After accomplishing absolutely nothing of substance at their latest Wednesday, October 23 meeting, Mendo’s Measure B Advisory Committee decided to cancel their November meeting, Thanksgiving and so forth. County CEO and Measure B Committee member Carmel Angelo described the meeting cancellation as “going dark.” (Note to self: please add “going dark” to Ms. Angelo's list of emphatic adjectives: Robust, sustainable, and resilient.)
After discussing the salary for the project manager at some length, the Committee reviewed where they were on hiring this person: Answer: soon. Ms. Angelo added that the hard-hitting Measure B overseers are also now thinking about hiring a construction manager to assist the Project Manger.
The pending contract with an architectural firm? Also coming soon. The CEO’s staff has, however, finally finished a “draft” scope of work for the Measure B architect. Significantly, the Committee has expressed no interest in the content of that “scope of work.” A recommendation is supposed to be on the Board’s agenda next month. We can safely assume another eyesore box structure for Ukiah whomever the architect might be.
There was a very long discussion of what percentage of the Measure B money should be put aside for reserves. No decision was made.
Committee members congratulated themselves for getting a new high-tech sound system for the Committee’s meetings.
Not to be outdone, Third District Supervisor John Haschak told the Committee that he thinks the Measure B committee’s forward movement was positively brisk, that the project is "where it needs to be with the pending hiring of the Project Manager and an architect.” Haschak said the public should be thanking the Committee for all their good work. Haschak didn’t mention that these accomplishments — which barely amount to preliminary first steps — have taken almost two years.
Perhaps Supervisor Haschak wasn’t paying attention the day before at the Supes meeting when he and his fellow Supervisors discussed Measure B at some length.
Supervisor John McCowen thought that by now there should at least be some visible improvement in services.
Supervisor Ted Williams wanted to know why nothing substantive had been done so far, asking, “I would like to hear some perspectives on why we are at a block and what we can do about it.”
Measure B Founding Father Sheriff Tom Allman quickly went on the defensive: “The Measure B committee is certainly striving to fulfill our obligations to get the necessary services as well as the necessary buildings done and underway. However, you know better than most the bureaucratic process it takes to improve not only services but to get the job descriptions done for human resources and contractors in line — you and I experienced the Ortner debacle. In this county we have all experienced over 20 years without having a PHF. And while the voters have passed this less than two years ago, we are now at the point where the Measure B committee is making progress. I would welcome — and what we have right now — the CEO is certainly aware of the RFPs that have been out to the public saying, Tell us what you have to offer and tell us what it's going to cost because we need to know what's available. …”
The only RFP we know of that’s “out to the public” is for architectural evaluation and design services. There’s been some vague discussion of what hospitals and non-profits can do, but no RFP has even been requested, much less gone “out to the public.”
Allman continued, “We also know that over the past seven years this county has advertised for a psychiatrist at a quarter million dollars a year and we can't get anyone to respond. A quarter of a million a year for psychiatrist! So I hear what you're saying and what you are saying if you don't mind me saying is voicing frustration. What I feel in those meetings is frustration also with long discussions over a sound system, but with people who are often believing that just because we have the money we have the answer. If we had the answer we wouldn't have the mental health problem in this county that we have. So I challenge anybody listening to my voice to please come to the Measure B monthly meetings, one o'clock, conference room C and be very specific. Instead of saying we need help and what are you doing for us, come and say why aren't we doing — and then fill in the blanks, x and y and z, and let's have a conversation.”
Actually, several people have done just that, suggesting things like a modular unit in advance of the brick and mortar — Sheriff Allman himself vetoed that idea, saying it wasn't long term.
We have been bringing up the crisis van idea almost every year for at least 20 years (going back to the Marvin Noble tragedy). And Ukiah Police Chief Justin Wyatt suggested some kind of crisis van be set up two meetings ago, and so far all there’s been is some vague mention of maybe asking the people who run one in Oregon to come down for a chat.
Still others have said the County should get the nearly dormant but fully funded outreach van back up to full staffing. But that doesn’t even make it on the Measure B agenda, even though they voted to spend several hundred thousand to supplement it.
Allman continued, “We have 11 major stakeholders in mental health [i.e., the Meaesure B Committee] that get together once a month and we get together two hours a month, 24 hours a year, right at half the work week. We need suggestions other than just how to spend money because spending money is not the answer.”
Again, suggestions have been made. But they never make it onto the agenda, much less to where the “11 major stakeholders” could vote on it.
Allman continued, “We are going to have to think our way out of this with good rational solutions of where we are going to go. I don't know if any of the 58 counties in the state have come up with the answer. That's what you're asking about. Nobody has found the perfect pill. So your frustration is felt by many of us. And I'm not being critical of you, I appreciate you saying exactly what you said because I agree, we need professionals to come in and say, these are the solutions, let's give it a try.”
So they want professionals to offer solutions? Ukiah Police Chief or their own committee members or a member of the public bringing something up is of no interest.
Allman continued, suggesting that they try things on a provisional basis: “You know what? After 12 months if it's not working, pfffshshshshs — let's hear a big flushing sound and get rid of it. We got rid of Ortner because it wasn't working.”
First, that’s the first we’ve heard that privatizing mental health by hiring a former Ortner Exec to wire the job to Yuba-county based Ortner was some kind of experiment that was “flushed” after three years. And the Sheriff himself has dismissed a temporary idea like a modular for initial crisis services. Nor has he mentioned the County’s inability to staff the outreach van although he got it going and it’s funded with County and Measure B money. What’s the status of recruiting people for that?
Allman concluded, “We are not limited by anything except our own imagination and the amount of money we have to spend it on.”
Supervisor McCowen reminded the Sheriff that the Supervisors recently told the Measure B committee to go back and look at the Kemper report where a number of good ideas were laid out. Then McCowen suggested a joint meeting of the Board of Supervisors and the Measure B committee: "Let's see what we can agree on as a group and let's move this forward."
Measure B Committee Chair Dr. Ace Barash replied that they’ve had trouble hiring staff “because of the housing cost and difficulty of finding housing and the higher pay in Sonoma County.” He also said the Kemper report didn't spell out enough specifics about how money should be apportioned.
Not true. The $60,000 Kemper report laid it out quite nicely and nobody’s disagreed with it.
Barash continued with the lame excuses and finger-pointing: "It's not up to the Measure B committee to decide without somebody else having some — it would be nice to have experts in the field before we made decisions about how the money is spent before we decide to just give it here or give it there because it's not spelled out in the Kemper report. It gives categories, but not which agencies." Dr. Barash went on to wonder how they would staff the facilities once they are built and how much of that cost would be coming from Measure B.
CEO Angelo agreed that it's hard to staff up. Then she wondered how much would be left over for facilities and how such services would be continued after Measure B ended.
Maybe if somebody made this staffing question an ongoing agenda item for monthly tracking and follow-up…?
Supervisor Williams then asked a question we raised way back before the County even hired Kemper: “Does Health and Human Services staff have any recommendations that they could bring to Measure B? It seems like asking the people who work in the field who have the expertise would be the right way to move forward. Why do we not have our own staff recommending a plan of allocation of funds and what services to pursue?”
CEO Angelo agreed that that was a good question and that they would look to the mental health staff to come forward with their recommendations. "Your comment is correct,” the CEO said. “We have thought about it. It just has not been agendized — the mental health staff coming forward with a plan for say $3 million or so for services."
The more likely reason that the County’s mental health staff has not been asked for recommendations is that they are only involved in what they consider to be Mendo’s “severely mentally ill” — i.e., the reimburseables. They have very little to do with the non-reimburseables — the mild to moderately mentally ill. Some numbers for that category as well as for “substance abusers” are in the Kemper report, but Mendo continues to pretend that the Kemper report doesn’t provide enough specifics. (See the also ignored $50,000 Marbut Report on the homeless.)
Measure B Committee member Jan McGourty offered the observation that the mild to moderately mentally ill are to some extent seen by the County’s widespread health clinics, and that she’s in the process of “surveying” those clinics. But nobody has asked the clinics about what kind of help they could use for those mild to moderately mentally ill that the County turns away.
Coincidentally, a Coast Hospital ER staffer told us recently that at any given time four of their eight ER beds are taken up by mentally ill people under some kind of staff-intensive observation or medication or stabilization, leaving only four beds for more conventional “emergencies.” He said that because of the mental patients, several times a week their ER room has to decline real emergencies and shuttle them inland because their ER is full.
After “going dark” in November, the Measure B committee will hold their last meeting of 2019 on Wednesday, Dec. 18 when, with luck, they might have a project manager on board who will magically get everything moving.
From Supervisor Williams:
Two years have passed since voters cast support for the Mental Health Sales Tax known as Measure B. In light of the upcoming Behavioral Health Forum (Nov 25, link below), I'd like to hear your questions and concerns about execution. I know the 5th district will be brutally honest, but the most helpful feedback to catalyze progress will be specific ideas. Give us marching orders -- it's your money.
Three Very Specific ‘Ideas’
ONE: Get A Damn Crisis Van Going!
(Note: Ukiah Police Chief Justin Wyatt already proposed pursuing this at the September Measure B Committee meeting, but the idea was loosely pawned off on the local NAMI rep who expressed no real interest in it at the time and without even a deadline date to report back.)
From my report of the September Measure B committee meeting:
According to a recent Wall Street Journal article “The program in Eugene is unique because Cahoots (Crisis Assistance Helping Out On The Streets) is wired into the 911 system and responds to most calls without police. The name Cahoots was intended to be a humorous nod to the fact that they are working closely with police. Cahoots now has 39 employees and costs the city around $800,000 a year plus its vehicles, a fraction of the police department’s $58 million annual budget.”
Ukiah Police Chief Jstin Wyatt said the Eugene program works well and should be considered by Mendo and the Oversight Committee. Of course there was a long conversation about it and how California’s new stricter “use of force” rules for cops would make the crisis van even more valuable, especially in cases where someone is suicidal but not otherwise violent or with a weapon. Wyatt said the CAHOOTS crisis van allows mental health staffers to “meet people where they are.”
Redwood Quality Management Director Dan Anderson said he was familiar with the concept and that his company gets “occasional requests to be mobile. We struggle to do that. But it’s haphazard; not coordinated with dispatch or law enforcement. We don’t know when; there’s no plan. It’s inconsistent and stressful. There are no clear directions. It’s off kilter.” In other words, a standard Mendo approach.
Anderson added that the idea would be “important to pursue. We would love to partner and be more mobile. It’s a good program. CAHOOTS is a place to begin. We should invite somebody down from Eugene. It would also allow patients to de-tox.”
The County’s Mental Health Director, Dr. Jenine Miller, agreed, saying she worked on a similar program in San Francisco before working for Mendo and it worked well. (So why didn’t she bring it up long ago? Don’t ask.) Miller also thought that the crisis van staff should have the ability to administer meds in the field. However, Miller muddied the water by suggesting they look at “the full spectrum of [crisis van] models.” (This alone means that any real consideration of the idea will be delayed by who knows how many more years.)
Measure B Committee Chair Dr. Ace Barash said he expected that the subject would be on their agenda next month when they would conduct a “robust discussion” of it. (Translation: We will talk about it for a while but never do a single thing. If they were serious, they’d have tasked somebody to do a presentation on the viability of a pilot program next month. But that’s obviously too much to ask.)
(Update: the item was NOT on the October Measure B agenda. It wasn’t even mentioned.)
TWO: Get The MOPS Program Going Again by having monthly status reports from Dr. Miller about what they’re doing to staff this FUNDED program. Do not accept lame excuses about hiring difficulties, etc. If they can make the status of hiring a program manager a monthly reporting topic, they can certainly make the much more directly useful MOPS program status a monthly topic.
THREE: Get (Lease/Buy) A Commercial Mobile Crisis Modular Unit and put it on the vacant lot the County just bought back from RCMS. Then, if/when a facility is actually built there, move the modular to the Coast to reduce the ER crowding at the Coast Hospital Emergency Room.
There is no excuse for not doing these three very specific things NOW. How can Mendo officials let the Measure B mandate be delayed for years when there are workable interim solutions like these available? It’s downright disgraceful! All three of these proposals would also serve as a useful pilot or training program for when the longer-term facilities finally open someday.
And don’t give me Sheriff Allman’s lame excuse that a mobile or modular facility is “not a long term solution.” At the rate the Supes and the Measure B Committee are going now there will never be a “long-term solution.”
Stop fiddle farting around! Measure B has been taken over by the usual Mendo Meeting “WHENEVER” Mentality. Meetings are not action! People need these services. Get off your ass, Mendo!