CEO Angelo’s Best Interest

At the December 2019 Measure B meeting, B's then-board chair Dr. Ace Barash, on staff at Adventist-owned Howard Hospital in Willits, read a letter the County had received from the Adventists’ Mendo honcho, Jason Wells, since replaced by another Adventist exec. 

Wells said that with their upcoming operating agreement with Coast Hospital, the Adventists expected they could provide the equivalent of Psychiatric Health Facility (PHF/”Puff”) services at their old, recently vacated emergency room in Ukiah, and also at the Coast Hospital: Ten beds on the Coast and six beds in Ukiah (eight if they did a little more remodeling) for a total of that magic number of 16 beds — which has something to do with optimal reimbursement, although Mendo averages less than half that number of severe cases at any one time.

There was some question about whether the County could use Measure B tax funds to finance construction/remodeling at a privately owned facility like the Adventists. County Counsel Christian Curtis said he’d look into it and get back to the Committee and Board of Supes. Meanwhile, Mr. Wells was asked to submit a formal proposal in 60 days, spelling out what the Adventists would do for a few million Measure B dollars.

Two months later Supervisor Ted Williams wrote, “I was thankful to find board support for action I proposed on Dec 10, 2019: ‘Discussion and Possible Action Including Direction to Executive Office to Perform Operational Feasibility of Proposed Measure B Funded Facilities.’ Sheriff Allman summed up my request, calling the end product a ‘business plan.’ Jason Wells of Adventist Health was notified of the item and offered a letter suggesting Adventist's hospitals could operate as a provider for secure in-hospital psychiatric care, potentially mitigating the need for new construction. Details, feasibility and cost are still to be determined.”

And that’s where it remains to this day: Undetermined. Presumably because CEO Angelo and her staff didn’t want to.

According to the Measure B committee meeting minutes for February 2020:

“Item 3e) Discussion and Update Regarding Approval of Request from Mental Health Treatment Act Citizen’s Advisory Committee for Board of Supervisors to Direct County Counsel to Conduct Legal Evaluation, Research Analysis and Assessment of Adventist Health Partnership Legality; Including Restriction, Necessary Control, Implications, and Compliance Regarding the Possible Use of Public Tax Dollars to Fund Operations of a Private Entity. 

“[Deputy CEO] Sarah Dukett advised this is a carryover item from the last meeting. Acting County Counsel Christian Curtis provided a verbal update, advising the Committee that the opinion is not yet complete, but should be soon. Member Allman requested the opinion be distributed to the Committee as soon as it is ready. Counsel Curtis advised that if the Board of Supervisors waives privilege, the opinion could be made available to the Committee before the next Measure B meeting.”

The March 2020 Measure B meeting was cancelled, perhaps because of the onset of covid, but no official reason was given.

At the April Measure B Committee meeting County Counsel Christian Curtis, having labored mightily for more than four months with a highly anticipated request for a “Legal Evaluation, Research Analysis, and Assessment of Adventist Health Partnership Legality; Including Restriction, Necessary Control, Implications, and Compliance Regarding the Possible Use of Public Tax Dollars to Fund Operations of a Private Entity,” finally rendered his opinion.

The Measure B minutes record Curtis’s “opinion”:

“County Council [sic], Christian Curtis explained that in general, it is legal to use public funds to pay a private entity as long as the partnership meets the needs of the public good.”

That was it. Nothing was written. No “evaluation,” no “research analysis,” no “assessment of Adventist Health Partnership Legality,” nothing about “restriction, necessary control, implications and compliance…”

But at least it was clear and to the point, as long as “the public good” — which should be in the opinion of the elected office holders, not the CEO — is foremost.

The minutes then reflected that “Committee Member Riley asked about the status of the detailed proposal that had been expected from Adventist Health months earlier.”

“Member [CEO Carmel] Angelo explained that in 2019, the top Regional Executive of Adventist Health, Jason Wells, met with Mendocino County CEO, Carmel Angelo regarding the potential of creating a psychiatric inpatient service/program. Based on that meeting, [Committee] Member Ace Barash who is an Adventist employee drafted a letter of interest at the request of Jason Wells. No further business between the public and private entities has taken place.”

The minutes continued, “Member Barash believes that Adventist Health remains interested in working with Measure B.Project Manager, Alyson Bailey [and] will attempt outreach to Adventist Health through Member Ace Barash. If successful, this outreach will produce a feasibility study/option for inpatient care funded by Measure B.”

Ms. Bailey was fired from her Project Manager position in February of 2021. We have not seen whatever letter Dr. Barash may or may not have sent to the Adventists, but if a letter was sent it certainly didn’t have the imprimatur of the Measure B Committee or the County. 

At a subsequent Measure B meeting, Dr. Barash made off-hand mentions of ongoing off-the-record discussions between the County and the Adventists.

By May of 2020, the idea of exploring the Adventist option had disappeared from the official radar without explanation. Supervisor Williams had agreed to pursue the idea with the Adventists. But like everything related to Measure B, more months of silence rolled by without mention or explanation. Williams occasionally wondered aloud if there would be enough money for the PHF and for services but nothing came of that either. 

In March of 2021, the Supervisors, frustrated by staff’s refusal to provide a Measure B budget or plan or financing model, abruptly voted to officially accept the 2018 Kemper report as the Measure B Strategic Plan.

Mr. Kemper specifically mentioned the PHF in that now official plan, saying that a PHF shouldn’t cost more than $8 million.

When asked if that was a good number at an early Measure B meeting, Mr. Kemper staunchly defended his number, saying it was based on recent similar PHFs in other parts of the state. Adjusted for inflation, it might be a little higher now.

The next time the subject of the cost of a PHF came up, before she abruptly disappeared last fall, then-Measure B project manager Alyson Bailey told the Measure B Committee that a PHF would cost about $20 million. Nobody knew where that number came from, nobody asked, nobody seemed bothered, nobody wondered what happened to Kemper’s estimate.

But the PHF doesn’t need to cost $8 million, much less a preposterous $20 million or more. Adventist Health was on record as offering to remodel their old emergency room in Ukiah into a PHF — a facility already built to hospital standards — and accommodate the Coast population and emergency room which has now been completely abandoned. 

The Adventists’ proposal was brought up in several Board meetings by Supervisor Williams; the Measure B Committee discussed it and somebody was supposed to have been asking the Adventists for a formal cost estimate. Williams even noted, without contradiction, that having a PHF at or near a hospital had several other obvious advantages, specifically the availability of doctors and medications, but also because mental patients frequently enter treatment via the nearby emergency room(s).

The Advenists’ offer foundered in the usual Measure B incompetence and blather, combined with CEO Angelo’s attitude that she will only pursue grossly overpriced projects for everything related to Measure B. At at early Measure B meeting Angelo famously compared building a PHF to a private person remodeling their kitchen for $50,000!

Of course, no “feasibility study/option” from the Adventists or staff was produced and, as usual, the Measure B Committee and the Supervisors never raised the subject again. 

Nevertheless, Supervisor Williams who had also volunteered to work with Mr. Wells for some kind of study, proposal or option, later blamed the problem in getting a Psych facility into operation was a resistant public, which, he and the committee implied several times in recent months is a result of the public’s “stigmatization” of the mentally ill, a demonstrably untrue claim. The fact that the public wanted treatment for the mentally ill was made obvious with the passing of Measure B. 

Oddly, Williams, who worried frequently about having enough Measure B money to build and operate a PHF, hasn’t mentioned the Adventist offer which, because it would be based on use of an existing emergency room, wouldn’t engender alleged stigmatization problems, even if it were true.

Fast forward to the Supervisors meeting last Monday, May 24 where CEO Angelo, after months of unilaterally keeping the easiest, cheapest and quickest way to provide PHF services in Mendocino County off of any public agenda, answered a question by Supervisor Mulheren about the Adventist option.

Angelo replied that Dr. Barash had indeed sent a letter saying Adventists were interested in running a PHF previously, Angelo conceded, adding. “In a year, we have not been able to reach agreement on cost or what that would look like.” CEO Angelo, added that she had received a “legal opinion” — i.e., County Counsel Curtis’s casual reference that it would be fine as long as the arrangement was for “the public good.” Angelo then declared that “It’s in the public’s best interest that the County is not tied to one provider for the service of the PHF. For multiple reasons, whether it’s cost, whether the service is at an optimal level, so we can go ahead and change providers, or if we really needed to we could hire our own staff and run the PHF.”

Angelo then asked Mental Health Director Dr. Jenine Miller if she had anything to add about the “most recent endeavor with the RFP” for PHF services which had been awarded to TeleCare in the East Bay.

Dr. Miller replied, “We don’t have a full award at this time and we don’t want to give out too much information at this time.”

Angelo continued, “In good faith we have made attempts to have the Adventists provide these services. We collectively have not been able to reach an agreement that would be in the best interest of the community. Because we are just finalizing an RFP process right now that is probably the most information that we could give out at this time.”

Angelo and the Board then proceeded to order staff to design and build a PHF at the site of the old Whitmore Lane Nursing Facility which Angelo said would have to be mostly demolished and rebuilt at a cost of $20 to $25 million. This incredible cost, obviously based on nothing at all, is from the same CEO who said the Adventists option had been ruled out because of “cost” and “optimal service” considerations. 

Not a word of skepticism or comment was uttered from the Supervisors.

CEO Angelo told the Board that building the new PHF on Whitmore Lane to “OSHPD [hospital] standards doesn’t happen overnight. It will be a few years to meet those requirements and to get licensed.”

By which time the County will have no choice but to sink as much money into Whitmore demolition and design and reconstruction as the CEO tells them to, to make sure the gold plated facility costs as much as possible while delaying whatever beneficial mental health services could be provided for “a few years” — i.e., in Mendo time, maybe never.

At which time CEO Angelo will be comfortably back in San Diego enjoying her $150k a year retirement pension.

* * *

Supes Briefs

SUPERVISOR Maureen 'Mo' Mulheren participated in the Board’s Big Pot Meeting last Wednesday from her office at the County Admin Center, thanking staff for helping her set it up. The first step in a return to regular meetings? Maybe, but slo mo seems to be the Mendo model.

SUPERVISOR JOHN HASCHAK conceded Wednesday that the new version of the County’s “use permit” pot ordinance had a few provisions/restrictions that he likes, but that in the end he preferred a “go-slow” approach and didn’t think he could support the expanded gro size to 10% of parcel size, translating, on large land holdings, many more legal acres of marijuana under cultivation by, presumably, more well-funded organizations and individuals.

SUPERVISOR WILLIAMS, after acknowledging that he’s been on the dissenting end of a number of votes since taking office, then urged his colleagues — i.e., Haschak — to “show solidarity” on this vote and that the Board “should defend the County and move forward.” Supervisor Glenn McGourty agreed, adding, “We need to do this as a group and stand together and not undermine each other.”

THERE WAS SURPRISINGLY LITTLE public input on Wednesday — previous Board pot discussions involved hundreds of emails and hours of public expression — which Supervisor Haschak attributed to the public “no longer believes we’re listening to them.”

IN THE END, the Board didn’t want to include the Planning Commission’s “compromise” proposal of no more than 2 acres per parcel until maybe a later date, thus rejecting even this reasonable brake on corporate pot farming sure to result on large scale marijuana holdings and operations.

HASCHAK WAS UNMOVED: “Go ahead and vote on it,” he said, dismissively, “but this expansion, whether we do it cutesy like, and manipulate prescription zones, whatever. But it’s not what people want. I’ll just leave it at that.” Then, not leaving it that, Haschak added, “Our commitment should be to the people who have been in the system, who haven’t been able to get through because of the County’s mishandling of the whole ordinance. We can have a new process for new people to get through. … But people do not want this expansion. There’s a myriad of reasons. Just look outside with the drought. … I don’t have a say in the referendum, but the people will, and I’m just staying out of it right now but the people will decide if they want to go forward with something or not.”

THIS WAS HASCHAK'S finest hour. It's positively exhilarating to see him sticking to his guns on this crucially important issue.

THE BOARD then voted 4-1 to proceed with the expansion without the two-acre cap. Haschak, perhaps reminded by his colleague, Williams, of Williams' dissenting NO votes, voted NO.

AND THAT was when we realized what Williams and McGourty were trying to do: They apparently think that if the Board, including Haschak, voted unanimously for the expanded ordinance, it would somehow discourage the people who are preparing a referendum against the county's expanded rules — most of whom are in Haschak’s Third District — from their plans to circulate a petition with a more restrictive ordinance. By removing even the two-acre compromise limit — two acres is itself A LOT of pot — however, the Board has probably only motivated the referendum people even more.

* * *

Why Is Mendo Proposing To Defund The Sheriff’s Vehicle Budget? 

Among the 19 Mendo Graduates of the California State Association of Counties Executive Credential Program for 2020/21 are Supervisor John Haschak, Supervisor Ted Williams and Darcie Antle, the newly promoted Assistant Chief Executive Officer (and Mendo’s Budget Point person)

Next Tuesday, all 19 of them will be the subject of a big “presentation of credentials.”

We couldn’t find anything about what the “credential” entails but it costs an undisclosed amount of money and “credential” holders get: “a Unique framed Credential, a Lapel pin, a Listing on the Institute website, Recognition at a CSAC annual conference, and Listing displayed at CSAC Institute.”

Get back and make way, Mendocino County.

That lapel pin and framed certificate showing us that Supervisors Haschak and Williams are not just “supervisors,” but “credentialed supervisors” sound particularly impressive.

One would hope that Mendo’s newly credential managers and officials would at least be able to produce a clear, non-contradictory budget.

However, based on the accompanying budget agenda package for later that same Tuesday, the “credentials” start to sound more like the Matchbook School of Art..

On the one hand, we read in the intro to next year’s proposed budget that it contains a “Large investment into salaries, benefits, including public safety.”

On the other hand, the Sheriff’s (non-jail) budget chart shows that the Sheriff has asked for about $18 million (no noticeable increase from prior years), most of which is salaries and benefits. including about $1.2 million in Overtime.

But the CEO’s proposed “adjustment” reduces the Sheriff's budget by a total of about $2.3 million and totally eliminates the Sheriff’s request for about $1.3 million in “vehicles/equipment.” And without explanation.

Elsewhere in the disjointed — but presumably “credentialed” — budget presentation we read that…

“The Sheriff’s Office has run over budget for several years primarily due to the ever-increasing cost of labor and benefits for the personnel necessary to meet public safety needs of Mendocino County. Also of note, for FY 2020-21 the Executive Office decreased the Sheriff’s Office Net County Cost from $15,243,953 (Adopted/Revised) in FY 2019-20 to $14,724,924 (Adopted/Revised) for FY 2020-21, despite fiscal year-end Net County Cost coming in over $287,300 in 2019-20.

“To help balance the budget, reduction of expenses in other areas have been realized, such as the postponed purchase of updated patrol vehicles. The Sheriff’s vehicle fleet is aging rapidly, with many of its patrol vehicles operating with high mileage (13 vehicles have over 100k mile odometer reading). During the recent Wildfire event last October, over 200,000 miles were logged on the Sheriff’s vehicle fleet in a one-month period. It is unrealistic to sustain savings in this area, and in FY 2021-22, the Sheriff is asking for additional funds to replace a number of vehicles with high mileage.”

Sounds like the Sheriff has made a good case for some new vehicles, but the CEO has turned him down flat. We await Tuesday’s explanation for how that plays into a “large investment into salaries, benefits, including public safety.”

* * *

Kitchen Table Reorganization

Item 5b) on next Wednesday’s Supervisors Agenda has been drifting around the County’s Low Gap Bunker for several years:

“Discussion and Possible Action Including Recommendation from the Health and Human Services Agency (HHSA) Advisory Board to Move From the Current HHSA Structure to a Two Department Model of Social Services and Health Services. (Sponsor: Health and Human Services Agency).” But the actual two-department proposal is not really from the HHSA Super-department — which currently is overseen by an unnecessary administrative layer called HHSA — or the Advisory Board. Instead the proposal is from an odd Ukiah outfit calling itself “Kitchen Table Consulting.”

According to their website, Kitchen Table Consulting “donates 10% of all proceeds to a few worthy non-profits, including, but not limited to: Hearthstone Village, Sierra Club, The ACLU, The Southern Poverty Law Center, Planned Parenthood and our semi-public radio station, KZYX.

Owner Jen Dalton: “Jen is dynamic and well-networked with expertise in developing strategic intentions and advocacy efforts for organizations of all sizes, from grassroots to global. She is a highly trained group convener, facilitator and co-active coach and has designed and facilitated numerous multi-stakeholder collaborative impact efforts. Her passions lie in community food and community health with a foundation in heart and nature-based emergent strategies.

“Kitchen Table Consulting (KTC), began in 2008 after Slow Food Nation in San Francisco (for which Jen was the Program Director) and was named for San Francisco’s Kitchen Table Talks, of which Jen was a co-founder and co-organizer along with her fellow Slow Food Nation colleagues.”

Which obviously qualifies Ms. Dalton to decide how HHSA should be organized. What kind of meanie face would dare question this person?

Ms. Dalton then proceeded to diagram the agency with three “recommendations” which are nothing but a bunch of irrelevant circled buzzwords in circles with arc-lines connecting them. 

Then she offered four more “recommendations”:

“Kitchen Table Consulting Recommendations #4 - 7 

#4. Streamline the Human Resources hiring process to increase equity and efficiencies in hiring. 

The Executive Office is hiring an Equity Office to focus on diversity and equity across the County departments; this includes addressing the issue of equity in the hiring process. The hiring process has continued to be streamlined to increase efficiencies in hiring employee [sic]. 

#5. Streamline and re-evaluate contracts approval process for increased efficiency and equity. 

The departments have started the contract evaluation process, which has included Granicus trainings, to increase efficiencies and equity within the contract approval process. The next step is to get Cobblestone training and to identify key staffs as leads. 

#6. Streamline the Travel Request Process 

As travel has halted due to the COVID -19 Pandemic, this recommendation was not addressed as one of the priority recommendations but will be reviewed and evaluated within the next year. 

#7. Streamline the Disaster Response and Recovery process to increase the effectiveness and reduce the impacts on daily operations of branches and staff. 

We continue to recruit and train staff members for the Care and Shelter Team, we increased the number of staff trained to provide pandemic response, and have worked to rotate staff responding to the pandemic to reduce the impact on daily operations. We will continue to evaluate this process.”

What any of this gibberish has to do with converting the top-heavy HHSA from four administrative offices to two is hard to discern. But it’s what you’d expect from KZYX fans.

Back in 2010 when HHSA was created, combining Social Services, Mental Health and Public Health, the theory was to save time and admin by combining the three overlapping offices into one, which was supposed to save on administrators, analysts, managers, etc. 

Instead, under the accumulating leadership of then HHSA Director Carmel Angelo, the three offices were enlarged and a fourth redundant office was added to the existing three, thus creating four overlapping and redundant offices where three had been, and more higher paid management was larded on and success was declared. 

Nobody bothered to ask if any savings or efficiencies had been achieved.

Under this latest two-department proposal, again nobody has asked why this is an improvement, how the existing bloated managerial arrangement will be rearranged, or if any money or time will be saved. In fact, nobody really cares since the entire apparatus is built into the grant-driven funding rate structure and the more management you can stuff into the equation the higher your reimburseable overhead and the more you can glom from state and federal grants. If anyone is helped by the “services” being provided is a secondary consideration if public welfare is considered at all..

So good job Ms. Dalton, you have muddied the water so much that nobody will dare ask a serious question for fear of producing another boatload of the “diversity and equity across the County departments” gobbledeegook variety Ms. Dalton might reply with.

* * *

Mendo To Spend $75k-Plus Travel For A “Strategic Plan”

(The (bulls)hits just keeps on coming…)

Responding to a Grand Jury finding in August of 2019 that the Supervisors had “no published long term county-wide strategic plan, e.g., fire response, homelessness, cannabis, housing and economic development, the Supervisors said they agreed and “the Board looks forward to implementing previous Board direction to initiate a strategic planning process…” They cited a lengthy collection of documents which they implied together formed the equivalent of a strategic plan: The General Plan, the County Budget, various joint powers agency documents, their “Emergency Operations Plan,” a number of health and human services plans, and their on-going, if failed, attempts to get their arms around cannabis legalization.

Nothing happened, of course. Nothing was “initiated.”

In March of 2020 the Board voted unanimously to “direct staff to establish a strategic planning process this fiscal year to begin January, 2021.”

“Staff” of course did nothing, probably citing the universal excuse for inaction, the onset of covid for their (the CEO’s) failure to act.

On Wednesday’s Agenda is Item 6a) “Discussion and Possible Action Including Approval of a Submitted Proposal to Facilitate the Strategic Planning Process for Mendocino County; and Conduction [sic] of an Interview with Applicant Bischoff Performance Improvement Consulting and The HR Matrix, LLC; and Direction to Staff to Negotiate the Contract Scope of Work for Approval at the Next Available Board of Supervisors Meeting. (Sponsor: Strategic Plan Ad Hoc Consisting of Supervisors Haschak and McGourty)” 

And if you think that sounds like a wonderful way to waste a lot of time and money on something that nobody wants or needs, you must work for Dr. Bischoff.

A large collection of generic material is attached to the item, including “Data Collection and Consulting Methodology — Bischoff Consulting will serve as the contracting entity for this consulting project. Meetings and consultations will be conducted via Zoom to the extent possible. Online surveys will be developed using the user-friendly Survey Monkey platform. We will create a dedicated DropBox folder to share documents with the Project Manager and Strategic Plan Task Force.”

Oh-oh, now it’s morphing into a “task force.”

Dr. Bischoff, a Sonoma County woman who is regionally famous for bigger money wasting exercises in the much larger county to our south, then adds: “Project Cost Estimate: This planning engagement [sic] is expected to cost $75,000 plus actual costs associated with travel (mileage, lodging, and meals) between Sonoma and Mendocino County and within Mendocino County. This cost estimate is based on a level of effort of 300 hours at a rate of $250 per hour.”

Supervisors McGourty and Haschak are taking the credit for the resulting $75k-plus “engagement” and whatever pile of ignorable paper and on-line “strategic plan” materials this booshwah artist will generate.

Meanwhile, the drought deepens, the fire season unfolds, Dr. Doohan continues with her $100k-a-year plus mystery activity to the end of December or longer, and HHSA will bumble along under as many strategically overpaid managers as Mendo’s newly “credentialed” executives can hire.