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County Notes (February 24, 2021)

You Thought Ortner Was Gone?

They are — but…

Tuesday Supes Agenda:

“Item 5d) Discussion and Possible Action Including Adoption of Resolution Granting Chair Authority to Issue Subpoenas Regarding Documents Related to Behavioral Health Services (Sponsors: County Counsel and Health & Human Services Agency-Behavioral Health)”

Attached to this cryptic item title (The Supes already have subpoena power under their “quasi-judicial” powers and duties) is a proposed resolution which in main part reads:

“WHEREAS, the State of California Department of Health Care Services is preparing to engage in a regular audit of Mendocino County regarding its contracts for specialty mental health services, including but not limited to Board or Supervisors Agreement No. 13-016 with Ortner Management Group (“OMG”); and 

“WHEREAS, subsequent to the termination of the County’s contract with OMG, OMG dissolved its corporate form; and 

“WHEREAS, County staff have requested, verbally and in writing, that the persons who formerly served as officers or agents, or who may currently be successors in interest, of OMG provide to the County documents related to OMG’s provision of services pursuant to the County’s contract with OMG, including all documents between OMG and any contractors, subcontractors or vendors used by OMG to provide services to the County; and 

“WHEREAS, the those [sic] persons contacted for this information have failed to comply with the County’s requests to provide said documents, which are essential to the County’s ability to respond to the forthcoming audit by the State; and 

“WHEREAS, authorizing the issuance of subpoenas in this matter is necessary and important to the County in order to have all records and documents relating to the OMG contract available for the State audit, as well as for the County’s ability to analyze OMG’s performance under the contract for the County’s own purposes…”

Translation: Ortner Management Group, aka OMG of Marysville, the now apparently “dissolved” outfit that the County contracted with for adult mental health services through a bidding process that was rigged by former Ortner Manager Tom Pinizzotto, hasn’t provided the necessary documentation to support a state audit of services. 

If Mendo can’t provide the documentation to the state, millions of dollars in state reimbursements for services alleged to have been rendered more than five years ago might be withdrawn by the state’s green eyeshaders.

AVA Readers might recall that Ortner started off with a convenient documentation deficit because of a large water leak in the Mental Health Department offices on Dora Street just before Mental Health Services were privatized in 2014. That leak destroyed or damaged lots of mental health paperwork that Ortner could have used to get started on a risky, but plausible, yet unprecdented, one-of-a-kind privatization of services project that soon turned into a FUBAR of the First Order.

Ortner got the adult services contract under circumstances that were so obviously corrupt that the Grand Jury wrote it up, saying the contract had “an appearance of a conflict of interest” because it “appeared” that Mr. Pinizzotto, first hired as a consultant and then brought in to manage/privatize mental health services, had steered the contract to his former employer, Ortner. 

Splitting hairs on an otherwise bald contract head, the Supervisors said that since Pinizzotto no longer worked directly for Ortner nothing overtly illegal had occurred!

Ortner’s adult services contract lasted for three years before local doctors and cops started complaining about OMG’s services and response times and Ortner’s contract was terminated and turned over to Camille Schraeder who, it is presumed, does a better job with the paperwork. (But who knows? These things take years to process.)

The Grand Jury also found that because the County (i.e., Pinizzotto and staff including the County Counsel’s office) had prepared a “poorly written contract” that Ortner had taken advantage of the loose language to shortchange severely mentally ill patients. Over the three years of the Ortner Contract, the seldom seen Ortner was paid well over $20 million for alleged services. 

Don’t forget that 1) Ortner didn’t even provide many of the services, instead they subcontracted out most of the local activity to existing smaller providers — what the above resolution calls “any contractors, subcontractors or vendors used by OMG” — with probably minimal oversight and even less required documentation; and 2) Ortner didn’t know how to properly bill for these services in the first place — the contract called for Mendo staffers to train them! (Anyone with medical billing experience knows how ridiculously complicated medical billing can be — which would be greatly simplified under Single Payer.) 

Back in 2016 (five years ago now) during the turnover from OMG to Schraeder & Co. (Redwood Community Services), Mental Health staff assured the Supervisors that although there were a few hiccups in the transition, Ortner was providing the necessary documents to facilitate the transfer to Schraeder & Co. 

In June of 2016 we wrote:

“Supervisor McCowen asked why Ortner seemed to be slow in providing various documents that the County wanted. Dr. Miller explained that if Ortner had not been terminated prematurely, these documents would have been due in a matter of years, not right away, due to the long delays in billing and reimbursements. But since Ortner is being terminated, Ortner needs to provide the docs earlier than expected, and it’s taking time. So much time that Ortner needs an extra $64k (over the $400k to close out the contract) to maintain staff to provide the billing documents before Ortner becomes one more sad chapter in Mendocino County history, bunco division. Ms. Moss-Chandler added that ‘these items are being resolved and OMG is working cooperatively to deliver all the items called for’.”

“Supervisor Gjerde asked if there was a 10% holdback provision in the Ortner contract ‘to make sure of performance.’

“’All prepayments have been made already’,” replied HHSA Director Ms. Moss-Chandler. ‘There’s no contract provision that states that.’

“CEO Carmel Angelo added, ‘I am in communication with Mr. Ortner, so these questions are being asked. I have assurance for a successful closeout. What you will see on June 21 [2016] is the [$64k] four-month contract [extension] to cover staff to continue billing for rest of the contract.’

“Translation: Mendo has to pay Ortner to bill the County, but apparently Mendo hasn’t paid enough. ‘Billing’ is clearly the most important ‘service’ Ortner provides. And they’re not very good at that either.

“Supervisor Gjerde said he would ‘reluctantly’ vote for the additional $400k and the $64k, adding, ‘But staff should hold back additional funds to make sure documents are submitted in timely manner’.”

Based on this latest proposed resolution, however, whatever may have been paid for and/or provided back in 2016 obviously wasn’t enough to support the state’s standard years-delayed audit — an audit that County staff knew in advance would eventually arrive.

The primary justification invoked by CEO Carmel Angelo for privatizing mental health services in the first place was that county mental health staff had been unable to respond adequately to earlier state audits, which resulted in millions of dollars worth of state reimbursement withdrawals.

Instead of solving that reimbursement paperwork problem through training or farming out the mental health billing to a professional billing outfit, Angelo brought in Pinizzotto, who in turn brought in Ortner, his former employer, and turned the annual $20 million mental health department over to his former employer, creating one of Mendo’s most infamous, longest lasting, most costly, most unnecessary, most convoluted bungles in recent memory. Hundreds of mental patients and their families suffered. 

Ortner’s contract started in 2014 and lasted for the aforementioned three years before it was terminated. 

Now the state wants Mendo — which has already paid out the $20-million-plus to the no-longer-in-existence OMG — to justify its bills. Hence this latest, but seriously belated, “resolution” to give the Supes specific subpoena power to try to get the documents from Ortner’s former managers and staff and contractors from more than five years ago.

Sadly, not only was this predictable, we actually predicted it. 

In November of 2016 we wrote: 

“Supervisor Gjerde’s question about the mental health financial audit was never directly answered. The ‘clinical audits’ (EQROs) [that Dr. Miller talked about] are nothing more than the usual state rubber stamps. What Gjerde was obviously getting at was how much the County is liable for during the three years of Ortner’s inadequate mental health services which the County may not be reimbursed for. But for reasons that remain unclear, Gjerde didn't press the point. No one said where those five year audits are or when they will be posted or whether Ortner’s bills qualify for reimbursement. In fact, these audits will never be online nor will they be explained or reported on. No one knows how much liability the County has regarding Ortner’s three years of unsupervised, failed service, and nobody will worry about it again until a multimillion dollar bill appears at the supervisors’ doorstep in a year or two or five. And everyone will pretend to be shocked.

“IF THE SUPERVISORS and staff can't speak clearly about the mental health situation, they certainly can’t expect it to improve. After lots of self-congratulatory baffle-gab about cooperation and understanding and challenges and coming together and how amazing and great everyone is and so forth — and we assume Redwood Quality Management is doing a somewhat better job than Ortner even though Ortner set the bar so low that practically anything would be better than Ortner — they can't get direct answers to direct questions. And the Supervisors won’t push for direct answers because their hard-earned reputations as Nice People would be jeopardized. Pathetic. Truly pathetic.”

Mendo is about to open yet another Chapter of “The Ortner Fiasco,” a travesty that just keeps on giving. Incompetence of this magnitude, in ordinary circumstances where public money goes missing without so much as a receipt, is called fraud.

It will be interesting to see how the current Board reacts to this hail-mary subpoena power request. Of the five currently sitting Supervisors, only Dan Gjerde was on the Board during Ortner Time. If it was us, we’d ask staff: “How much do we stand to lose on this entirely avoidable crap?” Followed by, “How much will the outside lawyers cost to pursue this?” and, then, “What happens when Ortner and his pals can’t provide the paperwork which they probably don’t have and which may not even exist?”


Redistricting 2021

In a normal 2021 it would be the time to start thinking about redistricting Mendocino County’s oddly configured Supervisoral districts. 

About this time in 2011 the then-Board of Supervisors decided to form a redistricting committee made up of civic-minded volunteers from each of the county’s five districts. I was one of them. 

We met several times in Ukiah and a few times in outlying cities, poring over maps and legal docs and listening to public input. After several months of exhaustive analysis we came up with two alternative proposals, the most interesting of which was a proposal to move the “Village” of Mendocino a few miles north into the Fourth District because Mendocino has more compatibilities with Fort Bragg these days than with the rest of the ag-heavy Fifth District.

But since the Fifth is so sparsely populated, the proposal would have snagged a number of inland population clusters, including some Ukiah suburbs. Supporters of that alternative thought it would make the Fifth District more politically balanced, not the “coast-liberal” bastion that it now is which, since the late 70s, produced such political luminaries as Charles Peterson, J.David Colfax and Dan Hamburg.

Prior to these mercenary seat warmers, the 5th District was represented by the pragmatic supervisors Joe Scaramella and Ted Galletti, and before them mostly hard-drinking ranchers mostly concerned about roads, road contracts, road locations, and keeping their own property taxes as low as possible. 

The Fifth these days is fortunate in the pragmatic and conscientiously representative Ted Williams as its supervisor than the self-interested arrogant reps the 5th suffered under for years prior.

The 2011 Redistricting Committee’s other recommendation was closer to the current configuration but made some adjustments to reflect population changes and to move some of the Willits suburbs out of the Fifth District.

The Fifth District ends up being very large no matter how you draw the lines. Like 2011, the 2021 census undoubtedly undercounts Mexicans. Using census data is inherently skewed by the Fifth District’s low reported numbers, probably even lower this year. In fact, we’ve heard that the 2021 census will show a net drop in Mendo’s population and that will probably result in some enlargements to most district lines just to keep the minimum population balance in each district.

In the end in 2011, however, then-Board Chair Kendall Smith, assumed at this paper to be not only incompetent but mentally unbalanced, ignored all the Committee’s work and came up with her own minimal revisions, declaring that things were fine the way they were and that the liberal lock on the Fifth was fine with her, so there was no need to change any boundaries. A week later all the committee members got pro-forma thank you notes signed by Smith for their ignored work.

Due to covid, the census has been delayed and the accompanying redistricting process has now been pushed out by at least four months, which might mean that Mendo would consider forming another redistricting committee as early as June or July, census data permitting. 

If it were up to us, we’d recommend no committee unless the Board wanted to seriously consider updated versions of the 2011 proposals. If they have no desire to reconsider, don’t waste everybody’s time with more meetings; simply have the County’s mapping and elections staff work up a purely mathematical new version of the existing maps and be done with it.

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