San Diego’s behavioral health system has long been plagued by bottlenecks and a lack of places for patients to stabilize after they land in local hospitals. Now major state reforms are expected to put more pressure on that clogged system.
In response, San Diego City Councilman Raul Campillo called a special committee meeting Wednesday to hear from hospital officials, first responders and others about local bed and service shortages.
A big takeaway: There aren’t enough places for people to go after they leave the hospital.
How that’s playing out at two hospitals: Jerry Gold, Scripps Health’s behavioral health administrator, said a third of the beds at Scripps Mercy Hospital’s inpatient psychiatric unit in Hillcrest are now filled with people waiting for a longer-term destination. Some patients wait months – and even hundreds of days.
Christiana Paul, a vice president at Sharp Mesa Vista Hospital, noted that the challenge is particularly acute for behavioral health patients with Medi-Cal rather than commercial insurance. Paul said Medi-Cal patients are twice as likely to be readmitted at Sharp Mesa Vista and are spending nearly six times as long in the hospital than commercial insurance patients.
What the county’s doing: Luke Bergmann, the county’s behavioral health services director, detailed county projections that it needs hundreds of new non-hospital beds to better serve behavioral health patients with Medi-Cal and address clogs in the system. The county has received state grant funds to try to bolster patients’ access to board-and-care homes, which typically assist residents with medication and meals. Bergmann said the county is also exploring using a former Hillcrest property once eyed as a mental health service hub to house dozens of board-and-care beds.
On the street: Aaron Meyer, a UC San Diego psychiatrist who is the city’s first behavioral health officer, reported that San Diego Fire Rescue received nearly 32,000 emergency calls about psychiatric and substance use concerns last fiscal year. He also noted that 28 people with behavioral health conditions accounted for 2 percent of all EMS calls.
Meyer said behavioral health patients with other health conditions can especially struggle to get the care they need. He called for a real-time dashboard of available treatment beds to allow first responders and others to link people with services and a hub where people with both behavioral health and substance use challenges can be assessed and connected with the care they need.
Police Lt. Michael Stirk of the department’s Neighborhood Policing Division echoed Meyer’s call for a one-stop shop for behavioral health patients and also urged data-sharing among behavioral health providers to minimize repeating crises for patients and for additional detox beds.
“We would like to ensure that a bed is always available when someone says yes to treatment,” Stirk said.
Meanwhile…CARE Court is coming: County leaders including Bergmann gathered Wednesday to explain how the new state mandate to compel people with psychotic illnesses into treatment will roll out. CBS 8 shared more details. As our Lisa Halverstadt has previously reported, the county projects CARE Court will in its first year serve 250 people and it’s not clear what percentage of them will be homeless despite Gov. Gavin Newsom’s focus on that population as he’s championed the initiative.
Vista’s Getting Its Second Homeless Shelter
Vista is moving forward with its own homeless shelter and will continue its partnership with a network of existing North County shelters.
Background: The Vista City Council held an emergency meeting a couple weeks ago after learning that its homeless residents aren’t getting into shelters because of limited shelter capacity.
For years, Vista has contributed about $200,000 annually to the Alliance for Regional Solutions, a network of eight North County cities that collectively contributes funding to homeless shelters in that part of the region. Vista contributes the most out of all North County cities.
Because of the city’s contribution, its homeless outreach team can refer homeless people to two homeless shelters in North County – Haven House operated by Interfaith Community Services in Escondido and La Posada de Guadalupe in Carlsbad operated by Catholic Charities.
The Latest: After learning about a lack of open shelter beds for Vista residents over the past 10 months, Vista leaders decided Tuesday to move forward with a low-barrier, non-congregate shelter in their own city. A non-congregate shelter is one that provides private units or rooms to homeless individuals and families.
The council voted to send out a Request for Proposals to solicit applications and bids from potential service providers that would operate the shelter. The city expects to choose a service provider by the end of November.
Vista will also continue to partner with existing shelters and will keep contributing to the Alliance, but moving forward, it will pay for each shelter based on utilization. So, instead of contributing $200,000 up front, Vista will only pay for the beds used by Vista’s homeless residents.
More on Palomar Health’s Unusual Demands for Its Website Visitors
Earlier this week, North County reporter Tigist Layne revealed that Palomar Health added rules to its website that limit public access to information. The public health district’s terms of use agreement shows up as a pop-up that takes up the entire screen. The only way to get the pop-up to disappear, and access the website, is to accept the 3,000-word terms of use agreement.
If visitors don’t agree to the rules, they can’t get into the website. It’s a unique barrier that one expert said is “definitely problematic” for a public agency.
Palomar Health didn’t answer our questions on the rules. But KPBS picked up the story and Palomar Health told them it’s “committed to ensuring the public’s access to information.”
What’s going to happen: The health care district told KPBS it’s in the process of updating the website’s “outdated” terms of use. It expects to have that done by the end of the year.
Laurie Edwards-Tate, Palomar Health board director, told Layne she came across the terms agreement for the first time only a few weeks ago while attempting to access meeting agendas.
“It was shocking to me, and I felt prohibited from its use and I felt like it was a barrier for being able to access it,” Edwards-Tate said, speaking on her own behalf and not for the board. She added that, to her knowledge, the terms of use agreement was never brought up in a regular board meeting.
The Learning Curve: College Rankings, What Are They Good for?
Our resident education expert Jakob McWhinney is in the process of obtaining a bachelor’s degree from San Diego State University. It’s fair to say he lives and breathes education.
So, when the U.S. News and World Report released its new college rankings, and SDSU shot up the list, it piqued his interest. In the latest Learning Curve, McWhinney gets into college rankings and recent changes.
Should people care? What do they offer students? McWhinney gets into that and more in the Learning Curve. Read it here.
In Other News
- The city and the county each recently learned they will receive state grant funds to address encampments. The city grant will focus on a corridor along Interstate 15 while the county grant will focus on an area along the Sweetwater riverbed that includes Chula Vista and National City.
- You’ll want to plan ahead this weekend as work continues on the freeway bridge over state Route 163. The Union-Tribune has more on what to expect.
- The San Diego Fire Rescue Department is getting a new fireboat. (CBS 8)
- NBC 7 reports that rideshare drivers are struggling to keep up with rising prices at the pump.
The Morning Report was written by Lisa Halverstdt, Tigist Layne and Andrea Lopez-Villafaña.
Correction: An earlier version of this post misstated the city behavioral health officer’s statement about the share of San Diego Fire-Rescue emergency medical service calls tied to 28 behavioral health patients. Their calls accounted for 2 percent of all EMS calls.
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