Abele Desperate To Abandon Mentally Ill In Privatization Move

For the past decade, the mentally ill in Milwaukee County has been getting neglected and maltreated.

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.

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.

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.

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.

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.

One does not have to be a mental health professional to understand that this instability is not therapeutic for the patients.

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.

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.

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.

Ironically, the Milwaukee Journal Sentinel has been advocating for Abele's privatization scheme, both in "news" stories and on their editorial page.

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.

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.

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.

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.

Walker Could Have Avoided BHD Problems Three Years Ago

At Milwaukee County First, I write that I have found out that Walker had a proposal for a secure unit at BHD that would have prevented much of the problems we are watching unveil today. Walker rejected it out of hand.

Basically, it comes down to this:

But even more important than Chianelli’s future with the County is that Scott Walker needs to be held accountable for again putting his political aspirations before the best interests of the county that he is supposed to be leading. He also needs to come up with a plan on how he is going to fix these problems he has created with his ideological short-sightedness.

When Tom Ament had put his own interests before the County’s, at least that only cost us money. Lots of money to be sure, but still, only money.

When Scott Walker puts his interests before the County’s, not only does it cost us a lot of money, but people, our most vulnerable citizens, get hurt and even die because of it. That is simply unacceptable.

A Growing Call To Fix BHD

The problems at BHD are gaining more attention as things start to reach a boiling point. Now three supervisors and some community advocates are calling for these problems to be fixed, including removing BHD Director John Chianelli from his duties.

As James Rowen points out, why were there only three supervisors calling for action to be taken?

I should mention that Milwaukee County First has been calling for that for a while. Speaking of MCF, see the real reasons for the problems listed in our latest posting.

Also, since I've bashed on the paper plenty of times, I would like to commend and recognize Steve Schultze and Meg Kissinger of the Milwaukee Journal Sentinel for doing a great job covering this developing story.

Deplorable

From Milwaukee County First:

“Deplorable.”

That is the word that the Milwaukee Journal Sentinel quotes County Board Supervisors and mental health advocates having used to describe Behavioral Health Division Director John Chianelli’s excuses for how a female patient at BHD was allowed to be repeatedly sexually assaulted and impregnated.

From the article:

Milwaukee County’s top mental health administrator intentionally houses female patients with men known to be dangerous “because the presence of women reduces the likelihood of the men being violent,” according to a county supervisor’s letter obtained by the Journal Sentinel.

John Chianelli, administrator of the county’s Behavioral Health Division, told county supervisors during a closed-door session last month that segregating men and women would result in more violence.

“It’s a trade-off,” he said. “Putting 24 aggressive male patients into a male-only unit would increase the level of violence in the unit.”

These comments were made in a closed session in which members of the County Board questioned Chianelli regarding the reports of repeated sexual assaults being allowed to happen.

The Board apparently thinks that the main reason for these sexual assaults are simply because patients are in co-ed units. Chianelli is feeding into these perceptions by trying to say that sexual assaults of female patients is an acceptable trade off for a higher level of physical aggressions if they were housed in an single-gender unit.

They are both wrong.

Read the rest here.

Walker, Chianelli Continue To Fail Vulnerable Citizens

Scott Walker and John Chianelli continue to bungle things at BHD, allowing a cognitively delayed young woman be repeatedly sexually abused, allowing the perpetrator into the community without any precautions, and risking $60 million in revenue.

Just so Walker can run for governor.

Story at Milwaukee County First.

The Mentally Ill Are NOT Second Class Citizens

Scott Walker and his minion, John Chianelli are again willfully neglecting the mentally ill, allowing them to be sexually and physically assaulted. And they manage to maltreat these vulnerable people while potentially costing tax payers millions in lost funding.

Chianelli needs to be fired and Walker needs to do some serious apologizing.

Full story is at Milwaukee County First.

Accountability And Consistency Are Foreign Concepts To Scott Walker

Two years ago, an inmate named Freddie Dudley allegedly escaped from the Community Correctional Center and killed another man. Scott Walker acted quickly to make sure "accountability" was enforced. He felt compelled to, since he was up for re-election in the spring.
His idea of "accountability" was to fire four corrections officers.

The only problem was, the officers didn't do anything wrong. But because of Walker's grandstanding, it still took them the better part of a year to get their jobs back. Walker's politicking cost at least one officer his home and custody of his children.

About the same time that the wrongly-fired officers were getting their jobs back, it became obvious to anyone that the then Superintendent of the House of Correction, Ron Malone, was not up to the task of being the Superintendent. Malone oversaw a host of problems stemming from an inmate being allowed to die from a drug overdose, to not even knowing the policy in his own facility to horribly failing a federal audit.

Malone clearly deserved to be fired, or at the very least not be reappointed to the job, since it was just a few months after Walker's re-election. Despite this overwhelming amount of evidence of Malone's incompetence, Walker nominated him for re-appointment.

More recently, just earlier this month, as part of an ongoing series of stories in the Milwaukee Journal Sentinel regarding child care fraud, it was discovered that a woman who was suspected of defrauding the system was given another check in the amount of $25,000, Walker immediately stepped up and fired the administrator of the program, no questions asked.

But like with the correction officers, it was found that the county worker was not to blame and that she was returned quietly to her position.

This brings us up to now.

Last week, it was revealed that one of Walker's cabinet members, John Chianelli failed to do his job with the slightest bit of competence or diligence. The end result was a sudden $3 million shortfall in the current budget. Cory Liebmann points out that this was only the very tip of a large iceberg, and shows us a larger portion of Chianelli's long record of failures.

Now, given Walker's past behaviors, one would have expected him to take immediate action to show that he wants to run a lean, efficient government. This is especially true since he has the high aspiration to be governor someday.

But one would have been wrong. Walker has not said one thing about Chianelli's failure, much less taken any sort of action. However, Walker did try to take it out on innocent county workers and the citizens they provide services for, by laying off 180 workers.

This is a major failure on Walker's part, and shows that he is not really in possession of any leadership qualities.

As Cory so clearly puts it:

The bottom line is that someone must own the incompetence that has been demonstrated at the Behavioral Health Division. Scott Walker appointed John Chianelli to his current position and who knows, maybe Chianelli is just doing Walker's bidding out there. But if he is acting completely on his own then Scott Walker must hold him accountable. If he is unwilling to do so then Scott Walker is essentially volunteering to take ownership of that incompetence himself. And goodness knows that he has plenty of that all on his own.