Decision on Merger Was Reasoned and Rational

As a member of the Board of Supervisors who voted in favor of merging the Public Social Services Agency (PSSA) and the Behavioral Health Department (BHD), I am compelled to respond to your editorial comment on this matter, “Protect the Mentally Ill,” Sept. 27.

You contend that the merger was done in a hasty manner. To the contrary, the decision by the board was made with considerable forethought and analysis. During county budget hearings in June 1997, the board voted 5-0 to direct the chief administrative officer (CAO) to review, study and report back within 90 days on the advantages and disadvantages of the merger.

The CAO solicited ideas on restructuring from a wide spectrum of county staff. He also advised the board that the 90-day time frame should be postponed until the state’s welfare reform legislation was enacted and the PSSA director was hired.

Since then a number of important processes have been initiated. Preliminary discussions on the potential restructuring were held with the regional office of the California Department of Health Services, which is responsible for medical and mental health licensing. Staff from the Department of Health Services indicated that with the licensee being the county Board of Supervisors, licensing would not be a problem with the restructuring.

The CAO also commissioned Deloitte & Touche L.L.P., a nationally recognized audit firm with expertise in health care finance, to study the potential financial ramifications of restructuring. Deloitte & Touche conducted a thorough analysis and issued a report to the CAO. The report concluded under various options, including merging PSSA with the BHD, there would be no negative financial impacts.

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In addition to these efforts, individual board members spent large amounts of time speaking with a wide variety of constituent groups and county staff regarding this issue.

When the time came to decide this issue, I was fully informed and prepared to enact a policy that was in the best interest of serving various populations the county has a primary responsibility to, including the mentally ill.

Regarding the federal government rejecting the merger: It has not. The federal government rejected a draft delineating the relationship between the medical system and the mental health system. I have requested that staff survey other counties to see how their systems operate. The analysis has confirmed that counties have considerable discretion. What we are doing in Ventura County is well within the acceptable parameters.

I assure you, this Board of Supervisors will continue to work with the appropriate regulatory agencies to secure the necessary agreements to protect funding.

The assertions in your editorial that care for the mentally ill will be driven by welfare work requirements and that treatment will be directed by welfare social workers are not accurate. If they were, I would not have supported it. The reality is that the Behavioral Health Department’s director has been a licensed clinical social worker for the past 12 years, similar to the other 54 counties in the state. I must also point out that during that period, Ventura County was recognized throughout the state and country for its treatment of those with serious mental illnesses.

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The National Alliance for the Mentally Ill in a recent press release indicated the importance of vocational rehabilitation, employment assistance, provisions for support services to ensure medication compliance, and assistance with daily living in conjunction with quality medical services as essential components of successful treatment. I too believe this not only to be important but essential.

This merger will keep in place the successful elements of the Behavioral Health Program while creating greater access and support services for severely mentally ill individuals. The highly trained, skilled and experienced mental health professionals will remain in charge of the Behavioral Health Department operations within the Human Services Agency structure.

The Ventura County Board of Supervisors has a long track record in support of services to the mentally ill. I assure you this commitment continues today and will in the future.