The Los Angeles County Board of Supervisors voted Tuesday to merge its three health departments, under the argument that it will ultimately expand services for the county's neediest residents by reducing barriers and bureaucracy and could take on larger issues like homelessness.
The vote followed a report outlining the benefits of the merging the departments of Mental Health, Health Services, and Public Health - and testimony from dozens who showed up to protest consolidation. But the vote itself had not been on the supervisors' public agenda.
Guyton Colantuono, director of Project Return Peer Support Network, a services provider that contracts with the mental health department, told KPCC the merger might have the unintended effect of subordinating mental health.
He said a medical doctor, works in an authoritative way by prescribing a specific treatment - and that's not how it works the mental health department.
"We practice the recovery model," Colantuono said. "Patients are very involved in creating their own treatment plans."
That involvement of patients and relatives even influences administration of the public mental health system.
"The consumer and family voice would be lost in a larger bureaucracy," he said.
Supervisors tried to assure mental health and public health advocates that their departments would maintain their budgets and missions despite the merger.
"We are not serving our clients well by having these three different systems," said Supervisor Sheila Kuehl.
Right now, someone who needs mental health care and medical care has to navigate two different appointment systems, payment systems, and health records systems--and visit different locations for care. That could change when the agency takes form.
Four of the five board members supported the merger. Supervisor Don Knabe abstained from the vote, pending details of what the actual agency would look like.
Dr. Mitch Katz, current director of Health Services, and one of the leading candidates to take the helm of the new health agency, said there's no great way for the departments to work together when they're completely independent from one another.
"Let's choose the three or four projects that have the biggest impact," he said. "Let's put all of our resources towards those projects, and when we're done, then we'll go onto something else."
Merging the departments will allow them to take on issues that plague the county, and highly impact public health care systems, like homelessness and jail crowding, he said.
The board is expecting to discuss details of how the agency will work in the coming months.