County to Study Use of Tobacco Suit Funds

Moving to beef up services for the mentally ill, the Board of Supervisors agreed Tuesday to explore a plan to spend a portion of Ventura County’s share of tobacco settlement dollars on expanded housing and treatment.

But the board stopped short of endorsing a companion proposal by Supervisor Frank Schillo to designate by ordinance roughly $4 million, or less than 50% of the annual $10 million received, to pay for the mental health care programs.

Supervisor Judy Mikels, considered a crucial vote on the issue, said she would not support an ordinance because it would tie the hands of future boards. County officials don’t yet know the actual cost of Schillo’s plan because his $4-million estimate is only a rough guess, Mikels said.

“I’d ask the board not to go down the ordinance path yet,” she said. “I’d like to see a true fiscal analysis of these proposals first.”

Supervisor Susan Lacey said she opposed an ordinance because of the risk that state lawmakers would tie settlement dollars for future years to programs that might not mesh with the county’s plans.

Supervisor John K. Flynn, who supports an ordinance, urged his colleagues to reconsider, saying the money is sorely needed to follow through on the mental health expansion.

“The commitment is there, but it doesn’t become real until we put some money into it,” he said.

Schillo said later that he was satisfied with his colleagues’ level of support.

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“I don’t necessarily have to have an ordinance if the board will agree to the programs,” he said.

Health Care Agency officials urged the board to work fast in considering how to proceed. One component of Schillo’s plan is a partnership with UCLA for specialized training of county physicians in the mental health field.

The training course is modeled after a similar residency program by UC San Diego, Dr. Marvin Karno of UCLA’s Neuropsychiatric Institute told reporters after the meeting.

The developing Cal State Channel Islands campus is being discussed as the site for the training program. Karno said he would like a commitment from Ventura County by March 1.

Schillo’s proposal also calls for housing facilities to be developed at two sites--a shuttered psychiatric wing at Ventura County Medical Center and a parcel of 17 acres on Lewis Road in Camarillo. His plan would create supervised housing for 250 seriously mental ill patients and long-term housing for 40 patients who must live in a locked facility.

Since the closure of Camarillo State Hospital, no such facility exists locally and 40 such patients have been sent out of the county in costly placements.

It also could shorten waiting lists for the roughly 3,000 children and adults cycling in and out of the county’s mental health system, said Dr. David Gudeman, chief of the Behavioral Health Department.

Supervisors agreed to pass along Schillo’s proposals to the board’s tobacco settlement subcommittee and the county’s Mental Health Board for further review. The board asked both groups to provide responses within a month, in time to give UCLA an indication of how serious the county is about the residency program.

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In supporting a study of Schillo’s proposals, supervisors did not rule out also using tobacco settlement money for other purposes, such as chipping away at a projected $5-million deficit or funding a juvenile justice complex.

In other business, the board elected Supervisor Kathy Long of Camarillo to serve a one-year term as chairwoman, succeeding Lacey. The title rotates among supervisors annually.

Also, Health Care Agency Director Pierre Durand gave the board an update on a number of regulatory reviews affecting the Medicare reimbursement rate received by county public health clinics.

Durand told board members that his staff was making progress with federal officials, who have reduced the level at which the county’s Medicare programs are reimbursed until the county meets several requirements relating to clinics and contracts with physicians.

Regulators have imposed several requirements on the county in the past two years.

The reviews were triggered by an ill-fated decision to merge the county’s mental health and social services departments in 1998. The biggest financial hit so far has been the county’s $15.3-million settlement of a federal Medicare fraud lawsuit.

In recent weeks, supervisors and top county staff members have been meeting with the area’s congressional delegation to plan strategies for reducing the amount that the county will ultimately have to pay the federal government, said Larry Siegel, the county’s lobbyist.

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During Tuesday’s meeting, mental health advocates applauded the board for giving the Schillo proposal initial support. But some advocates stopped short of endorsing his concepts until additional programs are considered.

One mental health board member, Neal Andrews of Ventura, said he would like to see dollars devoted to job training programs for the mentally ill.

Meanwhile, a retired Camarillo psychologist who last fall resigned from the Mental Health Board in protest of the chairman’s ouster announced Tuesday that he and others had formed an advocacy group, the Coalition of Concerned Mental Health Professionals of Ventura County.

Shlomo Kreitzer declined to answer questions about the group’s membership, saying several members are county mental health employees who fear retribution if they are identified. He said the group would serve as a watchdog to ensure that the county was following state law as it relates to the mentally ill.

Kreitzer said the group is concerned that money meant for mental heath services and substance abuse is being diverted to other programs, that clinicians have lost too much decision-making authority to physicians, and that patients are not receiving enough treatment time with psychiatrists.