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Ficano Gives County Agency a Much-Needed Wake-up Call - 2/7/03

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  • visionary1@cyberservices.com
    Wayne County Executive Robert Ficano did the right thing earlier this week in raising questions about contracting practices at the Detroit-Wayne County
    Message 1 of 1 , Feb 7, 2003
      Wayne County Executive Robert Ficano did the right thing earlier this week in raising questions about
      contracting practices at the Detroit-Wayne County Community Mental Health Agency. This agency has had a long
      track record of problems, including accumulating bad debt. It needs a shake-up. The county executive already
      projects that the mental health authority will have a deficit this year at a time when the county must erase a
      shortfall projected to be as high as $54 million. This is in addition to any spending cuts the state may order
      the mental health agency to make. Ficano is having the accounting firm of Plante & Moran audit all county
      agencies, but the mental health authority deserves particular scrutiny. There are service providers and
      subcontractors that owe the county more than $15 million, according to the county executive. That explains in
      part why Ficano decided this week to fire two top financial officials at the mental health agency. Given these
      concerns, it is no wonder that the agency's board and the county commission are disagreeing about who should
      become the agency's permanent executive director. The mental health board voted last week to extend the
      contract of interim Executive Director Patricia Kukula -- who has less than a year on the job -- through 2004.
      Her contract was set to expire in June. The mental health board reasoned that the agency needed stability. It
      has had eight directors in nine years. The Wayne County Commission on Thursday correctly overruled the board
      and rejected its request to extend her contract. If the authority is already projected to run a deficit because
      of bad debts only three months into the new budget year, something needs to be corrected. The mental health
      authority annually spends $530 million to help provide services to about 75,000 people suffering from mental
      illness, developmental disabilities and substance abuse. Most of this money comes from the federal and state
      governments, with the county pitching in a little. The spending translates into more than $7,000 a case, which
      is a large amount of money. While severe mental illness can require expensive treatments, a lot of the agency's
      services do not require costly hospital stays. Since the agency provides treatments for a broad range of
      illnesses, the county needs to ask hard questions. At the least, the agency needs to conduct a national search
      for its director. After all, the agency is one of the largest of its kind in the country and needs a top-flight
      administrator. If Interim Director Kukula can beat national competition, she deserves to stay. The agency's
      contracting and spending practices need to be examined because of its history of problems. The last interim
      director eventually resigned because she had a conflict of interest. And in 1993, the state's auditor general
      went through three years of the Detroit-Wayne County mental health board's records and found the board allowed
      service providers to overbill Medicaid and Medicare by several million dollars. The county executive will need
      to be careful about creating reforms in the mental health agency. The law still gives the board the authority
      to choose its executive director. But if bad debt is a growing problem for the mental health agency, Ficano and
      the county commission are correct to intervene and demand more accountability.

      Detroit-Wayne County system has history of problems Questions have been raised about the performance of the
      Detroit-Wayne County mental health system during the past decade: * Wayne County Executive Robert Ficano this
      week questioned contracting practices. * Former interim agency Director Karen Schrock resigned in 2002 after
      refusing to resolve a conflict of interest by separating herself from a nonprofit with county contracts that
      she ran. * The agency has had eight directors in nine years. * In 1993, the state auditor general documented
      millions of dollars in overbilling by the system's service providers. * In 1992, Gov. John Engler, in response
      to a Detroit News report, criticized the authority for allowing three group homes to operate after repeated
      serious violations of laws and allegations that mentally impaired residents were denied medical care,
      physically and sexually abused, and cheated out of money.

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