Public Trough II

People keep asking me why the Sacramento County Department of Health and Human Services, Division of Behavioral Health Services (to spare my fingers, hereinafter known as DBHS) is dismantling effective community programs in favor of a monolithic county bureaucracy. Lately, attention has also turned to the Sacramento County Mental Health Treatment Center, affectionately known as SCMHTC, or “schmick,” and why the county keeps paying for this dinosaur rather than replacing it with Medi-Cal funded Psychiatric Health Facilities (PHFs). Earlier today, I found myself answering the question in an email to a prominent mental health activist, and thought it would save a lot of time and trouble to just post it publicly. So here’s my take on why DBHS keeps insisting on spending more money to provide less service.

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Sacramento County Mental Health… again

On 26Mar2010, at 15:54, =====@======.=== wrote:

I’ve specifically been praying for $1M for TCORE. Is that about right?

Understand that I have no inside knowledge of the budget of TCORE, DBHS, or the RSTs. I’m going by things I’ve heard, so these numbers might be wildly wrong. On the other hand, after 13 years in this system…

Ponder this:

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The DMV Gets It!

Hard on the heels of my experience with the San Juan Unified School District came one of startling contrast, even more so because it came from such an unexpected quarter: the much-maligned California Department of Motor Vehicles. Was the experience a good one? Not really. Did it contrast in almost every way with the one at San Juan? Remarkably so, in that the DMV has clearly put thought into almost every aspect of their interaction with their customers, all with an eye toward reducing the anxiety of the public. To wit:
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Getting It: how the San Juan Unified School District could do better

who got it

In the late 1990s, word around the internet was that web search was pretty much a closed book. The search engine du jour was a site named Alta Vista, and it’s where nearly everyone went to get their searching done. They needed to productize and monetize their site, and so their search page started growing ads and portal features and flashing ads and animated ads… it was said that advertisers could even pay to influence the placement of search results. Alta Vista had to, right? Else how could they stay open, let alone make any money?

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José is not a poster person. He’s not a starving doe-eyed child. He isn’t a struggling single mother. He isn’t bravely fighting cancer. He hasn’t risen to national prominence despite humble beginnings and devastating misfortune. He’s 45. He is Mexican. His face is weathered from too much time in the sun. He is obese from too much of a gringo diet. He has bipolar disorder, and does not really understand his disease. He speaks very little English. His hands are large and roughened from so much real work. And he is undocumented.

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the public trough

I recently attended a rally protesting cuts to health care for the mentally ill here in Sacramento. The Sacramento Bee covered the rally, and one of the first user comments on the web page accused the protesters of “feeding at the public trough.” At first I was indignant but, you know, I can understand the reader’s anger and frustration. Looking through the short article, several interesting facts emerge. Please try to bear with me as I attempt some arithmetic:

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The Screen Time Conspiracy and other “clinical guidelines” woes

I recently received a communiqué from a physician asserting that the “AAP [American Academy of Pediatrics] recommends no more than one hour each day of screen time.” This immediately raised my hackles on several levels, beginning with the implied criticism that I was not being a responsible parent. (Parents out there, raise your hands: how many of you limit your children’s total time watching television and using video games, computers, handheld games, or cell phones to less than one hour per day? Every day? Be honest! Include time the child spends in others’ care, including school. Are you sure? Do you know how to program your television’s V-Chip? I don’t see many hands out there. The rest of you must be BAD PARENTS.)

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