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Proposed Legislation to Change Oversight of County Mental Health Service is Deeply Flawed

By Candice Owley Published in Milwaukee Journal Sentinel February 28, 2014

In a recent editorial, former County Supervisor Lynne De Bruin, stated support of newly introduced legislation that would dramatically change control of mental health services in Milwaukee County. While I share her frustration on challenges to create a quality community based system of care, the solution she supports is not only wrong, but her rationale is flawed. I served on many of the same committees as she did and worked closely with the transitions of the same County programs and services and have a very different view.

De Bruin states that the planned changes are similar to the closing of Doyne Hospital and the Milwaukee County School of Nursing, but there are no similarities. She correctly notes that, when Doyne was closed, many services and staff ended up transferred to Froedtert Hospital; but, over time the County had no responsibility regarding future programs or funding of medical services. The same scenario applied to the School of Nursing, which transitioned to MSOE. Again, there was neither ongoing operational responsibility for nursing education, nor funding by the County.

As president of the nurses’ union, I represented the nurses in both of these transitions, so have an intimate understanding of what took place. In reviewing the proposed legislation, it is clear there is no similarity with what is proposed for mental health services. The legislation proposed by State Representative Sanfelippo and Senator Vukmir describes a dramatically different scenario: continued full funding by the County--but zero control over services. This radical legislation mandates Milwaukee County property owners provide a minimum of $177 million dollars per year to a private group of individuals handpicked by Governor Walker with no accountability to Milwaukee taxpayers. These private individuals will determine what services will be provided in our community and who will provide those services. The bill will strip all authority from the local elected representatives. The Milwaukee Journal Sentinel has stated this will bring Milwaukee into parity with the rest of the counties in the state, but that is also not correct. In none of the other 71 counties will local homeowners be required to turn over their property taxes to a private board with no accountability to citizens of their communities.

There are so many flaws with this legislation that it must be withdrawn or voted down. Who holds liability: the private, Walker appointed board with complete control over all services, or the County taxpayers whose only role is to pay the bill? Will the Walker board be required to comply with open meeting requirements? If the private board contracts for services, will there be bidding requirements such as exist currently for the dozens of private contracts for mental health services currently in place in the County, or can any or all services be turned over to private individuals or companies with no bidding, input or vote by local taxpayers? Will the Walker appointed board have authority to mandate private providers, including hospitals, or expand capacity to ensure adequate services?

Do we trust Walker to appoint individuals with the correct sensitivity towards persons with mental illness? Recently released emails, from the time when Walker was County Executive, reveal he surrounded himself with staff that made demeaning and disgusting comments, not only about BHD (“loony bins”); but, more troubling were the statements they made about persons with disabilities and mental illness. The attitude reflected in these emails may be the very reason positive changes could not be made when Walker was the County Executive, and also why he should not be trusted to oversee the system in the future.

I share the frustration of the staff, consumers and advocates regarding a lack of sufficient community based services, wrap around programs, and partners with private area hospitals. We should and must do better in Milwaukee County to provide a system of care and services that persons with mental illness and developmental disabilities deserve. We need to restore national certification of BHD which has been put on hold by County Executive Abele’s administration. Attention must be paid to the significant and growing nurse vacancy rate, and troubling nurse-to-patient ratios at the County facility. These are challenges that need immediate attention and will not be fixed by the proposed legislation.

Our union would welcome an advisory board of individuals with a passion for care to serve as champions of such a system, but we do not, and cannot, support legislation that would strip all Milwaukee County citizens of a say over how their taxpayer dollars are spent. It is our community, and we must not turn over our rights or responsibilities to a Walker appointed board.

Candice Owley, a registered nurse with a master’s degree in public administration, is the current president of the Wisconsin Federation of Nurses and Health Professionals which represents health professionals in both public and private health facilities in the Milwaukee area.