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Waiting For Ortner

The great transition from one privatized mental health entity to another private mental health entity is just over a month away and nobody knows how many clients there are or what kind of back-up paperwork the Yuba City privateer will produce. He made millions off Mendocino County but what exactly did he provide and where did all the money go?

Mendocino County’s new mental health director, Janine Miller, told the Supervisors on Tuesday that the County still has a lot of vacancies in her department, most of them unfilled for months.

Ms. Miller, who has inherited a true quagmire and we hope she's not being set up as a scapegoat for disasters to come, disasters she did not set in motion, said there are about 40 employees in her department but 57 authorized positions, leaving 17 vacant. Miller and several senior members of her staff are covering multiple positions to partially make up for the vacancies, but it’s not easy, she said. And since there's no way of corroborating bureaucratic assertions like this I suppose we have to take her word for it.

Third District Supervisor Tom Woodhouse agreed, sort of.

“A good example of a vacant position — it's been vacant for awhile; it's been vacant for whole time I've been here and it has been vacant for at least two years or three years or — is the County Psychiatrist. We are offering I think around $300,000 a year for that position and it needs to be a minimum of $400,000 to attract anyone. We might as well take it off the chart. We are never going to get that person here. And that's where we would be paid back by the feds and the state and it's nonsense to have that position listed here. I'm not saying that to you, I am saying that to myself: Why do I allow that? That's ridiculous. It's pretending you're going to paint the house and you don't have any paint and you are never going to do it. We need that position filled. Without that we can't do a damn thing. So why can't we start with that? I guess I'm asking the CEO in our next budget round to put that position at $400,000 and if somebody files a grievance, let them. Sorry about that.”

CEO Carmel Angelo: “If the full board wants to pay $400,000, I will put it in. No problem.”

Board Chair Dan Gjerde, as always attentive and on task: “But the question is, Is there money to do that? I guess the question I have also is my understanding is that the Sheriff's office also has a position of a psychiatrist and they are also unable to hire them but they have a doctor in the box, like someone doing tele-psychiatry.”

Angelo: “There's no county position for a psychiatrist [at the jail]. That would be contracted. I'm assuming that's contracted to CFMG [the jail medical service].”

Gjerde: “So they are unable to fill the position and they have someone on a monitor coming through a television screen. So why not take the two positions and combine them into one and have a real live body here?”

Angelo: “Certainly we can look at that. One is a contract position and one is a county position. I think we have to look at how we would do that.”

Deputy CEO Alan ‘The Kid’ Flora, a capable young dude whose contributions to the public discussion are unfailingly pertinent: “Mental health is not one of those programs that you can direct bill any amount of cost that you want back from the state and the federal agencies. If the salaries are increased for example, my understanding is that generally speaking 60% of that cost has to be paid from our revenue sources that we get, primarily realignment revenue which are based on sales tax receipts at the state level. So that is a limited supply of funds. You can't just increase that at will.”

Woodhouse then tossed a word salad which, listening very, very carefully seemed to arrive at an assertion, albeit a self-contradictory one:

“We have the tele-psychiatry in Laytonville. We are going to work with the clinic and it will take time to get it together but they are going to do it. I'm going to bring that to the board. But the people in my district are killing themselves. We have to get a psychiatrist here. If you have a tele-psychiatrist, they can look at somebody and prescribe medications and save their life and stabilize them while in crisis. That's the whole purpose of what we are trying to serve here. So I'm not angry, I'm just determined that we are going to do this. Every time I ask the question I always get the response of why we cannot do it. And I agree. It's impossible. We can never do it. Now how can we proceed ahead and do it? I don't care which one of these things we do. But we have to start changing things. Proceeding like we are now is going to lead to failure and I refuse to sit here for two more years and do that. We are going to change this. I'm proud that you are here. I'm excited you are here. I'm glad that you are here. I am asking for help and how to go forward.”

Hmmmm. I'd say on balance that Woodhouse wants a shrink for his constituents even if it's a doc in a box like they have at the jail. But I’m just guessing.

Predictably, none of Woodhouse’s colleagues picked up on any of this, and none of them expressed any interest in putting up $400k for the vacant County psychiatrist position.

* * *

Later in the meeting, during a discussion of how the County was going to use some $500k in Mental Health Housing grant funds that have gone unspent for a couple of years or so, Chair Gjerde asked Rural Communities Housing Development Corp. executive director Tim Pallesen how he was going to proceed to find a location for a mental health housing facility with perhaps 30 or 40 beds in one of the three incorporated cities in Mendocino County.

Let's hold it right there. Let's all get behind the Sheriff's plan, all pull at the same oar at the same time. He has the first sensible, doable, much less expensive, much more practical idea ever broached in modern Mendocino County. Boiled down? Our own mental health facility, where, we would hope, the mentally ill now housed at the un-therapeutic County Jail, would he held and, perhaps, even made functional again. We would also hope that the free range, drop-fall drunks and thanatoid-type dope heads who make up the bulk of the "homeless" would also be confined because, objectively considered, they're also crazy. Staff? The mental health people presently wandering around with coffee cups doing zero of practical value for the mentally ill.

Pallesen suggested that the county contact the city councils in the three cities and “ask them to confirm or deny that they would support any project that would be in their cities. We would then come back in and report to this board the results of that communication.”

Pallesen! Dude! Listen up! Get behind the Sheriff's plan. The cities aren't going to go for anything inside their city limits unless the Sheriff and their police chiefs get behind it. Everyone, including you, ought to looking long and hard at the old Willits hospital for a centralized facility with services concentrated there, not all over hell and vaguer than hell like they are now, with the cops doing ALL the mental health heavy lifting.

Gjerde: “I think their support or lack of support would definitely have to do with the location. There needs to be some idea of where. (The Willits hospital, Dan. Get on board!) They might support it if it was here, but not there. Within their city, or near the city. If it is just a blanket statement, that is not enough information to say whether they support it or not.”

Pallesen: “Would you like a formal statement from the various city councils in the form of resolution?” (Which is highly unlikely you could ever get.)

Gjerde: “I think they need to have some idea where in the city you are thinking. There needs to be some initial research to identify three or four possible locations and if it was any one of these locations, would you support it and if so which ones?”

Pallesen: “Unfortunately, there is a real estate availability issue that is pretty transitory. So any time a city council would say this is a good spot here, it might take us at least three months before we can even make an offer on it, and then the price might go up and also it might disappear from the market.” (Jezus H, Pallesen! We can get the old Willits hospital for less than  $2 mil. Focus, man, focus!)

Gjerde: “But I think you're asking too much of someone to say ‘anywhere,’ is it okay? It's not realistic to request that, to ask for a blanket ‘anywhere’ approval.” [Laughs.]

Pallesen: “Okay, yes we certainly would be working with the city in getting that kind of input from them, for sure.” (Translation: Endless meetings, endless donuts, endless confusion.)

Gjerde: “Not to criticize anyone here, but it's unfortunate that the county has held this grant for a couple of years now and it's unfortunate that it's taken this much time because we knew it would take more time to do site identification and more time for the cities or the county to identify Community Development Block Grant funding and other funds to provide the match. The chart you have concerning the example from Arcata is very enlightening because it shows they had about $870,000 to match in loans or grants that the city obviously had the time to cobble together. With such a short time frame here at this point to make decisions and accumulate matching funds—” (We're spending twenty MILLION every year right now for what? Nada. Nothing. Christ on a gd crutch. Shake yourselves. Do the goddam math. 100 crazy people, maybe 200 if you factor in the career drunks and free range tweekers. Divide 200 into twenty mil. You can't come up with a viable plan?)

Pallesen: “I don't think it's there. It would be great if it happened. But I don't think it's reasonable to expect any of the three cities to come up with money.” (They don't have it because they pay their governments so much there's hardly anything left to do what needs doing. But the County has twenty annual mil! More if the Sheriff's plan is approved by the voters.)

Gjerde: “But they could have had a headstart on this process two or three years ago — they could have.”

Pallesen: “That's possible.”

Gjerde: “Anybody can apply for community development block grants every single year. And they probably have, both in Fort Bragg and here in Ukiah — for two or three years now. And now here we are three years later trying to scramble and put something together.”

Pallesen is supposed to begin looking for sites in Willits first (apparently because it’s midway between Fort Bragg and Ukiah), then Fort Bragg and then Ukiah. (Here we go. The site search. Hello, Happy Donuts? Can you bake us three years worth?)

* * *

The ambitious Transition Plan which lists the tasks necessary to turn the for-profit Ortner (Yuba City) adult mental health clients and services over to the for-profit Redwood Quality Management Service (Ukiah) continues to show that most tasks remain conspicuously incomplete. A few more meetings have been held and various agencies and companies "continue" to do various amorphous things, but that's about it.

One recent update reports that “RQMC has developed a general plan for handling application assessment, assigning care managers, documentation and reporting. This includes planning for client centered flex funds to be used for non-Medi-Cal client needs.” There it is, folks. The crux. How do we get paid for the people who don't have insurance, formerly known as a public responsibility.) But the “plan” is not in writing and it doesn't say anything about anything actually being completed. (Because none of the people involved in the transfer are what you would call "clear thinking.")

Another task involving development of a replacement outpatient provider service shows that the only new development is that “Ford Street has decided not to provide mental health services through Medi-Cal at this time although they will continue with their clients to provide drug alcohol treatment.” (Because there's lots of public money for that and it's your basic growth industry as more and more citizens grow ever more despairing.)

Everything else on the transition plan task list is either “continuing,” holding more meetings, or “in process.” (Everyone involved ought to be locked in a donut-free room until they get it done.)

The County’s high-paid mental health consultant and smooth talking jive-o, Lee Kemper, who prepared the report last February documenting many of the problems with Ortner and precipitating the challenging transition that Ms. Miller is trying to arrange, told the board that it’s now been over two months, and it wasn't even clear how many clients Ortner had, much less what kind of documentation they have on each one. Kemper said that he’s heard that Ortner had somewhere between 200-500 clients and that the county has still not received any documentation concerning these clients. (Because the County has been ripped off, big time, a fact documented in these very pages for more years now.)

But Ortner collected millions with almost no accounting for the money.

Mental Health Director Miller said that Ortner had been rhetorically cooperative so far, having agreed to deliver the records, but nothing has been supplied. (Can we say “scam”?) Apparently Ortner plans to scan in their documentation and put the entire document collection on a flash drive and deliver it to the County in one giant submission sometime in June. But nobody knows what it will look like or how compatible the data will be with the “Avatar” electronic health records patient management system the county hopes to use with their new contractor Redwood Quality Management Company (RQMC). (Can we say “criminal” mis- and malfeasance?)

Given Ortner’s wildly overpriced and undelivered "services" on just about everything else over the prior three years, we suspect his "records" will be incomplete and indecipherable.

Ms. Miller — and she has our total sympathy and best wishes as the blindfold is placed around her eyes and she's lead to the firing squad — insists that things are moving along as best they can toward the July 1 date when Ortner will go away and Redwood Quality Management will magically pick up the pieces. But as consultant Kemper said, it is unknown what the extent and quality of Ortner’s records will be. Kemper pointed out the obvious: the sooner they can be submitted the better. (Gee, thanks, Mr. Consultant. You can go now.)

Of course, waiting until the last minute like this for the Ortner documentation — the Mendo equivalent of Waiting For Godot — means that any problems with information — gaps, errors, questions, misidentification, confusion, contradictions, etc. — won’t show up until Ortner is gone and unavailable to answer questions — unless the price is right.

Somehow the County’s understaffed mental health department will have to figure out a way to prioritize the Ortner stuff — and the who-knows-how-many mentally ill clients themselves — so that the ones in the most urgent need will get the earliest service.

How all that will be done given the short staffing and the growing list of incomplete, in-process tasks, remains an open question whose answer lies inside a giant jelly donut.


  1. james marmon May 25, 2016

    (Woodhouse) “Proceeding like we are now is going to lead to failure and I refuse to sit here for two more years and do that.”

    (Angelo in her mind) “You will do what you’re told to do, shut the fu.. up.”

    • james marmon May 25, 2016

      The problem with this transition is that everyone is rolling on the same side of the boat, with Schraeder as the captain. What do you think could go wrong? We will end up right back where we are today, only deeper in the hole and less likely we can dig out.

      • james marmon May 25, 2016

        “groupthink” do you think? What have I been trying to teach all of you over the years? Even the mighty AVA is over there rolling. mkultra is a success.

      • james marmon May 26, 2016

        Please change rolling to rowing, good grief.

  2. mr. wendal May 26, 2016

    “A few more meetings have been held and various agencies and companies “continue” to do various amorphous things, but that’s about it.”

    It’s ALL amorphous and will continue to be until the supervisors ask for details and a true detailed plan. Supervisor Gjerde is beginning to do so and it’s notable that a common reply he receives is in the form of a series of questions from the county employee (including Ms. Miller) asking, more than once in different ways, if he really wants them to get the requested details and then, after a bit of back-and-forth, saying that if he really wants the information they will get it for him. The attitude shows that there is still a great reluctance to share details with the supervisors or general public…just like the attitude of the Mendocino Coast Hospitality Center. Their billings to Ortner ought to be a real hoot after seeing the Giving Garden invoices.

    • BB Grace May 26, 2016

      Meanwhile, The Stepping Up Inniative has County courts, jails, social services working better than ever with great grants.. $29 Billion.. in other counties while Mendocino doesn’t bother to explore Stepping Up Inniative as an option to get out of privatization.

      I’m not opposed to privatization. Stepping Up Inniative is not privatization, it’s County COURTS using their power to establish a County mental health program that eliminates frequent flyers.

      It’s a very humanane, rational, and billions in grant money being offered and Mendocino ignors that? Not even as a way out in case RQMG doesn’t work out? It’s way better than laura’s law.

      • mr. wendal May 26, 2016

        Our county is usually miles behind other parts of the country. Have you considered making a presentation about Stepping Up to the Board of Supervisors (emphasizing the billions of $$$ available)? They may not really know what it is, which is probably the best way to help most of our frequent fliers and people on the streets with the clients taking an active part in their recovery. It looks to be very effective.

        • BB Grace May 26, 2016

          Honestly Mr. Wendal, I was relieved with the Kemper Report, which at the time the County had given $150K to the Sheriff for training for the Stepping Up Inniative. When the Department made it’s report to the County Supes and Angelo, they didn’t know what to do with it and directed it to Mental Health, which was reforming while OMG was still in. Nothing has ever been said by anyone in the County again about Stepping Up, but there’s been plenty going on in Mental health with Old Coast, Housing, an election with the Sheriff’s jail on the ballot.

          I think about it all the time.. and hoped someone like Marmon who has professional experience might see it as a “light” (ppffft for that thought).

          Stepping Up is a coming from the courts and I hoped McEwen, since he goes there might shop the idea around, see if it’s on a map there. So many folks are doing Mental Health essays in the AVA.. I haven’t.

          I’m working on my next food essay and wishing someone would make Stepping Up an issue. sigh.

          • james marmon May 26, 2016

            Lee Kemper has no idea how this plan will interface with the Court system, primarily Dependency Court. No other County has ever done this, another Mental-cino first. The duo ASO (asshole) plan was a stretch, this “all in one” plan will not work. I will take this to the streets and let the consumers know the dangers they are in, especially parents with young children.

            Simple Definition of interface

            1: the place or area at which different things meet and communicate with or affect each other

            I just wonder if anyone met with the Judges before they decided to go “all out balls” on this plan. Unfortunately most of them are on the Schraeder dole as well. Dependency Court brings in a lot of money to the County.

            I see it as a big conflict of interest and will make sure it is pursued in the higher courts, if not dealt with here.

          • james marmon May 26, 2016

            If I’m a parent and get an unfavorable mental health assessment or unfavorable recommendation to the court, I’m going to scream bloody murder, and argue they are just after my children. Because they really are.

          • james marmon May 26, 2016

            One thing about this plan, the adult parents won’t have to worry about signing any silly Release of Information (ROI). Schraeder children’s team will have all his or her information at their finger tips.

          • BB Grace May 26, 2016

            I fail to see what good screaming and “taking it to the street” is going to do. Is that what they taught you in Master’s SW courses?

            Do you even follow the Stepping Up Inniative?

            Blah blah blah rant rage threaten.. really Marmon.

            PS. I really like the edit app. :)

          • james marmon May 26, 2016

            I’ve already spread the rumor that the mentally ill are going to be treated like children, lol. That is not going over real well. Don’t underestimate me, I was born and raised and have 62 years of experience on the streets of Mendocino County. I have no problem in that briar patch and know my way around pretty well. They definitely don’t want me in their jail.

          • james marmon May 26, 2016

            Wait until I tell them what Sonya Nesch wants to do to them.

          • james marmon May 26, 2016

            Sonya Nesch’s Thesis. You better watch out BB Grace, I hope you’re not a deviant.

            “The types and frequency of deviance. and the relationship between deviance and factors in the pre-Intermountain. Intermountain. and post- Intermountain experiences were studied using the male population of the 1964 graduating class at Intermountain School, Brigham City, Utah. Among the important findings are the following. Of 233 total deviant acts. 8’4 were time schedule violations and 66 were drinking and drinking-related violations. The quantitative pattern of deviance was about the same during the sophomore and junior years and then decreased during the senior year. There was an inverse relationship between family size and deviance. The lowest average deviance rate occurred among those students whose parents were living together. The students who started school at ages six to seven had the lowest average deviance rate. There’ was a negative correlation between grade point average and degree-of deviance. Deviants had higher average scores than non-deviants on ten of twenty characteristics evaluated by counselors and teachers. The former Intermountain students with the highest’ post-high school productive activity scores also had the highest high school average deviance rate.”


            I can’t imagine what she must have put her poor daughter through for 25 years, “advocating for someone with a mental illness.”

          • Mark Scaramella Post author | May 26, 2016

            The Mendo Stepping Up momentum was started and pushed by Stacey Cryer who is now gone. If you are interested in whether anyone else in HHSA, such as the new high paid Director and Assistant Director, are going to bring it back to the table you should contact them now directly. The Sheriff was also involved, but he seemed more of a prop than an advocate, and he’s now moved on to the sales tax measure effort. When Cryer proposed it is was so vague as to be useless and unsupportable, although the concept of diverting mental cases from jail has merit in theory. The Public Defender liked the idea too. But if you expect any real action from her (unlikely at best), better not mention the AVA.

          • BB Grace May 26, 2016

            Thank you for stepping up Mr. Scaramella.

            It seemed to me that the Stepping Up Inniative landed on Cryer’s desk like every County BHSA with a learning curve. Pinizzotto handed out color printed copies of the first webinar at a Mental Health Board meeting and had little to say. My bet was he was multi-tasking while he was paid watching the webinar, also one of his schticks was to hand the Mental Health Board members a 63 lump of paper at the beginning of the meeting like that. It showed he had no interest.

            I think that the problem was the timing, and now we have an election. I don’t know enough about courts to know which court this would belong.

            What I do know is everyweek I get great updates from Council of Government, Justice Center showing their acheivments and grants galore.

            I don’t have any expectations. I have hope knowing that Stepping Up Inniative is happening, is successful, is well funded that Mendocino can eventually make it’s way after it spends tax payers money doing what SUI would do for us.

            Thank you again for your reply.

      • mr. wendal May 26, 2016

        Well, I see that the county supervisors did allocate $150,000 for the Steppping Up initiative last year. But they didn’t say how it must be spent. They also signed a Stepping Up Resolution. It may just be lip service since they were in deep with Ortner at the time.

  3. james marmon May 27, 2016

    I want to explain my comments about Sonya Nesch and my concerns. Ms. Nesch almost from the onset of the Ortner deal went after them and pushed for her friend Camille Schraeder to take over. Ms. Nesch also organized the medical profession against Ortner as well. She also spoon fed Bruce Anderson and the AVA with her poison too, and manipulated the overall extremely gullible Mendocino County Citizenry, including myself into believing these people were bad.

    Ms. Nesch is or was the Director of Emergency Medicine at Mendocino Coast Hospital, and that is how she was able to influence the entire emergency medical staff in our 3 hospitals and our well intended Sheriff Tom Allman into moving forward with her plan, to destroy Ortner and put our trust in the Schraeders.

    My concerns is not so much her motives, but what is her vision for Camille Schraeder and our most vulnerable population, the mentally ill. As we have witnessed, Ms. Nesch appears to have the power to make or break any organization that attempts to provide emergency services to the mentally ill. She is also a strong advocate for forced medications and Laura’s Law, in which she pushed for from the beginning.

    I too was an advocate for Laura’s Law but have somewhat softened my stance on the program. After giving all this some thought, I have to give Ms. BB Grace credit for enlightening me, and now I too have concerns about the sheriff’s new facility and Mendocino County becoming a police state.

    My master’s concentration at Sac State was Mental Health, and I was employed by two different counties as a mental health specialist. I won’t get into all my duties right now, but I know the field pretty well.

    What is Schraeder’s, the sheriff’s, the doctor’s, and Ms. Nesch’s plans for moving forward? It is a big secret right now, but I’m sure it involves pharmaceuticals, lots of pharmaceuticals, forced pharmaceuticals, and incarceration for those who refuse pharmaceuticals.

    We already know that Schraeder heavily drugs the children in her care on the children’s side, and that she is a strong supporter of the use of chemical restraints to keep the little ones in line. How she deals with full grown men and women is going to be interesting to say the least.

    To be continued…..

    • BB Grace May 27, 2016


      “Ms. BB Grace credit for enlightening me, and now I too have concerns about the sheriff’s new facility and Mendocino County becoming a police state. ”

      If there is ONE THING concerning Mental Health I would hope to be enlightening about, it is reminding that The Stepping Up Inniative is happening, is proving successful, and has $29 Billion to spend.

      I think because Stepping Up Inniative is coming from the Justice department, working with County governments and behavioral health services to end “frequent fliers” and those recycling through the court system, some judges have had enough of the same faces and decided to put an end to it. Justice has power and money and Stepping Up is an opportunity to use that.

      I wonder if Mendocino doesn’t go there because they fear Stepping Up Inniative would work, and then what would happen to all those service jobs?

      • james marmon May 27, 2016

        If you remember Ms. BB Grace, the whole movement against Ortner was that they were not providing the social supports for their clients when they returned home. I do not blame Ortner for this, I blame the County. The county has poured millions and millions of dollars into the children’s system of care over the years and completely eliminated all social supports for adults. Adults with Mental Health issues are seen as bad people in Mental-cino,” we take their kids instead of renting them a house.

        I want to see the Schraeder’s vision, what is it. Does she still hate adults with mental illness, and if not, when did her view change. Is she all of sudden against the use of chemical restraints? If so, when did she change.

        Its going to be interesting to see how many of these people are going to be warehoused in her tiny house village. What a life, drugged and placed in an 8 x 8 cell.

        • james marmon May 27, 2016

          I think I would choose to drink myself to death first.

          • BB Grace May 27, 2016

            I believe choosing to drink oneself to death is how many wind up with no choice but the Sheriff and maybe County BH services.

            Why not start researching Stepping Up and advocate for Mendo and Lake Counties?

            Because you enjoy name calling, insulting, threatening others and scaring people who come to you in need of help?

  4. james marmon May 27, 2016

    I’m afraid we’re moving to the medical model here in Mental-cino.

    “The film one flew over the cuckoos nest demonstrates the way in which drugs are handed out like smarties merely to keep the patients subdued.”

    “Note also in the film that the same type of drug is given to every patient with no regard for the individual’s case history or symptoms; the aim is merely to drug them up to the eye balls to shut them up!”

    “Myth of the chemical imbalance: Psychiatric drugs have often been prescribed to patients on the basis that they cure a ‘chemical imbalance’. Although scientists have been testing the chemical imbalance theory’s validity for over 40 years–and despite literally thousands of studies–there is still not one piece of direct evidence proving the theory correct.”

    So, we don’t even know what theory Schraeder is going to implement here, but we have blind trust in her and the medical profession.

    • james marmon May 27, 2016

      I adhere more to the social model for treating mental illness and I plan on being heard on this issue, even if I have to organize the mentally ill to fight back, which will be no problem.

      “Evidence has shown us that medication is not always the answer, and where it is useful it is very rarely a solution in and of itself. So we must continue to wave the flag and fight-the-fight. Mental health is a social issue and social approaches must underpin individual recovery.”

  5. james marmon May 31, 2016


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