• Update: The Santa Clara County Board of Supervisors unanimously voted to have staff compile a proposal for a county-run inatpeint psyhicatric unit for teenagers. Read the story here.
Santa Clara County could launch an inpatient psychiatric unit for teenagers at Santa Clara Valley Medical Center in San Jose in several years, addressing a longstanding gap in the local mental health system.
After unsuccessful efforts to encourage the establishment of a private inpatient facility, the county Board of Supervisors will discuss on Tuesday a proposal to build a $50 million to $70 million adolescent unit at the public hospital. The prospect of such a facility is a significant step forward in a county that for years has had no local inpatient options for adolescents in acute psychiatric crisis.
Local elected officials and parent advocates have been pushing for such a psychiatric center for several years. Santa Clara County youth who are hospitalized for suicidal thoughts or attempts are sent to hospitals in San Mateo County and as far away as Sacramento, separating them from their families and primary health care providers.
Each year, more than 600 youth are transferred from local emergency rooms to hospitals outside of Santa Clara County, according to Supervisor Joe Simitian, who has been at the forefront of the effort to address this problem.
"It's time to ask and answer this threshold question: Is our board and our county prepared to say, 'Yes, this is a responsibility we want to take on?'" Simitian said. "I think we can and we should."
In February, the Board of Supervisors approved a stop-gap solution of sorts: a contract with San Jose Behavioral Health to offer a 17-bed inpatient psychiatric unit for 14- to 17-year-olds. The facility's small size and location in south San Jose has made it difficult to fully meet the need for these services, officials say.
According to the new proposal, the county would provide a state-of-the-art unit with an ideal location and setting for this kind of facility. Being at Valley Medical Center offers both a more central location and easy access to other medical services.
With up to 36 beds, the unit would serve Medi-Cal, uninsured and commercially insured youth. (The highest percentage of Santa Clara County youth admitted to psychiatric hospitals in the 2017 fiscal year were on Medi-Cal, 56 percent, compared to 34 percent with commercial insurance and 10 percent with no insurance, according to the county.)
The county hopes to partner with organizations like Lucile Packard Children's Hospital Stanford, El Camino Hospital, Kaiser and Uplift Family Services (which operates a 24/7 mobile service for teens in crisis and a short-term stabilization unit for youth in San Jose) to provide services, but the actual staffing for the unit has yet to be determined. The county is hopeful, however, that partnerships would enable patients to stay connected to their primary care providers and mental health physicians, and also make sure they receive critical follow-up care after typically short hospital stays.
Laura Champion, Uplift Family Services' Bay Area executive director, said that centralizing inpatient psychiatric care is "essential" and her organization hopes to be "heavily involved."
Christopher Dawes, president and CEO of Stanford Children's Health and Lucile Packard Children's Hospital Stanford Hospital, said his organization is "open to discussing any form of collaboration and we are committed to contributing our expertise in pediatric mental health."
Lucile Packard was among the organizations who responded to a request for proposals the county issued last year to develop an inpatient unit, which ultimately failed due to the cost.
Paul Lorenz, Valley Medical Center's chief executive officer, said he sees the new proposal, with both public and private involvement, as a "financially viable model." In the future, he hopes the unit will become a well-regarded, regional draw, akin to the hospital's spinal cord and brain injuries center.
"Given the size of our county and our population, why wouldn't and why shouldn't we have a service in our community that can rival the best?" Lorenz said.
Simitian estimated that a 36-bed facility would potentially serve hundreds of families annually given that the typical patient in such a unit stays for about six days.
Staff are recommending the Board of Supervisors direct the county executive to develop detailed plans and a budget for a facility. Valley Medical Center has identified several existing sites that could be repurposed, a staff proposal states.
If the board approves the proposal, Lorenz said Valley Medical Center would start on preliminary design and construction plans to get a firmer estimate of the cost.
The hospital also plans to convene a group of its own experts and staff as well as representatives from potential partners to work out operational details for the unit, such as staffing.
If approved, the county estimates that operational and construction plans would come back to the Board of Supervisors within a year.
The Board of Supervisors' Nov. 7 meeting will begin at 9:30 a.m. at 70 West Hedding St., San Jose. View the proposal here.