Uncertainty surrounds mental health hospital

By Beth Kevit

The view from the waiting room is wearing on Milwaukee County Supervisor Joe Sanfelippo.

He said he has waited for a year and a half for a task force to restructure the way the county delivers mental health services, such as shifting patients to community-based clinics from the Behavioral Health Hospital on the Milwaukee County Grounds in Wauwatosa. That restructuring, he said, could lead to the county tearing down the hospital and replacing it with a smaller building.

The problem, Sanfelippo said, is the task force never was given a deadline.

“Eventually, we have to get to a point,” he said, “where there is a new hospital.”

But that’s not happening, Sanfelippo said, with a task force under the direction of Paula Lucey, administrator of the county’s Department of Health and Human Services Behavioral Health Division.

“She just is not doing anything to get the ball rolling as far as a redesign,” Sanfelippo said.

Lucey disagreed. She said the restructuring is focused on changing how patients are served, not where. A new hospital, Lucey said, might be a byproduct, but the real work already is under way.

The task force was created in 2011 to review studies that examined the county’s mental health care system and to find ways to put those recommendations into practice. Lucey said some already are in place, such as Milwaukee’s newly opened crisis resource center and the creation of a women-only unit at the hospital.

The division’s new intensive treatment unit is part of the restructuring, she said, as is the reorganized mobile crisis team, which puts more emphasis on mental health professionals and less on police presence.

The next big challenge, she said, is to close a 24-bed hospital unit and an acute care unit.

It would be difficult to put a deadline on that kind of work, said Supervisor Peggy Romo West, who sponsored the resolution that created the task force. She said there is too much uncertainty about what the community would require from BHD, how much members of the task force could accomplish on top of their other duties and how much money would be available to make system changes.

The county gave the division $3 million at the start of the year to begin restructuring the system. So far, the division has spent $1.9 million. Whatever is left unspent at the end of the year must go back to the county unless the division can persuade supervisors to allow for more time.

Sanfelippo said the spending delay underscores the need for a deadline.

“Here we have $3 million to beef up the system we couldn’t even use,” Sanfelippo said. “They floundered on that $3 million.”

Lucey said she expects a smoother process with the help of Zia Partners, a consultant based in San Rafael, Calif. According to information provided to supervisors, plans to spend the remaining money include creating supporting housing and employment opportunities for patients.

Once the county gets a grasp on what’s left over at the hospital, Romo West said, then supervisors can start discussing a new, smaller building.

Much of that discussion took place among members of the New Behavioral Health Facility Study Committee, which Sanfelippo led and which wrote one of the studies the task force was instructed to consider. According to that study, the hospital is too large. The study included a hypothetical model for a new hospital about one-third the size.

Restructuring the services and building a new hospital are connected, Sanfelippo said. He said the county is spending too much on maintenance and operations at the hospital, which does not house as many patients as it was designed to in the mid-1970s.

Sanfelippo said the county has waited long enough. He has drafted a resolution that would require the task force deliver its restructuring plan in December. According to the resolution, the plan would detail specific changes, steps that would be taken to achieve them, and a timeline and benchmarks for progress.

If the supervisors get a timeline and the task force sticks to it, Sanfelippo said, discussions about a new hospital could start in about a year and a half. The task force wouldn’t have to be finished by then, he said, but there must be progress.

“It has to be down on a piece of paper,” Sanfelippo said. “You can’t shoot from the hip.”

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