Nameless, Faceless Helpers
by Malcolm Macdonald, November 20, 2013
Last week some local newspapers published what was essentially a press release from Mendocino County’s Health and Human Services Agency (HHSA). The article opens with the line, “Responding to ‘local media (reports) of allegations of poor mental health services,’ the Mendocino County HHSA on Monday issued a statement explaining that mental health services still exist, and inviting the public to participate in the process.”
The nameless, faceless folks heading the Health and Human Services Agency would like anybody in Mendocino County to participate as long as those participants don’t criticize what is going on with mental health services in this county. As readers will remember, Mendocino County privatized its mental health services as of July 1, 2013. Redwood Quality Management Company (RQMC) will receive $8.8 million for fiscal year 2013-2014 to provide mental health services to children and youths under the age of 21. The for-profit Ortner Management Group is receiving $6.7 million for adult mental health services. Ortner was also allotted $79,754 for preparation and transition during the month of June, 2013. RQMC, despite a larger contract, was allotted $68,000 for the transitional month. Could this be because RQMC has already been providing services in this county for years?
Given that the contracts indicate a starting date of July 1st, notice this line from the HHSA press release, “the contractors on July 15th began answering the mental health services crisis line.”
What happened to people in crisis from July 1 to July 14? Did Mendocino County receive a refund for the lack of services provided for the first two weeks of the contracted period? If not, why not? Maybe taxpayers should get two weeks subtracted from their bills this year? Apparently, the reverse is true; Mendocino County taxpayers are paying for two weeks worth of contracted mental health service that did not occur. Two weeks of this privatized mental health service costs the county approximately $595,000! Ortner’s share of that is about $257,000!
Last week’s press release from Mendocino County’s HHSA makes no mention of the fact that Ukiah’s Ford Street Project backed out of a subcontract with Ortner Management Group because Ford Street wasn’t being compensated for the amount of time its staff put into organizing the operational procedures for the new system of services.
Ortner Management Group
The HHSA press release also claims, “During the transition, services have actually been enhanced,” and that the rollover of the crisis line from county staff to the contractors “went smoothly and was seamless to the public.”
It certainly wasn’t seamless for the person who sent this email about the crisis line: “Mendocino County has just informed me that they lost all records of my August [dates deleted to protect privacy] phone calls to the Mental Health Crisis Line to get help for my son.”
The email goes on to say: “Please create a crisis communication system that works as this is unacceptable. My calls went to 800-555-5906, one of seven Mendocino County Crisis Lines.”
That 800-555-5906 number is still the one plastered across Mendocino County’s HHSA homepage for Behavioral Health & Recovery Services as the crisis line. Hopefully, it works better in late November than it did in August, a month for which Ortner Management Group was doled out more than $558,000 to provide mental health care for the citizens of Mendocino County.
The AVA and this writer followed the case of that parent and adult child from that point on (see AVA issues of September 11, 25, and October 16, 2013). The HHSA press release characterizes such reporting thus: “It is especially unfortunate that some individuals choose to discuss knowledge of very particular cases, something that providers cannot respond to out of courtesy to the families involved and due to strict confidentiality laws and HIPAA requirements. No story is one-dimensional. Often there are many, many facets to consider. Certainly they are not to be played out in the pages of any local media outlet. To do so is to risk victimizing the patient, their family and friends.”
Readers should know that the parent whose emails were quoted here, and in earlier issues, brought the story to us, through an intermediary at first, then at times directly, either via email or phone conversations. The parent was extremely frustrated with the lack of and/or quality of mental health services being provided for the adult patient. Furthermore, copies of the email quoted above, and many more, were also sent to the county’s mental health director, two county supervisors, the county sheriff, a local police chief, and many of the members of the county mental health board. In the AVA the names of the parent and the adult child were changed to protect their identity. The same can’t be said for one publicly attended Mendocino County Mental Health Board meeting at which the full name of one of these people was blurted out by an official who should know better. The reality is that the case of the adult patient might not have progressed as far as it has to date if the parent wasn’t willing to be so publicly vocal.
The hierarchy of Mendocino County’s Heath and Human Services Agency (Stacey Cryer is the agency director, Tom Pinizzotto is assistant director/ head of Mental Health Services) would do far better to concern themselves with making privatized companies such as Ortner Management Group more accountable than spending taxpayer time and money worrying about press coverage that brings problems with the current mental health service system to the light of day.
Sonya Nesch Adds:
The Mendocino County Health and Human Services Agency (HHSA) Director Stacy Cryer and Assistant Director Tom Pinizzotto’s recent response to media criticism of Adult Mental Health Services raises the following questions:
1. “Mental health services still exist.” Where are the Adult Mental Health services outside of Ukiah’s Manzanita and Ortner’s Access Center?
2. Crisis Calls — “follow-up is managed daily.” Are all adult crisis calls resolved daily or just “managed,” whatever that means?
3. “Mental Health services have not been reduced.” Does HHSA think Ortner’s 800 number replaces walking in to get Adult Crisis Services during the Fort Bragg office hours? Why did you reduce Fort Bragg Adult Mental Health services to three days a week (closed for lunch) for Outpatient Services and eliminate Case Management by two licensed medical professionals? Where are the state-mandated Ortner Psychiatric Emergency Services?
4. “Wellness Center services continue to be provided.” Why does this only exist at Manzanita in Ukiah?
5. “During the transition, services have actually been enhanced.” What specific “transition services” and how have they “actually been enhanced”?
6. “Mental Health system has access to psychiatrists 24/7…” They are not local medical providers. They are Ortner’s Yuba City psychiatrists including the Ortner Medical Director, Dr. Riley, who has been reported in the media denying hospitalization to a homeless psychotic man, choosing instead to get medication for him to take at a homeless shelter.
7. HHSA’s “goal is better services tomorrow than we have today”? Take a look – with Ortner in charge you are moving backward for Adult Mental Health patient services.
8. HHSA is claiming credit for a Suicide Prevention Project that was established in Marin County about two years ago and Mendocino County Children’s Services (not Adult Services) have been using their 24-hour hotline for many months.
9. Critics claim “that mental health services have been eliminated (on the coast) … Services are provided by the County” (only Outpatient Services three days a week remains). Ortner has no contracts for coast Psychiatric Emergency Services or Recovery Services. The for-profit corporation Ortner has been trying to make homeless shelters provide the Mental Health services for them, for a pittance of the millions our Supervisors give them. Ford Street Project was smart enough to realize they cannot provide medical professional services to patients, and would not contract with Ortner.
10. HHSA says going to the media “risks victimizing the patients and family.” Patients, families and our communities were victimized when Cryer and Pinizzotto began denying state mandated Psychiatric Emergency Services, and Recovery Services to patients.
11. HHSA says that going to the media “undermines the efforts of many very dedicated public servants.” Didn’t HHSA undermine these efforts by eliminating more than 90 of their positions, and choosing the inexperienced Ortner over Optum (Mental Health services provider in 24 states)? Cryer and Pinizzotto should look in the mirror instead of being the pot calling the kettle black when they say, “Reports are often not accurate, not fully told and serve to do more harm than good.” A good therapist can explain their behavior and words to them – it’s called projection.
12. The HHSA suggestion that the public participate through the Mental Health Board is disingenuous – one gets 3 minutes to speak and no answers are given and no problems are resolved.
Sonya Nesch of Comptche is the Author of ‘Advocating for Someone with a Mental Illness.’