Numbers? You Want Numbers?

Last month, Measure B project manager Alyson Bailey told the Measure B committee that she would have “numbers” for a Psychiatric Health Facility, Crisis Residential Treatment Center and Crisis Stabilization Unit “maybe in two weeks if all goes well, but surely less than a month.” 

The promised numbers did not appear at last Wednesday’s Measure B Oversight Committee meeting.

Ms. Bailey did produce some numbers. She told the Committee that she needed $435 to trim some weeds at the Orchard Avenue site next door to Camille Schraeder’s mental health services offices where a Crisis Residential Treatment center is planned.

This modest request for $435 produced 15 minutes of irrelevant discussion, the highlight of which was Fifth District Committee Rep Ross Liberty’s question.

Calling the Crisis Residential Treatment building a “crisis continuum facility,” Liberty said they should not spend the $435 now because “if we can’t operate it, we should not design and build. Why are we spending $3.6 million on a building in case this works? It doesn’t seem right. I’ve been challenging that the whole time. We don’t know if we’ll have a facility there. What am I missing?”

The point, Ross? 

The $3.3 (not $3.6) million the Board authorized for design and consulting services is not entirely for the Crisis Residential Treatment Center. If the Committee is going to have to approve every little expenditure like this, and deal with incoherent questions like Mr. Liberty’s, well… this sucker's unlikely to ever get built.

Ms. Bailey did say that the County’s Sacramento consultant is diligently consulting away on “programming, site investigation, community outreach, CEQA…” and is “still working on design and construction” for the Orchard Avenue site, despite Liberty’s (incorrect) point about whether there will be a facility there.

Actually, the County has already committed to the state’s Mental Health Financing agency to build *something* at the Orchard site.

As for numbers, the long-forgotten Mr. Kemper, nicely compensated for his ignored professional advice, told the Committee and the Board about the operations costs two years ago, not that anybody seemed to be paying attention.

Committee member Jed Diamond was way ahead of Liberty, asking when construction will begin.

Ms. Bailey replied with a typical non-answer that at the moment “five management firms have applied,” and they could start “managing” the construction “as early as August.” According to the terms of the state’s $500k (partial) grant the building is supposed to be up and running by November of 2021 — assuming of course, that all the “programming, site investigation, community outreach, CEQA…” etc. is done. 

Since nobody involved with Measure B cares about dates, or deadlines, or even numbers, even that date is doubtful.

Mental Health Department Director Dr. Jenine Miller said that a Request For Proposals for the CRT operations will be released soon. “So then we’ll know who’s operating that facility,” added Ms. Bailey — as if there’s any question about whether the Schraeder machine that’s already there next door will get the contract.

What about the “numbers” that Ms. Bailey was unable to produce?

Dr. Miller said she is preparing a “Request for information/qualifications” for operating a Psychiatric Health Facility, emphasizing that whoever it is has to have their own substantial financing capacity because mental health services have to be paid for out of pocket then reimbursed months if not years later by the state or feds, if the billing is correct, and even then only if the “client” is severely mentally ill. Services for all the other 5150s will have to be financed by who-knows-who — or simply denied as they are now.

The trouble with this discussion is that Mr. Kemper already did the cost estimates for all this and nobody has disputed his “numbers” except to say that a couple of years have passed since he prepared them, erroneously assuming that he was dealing with competent people.

Back in 2018 Mr. Kemper said that the cost of operating a 16-bed Psychiatric Health Facility (PHF) would be about $3.4 million per year. Much of which would be covered by existing funding streams, such as the up to $1000 per day cost of sending existing 5150s out of county, and other Medi-Cal and MediCare reimbursement sources, besides Measure B.

Mr. Kemper also noted that Mendo isn’t doing anything to reduce the high number of 5150s, which would be much more cost effective than just building new PHFs and CRTs.

But what on earth could Mendo do to reduce 5150s, which would also reduce the strain on the Sheriff’s department, and local police departments and their budgets?

For starters, Mendo might look at Butte County (Chico area) where a Mobile Crisis Response unit has been operating quite cost effectively for a couple of years now and claims — with detailed reporting and data — to have reduced 5150s by a third.

Mendo might also look at Oakland’s nascent mobile crisis response program which is modeled on the Eugene, Oregon program that the Measure B committee was all for last year when Ukiah Police Chief Justin Wyatt suggested it.

Unfortunately, nobody has done a thing to follow up on any of this since then, much less ask about the fully-funded but dormant Mobile Outreach Program which could easily be reconfigured into a fully funded Crisis Response program like Butte County or Oakland.

In other time wasting items, Measure B Committee Chair Donna Moschetti told her colleagues that the County’s Behavioral Health Advisory Board had created an ad hoc to go over mental health service gaps “and give our recommendations to this committee as we were charged to do.”

That of course will never happen. It’s not even necessary because, again, Mr. Kemper already did it in that same 2018 report entitled “Mendocino County Behavioral Health System Program Gap Analysis & Recommendations for Allocation of Measure B Revenues.”

Mr. Kemper did a much better job than Ms. Moschetti’s ad hoc could ever do, so why are they wasting more time on it?

Ms. Moschetti said that on July 22 the ad hoc would have “a comprehensive report and strategic plan” which would address “what we need and what we can afford, etc.”

That’s exactly what the highly praised Mr. Kemper has already done and which the Supervisors have been asking for — apparently unaware that they already paid handsomely for the information they re-seek two years ago.

But that would require somebody do something besides incur more delays. So Mr. Kemper’s fine report has to be formally tossed into the memory hole.

There was a long discussion of the $120 per hour the County and Measure B has been paying for nebulous “construction contracting consulting services” from a woman named “Sally” who has run up tens of thousand dollars in consulting bills without a single piece of paper being submitted besides her one-line bill. When one of the committee members suggested maybe she should provide some reports or at least an itemized bill, the rest of the committee disagreed, saying that perhaps impertinent requests like this one should be left to Ms. Bailey.

In the end the committee decided to recommend to the Supervisors that another $20k be spent on whatever Sally is doing. (Here you go, Sal. Here's another twenty grand for whatever it is you're doing.)

Last month we described the Measure B committee’s progress as “pathetic.” But it’s at least double pathetic. Nearly three years in since Measure B passed, and the whole show is marching steadily backward.