Behavioral Wellness Director Toni Navarro wants a contractor to operate Santa Barbara County’s Crisis Stabilization Unit, which is a short-term mental-health facility.
The county Board of Supervisors approved a request-for-proposals process Tuesday that aims to get a contract approved and in effect by January.
The county’s Crisis Stabilization Unit, at 305 Camino Del Remedio at the Calle Real campus, has been closed since May 2022 for lack of staffing, Navarro said.
For several years before that, it was underutilized and sporadically open as staff were diverted to work in the nearby Psychiatric Health Facility.
“We have struggled with our census at the CSU – it’s not a secret that it’s not as full as we would like it to be,” clinical operations director John Winckler told Noozhawk last year.
From winter 2016 to spring 2022, the CSU served fewer than 300 people per year while it had capacity for 1,460 people.
The Behavioral Wellness Department plans to reopen the CSU as a locked facility, meaning patients can be involuntarily admitted and must be cleared to leave.
It was an unlocked facility for licensing and funding reasons, but that hampered its effectiveness and use, hospital and county staff have told Noozhawk.
A locked CSU will add involuntary, acute mental-health care beds to a system with too few of them. Santa Barbara County has 16 available psychiatric inpatient beds and needs 43 beds to serve its population, a 2021 state assessment found.
Behavioral Wellness has its 16-bed Psychiatric Health Facility, an eight-bed CSU that can hold people for less than 24 hours (currently closed), and a 10-bed sobering center for people to stay up to 72 hours.
County staff run the PHF and CSU, while Good Samaritan manages the sobering center.
“With Santa Barbara County’s rates for CSU services being some of the highest in the state, BeWell anticipates a strong response to the CSU request-for-proposals,” Navarro and her staff wrote in a report to the Board of Supervisors.
Proposals are due in late September, and an intent to award will be announced in mid-October. The county aims to have an operational contract in effect by Jan. 1, 2024.
The chosen contractor will hire and train staff; provide services to eight clients at any given time and serve 2,190 clients per year; assess clients for mental health or substance use disorders; and refer clients to follow-up services.
Also on Tuesday, the supervisors renewed contracts with out-of-county mental health facilities.
The contract with Sylmar Health and Rehabilitation Center in Los Angeles County is for three years and up to $3.2 million. Last year, Sylmar had an average caseload of nine local clients per quarter.
The contract with Merced Behavioral Center in Merced County is for three years and up to $1.3 million. Last year, Merced had an average of one local client per quarter.
The contract with Crestwood Behavioral Health (with facilities in Kern, Shasta and Santa Clara counties) is for three years and up to $1.8 million. Last year, Crestwood had an average of 33 local clients per quarter.
Santa Barbara County has no institutes for mental disease (IMDs), which include acute psychiatric hospitals, skilled nursing facilities and mental health rehabilitation centers, Behavioral Wellness staff said.
The contracts are funded by state money.
Any IMD facility with more than 16 beds is excluded from Medi-Cal reimbursement, making care in those larger facilities cost twice as much without that federal match, according to the California Department of Health Care Services.