Starting next week, Orange County is getting a new leader for public mental health services who’s vowing to focus on transparency and listening to community members about how to fix gaps in services.
Veronica Kelley – a longtime OC resident – is returning to the OC Health Care Agency after five years as behavioral health director for San Bernardino County.
When she starts next Friday, Kelley will oversee a team of 1,000 behavioral health staff at the county Health Care Agency who manage a range of mental health and addiction treatment services.
Her appointment comes as community advisors to the county have expressed concerns that officials don’t listen enough to the community about gaps in the mental health system.
In an interview with Voice of OC, Kelley said a major focus will be hearing from local residents and explaining the mental health system and money flows in an understandable way.
“Having [the] community voice is essential, especially having family members – of which I am a family member,” she said.
Amid concerns that the county’s complex spending documents have been making it difficult to follow the money for mental health and addiction programs, the incoming mental health chief says she’s committed to transparency and engaging the community.
“Without having looked at [the budget issue] about specifically, there’s always room for improvement because nobody is perfect, no system is perfect,” Kelley said. “That would be something I am really committed to as well, is improving transparency and collaboration.”
Her appointment comes as community advisors to the county have been raising concerns about transparency and lack of community engagement from county officials.
One of the most visible signs of that was the move by the county’s Behavioral Health Advisory Board to elevate as its chair Matt Holzmann, who has been outspoken in calling on the county to be more transparent on how it’s spending hundreds of millions in mental health dollars.
Kelley said it’s important to lay out the spending for residents in an understandable way.
“Being able to break it down, so that people can be able to understand it … I think that’s really important,” she said.
“And at the end of the day, I hope to be able to do that. I hope that transparency and collaboration will be a key thing that people think of when they think about behavioral health service.”
Transparency has been elusive over the Behavioral Health Advisory Board’s appointment of Holzmann.
County health officials have refused to release audio recordings from the board’s public meetings, claiming the public is better served by not disclosing them.
“The County has determined that the public interest in withholding disclosure outweighs the public interest in disclosing the recording because it will have a chilling effect on candid and deliberate and robust discussion at the [advisory board] meetings by [board] members and County staff,” county officials wrote in September in response to a Voice of OC request for such audio.
Voice of OC followed up a week ago with a request for audio of the advisory board’s latest meeting, and after multiple follow-up messages Health Care officials haven’t responded one way or the other about whether they’ll release it.
Holzmann says he welcomes the opportunity to work with the new mental health chief.
“Dr. Kelley is uniquely qualified to lead Orange County’s behavioral health community,” Holzmann told Voice of OC in a statement.
“Her commitment to excellence in serving those most in need and her understanding of systems and management will serve Orange County well. We are excited to welcome her back to Orange County.”
The county still has a long way to go when it comes to mental health services, said Brooke Weitzman, a leading attorney for disabled homeless people in Orange County.
She said the county has learned that non-congregate shelter – such as motel rooms in the Project Roomkey program – is “wildly successful” in getting homeless people with mental health conditions into services and stabilized housing.
But she said the county scaled back such programs despite federal officials agreeing to cover 100% of the cost.
And the county won’t share the data on how effective the Roomkey program was, Weitzman said.
“We see that those programs worked better [and] in the long run they cost less,” Weitzman said. “So if the data supports this is the better route, and the money’s available, why aren’t we taking advantage of it?”
Weitzman also encouraged Kelley to look at expanding access to existing mental health programs, some of which are only available weekdays between 9 a.m. and 5 p.m., despite broad agreement that barriers to mental health services should be broken down.
Regarding overall challenges facing county mental health departments across California, Kelley said the state is typically 6 to 7 years behind in reimbursing counties for mental health programs – and much of the funding for services is short-term and restricted.
For example, the cost for care at state mental hospitals can sometimes reach $1 million per year, but it can’t be billed to low-income health insurance under Medi-Cal, so the county has to “eat” that cost, Kelley said.
And one of the county’s largest funding sources for mental health services – the Mental Health Services Act – can’t be spent on any type of services that previously existed.
“Those kinds of restrictions make it really difficult,” Kelley said. “We patch things together, but we do that so we can leverage the dollar and can make it go further.”
Kelley said she’s working with colleagues from across California to reform fragmented elements of the mental health care system – such as lifting much of the current limits on county mental health clinics being able to serve people who walk in the door with mild or moderate mental health conditions.
“We want to get our services out on the street,” she said.
While mental health is critically important in local communities, it’s often funded at a much lower level than physical health care, Kelley noted.
“If you look at the funding for physical health care and compare it to behavioral health, you’d see a huge disparity,” she said. “So we’re the least funded, but most crucial.”
Nick Gerda covers county government for Voice of OC. You can contact him at firstname.lastname@example.org.