Millions Spent on Mental Health, Homeless and Veterans

Written by Neil Farrell

Neil has been a journalist covering the Estero Bay Area for over 27 years. He’s won numerous journalism awards in several different categories over his career.

April 19, 2024

San Luis Obispo County recently dealt with several health-related items addressing some nagging problems, and seeking or allocating millions of dollars for different programs serving a variety of clients.

County Supervisors were asked to approve applying for $7 million in bridge housing funding from the State specifically for those with mental health problems.

They approved a $1.3 million contract with a local hospital for acute psychiatric treatment; and another contract to assist senior care facilities.

And lastly, they approved funding for a program to provide mental health support for military veterans.

Bridge Housing

Supervisors gave the OK for the County Health Agency to apply for up to $7 million for the “Behavioral Health Bridge Housing Program,” administered through the California Department of Health Care Services (DHCS).

The money is part of a $1.5 billion allocation in the 2022 State Budget. The funding set up so-called “bridge housing,” a sort of “missing link” between homeless shelters and permanent housing. Essentially is gets people off the street and into safe housing while they look for a permanent place to live. With this program, the target is people with serious mental illness or drug abuse problems.

The money will be used for “operational and supportive services funding to quickly expand bridge housing implementation and includes short-term [less than 90 days] and mid-term [90 days-2 years] shelter and housing,” said a County report from the Health Agency.

This new money comes on the heels of other State efforts to address this issue, and the Behavioral Health Bridge Housing Program or BHBH is designed to complement those other efforts.

The County in August 2023 accepted a $7.5 million non-competitive grant under this budget allocation and contracted last February with Transitions Mental Health Association (TMHA) to set up a bridge housing program here.

“The services provided through the TMHA contract,” reads the County report, “includes 10 beds in a licensed housing facility with 24/7 supervision and eight beds of rental assistance, including supportive services and outreach.” 

This new grant application is a competitive-bidding situation with other counties and cities competing for the money. The deadline to apply is April 10. It would cover from July 1, 2025 to June 30, 2027. 

The report said it can be used two ways: up to $5 million for “shelter, interim housing, and/or auxiliary funding for assisted living, housing navigation, and outreach and engagement, including services; and up to $2 million for the purchase and renovation of existing structures [spending] up to $75,000 maximum per bed.”

County Behavioral Health was still working out how this program will work and if the grant were awarded, they would go out for bids again to administer this money.

Acute Care Contract

Supervisors also approved a $1.3 million agreement with Sierra Vista Hospital in San Luis Obispo to “provide acute psychiatric care for adult and youth/adolescent Behavioral Health clients.”

The agreement extends an existing contract through June but it has possible extensions built in.

The County contracts with several facilities for its mental health programs and sometimes folks need extra care. “In some cases,” the County report said, “the appropriate level of care for persons with serious mental illness may be acute psychiatric hospitalization. Apart from State Hospitals, acute care hospitals offer the most intensive level of care in the mental health care continuum.”

Sierra Vista is specially equipped for these troubled folks. “Acute psychiatric hospitals,” the report said, “are locked multi-bed, typically short-stay, facilities that are primarily engaged in providing intensive care of persons with severe mental illness. 

“Services may include psychiatric assessment, clinical treatment, social work, related psychiatric services, medical attention, and medically supervised detoxification.” 

These services are offered 24/7 at acute hospitals, and the County Behavioral Health in 2021 and 2022 contracted with SVH and other hospitals outside SLO County, too.

Those contracts have already been extended by the Health Agency Director, as stipulated with the previous approvals including a 25% increase in service rates. But Sierra Vista had a few rate hikes that went above what the director could approve, thus Supervisors were asked to approve them and the extension of the contract through this June.

They only get billed against the budget when the County needs more beds than it can provide or if deemed necessary by the staff. 

“Behavioral Health oversees the contracted operations of a 16-bed Psychiatric Health Facility [PH],” the report said, “however, due to the disposition of some clients, client insurance, the census on the PHF, age of the client, and/or quarantine issues related to COVID-19, clients may need to be transferred to other facilities for appropriate treatment.”

Fix Up Care Facilities

The County received another State grant designed to assist senior citizen facilities that accept State and Federal funding for the poor. 

The County got over $700,000 from the State’s “Community Care Expansion Preservation Program,” which the County said has two parts — Operating Subsidy Payments or OSP, and money for capital improvement projects at existing facilities.

Transitions Mental Health Association (TMHA) operates two such facilities in SLO County and Supervisors awarded most of the State money, some $631,000, to them.

“California has a shortage of adult and senior care facilities [e.g., Adult Residential Facilities and Residential Care Facilities for the Elderly] that accept individuals receiving or applying for Supplemental Security Income/State Supplemental Payment or the Cash Assistance Program for Immigrants,” the report said.

The California Department of Social Services created this grant program to try and support these critical facilities trying to help them stay open and continue to accept the government funding.

Last October, the County Health Agency went out for bids from qualified facilities for this money and chose TMHA. The $631,000 would be used for making numerous mostly minor repairs to their two facilities, among them are: weather stripping, new furniture; replacement of garbage disposal, replacement of a screen door, upgrade of bathroom vanities, toilets, sinks, and faucets, and installation of a security system/automated access system (cameras, monitors, and alarms).

There are some more hefty repairs they want to do as well, including upgrading the utility room, carpet and flooring replacement and upgrades, HVAC replacement, and seismic upgrades.

TMHA will oversee the grant and its maintenance staff or contractors would do the work. The grant monies are coming in two installments of $338,000 and $387,000. And the County is keeping 15% of the overall State grant ($726,000) for its expenses, some $94,000.

Money for Veterans

County Supervisors have also gotten some money to help veterans with mental health issues.

Morgan Boyd the County Veterans Service Officer brought the matter to Supervisors asking them to accept $200,000 from the State Department of Veterans Affairs and the 2004 Cal Vet Mental Health Services Act. The grant covers from July 1, 2024 to June 30, 2026.

In the typical military tradition, the County hopes to do a lot with what is actually not a lot of money. “It is recommended that the Board: 

1) Accept a grant award from the California Department of Veterans Affairs (CalVet) in the amount of $200,000 from Cal Vet Mental Health Services Act (MHSA) funds for the period of July 1, 2024, through June 30, 2026, to provide enhanced support for mental health outreach and support services for California veterans living in San Luis Obispo County.

• Approve an agreement with The San Luis Obispo Vets Center to provide Behavioral Health outreach resources to veterans and their families in San Luis Obispo County;

• Approve an agreement with Cal Poly Center for Military-Connected Students to connect veterans and family members to VA resources;

• Approve an agreement with Honor Flight Central Coast to connect veterans with services and programs to help with mental health needs;

• Approve an agreement with Operation Surf to reduce stigmas and encourage those with mental health needs to seek help;

• Approve an agreement with the U.S. Department of Veterans Affairs to enhance access to mental and physical healthcare for veterans and their families;

• Approve an agreement with CAPSLO to provide homeless veterans with referrals to supportive housing programs; 

• Approve an agreement with Ponderosa Homestead to provide veterans assistance with aging services; 

• Approve an agreement with the San Luis Obispo Veterans Services Collaborative to refer veterans for assistance with mental and physical health needs, aging services, and housing assistance; 

• Adopt a resolution amending the Position Allocation List (PAL) for Fund Center (FC) 186 – Veterans Services to extend the 1.00 Limited Term FTE Veterans Services Representative I/II/III through June 30, 2026.”

That last item is key for this whole thing, as the grant monies will mostly be used to pay whoever lands this position and they would then do the coordinating called for in the other dozen bullet items.

The program is CalVet’s attempt to address the mental health issues of the State’s veterans. “CalVet’s MHSA program,” the report said, “aims to expand and enhance the county mental health services for veterans, including treatment and other related recovery programs, in California communities where they reside or return to after military service.”

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