LA County Gets Ready to Expand Mental Health Beds
After a public hearing on Tuesday, January 23, 2019, the LA Board of Supervisors (BOS), unanimously approved a motion Supervisor Barger to plan for an expansion of the number of local mental health hospital and step down (IMD) beds. This is necessary because Los Angeles County has been losing mental health hospital beds at an alarming rate, so much so, that the shortage of beds is considered a national public health emergency.
Leading Mental Health experts recommend that across the 50 states there should be at least 50 public mental health beds per 100,000 residents to keep up with demand. LA County, however, has only 22.7 such beds per 100,000 residents and the State of California has only 17.05.
The shortage of beds means patients can’t always get treatment at the level of care they need or when they need it. This contributes to ERs and Acute Care placements becoming”revolving doors” where people are hastily treated and released only to relapse. For those who are held for admission, they may spend days, even weeks in an Emergency Room waiting for an Acute Care bed. Such beds may end up being far from their homes, friends, and family or delivering an inferior quality of care.
A critical factor making the shortage of acute care beds worse is the even greater shortage of subacute beds. When no subacute beds are available for them, patients can languish in the acute care environment for many months and even a year or more. Meanwhile, these patient are not given the full program of care that they need to have a chance at recovery. This bottleneck also drains mental health treatment funds because acute care beds cost roughly twice as much as subacute ones.
The “Addressing the Shortage of Mental Health Hospital Beds” motion directs the County’s Department of Mental Health to report back to the BOS by the end of May 2019 (Mental Health Month). This report will plan the creation of new hospital and IMD beds, the preservation and expansion of contracted beds (paid for by DMH but run by another entity), and assess the number of current and future beds needed to support the county jail population. Additionally, the report will cover available and proposed funding streams for implementing the plan, including the Federal dollars that would come to support subacute IMD beds if the State of California moves forward on the paperwork to receive a federal waiver of the “IMD exclusion”.
Scores of supporters turned up at the BOS meeting to speak on behalf of Supervisor Barger’s motion and to witness the board’s action. Due to the large number of individuals who wished to speak, each was allotted only one minute to tell their story and make their points. Written comments were also taken from the public. Among the many public concerns expressed were the need to better assess and ensure the quality of current and future bed spaces, ending revolving door practices at ERs and hospitals, respecting the needs of diverse communities and cultures, locating beds close to communities where patients and families live, the impacts the bed shortages have on individuals and families, the added burden on the criminal justice system, and how our county jail is now the largest residential psychiatric institution in the country (40% of LA County inmates suffer from some form of mental illness).
With the passing of this motion, the BOS has taken an enormous first step. Their expressions of support made at the hearing are tremendously encouraging. Kudos to Supervisor Barger for writing this motion and to Supervisor Solis for cosponsoring it. However, it will take the support and the involvement of the entire mental health community to make sure the best possible plans are drawn up, are responsive to community needs, and are implemented well.
NAMI advocacy and leadership has played an important role in getting us this far. NAMI county leaders have been and continue working closely and tirelessly with both the DMH leadership team and the BOS to bring our local system of mental illness care into the 21st century. NAMI LACC’s top advocacy priority for the past year has been to break the IMD bottleneck by advocating for the expansion of IMD beds.
NAMI members were at this hearing in sizable numbers with many of them addressing important points to the BOS. Leading the NAMI contingent to support this motion was the president of NAMI Los Angeles County Council, Paul Stansbury, speaking officially on behalf of the council. The advocacy committee co-chairs for NAMIGlendale, John Hallowitz and Barbara Knighton, were also there to share personal stories to highlight important concerns in respect to need for more beds in the county.
The people of LA County, as do people everywhere, deserve a caring system of mental health that effectively addresses the needs of individuals with mental illnesses and supports the vital role played by family caregivers. By becoming a member and supporting NAMI Glendale (or your local affiliate) you help this essential advocacy work. By joining in and supporting your affiliate’s advocacy efforts you help build a bridge to a brighter future for all.
reported by John Hallowitz
Read the Complete Original Motion by Supervisors Barger here. Does not include the amendment to include IMD beds and address the IMD Exclusion.