Posted On Nov 24, 2022

San Luis Obispo County's only low-income-serving psychiatric hospital is set to change hands soon.

The SLO County Health Agency is finalizing a contract with an outside vendor to take the reins of its 16-bed psychiatric health facility (PHF), an inpatient unit primarily serving adult patients on Medi-Cal.

A final contract for the transition will go before the SLO County Board of Supervisors at a December meeting.

"Our hope is sometime in the summer [of 2023] to transition over to the new vendor providing the services," Interim Health Agency Director Nick Drews said. "The state has quite a few PHFs that are run privately or by nonprofits and not by a county specifically. It's become more and more of a trend."

The decision to outsource the PHF is about a decade in the making, department leaders told New Times. They attribute recent challenges in running an in-house PHF to the local psychiatrist shortage.

"It's really difficult to find psychiatrists who will come and live here," County Behavioral Health Director Anne Robin said. "The county staff who worked within our unit are fabulous. They do a great job. It's been the psychiatry coverage that's been challenging."

Robin added that recruiting psychiatrists for the PHF is especially difficult because the county competes with the California Men's Colony and Atascadero State Hospital for the same doctors.

"For the psychiatrists who reside in the county, many want to work for those two state entities," she said.

And while outpatient offices can turn to telemedicine if necessary, inpatient units require a psychiatrist to be on-site at all times—putting the facility in a constant staffing bind.

"We serve folks in psychiatric crisis who need a very high level of care," Robin said, "who are coming to us for treatment due to being a danger to themselves or others, or who are unable to provide food, shelter, and clothing due to their mental illness."

One of the main benefits of using a third-party operator for the PHF is better psychiatric coverage, according to Drews. Most private contractors operate more than one PHF and therefore have more doctors on staff to deploy.

"Having a company with a larger pool to pull from is a benefit, because it's going to be a lot easier for them to find a psychiatrist than it is for us," Drews said.

The transition puts the jobs of nearly 30 county employees at risk. Robin and Drews said that the county will work hard to either connect the PHF workers with the new operator or find different roles for them in other county departments.

The PHF is just the latest SLO County facility to turn to the private sector for services. In 2019, the county jail privatized health care following a spree of jail deaths and lawsuits alleging inadequate care.

Earlier this year, the SLO County grand jury investigated the PHF as part of a report that found deficiencies across the county's mental health care system.

Robin encouraged the community to stay involved in the mental health conversation and hopes that more people will join the field.

"I'm glad that attention is being paid to the need for mental health services, because as we've seen, there's a growing need across the community and across the nation," Robin said. "We want to encourage people who are interested in mental health to get into the field because we really need to build up our workforce again."

Original Post: SLO County to outsource psychiatric health facility