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Sonoma County adds new psychiatric beds, but mental health advocates say more are needed

The Press Democrat - 1/22/2022

Jan. 21—Sonoma County has taken a crucial step toward closing a yearslong gap in psychiatric emergency services that has turned local hospitals and the county jail into de facto asylums.

The Sonoma County Healing Center, a 16-bed psychiatric facility for low-income residents suffering acute mental health crises opened Thursday, a move heralded by local mental health advocates.

Those same advocates, however, cautioned that there is more work to be done in the form of additional beds as well as more robust outpatient behavioral health services to keep people from requiring a locked psychiatric bed.

"It's a step absolutely in the right direction," said Mary-Frances Walsh, executive director of NAMI Sonoma County. "We talk to so many families who have a loved one that needs hospitalization, and because there are no psych beds available locally they are often sent out of county."

James Gore, chair of the Sonoma County Board of Supervisors, in a statement described the facility as a "important resource to ensure that those with mental health issues do not fall through the cracks and get the critical care they need."

The new facility is at 7440 Los Guilicos Road in Sonoma Valley, site of the former Valley of the Moon Children's Center, which has been vacant since 2009. It will be operated by Crestwood Behavioral Health, Inc.

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Under and agreement with the county, Crestwood has set aside 14 beds for Sonoma County has residents. The other two beds are set aside for Marin County, local officials said.

Sonoma County, which paid the nearly $4,625,600 construction cost to remodel and build out the facility, is responsible for paying Crestwood $1,000 a day for each of the 14 beds, whether or not the beds are in use, according to a county supervisors' report.

The 14 psychiatric beds do not come close to replacing the number of secure psychiatric beds that were lost about 15 years ago because of financial concerns. Back then, the county had two psychiatric hospitals with 60 beds available for low-income residents in mental health crises.

One of the hospitals, owned by the county and operated by Sutter Health, had 30 beds and was shuttered in 2007 because it was costing the county about $2 million a year to cover the difference between the cost of patient care and the reimbursement Sutter got from Medicaid, Medicare and private insurers.

The second psychiatric hospital, run by Santa Rosa Memorial Hospital at a satellite facility on Fulton Road in west Santa Rosa, was closed in 2008. At that time, Memorial's operator, St. Joseph Health, said the facility had lost nearly $22 million during the preceding three years.

Mental health professionals and the county's sheriff at the time warned that closing the hospitals would lead to a crisis in jails and local hospitals. But the county's then-mental health director Art Ewart said such concerns were overstated and that the county was trying to find ways to set up an alternative 16-bed, non-hospital psychiatric health facility.

That wouldn't happen until May, 2020, when local supervisors finally approved the construction of a psychiatric health facility, known in the mental health arena as a PHF or "PUFF." Under federal rules, psychiatric facilities not connected to a hospital with more than 16 beds are not eligible for federal Medicaid matching funds for adults between 18 and 65.

With the creation of a PHF in Sonoma County, health officials hope to provide more local options for low-income residents who require temporary psychiatric hospitalizations. But the county also hopes to save money.

About 40% of patients at the county's Crisis Stabilization Unit, essentially an emergency department for mental health patients, end up needing to "overstay" for periods that Medi-Cal will not reimburse. Officials said that in fiscal year 2018-19, the crisis unit generated $12,273,684 in un-reimbursable services.

At the facility, clients will receive intensive psychiatric treatment for an average of eight days. Tina Rivera, interim director of the Sonoma County Health Services Department, said the opening of the Healing Center was long overdue.

Opening a health facility within Sonoma County will close the gap in the psychiatric crisis care continuum, improve client care, and address negative impacts experienced by other local services," said Rivera in a statement.

Kaiser Permanente, Sutter Health and Memorial Hospital contributed $625,000 for the project. Tarek Salaway, senior vice president and area manager for Kaiser Permanente in Marin and Sonoma counties, said Kaiser's $250,000 grant was an effort to expedite the opening of the facility for low income residents and to help reduce health disparities "We know that the mental health of the community has been impacted by the North Bay fires and now the pandemic," Salaway said.

More than You can reach Staff Writer Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @pressreno.

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