Supervisors Vow to Stop Mental-Health Feud

Reeling from a scathing state report on the county’s mental health program, supervisors Wednesday pledged to stop the bickering that has endangered millions of dollars in state and federal aid and mired the mental health department in chaos.

Supervisor Judy Mikels said change must start with the board, which has been split into warring factions for more than a year on mental health issues.

“We have some very divisive parochial issues that we need to deal with,” said Mikels. “The report gives us the vehicle to clear the air, get everybody to back off, back down and be quiet.”

But even as they spoke of consensus, board members disagreed over how to reach it. A majority of supervisors reaffirmed their commitment to quickly appoint acting Behavioral Health Director David Gudeman as permanent head of the department.

Supervisors Mikels, John K. Flynn and Frank Schillo say the move is necessary to bring stability to the department. That would be the first step in responding to a state audit released Tuesday that is highly critical of the county’s mental health programs.

But board Chairwoman Susan Lacey and Supervisor Kathy Long insist that Gudeman does not have sufficient experience to manage the mental health department’s $50-million budget and 550 employees. They say a broad search should be conducted to find a replacement for former director Stephen Kaplan.

“If we bring in the right person to head the agency, we can get this all untangled,” Lacey said. Gudeman is favored by one faction on the board--Flynn, Schillo and Mikels--who support the fiscally conservative policies of Health Care Agency Director Pierre Durand.

The others oppose recent changes made by Durand.

The audit released Tuesday by the state Department of Mental Health documents a deterioration in services that has occurred over several years. Auditors say an atmosphere of fear and intimidation exists between managers and mental health staff.

Too many patients are being unnecessarily hospitalized and the role of psychiatrists on mental health teams has eroded, the reviewers found. Mental health care has declined so much that Ventura County no longer qualifies as a state model, which has brought $5.4 million in extra funding each year.

Dr. Stephen Mayberg, director of the state’s Department of Mental Health, said Wednesday it is difficult to pinpoint when an erosion in Ventura County’s programs began.

A “benign neglect” occurred over several years as top managers in the county’s health departments were replaced, Mayberg said. The new managers, including Kaplan and Gudeman, had less knowledge of how the state’s “Systems of Care” programs should be run, he said.

“When people move on, some of that history is lost,” he said.

Ventura County will lose its allocation unless it commits to reinvigorating its mental health system, Mayberg said. The county has until July 1 to tell the state agency whether it intends to file a written plan of correction.

“We would hope because of Ventura County’s history of leadership . . . that they will choose to reinvent their program,” Mayberg said.

Tuesday’s audit was the latest salvo in a long-running battle over how the mental health department should be run. Last year, the county attempted to merge its mental health and social service departments. But it rescinded the action after federal regulators found that the merger violated Medicare billing rules, endangering millions of dollars in federal aid.

Durand then ousted Kaplan, who fought for the merger and was an ally of Lacey and Long. Then state Sen. Cathie Wright (R-Simi Valley), another ally of Long and Lacey, called for a state audit of programs and finances.

On Wednesday, supervisors had differing opinions on how to begin rebuilding programs. Mikels suggested the county bring in a paid referee to meet with the Board of Supervisors, mental health managers and staff, patients and families to hash out differences.

But Flynn said Gudeman should be appointed and given the immediate task of drawing up a rehabilitation plan. The proposal would then be discussed with the Mental Health Board, a community advisory group, and the Board of Supervisors before being sent to the state Department of Mental Health, Flynn said.

The trick, of course, is getting everyone to sign on. Lacey said that while she disagrees with her colleagues on Gudeman’s appointment, she is willing to listen to proposals.

“We need to get a plan in place quickly and we need to do it seriously,” Lacey said. “I’m sorry it had to be so negative before we could get to a place where we can solve our problems.”