Every year, at budget time, Scott Walker, while Milwaukee County Executive, would make cuts at the mental health complex, closing beds and forcing people into the community whether they were ready or not. At the same time, Walker would also eliminate the community support program in an effort to privatize those services as well.
The County Board, listening to the patients, their guardians, their families and their advocates, would restore the services that Walker had cut, or at least as much as they could.
Even with the funding restored, Walker would misadminister these services. This culminated in the last few years of Walker's reign, when Walker's hand-picked director, John Chianelli, drove the system into the ground so much that it was found that the facility was in "shoddy condition" and that he was allowing female patients to be sexually assaulted in a "trade off" for less fights. And despite all these cuts in service, Chianelli still managed to end up with a huge deficit.
When Chris Abele came into office, there was some hope that these nightmarish conditions would be alleviated. Those hopes would be shattered as Abele continued with the goal of closing the hospital and privatizing the entire system. Not only that, he said he would do so in just a couple of years.
And don't kid yourself - Abele's motive has nothing to do with reforming the system. It is pure and blantant privatization. While he is claiming to be pumping $5 million more into the system, he is also eliminating targeted case management and community support programming.
In other words, the money is not going to increase services. It's going to pay for the CEOs and other administrative staff of the agencies to which Abele wants to farm these people out.
Abele's move to open them county's mental health system to profiteering comes over the protests of the patients' families, guardians and advocates. It also comes over the medical advise of the treating physicians and other health care experts who know these patients better than anyone else.
Fearing that the County Board might again do the right thing, Abele is again running to Madison - as he does every time he has a very bad and very unpopular idea - spending political and monetary capital in order to get the state legislature to pass a bill further concentrating power into his hands. This time he wants to take away the County Board's ability to set policy about the mental health complex, even though it's the Board's job to set policies such as those.
So why is Abele so anxious to privatize Milwaukee County's mental health system that he is willing to go to such extremes?
Because it's not working.
I pointed out months ago that there was simply not enough resources to successfully take these people in and keep them and the community safe. As a result, these vulnerable citizens are not getting bounced around like ping pong balls:
Furthermore, there are not facilities that have sufficient resources to keep the patients of the complex or others safe. And if there is a facility that would be able to keep everyone safe, the cost of such services is much more than Family Care is willing to pay.One does not have to be a mental health professional to understand that this instability is not therapeutic for the patients.
This all came to light during the meeting. The following is a prepared report which was presented to the committee by Dave Eisner of AFSCME District Council 48, which represents many of the staff at the mental health complex:
The proposed 2014 Departmental Budget of BHD has now been released. Plans are to place 24 clients from Rehab Center-Central into community-based settings by July 1, 2014. The Center for Independence and Development (formerly Hilltop) is expected to close in 2014 by placing all of its 48 residents in community based settings by November 1, 2014.It should be noted that the only issue that Abele's people argued out of all of these statements was the number of patients returning to BHD or being shuffled around. Supervisor Peggy Romo West, Chairwoman of the Committee, quickly shut that down, stating that she had received independent emails from different people saying similar things. She said that it's not clear what it was yet, but something negative was happening at the complex.
As of June 12, 2013, the Center for Independence and Development (formerly Hilltop) has placed 8 clients into community based settings. 2 of these clients have returned to BHD, 1 back to CIDS and 1 to Acute Care. The 2013 Adopted Budget called for 12 clients to be placed into the community by April 1, 2013 and an additional 12 clients to be placed by July 1, 2013 from the Center for Independence and Development. So out of the goal of 24 client placements by July 1, 2013, six (6) have been placed.
It has been observed and reported that Rehab Central patients who have been placed into the community are returning to BHD through the Psych Emergency (PCS) and are ending up in Acute Care. That raises the question as to how those placements are then counted?
The apparent lack of success in placements into community settings and the limited amount of placements does not bode well for BHD's optimistic plans in their 2014 Budget request.
It has been reported to us that there is a severe shortage of proper group homes and appropriate facilities to send residents to, in the community, contrary to what Administration has been reporting. Many of the residents are scared. The majority of them have no family support.
We are hearing that Long-Term placements where clients have been inpatients at BHD for decades are having problems. There are supposed to be visits and transition done over a period of time to be able to acclimate the clients to a community setting and to community staff. This is not occurring and clients are just being placed. This uncertainty has heightened some of the clients behaviors and is causing them much anxiety.
We are hearing that Guardians are upset also. Because this is being approached as a closure and not a downsizing, the Guardians have no choice in the placement of their wards.
All of this information has been reported to us by staff who work at BHD.
While it is recognized that reforms are needed at BHD, we strongly urge you as policymakers for Milwaukee County to thoughtfully review all aspects of this plan, and to proceed with an approach that provides high quality care, treatment, and safety for all patients, includes Guardians and front-line staff at BHD in the discussion, and that whatever is ultimately decided should be done in a cautious manner with achievable results.
There was no denial that patients were being placed recklessly or that there was a severe shortage of available facilities and resources to meet the needs of these vulnerable adults.
As noted in the cited piece above, placing these patients into the community, if it were done correctly, would take a considerable amount of time. It requires finding a suitable placement, getting support systems into place and giving the patient sufficient time to transition.
Even then, there are some people who are just not ready to be in the community and cannot be kept safe from harming themselves or others.
And in the time that Abele's been actively pushing for the privatization of the mental health system, there have been serious problems with the people being forced out of the complex, such as this story:
A 47-year-old male has been released from Froedtert Hospital after having his ear bitten off by a 24-year-old man Friday afternoon in Waukesha.Staff at the mental health complex. appearing before the County Board and state legislators, have identified the attacker as a patient of the mental health complex who was discharged under Abele's plan. Now the poor man is going through the court system and could end up in prison instead of getting the treatment he needs.
The suspect was taken into custody, but the victim, who has served as the suspect's caregiver for about a month, did not want to file a complaint or have any charges filed.
Capt. Ron Oremus of the Waukesha Police Department said the suspect has a benign brain tumor that results in a cognitive disability impacting his ability to make decisions and affects his ability to control his impulses.
"That's not a good combination," Oremus said.
The caregiver and the suspect were at the Medical College of Wisconsin (Westbrook Health Center), 2315 E. Moreland Blvd., in Waukesha for blood tests after the suspect bit the caregivers' arm two days earlier.
But no blood tests were given as Oremus said the suspect was too agitated at the hospital.
While they were in the caregivers' vehicle heading out of the health center, the suspect became agitated once again and bit off a portion of the right ear lobe and the part going up the side.
Oremus said after the suspect bit the ear off, he handed it to the caregiver.
Sgt. David Wanner said immediate medical attention was provided to the victim from the Medical College staff before he was transported to Froedtert Hospital.
"They tried to reattach it but it was not a viable option," Oremus said.
I say it's ironic because thirteen years ago, they were reporting on how such maneuvers, like Abele's current one, don't work:
A six-month Journal Sentinel investigation of the plight of the mentally ill in Milwaukee found many people like John, wandering homeless, living in squalor, imprisoned in vast numbers, and warehoused in nursing homes or other institutions where they get little, if any, care.The paper ran another series of articles called "Abandoning Our Mentally Ill" just four years ago showing the same sort of problems occurring, despite promises of extra money being put into the system and that things were going to be different this time.
Many of the mentally ill once hospitalized, however, have fared better and, due to the reforms, are now able to live inconspicuously and to contribute to the community. No one pines for the old days when the mentally ill were locked away in wholesale fashion. Still, the mentally ill and those who care for them say there must be a better way.
When the new laws governing the care of the mentally ill were passed, they promised a full range of treatment in the least restrictive environment. But a quarter of a century later, even the framers say those reforms have failed to deliver. There is a pervasive frustration with the new system expressed in dozens of interviews with the mentally ill, their families, their caregivers, legal authorities, politicians and civil rights advocates on both sides of the issue of whether the mentally ill should be committed.
Another bit of irony stemming from the paper is that when Walker's hand-picked John Chianelli was trashing the mental health system through his incompetence, the paper called for him to be fired and rightfully so.
But one of the agencies Abele is relying heavily on to take in these patients is Transitional Living Services (TLS). And who is the Regional Director for TLS? John Chianelli!
The guy they thought was unfit to direct the care for these people in a controlled setting like the mental health complex is suddenly fit in a less supervised, less safe setting? I don't think so!
In sum, Abele's plan to privatize Milwaukee County's mental health system is ill-advised and irresponsible. As has been recently reported by The Center for Media and Democracy, privatization of public services like this opens the door for victimization of the most vulnerable while increasing the wealth of the profiteering agencies and corporations. Furthermore, privatization of human services is almost always much more expensive and much less efficient.
Abele's plan is a lose-lose-lose situation where the mentally ill, public safety and the taxpayers all lose. The privatization should be stopped or at least slowed enough that it could be done in a safe and responsible way. Furthermore, there should be plans made to build a new, but smaller, facility built so that the most vulnerable of these vulnerable citizens can be safely taken care off.