While campaigning for an extreme right-wing candidate for governor in New York, Scott Walker missed the deadline to name all members to a board that will oversee mental health care in Milwaukee County as required by law.

The Milwaukee Journal Sentinel is reporting that Walker missed yesterday’s June 9th deadline to name all 11 appointees to the new Milwaukee Mental Health Task Force, which was established by a law passed in March and published April 9th to replace the Milwaukee County Board in overseeing funding decisions for mental health in Milwaukee County.. The law requires that Walker name appointees within 60 days of the law’s publication. The Milwaukee County Board, responsible for recommending five appointees, submitted its names to Walker on May 16th.

Perhaps nowhere has Scott Walker’s craven political ambitions been on more prominent display than in his failure to manage the Milwaukee Mental Health Complex during his tenure as county executive. Walker's privatization of jobs and overall mismanagement of the Mental Health Complex was marked by multiple reports of patient deaths, the sexual assault of mentally handicapped patients and the findings of a federal investigation, which Walker suppressed during his campaign for governor, that the county failed to manage the complex and protect patients.

Walker’s mismanagement and blatant disregard for public safety was further revealed when more than 27,000 pages of documents released in the first John Doe criminal investigation showed Walker’s campaign and county office coordinated his response to scandals at the Milwaukee County Behavioral Health Division (BHD) with an eye only on exonerating Walker of any liability.

The Milwaukee Journal Sentinel reported in February 2014 that:

“Instructions from Scott Walker's campaign manager were explicit: Delay settlement of a long-standing legal case over the starvation-related death of Cindy Anczak at the Milwaukee County Mental Health Complex. ‘Could care less what it is on,’ Walker campaign manager Keith Gilkes wrote in an Oct. 22, 2010, email exchange with a Walker aide at the county, referring to the claim's legal basis. ‘Keep it buried until Nov. 2nd and then hopefully they'll settle.’ Walker went on to win his term as governor that Nov. 2. Anczak's parents, Jean and Myron Anczak of Greendale, would wait another full year before the county approved a $125,000 settlement.”

The emails also revealed that:

· Tim Russell, a top Walker aide convicted of a felony in connection with the John Doe investigation, joked about having a county supervisor killed and suggested ways to stifle criticism of problems at BHD.

· Kelly Rindfleisch, another top Walker aide convicted of a felony in connection with the John Doe investigation, downplayed the serious public safety problems at BHD because, “No one cares about crazy people.”

· Scott Walker personally ordered the firing of a qualified physician because she had previously worked as an model.

“Back in 2010, Scott Walker said the “buck stops” with him when it comes to the gross mismanagement and disregard for public safety at Milwaukee’s Mental Health Complex, but apparently the buck stops in New York, where Scott Walker was campaigning for president yesterday instead of doing his job,” Democratic Party of Wisconsin Chair Mike Tate said Tuesday. “Scott Walker’s continued refusal of any accountability whatsoever when it comes to Milwaukee County’s mental health care system is deplorable. Just like his jobs failures and fiscal irresponsibility, public safety failures weren’t Scott Walker’s fault when he was Milwaukee County executive and somehow are still not his fault now that he’s governor.”

BACKGROUND

Tragedy at BHD Under Scott Walker

In 2006 the State of Wisconsin ordered Milwaukee County to take immediate steps to ensure patient safety at its mental health complex. The action came after a state and federal inspection which found 11 safety and health violations. The inspection was initiated after one patient died of starvation and a second lost 44 pounds in only three months. Also, two other patients died in 2005 after ingesting contraband narcotic drugs. (Milwaukee Journal Sentinel, “County making changes,” 12/28/2006)

The state’s inspection occurred from November 13th-20th of 2006. The state issued their highest alert at the end of that inspection, declaring all patients at the facility to be in immediate danger. The alert was lifted later that day after county officials promised to make the necessary changes. (Milwaukee Journal Sentinel, “Top alert issued against complex,” 12/24/2006)

As part of the aftermath of these events, the County Board voted to hire additional staff to improve the monitoring of patients. (Milwaukee Journal Sentinel, “Board hires mental health staffers,” 3/1/2007)

In 2010 the Milwaukee Journal Sentinel did a damning investigative series focusing on the tragic lack of care of one patient at the Mental Health Complex. The report focused on a woman that was diagnosed as moderately mentally retarded and dangerously mentally ill. Officials allowed a male patient with a history of sexual violence to have easy access to this woman and other patients. Later she became pregnant while in the care of the Mental Health Complex. Not only was it a tragic failure that they exposed her to another person with such a history of sexual violence but they also failed to give her the birth control injections that she was supposed to have. In addition hospital staff didn’t advise the patient’s guardian that she became pregnant in July 2009. In fact they waited weeks before they told her guardian about the pregnancy. (Milwaukee Journal Sentinel, “Out of chaos, a baby is born”, 4/21/10)

The women ended up giving birth to the child in April 2010. The Journal Sentinel estimated that the horrible errors at the complex cost federal, state and county taxpayers at least $700,000 in extra patient care costs and legal fees in the course of just one year. They expect the total costs related to the tragic incident to end up costing more than $1 million. The cost to treat the woman during her pregnancy was roughly $400,000. (Milwaukee Journal Sentinel, “Out of chaos, a baby is born”, 4/21/10)

After the Milwaukee Journal Sentinel ran their disturbing series on the patient and the circumstances around her pregnancy, many Behavioral Health and Walker administration officials pledged to improve operations and prevent such things from happening again. However the same patient only a few months later was allowed to walk right out of the facility and ended up entering an area home and assaulting a mother in front of her young children. (Milwaukee Journal Sentinel, “Patient left complex, attacked area homeowner”, 10/8/10)

The abuse issues went even beyond just patient to patient problems and also involved treatment staff. Administrators at the Milwaukee County Mental Health Complex allowed psychiatrist Karl Strelnick to keep working there for years even after he was investigated for repeatedly having sex with a patient in a locked room at the hospital. Strelnick surrendered his license in 1987 after admitting to having sex with two patients. But even with that on his record he was hired again at the Mental Health Complex in 1992. He had yet another allegation of having sex with a patient in 2002 and was investigated by several entities for several years since that point. Even with the long history of admissions and allegations Strelnick continued working for the county for years. (Milwaukee Journal Sentinel, “Even after sex allegation, Mental Health Complex psychiatrist kept job”, 12/23/10)

Even with the Mental Health Complex getting years of negative publicity for the horrible incidents that repeatedly happened there, a no accountability culture continued at the facility. At the center of much of the criticism was former administrator of the Behavioral Health Division, John Chianelli. (Milwaukee Journal Sentinel, “Lack of accountability continues, despite deaths, threats to funding”, 8/22/10)

Scott Walker supported Chianelli as the head of the division repeatedly and through many bad situations. Many called for Walker to replace him as the administrator but Walker refused. Eventually after the long serious of damning stories in 2010, and during a heated race for governor, Scott Walker finally demoted Chianelli. (Milwaukee Journal Sentinel, “Chianelli demoted as head of Mental Health Complex”, 8/25/10)

Even with the 2010 reports pointing to the Walker administration’s failures, Walker still put his campaign for governor ahead of full disclosure. Walker repeatedly refused to release the results of a federal investigation into the constant tragedies that happened on his watch. He resisted such open examination all the way to the end of his administration in Milwaukee County. (Milwaukee Journal Sentinel, “Milwaukee County Board urges release of mental facility report”, 11/4/10)

Gross Mismanagement at BHD

Even with years of major overtime issues the problems at the Mental Health Complex continued and even grew in 2009 and 2010. For example, in 2009 nearly $4.1 million was paid out in overtime. The Behavioral Health Division ranked second only to the Sheriff’s office, which has 400 more employees. At a time when the complex was declared unsafe by federal inspectors, two medical directors at the complex collected more than $300,000 in overtime. A janitor at the facility collected more than $50,000 in overtime in 2009 while a nurse in charge of staff development topped $260,000 in overtime over 4 years. After the Milwaukee Journal Sentinel examined overtime records at the Mental Health Complex, they found at least 10 employees that actually doubled their pay through overtime. (Milwaukee Journal Sentinel, “Mental Health Complex staff ring up major overtime”, 10/9/10)

Overtime at the Mental Health Complex went up again in 2010, reaching $4.3 million. At that time even Joe Sanfelippo, a Scott Walker ally on the County Board, said “that is gross mismanagement. It’s like there’s no oversight out there.” Scott Walker enforced furloughs that year and some have suggested that they actually helped fuel the runaway overtime costs. Some observers described the furloughs created a kind of domino-effect of problem. When staff are furloughed, often others are called to fill in often on overtime. Sometimes actual registered nurses were tapped to fill in for absent nursing assistants, at a much higher pay rate. (Milwaukee Journal Sentinel, “Overtime set to rise $4.3 million at Mental Health Complex”, 10/30/10)

In 2008 there were 113 positions at the Behavioral Health Division that were fully funded but vacant. In 2009 there were 46 positions that were funded but vacant. (Milwaukee County, “Report on Vacant and Funded Positions – Revised,” 10/17/2008; Milwaukee County, “Report on Vacant and Funded Positions,” 6/26/2009)

Bad Budgeting at BHD

In late October 2009, Scott Walker announced another sudden deficit and the need to lay off up to 180 employees. Reports in the media revealed that the suddenly discovered deficit was largely due to the incompetence of Walker’s appointee to manage the Behavioral Health Division, John Chianelli. According to the report, almost the entire $3.6 million deficit was brought about by Chianelli’s failure to run the new Medicaid reimbursement formula for most of the year. Chianelli reportedly didn’t realize that the new formula was going to be problematic for BHD’s budget until sometime in August. (Milwaukee Journal Sentinel, “Walker’s layoff plan causes outcry from supervisors,” 10/29/2009)

Privatization at BHD Costly, Ineffective

A fiscal report of the private security services at the Behavioral Health Division shows that it was over budget by $527,961.13 in 2008. A similar fiscal report generated on 10/2/2009 showed that the private security firm was already over budget by $2,772.62. (Milwaukee County, “Internal Fiscal Report, Behavioral Health-Security, 2008 and 2009” 10/2/2009)

Given its record over the last two years, the privatized security service is hardly an example of efficiency or cost effective budgeting. Furthermore, assaults at Behavioral Health grew by 50% from 2004 through 2007. (Milwaukee Journal Sentinel, “Assaults jump at facility for mentally ill,” 8/29/2007)

Nearly every year that Scott Walker was Milwaukee County executive, he tried to privatize a very effective program at the Behavioral Health Division called Targeted Case Management. The program assigns a person living with chronic mental illness with a capable case manager. The case manager helps the client with everyday tasks such as finding proper housing, managing bills, and ensuring continued treatments. The program aids the client by assisting them in effectively living in the community.

Pay-to-Play at BHD

At the very beginning of 2007, Scott Walker began publicly discussing the idea of moving the County’s Behavioral Health Division from its Wauwatosa location to the former St. Michael’s Hospital. Although the Walker Administration’s planning may have taken place earlier, they didn’t formally ask the County Board to take up the issue until January 2007. In one of the earlier stories about this idea, Scott Walker suggested that if the move happened, the County could sell the land from the previous facility. At that time, he indicated that some entities already expressed some interest in buying the land. (Milwaukee Journal Sentinel, “County steps toward selling Mental Health Complex,” 1/11/2007)

The Walker Administration released a study, that it produced, that supported the argument for moving the Behavioral Health Division. Some members of the County Board began to examine the Walker study that supported the Walker position. One Supervisor skeptically called the numbers in the Walker document, “hokey numbers” that were not reliable. (Milwaukee Journal Sentinel, “Mental hospital move called cheapest way,” 5/14/2008)

At the time that the Walker study was released, he also released more details about his plan. He revealed that a private firm, Weas Development of Wauwatosa would actually purchase the St. Michael’s property from Wheaten Franciscan Healthcare, make necessary upgrades and then lease it to Milwaukee County. Under the Walker plan, the county would lease the property at St. Michaels for 25 years. Along with his plan to move the BHD, Walker included plans of privatizing many county jobs at the facility. (Milwaukee Journal Sentinel, “Mental hospital move called cheapest way,” 5/14/2008)

In 2008 Weas Development and Wheaton Franciscan Healthcare spent $1,471.20 and $975.00 respectively in lobbying Milwaukee County officials regarding moving BHD. (Milwaukee County Clerk, “2008 Lobbying Expenditures by Organizations Registered as Lobbying Principals with the Milwaukee County Clerk,” 2/26/2009)

County auditors and analysts from the County Board spent several months studying the various options regarding the BHD and released their initial finding on July 11, 2008. The primary observation was that it would be more cost effective to either upgrade the current facility or build a completely new facility on county property. The audit also suggested that Walker’s plan to include the privatization of most positions at the facility should be taken as a separate issue. (Milwaukee Journal Sentinel, “St. Michael purchase costlier than thought,” 7/19/2007)

What also appeared to be a regular theme in the report was that there would be initial savings from the Walker plan to lease St. Michael’s, but those savings would only happen in the short term. Over the long term, his plan was not the most prudent or in the best interests of the County. (Milwaukee County, “Interoffice Memo from Director of Audits to Milwaukee County Committee on Finance and Audit,” 7/11/2008)