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Dec. 10, 2013
OLATHE Johnson County commissioners are considering assuming direct oversight of the county’s cash-strapped mental health center.
County staff is recommending the move, which could come as early as Thursday’s commission meeting, following an outside review that said the center’s current volunteer governing board has created “an unhealthy, unproductive atmosphere” within the organization and “demonstrated a lack of understanding of their roles and responsibilities.”
Through the proposed action, the commissioners would dismiss the current governing board and appoint themselves in their place. The commissioners also would appoint a community advisory body under that plan.
Such a move would revamp a governing structure in place since the county established the mental health center more than five decades ago.
The critique of the governing board’s performance came from a five-person technical assistance team from the Association of Community Mental Health Centers of Kansas.
Some county commissioners expressed displeasure with the harsh criticism of board members who donate their time as appointees of the commission. Commissioner John Toplikar also questioned whether the suggested action complied with the county charter.
There has also been talk on the commission about perhaps consolidating the mental health center with another agency or department, such as the Department of Health and Environment.
Headed by Ron Denney, the retired executive director of the Four County Mental Health Center in Independence, the team issued a 21-page report after spending two days at the center last month at the request of the county manager’s office.
In accordance with a Nov. 7 directive from the county commissioners, the county manager’s office has assumed day-to-day management of the center along with Chad VonAhnen, who is providing some temporary administrative assistance through his role as executive director of the county agency that serves the developmentally disabled.
The mental health center’s board placed its full-time executive director, Maureen Womack, on paid administrative leave in October amid revelations that the center would need a taxpayer bailout of about $1 million to keep operating into early 2014.
She has since resigned, a county spokeswoman said Monday.
Established by the county in 1962, the Johnson County Mental Health Center serves about 11,000 patients annually with a budget of about $30 million. County taxpayers provide about half the center’s annual funding.
The technical assistance report listed 10 areas for improvement and included two dozen recommendations for county officials to consider. The report noted that the center has dedicated staff ready to make the changes necessary to stabilize the agency.
Much of the report focused on getting the mental health center back on firm financial footing, including having proper staffing levels and refining the agency’s programs and services.
In general, the reviewers said, the county must run the agency more like a business, meaning it must bring in more revenue and hold staff accountable for productivity.
“It almost comes across that the center is ashamed to accept money from individual citizens,” the report said.
It was their understanding, the reviewers said, that the agency had left open about 120 positions during the past several years through attrition. The report called this “extremely shortsighted” in that some of the positions could have generate money for the agency, mainly by billing Medicaid.
Denney, the head of the technical committee, said the criticism of the governing board came largely from interviews with the staff.
With very few exceptions, he said, staff blamed the board for what they considered to be a bad hire in Womack and then for waiting too long to take any action against her. Womack has declined to comment on the situation.
Denney said it appeared that Womack’s main problem was not communicating well enough to staff why she was making certain decisions, such as beginning to implement productivity standards for staff. The productivity standards “are within normal limits” for a Kansas mental health center, the report concluded.
Under Womack, who came on as executive director about two years ago, Denney said it seemed the Johnson County Mental Health Center was taking steps needed to maximize reimbursements.
Most other mental health centers around the state learned that lesson years ago, he said.
“They are about five to 10 years late,” Denney said, noting that center might not have acted earlier because of the sizable sum it receives each year from the county.
Denney said the technical assistance team did not interview members of the governing board for its report. He said that was probably a mistake, but that the team was acting very quickly at the request of county management.
In taking issue with the criticism of the mental health board, Vice Chair Allen Rawitch said it was “rather strange” that the technical assistance team did not get input from the board.
Perhaps they were rushed, he said, but “I’m not sure that is an excuse to not be thorough and get the information you need.”
He said the volunteers on the board strived to act in the best interest of the agency and its patients. Rawitch said board members had discussed whether the productivity standards were clear enough for the staff.
But he said it was appropriate that the board left staffing decisions to Womack and other center professionals.
He said it was not up to him to agree or disagree about the recommendation to dissolve the current board.
At last week’s commission meeting, Commissioner Toplikar asked if the commission could take that step without at least holding a public hearing in accordance with the county charter. He said he would talk with county legal staff for more guidance.
Commissioner Ed Peterson said most of the issues raised in the technical assistance report seemed to be managerial problems outside the purview of a governing board.
“I’m not sure how many problems we would actually solve by stepping in ourselves,” he said.
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