Sooner Politics

By David Van Risseghem

  The Mental Health Association Of Tulsa Has Entered The Debate On The Tulsa Jail Bond Politics.
Executive Director, Michael Brose Addresses His Complex Response To The Jail Bond Vote.

   Like Michael,   many of us who serve in leadership for mental health advocacy are sorting out conflicting concerns about mental health treatment, and the format in which it is being delivered; or not delivered.
   I am the President-elect of NAMI Tulsa. The National Alliance on Mental Illness is the largest advocacy organization for mental health issues. Our organization has not endorsed either side of the upcoming bond election, in Tulsa County. I happen to personally oppose the current jail bond and several others in NAMI are also concerned that the jail has encountered “mission creep” into  public mental health through criminalizing people who are experiencing a nervous breakdown.
Mr. Broce’s comments (printed in blue) are very insightful and I want his concerns to be further amplified.  I’m going to post Michael’s recent letter and give my own comments:
   Unfortunately, sometimes you have to swim upstream
   Over the past few weeks, I’ve been repeatedly asked about my thoughts regarding the April 1 tax extension vote to expand Tulsa’s David L. Moss Criminal Justice Center, and to improve its facilities and treatment for inmates impacted by severe mental illness.
   Mental healthcare is critical care. It needs to be available wherever and whenever it plagues humanity. To neglect it is to endanger the sufferer and every person within that person’s sphere of interaction. Most people with mental illness are NOT violent. But life-threatening concerns are always present. As the current trend progresses, one day, someone you love will likely face the criminal charge of being mentally ill.

   Like many issues in search of a simple answer, this question is complex. I do support Sheriff Stanley Glanz’s proposal for several reasons. First, Sheriff Glanz, and deputies who operate the jail, have no control over who is placed in the jail. They have to accept and care for whomever law enforcement charges and brings to the jail. Inmates can only be released if the sheriff receives an order from the court to do so. Second, the sheriff clearly recognizes inmates with severe and untreated mental illness committed crimes they would not have committed if they were receiving the treatment they desperately need in their respective communities.

   This is a very valid point.  The county sheriff houses inmates whom the sheriff has prosecutorial role. He and his deputies are charged with the duty to keep the inmates safe and keep the county safe. He is not responsible for the failures of the state in providing the preferred mental health facilities which many of these sufferers should should be treated at.
   Sheriff Glanz has personally witnessed bad things happening to people who are severely ill, and have been placed in his jail, almost always due to the absence of enough treatment beds in the community. Because of our failure, and the State of Oklahoma’s failure, to fund treatment beds adequately for Northeast Oklahoma, people who are severely mentally ill continue to be placed in his jail. He wants to properly care for them in an area where they are free from being preyed upon in the general population of inmates. The sheriff also wants to have the resources to properly train specialized officers who understand mental illness, and their special needs.
   Sheriff Glanz is personally named as a defendant in wrongful deaths. He does not get to choose the medical staff which treats the inmates. That is the county commissioners’ role. He does ultimately answer for the failure of his wardens and staff, when they fail. If their failure results in harm or death, then he cannot pass the blame on lack of resources. If he feels he cannot do his duties correctly, his duty is to resign his role.
   Is the sheriff’s proposal the long-term answer? No.
   Sadly, this is the reality of our refusal to properly fund treatment beds to serve the size and population of Northeast Oklahoma. We need to help the jail properly care for these inmates who live with severe, untreated mental illness at no fault of their own now. At the same time, we must organize all of our combined efforts to insist lawmakers begin investing in people who, if they receive the treatment they need in their own communities, become taxpaying, contributing members of the community. Sixty percent of Mental Health Association in Tulsa employees are doing just that — living in recovery with severe mental illness, because they secured adequate treatment in the community. Many of our employees have histories, and sad stories, of incarceration in jail and in prison. With adequate treatment, they live in recovery, pay taxes, have families, and they are gainfully employed. They are the fortunate ones. Right now, the jail is full of people facing charges because their severe mental illness went untreated and, subsequently, have committed non-violent and often petty crimes. On any given day, 33 percent of inmates in the jail will present with a severe mental illness, according to the Tulsa World’s own Julie DelCour. Simply put, these inmates were unable to secure adequate treatment in their community, and now they are behind bars.
   This is the “heart” of the Oklahoma issue. None of the problems will truly be resolved by a jail bond. In fact, it may take longer to bond and build a jail than for the state to appropriate funds to open treatment centers in existing facilities. Correcting the state funding problem this month, could result in a shrinking jail population in every county of our state, this year! The legislature is now in session. we don’t need to wait until the next bond election to fix the problem.

   The Mental Health Association in Tulsa supports the sheriff’s desperate appeal to support the tax extension vote. At the same time, we call on the sheriff, the Tulsa County commissioners, Mayor Dewey Bartlett, the Tulsa City Council members, and the whole of the community, to join forces, regardless of party affiliation, and insist together that Oklahoma lawmakers, and Governor Mary Fallin, invest in Northeast Oklahoma with the community-based treatment and beds we so desperately need. This isn’t about raising taxes. This is about investing in our people. Sadly, sometimes you have to swim upstream.  

   Some folks don’t care about treating mental illness, until their loved one becomes stricken within it’s hideous grasp. I, and many other mental health advocates urge every Oklahoman to look beyond the jail bond elections and help fix the statewide failure at the state capitol.  There are some who are using my arguments only to defeat a county tax increase. I am aware of that.
   If we don’t fix this problem right, we will see endless ballooning county bond issues and ever higher expenses in criminal justice funding, at a very wasteful misappropriation of effective treatment and a much worse record of successful recovery.


By Mental Health Association In Tulsa On March 27, 2014
By Michael W. Brose, MSW
Executive Director
Mental Health Association in Tulsa

Michael Broce and MHAT’s full messages are available at: http://goo.gl/48nYvD 

   The Oklahoma Mental Health Department has released the following statistical evidence for money saved and lives restored through pro-active solutions to mental health crisis. Each of these programs is currently under-funded and under-utilized.

   Only 15 of Oklahoma’s 77 counties have a mental health court. Most of the treatment programs are full and not able to receive new clients. Yet many of those turned away are forced into county jails and prisons, because of the imapct their untreated illness poses to the community.

Proven Mental Health Programs Making a Difference in Oklahoma
  Mental health and substance abuse services have traditionally been the most under-funded of government programs.  Yet, our state leaders demonstrated during recent years that they now recognize the benefits of increasing access to treatment. While Oklahoma has not progressed to the point at which we need to be, many accomplishments deserve attention. Examples of programs and services that will hasten progress include:
Mental Health Courts
  Mental health court is a highly structured, court-based program providing a treatment alternative for non-violent offenders diagnosed with a mental illness. Court structure and processes are designed to identify and address the unique needs of a non-violent person who has come in contact with the criminal justice system because of his or her mental illness. A review of data from the state’s first Mental Health Court program indicates notable improvements in the lives of participants. Several factors were measured and compared against pre-court measurements, resulting in significant findings regarding program graduates. Some key points are as follows: 

Percent Reduction
Hospital Days
98%
Arrests
77%
Jail
97%
Unemployment
80%
Programs for Assertive Community Treatment (PACT)
  The Program of Assertive Community Treatment (PACT) is an effective, evidence-based service delivery model providing intensive, outreach-oriented mental health services to people with schizophrenia, bi-polar disease and other serious and persistent mental illnesses.  Using a 24 hours-a-day, seven days-a-week team approach, PACT delivers comprehensive community treatment, rehabilitation and support services to consumers in their homes, at work and in community settings. 

  Building community supports such as PACT and other non-traditional programs of care allows an individual, who otherwise may be subjected to multiple hospital visits, or jail, the ability to address the demands of their illness while remaining in the community.  The program is intended to assist clients with basic needs, increase compliance with medication regimens, address any co-occurring substance abuse, help clients train for and find employment, and improve their ability to live with independence and dignity. PACT was implemented in Tulsaand Oklahoma City in May of 2001 with $2 million provided by the state legislature.  The program now has an annual appropriation of $5.3 million, much of which is used to draw down additional Medicaid funds, and has expanded to include 14 PACT teams serving 19 counties statewide.
Oklahoma is considered a national leader in this area.  The following measures show a pre/post hospital and jail comparison for consumers: 
Pre-PACT
Post-PACT
Percent Reduction
Hospital Days
5,233
1,942
63%
Jail Days
1,050
314
70%
Systems of Care (SOC)
  In the fall of 2002, Oklahoma received a six-year, $9.4 million “Systems of Care” grant to establish children’s behavioral health service “hubs” throughout Oklahoma.  The program has since expanded to serve children in 54 counties throughout the state.

  There is a tremendous need to expand children’s services throughout the state and programs such as Systems of Care, which cut through red tape and focus attention on the needs of the children and their families to provide the appropriate level of services.  It is targeted to impact children, birth through age 21, with serious emotional and behavioral problems at home, school and in the community; and, it has been proven as a model system. 
  Evaluation demonstrates significant achievements in a child’s behavior when measuring outcomes following six-month client participation. Examples include: 
  Percent Reduction
Out of Home Placements
30%
School Detentions
53%
Self Harm Attempts
39%
Arrests
48%
Community Mental Health Centers (CMHC)
  One of the major challenges currently facing the department is that of equitable funding for community mental health centers.  Despite this struggle, the CMHCs continue to provide core services such as medications, counseling, and case management that help many people with mental illness live a life in the community.  In addition to core services, most CMHCs are able to offer best practice, evidence-based services, albeit on a limited basis. 

Medicaid for Mental Health Providers
  In recent years the Medicaid program has become a significant revenue source for mental health providers.  Much of this increase has come about because CMHCs are assuming more responsibility for persons needing treatment as opposed to state hospitals.  Many CMHC services are Medicaid reimbursable, while state psychiatric hospitals are considered institutions and are, therefore, ineligible for Medicaid.

Medications
  The advent of more effective psychotropic medications for people suffering from schizophrenia, severe depression, and bipolar disorder has enabled many more clients to lead normal, healthy lives in their communities.  These “new generation” medications have improved quality of life for many people and have the potential to decrease hospitalization costs for states.  It is important to provide appropriate medications on a consistent basis for all clients.  Otherwise, persons with mental illness are stabilized in hospitals with medications, discharged, then either cannot or do not continue to take prescribed medications.  Their condition deteriorates until law enforcement or loved-ones intervene, then they are re-admitted to a hospital.

Forensic Services
DMHSAS is responsible for providing several forensic services: evaluating all people charged with a crime that are believed to suffer from mental illness, treating defendants with mental illness who are waiting for trial, but are not competent to proceed because of their mental illness, and hospital based treatment for  persons adjudicated as Not Guilty by Reason of Insanity (NGRI). The forensic population, served at the Oklahoma Forensic Center in Vinita, is on the increase.  In July 2000, there were 132 forensic patients at OFC.  Census now averages approximately 160.  Occasionally, there is a waiting list of individuals being held in local jails awaiting the availability of a bed at OFC.  In addition many of the buildings are over 70 years old with numerous maintenance needs.  In the 2004 Legislative Session, DMHSAS received approval for up to $18.9 million in capital bond funds to build a new, 200-bed forensic unit.  Ground breaking on the new construction occurred in July 2006. 

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Representative, Jason Murphey publicly  advocates for extending Oklahoma elective term limits to county governments. See Okscam history at bottom of the post.
Here is his facebook post:


  A legislative committee recently approved an initiative to place a term limit of 12 years upon county commissioners.

  There is little doubt that term limits on Oklahoma legislators was a key factor in breaking up the old guard, evil empires, and political machines — a time when lifetime politicians adversely dominated Oklahoma politics.
  The people of Oklahoma made our state the first to pass term limits and did so based on their frustration with the fact that very bad politicians could stay in power by attempting to direct largess to their constituencies who were then less likely to vote them out of office.
  As a member of the House of Representative, I have had a front row seat to see wave after wave of politicians hit the term limit wall of 12 years. It’s very difficult for these individuals to reach that wall without having been co-opted in some way. I have concluded that 12 years in office provides an excellent stopping point for keeping citizen legislators from transitioning into co-opted career politicians.
  I enjoyed the opportunity to be the House author of the bill which successfully sought to apply the term limits concept to statewide elected officials and have thus cared greatly about this topic.
  It’s time for term limits to take the next step. So far county government hasn’t experienced the benefits of term limits reform. Several days ago, the Government Modernization Committee approve the plan to apply the 12 year term limit to county officials as well.
  Notably, commissioners are much better positioned than their legislative counterparts to use their power to stay in office.
  Commissioners have direct access to the resources of the county, with few checks and balances to stop them from rewarding supporters and punishing enemies. This puts each commissioner’s constituency in a very precarious position. They may be afraid to publicly oppose a co-opted commissioner who could withhold much needed resources from their area. Those trapped under the tyranny of a co-opted commissioner may realize he has locked down a strong support base by providing favors and special treatment to a majority at the expense of the minority. For these individuals, the application of term limits would provide a welcome relief.
  That’s just part of what makes this proposal so very important.
  You may recall the famous quote, “Power tends to corrupt. Absolute power corrupts absolutely.” People are not naturally equipped to be career politicians. Constantly being treated like a VIP and feeling important ruins many good people. It’s almost impossible to withstand the tremendous pressure of the constant limelight to which many politicians become addicted. To feed this addiction, they become co-opted by, and hostages to, their own pride, selfish ambition, situational ethics, cynicism, greed, special interests and narcissism. Their previously held values and principles become secondary to this array of highly corrupting factors.
  Many elected officials succumb to these temptations, whether it is at the state or county level.
It may take a while to win final approval for the term limits proposal but until that time voters are well advised to provide extremely intensive scrutiny to any official who attempts to stay in office beyond a 12-year time period. 

I’m worried that several years
from now, after the fear factor dies
down, that the fundamental
reforms will have never been done”
U.S. Attorney, Bill Price – 1984

The FBI’s largest local government scandal ever, was the shameful Oklahoma County Commissioner Scandal. It was uncovered by IRS agents in 1980. By the end of 1984, over 250 people were sentenced for kickbacks and money laundering. Almost every Oklahoma county was harmed by the corruption. Mostly, it was disguised as infrastructure spending. Taxpayers saw a drop of about 40% in county costs when the initial federal action was completed.
U.S. Attorney, Bill Price, was a lead prosecutor in the crackdown. He later ran for governor, but was defeated by David Walters, who later confessed to kickback corruption in his campaign financing.
  At the summation of the case, he said “many, many” other suspects were given the same offer to cooperate “but they chose to protect their friends.”

Price said; “laws allowing for a statewide grand jury or a multi-district investigation overlapping the jurisdictions of several district attorneys are necessary if Oklahoma is to be able to keep its own house clean.”
“Some of our best cases would have been totally unprosecutable by the state because they involved kickbacks in, say, 10 or more counties,” Price said.
“There have been some reforms, but I’m worried that several years from now, after the fear factor dies down, that the fundamental reforms will have never been done,” Price said.
“If there is corruption in the future, no doubt we’d be willing and able to go back in again,” Price said, adding that with the reforms he’s calling for, the next prosecutions “could be handled successfully by the state.”

Further reading:
Newspaper article of unfolding scandal
History of Oklahoma Scandals