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The city's nearly year-long transfer of its mental health services to nonprofit care providers has been nearly "seamless," according to Deputy Mayor John MacKinnon. But one critic at an assembly work session Monday night said some long-term care has been lost. Another claimed the city has merely transferred provision of some services to another of its own departments.
City Manager Dave Palmer began the process of dismantling the city's Health and Social Services Department in February, citing problems with the department's red ink, looming deficits and competition with private, mental-health care providers.
"The transfer is pretty much complete," said Deputy City Manager Donna Pierce at Monday's meeting. "It did go remarkably smoothly."
Juneau Youth Services, one of the nonprofits that took over programs, has had its day treatment program boosted by 25 percent, said JYS Executive Director Chuck Bennett. JYS also took over the city's Alaska Youth Initiative component, which provides mental health services to children while keeping them in-state and out of institutions. Overall, JYS has grown about 10 percent and "two or three" of the old city department's clinicians have been added to JYS's staff of 120, he said.
"But from a consumer point of view, some families are concerned about long-term care, which the city used to provide and JYS no longer can," Bennett said. "The city had been delivering that for years."
State officials analyzed mental health care statewide as well as Outside and concluded that the short-term care model works as well as the long-term model, he said.
With state funding for long-term care no longer forthcoming, JYS tried to provide the service on its own and lost between $5,000 and $6,000 a month for three months this year, Bennett said.
Gastineau Human Services, a nonprofit substance abuse treatment and community corrections provider, had expected to get more of the chemical-dependency pie than it did, according to GHS Executive Director Greg Pease. "Last night's meeting seemed more like an orchestrated love fest than anything else," he said. "Funding that was to go to a variety of nonprofits - AWARE (the women's shelter), GHS, Tongass Community Counseling - all of it, 100 percent, has gone to Bartlett Regional Hospital."
The city handed over management of Health and Social Services' Juneau Recovery Hospital, a chemical-dependency facility, to city-owned Bartlett last summer.
"When the transition began, we were asked to come up with services and to hire people from Health and Social Services, and we did both - to no avail," Pease said.
Pease said he could no longer identify who, among city staff, is responsible for planning for chemical-dependency services or to answer funding requests.
Another of the nonprofits deemed the transition successful.
"From the point of view of the consumer, (the transition) has been a non-event," said Brenda Knapp, executive director of the Juneau Alliance for Mental Health Inc.
The city granted JAMHI use of the old Health and Social Services building near Salmon Creek, which - with the same services provided, same location and same phone number - made for an easier transition for clients, she said.
JAMHI has seen a 30 percent increase in clients and is recruiting for professional staff, Knapp said. It has also had to "re-recruit" after new hirees departed. "A big challenge in the coming year will be to make sure we have qualified staff," she said.
JAMHI's arrangement with the city for use of the Salmon Creek building ends Dec. 31, and JAMHI is negotiating with city staff for a year's extension. Auditors have advised mental health providers that the organization needs to consolidate its Salmon Creek and downtown operations.
The principal rationale for getting the city out of the mental health business - an excess of red ink - is not going away, at least not for a while. City subsidies for services are hovering at about the same level now as they did before the department got the ax.
The city subsidy for Juneau Recovery Hospital was $1,047,000, the same as for JRH under Bartlett management today, according to Pierce. City subsidies for program costs, transition expenses and rent for the Salmon Creek building provide JAMHI about $300,000, the same support it got before the transition.
"The expectation is that the city's contribution will decline over time," Pierce said.
Fernand Chandonnet can be reached at firstname.lastname@example.org.