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October 17th, 2001 Chris Lydgate | News Stories
 

The Long March

Turf battles threaten mental-health reform.

     
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IMAGE: basil childers

The long and tortuous campaign to reform Multnomah County's splintered mental-health system--described by County Chair Diane Linn as her top priority--has become bogged down in a quagmire of confusion, bureaucratic resistance and racial politics.

Three weeks ago, Linn created a new Office of Mental Health Services and named Jim McConnell, the director of the county's Department of Aging and Disability Services, its temporary director. His mission: to shatter institutional inertia and implement a saner system.

A diminutive Catholic priest with a Dubliner's brogue and a leprechaun's grin, McConnell, 61, is widely regarded as a smart and capable administrator. But he's up against a powerful opponent: Community and Family Services director Lolenzo Poe.

As a member of the Portland Public Schools Board, Poe, 49, is one of the most prominent African-Americans in Portland and has forged strong relationships in local ethnic communities. As director of CFS--which includes the Behavioral Health Division--he controls a budget of $207 million and a staff of 421. And he has his own ideas about how reform should proceed.

The immediate dispute revolves around services to children: McConnell wants to centralize adult, children, and alcohol and drug services in a single unit under his direction; Poe is trying to keep children's services under his own control.

Fundamentally, however, the debate is over who runs the show. "There's definitely a battle for control between Lolenzo and Jim," says one observer. "Lolenzo is trying to hold onto his programs, and Jim is saying, 'I'm in charge of the whole system.'"

Reforming the system is a task worthy of Sisyphus, involving consumers, families, advocates, hospitals, schools, public employees and dozens of private providers, plus the usual maze of local, state and federal agencies--many with conflicting interests.

In recent weeks, however, the issue of race--cloaked in the terminology of "cultural competence"--has complicated matters still further.

Last month, Leslie Goodlow, a midlevel county bureaucrat, publicly criticized McConnell's management team (which consisted of three white guys) for the Office of Mental Health Services. "I understand your concerns about cultural competence," she told him at a departmental meeting. "But if that's the case, why are the people you've selected all white?"

Meanwhile, members of the county's Cultural Competence Committee--a panel charged with ensuring that the redesign improves services to minorities--are fuming because they were not consulted about McConnell's appointment, which they view as an effort to shunt Poe aside.

"If you look at the people on the top level, they're all white men," says Jeanne Cohen, of Project Network, a substance-abuse program for women and their children. "The only person of color is Lolenzo. And we really question how involved Lolenzo is in all of this. In some ways, this redesign actually marginalizes him."

The committee made its concerns public at an awkward meeting of the Mental Health Coordinating Council on Oct. 3. "There's growing frustration over the unwillingness or inability of leadership to deal with people who don't look like them," declared committee member Stephaine Parrish Taylor.

"We're being used," agreed Kathie Prieto-Hawkins, also of Project Network.

Even as advocates for cultural competence were voicing their dissatisfaction, Poe fired off what some insiders call an "Al Haig" memo.

"I know there have been many conflicting reports and directives," Poe emailed department employees on Oct. 9. "But unless you receive written notice as a result of layoffs, please continue to report to your current supervisor"--in other words, Poe.

For weeks, the county chair's office seemed reluctant to wade into the mess. Asked on Oct. 5 who was in charge of mental health, the county's chief operating officer, John Ball, replied, "That's a sort of loaded question around here."

Mental-health sources say Linn has been reluctant to confront Poe. "Getting rid of him is not politically feasible," says one insider. "Lolenzo has resisted reorganization, but the chair doesn't have the stomach to steamroll him."

In recent days, however, the chair's language has become more emphatic. "Who's in charge? I am," she told WW. "Jim is overseeing all the mental-health services for the county right now.... This mental-health system desperately needs some clear direction, and we've asked Jim to do that."

Linn disputed the suggestion that personnel issues threatened to derail reform efforts. "No one is too important to be replaced," she said. "Including me."


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