Funding Mental Health Services

Re “Behavioral Health Unit Threatened with Funds Cut,” Feb. 27.

[State] Sen. Cathie Wright’s threat would put at risk the care and treatment of disabled people who had no part in the failed merger of Ventura County’s mental health and social services agencies. And it ignores the illegalities that must be corrected to prevent a catastrophic loss of federal funds.

The Ventura Model for community care needs local and state public scrutiny. For too long, all criticism was considered heresy and met with open hostility, not only by Steve Kaplan but by Randy Feltman before him. It was first funded in 1989-90 with a yearly state grant of almost $4 million. The county promised to reduce utilization of state hospital and local in-patient costs by more than $3 million. But no provisions were made to replace the cuts to intensive levels of care.

State hospital and skilled nursing beds were drastically reduced, and other housing with staff was eliminated. Clients were encouraged to live independently. Advocates asked repeatedly for statistics on the success rate of placements but were stonewalled. Numbers and causes of accidents and deaths were not forthcoming. These are vital data that should undergird policy and be readily available.

People who benefit most from the Ventura Model are those who recognize their illness, are reliable about taking medications and can access other parts of the system without too much help. A few are able to work, and we applaud their success. Far more numerous are those who need much more support.

Despite rumors to the contrary, the reorganization under Dr. Pierre Durand does not include dismantling the Ventura Model. Psychologists, nurses, social workers and others are necessary for comprehensive care. But it is critically necessary to restore physician authority in the treatment of brain disorders and to meet certification requirements for Medicare and Medi-Cal reimbursement. This is Dr. Durand’s charge, and he should not be impeded or delayed.

LOU MATTHEWS, Past President, Ventura County Alliance for the Mentally Ill, Ventura

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The threat by state Sen. Cathie Wright to cut state funds was ridiculous, absurd and an attempt to hold the mentally ill hostage. Her claim that the system of care reforms worked so well is exactly the problem as the reforms are not Health Care Financing Administration (HCFA) compliant in the area of physician oversight.

Sen. Wright’s threat is an apparent fit of political pique in reference to Health Care Agency Director Pierre Durand. It is unethical to use the mentally ill as a bargaining chip to intimidate county officials into complying with arbitrary and unsupported state mandates.

Sen. Wright’s notion that Dr. Durand’s move threatens to undermine the reputation of the county’s Behavioral Health Agency is based on misinformation. We advocates know very well that the administrations of Randy Feltman and Stephen Kaplan were full of smoke and mirrors such that what both were selling statewide for years about the Ventura model is a myth. This was proven by the unprecedented number of mentally ill who died last year.

Now we advocates want to make this myth a reality. With the Behavioral Health Department adhering strictly to the rules of HCFA, the team approach of psychiatrists, social workers, educators, etc. working together would still be very much alive and would ensure greater success. The psychiatrist on the team should have the ethical responsibility of not allowing treatments inconsistent with good medical practice. If this were followed, our county would not only be in compliance with federal laws but would really be a model in treating the mentally ill.

LITA Z. BIEJO, Moorpark