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Santa Barbara County Mental-Health Officials Plan to Add Beds, Crisis Centers in Coming Year

The Department of Alcohol, Drug & Mental Health Services expects to be over budget by $2.5 million this year from extra costs for out-of-county institutions for mental disease and out-of-county psychiatric hospital stays for Santa Barbara County patients.

ADMHS gets most of its funding from state and federal resources, but received $3 million from the county’s general fund last year, and is asking for $3.3 million more in the coming year.

New director Alice Gleghorn, who joined the county in December, already has plans to add back some of the 50 mental-health beds eliminated since 2007.

There’s a standard for acute-care beds that calls for 10 beds per 100,000 residents, which means Santa Barbara County should have 40, Gleghorn said. “We have 16.”

It costs the county $1,700 per bed, per day, to house someone in the Psychiatric Health Facility, but there is some funding available from state and federal agencies, depending on the patient.

Her department is getting ready to open a crisis-stabilization unit in the South County, and got $1 million in grant funding for one in the North County, she told the Board of Supervisors at Wednesday’s budget workshop.

She wants to get "safe and stable" housing options for mental-health clients back to 2007 levels, and more outpatient treatment options, particularly for clients involved in the criminal-justice system. 

The county is being inundated with people who need inpatient mental-health care, and ADMHS is trying to divert clients from those more-restrictive, more-expensive forms of treatment.

It’s important to have resources in the county, since it’s difficult for patients to reintegrate into the community if they’re far from home, Gleghorn told the board.

Following a statewide and national trend, the county is seeing far more clients who are misdemeanor defendants referred as incompetent to stand trial, or ISTs.

ADMHS only sees court-ordered ISTs charged with misdemeanors, while felony cases are referred to state hospitals.

More cases are being knocked to the county with Proposition 47, which turns some nonviolent felonies into misdemeanors and sends clients from state hospitals to ADMHS, Gleghorn said.

Fifth District Supervisor Steve Lavagnino questioned the need to prosecute those cases.

“I don’t want to be paying $50,000 a month for someone in for petty theft or something where, in the situation right now, they’re not going to jail anyway,” he said.

County Counsel Michael Ghizzoni said county departments have been meeting to explore outpatient programs to restore people to competency. ADMHS is expanding its forensic team to get a treatment option tailored for these people, Gleghorn said.

She also revealed that mental-health patients in the County Jail do not have access to court-mandated psychiatric medications.

One of her budget presentation's objectives for 2015-17 was to "explore the possibility of access to court-ordered medications in the jail resulting in quicker stabilization of psychiatric symptoms and less deterioration of clients in acute psychiatric distress." 

Gleghorn said her department needs a resolution from the Board of Supervisors in order to use state law that allows treatment in jail facilities.

If people take medications voluntarily, they are provided now by the jail health care contractor, Corizon Health, but people refusing medication (often people deemed incompetent to stand trial) don’t have access to those medications, she said.

If there isn’t room at the county’s 16-bed Psychiatric Health Facility, some people are instead sent to the County Jail, Gleghorn said. Since the jail isn't designated as a treatment facility, detainees who refuse medications don't receive them, she said. 

It’s “something we can work together to change in Santa Barbara County,” she told the supervisors. Providing those medications should be within the scope of Corizon’s existing contract though, she said.

Because of the Psychiatric Health Facility’s licensing, federal funding would drop if it added more than 16 beds, but the county could open another one to get around that funding exclusion, Gleghorn said.

She presented a snapshot of acute-care placements, from March 27, that showed the county has 167 people in care, including nine children.

The PHF beds were full, as usual, costing $1,697 per day for room and board, and there were more than 90 people in out-of-county institutions for mental disease, costing $185 per day.

There were more than 30 people in out-of-county psychiatric hospitals, costing an average of $711 per day for room and board. Some clients are placed as far away as Morgan Hill and Oakland, Gleghorn told the supervisors at a previous meeting.

Budget workshops are scheduled to continue Friday, and the Board of Supervisors will hold hearings in June to make final funding decisions for the 2015-16 year. 

Noozhawk news editor Giana Magnoli can be reached at .(JavaScript must be enabled to view this email address). Follow Noozhawk on Twitter: @noozhawk, @NoozhawkNews and @NoozhawkBiz. Connect with Noozhawk on Facebook.

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