Mental Health Chief Resigns Amid Feud With Boss

Stephen G. Kaplan resigned Monday as director of Ventura County’s Behavioral Health Department, saying he can no longer lead the department because of feuds with his boss, Health Care Agency Director Pierre Durand.

Kaplan, who at Durand’s insistence had been on a monthlong leave, said his departure was inevitable in the wake of a disastrous attempt last year to merge Behavioral Health with the county’s social services agency.

Kaplan supported the merger, but Durand opposed it.

Federal authorities ruled that the reorganization violated billing procedures, and they have threatened to withhold county reimbursements. As a result, county supervisors rescinded the merger Dec. 22, eight months after it went into effect.

“It is well-known I have significant philosophical differences with the Health Care Agency administration on the purpose/role of Behavioral Health, how it should be operated and its future,” Kaplan, 48, wrote in a memorandum announcing his resignation. “Given these circumstances, it would not be good for me personally nor the department . . . to continue.”

Kaplan’s announcement comes days after state Sen. Cathie Wright, who sits on a key finance committee, threatened to cut off $5.3 million in annual funding for the county’s mental health agency. The Simi Valley Republican said she was worried that changes in management could undermine the county’s reputation as a model for delivering quality care.

But Dr. David Gudeman, who was named acting director of Behavioral Health last week, insisted Monday that there will be no substantive changes in patient care. Gudeman, 39, said he is committed to the idea that psychiatrists should collaborate with social workers, psychologists and others to provide the best possible mental health services.

“When I was a resident, I used to come up here and moonlight because I appreciated the system so much,” said Gudeman, a psychiatrist and internist. “I’m committed to the team process.”

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Behavioral Health employees had been waiting for word of Kaplan’s fate since Jan. 29, when Durand forced Kaplan to take a 30-day leave. Three of Kaplan’s top deputies have been ousted or reassigned.

Although Kaplan’s resignation was not a surprise, his memo was a blow to many in the 560-employee department, county sources said. Kaplan earned the respect of staff during his 18 years in county government, the sources said.

“It is heartbreaking to see someone so decent and honorable go down like this,” said one longtime employee.

Kaplan said he is saddened to step down, but saw no other choice.

“I’m obviously highly disappointed that it ended this way. It wasn’t something that I ever dreamed could happen,” he said. “But there is really no place for me to operate.”

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He and his wife, Susan, will continue to live in Ventura, Kaplan said. He plans to find work as a consultant in mental health and social service fields.

Durand declined to comment Monday.

Disagreement over Behavioral Health’s operations festered quietly until the merger attempt failed. A majority on the Board of Supervisors supported combining Behavioral Health with the county’s social services agency to form a larger Human Services Agency.

But the board was informed Dec. 21 that the reorganization violated federal medical billing rules and could cause the county to lose up to $15 million in federal health care reimbursements. The next day, the board rescinded the merger.

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Supervisor Frank Schillo, a persistent critic of the merger, said Kaplan gave the board incomplete information about whether the merger was legal. And now he is being held accountable, Schillo said.

“Nobody is indispensable,” Schillo said. “The system is a lot bigger than that.”

With the vote to rescind the merger, Kaplan was back under Durand’s control. Durand’s decision to name Gudeman as Kaplan’s replacement, as well as to elevate other psychiatrists to administrative roles, shows that he intends to place more emphasis on a medical approach to mental illness, county sources say.

Gudeman disputes that.

The U.S. Health Care Financing Administration is in the midst of a review of Ventura County’s Medicare billing practices to determine if billing is being done properly. Changes in leadership at Behavioral Health, Gudeman said, are being made to bring Ventura County into compliance with the federal government’s billing rules.

“The clinicians, psychiatrists and psychologists will take an increased role on the teams in order to become Medicare compliant,” Gudeman said.

Kaplan was hired by the county in 1981 as a therapist in an outpatient mental health clinic. A graduate of the University of Michigan with a master’s degree in social work, he quickly rose through the ranks.

He was one of a handful of county mental health officials and policymakers who instituted reforms in the delivery of patient care in the mid-1980s. Their ideas for offering a comprehensive program of services for those with serious mental illness were lauded by the state and eventually became the model for other counties.

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Durand appointed Kaplan director of Behavioral Health in 1996.

Their philosophical differences about how the department should be run soon became apparent, sources said. Kaplan favored the approach cited in the so-called Ventura mode: spend money up front on comprehensive mental health services with the goal of reducing other county costs, such as jail time and group-home placements.

But Durand, under pressure to reduce costs within the Health Care Agency, wanted a more streamlined operation, sources said.