The county Board of Supervisors voted 4-0 Tuesday in favor of an agreement and a $32 million loan for UC San Diego to develop a psychiatric inpatient facility and crisis stabilization unit for Medi-Cal recipients at the university's East Campus Medical Center.
The facility — previously called Alvarado Hospital — will have 30 new inpatient psychiatric beds for people needing 24-hour observation and care, and a short-term crisis stabilization unit, according to a statement from Supervisors Monica Montgomery Steppe and Terra Lawson-Remer.
The county will lend the money out of its general fund reserves, which the school will pay back with interest, according to a staff presentation.
Luke Bergmann, county Behavioral Health Services director, said that while the facility will be located in the north-central part of the county, it can serve the eastern portion as well, home to a concentrated number of Medi- Cal recipients.
He added that once the facility is open, it will also reduce law enforcement involvement in cases involving mental health issues.
Dr. Jeff Daskalakis, chairman of UCSD's psychiatry department, said an enhanced behavioral health services model "is an emphatic response to the regional shortage of acute psychiatric beds, freeing up capacity in other medical units to handle rising emergency demands."
Medi-Cal is the state Medicaid health care program for low-income children and adults. UCSD officials said Medi-Cal recipients "can face additional barriers to behavioral health treatment, reflecting socioeconomic disparities and increasing the importance of establishing medical treatment options for vulnerable populations."
The county and UCSD must finalize the agreement by Oct. 21, followed by university regents approving it by Oct. 31. The plan will also require regulatory approvals.
"The next several weeks will be quite busy," one county official said.
UCSD said expanded behavioral health services at the East Campus Medical Center "are planned to be fully functional as soon as 2026, if approvals and funding allocations move forward as expected."
UCSD Health will continue providing emergency psychiatric services at its Hillcrest and La Jolla campuses after the new hub is completed, while emergency psychiatric services and inpatient units will continue at the San Diego County Psychiatric Hospital.
In May, supervisors approved negotiations with UCSD on a mental health care facility.
"I really didn't think we'd be here in 120 days," said Montgomery Steppe, who praised county staff, UCSD and her staff for their efforts. "It just took a lot of work from all of you and us to get where we are," she said, adding that the agreement will help community members "who otherwise wouldn't be able to afford this type of care."
Montgomery Steppe, an early facility proponent, noted that one in 20 San Diego County residents are living with a serious mental health condition, and that figure increases to a one in 13 for those in a low-income household.
Lawson-Remer, the board vice chair who ran meetings in Chairwoman Nora Vargas' absence, said the agreement won't just result in more beds for those in crisis, but will also provide cutting-edge treatment.
During public comment, Patty Maysent, CEO of UC San Diego Health, said plans to improve mental health care began eight years ago.
"It (has) been a long, bumpy journey," but UCSD is ready to partner with county to make progress "on the challenging crisis of mental health," Maysent said. The goal of the new inpatient facility "is to help return patients, to their lives — not just getting back in the system again and again," Maysent added.
A county resident told supervisors she spoke out on behavioral health services 21 years ago, and said previous board decisions to outsource care "proved to be a very bad choice."
"I do this in honor of my brother, who's no longer with us," she added.
Steve Koh, a psychiatry professor at UCSD, said mental health issues affect every single person, no matter their background.
"What is in front of you is putting the right place, right policy (and) the right political will" to improve mental health care, Koh said.
He added the county can set an example for the rest of the nation, and establish an important standard for the region and rest of California.
Josh Bohannan of Father Joe's Villages also supported the UCSD facility. He said that one of Father Joe's biggest challenges is someone coming into its waiting room in the throes of a mental health episode.
"Our shelter beds are not the right fit," he said.
