Mental health plans lie fallow

Section: Health

Kate Moran

In early September, the president of the Metropolitan Human Services District called a news conference and triumphantly announced a plan to relieve the critical shortage of services for patients with mental illness, drug habits or both.

Ben Bagert said Metropolitan would convert a former state institution in Belle Chasse into a haven for those patients, many of whom have landed in jails and hospital emergency rooms since Katrina obliterated programs designed to keep them stable. "Help On Way," said a news release he distributed at the time.

Three months later, Metropolitan still has not opened the 62 beds, the intensive outpatient clinic or the "board and care" operation that Bagert promised at the news conference. In fact, little work has been done to prepare the Belle Chasse facility to receive its first patients.

Time is running out to do so. Bagert signed a six-month lease for the Metropolitan Development Center, a facility on F. Edward Hebert Boulevard where the state used to house people with developmental disabilities. The lease expires at the end of February, when the state can either renew it or seek a buyer for the 500-acre campus.

Bagert said he is angry and frustrated that Metropolitan has allowed the facility to sit empty, a situation he blames on agency staff. He said the executive director, Jerome Gibbs, promised in September that he could open the facility within four to six weeks.

"There are no excuses for this, no matter what," Bagert said.

This sort of inertia has characterized other initiatives from Metropolitan, an agency created by the state four years ago to care for patients with mental illness, drug addiction or developmental disabilities such as cerebral palsy. The agency was young when Katrina hit, and physicians and social workers have complained since the storm

that Metropolitan has repeatedly failed to revive critical services and follow through on promises -- despite its $29 million budget from the state.

Patients not moved

Gibbs, the executive director, said his agency has not yet opened the Metropolitan Development Center because he found some of its buildings in a greater state of disrepair than he anticipated. For one, he discovered a leak in the roof of the building where Metropolitan planned to house the intensive outpatient clinic.

What's more, Gibbs claimed the state has failed to move all of its patients out of the campus and into group homes embedded in regular neighborhoods, as it was supposed to do by early November. Until those patients are gone, Gibbs said, he does not have a place to put 30 so-called "crisis respite" beds for mental patients who were healthy enough to be discharged from the hospital but still require some supervision.

Both the state and Metropolitan's board president contradicted that account, however.

Bagert toured the campus last Wednesday and said the buildings needed only minor repairs -- a leaky air conditioner, a busted water heater -- that could be tackled in a few days by a skilled maintenance crew.

"I can think of two or three easy fixes from my days as a construction worker in college," Bagert said. "When you consider the urgency of the situation, to let something like this stop you is inexcusable."

While some of the state's patients are still housed inside one building that was supposed to be available to Metropolitan, Bagert said there is an empty building called the central clinic where Gibbs could have opened the crisis respite beds.

Bob Johannessen, a spokesman for the Department of Health and Hospitals, also said the remaining patients should not have been an impediment.

"We have had some difficulty finding appropriate community placements for these individuals, but that should not stand in the way," Johannessen said. "We have spoken to Dr. Gibbs, and he assures us that we have not done anything or failed to do anything that would impact their moving in."

Plan still viable

When Bagert called the news conference in September, he said Metropolitan planned to provide four different services on the Belle Chasse campus: 30 crisis respite beds, 32 detoxification beds, an intensive outpatient clinic and a "board and care" unit for mental patients

who also suffer from drug or alcohol addiction.

That plan has since been truncated. Gibbs said he scrapped plans for the board and care unit after residents from nearby subdivisions worried that it would bring homeless people to the area. He said Metropolitan found a contractor that could house those patients in group homes in New Orleans instead.

Gibbs said he also discarded plans for the detox beds after state authorities told him they wanted to provide the beds themselves. The state sought bids in October from agencies that could run the detox beds, but Johannessen said Metropolitan never applied. The state is now finalizing a contract with Odyssey House, a New Orleans nonprofit.

Although Metropolitan is halfway through its lease with the state, Bagert says he thinks the plan to open the Belle Chasse campus can still be salvaged. If Metropolitan gets the site up and running over the next few weeks, he believes the state would be inclined to renew the lease.

Gibbs said he has not dis

cussed with the state whether Metropolitan might have use of the campus after February. Metropolitan was supposed to pay the state $77,600 a month for use of the facility, but Gibbs said the state has not charged rent because his agency has not occupied the buildings yet.

Bagert has led the Metropolitan board since the agency's inception in 2004, but he resigned his leadership role earlier this month after several new board members took office. He remains on the board but says he plans to leave the agency in four months or when Mayor Ray Nagin names his replacement, whichever comes first.

Community access needed

The new board president, Dr. Don Erwin, a former Ochsner physician who now runs the St. Thomas Community Health Center, met with Gibbs last week and was briefed on the plans for the Belle Chasse campus.

Dr. Elmore Rigamer, the medical director of Catholic Charities and a sometime critic of Metropolitan, praised Gibbs for trying to find a way to provide more mental health beds in the area. However, Rigamer ex

pressed concern that the Belle Chasse campus -- on the other side of the Gulf Intracoastal Waterway from Algiers -- was too isolated from downtown New Orleans.

"After you detox somebody, when you are rehabilitating them you want them to be in the community and not apart from the community," Rigamer said. "You want them in work programs, and sometimes we have to teach them to manage their money and navigate the transportation system. Sometimes they've dropped out of life for a while."

Gibbs said he has ordered two vans to transport patients between the Belle Chasse campus and New Orleans. He promised in September that he would also talk to the city ambulance service about helping to move patients, but Dr. Jullette Saussy, director of the city's emergency medical services, said Gibbs has not been in touch with her.