SAN JOSE — There’s been a severe shortage of inpatient psychiatric care facilities for troubled teens and youth for decades in Santa Clara County, and on Tuesday supervisors will hear a pitch to build a new specialty center on the Valley Medical Center campus to address that need.
For years, kids who need short-term psychiatric hospitalization — usually because they’ve been deemed a hazard to themselves or others — have been shuttled to facilities in Alameda, Contra Costa, Solano and even Sacramento counties.
While the county recently contracted with the privately run San Jose Behavioral Health Hospital for a limited number of psychiatric beds for youths age 14 to 17, Supervisor Joe Simitian said that’s “a good start, but far from what the county needs to meet the demand.”
His proposal aims to construct a two-story facility with 36 beds in semi-private rooms on a portion of the county-run VMC campus on Bascom Avenue in San Jose. According to the county report to be heard on Tuesday, “several sites occupied by buildings at the end of their useful life potentially could be repurposed for this facility.”
In 2017, 689 Santa Clara County youth were admitted to psychiatric hospitals, each with a stay averaging six days, according to the report. And 488 of those admissions were Medi-Cal beneficiaries or uninsured youth, the population that would likely be served by a county facility.
From the Bay Area north to Sacramento, there are 229 inpatient psych beds for kids age 13 to 17, and 30 for those 12 and younger.
Simitian asked county officials in 2015 to look into the possibility of having something closer to home.
“It’s better therapeutically for these kids to be close to their community when they’re in crisis,” he said. “Close to their family, their friends, and their own local mental health providers.”
County dialog with patient advocates, nonprofits, family members as well as hospitals resulted in an outline for an inpatient youth psychiatric program. But a bid to find someone to helm the effort was unsuccessful. Simitian said the required financial undertaking was too big.
“As I had conversations with Kaiser, Lucile Packard and Stanford, everyone agreed the problem is real and wanted to do their part, but nobody felt they could take the lead in making the kind of facility that would provide the kind of beds these kids need,” Simitan said. “What became clearer and clearer was Santa Clara County needs to be the place that says it will pick up the responsibility for actually building a facility.”
If the board of supervisors agrees, county staff would prepare detailed construction and operational plans for an Adolescent Acute Psychiatric facility. The cost is estimated to be between $50 million and $70 million. County Executive Jeffery Smith said it would be a “significant” investment, but one that’s aligned with the board’s priorities for access to quality health care, “particularly for children and families in crisis.”
Paul Lorenz, CEO of the Santa Clara Valley Medical Center, said in a statement that there are advantages to the county running such a facility on its existing campus.
“The hospital will provide acute inpatient care,” he said, “and when a child is ready for discharge we would work closely with Behavioral Health Services on case management and transition to a community-based setting.”
Cameron Bolish, a spokesman for the San Jose Behavioral Health Hospital that the county contracts with, said additional beds are welcome. He said that due to the lack of such facilities statewide, their 80-bed building gets patients from as far north as Butte County and as far south as Fresno.
“The county’s push to get its own adolescent facility would give more options, and we definitely don’t want to be the only option,” Bolish said. “If we’re at capacity, we don’t want to say, ‘We’re full, we’ll put you on a waiting list.’ This is not a waiting list matter. We are dealing with people who might have tried to kill themselves, or kill others or are otherwise unstable.”
Former San Jose Councilman Pierluigi Oliverio, a candidate for supervisor in 2018 who has been vocal about mental health as well as fiscal issues, said the proposed facility may not be the most efficient use of limited land on the VMC campus. He also pointed to the county’s spotty track record with projects at the site: the VMC expansion bed building that’s now nearing completion is years late and $180 million over budget.
“I think this is a step in the right direction, and I’m sympathetic to any bed we can get but at the same time obviously the county isn’t very good with capital projects,” he said. “And if we’re going to be using a scarce piece of county-controlled land at VMC, we need to see if the best use of that land is for only 36 beds.”
