Mark Twain is credited with apologizing to a friend for sending a long letter because he didn’t have time to write a short one. With that in mind, I would like to apologize to the reader for a long chronology of Measure B, because a short letter would not give justice to the genesis of what Mendocino County possesses.
In 2009, during the economic downturn, CEO Angelo and I had a public display of emotions where I showed dismay at her for suggesting that I lay off 25 Deputy Sheriff’s to balance the budget. Such a far-fetched suggestion was beyond reasonable and I clearly and publicly denounced such a recommendation. After some board room bantering, the chair of the BOS recommended a 15 minute recess, and directed the CEO and I to privately discuss our differences. This turned into our “Monday Morning Meeting,” every Monday at 8:30. This created a much better relationship between the CEO’s office and the Sheriff’s Office. As we all know, communication makes better relationships.
I had worked for MCSO since 1985, prior to the demise of the Psychiatric Health Facility (referred to as a PHF, or “Puff”) and I experienced the 1991 dismantling of the County PHF wherein the Mental Health Department tacitly transferred additional duties to law enforcement, after the State of California decided to “realign” mental health services. History has shown that this realignment has increased law enforcement’s role in emergency mental health crisis and has relieved the very agency which is trained for this, the Department of Behavior Health.
No additional funding was transferred to law enforcement, just the transfer of some basic duties which formerly were performed by the Dept. Of Mental Health (presently referred to as the Behavioral Health Division of Social Services).
In 2014, after eight years of frustration with the expectation that law enforcement deal with the day-to-day mental health crises throughout our county, I sat down with the CEO on a Monday morning and asked a simple question: ‘Why don’t we have a PHF?”
I saw this as a reasonable question, with the intent of removing law enforcement from the crisis driver’s seat, and allow law enforcement to return to enforcing laws. The CEO’s answer was short, poignant and direct: “Sheriff, we can’t afford to build it and we don’t have the funds.” That was a fair answer, and the answer which drove me to personally collect 3,000 signatures and have other supporters collect over 1,500 signatures to get Measures AG and AH on the ballot.
This county-wide measure failed by approximately 100 votes. The BOS then put Measure B on the ballot for the next election, and I personally collected contributions and campaigned for the passage of Measure B. As you may remember, over 160 signs were put up throughout the county and a letter-writing campaign was started to our newspapers so we could pass “Measure B, for Better Mental Health.”
I was joined by a small group of citizens who met weekly with one goal in mind: to improve the mental health of our county and get a PHF facility up and running. 83% of the voters agreed with us, and passed a small sales tax which will build a brick and mortar PHF and will forever add additional funds to the Department of Mental Health to improve Mental Health Services. The CEO’s concern(s) of not having the necessary funds had been eliminated. A bright future was forecast for allowing our hospital emergency departments to have beds freed up and a PHF was forthcoming.
Now for the reality. Almost four years later, we have no clear direction on building a PHF and the Behavior Health Department continues to rely on law enforcement to handle the majority of mental health crises. As I said during the initial campaigns, “You wouldn’t call a plumber when your house is on fire, so why do we call law enforcement when a mental health patient is having a crisis? We need to send a mental health professional.” My words continue to ring true and unfortunately, I will follow up with “I told you so” when a true crisis strikes.
Sheriff Matt Kendall and UPD Chief Justin Wyatt have implored the Measure B committee to fully institute a street response for mental health professionals, and they have both agreed to have a paid responder to join these professionals. Why hasn’t the county hired the others? Why are law enforcement officers continuing to be asked (demanded) to respond to mental health crises? Many times, there are no laws being violated yet the Behavioral Health Department has no professionals ready to respond, even during the work hours M-F, 8-5.
This has to change. Unless the BOS wants to put the Behavior Health Department under the tutelage of the Sheriff’s Office (I’m not encouraging this), I don’t see a vast improvement. Let’s be clear, marijuana is NOT the Number 1 problem in our county, the lack of Mental Health services is our Number 1 problem.
Please read that sentence again.
It is time that all five of our Supervisors put Mental Health services as the first item on every agenda they have. The more we discuss our problem, the closer we are to a solution. We can’t ignore it and then scream at law enforcement for merely doing someone else’s job.
While I am concerned about the cost of liability, my primary concern is the improved care of victims of mental illness. I write this as a brother of a mental health victim who chose to take his own life in 2005 (not in Mendocino County).
As I said at the beginning of this, I’m sorry for the length of this letter. It is time that we start seeing letters from citizens who are supportive of the Behavioral Health Department taking the reins of all behavior health crises in every corner of our county. Simply saying that a change is in the future is no longer believable. Action is what we need, and don’t blame the Measure B committee for this failure. The Supervisors and the Behavioral Health Department can make a difference. Law enforcement will be there to help, but not to be the sacrificial cow when something goes wrong.
— Tom Allman, Concerned Citizen Member of Measure B Committee Sheriff, Retired
The Fort Bragg Police Department has this same problem. About 50% of their time is spent dealing with individuals with mental health issues. Many homeless and transients represent a growing problem but during the pandemic, drug and alcohol abuse has increased along with suicides and violent assaults, not just from the homeless. County wide we are seeing a staggering murder rate for such a lightly populated county. We cannot continue to expect our law enforcement officers to bare the brunt of this crisis. Many of the calls made to law enforcement throughout the county involve a relatively few individuals who take up a greater amount of time of our officers. Our law enforcement is handicapped because they often have no option but to advise and then release those with mental health issues. In Fort Bragg we often see individuals exposing themselves in public. This county spends millions in mental health services but most clients only see a revolving door where NGO’s, who are subsidized by our taxpayers to provide mental health services, are more concerned about how much they can bill Medi-cal to justify the continued operation of their organizations. It is important to understand that it is not just the Sheriff’s Department, but the cities of Fort Bragg, Willits, and Ukiah that share these same problems.
Although I greatly respect Tom Allman, his history is a little off. 1991 Realignment was the state shifting funding for Mental Health Services from the State level to the county level, making each county its own managed care entity. This would not have impacted law enforcement (though as a result of the LPS Act of 1968, California began shutting down the majority of its state hospital system with patients returning to communities – this definitely impacted local law enforcement). The PHF closed in November of 2000 due to the inability of the County to fully staff the facility with medical personnel according to regulation. This resulted that instead of the convenience of law enforcement just dropping off 5150s at the PHF, they had to be taken to the ERs, medically cleared, then seen by County crisis staff. And finally, currently Behavioral Health is in the County’s Department of Health and Human Services.
With Telecare as the PHF operator things might work out better than they did in the 90’s when the Sheriff’s department was dropping off dangerous criminals at the Mendo PHF. That’s why they couldn’t keep it staffed. A good friend of my who was a RN at the Low Gap PHF had her arm seriously broken just prior to its closure. With the new mental health wing at the Low Gap jail, those criminals should be able to be cared for there.
Remembering Doug Rosoff
“As Mendocino County”s Mental Health medical director back in 2000, Rosoff made news when he complained to county officials about jail inmates being sent to the county psychiatric health facility, the locked facility known as the PHF, or “puff,” where the mentally ill in crisis were sent for evaluation and stabilization. At the time, the PHF was having trouble staying open because of a shortage of qualified nurses to staff it.
At the time, Rosoff said that sending inmates to the PHF meant that other patients were being sent out of county for care at great expense to the county.
He also said that inmates were sometimes sent to the PHF unnecessarily and on the orders or advice of judges and defense attorneys, not mental health professionals – something that did not endear him to local defense attorneys. He complained of prisoners being cared for in the PHF for months while they awaited trial, an unnecessary situation he thought simply provided the inmates with more comfort.
“You can lounge around watching television, making phone calls, playing ping pong,” he said. “If I was in an inmate’s shoes, I would prefer to do my time in a psychiatric facility instead of a correctional setting.””
https://www.willitsnews.com/2012/08/25/remembering-doug-rosoff/
Marmon
A positive note about the Whitmore Ln. shack as a PHF unit is that it is outside of Ukiah city limits, meaning the Sheriff’s office will have to respond to emergencies there, not UPD. When the PHF was at low gap, UPD were frequently called to the facility to get things under control. Assaults and rape on inpatients at these facilities are always a concern when you mix criminals with non criminal mental health clients. Most mentally ill folks live their entire lives without committing crimes, to mix them with those who do is a crime in itself.
Marmon
A shack as a PHF? Hell boy, just throw some money at it, and it’ll be the Ritz.
A perfect location, none of those despicable NIMBY types in the hood, County already owns the property, and it’s in Ukiah. Ain’t that where the action is?
Be well,
Laz
Even though Dr. Miller says they have already selected Telecare as their PHF Operator, I suspect as soon as they do all the heavy lifting of getting the facility up and running, the County and the AVA will run them out of town so the Schraeders can step in and take over, just like the Ortner situation.
Marmon
“the county and the ava”?
I’ve heard many County types arrogantly say, “I don’t read the AVA.” But if pressed just a little, they seem to know what the AVA’s up to.
Be Swell,
Laz
I think the original Kemper Report is why Ortner isn’t here.
Bull Shit! Ortner started out from scratch, they didn’t even have client files thanks to the great flood at the County Mental Health building where the files were stored. Angelo had completely gutted the Adult System of Care. The Schraeders were treated much differently. Throughout the years the County partnered with the Schraeders in building a complex Children’s System Care infrastructure, mostly through money from Social Services and the foster care industry. To compare Ortner with the Schraeders was like comparing apples to oranges.
Marmon
Kemper was not immune to political pressure, we got what we paid for, just look at the Orchard Street Project, Kemper was told it was a shovel ready project which was far from the truth, but that’s why it was moved to the highest priority over the PHF Unit.
Marmon
The ongoing absence of a PHF (residential crisis care facility) has seriously impacted my life as the parent of a very sick daughter-during a psychotic break over a year ago the ONLY bed they could find for her was in Pasadena-miles and miles away from me and any familiar faces. She has since been transferred no less than 4 times to places in LA county-a huge myriad of services,depts etc. Our long-distance communication has been heartbreaking. I am planted as a senior in Mendocino County and not only because of Covid but personal health issues I cannot easily go to see her and cannot get her transferred to a suitable care facility up here. Our separation has been a total nightmare that wouldn’t have happened if there had been a local crisis center in Mendocino County. I get infuriated whenever I notice yet another committee, another study, another discussion involving proposed solutions with NO TANGIBLE results. Yes, action is imperative and if someone could tell me exactly how I could act in this matter I would truly appreciate it. How I miss Tom Allman-his commitment to this cause was exemplary and who now is as dedicated who is in a position to actually force a change at last?
Ms. Nancy, PHF units can’t be used for long term care, 14 days at the most with court approval. After 14 days they have to be released or placed under a conservatorship where they will be housed in a facility like a care home or a IMD (Institution of Mental Disorders). Don’t be offended because most people don’t understand that either, including the AVA staff. 90% of the County’s out of town placements are in different levels of care such as IMD’s and Care Homes. A PHF will not solve your woes.
Marmon
Mr. Marmon is correct. However, there are a number of mental health IMDs and lower care Board and Cares across Northern California that are much closer than Pasadena. Therefore, you may wish to speak with Behavioral Health about that possibility. The only difficulty is when they have both mental health and either physical health or developmentally delayed co-occurring conditions – finding placements for these are difficult and you may be only to get what you can find available, even if it’s in Southern California.
A Mendocino County PHF in my mind is ridiculous, If we really wanted to keep our love ones close we would be looking at other levels of care. A Crestwood IMD, or a Davis Guest Home or Willow Glen (Ortner) in Mendocino County is what they really need. I personally do not think a PHF in Mendo is the best path forward. A board and care, and/or an IMD would be more sensible in my opinion.
Marmon
Well, the voters have spoken and it is what it is. However, there is funding in the new budget for counties to either create or partner with someone for licensed board and cares. Perhaps knowing a PHF was in the area, someone might be more interested in opening a B&C locally.
“the voters have spoken”
The voters didn’t even understand what they were voting for. Allman himself did not understand what a PHF really was and what it could actually do. He relied on his memory of the old PHF which he himself helped closed down because law enforcement didn’t know what a PHF’s purpose really was. They are 72 hour facilities and before anyone can be admitted they have to be medically cleared at the hospital first. They are not for long term care, and they will not take anyone in that is high on drugs or alcohol, even if they are suffering a psychotic event. A PHF does not detox. That young man that was running around naked a couple of weeks ago in Ukiah would not have qualified for admission in a PHF. After the drugs wore off he was released from jail and was never sent to a PHF for stabilization.
Marmon
Law enforcement and the Courts got away with a lot of crap in the old PHF because it was County operated. With a private operator in charge, people are going to get a rude awakening.
Marmon
Title 9 does allow for substance induced psychotic, mood, or anxiety disorders for inpatient medical necessity (§ 1820.205), so they could still end up there if medically safe. But because PHFs are free standing institutions, they are unwilling to take the aggressive, violent ones unless the ER “snows” them with antipsychotics, which often ERs don’t want to do.
From what I heard from Miller yesterday Mendo’s PHF won’t be free standing. She stated that because the County would own the building they will tell the private operators who they will or will not accept into the facility. Good luck with that, no private operator will risk their license or reputation under those conditions, especially Telecare.
Telecare Exclusion Criteria
We cannot accept individuals who:
Have complex medical problems that cannot be treated on an outpatient basis
Have a primary diagnosis of drug or alcohol abuse, or an eating disorder
Are on a criminal justice hold
Marmon
Tomorrow’s Measure B meeting has been canceled?
Be Swell,
Laz
“Free standing” just means they don’t have any medical facilities or any other supports attached. The criteria you listed is consistent with what they’re able to do as a result.