Population by service area! 1-79,142 2-54,052 3-89,449 4-126,237. 5-73,062 6-79.157. 7-144,401 8 99,597 9-44,413. 1 From "Demographic Characteristics," Department of human resources, April 1973. Population by election district 1-93.837 2-94.055. 3-95,097 4-94,585 5-94.637 6 -95.000 7-94,883 8-94,416. 1 Not availadle. Present Data gathering is by Census Tracts within each Service except for the D.C. Schools, Police and Fire Departments. Statistical data should be collected by Wards within each Election District for use by Council in setting priorities and evaluating Budgets. Service Delivery and Data Gathering by Wards within Election Districts make it easier for you, the Members of this City Council to keep up with your Constitnents and vice versa, thereby giving City Council Members first hand knowledge of Service Delivery through office location in your Ward. This focus of services in neighborhoods should improve coordination and communication for all services through the use of smaller units for delivery of services coordinated by the aforementioned non-government personnel. Staff education and training developed in smaller units (The Election District Centers) will involve all staff of these Centers (one-stop), no matter what their discipline or training. Management by Objectives Techniques can also be instituted at this level. This eliminates a high cost budget item, namely centralized education and training unit. We suggest you check Budget request for F.Y. 1975 and 1976. This money can be substituted for workshops, speakers and Educational leave for staff to: 1. Upgrade their basic skills. 2. Enter Continuing Education for Formal Credits, not just a Batch of Certifiers. 3. Eliminate Community Services Division. Problems encountered with Election District Plan 1. Resistance to change. 2. Resistance to dissolving government empires built up through the years. 3. Resistance to working directly in the Community. 4. Each Election District Coordinator would be developing basic skills and continued education using the Team Approach rather than Centralized Office Approach. 5. Reduction in rentals (lease breaking) moving costs, large renovation projects. 6. Relating Environmental Services, Court System, D.C. Public Schools, Recreation Department, Police and Fire Departments to the Election District Plan. 7. Education Federal Program Evaluators and Grantors to the Plan. The plan calls for 1. Elimination of Service Areas and four Health Areas A, B, C, and D. 2. Employee Re-designation, re-deployment, detail, etc. 3. Movement of Services to Election Districts and Coordination of presently operated services within each Election District. 4. Community Coordination of the Centers by non-governmental personnel. 5. Improved Training to upgrade skills on Neighborhood Level. 6. Collection of more meaningful and accurate statistical data. 7. Smoother Transfer of St. Elizabeth's Hospital if approved by Congress. Election District Centers (One-Stop) Essential Daily Services (Public and Private) Include: Election District: Health Clinics, Mental Health Outreach Teams (Clinics), DVR-Counselors and Programs, NTA Clinics, Veterans Affairs. Probation and Parole Services, Legal Services, Senior Aid Programs, Day Care Services, Recreation Roving Leaders/Boys Clubs, Clothing Banks, and Emergency Food Bank (either in or nearby building). Employment Office: District of Columbia Manpower. Social Security. SSA: Food Stamps, Counseling, Medicaid Certification. Pharmacy. Functions Remaining In DHR 1. Office of Planning, including: Research; ADP-Payments, etc., and Grants Management (Office of Administration); and Budgets. 2. Personnel Processing and Management. 3. Special Programs: Institutions, except D.C. General (treated in another paragraph); Art; and School Coordination. 4. Fair Hearings Division. Functions Removed From DHR 1. D.C. General Hospital-Removed as requested by Local Medical Societies only if governing Board is composed as follows: (a) Users and Community Neighborhood referrers, 70 percent; (b) Medical Societies and Professionals, 30 percent. 2. Eliminate completely Centralized Education and Training Division whose effectiveness in Developing Relevant Training Programs is Highly Questionable. Additional Recommendations 1. Development of a strong follow-up system for clients for all services at all agencies to be used as an evaluation tool for quality of services. 2. Development of closer relationship between Election District Centers, Psychiatrists and the Courts. 3. Remove Doctors from Administrative positions including the inefficient Director of Area C Community Mental Health Center. Doctors should give services to patients and teach staff. This would increase productivity of Doctors thereby reducing Doctor shortage in Public Services. 4. Improved Psychiatrist treatment services for our emotionally disturbed children and youth who are indiscriminately given medication to control them with no therapy. This is especially so at Area C Center where the Doctor assigned is not a Board Certified Child Psychiatrist who subscribes to Nazi philosophy and is a racist who says All Black People have syphilis. AREA B COMMUNITY MENTAL HEALTH CENTER, Hon. WALTER FAUNTROY, CITIZENS ADVISORY BOARD, Washington, D.C., March 18, 1975. 326 Cannon House Office Building, Washington, D.C. DEAR CONGRESSMAN FAUNTROY: We, as concerned citizens and members of the Area B Community Mental Health Center's Advisory Committee, are drafting this letter to request your investigation of problems that are impeding the delivery of quality mental health services throughout our city. The problems of Area B Community Mental Health Center, in particular, are myriad. The staff there finds itself in a hypocritical stance. It is expected to continue providing quality mental health services to a constant population of about 237,000 people on a budget that has been cut from $3 million to $1.5 million. Staff, once numbering 250 persons, has been reduced to 193. While the staff is highly dedicated and loyal to the program, it is also overworked and underpaid and signs of lowered staff morale are evident. Despite the serious nature of these problems, the focus of our letter today is on a situation which we consider even more urgent (i.e., the merger of the inpatient care units at D.C. General Hospital). As you well know, a homicide recently occurred on that merged unit, and we find ourselves asking the obvious questions: Could it have been avoided? What circumstances led to this tragedy? In our view, the tragedy was predictable. The program is understaffed and is -operated in a physical structure which is inadequate. Security measures and -communication systems are poor, producing a high state of anxiety and fear among both staff and patients. The logical end to such fear was predictably overreaction in a moment of crisis. It is our understanding that the merger was effected as an economic measure, but it seems obvious to us now that the problems--indeed the tragedy-which have resulted negate the original intent of the merger. We believe you will support our position that human life, must be held above the dollar value of any program. We, therefore, implore you as our representative, to begin an investigation of the in-patient unit in an effort to insure that further tragedies will not occur and that quality services will be provided to citizens of our city who are in need of in-patient mental health care. Sincerely, Rev. ANNIE M. WOODRIDGE, President. (Ms.) EVELYN PETTIFORD, Secretary. (Mr.) ANDRE BOYER, Treasurer. STATEMENT FOR THE IMPLEMENTATION OF THE ORIGINAL PLANNED AREA B CMHC'S INPATIENT SERVICES AT 1125 SPRING ROAD, NW., AT THE COMPLETION OF NECESSARY RENOVATIONS In the past, planning for the Area B Center was reflected in its original, continuing and growth grant applications. These grants have been based to a great extent on anticipated changes that have not materialized. A major change anticipated has been the renovation of the Area B facility, which would permit the expansion of the inpatient services and the provision of inpatient and emergency services within the Catchment Area. The 1973 Mental Health Act and the District Codes and State Plan provides that a comprehensive range of accessible, coordinated mental health services that consist of inpatient care, outpatient care, partial hospitalization, and twenty-four (24) hour emergency care to the residents of its area. Since the renovations are almost completed, it would become imperative and a must to implement the original plans. The move of inpatient services into the catchment area will coordinate mental health care to the population served by the Area B Community Mental Health Center. COMMUNICATION AND CONTINUITY OF CARE Geographical isolation, as it presently exists, results in inadequate services and lack of liaison between inpatient and parent facility, therefore, the patients do not benefit from continuity of care and this results in the loss of many patients. TRANSPORTATION The lack of adequate transportation can result in involved costs, multiple risks from a medical-legal standpoint, staff and/or patient injuries, e.g., acutely psychotic, assaultive, agitated, homicidal patients. STATEMENT OF REV. ANNIE M. WOODRIDGE, PRESIDENT, AREA B COMMUNITY MENTAL HEALTH ADVISORY COMMITTEE Reverend WOODRIDGE. I am Rev. Annie M. Woodridge, president of the Area B Community Mental Health Center Advisory Board and a member of the Coalition on Mental Health Planning, which I represent today. I wish to thank the chairman and members of the committee for their invitation to testify at these hearings on St. Elizabeths Hospital and mental health services in the District of Columbia. My remarks will be confined primarily to mental health in the District. However, we would like to go on record as being in opposi tion to the transfer of St. Elizabeths Hospital and that no further consideration be given to this idea until the District gets its own human service delivery system in order or until a separate mental health authority exists as recommended by the Rome Committee Report. MENTAL HEALTH AUTHORITY PROPOSED The District needs a separate mental health authority. In the recent past, several attempts have been made to establish a separate mental health authority. One in particular was a bill, S. 2914, introduced by the then Senator Joseph Tydings, as reported by the Mayor's task force on public health goals. Commentary dated January, 1970 follows: Some officials at NIMH have said informally that they are in favor of the till because the 24 States that have such a separate department generally have more stable mental health programs. The Health Department and the City may be expected to oppose it-it would mean one more department and the administrative inconvenience of transferring funds and personnel and the inevitable additional administrative overhead; it would constitute one more department to report to the Mayor. Many of the City's private agencies in the mental health field will support the bill because they think that mental health is ignored in the massive health department. The Health Department is currently the largest. most expensive department in the City. Its responsibilities are so immense and its record so spotty that perhaps mental health does need a voice of its own and an administration devoted to its own cause. The potential of any new authority transcends the Health Department, expanding into the concerns of the juvenile court, schools, welfare, and prisons. Currently, in each department, mental health has the problem of competing in priorities with the foremost focus generally always elsewhere. It has no clear voice of its own at the City Cabinet level. Mental Health needs revitalization of personnel; candidly, many of the personnel interviewed were next to demoralized. A new administration devoted exclusively to the advancement of mental health would attract new personnel; it would also be the cause for the centralization of responsibility now lodged in the several departments. Since fiscal year 1970 there has been a continuing decline in District financial resources to support mental health centers. The obvious result is the ultimate but slow death of the community mental health center if this dismantlement is allowed to continue. The advantages and disadvantages of a separate mental health authority has long been debated in both Government and the community. The outcome of such debates and DHR reorganizations has always been obvious, as indicated by our present low priority status. Today it is obvious that the District government is much further behind than it was in 1970 when an NIMH official, as reported by the Mayor's task force on public health, suggested that the District of Columbia needs its own community mental health services act to insure guaranteed funding and local Board control. Details of such acts are not available, however, it was noted in the same report, 1970, that 34 other jurisdictions have enacted similar legislation. The idea is worthy of further examination. The idea of a separate mental health authority for the District of Columbia has significant community support from both the professional and lay public, as well as in the upper echelons and branches of Government. Recent conversions and conferences and other written proposals specific to this subject overwhelmingly support and recommend a separate mental health authority, therefore we strongly recommend to the mayor and city council that the Department of Human Resources be reorganized to permit the action necessary to implement the recommendation with all deliberate speed. COMMUNITY NEEDS For too long the mental health needs of this community have been neglected. The bureau and/or administration charged with meeting these needs have been tucked away either in the old Department of Public Health or the new Department of Human Resources. This even further removed from the levels of power where decisions are made which directly affect the lives of thousands of people, including clients, staff, and the general citizenry. It is sufficiently evident that mental health is suffering financially even more today than ever with the current period of inflation and recession. This fact is compounded by a decision made by the city government in 1969 not to allocate or appropriate District funds as matching moneys for Federal grants supporting community mental health centers; in effect, pulling the rug from under the community mental health center and defaulting on its legally obligated commitment with impunity. This demonstrates the beginning of the process of dismantlement of the community mental health centers. The effect of such actions are significantly pronounced at the center administrative and contact level. Programs have diminished in size. due to loss of staff, large budget deficits occur without center or administration level knowledge, lack of financial accountability, numerous staff reorganizations and shifts occur to compensate for losses, staff are asked to do twice the work, affecting both quality and quantity of services provided. The staff has become highly demoralized and has been driven to a degree of ineffectiveness due to fear of loss of jobs for those persons on expiring Federal grants. Confusion and job insecurity were results of city government indecision in the matter of expiring grants, which in fact was not attended until the problem reached crisis proportions, which is symptomatic of the crisis-run DHR management system. Efforts to expand services to increase the physical continuity of the centers in the form of satellites have been abandoned. Staff shortages and numerous hiring freeze periods have caused the retrenchment of established outreach programs. These retrenchments |