Bureau to make

substantial progress towards being a better learning organization.

We recommend the Bureau:

Implement annual individual perormance assessments.

Implement a disciplinary matrix as a guideline or

more consistent disciplinary decisions and a means o

communicating expectations to employees.

Produce regular management reports on the eectiveness

and use o the Employee Inormation System.

Research and implement eorts to reduce turnover in key

positions.


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Strengthen the cultural learning environment by addressing

issues identied in our employee survey: providing

additional training time or employees as appropriate and

as unds become available; ostering a better atmosphere to

encourage suggestions rom employees; and encouragingupper level managers to spend more time in the eld.

Explore ways to speed investigations o incidents and at a

minimum give explicit, written authority to one person to

advocate or the timely and thorough completion o of cer

conduct investigations.

Improve accountability and oversight or the SERT unit by

continuing internal reviews, as reported by the Bureau, and

by establishing a process to independently review SERT

training.


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Chapter Background

A high perorming organization gathers operational inormation

and uses that inormation to improve its processes and service

delivery. This can be reerred to as organizational learning. Dierent

organizations exhibit varying levels o organizational learning.

According to a study in the Public Administration Review, the

learning organization can be examined along three dimensions:

What is organizationallearning?

Structural The structural dimension

includes policies and processes that

promote inormation sharing regardless

o organization hierarchy.

Technological Technology supports

the organizations ability to collect and

communicate data.

Social The social dimension includesparticipative leadership and empowered

employees.

In short, a learning organization has processes in place to enable it to

learn rom both its ailures and its successes. It collects inormation

on how well things are working, assesses that inormation, empow-

ers employees to suggest new ways o doing things without ear o

ridicule or retribution, makes appropriate changes to policies and

procedures, and imparts knowledge to employees. It is able to inte-

grate this learning so that mistakes are less likely to be repeated.

Chapter

Chapter

Chapter


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The Portland Police Bureau is a large, complex, multi-aceted

organization, with about ,00 employees. About ,000 o those

employees are sworn of cers who are authorized to use appropriate

orce to enorce laws. Other Bureau employees collect and analyze

crime data and provide inormation to solve crimes. Administrativeand nancial analysts provide budget expertise, human resource

management and inormation technology resources. Each o these

sub-organizations utilizes specialized data sources that collect

management inormation.

This report ocuses on the operational, street level work o the Bu-

reau that directly aects Portlanders and constitutes the bulk o the

Bureaus service delivery, including over 00,000 calls or service each

year.

How the Police Bureaulearns

Figure 1 PPB Learning Process

Source: Audit Services Division review o Portland Police Bureau documents

Implement

Training i

necessary

Review

o event

Event

Change policies

and procedures i

necessary

Outside review,

Bureau-initiated

research, etc.


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During our review we ound examples o many organizations and

people who examine Police Bureau activities. Bureau internal process-

es include the Review Board, the Tort Review Board, Internal Aairs

and the Training Division. City organizations that oversee Bureau

activities, but that are independent rom the Bureau, include the CityAuditors Independent Police Review division, the City Attorney, Risk

Management, and the City Auditors Audit Services Division. Enti-

ties outside City government include the Multnomah County District

Attorney, the Citizen Review Committee, the Federal Department o

Justice and the news media.

Most of cer-resident encounters require some reporting, i only that

a contact was made. In more serious cases, a ormal, detailed re-

port is required or internal review. Sergeants complete these Ater

Action reports detailing what happened, how of cers responded,and rendering an opinion as to the eectiveness o the actions. In

cases that involve certain types o use o orce, or where the potential

discipline is a suspension without pay or greater, the review levels

include a ormal Police Review Board evaluation, which includes

members o the community and sta o the City Auditors Indepen-

dent Police Review division (IPR). Review Board discussions in use

o orce cases include assessments by Internal Aairs, the Detective

Division, and the Training Division. The ormal hearings are acilitated

by an independent contractor. The Board makes recommendations

or policy changes and discipline to the Chie. A community member

or of cer involved in the case who disagrees with the Review Boards

decision can appeal to the Citizen Review Committee. The Chie and

the Commissioner-in-Charge are responsible or nal determination

o culpability and discipline.

Independent investigations and evaluations may also be conducted

by the IPR.

Policy changes and changes to training procedures may result rom

these recommendations.


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And while there has been a recent increase in the number o of cer-

involved shootings, the general trend over the past teen years has

been down.

Figure 3 Of cer-involved shootings, 1997-2011

0

3

6

9

12

1997 1999 2001 2003 2005 2007 2009 2011

Trendline

Source: Independent Police Review Division. Trendline by Audit Services Division

In addition, we contacted representatives rom cities o compa-

rable size to Portland (between 00,000 and 0,000 population) and

ound that Portlands rate o of cer-involved shootings was relatively

low. Figure shows Portlands average annual rate o of cer-involved

shootings is second lowest among the group.


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0


Figure 4 Average number o Of cer-involved shootings, 2006-2010

(cities 00,000 - 0,000 population)

Source: Audit Services Division survey o other city police agencies

* 00-0

** 00-00

0

5

10

15

20

Washin

gton

,DC

*Milw

auke

e,WI

Oklah

omaC

ity,OK

Denv

er,CO

Louisville

,KY

Tucson

,AZ

FortW

orth

,TX

**Atlan

ta,GA

Cincinna

ti,OH

Charlotte

,NC

Nashville,

TN

Seattle

,WA

*ElP

aso,

TX

Portl

and,OR

Sacra

mento

,CA


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So why the gap in public trust? Perhaps because high prole cases

continue to warrant public attention:

Multiple of cers cited or o-duty DUII

O duty of cers cited in road rage incidents

Large monetary awards given in use o orce cases and to

amilies o persons killed in of cer-involved shootings

Disciplinary decisions overturned

Technical mistakes made by of cers such as an of cer

wounding someone when mistakenly using live shotgun

rounds rather than beanbag rounds

The public rightully asks why these incidents continue and why, in

their view, of cers are not held accountable or their actions. Andwhy these incidents happen despite improvements to policies and

processes the Bureau has established in recent years. This audit ad-

dresses a vital public concern o how well the Bureau attempts to

learn rom past experience.


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Chapter Structural and technological

processes are in place to oster

organizational learning

Our review o past of cer-involved shooting cases, the Bureaus

response to those cases, and the structural processes the Bureau has

in place to assess outcomes rom those cases, shows that the Bureau

has in place many o the necessary elements to learn rom experience

and improve operations, and that management is generally respon-

sive to recommendations rom both external and internal experts.

Bureau representatives reported that important initiatives such as the

Critical Incident Command system resulted rom reviews o incidents.

The Bureau is also attempting to proactively identiy of cers with

potential perormance problems by implementing an Employee Inor-

mation System.

Since the early 0s and the introduction o Community Policing

as a over arching philosophy, the Bureau has made a series o

improvements to service delivery and instituted review processes

to collect inormation and learn rom its mistakes. In addition,

the strengthening o civilian oversight has added a layer o public,

independent accountability.

The major structural systems that collect management inormation

and produce analyses and recommendations include:

The Review Board The purpose o the Review Board is

to review incidents and investigate complaints o alleged

of cer misconduct, which includes, or example, certain use

o orce cases and cases where an investigation results in a

proposed discipline o suspension without pay or greater.

Prior to 00, what was known as the Perormance Review

Board reviewed cases and recommended policy changes,

Inormation collectionand review systems

extensive andimproved in recent

years


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but its voting membership consisted only o sworn Bureau

employees and one community member chosen by the Chie.

Changes made by City Council in 00 signicantly revised

the Review Boards membership and improved transparency.

Currently, voting members include one community member

recommended by the City Auditor, a peer of cer, an Assistant

Chie, the Director o IPR or designee, and a Commander or

Captain who supervises the involved of cer(s). In certain

serious cases, such as of cer-involved shootings, an additional

citizen and peer of cer are included to review cases and to

vote on recommended ndings and discipline.

Advisory members, who provide technical expertise to the

proceedings, include representatives rom the Citys Bureau

o Human Resources, the City Attorneys Of ce, as well asrom internal organizations such as Training and Internal

Aairs. The Board hears detailed reports rom Internal Aairs

and the Training Division when appropriate. The Board

makes recommendations to the Chie regarding ndings and

discipline. Findings may include recommended changes to

policy as well as discipline. The Chie and Commissioner in

Charge make the nal decision whether to accept the Review

Boards recommendations. Our review o cases, described in

a later section o this report, shows that most o the Review

Boards recommendations are accepted by the Bureau.

Proessional Standards Division The mission o the Division

is to promote organizational accountability by completing

air and complete internal investigations and to evaluate

programs and policies to help improve operations. The

Division consists o two main units, Internal Aairs, which

is staed by experienced investigators, and Standards and

Accountability, which manages systems such as the Police

Liability management system (including the tort Review

Board), and the Employee Inormation System (EIS).

Employee Inormation System (EIS) EIS was ully implementedin December o 0. The purpose o EIS is to identiy

issues or patterns o behavior in Bureau employees that may


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require intervention o some type. EIS regularly downloads

data rom various sources, such as the Citys payroll system

and Risk Management Database, Multnomah Countys

District Attorney Inormation Management Exchange, the

Oregon Judicial Inormation Network, and the AdministrativeInvestigations Management system, that show complaint and

commendations data on of cers.

Individual of cers who meet thresholds on a variety o criteria

are reviewed by supervisors and scheduled or interventions.

Thresholds include:

Three or more complaints o any kind within a six month

period

Two or more o the same specic allegation in a six

month period

An arrest to orce ratio o 0 percent or more

An arrest to orce ratio three times over the shit average

Any criminal complaint

Any use o deadly orce

Our detailed review o the EIS system showed that it mostly

complies with best practices in the eld o what is more

commonly reerred to as early intervention systems. Thesesystems are important to identiy of cers who may need

help and mentoring beore serious issues arise. It should

be noted that the EIS does not replace a good supervisor. It

merely acts as a supervisory tool. Our detailed review, along

with recommendations or improvements, is contained in

Appendix A.

While daily monitoring is done, no high level annual report

is produced that identies system perormance measures

and tracks those over time. This inormation is contained

in the database, but there is no pre-designed report ormanagement. To better utilize all eatures o the system,

Bureau managers should receive this inormation in order to


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determine how the system is being used, the ef ciency o the

process, and the eectiveness o the service.

Although the EIS complies with most best practices, the

Bureau has not implemented the system in a timely manner.

The Audit Services Division o the City Auditors Of ce has

long noted deciencies in the Bureaus early intervention

practices. In a audit we ound the Bureau had a warning

system which was not ully utilized as there was little

evidence that all of cers who were agged or counseling

ever received it.

We recommended the system be used as intended, as a tool

to help identiy problematic behavior and provide counseling

and help to of cers in need. The Bureau acknowledged the

value o such a system, purchasing a computer system tohelp ag employees needing attention. Design o the more

sophisticated EIS system which is currently in place began

in 00. It was delivered to the Bureau by its contracted

designer in 00, but was not ully implemented until

December o 0. More timely action on this item may

have assisted the Bureau in avoiding some problems with

individual of cers over the past several years.

Bureau sta reported some o the barriers to implementing

EIS involved labor and technological issues. They also cited

the need to vet out the system.

Independent Police Review division (IPR) and Citizen Review

Committee (CRC) IPR was established in 00, along with

the CRC, to receive complaints about police misconduct,

to review the adequacy o Bureau investigations into

resident complaints against of cers, and to provide an

appeal process or complainants who disagreed with police

ndings. In March 00, that authority was expanded to

include ull investigatory powers o police actions, regardless

o whether a community member lodged a complaint. IPR

was also given authority to investigate complaints madeby other of cers and to participate ully in every aspect o

administrative investigations, including o of cer-involved

shootings and in-custody deaths.


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IPR utilizes a database that tracks all complaints received.

Sta issues quarterly and annual summary reports or the

Chie, Commissioner in Charge, City Council and the public on

IPR and Bureau activities, policy recommendations, and the

status o recommendations.

IPR has also contracted with outside expert consultants

to assist in the review o of cer-involved shootings and

in-custody deaths, and to produce public reports and

recommendations or improvements.

Sta rom IPR provides technical support to a panel o

citizen volunteers, the CRC, which acts as an appeal body or

of cers and members o the public who disagree with Bureau

ndings on complaints. The CRC also has standing and ad

hoc committees which review Police Bureau policies andtraining programs. They sometimes make recommendations

directly to the Bureau or improvements.

Action Item Database Police Bureau managers recognized

that they have not done a complete job o tracking the status

o recommendations rom various sources. As we ound

in this report, recommendations come rom many internal

and external sources, and tracking recommended changes

is vital to a learning organization. Without a good tracking

system, the valuable work that goes into analysis and review

o important learning moments is wasted. For example,we ound there was no documentation and no institutional

memory why certain recommendations rom the Review

Board were not implemented.

Recognizing this as an organizational weakness prior to our

audit work, the Bureau recently instituted an Action Item

Database or tracking recommendations rom any source and

ensuring internal accountability or implementation. Figure

shows a screenshot o the database system and how it can be

used to track implementation and accountability. The system

is currently tracking about 0 open recommendations and

contains records on an additional closed recommendations.


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Figure 5 Action Item Database screenshots

Source: Portland Police Bureau


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Beginning in 00, the Police Assessment Resource Center (PARC)

issued a series o reports that examined of cer-involved shooting

and in-custody death cases and made recommendations or Portland

Police Bureau improvements. Four reports were issued between 00

and 00. PARC was hired by the City Auditor or an independentexpert analysis o the cases and to make policy recommendations

that could reduce the likelihood o uture incidents.

In the rst report, PARC reviewed thirty-two PPB cases. The report

ound serious deciencies in the investigative and review process

that needed to be addressed. Among those were that many o the

cases were not even reviewed by the (then) Review Level Committee.

And those that were reviewed were not ocused on lessons learned,

and underemphasized policy and tactical issues. Interviews were not

prompt, some witnesses were not interviewed, and of cers were pre-interviewed, which could, in some circumstances, appear to be an

eort to protect a PPB of cer.

By the nal report in 00, PARC called PPB an increasingly excel-

lent police department, citing substantial progress. The report

noted improvements to the investigations process itsel, including

the manner in which the (then) Use o Force Review Board made use

o detailed analyses by the Detective, Training and Internal Aairs

Divisions, as well as Ater Action reports. PARC did note, however, that

improvements could be made in each o those divisions individual

investigations.

In addition, the Bureau was in agreement with all recommenda-

tions made by the Los Angeles-based Of ce o Independent Review,

an independent police auditing group, ater a detailed review o

James Chasses death in custody.

We reviewed of cer-involved shooting case les and one death-in-

custody case rom 00 to 00. These were cases that had not been

reviewed by the PARC sta but which had been through a complete

administrative review by the Bureau. We looked or common themes

in the analyses and recommendations made by internal experts

(primarily the Training Division) and the Review Board.

Bureau responsive tooutside experts

Bureau has madeattempts to address

common issuesidentied by internal

experts


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0


We ound many issues related to eld communication and eld

supervision. There were, o course, many dierent circumstances in

these cases, but we believe that the Bureau should be able to learn

rom general themes that seem to recur.

Some examples o communication and supervisory issues ollow, but

it should be noted that we are not concluding that had these issues

not been present the outcomes would be substantially dierent or

that any of cer or the Bureau is at ault. We are presenting ndings

by the internal Review Board as examples o communication and

supervisory issues that arose rom our case review. The Bureau imple-

mented many recommendations by the Review Board in response

to these incidents (highlights are listed on page with details in

Appendix B).

Person shot while communicating with the HostageNegotiating Team (HNT). Of cer was basically out o contact

with what was happening with HNT. Updates to those in

the eld were not given. Supervisor did not maintain xed

command center.

Of cer shot person driving a car. Training Division concluded

that communication between the of cer, --, with other

district of cers, and with two of cers on-scene was virtually

non-existent.

Of cers shot man who appeared to take a shooters stanceat them. Internal review concluded there were not enough

supervisors or of cers initially on-scene.

Man shot at by an of cer who was unaware the man was

in communication with other of cers and was actively

engaged in negotiations. Also, there was conusion about

who the incident commander on scene was, so three

supervisors engaged in negotiations resulted in a breakdown

in communication. Of cer who shot man had turned down

lapel mike in order to not give away their position (of cer did

not have an earpiece).

Man shot at during warrant service. One of cer did not inorm

other of cers he had previously been on the mans property

(the man had seen the of cer and was alert to them), and

of cers were not properly brieed. In addition, the supervisor

had been awake or almost twenty-our hours.


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In a cross-jurisdictional incident with Gresham Police, it was

not clear which precinct sergeant was in charge.

Man shot by an of cer even though the man was in

communication with other of cers. Three sergeants were

on duty, but none o them appeared to be monitoring the

event according to a Training Division note. The Training

Division also noted, the conusion and lack o coordination

resulted in a delayed responsepotentially contributed to a

lack o situational awareness.

Internal Review Board recommendations rom these cases

mostly addressed

We requested a status report rom the Bureau on thirty-nine ma-

jor recommendations made through the Review Board process or

the cases we reviewed. According to the Bureau and our review o

documentation, o the total, thirty have been implemented, one is

in process, and eight were not implemented. Most o the recom-

mendations that were not implemented related to the production

o video training. Although current Training Division managers did

not know why specic videos were not produced as recommended,

they speculated it had to do with not having unds available. Man-

agers told us that training videos are relatively expensive and time

consuming to produce.

Some highlights o the implemented recommendations include:

Comprehensive research on best practices or use o orce

policy, and roll call video training on revised deadly orce

policy.

Community education on understanding police procedures,

particular distribution o pamphlets on what to do i you are

stopped by police, and Teens and Laws.

Purchase o earpieces or all of cers who are authorized to

use the AR- assault rie.

Full training scenarios using actual communication devices,

and mandatory attendance by those who may be in charge

at the scene o an incident.


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Making a priority o determining who is in charge on scene.

This has been improved by training all sergeants in handling

large scale events, and by including training in the Sergeants

Academy and Critical Incident management.

One recommendation made by the Review Board which was not im-

plemented, was to establish an independent audit process to review

Special Emergency Response Team (SERT) training methods. Based

on our review o case les we believe that recommendation has merit

and should be implemented.

The Bureau reported they currently review SERT procedures on a

continual basis and employed an independent reviewer on at least

one occasion. However, we believe this critical unction should be

reviewed periodically and regularly by an independent entity.

For a ull listing o the recommendations we requested inormation

about, please see Appendix B.

In addition to these Review Board-recommended eorts, Bureau

managers told us that other important programs such as the Critical

Incident Command system and the AR- review committee resulted

rom internally initiated reviews o these incidents.


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Chapter Learning aspects o police

culture need to be addressed

In order to take ull advantage o the learning systems and

processes, Bureau employees must eel ree to express their ideas

and suggestions or improvements, knowing their eorts will be

supported by Bureau leaders. In addition, the success o the learning

process may depend on the degree to which learning attributes, such

as training and employee input, are demonstrated as being valued

by management. Our employee survey ound that Bureau managers

could do a better job o promoting and demonstrating they value

these learning dimensions.

Based on work published in the Harvard Business Review, there are

three primary distinguishing characteristics o a learning organization:

. a supportive environment that encourages employees to

share inormation without ear o harsh judgment

. concrete learning processes that collect inormation and then

transers the inormation to employees

. leadership that reinorces learning by actively soliciting ideas

and viewpoints, and spending time on problem identication,

knowledge transer and reection

Chapter Two o this report described the Bureaus major processes or

collecting inormation and making improvements to operations. This

chapter assesses the degree to which the Bureau provides a support-

ive learning environment and provides leadership that demonstrates

the value o employee input or problem solving.

Employee perceptionsare important to

promote learningthroughout the

organization


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Employees are a vital component in any learning organization. Their

perception o the degree to which the organization values learning

attributes, such as inormation collection and training, impacts their

ull participation in organizational improvement eorts and will, to a

large degree, eect the results o these eorts.

We conducted a Bureau-wide employee survey ocusing on the three

learning aspects above. Three hundred sixty-six Bureau employees

responded (about percent o all Bureau employees), with

identiying themselves as sworn employees. Employees rated their

responses to statements, and many included narrative comments. In

addition, we spoke with about a dozen of cers to get more detailed

inormation on several topics.

A word about our analysis o statement scores Many scores clustered

around neutral on our rating scale. Few scores strayed ar rom neu-

tral in either direction. One interpretation o a score close to neutral

might be as neither good nor bad. However, in our judgment, we

do not consider this to be a good score. Generally speaking, ew

organizations claiming to be high unctioning would view scores indi-

cating neither good nor bad to be the ideal position.

In virtually every survey statement below, responding of cers were

less positive about the Bureau than their managers. And generally,non-sworn (civilian) employees were less positive than sworn

employees. Our discussion mainly ocuses on of cer opinions, since

that is the ocal point or inormation gathering and where changes

to policy and tactics yield results or residents.

A supportive learning environment is one in which employees eel

sae disagreeing with others, owning up to mistakes and presenting

minority viewpoints. A well unctioning learning organization

recognizes the value o opposing ideas and takes time to revieworganizational processes.

Of cers less positive

than managers

Supportive learningenvironment needs

improvement


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Even though many of cers eel it is easy to speak up about how

things are going, many do not eel that enough time is dedicated to

actively soliciting input and reviewing work. This can impede im-

provements, and perhaps contribute to employees who believe their

opinions dont count. Survey respondents scored statements moder-

ately highly: that in their units, its easy to speak up about whats on

their minds; that dierences o opinion are welcome; and that people

are eager to share inormation about how things are working. How-

ever, respondents gave mainly neutral ratings to supervisors actively

soliciting and using ideas or improvements, and to managers en-

couraging multiple points o view. Many respondents also reported

that there is not enough time given to reviewing how work is going.

Even though survey respondents gave relatively high marks to state-

ments concerning the reedom to speak up about ideas, we heard

Figure 6 Supportive Learning Environment

People in this unit are eager to

share information about what

works and does not work

In this unit, it is easy to speak up

about what is on your mind

Differences of opinion are welcome

in this unit

My unit managers encourage

multiple points of view

My supervisors actively solicit and

use our suggestions

Despite the workload, people in

this unit find time to review how

work is going

Of cers Non-swornSworn Mgrs

Strongly

Disagree

Neutral Strongly

Agree

Source: Audit Services Division survey o Portland Police Bureau employees


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anecdotes rom several of cers and through survey comments that

not everyone eels so positively. Several said that suggestions are

usually respectully listened to but that changes were rare. Several

said that they, and others, had given up making suggestions. One o-

cer complained he had been reassigned and retaliated against aterraising concerns about another of cer. Some said that of cers who

complained risked being labeled as negative and jeopardizing their

career. These comments were also made by several respondents in

employee survey comments.

Non-sworn employees responded much more negatively about their

reedom to speak up with ideas or diering opinions. They eel about

as negatively as of cers that managers do not actively seek their

input.

A learning organization has ormal processes or collecting and

disseminating inormation, or gathering inormation on customers

and technological trends, identiying problems, and developing

employee skills. While Chapter Two o this report identied

Bureau processes or collecting and evaluating inormation, our

survey ocused on employee perceptions on how well the Bureau

implements these aspects o a learning organization.

Employees in general do not think the Bureau does a good job ocollecting inormation. One o the most negatively rated statements

was the general statement, Our organization collects inormation

rom employees about how well things work.

Sworn of cers seem very satised with the quality o the training

they receive, but do not think enough time is allocated or it. Sworn

of cers appear to be very satised with the realism o training scenar-

ios, and are condent they know how to communicate inormation

during critical incidents, and in de-escalating incidents with people in

mental crisis.

Scores mixed orconcrete learning

processes


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Of cers responded that not enough time is allocated or training.

Adequate time or transerring knowledge (training) is a key signal

o managements value o learning. Non-sworn employees are even

more negative about their training opportunities and the amount o

time allocated or training.

Bureau senior managers told us that the amount o training of cer

receive exceeds national standards. They also noted that additional

training would require the City to provide more resources.

Figure 7 Inormation collection and training

I know how to communicate with team

members and command staff duringcritical incidents

I received adequate training to de-escalate

incidents involving persons in mental crisis

I receive adequate training to do my job

In the past 12 months I had opportunities

to learn how to grow

Training scenarios are realistic and help me

manage actual events

Training is valued by the Bureau

Adequate time is made available for

education and training

Our organization collects info from

employees about how well things work


Strongly

Disagree

Neutral Strongly

Agree



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More experienced of cers were much more negative on virtually

every aspect o this category. For example, of cers with more than

ten years experience rated the adequacy o time available or train-

ing % more negatively than of cers with -0 years experience.

They rated the degree to which training is valued by the Bureau %worse than of cers with 0 years experience.

A learning organizations leaders signal the importance o learning

by allocating time or problem identication, knowledge transer and

reection, and actively engaging in questioning and listening.

Scores low orleadership reinorcing

learning

Figure 8 Leadership and learning

My unit management is attuned to

and knows what is happening in

the field

We, as a bureau, learn from our

mistakes

My supervisors actively solicit and

use our suggestions for improving

things

As an organization, we know where

we are going and how to get there

When something goes wrong the

Bureau corrects the underlying

problem so it wont happen again

Senior management is attuned to

and knows what is happening in

the field


Strongly

Disagree

Neutral Strongly

Agree



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Respondents gave relatively low scores to statements about super-

visors actively soliciting and using their ideas, and whether upper

managers are attuned to what is going on in the eld. While of cers

generally think their unit managers are attuned to what is happening,

they reported that upper managers are not. This likely contributesto an overall poor view o the Bureaus ability to correct underly-

ing problems and to relatively negative scores or management in

general. Respondent opinions on the Bureaus results at correcting

problems and or leading the organization in a planned direction are

some o the lowest on the entire survey.

Of cers we spoke with had concerns about upper management, the

decision-makers, being disconnected rom what is happening in the

eld. They wondered how the Bureau could learn rom mistakes

i the decision-makers had not been in the eld to gain a currentperspective. This was also mentioned in the employee survey com-

ments.

Despite these perceptions, Bureau senior mangers told us they cur-

rently spend time in the eld working shits and attending role call.

In addition, more experienced of cers are much more negative o

the Bureau eorts to correct mistakes and especially eorts to collect

inormation rom employees. Those of cers with more than ten years

experience rated the Bureaus eorts at collecting inormation %

more negatively than those with 0 years experience. They ratedthe Bureaus general eorts at learning rom mistakes % worse than

those with 0 years experience.


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0



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Chapter Improving the eectiveness o

learning processes

The Bureau has made determined eorts to improve its processes

or collecting inormation and making organizational improvements.

Over the past 0 years, the Bureau instituted many new policies

and procedures to review its operation and reduce the number o

negative police-resident encounters. However, there continues to be

a series o high prole cases that undermine public trust and oer

learning opportunities or the Bureau.

While there are likely many variables that impact these events and

the public perception o them, our review o cases, consultations with

outside experts, and experience auditing the Police Bureau illuminate

several actors that may help make the Bureaus improvement eorts

more permanent and improve results. The ollowing areas are key to

improving the learning process and results:

In some instances, employee turnover can be good or an

organization. It provides an inusion o new knowledge, sometimes

replaces poor perormers and enhances the prospects or

promotional opportunities or others. The cost o excessive turnover

can be very high in tangible and intangible ways which include

training costs and the loss o valuable experience that has been

learned on the job. Key positions in the Bureau, especially rst line

supervisors, who are likely the rst to spot individual of cers who

may need special attention and mentoring, are vital links in the

learning process chain.

Retaining institutionalmemory and taking

advantage oexperience by limiting

turnover in keypositions


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Turnover at the highest levels o the Bureau is common. While Police

Chies depart or many reasons, turnover is requent. Between 000

and 0, Portland had our Chies o Police, ranging in tenure rom

two to ve years. During the same period there were six Assistant

Chies o Operations, ve Assistant Chies o Investigation, and veAssistant Chies o Support Services. Stability in these positions

would likely provide the basis or sustained learning practices with

Bureau-wide impact.

Bureau mangers told us this is a complex issue which requires work

with the Commissioner-in-Charge, the union and the Bureau o Hu-

man Resources.

There is also high turnover at lower management levels in the Bu-

reau. We reviewed organization charts rom several divisions within

the Bureau including Training, Drugs and Vice, Detectives, Tactical

Operations, and Central Precinct. The organization charts were rom

00 through 0.

Two important examples o turnover rates:

While there were only two Commanders at Central Precinct

during the ve-year period, we ound signicant turnover

at all other management levels, rom Lieutenant through

Sergeant. O the three total shits, two -- the Aternoon

and Night shits had a dierent Lieutenant every year.

The morning shit had three dierent Lieutenants in the

ve year period. Turnover within the ranks o Sergeant at

Central Precinct ranged rom percent to 0 percent every

year. This represents a signicant loss o experience at the

precinct line supervisory level, where of cers requently

ace challenging situations, use critical judgment, and need

mentoring rom those with more experience.

The Training Division plays a critical role in the learning

process by assessing incidents, determining compliance

with existing policies and training practices, and makingrecommendations or improvements. While the turnover

in the of cer ranks in Training was relatively low, managers


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turned over at a high rate. In the ve year period rom

00 through 0, there were three dierent Commanders

o the Training Division. Likewise, turnover in the lower

management ranks o Lieutenant and Sergeant was high, and

in one year all our sergeants let the Division.

The timely review, development o recommendations and

implementation o policy and training improvements is important to

ensure that mistakes dont happen repeatedly and are corrected as

soon as possible.

Our current review and past experience conducting audits o the

Bureau shows that the Bureau could improve the timeliness o action

to improve operations. For example:

Our audit o the community complaint process

ound that the Bureau was not ully utilizing the system or

identiying problematic of cers with multiple complaints,

and that increased supervisory attention would improve its

unction and results. Several years later, in 00, the Bureau

hired a contractor to develop the extensive system which is

the current Employee Inormation System. The developer

turned the system over to the Bureau in 00, but it was not

ully implemented until December o 0. While this system

does meet most best practices, timelier implementation o

the system and better utilization o prior systems may have

helped identiy of cers needing intervention over the past

several years (see Appendix A).

In the same audit, we noted that complaint

investigations were not prompt. Timeliness is again an

issue in the current audit, where we examined the time to

complete administrative reviews o ourteen of cer-involved

shootings between 00 and 00. During that time

period, on average, it took almost one and one-hal years to

complete administrative reviews and all investigations, and

nalize recommendations rom the Chie. Timeliness was

cited as an issue by the employee union in several o these

cases. A lack o timeliness may impede the learning process,

delay needed changes, and erode public condence in the

entire review system.

Improving timelinessin implementing

important proceduresand systems, and incompleting internalreviews o incidents


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Sta rom the IPR has conducted studies o the timeliness o the Bu-

reaus investigations o of cer conduct and made recommendations

or improvements. According to IPR sta, some improvements have

been made to processes, notably the implementation o a case track-

ing system. However, IPR sta reported to us that in their opinionthere is a barrier to pushing investigations to completion when many

dierent PPB reporting units are involved. It is dif cult, or instance,

or a manager in one Branch, like Investigations, to insist that sta in

another Branch, like Operations, complete their piece o an investiga-

tion. More coordination, or a single manager given cross-division

authority to shepherd investigations through the process could en-

sure both speed and completeness.

Identiying of cers who need mentoring, additional training and

perhaps even proessional counseling is critical in a learning

organization. As a key component in resident-police interaction,

the of cer must know what is expected o him or her and the

potential consequences o their actions. One important tool that

organizations, including much o the rest o the City o Portland

use to gain this inormation and provide employee eedback, is

the annual perormance appraisal. In addition, determinations o

ault and recommendations or discipline or poor perormance are

sometimes overturned in arbitration i disciplinary decisions are not

consistent. In some cases, as shown above, over a year o work bymany people in the Bureau could be wasted, and changes to policy

eectively blocked.

More consistent discipline

While there have been ew arbitration awards since 000 that over-

turned Bureau-imposed discipline, some have been high prole cases

and illustrate weaknesses in the Bureaus application o discipline.

There have also been many cases that have allen short o ull arbi-

tration, but where of cers nal discipline was reduced ollowing the

submission o a ormal grievance.

Bureau managers said they do have in place a process by which simi-

lar cases are reviewed beore a disciplinary decision is made.

Initiating consistentapproaches to of cer

accountability


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Grievances When Bureau employees submit union grievances about

discipline, a typical claim is that the discipline was inconsistent and

more harsh than similar past cases. In many cases, this results in

reduced discipline or the of cer. O the twenty completed cases

since 00 where of cers disagreed with their discipline and ledinitial grievances with the union, eleven were ultimately settled or

arbitrated or less discipline than originally imposed by the Bureau.

Although specic reasons or settling or lesser discipline are not al-

ways stated in documentation, City Attorneys told us that grievances

almost always include a claim that the proposed discipline is harsher

than in past similar cases.

Arbitration Cases are arbitrated by a neutral third party when the

Bureau and the grievant and the union dont agree on a settlement.

We ound several cases in which the arbitrator specically determinedthat the discipline did not align to past practice or the seriousness o

the oense.

In one case where the of cer was discharged and re-instated, the

arbitrator agreed there was unsatisactory perormance by the of cer,

but did not rise to the level o conduct that demands immediate

termination. It was noted that there was substantial disagreement

among the command sta that the discipline was too harsh beore it

was imposed. A second of cers discharge was overturned because it

too did not rise to the level suf cient or permanent separation rom

the police orce.

In another case, the arbitrator wrote that a demotion was inappro-

priate and excessive considering the nature o the oense, and not

consistent with past disciplinary actions. The arbitrator was trou-

bled by the Bureaus choice o discipline.

In yet another case, a substantial suspension without pay in a high

prole of cer-involved shooting was overturned because no internal

investigation had been done, so the Chie was not in possession o all

the acts in the case beore the of cer was suspended.

According to records we obtained rom the City Attorneys Of ce, o

0 settled or arbitrated cases where of cers led ormal grievances


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disputing their discipline since 00, cases had discipline reduced

rom the original determination by the Chie o Police. While it is not

clear how many were reduced primarily due to an inconsistent level

o discipline, City Attorney representatives said that inconsistency is

virtually always an issue in these grievances.

The requency with which disciplinary decisions are reduced or over-

turned is a rustration or police agencies nationally, not just in the

City o Portland. In response to this problem, some police agencies

(including the Washington State Patrol, Tucson, Arizona, Multnomah

County, and others) have adopted a discipline matrix which is de-

signed specically to improve the consistency o discipline imposition

and of cer accountability. Union of cials in some cases have also

endorsed the idea. More consistent guidelines or making disciplin-

ary determinations may help of cers understand the consequenceso their actions and improve accountability and perormance. We

have provided three examples o discipline matrices and guidelines in

Appendix D.

Using annual perormance appraisals to improve of cer

perormance and career mentoring

Identiying of cers who may need help on specic problems and ad-

ditional training on policy and tactics could be aided by instituting a

system o annual perormance appraisals. These appraisals also oer

an opportunity or employees to request eedback on their peror-mance, request specic training, and obtain career guidance. Results

o perormance appraisals can also be useul in the Bureau-wide

learning process by allowing the Bureau to tailor and ocus training

eorts on areas o demonstrated need. Existing reward systems are

reinorced when accompanied by a perormance appraisal system

reecting consistent values.

BHRs Manager/Supervisor Toolkit says that annual perormance re-

views provide both supervisors and employees with the opportunity

to review the employees successes and challenges o the previous

year. They also provide a ormal structure or delivering two-way

eedback and discussing mutual expectations, identiying any issues


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that are preventing the employee rom achieving optimal peror-

mance. They also are used to determine a course o corrective action

i needed.

In the City o Portland, all non-represented employees are requiredto have a perormance review annually. In addition, one o the Citys

largest employee unions, the City o Portland Proessional Employees

Association (COPPEA), with about 00 members, includes annual per-

ormance reviews in its collective bargaining agreement. Although

Bureau of cers do not currently receive annual perormance reviews,

these reviews are allowed under provisions o the union contract, but

will likely need to be negotiated.

In concert with the Employee Inormation System cited earlier in

this report, an annual perormance appraisal system would give

the Bureau a comprehensive system or employee evaluation and

an opportunity or extensive employee eedback and perormance

improvement.


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Chapter Recommendations

The ollowing recommended Bureau improvements, in concert with

the positive changes in learning processes we noted in this report,

will enable to the Bureau to make substantial progress in both

collecting inormation rom the eld and its employees, and in using

that inormation to learn rom its ailures and successes.

We recommend the Commissioner-in-Charge o the Portland Police

Bureau instruct the Chie o Police to implement the ollowing recom-

mendations:

1. Implement annual individual perormance assessments

With guidance rom the Bureau o Human Resources, the

Bureau should institute a system o annual individual

perormance appraisals or all employees. These appraisals

would oer an opportunity or employees to request eedbackon their perormance, request specic training, and obtain

career guidance. Results o perormance appraisals can also

be useul in the Bureau-wide learning process by allowing

the Bureau to tailor and ocus training eorts on areas o

demonstrated need. This is permitted under the current PPA

agreement, but will require additional discussions with union

representatives.

2. Implement discipline matrix

With guidance rom the City Attorneys Of ce and the Bureau

o Human Resources, the Bureau should adopt disciplinary

guidelines in the orm o a matrix. Such guidelines will


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0


help of cers understand the consequences o their actions,

improve accountability and perormance, and may decrease

the requency o reduced or overturned disciplinary decisions.

Please see Appendix D or examples rom other police

jurisdictions.

3. Explore ways to speed investigations o incidents and at

a minimum give explicit, written authority rom the Chie

to one person to advocate or the timely and thorough

completion o of cer conduct investigations.

Recent improvements to tracking the progress o investigations

are important, but more could be done to ensure that timelines

are adhered to across Bureau divisional boundaries. Authority

and accountability should be assigned to one person who hasexplicit, written authority rom the Chie to coordinate and

push investigations across the Bureaus divisional boundaries

while assuring both speed and completeness. That person

should provide periodic updates directly to the Chie. The Chie

must make it clear that timeliness in these cases is a Bureau

priority.

Bureau managers told us they recognize timeliness is an

important issue but are limited to some degree by review

processes that are outside their control. Some are dictated by

State law.

4. Improve accountability and oversight or the SERT unit

by establishing an independent process to review SERT

training.

This recommendation was originally made in 00 by the Police

Review Board as part o the review o the Raymond Gwerder

atal shooting.

The Bureau reported they currently review SERT procedureson a continual basis and employed an independent reviewer

on at least one occasion. However, we believe this critical

unction should be reviewed periodically and regularly by an

independent entity.


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5. Produce regular management reports on the eectiveness

and use o the Employee Inormation System

a. To better utilize all eatures o the system, Bureau managers

should receive regular management inormation to

determine how the system is being used, the ef ciency o

the process, and the eectiveness o the service.

b. The Bureau should implement a system to ensure that

each individual employee intervention is carried out to

completion as proposed.

6. Research and implement eorts to reduce turnover in key

positions.

These eorts could be ocused on recognizing and rewarding

technical expertise gained by sta members who stay

in certain key positions. Tenure in these key positions

could be encouraged by expanding pay grades within

certain classications, granting bonuses or tenure in those

classications, oering additional specialized training and

proessional certications, and de-coupling promotional

opportunities rom management.

This may require the Bureau to work closely with the

Commissioner-in-Charge, the union and the Bureau o Human

Resources.

7. Strengthen the cultural learning environment by addressing

issues identied in our employee survey.

a. Providing additional training time or employees as

appropriate and as unds become available, making this an

organizational priority.

b. Fostering a better atmosphere to encourage suggestions

rom employees by completing the eedback loop to those

who make substantive suggestions or improvement, andby ensuring that rst line supervisors know that Bureau

leaders value employee opinions.


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c. Encouraging upper level managers to spend more time

in the eld. That helps ensure policy changes, equipment

purchases, and tactical improvements reect the most

current eld conditions and incorporate lessons learned.

Bureau mangers told us they regularly spend time in theeld.

As discussed in Chapter employee perceptions are important

to ully implementing broad based improvement eorts.

Because these perceptions trump reality in some cases, the

Bureau may need to do a better job o communicating goals,

objectives, organizational eorts and limitations.


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Chapter Objectives, scope and

methodology

The overall objective o this audit was to assess the degree to which

the Portland Police Bureau exhibits the characteristics o a learning

organization. Those characteristics ocus on the systems and process-

es in place to collect, review and evaluate inormation rom the eld,

and the way that inormation is incorporated into policy and tactical

changes to improve the Bureaus service delivery. We ocused ourwork on the Operations Branch o the Bureau where the majority o

the Bureaus contact with the public takes place and where the public

has a compelling interest in organizational improvement.

In addition to interviews o Bureau sta and community members,

our initial audit program design was based on a review o literature

in the eld o organizational learning. It included literature rom

academic sources such as the Public Administration Review and the

Harvard Business Review, as well as literature rom practitioners.

From those sources we developed a work plan that incorporated a

review o several main areas o the Bureau learning process:

We identied and reviewed the bureau structural learning

processes. We assessed the eectiveness o those processes

by examining how the Bureau conducted investigations and

implemented recommendations rom both internal experts

(such as the Review Board) and external experts (such as

the Police Assessment Resource Center -- PARC). To assess

the eectiveness o the Review Board in making changes

based on experience, we reviewed ourteen cases o of cer-

involved shootings, noted common themes and requesteda status report o recommendations made by the Board. To

assess the degree to which the Bureau accepts outside expert


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recommendations or change we reviewed our PARC reports

and the Of ce o Independent Review (OIR o Los Angeles,

Caliornia) Groups report on the James Chasse incident.

We compared the Employee Inormation System to best

practices or early intervention systems and assessed

compliance with technology internal controls.

We assessed the cultural learning environment by conducting

a Bureau-wide employee survey. The survey was sent to

all approximately 00 employees and asked questions

concerning important learning organization aspects such as:

how employees view their ability to reely express ideas or

change; how well Bureau managers accept input about how

work is going; how the Bureau does at providing training

opportunities; and how well they believe the Bureau collectsand uses inormation to make positive changes to policies,

tactics, and the work environment. The return rate or the

survey was about 0 percent.

We also collected statistics rom the City Auditors Independent Police

Review division and rom other cities concerning trends in the use o

orce and the number o of cer-involved shootings.

Although we ocused our work on the Operations Branch it should be

noted that there are many dierent sub-units within the Bureau that

rely on inormation gathering and transer. Many are complex (likethe Administrative Investigative Management system and the Port-

land Police Data System) and some even overlap jurisdictions (the

national DNA database and -- or just two examples). It would

not be practical or one report to cover them all. Future audit work

should examine these and other systems or ef ciency and eective-

ness.

While we did interview IPR sta and rely on data produced by their

of ce, the objectives o this audit were not dependent on their inor-

mation. Thereore, although both the Audit Services Division and theIPR report to the City Auditor, there is no organizational impairment

to independence.


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A P P E N D I X

A


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Employee Inormation System

shows potential but management

should review annual perormanceinormation

One aspect o a learning organization is whether the entity has a sys-

tem in place to collect inormation about employee perormance. An

organization should use that inormation to acknowledge good per-

ormance as well as to identiy employees with potential perormance

problems. One way the Portland Police Bureau does this is by using a

supervisory tool called the Employee Inormation System (EIS).

The EIS is a database that electronically links to other systems the Po-lice Bureau already uses. EIS takes perormance inormation and, use

pre-programmed criteria, identies when of cers receive commenda-

tions or whether an of cer may need assistance or non-disciplinary

intervention. Some o these perormance thresholds include having

three or more complaints within a six month period and any use o

deadly orce. The Police Bureaus policy is to provide appropriate

support, mentorship, and review where behavior and/or perormance

problems are present.

The system and review process is overseen by the EIS Administra-tor, who is a sworn sergeant. The system alerts the EIS Administrator

when an of cers perormance threshold is broken. The Administra-

tor, as well as command sta, evaluates the alert beore the case is

assigned or a supervisor to review it. There are various options a su-

pervisor may select i they eel the of cer needs an intervention, such

as counseling and additional training. Interventions are approved

by command sta. It is important to note that the process is not a

disciplinary one, and the interventions are not meant to be punitive.

In addition, not all cases are assigned to a supervisor. For example,

some of cers might have higher orce ratios compared to others, due

to the type o work they perorm in the bureau. A threshold break-

age or some types o positions may not indicate a perormance

problem.


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The EIS system was delivered by the Bureaus independent contractor

in 00. It was of cially put into place in the summer o 0 with

the Chie o Police adopting an executive order on the system. The

executive order outlined the purpose o the system, as well as the

policies and procedures governing its work-ow process. The Bureauindicated that it was ully implemented in mid-December 0, when

users were ully engaged.

EIS aligns with best practices, emphasizing broad measures and sev-

eral intervention options

We identied our best practices that contribute to a good early

warning system:

Best Practice #1: Have broad perormance indicatorsEarly intervention programs should utilize a broad range o peror-

mance indicators and not rely on just one indicator. Using a broader

range is more likely to identiy of cers whose behavior requires

departmental intervention

Best Practice #2: Identication and selection procedures should be

in place

A strategy should be in place to identiy of cers or perormance

review and to select of cers or reerral to intervention. There is no

consensus on the best set o thresholds. Selection comes rom re-view o that of cer as determined by command sta.

Best Practice #3: There should be a number o intervention

options available

Intervention consists o some type o counseling or retraining or

of cers who have been selected. The Commission on Accredita-

tion or Law Enorcement Agencies (CALEA) Standards state that a

departmental Personal Early Warning System should have a menu o

corrective actions or of cers selected or intervention.


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0


Best Practice #4: Of cer perormance ater an intervention should

be monitored

Following an of cial intervention, supervisors need to ollow-up by

monitoring the perormance o an of cer or a specied period o

time. Approaches vary by their degree o ormality and record-keep-ing. Some jurisdictions, or example, may keep an of cer on a list or

a specied period o time ollowing the intervention and continue to

monitor their perormance.

We compared the recent Executive Order on the EIS (DIR .000)

and the EIS Administrators Standard Operating Procedures against

these best practices and ound the ollowing (see Figure 0).

The system appears to meet established best practices or early

intervention systems or three o the our areas. The lack o post-

intervention monitoring could be a weakness since it is not required,

but since the interventions chosen are approved by higher-levels o

management and not just the immediate supervisor, controls on the

intervention selection are built in. In addition, the EIS would display

additional threshold breakages i the problem continued.

IT controls are suf cient but EIS does not replace good supervisors

We perormed a high level review o the EISs technological controls

and ound that they appear to be reasonable overall. The system is

backed up daily, access is sound, and there is a suf cient separation

o duties. Since the EIS is heavily dependent on other sources or

its inormation, however, accuracy and timeliness could be hindered

i those original sources have technical issues or data entry delays.

These issues could present a delayed opportunity to a manager in as-

sistance an of cer. It is important to remember, however, that the EIS

is only a tool. It does not replace good supervisors who know their

sta and can determine when an of cer needs help. Ideally, those

would be in process beore and EIS thresholds would be triggered.


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Figure 10 Summary o EIS policies and procedures against best practices

Best Practice

Broad perormance

indicators

Intervention and

selection process in

place

Multiple

intervention

options

Post intervention

monitoring

Current Condition

Indicators range rom simple

ones, such as deadly orce to

more complex ones, such as

a ratio o arrest to orce as

compared to the shit average.

Positive indicators are also

included, such as two or more

written commendations within

six months.

Thresholds are programmed

in the EIS and are determined

by the Chie o Police and hispanel.

There are a number o checks

by dierent levels o managers

in the process beore and ater

an employee is selected or

intervention.

Several intervention options

available. These range rom

re-assignment to counseling

and varying lengths o

monitoring.

Interventions are determinedby an of cers supervisor and

command sta.

Post-intervention monitoring

is optional in EIS. Some

interventions involve 0, 0,

or 0 day monitoring, while

others do not.

The reason why it is not

required is to provide the

supervisor exibility in

selecting an appropriate

intervention.

Follows Best

Practice

Yes

Yes

Yes

No

Source: Audit Services Division analysis o Portland Police Bureau documents and best practices

literature


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An annual perormance report and periodic EIS testing would

enhance management controls

While daily monitoring is done, no high level annual report is pro-

duced that identies system perormance measures and tracks those

over time. While the inormation is in the database, there is no setreport produced or management. The EIS Administrator would have

to gather the inormation in the system. Management should receive

this inormation to determine how the system is used, the ef ciency

o the process, and the eectiveness o the service. According to the

Administrator, the EIS only became of cial in the summer o 0,

and an assessment would not be helpul until the system has been

in place or at least a year. We make several recommendations in

Chapter .


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Status o select recommendations rom internal PPB review processes

Source orecommendation

Date Recommendation Status

Internal Aairs Case # 00-B-00

Subject: James Jahar Perez

Incident Date: //00

Training Division

Ater Action Report

Mayors report

//0

//0

//0

Remove witness of cers rom post-

shooting responsibilities.

Conduct comprehensive research on best

practices or physical orce policy

Strengthen community relationships

by improving communication and

community training.

More citizen education on how to

respond to of cers during a traf c stop.

Creation o Perormance Review Board

and Use o Force Review Boards

Reinstituting 0 hours in-service training.

Hired ull time recruiting of cer to ensure

of cers reect the make-up o the City.

Implemented

Implemented

Implemented

Implemented

Implemented

Implemented

Implemented


62/102






Subject: Raymond Gwerder

Incident Date: //00

Training Division

Ater Action Report

Review Board

Not on

le

//0

//0

Full training scenarios using actual HNT

communication devices

Mandatory participation in scenarios by

Precinct Commanders and others who

may be an Incident Commander

Same as Training Division

Review and revise SERT and HNT policiesand procedures

Implement SERT Training audit system

Review and revise deadly orce policy

to clariy immediate threat vs. imminent

threat. Clariy signicant

Train on deadly orce policy changes and

create roll call DVD

Implemented

Implemented

Implemented

Not Implemented

Not Implemented

Implemented

Implemented




Subject: Dennis Young

Incident Date: //00

Training Division Not on

le

Conduct training exercises that include

analysis o pro-con decisions about

shooting at moving vehicle

Not Implemented


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Subject: Scott Suran

Incident Date: //00

Review Board //0 Training Division develop a roll call video

o this event

Implemented

Source orecommendation Date Recommendation Status


Subject: David Hughes

Incident Date: //00

Training Division

Ater Action Report

Review Board

Not on

le

//0

0//0

Provide training to of cers on dealing

with entire scene at a tactical incident

(containment, clear backdrop o of cers

and suspect, checking or other threats).

Resources should be managed

irrespective o precinct boundaries,

especially in critical incidents where

assistance is needed.

Use incident as table top exercise in SgtsAcademy

Implemented

Implemented

Implemented




Subject: Stephen Bolen

Incident Date: //00

Training Division

Review Board

//0

//0

Make roll call video o this incident (I

assume because it was mostly handled

correctly.)

Create Roll Call video

Not Implemented

Not Implemented


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Subject: Derek J. Coady

Incident Date: //00

Training Division

Ater Action Report

Review Board

Not on

le

/0/0

//0

Make a roll call video on radio usage,

specically on pros and cons o changing

nets during a tactical incident

IAD should try to nd out why SERT was

not involved in the warrant service when

they should have been. Related- Sgt.

said not serving the warrant was not an

option or him because his relationship

with his supervisor was not going well.He elt pressured to serve warrant to live

up to expectations.

A perormance review be conducted

related to the actions o the of cers in the

planning and service o the warrant

Not Implemented

Implemented

Implemented

Source orecommendation Date Recommendation Status


Subject: Jason Spoor

Incident Date: //00

Training Division

Review Board

//0

0//0

Make a roll call video on radio discipline

Detective Division should always

investigate whether a warning was given

Not Implemented

Implemented




Subject: Leslie Paul Stewart

Incident Date: /0/00

Training Division Not on

le

Provide earpieces to all patrol of cers. Implemented


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Subject: Lovaina Bermudez

Incident Date: //00

Training Division

Review Board

Not on

le

//0

Make it a priority to

racist portland police murder cover up

Documents