Los Angeles County supervisors voted Tuesday to move toward consolidating three departments dealing with different aspects of public health. But they did so over the objections of mental health advocates who worry that mental health services will get buried in a larger health agency.
The move, proposed by Supervisor Michael D. Antonovich, would consolidate the departments of public health -- responsible for controlling disease outbreaks, managing substance abuse programs and conducting health inspections -- and mental health with the Department of Health Services, which runs county hospitals and clinics.
Antonovich said a unified health agency would streamline costs and provide more comprehensive service to patients.
Proponents -- including health services director Mitch Katz, who would probably be tapped to run the consolidated agency -- said the three departments would maintain separate budgets and have their own directors but would be overseen by a single director.
"I believe that having the three health-focused departments working more closely together will provide better services to patients and result in less bureaucracy and better efficiency across the county," he said.
Dozens of mental health service providers, advocates and people dealing with mental illness expressed concerns at Tuesday's supervisors meeting.
"Mental health, addiction medicine and population health...are as important to the overall health of the community as good physical health, and need to be equal partners in the dialogue," Richard Van Horn, president emeritus of Mental Health America of Los Angeles, told the board.
Others said mental health would inevitably become a "stepchild" in a larger agency. Some advocates also complained that the proposal appeared to be getting pushed through without sufficient discussion with the people who would be affected
Larry Gasco, chairman of the county's mental health commission, said the volunteer commissioners only found out about the proposal last Thursday. Officials in the mental health department had learned of the proposal a couple of days earlier.
"Blindsided is a kind word," Gasco said.
As a result of the reaction, supervisors agreed to include public health and mental health officials -- as well as officials from the Sheriff's Department and stakeholders from outside the county -- in the process of coming up with a proposed structure.
The supervisors also sought to allay the fears of some county employees and labor leaders that the consolidation would mean job and service cuts.
"This is not about cutting dollars for services," Supervisor Mark Ridley-Thomas said. "What it is about is better coordination and integration."
A report is due back in 60 days on the proposed structure for a consolidated health agency and potential benefits and drawbacks of moving ahead.