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Bedlam On Low Gap

Some call it a debacle, others a fiasco — pick your adjective — but the escalating disaster of the County’s privatized mental health serices is now so severe that two judges, Ann Moorman and John Behnke, have ordered Ortner Management to court to explain the clusterfuck at the jail.

In July of 2013 Mendocino County became the first county in California to outsource mental health services to a private company. The raffling off of governmental services  is ordinarily a specialty of Republicans, but how and why a Board of Supervisors, chaired by liberal herd bull Dan Hamburg, in an overwhelmingly liberal county like Mendo, blithely handed off a traditional government responsibility to an incompetent private Yuba City business is mystifying.

A preliminary word about Supervisor Hamburg's relationship to both Ortner and the Superior Court of this mutually back-rubbing county.

With mentally troubled persons stacked up at the County Jail last year, Hamburg's troubled son, represented free of charge by then-County Counsel Doug Losak, jumped the line, courtesy of Losak and Ortner, and was placed in Ortner's intensive care facility in Yuba City. Then, when it came time for Hamburg, a wealthy man, to pay his fair share of this expensive, tax-funded, County-sponsored sequestration, the Mendo Superior Court waived fees.

And that, dear reader, is the way this county works. The publicly-employed libs, including the libs sitting as judges, all know each other, look out for each other's personal interests, hire each other, constantly tell the rest of us how wonderful they are. They call the tune in Mendocino County.

And here we are with the unconnected mentally ill untreated and languishing in the non-therapeutic confines of the County Jail. (Supervisor Hamburg, of course, sits on the County's Mental Health Board where, with his own little service dog dozing in his lap, the Supervisor, who specializes in theatric anguish, always looks on very, very concerned.)

Whether all the wine and weed has caused an increase in local crazy people is not germane. The point is, Ortner, in return for $7-8 million public dollars annually, was supposed to handle the competency evaluations at the jail but has failed to fulfill his contract.

Let’s put a human face on the logjam and see what it looks like down at the jail:

1368a
1368b

Corey Allen Heine, Daniel Curtis Bettencourt, Robert Edward Verville, Shawn Carolyn Balictar, Brent Michael Haas, Pablo Benitez Mora, Diane Donna Zaccaria, John William Driggs, James Dalton Jenkins, Robert Garver Ficarra, Eric Roland Wright, Robert Ed Taylor, Jacob Eugene Sellmer…

These folks have been trapped at the jail, awaiting mental health services for so long they’re almost timed out, meaning back to the streets to begin another round of catch and release. Don't expect Ortner to provide interim mental health services.

Under 1368 of the Penal Code, Ortner is supposed to conduct examinations of the jailed mentally ill. These exams are called competency trainings. Are these people well enough to stand trial or, as is more likely, well enough to understand that they're in jail for having committed a crime, invariably of the misdemeanor type? (In living fact, any cop knows who's nuts and who isn't, but in our system liberal arts grads gotta get their share of the dough thrown at the mentally ill. Enter jackals like the Ortner Management Group.)

The required jail evals haven't been happening, and Judge Behnke, before he went on vacation last week, fired off a show cause order to Ortner that requires Ortner to explain why it hasn't been happening. Unfortunately, Ortner himself will be spared a court appearance. His surrogates, Tom Pinnizzotto and Stacy Crier, will do the talking for him.

A new hire at the County Counsel's office, but long-time Ukiah attorney, Katherine “Kit” Elliot, appeared in Judge Moorman's court Friday to make excuses for Ortner's dereliction. With an F sharp voice not far from finger nails and blackboards on the noise meter, Elliot assured the judge that there was indeed a competency restoration program in place at the jail, and there was nothing, nothing really, nothing to worry about, nothing at all and blah blah blah.

“Yes, we’ve had some setbacks, nothing serious, and Gay Holden is supervising that program now. There was only one little problem we had with Mr. Pablo Mora* in that we didn’t have a Spanish translator to translate some of the materials into Spanish. But that’s all taken care of now. We have Maggie Jones, and she’s been able to obtain a translator. So everything’s fine, just fine, only a matter of time, that’s all.”

On page five of Exhibit A, paragraph eight, of the County’s contract with Ortner, it says that Ortner “will provide cultural competence. The Contractor will provide an Ethnic Services Coordinator to manage all cultural competence requirements… will utilize industry experts to augment annual training for target populations in Mendocino County.”

Did it take the County two years to realize that Spanish was spoken by lots of people hereabouts?

The contract includes this Mendo-mandatory clause: “Areas of focus in the implementation of the cultural competence plan include, not limited to, eliminations of the disparities in service delivery to special populations (Latino and Native American clients.)”

Both the District Attorney’s Office and the Office of the Public Defender have been negatively impacted by Ortner’s failures to evaluate the County's incarcerated mentally ill.  Most of the people pictured above are clients of the Public Defender. No surprise there. The lawyers in Public Defender Linda Thompson’s office are the lowest paid lawyers around. Understandably, they become highly irritated with the Ortner people who bill the County $4.82 per minute to “restore competency” (mainly dispense "antipsychotic" meds) to their clients, under the rubric of “Medication Management and Support.”

Ms. Elliot didn’t address the reason the other 12 defendants were not being restored to competency – only Mr. Mora. Judge Moorman, bullshit detector hitting on all cylinders, told Elliot that Her Honor wasn’t impressed with her excuse(s).

“I’m going to order you, Ms. Elliot – along with Mr. [Health and Human Services Assistant Director Tom] Pinizzotto to appear in this court on Tuesday”—

“Sorry, judge, but can’t we make it. Wednesday, instead? Ms. Crier would be a better choice to appear with Mr. Pinizzotto, so if we could make it the 21st I’d feel a lot better about it.”

“Alright, Wednesday, October the 21st at 1:30 or I’ll hold Mr. Pinizzotto in contempt. There has been a failure of due diligence and I will not tolerate this situation to continue.”

The judge read off the names of the defendants listed above then said, “And that’s just the tip of the iceberg. You send this message back to Ms. Crier and Mr. Pinizzotto or whomever, but I’m going to start leveling fines. Have I made myself clear?”

An F-sharp squeak indicated message received, and Ms. Elliot blushed her way out of the courtroom.

Anthony Adams of the Office of the Public Defender has been Linda Thompson’s point man on the competency restoration issue. He sent me this email:

“Good afternoon, Bruce. You asked me to provide some additional information concerning the issues surrounding our County’s mental health providers and the competency training that is supposed to be taking place in our county jail.

“By way of background, once Defense counsel or the Court forms the belief that a criminal defendant is not capable of understanding the nature of the proceedings, the nature and/or consequences of the charges against them, and/or the client is unable, due to some diminished capacity, to assist their counsel in their own defense, a doubt concerning the criminal defendant's competency to stand trial is declared. Once that declaration is made, the Court will suspend the criminal proceedings in order to have a psychological evaluation done to determine whether competency to stand trial exists.

"Should the assigned psychologist determine that a criminal defendant lacks competency, and if the court adopts that finding, the question of how the defendant might be restored to competency is broached. In those instances where the defendant is facing felony charges, any restoration must occur at a State Hospital by operation of law (technically, non-violent felonies can receive outpatient treatment although this office has never seen it happen with our clientele).

"However, if the defendant's criminal charges are misdemeanors, the court has the option to assign County Mental Health Services to attempt restoration in the County Jail. In Mendocino County, the availability of local restoration training is a function of work done by local providers to develop and adopt protocols for restoration.

"Those protocols were developed, in some measure, to help stabilize a defendant's mental health as quickly as possible as well as to minimize the amount of time and resources it would otherwise take to restore a person to competency should that person have to be sent to an outside organization or agency for such services.

“Notwithstanding those goals, there have been a number of recurring problems that have frustrated the goals of expedited stabilization and restoration. Routinely taking between three to six months, the process for restoration has been lugubriously hindered by poor communication between all of the respective interested parties, by inefficiencies in the protocols (or sometimes the absence of protocols), and, arguably, general mismanagement by those assigned to the restoration process.

"Once a client's mental health has been substantively stabilized, the competency training itself can be accomplished in very little time (within a week or two in many instances).

“As you saw today in Court, Judge Moorman has grown increasingly frustrated by the delays in restoration and has subsequently ordered Mental Health and County Counsel to be present in court on Wednesday the 21st at 1:30 to provide an accounting for the seeming inefficiencies and delays.”

Judge Moorman also noted that the failures of due diligence on Ortner’s part had crippled the DA’s ability to protect the public. Ortner, for a buccaneer of free enterprise, isn't very good at it. Everyone directly effected by his alleged services is complaining that mental health services in this county have never been more faulty, if they exist at all.

Judge Moorman will cut through the fog sure to be run out in court by Pinnizzotto and Crier.

We'll be there.

-=-=-=-=-=-

* Pablo Mora, whom I've known from years on the streets of Ukiah, was timed-out and released later the same day. He's something of a pest to downtown businesses. I've seen him in action: "Gimme a cup of coffee, fucker, or I'll bust your windows." His English is fluent, by the way, right down to current profanities.  And he spits like a camel! Mora can shoot one in your face from halfway across the street if you tell him to knock it off. I went around the downtown area and tried to warn some of the business owners that he'd been released, but they were way ahead of me on that bulletin, battening down the hatches, calling in bouncers, distributing latex gloves, Tyvek suits, and surgeon's masks. Pablo's loose!

Thank you, Mendocino County, thank you Tom Ortner of Yuba City for giving us the worst mental health services for the most money in California.

21 Comments

  1. Bruce McEwen Post author | October 21, 2015

    Blistering scolding in The Hon. Moorman’s court this afternoon. The judge made it clear her censure was not to be absorbed or deflected by county counsel, Katherine Elliot. Mr. Pinizzotto entered the courtroom a tall, dignified man with a stately bearing, but slunk out looking much diminished, afterwards. Full report next week.

    • BB Grace October 21, 2015

      It’s my understanding that people have the right to refuse “meds”, and that service providers contracted with Ortner and the County have established rules (Hmm must be some laws to back them up) that the service provider has the right to refuse services to any person using marijuana, drugs &/o alcohol.

      Am I wrong? Do you see how this is a problem if I am correct? Marijuana Culture is recognoized by the state, why not Mendocino County Mental Health Services?

      Something else I’m not getting is the relationship between the Mental Health Board and Ortner/ Redwood Quality Management, in that The Board is established from Proposition 63, which provides funds for THE PEOPLE of Mendocino for Mental Health.. some counties build community gardens and arts (occupational therepy for example). Is The Mental Health Board’s Prop 63 money paying Ortner the millions? If not, then why is Ortner reporting to the board? It’s not the Boards Prop 63 money, then it’s nice to get data dashboards and iCMS reports from OMG, but if the Mental Health Board is not paying Ortner, then isn’t it the Mental health Board’s business to mind the Prop 63 money?

      The Mental Health Board treasurer’s reports are concerned with the $10K the Mental Health Board is alloted for member expenses (gas/food). I have never seen any data on the Prop 63 funds Mendocino County receives, and have no idea where that money is going besides $10K to the board.

      Services provided by Mental Health Board have a seal, a Prop 63 logo. Ortner Management Group created a beautiful flyer with the Prop 65 logo. Many Mental Health Services Act events have the Prop 63 logo, but nothing that I ever saw the board work on or vote on, such as the Ortner flyer.

      Looking forward to your full report.

      • Bruce McEwen Post author | October 23, 2015

        If you google 1368 through 1370 of the Penal Code you’ll see how state law applies to forced meds; as for how the relationship between the OMG and MHB works, I wouldn’t trust either entity to be candid. In fact, to me, it more resembles one of those co-dependent marriages where both parties are in denial and paint an unbelievably rosy picture for the public. As for Prop. 63, I need to do some study on that subject. Thanks for the lead.

  2. Nancy October 23, 2015

    Regarding County MH finances, I refer you to the County Annual Budget, Schedule 9 for Budget Units 4050 and 4051. I’m the first to agree that even with the explanatory narrative they are not clear or tranparent to the general public. Also, note that the actuals for 2014-15 only go through May 30, 2015…not the full fiscal year. June is apparently a big revenue month…no projections are available.

    I also recommend you read the MHB’s Annual Report, especially the report prepared by the ad hoc Finance Committee which is attached. The full report is posted on the County website. It’s a little hard to find….Health and Human Services to Behavioral Health and Recovery Services to Mental Healh, to Mental Health Board…Annual Report.

    I Hope this helps clarify what is easily accessible as well as the challenges inherent in making a connection between the revenues, allocations and delivery of services.

    Thank you, We all need to keep asking the hard questions.

    Nancy Sutherland
    Chair: MHB ad hoc Finance Committee (2014-15)

  3. Bruce McEwen Post author | October 23, 2015

    There is certainly more interest in this story than I usually get from the readers, and I grasp the urgency, the peril we’re all in from a vast portion of the society having gone totally batshit, and the rest trying to capitalize on the phenom. My 4th wife was a mental health pro, having learned the trade from delving (perhaps too deeply) into her own psychosis. Mr. Ortner, in his interview with the Willits Weekly, says much the same thing: he came from a long line of psychotic specimens and asserts he’s one himself; so truly, it is the blind leading the blind throughout the Mental Health Industry,? My limitation as a courthouse hack keeps me from following up on your pertinent reading list. I have to cover a great many kinds of crime and cannot specialize in a general interest column, or spend more than a few inches on politics. My readers demand the spice of variety. (If you’ve ever been in jail, you will know that America’s Stupidest Criminals is the most popular TV program.) You, on the other hand, could expound rather thoroughly on this particular problem, with a bit of encouragement, I suspect: Please do! Your writing is as concise as your reading is large, and your insights are significant.

  4. J. Holden October 24, 2015

    Mr. McEwen,
    I read with great interest your 10/21/15 front page article “Bedlam on Low Gap” regarding the training program at the jail for defendants found not competent to stand trial due to a mental disorder. Since I created and continue to be involved with this little program under contract with Mental Health (not OMG) I would like to comment.
    The article provided some useful information, although some of it inaccurate, including the fact that my first name is not “Gay”. Close, but no cigar.
    Your article focuses on Judge Moorman’s understandable dissatisfaction with problems of delays between court orders for competency training and the subsequent authorization for the training to begin. However, it’s important to note that once our program itself receives Mental Health’s authorization to begin services, it is tremendously effective and efficient.
    In its first year this innovative program saved taxpayers an estimated $800,000 and saved mentally ill defendants over 2200 days of locked confinement in jail and state hospitals. The average wait time for training services was reduced from months to days, with a much higher rate of successful outcomes than under the previous system at state hospitals. The reduction in human suffering is incalculable.
    Also, I’m not sure where you got your figures, but the actual cost of our program is a small fraction of the amount incorrectly reported in the article.
    The referral delay problems that Judge Moorman is addressing with Mental Health are being remedied, as was the translator delay problem in Mr. Mora’s case. In the meantime, the training program we contract to do will continue to provide low-cost highly effective competency training services to mentally ill defendants willing and able to participate in the program.
    These positive facts may do little to “fan the flames of discontent” which the AVA declares as its mission on its masthead. Nevertheless, I would hope the public may be pleased to know the facts and figures of this important program.
    J. (not “Gay”) Holden, PhD

    • BB Grace October 24, 2015

      “J. Holden presented his Competency Restoration Program, for inmates that are not competent to stand trial. Typically, inmates must wait for a state hospital program for this restoration; this could take a year or more. J states that using his current curriculum, he could do the work in the local jail in 1 to 4 months, for $1500 per client, or $15,000 with a minimum of 10 clients annually.”

      http://www.co.mendocino.ca.us/hhsa/pdf/MHSA_December_Community_Innovative_Planning_Meeting_2014.pdf

      Is your Competency Restoration Program paid from the Prop 63 funds?

      Mr. McEwen’s article shows 14 pictures. How does your program work when you are limited to serve 10 people leaving 4 people not being served? Or are none of the 14 people pictured being served because they are active substance abusers?

      Something needs to be done about the “trimmigrant” population because this refusing to serve them is not what tax payers are paying for you know?

      You’re a tax payer. You see these same people. Why are we seeing these people if your program is working? How is your program saving anyone money when we are still seeing the same people on the AVA’s Daily Catch?

      • BB Grace October 24, 2015

        Oh Minumum served is 10.. so all 14 and more would be involved in your program. So why are we seeing their mug shots in the AVA?

      • J. Holden October 24, 2015

        BB,
        Very good questions. Thank you for asking them.
        1. I don’t know what funding source Mental Health uses to pay for this highly effective, humane, and cost-saving program.
        2. The program began as a Mental Health pilot project limited to 10 cases, to prove its value before committing to it further. That proof has been made and the program does not currently have a limit on referrals, except that people charged with felonies are the state’s responsibility to train. If the state or anyone else would provide funding, we’d be happy to serve that population too. I’m open to any and all suggestions.
        3. Whether or not a mentally ill person is a substance abuser or “trimmigrant” has no bearing on their eligibility for this service. The only criteria are that he/she is a misdemeanor defendant with a mental illness that renders him/her not competent to stand trial.
        4. A number of the defendants pictured in the article either are or have been served. Mr. Mora, cited in particular by the article, was rendered competent quickly once a translator was found. The Judge’s problem was with how long it took Mental Health to provide a translator, not with the training service itself, which is a program that the judges pushed to have created.
        5. The major problem of recidivism which you point out has nothing to do with this program. The program’s only purpose is to train mentally ill defendants how the law works and how to arrive at a rational defense strategy. Unfortunately, even after the training and resolution of the case, some of these folks do get themselves in trouble again once released. The program does work better at cost-effectively training these defendants than any alternative my several years of research has been able to find. But it is not a program designed to fix people’s mental illnesses or prevent them from becoming repeat offenders.
        6. Does our program work? We have a high success rate at rending defendants competent, and we do save the taxpayer hundreds of thousands of dollars. However, there are several reasons our program may not “work” with an individual. Most common are the defendant’s refusal to participate in the program being offered, the defendant’s lack of mental capacity to learn what it takes to become competent, and/or the defendant being in such a psychotic state that he/she is highly irrational, agitated, and uncooperative with our offerings. Our program has no control over these issues, which are sometimes overcome once the person clears from street drugs and stabilizes on medications, which can sometimes take weeks.

        J. Holden, PhD

        • BB Grace October 24, 2015

          Thank you Dr. Holden.

          Your appreciated and informative letter had me wondering what happened to Talon Barton? I guess you didn’t train Mr. Barton because his felony would have the state train him?

          Dr. Holden, I don’t know much about criminal law while I’m trying to understand what’s happening with mental health in Mendocino County. How could Mr. Barton be trained as compentent? I apologise for my lack of professional vocabulary, still, Talon Barton’s case bothers me as the ultimate FAIL in services.

          And I’m curious about the Stepping Up Iniative, as I’ve been following the webinars and see that people such as yourself are part of the soultion at meetings creating a County mental health system that works for everyone. Does the Stepping Up Iniative work for you?

          Thank you for helping me understand what’s going on with mental health in Mendocino County.

          • J. Holden October 24, 2015

            I’m not familiar with the Stepping Up program.
            As I mentioned, felony defendants such as Mr. Barton are not currently eligible for our training service funded by county Mental Health. Training felony defendants is the state’s Department of Mental Health’s responsibility. It’s too bad, because (1) defendants are routinely overcharged in anticipation of a plea bargain that often ultimately reduces the charges to misdemeanors, and (2) our local program is far more cost-effective and responsive than the state hospital option and could very easily be used with felony defendants.
            As I mentioned, I welcome any and all ideas about how we can get funding to provide competency training to felony defendants in our jail. I’m constantly looking out for this but haven’t found a funding source yet. Meanwhile, we are stuck with a waiting list for defendants to get into an expensive, inhumane, and marginally effective state hospital training program. Until we started this innovative local program, that was the only option for misdemeanor defendants as well.

        • BB Grace October 24, 2015

          Dr Holden,

          Thank you for taking the time to answer my questions and help me understand mental health services in Mendocino County.

          The Stepping Up Iniative has grants available through different organizations involved. The Justice Center was offering grants recently.

          I suggest watching the Video of Judge Leifman first as he is the one with the original motivation, and I think you will relate. https://stepuptogether.org/

          The webinars are good food for thought on solutions.

          In appreciation BBG

    • Bruce McEwen Post author | October 25, 2015

      Dr. J: Thanks to your assurances we can all heave a heavy sigh of relief that there was never a problem to begin with and whatever illusion the judges had that there was a problem was being swept away long before the order to show cause was issued. Your tone of breezy insouciance, the smug simper inherent in your comments, should go a long way to reassure the public that your are in command of the situation and there’s nothing for silly people like myself and the judges to concern ourselves with. Much relieved. But tell me this, Doc. Do they teach all that condescending arrogance at psy-school or is it a natural gift for chaps like you and the Ortner cadre?

      • J. Holden October 25, 2015

        Out to kill the messenger, are you?
        I never said there was “no problem” (there are plenty), that I am “in command”, or that my career has been a “sacrifice”. Your words, not mine.
        Never heard my writing style described as “breezy insouciance” (whew!), “smug simper”, and “condescending arrogance”, although it leads me to wonder if instead you are perhaps describing your own gleeful mudslinging, fact-distorting, name-calling, hyperbolic, ridiculing, sarcastic, ill-informed, journalistic style of vitriolic mockery. I hear “The Onion” and Fox News are looking for such writers.
        Goodness, here I’ve gone and sunk down to your level of toxicity. Shame on me. Won’t happen again.
        I’d suggest that you as a self-described “courthouse hack” do your journalistic homework (such as getting names and facts right) and see what you might do from your bully pulpit to improve things rather than posing as a heroic stone-thrower. For starters, please please help find funding to enable extension of our training to the many felony defendants rotting in jail cells waiting for state hospital openings.

        J. (not “Gay”) Holden, PhD

        p.s. Whatever is “4thw/”?

        • Bruce McEwen Post author | October 25, 2015

          Come on, Doc. It wasn’t such a long drop from your prim and stately fastness to the seedy warrens of modern newsmongering, and you took to it like a worm to a rotten apple… second nature, I suspect, eh Doc? Sure, it would be nice (for you) if we could all follow the lead of the NY Times and better learn to appreciate our betters. But from my perspective out here on the streets with the people you are so lavishly paid to “train,” it looks like we’ve already found too much funding for fellows like yourself. Maybe it’s time you spent a little time behind bars — ever contemplate the efficacy of that, Doc?

  5. Judy Valadao October 24, 2015

    OMG is a profit making business making its money off the misery of others. The less they spend or do, equals more into their pocket. Perhaps that is why so little is being done for those in need.

    • J. Holden October 24, 2015

      Judy,
      I wish it were as simple as that.
      Every person or agency providing service to people with mental illness can be said to be “making its money off the misery of others.” But I’ve been in the field for nearly 50 years (did my internship at Mendocino State Hospital), and in my mind the most serious problem is the huge reduction in funding of mental health services, whether the services are being provided by private or public agencies, profit-or non-profit. This is a national issue.
      In the names of “deinstitutionalization” and “community mental health” the politicians have ripped away funding for mental health services year after year, resulting in our nation having the same number of psychiatric beds per capita that it had 150 years ago. This has produced homelessless and hopelessness, and left overcrowded jails and prisons to become the default mental health treatment centers, for which they are not adequately trained or funded.
      It would do those politicians well to spend time behind bars themselves and be put on a state hospital waiting list.
      J. Holden, PhD

      • Bruce McEwen Post author | October 25, 2015

        Yes, by all means, put the politicians behind bars — all but Dan Hamburg (he’s too cool). As for your 50 years of sacrifice, Doc, I think you should get your statue put up in the foyer of the new courthouse, and also be paid 4thw/ the $800K you saved the county.

  6. Fix it October 24, 2015

    It seems that there are very few really good mental health healers.

    Most doctors seem to rely on Drugs that cause many problems and fix few. Pharma
    horror stories are endless.

    Historically State Hospitals have been nightmares of abuse.

    Perhaps we need to re-think The whole mental health issue.

    What are other advanced countries doing?

    There really has to be a better way!

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