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BHD Problems Could Have Been Avoided Three Years Ago

Posted by Chris Liebenthal on May 13, 2010

From Milwaukee County First:

Often in life, one thing can lead to another which leads to another.  Likewise, one thing not done can lead to other issues.  Today I found fine examples of both of those situations.

As most people are already aware, things are not good at Milwaukee County Behavioral Health Division (formerly known at Milwaukee County Mental Health Complex).  Things at BHD have rapidly gotten worse.  Part of this is directly contributed to the mismanagement by its current Director, John Chianelli.  But, by far and for a much longer time, the bulk of the problems is tied directly to Scott Walker’s continuous and irresponsible insistence on cutting services in order to “save money.”

We have seen problems with the budget, including a last-minute, end-of-the-year budget meltdown last year when Chianelli “suddenly” realized he was going to have a $3 million shortfall.  This sent the entire County reeling as they tried to find the money from other places.  Said short fall came because Chianelli failed to properly monitor the impact of changes in Medicaid coverage.

There has been a spike in patient-on-staff violence, increasing by some 50%.  This was, of course, followed with more workers being out due to their injuries, which caused there to be a lot of overtime, so much that it exceeded their budget.  This in turn led to more burn out, more absences and more overtime.

Other problems in recent years include one woman starving to death and a second person, an elderly man,  nearly doing the same, while in the care of BHD.  There have been other deaths as well, including a person who was on suicide watch dying from an overdose and a young man who ended up being shot to death by police during a psychotic episode.  This young man was in obvious need of inpatient care, but was turned away due to a shortage of beds, thanks to Walker’s budget cuts.

Most recently, there has been the story of a young woman, who has both cognitive delays and mental health concerns, who was allowed to be sexually assaulted repeatedly.  As this story developed, a debate on whether units at BHD should be coed or single gender. Stemming from this debate was the horrific statements by Chianelli, saying that the sexual assaults were “a trade off” for less physical aggressions found in single gender units.  There has been a growing demand for changes to be made at BHD, including relieving Chianelli of his duties as Director.

Today, in the editorial piece in the Milwaukee Journal Sentinel, we find that Pat Jursik is saying things were different than what has been reported.  Of course, Jursik is also a lawyer and is probably more concerned with the probability of lawsuits coming out of this fiasco.  This really is a pity, since this makes her seem just as culpable as Walker, putting money before the people she is supposed to be serving.

Another tidbit from today was on the Charlie Sykes radio show.  Sykes reported getting letters from the professional staff at BHD saying that they all supported Chianelli and found the allegations to be terrible and wrong. Sykes found this “interesting.”

I have also seen these letters and they are not signed by all of the professional staff.  They are signed by most, if not all, of the administrative staff who serves at Chianelli’s pleasure.  Not one front line worker, not one CNA, not one nurse or other people that work the floors everyday signed these letters.

This raised some red flags for me.  A couple years ago, when the poorly thought through proposal to move BHD into the old St. Michael’s Hospital was proposed, a couple of people, both well-respected doctors, who have been outspoken against it were suddenly gone from their positions and/or had their privileges to practice there were taken away.

So I started making some phone calls, and that is one thing started leading to another.

Sure enough, people were reporting that while no one was forced into signing these letters, some people were “strongly encouraged” and pressured to do so.  The common reason was they remembered what had happened to the two doctors and were afraid of angering the powers that be.

This led me to calling Dr. Timothy Wiedel.  Dr. Wiedel had been Chief Psychologist and Director of Legal Services at BHD from 1999 to 2008.  He was the doctor that was let go because of his vocal opposition to the St. Michael’s proposal, although Wiedel prefers to say “he suddenly chose to resign.”  Dr. Wiedel is a well known and respected professional in the region and has often appeared in court for expert testimony in cases.

He said that he was saddened but not surprised by what was going on at BHD.  It also did not surprise him when I told him that some of the signers of the letters felt pressure to sign, citing his departure as a reminder of what can happen.

But then Dr. Wiedel told me something I was not been previously aware of.

In 2007, in response to the increasing number of incidents of physical aggression, Dr. Wiedel took it upon himself to design and write up a full proposal for a secure unit to deal with the more aggressive patients that they had been dealing with.

The proposal made it through the various levels of bureaucracy until it actually made it to Scott Walker’s desk for his consideration for the 2008 budget.    Unfortunately, Walker chose to reject the proposal, which would have prevented the horrific events that are currently being played out.

Dr. Wiedel told me that in January 2008, he learned from Chianelli that Walker rejected the plan, in part, due to Chianelli speaking against the plan.  A couple of months after this, BHD was cited by the state for having too many incidents of physical aggression, making the citations this year the second time in three years that the security and staffing at BHD was found to be inadequate.

I then spoke with Stephanie Bloomingdale, who is the Director of Public Policy for Wisconsin Federation of Nurses & Health Professionals.  I contacted her since it was her union that had been calling for the secure unit for years and was wondering what her reaction to this discovery would be.  Ms. Bloomingdale had this to say,

“WFNHP has been calling for a secure unit for years, but Scott Walker rejected it out of hand and now we’re seeing the effects of his budget cuts over all these years.”

This pretty much says it all.  Due to Walker’s short sightedness and abdication of his responsibilities, a lot of people could have been spared suffering and pain.  Furthermore , it would  have proven to be much less expensive than the cost to clean up after his failures, including the inevitable lawsuits.

In summary, John Chianelli should still be relieved of his duties as Director of BHD.  Even if one puts aside the irresponsible and reprehensible statements that he allegedly made, he is still responsible for having a policy that allows these sexual assaults to occur in the first place.  He is also resp0nsible for such inexcusable problems such as the $3 million shortfall at the end of last year, the poor staffing rates forcing more overtime, more injuries and increasingly inadequate levels of supervision.

But even more important than Chianelli’s future with the County is that Scott Walker needs to be held accountable for again putting his political aspirations before the best interests of the county that he is supposed to be leading.  He also needs to come up with a plan on how he is going to fix these problems he has created with his ideological short-sightedness.

When Tom Ament had put his own interests before the County’s, at least that only cost us money.  Lots of money to be  sure, but still, only money.

When Scott Walker puts his interests before the County’s, not only does it cost us a lot of money, but people, our most vulnerable citizens,  get hurt and even die because of it.  That is simply unacceptable.


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