Agency Creation Too Hasty

Like a cartoon character running off a cliff, the Ventura County Board of Supervisors got several steps into thin air before it glanced down and realized it had a bit of a problem.

The mad dash came last month, when the board voted 3 to 2 to pull the county’s Behavioral Health Department out from under the Health Care Agency and graft it onto the Public Social Services Agency, renaming the whole shebang the Human Services Agency.

The oops came when a legal consultant warned that the merger, if not carried out correctly, could wind up costing the county $15 million or more and possibly lead to revocation of the operating license for Ventura County Medical Center’s mental health wing.

Uh-oh.

So last week the board majority tippy-toed back to safety by temporarily placing the new agency in custody of Chief Administrative Officer Lin Koester. The problem is that all doctors who work for the county need to report to an agency that holds a state medical license--and the shuffle left mental-health doctors uncovered. Placing Koester in charge of hospital administration for 60 to 90 days will buy the county time to get proper licenses in place for the new approach.

This episode illustrates a larger problem. The board rushed into large-scale realignment with too much haste and too little attention to detail, over the no votes of Supervisors Judy Mikels and Frank Schillo and against the recommendation of Koester himself.

In creating the county’s largest agency, the board took less time than it routinely takes on far less weighty matters. It offered no opportunity for public comment.

And judging by the hasty backpedaling on the license issue, it left at least one legal pitfall unforeseen.

What’s the rush?

Proponents of the merger, which creates an agency similar to those already in operation in Riverside and several other counties, say it will lead to a more “team-oriented” approach to treating the mentally ill, with psychiatrists and social service employees working hand in hand.

Opponents say the team approach will erode the authority of doctors to make medical decisions about their patients and will prevent the county from seeking Medi-Cal reimbursement for patients they treat.

Moreover, Mikels and others have questioned the true motives behind the change, arguing that it has more to do with personal squabbling and turf wars among certain bureaucrats and politicians than an intent to improve public services.

The merger would shrink the kingdom of Health Care Agency Director Pierre Durand and enlarge that of PSSA Director Barbara Fitzgerald and Randy Feltman, designer of the county’s welfare reform strategy--two results not likely to displease Supervisor Susan Lacey, who has most strongly pushed the plan.

Whatever its impetus, creation of the Human Services Agency clearly has begun without sufficient planning and debate. We urge the Board of Supervisors to wait on solid ground long enough to determine whether this next step is a safe one.