A new Marin County Civil
Grand Jury report recommends the county of Marin adjust its budgeting process
so that it can better evaluate mental health program costs and benefits.
The grand jury also faults
the county for failing to use the bulk of a $2.1 million state grant it
received in 2009 for mental health housing. And the grand jury says the county
needs to redouble its efforts to find a new site for the Helen Vine Detox
Center, which is losing its lease in February 2016.
There were some 3,700 mental
health patients in Marin in fiscal year 2012-13, according to Mental Health and
Substance Use Services, a division of Marin County’s Department of Health and
Human Services that oversees mental health services. These patients suffered
from conditions such as severe schizophrenia, bipolar disorder and major
depression.
The grand jury commended the
division for using grant money to implement two new intervention programs, “one
to de-escalate mental health crisis and another to prevent people from losing
housing.”
The county’s recommended
budget for fiscal year 2014-15 included $47.1 million to provide a safety net
of mental health and substance use services. Revenues from state and federal
sources were expected to contribute $36.2 million and the county’s general fund
was expected to contribute $10.9 million prior to the end of the fiscal year.
But the grand jury wrote that
during the course of its investigation of Marin’s mental health system, it
became apparent that the “budget process is flawed.”
The grand jury says it
repeatedly requested budget information from the mental health division about
its programs, but a budget for each program could not be provided. The grand
jury says instead it was told, “‘Marin County department budgets are developed
based on cost centers and organized based on state required templates, which
are not program specific.’”
The grand jury states, “The
county can and should use the same state data to develop its own budgeting
system that tracks individual program costs.”
This same grand jury made a
similar recommendation in its April report on homeless support services
available in Marin.
Suzanne Tavano, the county’s
director of Mental Health and Substance Use Services, said, “The county is
already underway with the Administrative Technologies of Marin (ATOM) project
and the production of financial reports that are formatted differently.”
The ATOM project is a new
software system under design to handle all of the county’s budgeting,
accounting, purchasing and payroll needs.
Charlie Haase, Marin’s chief
technology officer, said, “The new system certainly has the capability to track
things in ways that we can’t track them today. We’re setting it up with those
things in mind.”
Haase estimates it will be at
least two years, however, before the new system will be available for use by
the mental health division.
MORE HOUSING NEEDED
The grand jury says that
while a key responsibility of the mental health division is to provide housing
for mentally ill adults, there is a “significant lack of appropriate housing
for mentally ill adults in Marin.”
Marin General Hospital’s
17-bed inpatient mental health facility is the only locked psychiatric hospital
in the county. The grand jury notes that when no suitable beds are available in
Marin, the county must contract to house patients in other counties, “imposing
a burdensome and painful distance between patients and their families.”
The grand jury said that
locked long-term residential housing and post-crisis housing is also needed. It
says the county should have used a $2.1 million grant it received from the
state in 2009 to purchase mental health housing during the recession when real
estate prices were depressed.
Tavano said, however, that
the state required that counties only use that money to supplement new
construction projects initiated by developers.
“The county did not have a
choice,” Tavano said. Buying existing properties was not an option.
The county was able to use
about $700,000 of the grant to help underwrite the creation of five units at
the former Fireside Inn in Mill Valley. The remaining $1.4 million remains
unspent. In January, however, the county finally secured approval from the
state to use the money to purchase existing housing, and Tavano said the mental
health division is weighing its options.
Sandra Fawn, chairwoman of
the county’s mental health advisory board, said, “The county does provide over
400 rooms for mentally ill people.”
Fawn said the county housed
her mother, who suffered from schizophrenia, at St. Michael’s Extended Care in
San Rafael for seven years.
“The people there took great
care of her,” Fawn said.
Regarding finding a new home
for the 26-bed Helen Vine Detox Center, the county’s only public detox
facility, Tavano said, “We are in full agreement that the detox center needs to
continue. We are working very diligently on finding a location that will be
acceptable to all. It’s not a back-burner item at all.”
May
24, 2015
Marin
Independent Journal
By Richard
Halstead
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