Politics, Not Statesmanship or Service, Guides Mental Health Wrangling

In times of crisis, taxpayers look to elected officials for statesmanlike leadership. Instead of a statesman, Ventura County has been saddled with a venomous state senator who vows revenge on administrators she doesn’t like by seeking to block mental-health funds to the county she was elected to serve.

When I recently asked state Sen. Cathie Wright (R-Simi Valley) about the progress of Assembly Bill 34--the bill intended to provide state funding for special outreach programs for counties with a high population of homeless mentally ill--she replied that she will personally block this county from ever seeing “one penny of new state funds.”

Sen. Wright’s retribution--stripped of even a pretense of statesmanship--is motivated by political “spite-manship.” Above the welfare of mentally ill county residents, Wright places her need to defend decade-old illusions spun to glorify a state program she created, the Ventura Model Systems of Care.

Many believe this model never lived up to claims of increased outreach, a single point of responsibility and 24-hour access to care. The newly developed teams kept banker’s hours, and the crisis team was notoriously unresponsive. Even though an October 1995 independent study by Lewin-VHI Inc. revealed that the emperor had no clothes, the state Department of Mental Health and our local mental health director did not make this information public.

As Sen. Wright stated in a Ventura County Perspective article (“Politics Obscures the Nature and Value of Systems of Care,” July 25), the Ventura model mandated clear and measurable goals and continuous evaluation. Yet when advocates repeatedly asked for statistics to substantiate improvements in care and independent living success rates, neither Randy Feltman nor his housing coordinator or placement officer could or would provide them.

Sen. Wright labors under the impression that Systems of Care made possible the hiring of a full-time housing coordinator, leading to development of Las Posadas, a 30-bed residential program for the mentally ill. Systems of Care did not provide the funds and neither did the housing coordinator have a great deal to do with creation of Las Posadas.

The housing coordinator who Sen. Wright fumes was let go in 1995 (in fact, it was 1997) did little to create housing with supports for mentally ill people unable to live independently. The coordinator helped ill people obtain vouchers for scarce but existing federal housing, little more. And once a person was finally placed, there was insufficient follow-up and supervision.

This coordinator should not be confused with the Behavioral Health Department’s new five-year housing program under development by Lynn Aronson, a nationally recognized housing authority who understands the need for a spectrum of services, not the least of which is supervised residential care. If Sen. Wright has her way, funding for this critical program will never reach Ventura County!

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The absence of properly supervised residential care facilities appears to be a direct result of the emphasis on independent living by those administering Systems of Care. It’s deplorable for a county of nearly 800,000 to have only one quality 30-bed residential care facility when 2.2% of the population suffers from schizophrenia or manic depressive disorder and when 1,000 homeless mentally ill people live under bridges and in alleys and river bottoms.

Sen. Wright is piqued that county officials suggested that the penalties incurred by the county for fraudulent billing practices over the past eight years might have had something to do with state-funded Systems of Care. Yet it seems more than coincidence that the Cathie Wright Center for Technical Assistance for Children’s Systems of Care published a manual titled “Developing Blended Funding Programs for Children’s Mental Health Care Systems.” This manual teaches counties to convert unbillable social services into billable Medi-Cal dollars by running the funds for “one hot second” through the Department of Mental Health, after which they can be “given to another agency.”

Sen. Wright objects to Dr. David Gudeman’s new Behavioral Health administration because she chooses to believe that physicians in leadership roles will minimize the important contributions of social workers and erode Systems of Care, with its emphasis on teams of mental health workers. However, the Wright-mandated state audit concluded that the role of psychiatrists had eroded under Systems of Care. To comply with federal Medicare policies, psychiatrists, not social workers, need to make medical decisions. Correcting this imbalance is financially and medically necessary. Yet social-model proponents, fearing loss of their leadership position, repeatedly ignore Dr. Gudeman’s assurances that he has no intention of undermining the teams and the important support services they provide.

Sen. Wright has publicly accused Pierre Durand, head of the Health Care Agency, of siphoning off realignment funds intended for the mentally ill. A visit by advocates with the county Auditor’s office, as well as a review by the Sen. Wright-mandated state audit, has proven that accusation unfounded. Even so, Sen. Wright continues to disregard statesmanship-like efforts to approach her perceived political enemies personally and work out honest solutions.

Sen. Wright would rather hurl accusations and punish the helpless--the constituents she claims to care about and was elected to represent.

Susan Vinson is the owner of Business Digest and The Working Parent publications. She serves on the board of the National Alliance for the Mentally Ill, Ventura County Chapter.

Defense of the Systems of Care model has taken precedence over actual care for the mentally ill. Billing problems and emphasis on teams versus physician leadership point up two problem areas.