Everyone involved knows that the new Psychiatric Health Facility and the Crisis Stabilization Unit to be funded by the millions of local sales tax dollars are going to be built on the vacant lot next door to Camille Schrader’s operation on Orchard Street.
Why do we have to go through years of expensive planning and delay for what is obviously a done deal?
Because Mendo can’t do anything without going through every conceivable costly hoop they can think of in a false concept of “the public process.” And even more laughably, "transparency."
And so it was that last Tuesday the latest chapter in that farcical process unfolded when the Supervisors were presented with a long-delayed yet somehow urgent proposal to hand over $3.3 million to a Sacramento architiectural consultant called Nacht & Lewis to evaluate and design the PHF, CSU and the third component, a Crisis Residential Treatment facility (CRT).
The presentation was typical of CEO Angelo’s most controversial projects: wait for as long as possible, arrange some kind of gold-plated, highly proper and grotesquely overpriced package — remember how the CEO once compared the process to building a $50,000 kitchen? — and then tell the Supes that even though she and her staff took months to get to this nebulous point, there’s now a deadline and gosh we’re running late.
Board Chair Carre Brown said as much, noting that she’s heard lots of complaints — particularly from the Grand Jury — about how the Measure B Mental Health Facilities project hasn’t done much and is moving so slowly to fruition. This convenient observation from Mrs. Brown played right into CEO Angelo’s hands.
To ramp up the pressure even more, Angelo and her staff told the Board that they risked losing about $500k in unrelated state Mental Health Grant funds if they didn’t submit some kind of plan to have a Crisis Stabilization Unit in place by October of 2021.
This far off, irrelevant threat was all Supervisor John Haschak, already a dependable study in credulity, needed to go along with the rush-job Angelo and her staff presented.
The consultant confirmed the pre-destined Orchard Street site by saying that they only planned to look at it and Old Howard Hospital in Willits during the “feasability study” portion of their $3.3 million contract. However, Willits is on record saying that if the County was going to consider Old Howard, they’d have to comply with all of Willits’s city planning and construction codes. Moreover, several Willits residents have openly opposed the idea of a mental health facility in downtown Willits at the old hospital.
Ukiah, on the other hand, has no objections and is likely to welcome the project since the Orchard Street property already has Camille Schrader’s existing service facility next door and it is not in the downtown or a residential neighborhood. (Everything and anything distressing to West Side Ukiah is placed on State Street or east of State Street.)
So at this point there’s no real need for a “feasability study,” is there? Ukiah will accept; Willits will resist, ergo: Ukiah/Orchard Street is “feasible.”
When the subject of the surprisingly large $3.3 mil feasibility/design contract came before the Supes on Tuesday, Supervisor John McCowen’s first reaction was, “I think it would be prudent to hear from the full [Measure B] committee on that.” — i.e., whether this $3.3 million proposal was what the Measure B committee had in mind.
But after CEO Angelo cannily pointed out that the next Measure B meeting won’t be until mid-December and the item wouldn’t come back to the Board until January — Oh the delays! (Never mind that the CEO and her staff can take months bringing the contract to the Board, no problem. But now, it’s suddenly urgent.)
So we assume the $3.3 million will go on the slo-mo Measure B Committee’s December agenda — with the pressure on them that the Supes already approved the $3.3 million kitchen, er. psych facilities.
Supervisors Dan Gjerde and Ted Williams tried to inject a little rationality to the discussion:
Gjerde: “If we are only looking at three residential homes as crisis residential treatment, any architect in Mendocino County could do that. We don't need a specialist and this should not be part of the overall project. If we need a specialist for the PHF unit and the CSU perhaps, then the process that was used makes sense. But we do not need to spend $375,000 to remodel three homes.”
Williams: “I think there is a structural problem here between the Measure B committee, the executive office doing some of the tasks, and the supervisors being at arm’s length from this process. It's another train wreck. Nobody wants to be holding the bag for this. We all want the services and we are all thankful that it's funded and there's public money available to solve these problems. But this is an area where we really need a strategic plan. The idea of losing potential funds because we delay this, doesn't appeal to any of us either. But I think that comes out of not having a strategic plan. Maybe that's what we need to look at before we start looking at a specific contract. We should talk about what the process is and make sure we all agree on who the parties are and the flow. The fact that this has come to us without going through the Measure B committee and that Measure B committee members are not here to voice opinions should raise some concern. At the same time that we collaborate with the cities, we should collaborate with the hospitals. I spoke to Adventist hospital. They have interest in the CSU even at the Coast Hospital which may become theirs to operate in the spring. They seem like an important partner to be at the table. Not having their input and not having them at the oversight committee meeting is another red flag.
Chair Carre Brown: “The biggest criticism I hear is that nothing is getting done, nothing is moving forward and that is all over the county and that's the people who are actually financing this through sales tax and they want to see something moving [no matter how stupid or expensive]. We used the term ‘contingent,’ for the CRT and I think we need to go forward.”
Williams: "Do you see a way to separate that from this $3.3 million? I would like to see the CRT [Crisis Residential Treatment] go forward today. Purchasing structures sounds great. Supervisor Gjerde is right that any architect in this county can design a remodel. This does seem inflated.”
Supervisor McCowen then suggested approving the $3.3 million contract "contingent upon approval by the Measure B committee."
Williams: “I don't think I'm comfortable approving $3.3 million without understanding the services, if we can afford those services, deciding the scope with the cities and the hospital — there are too many unknowns here.”
McCowen: “I don't necessarily disagree, that's what we would hope would come out of the feasibility study. But this package is before us. We are not sure if this is in line with what the Measure B committee had in mind when they said go out for an RFP. So that's the basic question we want to hear back from them on.”
Williams: “I'm not against the plan. I would like more detail. For example, what services will take place in the structures and can we afford those services? And what funds will be left for the coast? If the Measure B oversight committee comes back and says they have support for this and we ask what is left on the table for the coast and the answer is nothing, then no, I don't support it. There are too many unknowns.”
Supervisor John Haschak: “People want some action. We've been at this for a long time. Obviously it doesn't sit well with us as the Board of Supervisors looking at this process and having it not go back to the Measure B and come up with a recommendation to us. But we have to recognize that a lot of people put a lot of work into this and this is hopefully the best we can do at this point. We won't know some of that information until the feasibility study is done and all that. So I guess I support a motion contingent upon approval of the Measure B committee to proceed with this.”
Supervisor Williams tried suggesting that the Measure B committee convene a special meeting this week. But he was told by the CEO that that couldn't happen. “If we're talking about expediency,” said Williams. “We don't need to wait until January, we just need the Measure B committee to come back with some answers.”
Gjerde: “I think these figures are just way too high! I don't think we should be contemplating $375,000 in architectural fees for remodeling three houses. I don't think we should be contemplating $500,000 for “predesign conceptual services” and I don't think we should be contemplating $2.2 million for actual design of approximately 20,000 square feet of commercial buildings. I would only support going back to Measure B with the concept of up to $300,000 for design services. And leave it at that. Because we don't have to have specialty architectural services to redesign three houses. That could be a separate architectural firm locally sourced for a lot less money. Then, after we've had the conceptual planning done, we can decide if we need a new RFP for the architectural services which would be Phase 3.”
Gjerde also noted that if you apply standard multipliers to a $3.3 million design — in the range of 7% to 15% — you end up with a construction cost that’s more than Measure B can probably afford. (7% translates to $47 million; 15% translates to $22 million)
Brown then asked CEO Angelo: “When we go through these processes we do evaluate cost?”
Angelo: “Yes.”
Brown: “The evaluation committee is still coming forward with this?”
Angelo: “Yes.”
Brown: “So I'm assuming they have looked at the scope of work?”
Angelo then issued her ultimatum: “The evaluation committee has looked at this scope of work and we did have mental health input initially and the evaluation committee has agreed on this. So that's that. On this. We came to you this way because of the timeframe and this is a government process and if this board was not comfortable voting this up then you could do the recommendation that you just did which is contingent upon a majority of the Measure B committee. I appreciate Supervisor Gjerde’s comments and his recommendation on how to move forward. To do that, we would be going back to the drawing board and scratching all of this, scratching this particular contractor who could apply for another RFP.”
Williams: “I'm not against this plan. I just want to see the other half of the plan. I want to see that we can actually staff and operate the facility we're talking about building. And hearing that the $3.3 million is not capped is a great concern to me. What happens when we spend this money and work through the process and we run over? We build the facility and find that we can't staff it, the personnel are not available here, or we can afford them? That doesn't leave us in a good position. I want to see a strategic plan. We are doing this but there are other components we need to work out. If we can't fit this within the Measure B budget then we would have to come back and revisit this plan and scale it down.”
Haschak: “The whole problem with Measure B is we don't know if we are going to have the money to staff it eventually. But the idea was and always has been to build these buildings with a certain amount of the money and then with the other part that would go on afterwards and that's where the staffing is going to come from whether we can find qualified persons who want to come to Mendocino County and work. That's always been a big question mark. But to build the buildings, I'm willing to go along with this proposal at this point.”
McCowen: “To take the time to develop a strategic plan which we actually got an outline of that via the Kemper report over a year ago, to do more in the way of a strategic plan would just further delay the process. Would questions of staffing levels and sustainability be part of the Phase 1 feasibility?”
Nicely outfitted Nacht & Lewis rep: “We would work with the county and [County Mental Health Director] Jeanine Miller and her staff to determine the staffing levels for the facilities and review other facilities. We do have a mental health expert on our team to assist with that process.”
Williams: “I'm stunned that we are talking about spending $3.3 million of public money essentially as a blank check with no assurance that we won't have overruns without a financial plan, not even a one-page document about what it will cost to staff these facilities. So I can't support this even though I want to. I have the same pressure from my constituents that this has been too long a process — why isn't the county moving? Here's the opportunity to move. Etc. But I can't do it because there are too many red flags and I think what will happen is we are going to spend the money up to $3.3 million and then talk about going over that and then running into, Where do we hire the people? It reminds me of the CV Starr Center [The Fort Bragg Rec Facility which was built without much regard for round the clock staffing and continues to suffer from that]. We need a plan with a binder and a financial statement that gives us some theoretical picture before we get started.”
The Board voted 3-2 to approve CEO Angelo’s rail-roaded, gold-plated kitchen approach — “contingent on Measure B committee approval.”
Will the Measure B committee get on board Angelo’s train and vote to approve what the Supes already approved?
Will Gjerde or Williams stick to their principles and appear before the Measure B committee in December and attempt to derail Angelo’s gold-plated train?
Whatever happens, history tells us that the Measure B Commitee and the CEO and the Supes will pick the most expensive and therefore slowest option available, albeit with some grumbling from a few malcontents.
The only real question is whether Camille Schrader’s company will still be around to staff whatever may be built.
I think it is time for the Adventist’s to pick up the phone. These folks know how to create a plan that actually works. ==> Utilize currently empty rooms/wings at our three hospitals for starters. There are families who need CRISIS CARE now….. One more out-of-town “consultant” hand picked by Carmella will give us only more smoke&mirrors and cost overages, per normal.
Or have you already forgotten about the 6 million you pissed away on the other “hand-picked by Carmella” debacle?
I believe Adventist Health has stated they are interested. That’s why the rush is on by organizations to get their hands on the money before Adventist actually gets a chance to make a difference.
If ole Howard had not been so single-minded by you know who, for nearly two years, something would be up, and running, today.
As always,
Laz
Ole “Fathead” put his reputation on the line for Measure B, I hope this puts an end to his reign. He caused so much damage to our county and the folks needing help. I don’t like to stand up for the Schraeders but Allman needlessly flooding the Emergency Rooms with his detainees caused the Schraeders, who had no previous experience in the business, to focus on Crisis situations only. The squeaky wheel always gets the grease.
“If you’re just going to do crisis, then you’re just going to do crisis”
-Lee Kemper
James Marmon MSW
Former Mental Health Specialist
Sacramento, Placer, and Lake Counties.
I am a client of rqmc I am a mental health severe ptsd needs patient non violent and a mom former ihss caregiver 8 yrs and also a homesteader entrepreneur in fort Bragg last 6 years and local community art business owner in Sonoma county previous to that. In Sonoma county 14 years ago I began a mental health crisis journey that lead to more trials and cocktails of meds that I as at risk of homeless vunerablity high woman could access in a small county then the best service for mental health treatment for my catagory of client was c.o.t.s In petaluma the committee on the shelterless and my partner and I were there when Mary issacks homeless shelter was just beginning and I mean we were the first round of clients who palbared Mary issacks funeral for the board members in house and forefront runners of treatment services that should be modeled nationwide, locally here in Mendocino county it’s a different story.
I just was talking with sage wolf about this the other day the RCS building bridges runs a ‘wet’; faculty as in Mary issacks was ‘dry’ meaning that the clients drug tested upon admittance.
She serves the underserved here in Mendocino county aka Ukiah home less who do have drug problems and need basic care like free just ‘gold plated’ donated building with appearance of prestige upon looking from the outside ; has public showers and a laundry facility that serves the public homeless, staffing and security are a completely joke. The level of education that’s required for these positions and dedication and unique client care rules policy’s and models are not there. What happens when client A is too drunk or what happens when client B gets his stuff stolen from? When numerous things go unattended such as the ability for rcs building bridges facility to serve food to the public, when loophole for that is one person going to the food bank to pick up for themselves and donate food to the facility. Ok that’s just one branch of repurcutions and consequences of underdeveloped planning on anyone responsible making and managing it in the first place
.l see we are talking about another ‘appearance only care model approaching…watch out folks your getting a palace to look at for 3.3 million now
ine it with gold on the outside of the building for the consitiuite people see we paid a ton to accommodate to the homeless population in Ukiah, were doing fine but don’t dare be a community auditor daresay a ‘gorden Ramsey ‘ undercover approach and open the doors to use the services listed in ‘ costly color advertisement and brochures’ in the insurance medic-cal patient rights and service provider books and what’s listed on the marketing hmis numbers for the county, the gold plated fiscal numbers are just as overlooked as the gold plated buildings, and now personally I am fed up and sueing MANZENITA services for maltreatment personal injury civil federal and also ada laws broken as well as procedures in processes that have everything to do with unplanned mental health agency maintenance and planning of execution of individualized accomadating and timely patient care from family’s to individuals to homeless to crisis patients are being pushed under the rug like myself to succumb to beautiful paperwork of insurance value of gold for their fiscal numbers and funding aka the patient case plan that model of paperwork through out all mental health agency in fort Bragg and Ukiah that outlines the insurance covered treatment we SHOULD be getting from all these supposedly connected agencies listed on our plan that work together to ensure our health.
Rqmc,RCS all county buildings, and in fort Bragg burtiz family conflict of interest run and MANZENITA, mchs,hospitality house , hospitality center to name a few under my belt of experience In Mendocino county and not one person lives up to these insurance claims to fame they sell on brochures’ and by making these gold plated empty staffed and underplanned buildings.
Btw our crisis team RCS and the umbrella of that fiasco I am saving the biggest lawsuit for last yet it seems it’s the most pertinent to mention that the team of ‘crisis’ here on the coast and in Ukiah have given me such quality care that I attempted suicide in oct 2018 and also have multiple unlay 51/50 holds with even no follow through after a attempted suicide I gave up on quality therapists in Mendocino county and having this demand letter to MANZENITA be not addressed in the correct manner down to the correct handed up process it should should show the seriousness that this county doesn’t take it’s mental health clients seriously enough or care-ful-ly enough to proceed with another gold lined outside appearance gathering place of unrequited hope for a future better then the current underserved care model that has no end or planning to end in sight.
I also have a management and marketing certificate from srjc and have looked at the models here for crisis are ghostly and full of ego, in a place that needs experience and lacks even an accessable ADA county coordinator and disabilty legal services are slim to none.
Blah to 3.3 to another ghost building that continues to kill clients or pick and choose who to give services to and who not , understaffed and underplanned and not management or office and client rules and protocol.
I propose we put that 3.3 million into a care team managment mental health services that somewhere has modeled actually working with homeless clients instead, oh and one more thing to Mr Williams I sent you a Letter regarding this before I got snowballed by MANZENITA and you said you would get back to me..I believe that was dec. ,2019 . Now I am on settlement with MANZENITA and reqruiting medi-cal patient advocate to tell everyone behind closed doors to do there jobs correctly and help make up for time they didn’t. MANZENITA aka rqmc will not be able to accommodate to this complaint just as much as RCS is not able to reprogram itself and all its staff and training as well as rqmc isn’t gunna get anything better then telephych med management for mental health.
Even adventisy doesnt have proper outreach crisis team the c.o.m.p.a.s.s. team whom I used right in beginning is a joke as well for actual services for mental health. They don’t have the care model either.
How is that 3.3 gunna all that or the thousands of underserved homeless from here to the coast on a crisis basis. Unedited and unformatted informal rant by Lauren Vier mendomadelocal@gmail.com
RE: MENDO’S MENTALS
Thank you for speaking out Lauren, more clients need to come out like you and really expose the mental health service delivery fiasco in Mendocino County for what it is. I know why they don’t, its because they will be dismissed as being mentally ill and therefore not credible reporters, who would believe a crazy person. “How would the mentally know if they’re getting good services or not, they’re mentally ill? “. Throughout the years I’ve tried to carry the torch for Mendo’s Mentals, but by doing so they just called me mentally ill too. Whether I am or not is debatable.
I’m worried that your mental health advocate may be more focused on smoothing things other than really making changes, hang in there and good luck.
James Marmon MSW
Former Mental Health Specialist
Sacramento, Placer, and Lake Counties.
I just stumbled upon this. I was very involved in mental health planning in the county from 1996-2012 as I ran a contracted agency. I remember when Measure B was adopted and have always had a lot of doubts about whether this facility would happen. Not because there isn’t a strong need for services. There is. What people may not understand that in the state/county mental health world, there are various regulations that are required which are important but much harder for small counties to implement. That’s why the PUF closed: they were required to have a certain ratio of staff to patients and not just any staff but staff with specific credentials. We all know how hard it is to find and hire and most importantly retain qualified mental health staff in Mendo. Or any human service staff but that’s a whole other issue. It’s much easier to have buildings; it’s really the day-to-day expenses that are the problem. The income to pay for these expenses usually comes – at least a great amount of it – on the county being able to bill for services to the state. A facility requires the same staffing regardless of the number of clients present. So if you have 10 beds, you need to pay for the staffing still if you only have 6 residents. Your budget to pay for these expenses is highly dependent on you being able to bill for the services for each client. Less clients=less billable services=less income to run the program. You think, well, there’s no shortage of clients. In the county as a whole, yes. But having however number you need and the required staff is hard unless you can mostly get to this with people in the Ukiah – maybe Willits – area. That’s why the coast can’t do a facility. When Allman started talking about the need for this, I didn’t support it because of these issues not being addressed adequately. And after all these years, still nothing. I think these services need to be provided in a way which is not focused on facilities but services, using existing resources. It’s sickening that this is still running around after all these years. The clients in the system are so right in their frustration.