Milwaukee County’s effort to privatize its mental health hospital via a no-bid contract has run into opposition from its appointed Mental Health Board, which governs the county’s behavioral health and substance abuse programs.
In July, Milwaukee County Executive Chris Abele’s administration put out a Request for Proposals (RFP) to privatize the county’s psychiatric hospital, emergency room and observation unit for adults, adolescents and children by 2018. The vendor, who’d receive a 20- to 35-year contract, would need to build or repurpose a facility to provide these services. Just two potential bidders responded and the county pulled the plug on the RFP process on Oct. 2.
Four days later, the Abele-appointed Health and Human Services Director Héctor Colón said that in the wake of the failed RFP he wanted to move ahead with a no-bid contract with one private vendor who’d take over the hospital by 2018.
As the Shepherd reported two weeks ago, Colón told the Milwaukee panel convened by Wisconsin Health News, “Right now I think we see either way it would be a sole-source option, whether it would be with a private health system here locally or a national entity. Either way it would be a sole-source approach.”
County ordinances require competitive bids for large contracts, with an exemption apparently granted after “no valid bids” have been received. That seems to apply to the suspended RFP for the county’s psychiatric hospital. Generally, no-bid, sole-source or single-source contracts are frowned upon because they can potentially steer a contract to a preferred vendor during closed-door negotiations.
Colón’s desire to offer a no-bid contract to a single private vendor isn’t completely supported by the Mental Health Board. The board, comprised of appointed mental health professionals, took over county supervisors’ oversight of the county’s Behavioral Health Division (BHD) last year via state legislation.
Last Thursday the Mental Health Board voted to form two committees to look into the county’s options. One committee would explore offering a contract to a national health care entity. The other committee would explore allowing the county to form a public-private partnership with local health care systems. They’ll bring their findings to the full board for action, likely early next year.
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Abele ‘Forgot’ about Budget Cut
The Mental Health Board also got a chance to review the cuts Abele made to the Behavioral Health Division’s budget.
According to the state law that created the board in 2014, the Mental Health Board approves BHD’s budget, which is then sent to the county executive, who is allowed to alter it. Abele’s BHD budget cannot be changed by county supervisors during their county-wide budget deliberations—or by the Mental Health Board after Abele alters it. In short, Abele has the final word on the BHD budget and the Mental Health Board has no way to override his actions, although the board can reallocate funds within its budget after Abele approves it.
Although Abele has been touting his support for the county’s mental health services, he actually cut $632,370 from the Mental Health Board’s approved property tax levy for 2016, which includes a major cut to a crisis-intervention program specifically earmarked by the board.
In July, the Mental Health Board approved adding $346,000 to BHD’s 2016 budget to support third-shift operations at crisis resource centers on the North Side and South Side. Currently, these centers do not take in individuals suffering mental health crises at night, so law enforcement officers take these individuals to the jail or the county’s psychiatric emergency room instead. The board’s budget amendment would allow these centers to operate 24 hours a day.
But Abele’s version of the BHD budget includes just $150,000 for third-shift crisis resource center operations on the North Side only, cutting $196,000 from the board’s amendment. Abele wants more data on whether the centers need to operate during the third shift.
Board member Brenda Wesley, outreach coordinator at the National Alliance on Mental Illness (NAMI) Greater Milwaukee, said during last week’s meeting that law enforcement officers say they need more options for individuals having a mental health crisis during the nighttime. Abele’s budget cut limits their options.
“We try to tell them to do the right thing but then we don’t offer them anything,” Wesley said of Abele’s cut.
Other Mental Health Board members noted that when Abele met with the board this summer he said that he’d approve their budget.
“Spoiler alert: You’re going to get what you asked for,” Abele told the board during his five-minute appearance before them on Aug. 27, a month after the board submitted its budget to him. “But that’s an easy choice to make because you’ve been doing great work.”
Mental Health Board Chair Kimberly Walker, executive director of Legal Aid Society, said Abele’s staffers had tried to explain his comments to her after his appearance.
“After that meeting, I was told by one of his staff people that he had actually misspoke,” Walker told the board last Thursday. “He had forgotten that he had made the adjustment to the budget that he was giving to the county board on behalf of the Mental Health Board. And when he was sitting here he just forgot.”
This article is part of an ongoing series about Milwaukee County’s mental health services. For more, go to shepherdexpress.com.
