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The San Benito County Behavioral Health Department faces leadership changes after years of contentious relations between management and frontline employees.
Behavioral Health Director Dana Edgull and Wayne Clark, a consultant for the department, presented a report on the department’s services, fiscal structure and statutory mandates. The presentation included an update on the department’s reorganization and interventions to address internal issues.
“It’s really an unprecedented time of change, and opportunity,” said Edgull. “And it’s requiring a lot of work, which we’re not afraid of, though we do have some system capacities and some challenges.”
In January, the department identified a number of goals to address, including:
- Providing stable, experienced and oversight leadership
- Improving organizational culture, functions and structure
- Guiding the department through the transitional period of new leadership
- Obtaining assistance in recruiting, identifying and hiring a permanent director
The department’s former director, Alan Yamamoto, retired in April 2022.
In August, the Board of Supervisors hired Edgull, who began working with the county in October.
In September 2022, the 2021-22 Civil Grand Jury Report said that department employees expressed high stress levels, feared retribution from senior management and faced staffing shortages, causing heavy workloads. The report also said the wait time for appointments and urgent services was too lengthy.
The department was last investigated by the Civil Grand Jury in 2014-15. That report noted that management lacked the support of staff because of poor communication and inadequate response to employee complaints.
Clark said that, since January, the department’s organizational culture has seen improvements in communication, staff morale, teamwork and collaboration and coordination.
Working with Clark, the department was able to decrease the funds returned to the state from $1.7 million to just $8, Edgull said. It also maximized Medi-Cal billing by upgrading the electronic health record system and introducing payment reform, an alternative payment method to cost-based reimbursements.
The department has also partnered with school districts under the Mental Health Student Services Act, which provides grants for partnerships between schools and county mental health departments. It now has a fully staffed substance use disorder team.
It has also increased community response with the creation of S.A.F.E. Team and a prevention team for outreach. As well as seeing a decrease of involuntary holds for people experiencing mental health issues since 2021, the presentation noted.
“I really want to emphasize that we are also very dedicated to equity and to looking at language equity and making sure that everything that we’re offering is bilingual, makes sense from a cultural perspective and is also paying attention to the needs of individuals that speak Indigenous languages and in our community,” Edgull said.
Current challenges include:
- Retention and recruitment within the department
- Increasing demands for behavioral health care
- Morale changes and directives from the department of health care services
- Increased responsibility of behavioral health departments such as legal and housing
The department is looking to add two deputy directors, Edgull said.
The department is also hiring a quality improvement supervisor, a mental health clinician, a case manager, an office assistant, an office services supervisor, and an accountant, said Rachel White, an assistant director, on Nov. 27.
To meet the remaining challenges, the report said the department is looking to work with the supervisors to obtain federal and state funds and increase organizational and treatment capacity, which includes adding two deputy directors, increasing contracted services and creating internships and work study opportunities.
There were no public comments.
“It’s been a long haul. And it seems to me that we’re on the right track,” Supervisor Kollin Kosmicki said. He then asked the presenters about improving morale in the department.
Edgull said the department is working to create surveys to understand how to boost morale.
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