Tuolumne County Behavioral Health director resigns

Advocates say replacement will face numerous challenges

Rita Austin resigned on Monday as the director of the Tuolumne County Behavioral Health Department, citing health issues.

Next Tuesday, the Tuolumne County Board of Supervisors will consider appointing Steve Boyack as the acting director while a permanent replacement for Austin is recruited. Boyack serves as the assistant director of the county’s Human Services Agency.

“I will be acting to ensure that all Behavioral Health programs are supported appropriately to maintain status quo with respect to our mandates to provide services to our clients and citizens of Tuolumne County,” Boyack said.

Human Services Agency staff is working with the County Administrator’s Office and Human Resources Department to develop a recruitment plan for a license-qualified permanent Behavioral Health director, according to memo to the board regarding Boyack’s proposed appointment.

Boyack declined to comment on Austin’s resignation.

In a letter to the Behavioral Health Department’s staff, Austin stated that she will be taking time after 25 years in public service to “address some health issues, adjust to having free time on my hands and continue in the private sector for a few years before full retirement.”

“For all of you, there are many new opportunities and changes on the horizon in the Behavioral Health system that promise to be both exciting and challenging,” Austin stated in her letter. “I wish you the very best on that continued endeavor.”

Austin could not be reached for comment Thursday.

According to published reports, Austin previously served as the Calaveras County Behavioral Health Services Department director. She began working for Tuolumne County as a social worker at the former Tuolumne General Hospital in June 2004.

In December 2011, Austin was hired as director of Tuolumne County’s Behavioral Health Department.

John Leamy works with clients of the Behavioral Health Department as the vice president of the Tuolumne County chapter for the National Alliance on Mental Illness, an organization that provides support and education for people and families of people suffering from mental illnesses.

Leamy described the role of the county’s Behavioral Health director as an “extremely difficult job” due to a number of factors, including the county’s lack of a local psychiatric treatment facility, a shortage of psychiatrists, unstable funding, and state laws that can hamstring the department from providing services people think it should.

“Some people have been very, very happy with Behavioral Health, and some individuals have had serious issues,” Leamy said of county’s services. “One of the common problems that people have is feeling that Behavioral Health doesn’t do enough for some of the mentally-ill individuals.”

The Lanterman-Petris-Short Act was a law passed by the California State Legislature and signed by former Gov. Ronald Reagan in 1967 that prohibits people from being committed to a mental health institution against their will unless they are deemed to be a danger to themselves, a danger to others, or gravely disabled.

While the law’s stated intent was to end “inappropriate, indefinite and involuntary commitment” of people suffering from mental illness, developmental disabilities, or chronic substance-abuse problems, Leamy said it has led to family members watching loved ones with disorders mentally deteriorate without any ability to intervene.

“It’s not against the law to walk down the street talking to lamp posts,” Leamy said. “You can be very hallucinatory, but as long as you get yourself food and get yourself home at night, there’s nothing that can be done as far as intervention at Behavioral Health.”

Leamy said adding to the problem is a shortage of psychiatrists in the county, a problem facing many rural areas throughout the United States.

One full-time psychiatrist practices in the county. Leamy said, following last year’s retirement of the Behavioral Health Department’s paid full-time psychiatrist, Dr. James R. Glover, whom Transparent California listed as the county’s top paid employee in 2014 with a salary of $206,000.

The county has since provided psychiatrist services via teleconference, known as telepsychiatry, under a $375,000-a-year contract with Kings View Behavioral Systems that was approved by the Board of Supervisors at a meeting on Aug. 16.

“I think it’s been going very well, but some people have issues with it,” Leamy said of the telepsychiatry services. “The biggest benefit that I can see is it gives access to a large number of different psychiatrists … If there’s a really bad mismatch, there’s always a chance of pairing someone up with a different psychiatrist.”

The county has also lacked a psychiatric care facility since the shuttering of the county-run Tuolumne General Hospital in 2008 due to financial constraints.

Leamy said that often forces people in crisis to be housed in facilities outside of the county, which can sometimes be difficult due to the lack of available bed space elsewhere. He compared it to the way the county previously housed detained youths in juvenile halls outside of the area before the recent opening of the $20 million Mother Lode Regional Juvenile Detention Facility in Sonora.

“So much has been made about how now that we have a juvenile hall in the county, we don’t have to send anyone away from their family,” Leamy said. “Well, we have to send all our mental health patients away from their family.”

Another issue is that funding for behavioral health services throughout the state is often unstable.

Leamy said he believed that Austin was good at getting grants to help pay for ongoing services. However, the lack of a more stable funding source makes maintaining those services at the same level more difficult.

“Mental health funding competes with public safety, roads and other government programs and services, and there’s only a finite pot of money,” Leamy said. “People are always talking about being overtaxed and cutting taxes, so where does that money get cut?”

With the Republican majority in U.S. Congress and President Donald Trump continuing to push for a repeal of President Barack Obama’s landmark Affordable Care Act legislation despite a failed attempt last month, Leamy said more challenges for whoever becomes the new Behavioral Health director could be on the horizon depending on the replacement.

“They’ve been able to help a lot more people in the last two years because more people qualify for Medi-Cal,” Leamy said. “If that eligibility is tightened up and those people no longer qualify, that will impact behavioral health services.”