Behavioral Health Unit Threatened With Funds Cut

State Sen. Cathie Wright jumped into Ventura County’s turf war over mental health services Friday, threatening to cut off millions of dollars of state funding for the troubled Behavioral Health Department if personnel continue to be forced out.

Wright blasted Health Care Agency Director Pierre Durand for sweeping out department Director Steve Kaplan and two of his top aides. The move threatens to undermine the reputation of the county’s mental health agency, which serves as the state’s model for patient care, Wright said.

Should Durand’s revamp of Behavioral Health disrupt the Systems of Care, a team approach to mental-health treatment, the Simi Valley legislator said she will urge state officials to cut off the $5.4 million the county receives each year to both serve as a model and provide training to other counties.

“If they ignore me, they don’t get funded,” Wright said.

The battle began in April when a sharply divided Board of Supervisors voted to merge Behavioral Health with the Public Social Services Agency. After the federal government threatened to cut millions of dollars of health-care reimbursements, the county quickly dismantled the superagency. Kaplan’s support of the merger sparked an intense political skirmish with Durand, his boss.

Wright’s threat carries weight because she sits on the powerful Senate budget subcommittee on health and human services. She also has influence as the lawmaker who sponsored the 1984 legislation that created the reforms contained in Systems of Care.

The reforms have worked so well they have been copied in 41 counties. Under the program, psychologists, probation officers, educators, social workers and psychiatrists work together on teams to treat individuals.

Wright is concerned recent moves by Durand to oust political foes in the Behavioral Health Department and replace them with an administration top-heavy with psychiatrists will result in a medical focus to treatment. That would violate the collaborative premise of Systems of Care, she said.

Ventura County is also obligated to provide technical assistance and training to other counties that are putting Systems of Care into place, Wright said. Some of the Behavioral Health Department employees being ousted are “the heart of the program,” the senator said.

Kaplan, for instance, was among a handful of county officials who launched the reforms here in the mid-80s.

“They get additional funding because they are to use their staff to go out and help other counties. Well, if they are not doing their job, they are not going to get the funding,” Wright said.

Durand wants a tight rein on the Behavioral Health Department, Wright contends, because he uses its revenue to cover costs at the Ventura County Medical Center. Before Durand took over the Health Care Agency in 1996, the county hospital was operating on deficits, she said.

“He found a way to get the hospital out of the red and he stuck with it,” Wright said.

Chief County Administrator Lin Koester met with Wright on Friday, but said he would not discuss details of their conversation. He confirmed, however, that he will order an audit of Health Care Agency budgets next week to address Wright’s concern about a diversion of funds.

“We will review any such issues quickly and thoroughly,” Koester said.

Wright described the internal battle as a turf war between psychiatrists and psychologists. She said she blames Durand for the unrest because “if he had left the department alone, he would not have this situation.”

Last month Durand forced Kaplan and his two top aides to go on leave. Under a draft organizational chart circulated this week, four psychiatrists would be elevated to top management positions, county sources said. The doctors are all political allies of Durand, the sources said.

“This is 110% political payoff,” one longtime Behavioral Health employee said.

Dr. David Gudeman, a psychiatrist who has worked for the county less than two years, is slated to assume the twin titles of acting director, replacing Kaplan, and acting medical director, replacing Dr. John Wong. Drs. Gerome Lantz, Craig Duncan and Timothy Tice, now working in mental health outpatient clinics, are tapped for other top positions, sources said.

Durand did not return phone calls seeking comment. Supervisor Frank Schillo, a supporter of the reorganization, did not dispute that Kaplan and the others were being ousted for opposing Durand.

“That’s the way we all live in society,” Schillo said.

But the reason they are being replaced with psychiatrists is to satisfy the concerns of federal officials looking into the department’s billing practices, he said. Patient care will not suffer, Schillo said.

“The requirement is that there has to be a direct line of responsibility through the doctors. . . . There is a team approach. You just don’t ignore the doctor.”

But Supervisor John Flynn, considered the swing vote on this issue, said it may be time for top county managers and policymakers to sit down and hash out the feuds and arguments over fiefdoms. The rancor surrounding the failed merger attempt has gone on for too long, the 24-year supervisor said.

“This is one of the most serious organizational problems I’ve encountered in county government,” he said. “Everyone needs to take a deep breath before acting further.”