Officials Seek to Allay Mental-Health Concerns

Attempting to calm a furor over how the county’s mental health department should be run, chief administrator Lin Koester and a group of top managers gathered Monday to assure the public that services for the mentally ill are not being disrupted.

Koester, flanked at a news conference by seven other county officials, sought to counter fears that the county’s highly regarded team approach to providing care is about to change for the worse.

“The teams are in place . . . and are functioning,” Koester said. “They have continued to function.”

Behavioral Health employees in recent days have expressed concern that wholesale changes are in store for the department in the wake of former director Stephen G. Kaplan’s forced resignation last week.

One of Kaplan’s top deputies is on stress leave and another has been laid off. Last week, Dr. David Gudeman, acting director of the mental health department, said the organization’s structure would be changed slightly to give psychiatrists greater authority on the teams.

But on Monday, Gudeman changed course and insisted that, other than replacing Kaplan and his deputies, little else will change. No other jobs will be lost, and doctors will continue to work in concert with other members of the teams--including social workers, psychologists and nurses--to provide care, Gudeman said.

Gudeman hinted, however, at future changes.

“The team process will be augmented,” Gudeman said. “The specifics will be forthcoming.”

Koester said he called the news conference because there has been “a great deal of concern, turmoil and speculation” about how the mental health department will operate in the wake of a failed attempt last year to merge the department with the social services agency.

Supervisors Susan Lacey, Kathy Long and John Flynn supported creation of the merger last April. But less than nine months later, the board rescinded its action after federal Medicare officials informed them that the new structure violated health care billing rules.

The merger prompted a review of the county’s billing practices by the U.S. Health Care Financing Administration. The results of that audit are expected in two months, Koester said.

Kaplan was criticized for failing to warn the board about possible problems with the merger and was forced to take a 30-day leave by his boss, Health Care Agency Director Pierre Durand. Kaplan resigned two weeks later.

Since then, Kaplan’s supporters--including Lacey and state Sen. Cathie Wright (R-Simi Valley)--have accused Durand of ousting Kaplan as political retribution and to clear the way for psychiatrists to wrest control of the mental health teams. Like Durand, most psychiatrists opposed the merger.

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Wright also alleged that Durand is diverting money from the mental health department to cover the costs of running the county’s public hospital.

At Monday’s conference, Koester said he is not aware of any diversion of funds and that he takes such accusations seriously.

“If anyone has information about a misdirection of moneys used, I will get on it right away,” he said.

During the conference, Auditor-Controller Thomas O. Mahon released the results of a county review of the Behavioral Health Department budget. The review was done after Durand alerted auditors to a potential $1.5-million shortfall in the mental health department’s budget.

Supervisor Frank Schillo, a critic of the merger, was quick to attribute the projected deficit to the “mismanaged merger” and used it as evidence that Kaplan had performed poorly on the job. But on Monday, Mahon revealed that the shortfall was actually $430,500, less than one-third of the initial projection.

Mahon attributed the discrepancy to the typical up-and-down flow of revenue into the mental health department’s budget. He said it is too early to project whether the deficit will grow, or disappear, by the end of the fiscal year in June.

After the hourlong news conference, Lacey met with reporters to respond to comments made during the session. She questioned Gudeman’s and Durand’s contention that the duties of Behavioral Health employees will remain the same.

“I know team leaders have been called and told they are no longer supervisors. They were told they would open the meeting and close it. And the doctors are in charge,” Lacey said.

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She said she believes the news conference was called to “smooth over some rough edges” as Durand attempts to reorganize the Behavioral Health Department.

“Maybe they think if they talk about it, [the disputes] will all go away,” she said.

Lacey said she is also disturbed by criticisms expressed over the weekend by Dr. Edward G. Arevalo, chief of psychiatry at the Ventura County Medical Center. He suggested in an essay published in a local newspaper that an investigation of Behavioral Health would reveal evidence of “child abuse, mismanagement of patients, faulty billing practices and preventable deaths.”

Lacey said she was “stunned” by Arevalo’s accusations and sent him a letter Monday demanding that he provide supporting information. If Arevalo does not respond by today, Lacey said she will “decide what needs to be done next.”

“If [Arevalo’s charges] do not have any basis in fact, then I think he needs to set the community’s mind at ease.”