County Supervisors have agreed to apply for a large grant to add beds to its system of mental health and drug treatment for juveniles and the homeless.
The County Behavioral Health Department wants to apply for money from the 2024 Proposition 1, including the “Behavioral Health Services Act” (State Bill 326) and the “Behavioral Health Infrastructure Bond Act of 2024” or BHIBA (Assembly Bill 531).
The BHIBA is a $6.38 billion general obligation bond designed “to develop behavioral health treatment beds and supportive housing for individuals experiencing mental health conditions and substance use disorders,” reads the report from Behavioral Health Director, Star Graber.
The California Department of Health Care Services will be awarding $4.4 billion of this money “to construct, acquire, and rehabilitate real estate or invest in needed infrastructure to add behavioral health treatment beds. The remaining almost $2 billion of bond funds will be administered by the California Department of Housing and Community Development [HCD], in collaboration with the California Department of Veterans Affairs, to develop permanent supportive housing” for veterans.
“Prop. 1 bond funds are 1-time funds to address historic gaps in the behavioral health continuum,” Graber’s report said.
Health Care Services released Round 1 of the money, some $3.3 billion this year with applications due by Dec. 13 and the money awarded next May (2025). Priorities are:
• Addressing urgent care needs for people with mental health or substance abuse conditions, including un-housed people, veterans, older adults, adults with disabilities, and children and youth;
• Invest in certain options that “advance health equity of behavioral health care and community options;”
• Increase options to being jailed, hospitalized, becoming homeless or being institutionalized;
• Meet the needs and remove barriers to access of “vulnerable populations” like homeless people, and “justice involvement,” meaning those who’ve been arrested;
• Make sure care can be provided in “the least restrictive” setting to “support community integration, choice, and autonomy;”
• Leverage County and Medi-Cal money “to support ongoing sustainability;” and,
• Leverage state investments in housing and homelessness.
Graber’s request was to allow them to apply for $22 million for “acquisition, construction, and rehabilitation of real estate for inpatient behavioral health treatment beds and short-term crisis residential beds for both youth [between 4-8 total beds] and adults [between 18-24 total beds].” The $22 million would cover from July 1, 2025 to June 30, 2030.
These residential facilities “provide voluntary crisis stabilization, therapy, case management, medication monitoring, and other services that support recovery and wellness, with typical stays of between seven to 30 days,” Graber said. “The exact number and mix of beds will be dependent on the facility acquired and fiscal sustainability, as ongoing operations will primarily be funded through Medi-Cal and Realignment funding.”
The County has a head start on facilities for kids, having garnered a $3.6 million grant from the “Children’s Crisis Continuum Pilot Program.”
It is working on this program along with the SLO County Department of Social Services and Santa Barbara County’s Dept. of Social Services.
So where will these new facilities for folks with mental health problems and/or drug addictions be established? They don’t know yet.
“After awards are announced by DHCS in May 2025,” Graber said, “the BHD will coordinate with County Central Services, Public Works, and County Counsel to acquire property and construct new or renovate existing building(s). After completion of construction/renovations, vendor(s) will be selected to carry out the operations of the facilities following the County’s procurement process. No additional staff is anticipated to be needed to carry out the project.”
From the County report, one doesn’t get the sense that this is a very big problem.
“A DHCS report on ‘Assessing the Continuum of Care for Behavioral Health Services in California’ [2022] identifies a gap between inpatient beds available [16 in the SLO Psychiatric Health Facility] and the number of beds needed in SLO County [24, with a gap of six].”
But they believe the need will grow. “The BHD,” Graber said of her department, “anticipates additional beds will be needed above the DHCS’s assessment in part due to SB-43 implementation, which expanded the criteria for involuntary detention and conservatorship to include severe substance use disorder [SUD], as well as personal safety and necessary medical care.”
The problem of kids with mental health issues isn’t being addressed here at all. “There are currently no youth behavioral health treatment beds in SLO or Santa Barbara Counties,” Graber said. “Additionally, there are no crisis residential beds within SLO County, which provide a step down from in-patient hospitalization. Youth and adults currently receive services at behavioral health facilities out of county when beds are unavailable within SLO County.”
SLO County contracts with several out of the area facilities to take patients, contracts worth millions that are renewed every year.
