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The Tompkins County Legislature will have at least two recommended alternatives to consider, as it seeks to determine the leadership structure for the County's Mental Health Department.

Meeting jointly for more than three hours, two committees of the Legislature deliberated on whether shared leadership of the Mental Health and Health Departments by Public Health Director Frank Kruppa should continue on an interim basis, as it has been for the past eight months, or whether to authorize a renewed search for a Commissioner of Mental Health.

Up for consideration by the Budget, Capital, and Personnel; and Health and Human Services Committees was a proposal to authorize a plan to extend the Public Health Director's interim dual management for another four years, making other necessary changes to facilitate that plan, with full evaluation of the approach to be conducted in the fourth year.  The budget committee ended up recommending, by a 4-1 margin, a revised version, advanced by Legislator Peter Stein (who serves on both committees) to shorten the interim arrangement to three years, through the end of 2018, plus such additional time in 2019 as the Legislature deems necessary to evaluate the performance of the combined department head model, determine whether it shall continue, and accommodate any necessary organizational transition.  After that time, a majority vote of the Legislature would be required to keep the arrangement in place.  (Legislators Stein, Mike Sigler, Glenn Morey, and Chair Jim Dennis voted in favor; Legislator Leslyn McBean-Clairborne was opposed.)

Health and Human Services discussed but declined to yet take a position on the proposal for shared leadership, as has been recommended by budget.  Last month, that committee, by a 3-1 vote, recommended the alternative, advanced by Legislator Will Burbank, that the Legislature renew the search for a Commissioner of Mental Health, while also forming a task force to examine operations and consider the future directions of both Health and Mental Health departments, including consideration of advantages and disadvantages of potential merged approaches.  That means multiple recommendations will now go before the Legislature.

All members of the Legislature attended the meeting, with the exception of Legislator Dan Klein, who is recusing himself from consideration of the issue due to a family connection to the Health Department.

Public comment to the committees was split—among ten who spoke were several members of the Community Mental Health Services Board who expressed ongoing deep concern about the process, supported the search for a new Commissioner, urged a careful deliberative process before any change in structure, and indicated that the Board as a whole is, at best, ambivalent about continuing the interim arrangement.  Among those in favor of continued shared leadership were the fiscal manager and medical director at Mental Health, and three members of the County Board of Health, including Dr. David Evelyn, Vice President for Medical Affairs at Cayuga Medical Center, who said it will provide unified administrative structure to allow for better collaboration and integration of the two types of services and help bring needed parity to mental health services.

Among legislators expressing concern was Legislator Anna Kelles, who thanked Director Kruppa for his interim leadership, but said she has yet to see the specific proposal that would put the two leadership positions into one, which she suggested is essentially a new position.  Legislator Will Burbank called it a "critical mistake" to build a position around one person and determine that makes sense organizationally.  Legislator Rich John questioned how the apparent deep division within the Community Mental Health Services Board would be addressed.  Legislator Carol Chock expressed hope that an approach could be achieved that would bring the two alternatives now before the Legislature closer together.

Addressing the committees, County Administrator Joe Mareane said, "If our goal is to build a strong, sustainable Mental Health Department, I strongly recommend staying the course.  We have a highly skilled leader and manager in place to implement the changes we all know are necessary; the kind of change that is necessary does not occur overnight…I suggest that this is our best path toward bringing our Mental Health department to the standards of excellence that its highly skilled staff deserves, and that is appropriately cautious in its approach to permanent structural change."

The issue is scheduled to go before the full Legislature for consideration December 15.

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