Mental health changes eased in

City's clients to be cared for by some of same staff as before

Posted: Monday, July 03, 2000

City mental health workers and their clients expressed outrage and dismay when the city manager announced in February that to save money Juneau aimed to get out of the mental health business by June 30.

City officials initially estimated 40 of about 60 workers would lose their jobs as the Department of Health and Social Services was dismantled and its business parceled out to private, nonprofit providers. Some workers were expected to move to the new providers or to other city departments.

But June 30 has come and gone, and the predicted catastrophe is -- so far -- almost a no-show: Fewer than 20 clinicians and case workers are expected to have left by the time the department closes shop in November.

Of those, several have signed up or applied with two of the new providers -- the Juneau Alliance for the Mentally Ill and Juneau Youth Services -- and two have gone into private practice.

City Manager Dave Palmer will probably introduce an ordinance dissolving the department in November, said Deputy City Manager Donna Pierce.

Until then, clients will continue to be accommodated by some of the same clinical and medical staff at the same phone number and facility as before -- a process intended to allay clients' initial fears, Pierce said.

``From the point of view of managing the whole process, the transition has gone well,'' she said. The state Division of Mental Health and Developmental Disabilities, the Juneau School District and other agencies ``have rolled up their sleeves and worked really well together.''

Many workers in the city's chemical dependency unit, about 30 or so, will be rehired by Bartlett Regional Hospital when the hospital takes over that part of the department's work, Pierce added.

The department's mental health unit has laid off about 11 thus far and several others will be laid off in the coming months. Three department workers will stay on to work with the mental health block-grant and adolescent health care program the city will continue to operate, Pierce said. They will also work with other city departments, she said.

The Empire's repeated attempts to solicit comments from clinical workers were unsuccessful.

``After all that's happened and with the transition under way, these (clinical workers) have decided to get on with their lives,'' said Gregg O'Claray, business agent for the Marine Engineers' Beneficial Association, the union representing city workers in Department of Health and Social Services.

When all is said and done, the remnants of the city department's programs will be served by only two full-time employees, said city Finance Director Craig Duncan.

The department's mental health facility will remain open until November. Clients can continue to call the same emergency services pager number and will still have access to the services of the department's contract psychiatrist, said city department clinical director Steve Sundby.

And customers whose cases are being transferred to JAMI will find that the city psychiatrist has contracted to work for that organization as well, Sundby said.

Sundby estimated the department has had more than 300 open cases during fiscal year 2000, which ended Friday, but many are now closed. JAMI stands to inherit about 150 cases of chronically mentally ill adults from the city, he said.

Transition teams comprising state Division of Mental Health officials, clinicians, nonprofit mental health service providers and others have worked on a number of issues, including facilitating state granting procedures for funding the new providers.

The teams also addressed client concerns such as confidentiality of records. The city will continue with its custody of client records for seven years, as required by ordinance. But access will only be through clients' requests, Sundby said.

As a member of the transition team, Sundby said he had answered ``quite a few of the clients' questions. In general, most of the people have been satisfied.''

JAMI's primary purview has been about 85 percent of the local caseload of chronically mentally ill adults, said JAMI Executive Director Brenda Knapp.

With the assumption of city services such as emergency service -- crisis intervention and crisis stabilization -- along with therapy, psychiatric services and general mental health support, JAMI has received state mental health grants of about $500,000 and plans to expand its pre-transition staff of 40 by 12, Knapp said.

Juneau Youth Services will pick up about $384,000 in state grants to fund its expanded services and will add another five to eight staff to augment its current 110, said JYS Executive Director Chuck Bennett.

Among other services, JYS will assume the city's Access program, which provides support for severely emotionally disturbed youths. It will also take over the city's Alaska Youth Initiative component, a program whose aim is to provide mental health services to children while keeping them in-state and out of institutions, Bennett said.

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