"While I'm sure it is uncomfortable to contemplate, EVERY ONE of YOU is getting paid a full time salary (nearly $100,000) (and more for County Counsel and DHHS administrators) to provide adequate psychiatric treatment to our most severely ill patients."

I am sharing a letter (content in italics) sent to the Humboldt County Board of Supervisors and others by Dr  Jennifer Wilson on March 31, 2021. 

I have written about the need for Laura's Law for years, I have called out the Board of Supervisors. and I did all of this repeatedly before any other media covered this issue. Those previous posts are accessible on this blog and I have linked them in this post.

I have also personally spoken to certain Supervisors, including Fourth District Supervisor Virginia Bass and former Second District Supervisor Estelle Fennell.

The identity of the person who shared it with me and is watching out for the public will remain anonymous. They sent it exclusively to me because of my previous coverage and the issue getting repeatedly ignored when they approached other media. 

I also want to thank the letter writer. Dr. Wilson is someone who we are very fortunate to have in Humboldt County and she took a risk with this letter.

March 31, 2021

To: Humboldt County Board of Supervisors: Supervisors Bohn, Bushnell, Wilson, Bass and Madrone

CC: Connie Beck, Director, DHHS, Humboldt County

Emi Botzler-Rogers, Director, DHHS-MHB Humboldt County

Paul Bugnacki, Assistant Director, DHHS-MHB Humboldt County

Heather Cooper, County Counsel, Humboldt County

Lea Nagy, President, NAMI Humboldt County

Rober Soper MD, Psychiatrist and Chair of BH Committee

Penny Figas, Humboldt-Del Norte Medical Society

Ruby Bayan MD, Psychiatrist and Medical Director of Waterfront Recovery Services

Marek Reavis, Public Defender, Humboldt County

Meagan O'Connell, Supervising Attorney, Conflict Counsel Office

Maggie Fleming, District Attorney, Humboldt County

Kim Bartleson, CEO of Humboldt County Superior Court

RE: Laura's Law and Urgent Need for Crisis-Residential Psychiatric Treatment and Supported Housing

Dear Supervisors,

I am writing to comment on the Board's exploration of the implementation of Laura's Law and the inadequate services in Humboldt county for the most severely ill patients in our community: patients with anosognosia (lack of insight into their illness and need for treatment). As you are likely aware, up to 40% of patients with chronic psychiatric disorders such as schizophrenia, schizoaffective disorder and bipolar disorder have anosognosia and resultant treatment nonadherence in standard outpatient treatment. As you hopefully know, being in a psychotic state is bad for the brain and the longer patients go untreated the higher chance that their illness will worsen, become treatment unresponsive, increase suffering and increase hospitalizations and incarcerations. The Humboldt County Board of Supervisors are responsible for the psychiatric treatment that is and is not provided by Humboldt County DHHS, for overseeing how public funds are being utilized and, ultimately, for the human suffering of patients, families and victims as the result of inadequate psychiatric treatment.

As you all are aware, Laura's Law (AB1421) in 2002 and the newer PC1001.36 Pre-Trial MH Diversion Law (AB1810) in 2018 were enacted by the California legislature to provide adequate psychiatric treatment to patients with anosognosia. Laura's Law includes comprehensive Assisted Outpatient Treatment to a subset of patients with severe mental illness and PreTrial MH Diversion allows for eligible patients to receive adequate psychiatric treatment rather than criminal punishment. While Laura's Law did not come with funding, many counties have found funding by shifting resources, obtaining grants and partnering with the state and many counties implemented Laura's Law more than a decade ago. Many counties are using MHSA funds (Prop 63 Millionaire Tax) which the California legislature enacted in 2004 in response to seeing so many deeply troubled patients on streets due to lack of sufficient treatment. At the state wide DSH Forum on MHDiversion in Sacramento in 2018 one of the presenters was Judge Stephen Manley from Santa Clara county who stated that ALL counties should be using MHSA funding on these patients. The Humboldt County Board of Supervisors are responsible for overseeing Humboldt county DHHS's use of MHSA funds. MentalIllnessPolicy.org is an excellent source of information on how some DHHS departments in CA are "working around" the letter (and the spirit) of Prop 63 in order to excuse themselves from adequately treating our most vulnerable mentally ill patients by saying that "The public wants us to spend it on ____" and "We obtained public input". With all due respect, the general public wouldn't know how best to treat severely ill patients but community partners such as consumers, consumer's families, treatment providers and MH administrators would (and should) know. It is my opinion that is is unethical and immoral for the Board of Supervisors and DHHS administrators to be spending public funds on non-treatment expenses unless/until adequate treatment is being provided. Some examples include: birthday parties and proclomations for Sempervirens, luxury offices in the Professional Building, parking spaces for administrators, travel and conference expenses for staff who don't provide direct service, private business consultants to analyze why DHHS-MHB is chronically understaffed and then not using the professional input obtained etc.).

While I'm sure it is uncomfortable to contemplate, EVERY ONE of YOU is getting paid a full time salary (nearly $100,000) (and more for County Counsel and DHHS administrators) to provide adequate psychiatric treatment to our most severely ill patients. I bet you all have comfortable warm homes to return to after your work days and have ample access to food and psychiatric treatment and I believe that ALL people in Humboldt county deserve the same.

I strongly support the implementation of AOT in Humboldt county along with crisis-residential treatment and staffed supported housing. Perhaps Humboldt county could partner with adjacent counties on developing such services. Perhaps a change in leadership of Humboldt county DHHS is in order if the current administrators are unable to provide adequate psychiatric treatment to the very patients that they exist to (and are being paid to) serve. Perhaps the Board of Supervisors will want to consider the ongoing and possible future costs to the county of NOT providing adequate psychiatric treatment and supported housing.

Sincerely,

Jennifer Katy Wilson MD

Previous coverage and related posts:

https://johnchiv.blogspot.com/2018/11/the-streets-of-eureka-are-safe-from.html?m=1

(has other links included in this post)

https://johnchiv.blogspot.com/2018/09/lauras-law-statewide-would-get-some.html?m=1

(has other links included in this post)

https://johnchiv.blogspot.com/2017/03/marin-taking-steps-to-address.html?m=1