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Reorganization Proper

September 15, 1985

County Chief Administrative Officer Clifford Graves was right to move decisively last week to impose an interim reorganization of the Department of Health Services.

Graves, the lame-duck head of the county bureaucracy, acted after months of crisis atmosphere created by problems that have plagued Edgemoor Geriatric Hospital and the county mental health hospital, known as CMH. The new structure, which will continue into next year when a successor is named to replace Graves, breaks up the large Department of Health Services into independent units for public health, mental health and physical health. Each section will be headed by an administrator chosen from within county government who will report to a temporary deputy chief administrative officer.

Although Graves leaves office at the end of the year and the new chief administrator should be allowed to oversee the imposition of the permanent structure, the situation within the Department of Health Services had deteriorated to the point that urgent changes were needed.

State investigators have found hundreds of deficiencies at Edgemoor and have fined the county more than $30,000. The problems there included two deaths, one of a woman who drowned while unattended in a bathtub. A separate investigation at CMH turned up three deaths there that might have been prevented. Graves and Health Services Director James Forde have been under fire from county supervisors, the San Diego County Grand Jury, state health officials and Assemblyman Larry Stirling (R-San Diego) for the management of the two institutions.

Under the interim plan, Forde has been reassigned as a staff consultant to Graves on health matters, and it seems unlikely he will be a part of the permanent structure. At its meeting Oct. 8, the Board of Supervisors is to determine what role outside consultants will play in creating the reorganization.

Graves' proposal, which he previewed last month, received only lukewarm support from the supervisors. But the supervisors, while quick to--properly--point the finger at Graves and Forde for the problems of the Department of Health Services, have provided little leadership to help pull it out of the quagmire.

Graves did not need their approval of his interim reorganization, but he will have to go to the board with personnel changes and for minor technical ordinances. It would be unfortunate for any of the supervisors to use those occasions as opportunities to obstruct his plan. The situation is too desperate and the need for action too immediate.

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