by Mark Scaramella, April 14, 2016
Proposition 172 Funds For Emergency Services: An Unsolvable Muddle
(Unsolvable by the Board of Supervisors, anyway.)
As we reported recently, the Board of Supervisors last week put off a decision to allocate some portion of Proposition 172 funds to local fire departments, ambulance services and various hybrid districts like Coast Hospital’s ambulance department in Fort Bragg.
The primary reason for the postponement was Supervisor Dan Hamburg who after four months of flab-gab sessions (along with Supervisor Dan Gjerde who seems to be taking a back seat on the Prop 172 funding issue) couldn’t even get his overview memo into the Board agenda packet in time for last week’s meeting. Supervisor Brown even chastised Hamburg for his fumbling by grumbling that Hamburg’s memo “should have been posted on Thursday like everything else.”
In the absence of proper notice, and for the benefit of the many fire department representatives on hand for last week’s Prop 172 discussion, Hamburg read his memo out loud. It didn’t have anything in it that couldn’t have been written four months ago before Hamburg started meeting with fire departments — more transparency, a dedicated line item in the County’s budget, proportionate replacement for funds lost in 1992 when the state shifted a huge chunk of property taxes from local government to the edu-monopoly instead of cutting the budgets across the board including those of the many state bureaucracies. Hamburg then boldly called for “staff” to come up with a recommended way to allocate some Prop 172 money to emergency services and for more meetings on the subject of revenues for emergency services.
That’s it. Again: Hamburg’s memo took four months.
SUPERVISOR JOHN McCOWEN complimented himself and his colleagues for even discussing the issue which has been a problem for 25 years. (Never mind that every other County in the state has been allocating a small portion of the Prop 172 sales tax revenue to emergency responders for decades. But not Mendo.)
McCOWEN then proceeded to complicate things even more than they already are by demanding information from each district and department that would, even if it somehow magically appeared in the Supes bloated agenda packet, simply raise more questions, and on and on.
AFTER TOSSING OUT the more, ahem, “novel” approaches to the problem (such as Jim Little of Laytonville and his pot tax idea, or the Fire District Association’s abortive demand for 30% of the Prop 172 money), there are two good sources of funds that could easily be siphoned off to supplement the various Districts (and let the Fire Chiefs Association — as competent and well-meaning a bunch as Mendo has anywhere) divvie it up as they see fit to whoever needs it most.
THE FIRST PLACE to get money is the Bed Tax which, as others have noted, is supposed to go toward covering the cost of the traffic accidents the bed taxed inevitably have when they aren’t in bed. The second is a portion of the giant pile of asset forfeiture and pot restitution revenues that clearly should be used to cover some of the pot-mob’s emergency services impact.
OF COURSE, such simple proposals are beyond the thinking of Hamburg who can’t even get a memo with specific options written in four months, or McCowen who can’t bring himself to allow anyone but himself decide how to allocate the funds.
THE ISSUE will be back before the Board on April Fools, er April 5th, and if they decide to do anything beyond turning the problem over to “staff,” the Major will personally pay off the rest of Jeffrey Bacon’s emergency services bill.
JEFFREY BACON is the poor guy who last year got into a motorcycle accident on Highway 128 requiring the life-and-limb-saving services of the Anderson Valley Fire Department. The Fire Department sent him a bill for a few hundred dollars to cover the response cost, but Mr. Bacon didn’t have the money to pay. Instead of asking to have the bill written off (which the District would have done if he’d asked), Mr. Bacon was so thankful for the help he received he offered to pay it off in $10 a month installments which he has assiduously been doing ever since.
MR. BACON’S experience — and the rest of the Anderson Valley Fire Department’s pretty good billing experience — flies in the face of Laytonville Fire Chief Jim Little’s claim that accident victims or their insurance carriers tend not to pay response fees. Mr. Little could learn a thing or two about billing out-of-district accident victims from the AV System which works reasonably well — and when it doesn’t the bills are turned over to a Ukiah collection agency to recover whatever it can.
Laura’s Law In Mendo: A $160k Flop
In November of 2014 the Board of Supervisors allocated $160k to a Laura’s Law pilot program for up to four mentally ill people who might meet the criteria. The establishment of the program was accompanied by a good bit of hoopla and cheering from advocates of the mentally ill who saw it as a possible way to avoid another Aaron Bassler style fatal situation (even though most of the people familiar with the Bassler case didn’t think Bassler would have qualified). The Laura’s Law advocates had been working for about three years in the wake of Bassler’s 2011 murder of coast enviro Matthew Coleman and Fort Bragg City Councilman Jere Melo to convince the Board of Supervisors to be only the second county in the State of California to enact it.
But this month, some 16 months later, according to a recent Ukiah Daily Journal article, only one (unidentified) person has even applied to be treated under Laura’s Law — known as a “referral.”
To be “referred” — aka considered as a candidate for Laura’s Law, a “qualified” referrer (family member, mental health staffer or cop) must go to some extreme lengths to fill out the County’s Laura’s Law referral form.
According to a flippant Karen Lovato, Mendo’s mental health program administrator, referral sources must be “credible.” “It can’t just be a neighbor or grocer,” said Lovato, as if a neighbor or a grocer would ever in their right mind even so mujch as consider trying to fill out the County’s ridiculously onerous referral form much less undergo the subsequent review process.
Imagine that you have an adult family member who you think might be disturbed enough to qualify for Laura’s Law.
Here’s what you have to provide to even apply (based on the application form on the County’s Mental Health webpage):
List and describe the mental illness, describe why the person is a “safety risk” in the community “without supervision.” Provide a “history of non-compliance with treatment,” and summarize the particular treatment that was offered but “non-complied” with, and explain why the “person may be at risk to self or others without treatment (or has been within the past 48 months).” Then you must declare that the “person does not/has not met 5150 criteria when evaluated, dates if known).” Then add an explanation that “person’s condition is substantially deteriorating,” and explain how the “person would benefit from assisted outpatient treatment” (aka, Laura’s Law).
Assuming you have accumulated something approximating the records for your adult family member “person” which would allow you to even begin to fill out the County’s Laura’s Law form… Or maybe you can consult with the Ortner privatized mental health staff and ask them to help you with the form… Oh wait, Ortner Management Group, having received a barrage of complaints from experts, cops, doctors and many people in the “mental health community,” has announced that they’re leaving Mendocino County on July 1. Maybe you can ask Redwood Children’s Services who has been asked to pick up the pieces for the adult mental health services — although they also have little experience with adult mental health or Laura’s Law.
Anyway. So you’ve finally managed to fill out the form upon which your disturbed adult family member’s treatment may depend — assuming you even knew about Laura’s Law or could find the form or could obtain and assemble some highly specialized information to fill it out — presumably without the cooperation of your family member. Now what do you do?
You first turn the form in to Ms. Lovato and her staff who will review it and comment on it (presumably not having been involved themselves prior to that point, or they would have filled out the form if they thought the person qualified). Then if the form makes it past Ms. Lovato, it goes to the County Counsel’s office.
Back in November of 2014 then-interim (now former) County Counsel Doug Losak told the Board what his office would do with the referral:
“Implementing Laura's Law— a lot of the process will go through the County Counsel's office, as far as reviewing— once they are given to us by Mental Health we will review the petition approximately one hour. At that point if we determine that it meets the state requirements it will take between two and four hours preparing the petition, gathering information necessary to file it and get everything ready for it, another hour for the attorney to review the petition, etc. and then one to two hours for initial hearing of an uncontested hearing and four hours if it's contested and then approximately an hour to an hour and a half for a follow-up court hearing, about, I believe, every quarter at that point.”
At that time back in 2014, based on conversations Losak had with Nevada County’s legal staff, Losak estimated there might be as many as 20 petitions per year. And given the workload involved — for County staff (not for actual treatment) — that’s how they came up with the $160k fund allocation.
But in the 16 months since that time, there has only been the one referral — and zero County Counsel reviews and Court Petitions and the resultant “assisted outpatient treatment.”
A recent Ukiah Daily Journal article didn’t address the question of why only one person has applied. But then looking at the process and the near-zero likelihood that the applicant would even make it past the County Counsel’s office, it’s pretty obvious.
Sheriff’s Simple Plan vs. Mendo’s Non-Plan
A few years ago, when Mendocino County was trying to balance its books in the wake of the 2008-2009 Wall Street looting of much of America, and at Supervisor John Pinches, instigation, the County conducted a major review of County-owned properties with an eye to selling off buildings that were not needed, moving out of leased space, and consolidating where possible, most prominently moving out of the Dominic Affinito-owned Social Services building on South Franklin Street in Fort Bragg and into the more cramped, but much cheaper Avila Center up the street.
General Services Administration Director Kristin McMenomey compiled a comprehensive list of facilities under the close scrutiny of Supervisor Pinches who led the charge to save hundreds of thousands worth of expenditures, especially on leased space.
A couple of years later, when the County was privatizing about $16 million worth of in-house mental health services, there was no McMenomey-style plan or any other plan except to dump as much of mental health as possible. The “transition” to Ortner, a private mental health pirate out of Yuba City, was badly botched, as documented in detail three years later by the Kemper Report (which only scratched the surface of the botch). Natch, the County had to pay Kemper a hefty sum of tax money to report what had become evident — Ortner was being paid millions while delivering little in the way of services.
Mendocino County was the first county in California to privatize mental health services. Supervisor Hamburg later called the ensuing mess simply “a rookie mistake.”
Predictably, the privatization process collapsed into a morass of complaints which finally came to a an unavoidable boil when most of inland Mendocino’s physicians and the Sheriff broke ranks and forced the County to conduct a review of Ortner's version of mental health services.
The Kemper review identified a number of problems which should have been foreseen by county administration and the supervisors at the time (many of which we pointed out here to no avail). But even if the County had been prepared to hand off mental health to Ortner, turning millions over to Ortner for anything other than expensive, residential out-of-county psych treatment was an idea which only the recipient of these public millions, Mr. Ortner, could approve of.
Now, here we are five years later, after three years of minimal service from Ortner, and the County is finally getting around to putting together a task list for turning the "services" Ortner didn’t provide over to Redwood Quality Management Service of Ukiah. The board gave direction to staff to start the transition on March 1. One month later all they have to show for it is a task list of things that are, except for one task, still not complete. The list would certainly embarrass Ms. McMenomey if she had had anything to do with it.
In fact, the only item on the list which is "completed," is the one called "perceptions of conflict of interest." (Perceptions? Only in Mendo) The status of this “task” is: "Defer to the Mendocino County Grand Jury on the question of a conflict of interest for the former Director. County executive to direct staff provide continued oversight of [Ortner] authorized by and periodically report publicly on them." This “task” — “deferring to the Grand Jury” — is the responsibility of a newly created entity called the "quality improvement committee."
As you can see (if you bother looking at the useless thing on line at the Supervisors agenda web-page) the list looks like it could have been assembled by the First Grade Class at the Ukiah Waldorf School. It is replete with subjective and ill-defined terms like "in progress," "working on," "being added," "initiate conversations," "consulting with," "discussions in progress," "language added," "discussion started," etc.
Many of the tasks themselves are hopelessly squishy: “propose definitions," “review," "begin a process of community consensus building," "discuss ideas and options going forward," "work with," "initiate," etc.
One of the tasks —"county financing, budgeting and financial accounting for mental health services," is supposed to be completed by April 1, 2016 the day the task list was prepared. But of course the status is not “completed” but: "in progress." No date is given when the progress will stop.
Failure to meet the completion dates has no meaning because nobody really cares if they meet the dates, most of which are July 1, 2016, the beginning of the next fiscal year when the “discussions” and “reviews” will be declared complete by fiat no matter what their status.
The only thing we know for sure now is that Ortner probably won't get much more money for mental health services after June 30 and Redwood Quality, the Ukiah-based private business, will get another $7 million in 12 monthly increments from July 1 to June 30, 2017.
Conspicuously missing from the task list is anything having to do with staffing at Redwood Quality Management Service. Redwood is supposed to provide several dozen qualified professional staff by July 1). Also missing from the task list is a task such as “negotiate new rates for services and administration."
The task list is certainly better than nothing, but not much, because it is primarily eyewash meant to postpone any real oversight of the transition activity until July at the earliest when things will start to crumble.
A close reading of the task list indicates that it is mostly the same pointless and ill-defined gibberish which we've seen from HHSA managers and in mental health documentation and discussions time and again in the past.
The obvious shortcomings of this vague non-plan didn’t stop the Board of Supervisors from lavishing praise on staff again last Tuesday as one Supervisor after the next declared how “proud” they were of the staff work described above. Either they didn’t read it or they think a list of gibberish formatted in crisp-appearing accountant columns is about the best anyone in Mendo can do.
Prediction: it will take at least a year of muddle and more service gaps before any of this produces any chance of providing the desired mental health results.
The task entitled, “Establish a renewed era of openness and transparency” drew our biggest guffaw. There was never an “old” era of openness and transparency.
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CONTRAST the above gibberish with Sheriff Allman’s about-to-be-proposed half-cent sales tax measure. Allman was a model of clarity.
Grilled Tuesday by speaker phone, Allman told the Supervisors that he simply wants to use five years worth of sales taxes to develop a local mental health facility which will 1. Provide a Psychiatric 72 hour hold capability, 2. Provide a 30 day transition and rehab facililty, 3. Provide outpatient treatment and drug rehab to walk-ins, and 4. Provide a place where the County’s far-flung emergency responders can learn how to handle psycho-breaks. The facility will be staffed by existing staffers, whoever they may be and however much they now cost — no more. It’s simple, clear, objective.
As one of Allman’s co-drafters Kate Gaston pointed out to the Board, “I’ve visited the jail several times. Mental illness leads to jail if a person is not officially declared 5150. And when they are, we have no facility in town. We send people to out of county treatment that we pay dearly for. We need to be reimbursed for in-county services and lower cost services. All this involves lost lives, lost time and there are no services in jail. This proposal answers multiple levels of needs. And it’s all reimburseable with an admin fee. We also need the post-trauma services to reduce the return rates. I understand the request for particulars — out [Allman’s] team can work on that. But I support having it on ballot. We have to stop filling the emergency rooms and jail for months, stop sending people out of county. We need local, earlier walk-in and outpatient treatment so that fewer people are stuck out of county.”