Shawnee & Lenexa

Questions on spending surround Johnson County Mental Health Center

Just over a year ago, the Johnson County Mental Health Center celebrated its 50th birthday with a gala celebration. Space was booked at the Overland Park Convention Center. The speaker — a best-selling author on bipolar disorder — was flown in. Tickets were sold.

At a cost of about $15,420, the center’s gala was meant as a tribute to a half century of service to the mentally ill, many of them among the county’s poorest citizens.

But only $3,425 in tickets were sold to recoup the cost, according to county records. With a loss of about $12,000, the 50th anniversary gala was instead a glimpse into spending decisions that were taking place at the agency during the first year of Executive Director Maureen Womack’s term.

After just short of two years on the job, Womack resigned this month amid controversy about the center’s finances. As this year comes to a close, the center is expecting a roughly $900,000 shortfall. Over a quarter of the fee-generating staff has left. And Chad VonAhnen, her temporary replacement, finds himself calming the fears of remaining and former employees about the future of the department.

Questions are being raised about how the department spent money during Womack’s tenure. For instance, mental health center spent $27,900 on a promotional video with Larry King and $3,000 on a leadership retreat immediately after the Johnson County Commission chided members of the governing board about their predicted shortfall.

The controversy in Johnson County isn’t the first time Womack has been questioned about decisions she’s made as head of a government-funded mental health agency.

County officials have steadfastly refused to discuss Womack’s performance, citing it as a personnel matter.

Womack defended decisions that brought criticism to two other agencies she ran before coming to Johnson County. She would not comment on the controversies surrounding her time in Johnson County.

“It was a pleasure to work there,” Womack said of tenure at the Johnson County Mental Health Center. “I’ve met some wonderful people.”

Maureen Womack was appointed to the head position at the mental health center in late 2011, at a salary of $146,000, replacing David Wiebe, who had been director for 26 years.

Her appointment came after stints in two similar positions in Norfolk, Va., and the Salt Lake City area.

Davis Behavioral Health, Inc., in Davis County, Utah, was Womack’s biggest administrative job after completing her education in the late 1970s and serving as a therapist and later an administrator in Gulfport, Miss. and Mobile, Ala.

Davis Behavioral Health is a non-profit that does much of its work through a county contract to serve the mentally ill. Womack took over the helm there in 1998.

In July 2008, the state auditor released a critical report on the health center, saying that $850,000 had been needlessly spent through the creation of five new auxiliary corporations to handle various aspects of the health center’s workings.

For instance, one corporation, Diversified Employment Opportunities, was created to find employment for mental health clients. But the clients were employed doing maintenance and other chores at Davis Behavioral Health Center itself, with money coming out of the center’s own budget, according to the audit report .

Other corporations, created for other aspects of the agency’s work, such as fundraising, also fared poorly in the auditor’s eyes.

“It does not appear that there was a need to go to the expense of privatizing activities that were already being done or could have been done” by the health center, the report said.

Soon after, Womack resigned that position. In 2009, she took over the Community Services Board of Norfolk, Va. There, she was credited with discovering that an employee had been paid for 12 years without working.

Womack used a consultant to fill in for and find replacements for five management employees she fired in connection with the payment, spending around $359,000, according to reports in Norfolk’s newspaper, the Virginian-Pilot. She also signed a five-year lease at a cost of $91,000 for some medical office space in a building whose owners went bankrupt two months later. That despite the fact that the agency already owned a building that would have worked, according to critics cited in the newspaper report.

In 2011, a few months before being hired in Johnson County, Womack’s judgment was again brought into question — this time by an investigator for the Virginia Department of Behavioral Health.

Womack’s agency was cited for noncompliance for not providing required criminal background check papers to the state when it hired its new chief financial officer, according to the newspaper. That person was hired despite a 29-year-old conviction of felony intent to distribute a controlled substance. The conviction would have been against the hiring policy of the services board at the time.

Womack defended her choice to The Star, saying she was proud of giving a second chance to a good candidate.

The Norfolk Community Services Board paid an executive search firm that specializes in behavioral health, the Meyers Group of Bethesda, Md., to find candidates for the CFO position and other top jobs there.

It was the Meyers Group that also vetted Womack for the Johnson County Mental Health Center opening a few months later.

Meyers Group President Stuart Meyer broke off a conversation with The Star on the matter to take another call and has not returned calls since.

Womack said she has no regrets about the way she handled things in Utah and Virginia. She said she had the backing of the governing bodies in those agencies, which had adequate reserves to cover the costs. The Utah mini-corporations were set up to keep money to fund employment of clients completely separate from other revenue, such as Medicaid, she said.

The office space in Norfolk was desirable because a health care company vacating it was leaving some medical equipment and it was in a good location, she said. And she didn’t have any expectation that the owner would file for bankruptcy, she added.

“I have never exceeded limitations on expenditures without full notification” of the governing bodies involved, she said.

The Johnson County Mental Health Governing Board, a group of volunteers appointed by the county commission, had not hired a new chief executive for 26 years when Wiebe retired. The board chose from among three candidates found by the Meyers Group search firm, said board chairman Kevin Moriarty. The board has the power to hire its executive without final approval by the county commission.

Moriarty, like other county elected and appointed officials, would not comment on Womack.

A former mental health center employee, Sandy Robertson, asked several questions at a recent governing board meeting about the hiring process and spending during Womack’s tenure.

At the top of the list was a question about a television video. In December 2012, the mental health center paid $27,900 to Profiles Television Productions of El Segundo, Calif., for an 8-minute video touting the center’s services, according to invoices filed with the county. The video was a part of the InView series and opens with a nonspecific introduction by Larry King. According to the Profiles website, the videos run on Discovery Channel and other cable networks.

County staff said it ran on an unspecified cable network at 6 a.m. July 22. It is also posted on YouTube, with about 2,700 views.

The governing board seemed unaware of that expenditure when Robertson asked them about it at the meeting. County Commissioner Michael Ashcraft, who attends the board meetings as a non-voting liaison for the commission, said he remembered being shown the video during a governing board meeting but was not told the particulars of its cost.

Then there was the 50th anniversary gala. It cost $7,000 to book the convention center facilities, but much of the rest of the $15,400 spent went to the speaker, Terri Cheney. Cheney is a former entertainment lawyer and Los Angeles writer who became a best-selling author with a memoir of her personal experience with bipolar disorder.

The mental health center spent about $6,000 on her speaking fees, $490 for books for her to sign and $1,700 more on airfare, lodging, meals and transportation, including $235 for taxi service, according to county records.

The event was supposed to be “revenue neutral,” with tickets and corporate donations paying the costs. Tickets were sold for $30 and $55 apiece. The ticket sales recovered about a quarter of the total cost of the event, according to county records. There were no corporate donations aside from ticket sales.

Mary Thornton Associates Inc., a consulting firm, was another top ticket item in 2012. The department spent $22,172 for three different members of that firm to pay three-day visits to the department. The visits were to check over billing procedures and prepare for state auditing requirements, said Tom DeWeese, director of clinical services at the Johnson County Mental Health Center. DeWeese could not recall another time consultants had been brought in for that purpose.

The only consultant-related spending for this year was $3,000 for a leadership retreat Aug. 16 at the Kauffman Foundation offices.

That leadership retreat took place just a few days after governing board vice chairman Cindy Neighbor and treasurer Stuart Conrad appeared before the county commission for a somewhat heated discussion of the department’s budget and the upcoming shortage. The county commission later approved a bailout of around $1 million so the department could meet its payroll.

According to a recent report from a state health care association commissioned by the county manager’s office, a combination of decisions have led to the situation, some of which started before Womack was hired. A main reason cited is a continuing loss of the case workers and clinicians who can bill for services.

The department has lost 66 of the 249 billing employees who worked there in 2009. Some left as the county encouraged voluntary retirement as a way of cutting back during the recession. The majority — 55 employees — left during Womack’s tenure in 2012-13. During that time, the amount of revenue generated from fees has gone down from $12.4 million in 2011 to $8.7 million projected for this year.

Although revenues were headed the wrong way before she was hired, Womack did little to reverse them during her tenure. The report cited a staff with new performance standards confused by changing demands and vision of who the center would serve. Although most of the staff was underperforming, the report said workers and middle management had little understanding of how to meet their billing goals.

For years, the department’s day-to-day spending decisions have been made by the director, with some input from the governing board. But they don’t typically come before the county commission. Commissioners Ashcraft and Eilert said they were unaware of the spending on videos and consultants.

The county commission, however, has final say over the center’s budget each year.

When it became clear this fall that the mental health center would need a bailout, the commission decided to get itself into the loop by assigning the county manager’s office oversight of the center’s finances.

Members of the mental health governing board expressed concern at their November meeting about getting the center back on track. Board member Mary Uhl asked for specifics about changes the county manager’s office may have in mind.

But figuring out what combination of changes will bring a balanced budget will be a complicated process, county staffers say.

County Manager Hannes Zacharias told the governing board that the top priority is to “be sure the clients get the treatment they deserve and expect,” while taking care of employees and finances.

Chad VonAhnen, who is splitting his time between temporary leadership of the mental health center and his current post as head of county developmental supports, said working with and reassuring current employees will be key.

As fee-generating employees left, the work load increased for those remaining. In the meantime, more clients coming in are suffering from severe disorders than the center has seen in the past. The knowledge that the center is on shaky financial footing now piles on additional stress, he said.

Zacharias said his meetings with center staff have been positive.

“My impression is that they are eager to come forward and assist us on this journey,” he said. “The mood of the working folks who provide the services is upbeat and optimistic.”

Meanwhile the county commission is debating whether to disband the mental health governing board and take over its management.

At a recent meeting, County Commission Chairman Ed Eilert urged the commission to act quickly so a new executive director can be hired soon. He also told the governing board that he would like to get the department’s finances stabilized before seeking a new executive director. Otherwise, he said, the best candidates may be leery of taking on the job.

“We need to be in the position to clarify to any potential person that the finances are in a solid position,” he said. “Whether that takes 90 days, 120 days, I don’t know.”

Eilert, VonAhnen and other county officials agree that it’s still too early to define exactly what changes will have to take place. But they do pledge to make sure the county’s clients don’t suffer because of administrative failings.

“There is no doubt we will make sure the clients’ needs will be met. Will they be met in the same way? I can’t promise that,” Commissioner Ashcraft said at the board meeting.

That uncertainty was what drew Robertson, a former case worker, to the governing board meeting. Robertson feared the controversy could hurt programs that have helped the county’s mentally ill population, a group that has few other resources.

“I don’t want to put anybody on the spot,” she told the board. “It’s really heartbreaking to see what this has come to.”