Community services chief sick, resigns

Spokane County’s director of community services announced his resignation Wednesday, disclosing he has early-onset Parkinson’s disease.

Kasey Kramer, 45, said the illness has not affected his work, but that he will retire to devote time to push for stem-cell research, and to establish a construction and development group in Spokane with several close friends.

Kramer, who managed more than $70 million in developmental disabilities and mental health programs, said his last day will be July 8.

“I’ve had more opportunities, and we’ve done more than I could have ever dreamed,” Kramer said. “I can look back and be happy with what we’ve done.”

For more than five years, Kramer concealed his illness from hundreds of county staffers, including Spokane County officials, he said. He held an emotional meeting with county employees on Wednesday morning.

“I have kept this secret, and that’s been harder than you might think,” Kramer said in an interview after the meeting. “I have a tough job. I think the desire to keep this hidden came from a desire to not make myself appear vulnerable. I don’t want people to treat me differently.”

Hired as director in 1994, Kramer became a controversial public figure, pushing for sweeping changes to the county’s public mental health system that, on more than one occasion, frustrated the region’s mental health providers.

In his tenure, the county transferred its mental health system to a managed-care firm, dramatically increased the number of housing units for people with mental illness, and launched an ambitious initiative to revamp children’s mental health care.

But like many regions in Washington state, Spokane County has also struggled with an increasing number of mentally ill inmates in jails and homeless shelters, patients in more severe stages of illness, and strict new federal guidelines that forced 1,300 low-income people from the public mental health system since 2003.

Kramer became the public face of the turmoil: Rumors swirled that he singled out Spokane Mental Health, his former employer, for cuts – an allegation Kramer angrily denied.

“To get this job done, sometimes you have to be willing to hang a target on your back,” Kramer said. “When I look back, I wish there had been less conflict, but I think some of it was unavoidable. Deep down inside, we all want to make sure that the clients get what they want.”

In April, a coalition of mental-health providers denounced Kramer’s plan to overhaul the county’s civil commitment service by severing an agreement with Spokane Mental Health. Kramer argued the contractor had been slow to change even as the county accrued hundreds of thousands of dollars in fines for committing too many people to psychiatric beds.

“We have not always agreed with the decisions made at the county, but they have had the authority to make those decisions,” said David Panken, executive director of Spokane Mental Health. “I don’t think it has ever been personal. I really do wish him well.”

Marilee Roloff, executive director of Volunteers of America, a local nonprofit that provides human services, said that despite often being at the center of controversy, Kramer always acted professionally.

“I just have nothing but admiration for him,” Roloff said. “If you are a visionary leader, sometimes you have to stir things up.”

Kramer said he noticed early signs of the disease during long bike rides, when his foot would tremor uncontrollably. He began taping his foot to his ankle to try to halt the spasms. The spasms also spread to his calf muscles.

“When I look back now, even in my 20s, I can see the symptoms,” Kramer said.

After a battery of medical tests five years ago, a neurologist diagnosed him with Parkinson’s, a degenerative neurological disease that causes tremors, muscular stiffness and a distinctive short, shuffling gait. The National Parkinson Foundation estimates that 1.5 million people in the United States have the disease, including the actor Michael J. Fox and the legendary boxer Muhammad Ali.

A physician told Kramer he would be wheelchair-bound in seven years, but he remains active today, lifting weights four times a week, riding a stationary bike and stretching daily to maintain flexibility.

“I am somebody who has to suck the marrow out of every day,” Kramer said. “I don’t mean to be fatalistic, but it will catch up with me.”

Kramer said he can sense the progression of the disease in his body. At the end of a long workday, his muscles ache and he walks stiffly, he said. The disease, which has predominantly affected the left side of his body, can make it difficult to type – at which point he dictates his notes.

“I don’t doubt that people have noticed me fumbling with a key or something,” he said.

He said he plans to lobby government officials and speak publicly to raise awareness about the disease. Recent developments in stem-cell research give him hope, he said, even though the controversial techniques face fierce political opposition from religious conservatives.

“I think our administration right now could say we are going to find a way to exploit these amazing developments and cure disease,” Kramer said. “There are thousands of people like me who are average, normal people who want to keep working. The potential treatments give them hope. When that time comes, I’ll be ready.”

Kramer said he also hopes to develop housing projects around the city, and spend more time with his wife, Mary, and two daughters, Delaney, 6, and Emily, 4.

In July and August, Kramer said, he will devote several weeks to fishing for salmon along the Washington coast.