When the state Legislature created the Milwaukee County Mental Health Board last year, it did so to remove politics from policy as the county transitions to a more community-based, person-centered model of behavioral health care.
The board, chaired by former Milwaukee County Corporation Counsel Kimberly Walker, is made up of appointed mental health professionals, advocates and community representatives, all of whom are donating their time to the board without the help of even one dedicated staff member.
The Mental Health Board has taken on the responsibilities of the Milwaukee County Board of Supervisors, which no longer has any oversight of the county’s mental health services. The new board has been working closely with the county’s Department of Health and Human Services (DHHS) and Behavioral Health Division (BHD) to craft the county’s mental health policies.
But a year after the Mental Health Board’s creation, members of the public—including the consumers of the county’s mental health and substance abuse programs, along with their advocates—are having difficulty connecting to the board and getting their concerns addressed.
Barbara Beckert, the Milwaukee office director of Disability Rights Wisconsin, said that the public’s access to the board has been an area of concern.
“If you look at the process to date there have been a lot of barriers for the public to have the opportunity to have access to the policy makers and you certainly would hope that’s not the intent,” Beckert told the Shepherd.
Brenda Wesley, a board member and director of education and outreach at NAMI-Greater Milwaukee, said she’s concerned about county residents’ awareness of the board and its policies, as well as the misinformation that can circulate in the community in the absence of a direct connection to the board.
“I don’t think the community knows about the board,” Wesley said. “The board is there but the community is unaware of what is happening, and [the board is] not inviting the community and they’re not doing anything to get out into the community to even have the discussion.”
Mental Health Board Chair Kimberly Walker didn’t respond to the Shepherd’s request to comment. DHHS Director Hector Colon’s office didn’t make him available to the Shepherd by press time.
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Questions about Transparency during Transition
The lack of access to the Mental Health Board is coming at a critical time. Milwaukee County Executive Chris Abele, DHHS Director Hector Colon and BHD Administrator Patricia Schroeder are aggressively pushing a redesign of the county’s behavioral health services so that more services are in the community and consumers have a greater role in managing their care.
Ironically, the public doesn’t seem to be involved in these major decisions.
“What we’ve found is there’s this kind of resistance to community input and partnership to brainstorm around some of this,” said Martina Gollin-Graves, president and CEO of Mental Health America of Wisconsin and co-chair of the Milwaukee Mental Health Task Force. “As an advocate, I feel a sense of frustration.”
The legislation that created the board in 2014 requires far less transparency than the county supervisor-led governance model. The new state law requires the board to hold at least six meetings per year, with one meeting being a “public hearing” held in Milwaukee County, interpreted by many as not being a working meeting but one that is devoted solely to listening to the community. An entirely public hearing wasn’t held in 2014 or 2015.
All of the board’s meetings are open to the public. The Mental Health Board’s website lists upcoming meetings and provides documents and audio from previous meetings. But agendas and meeting minutes are brief and the quality of the audio is poor. The board does not videotape its meetings. This summer, the board began announcing its meetings via the county’s E-Notify service so those who sign up for the service can be emailed in advance.
Perhaps even more critically, the board’s website provides no contact information for the board, so the public has no way to raise issues with members.
That said, the board does allow public comment at some of its meetings, but typically only from invited guests while members of the general public are allowed to speak on specific topics.
Earlier this summer, the Mental Health Board allowed public testimony on the administration’s proposed $189 million budget for 2016. But the testimony apparently changed nothing and the budget was approved two weeks later with only one alteration, which came from the board. Making that change wasn’t an easy task.
A handful of board members put forth two amendments at the final meeting on the budget, lacking any other mechanism to get their changes on to the board’s agenda. One amendment passed. It added $346,000 to allow crisis resource centers to remain open during the third shift so that law enforcement would have a safe place to take people in crisis at night. But an amendment that would allow the board to hire a policy research analyst to help them research issues, gather data independently and prepare for meetings lost by one vote. DHHS Director Colon, an Abele appointee, pushed hard against it during the board’s debate, even though he isn’t on the board and therefore doesn’t have a vote. Instead of utilizing a staff researcher, the board must continue to rely on BHD-provided data and proposals, instead of independently gathering data.
The public also was allowed to speak on the Behavioral Health Division’s proposal to privatize the county’s mental health hospital via a request for proposals (RFP). Still, just a handful of advocates provided testimony in the one meeting in which the public was allowed to speak. Their advice to go slow and involve community members in the board’s RFP process seems to have gone unheeded. The RFP for a 20- to 35-year contract to provide emergency and acute care services went out on schedule on July 15, just days after the July 9 public hearing.
This article is part of an ongoing series on Milwaukee County’s behavioral health services. To read articles on the Mental Health Board’s role and the county’s privatization plan, go to shepherdexpress.com.
