County seeks faster path by shifting mental health center plans to Alvarado

Call it a pivot of a pivot.

Like a running back bouncing down an unexpectedly open lane on the football field, County is poised for an opportunistic shift in its strategy regarding mental health resources serving metropolitan San Diego.

The first rapid change in direction came in 2019 when the County Board of Supervisors unanimously dropped a plan to lease a property it owns on Third Avenue in Hillcrest to developers, who were likely to turn the plot into a high-end condominiums. At the request of supervisor Nathan Fletcher, the board instead supported using the space as a behavioral health center, bringing together multiple levels of care in one location within walking distance of two major hospitals.

Announced in 2020, development plans pegged the hub’s cost at $100 million and a 2025 opening date, although an official said on Monday that the glacial pace of planning and licensing new hospitals had already pushed the schedule back to 2026.

On Tuesday, the council – again at Fletcher’s request – will instead consider spending around $28 million to renovate existing space at Alvarado Hospital Medical Center, 6 miles east of the Hillcrest site. Pivoting to Alvarado would not only be cheaper, but could happen, officials said, three years early, with an estimated opening date “in late 2023”.

“We see this as an opportunity to do everything we planned to do at Third Avenue, but do it much, much, much faster,” Fletcher said in a recent interview. “You have to be nimble; if you see a better opportunity, you should take it.

Alvarado has recently been very active in the local mental health care community, opening a 30-bed unit in 2018 that caters to seniors. In a statement, Alvarado’s owner, Prime Healthcare, said the partnership is designed to “help strengthen our county’s behavioral health safety net” at a time when the region “is currently experiencing an increase in the number and acuity of behavioral health patients”.

Dr. Luke Bergmann, the county’s director of behavioral health, said he thinks the original idea for the hub, which will primarily serve those on Medi-Cal, can stay the same at Alvarado.

“At its core, the idea of ​​the hub is to stabilize people in crisis, to use care management to connect people to ongoing care, and to direct people to that care,” Bergmann said. “This part is going to be happening now out of Alvarado, and I think it fulfills that original Third Avenue promise fabulously.”

UC San Diego, which was to operate the hub when it was planned for Hillcrest, will still be directly involved with Alvarado, Bergmann added, indicating that innovative work on mental health care delivery planned for Third Avenue will continue for drive on Interstate 8. to Alvarado.

The plan presented to supervisors on Tuesday calls for the reconfiguration of an existing, but unspecified, building on the Alvarado campus near San Diego State University to include a locked 44-bed unit for people with acute need for mental health care services. A crisis stabilization unit with recliners where patients can relax and receive treatment for up to 24 hours will also be part of the new Alvarado unit, as will an emergency psychiatric unit.

It was unclear Monday afternoon exactly where the unit would fit into the Alvarado campus, although a spokesperson said in an email that some beds may be located in the west tower of the medical Center.

Getting the concept up and running quickly, Bergmann and Fletcher said, is critical because the hub model is a central part of the county’s overall strategy to prevent hospital admissions by doing a better job of maintaining people in need enrolled in outpatient services.

If the council supports Alvarado’s plan, the Third Avenue location will remain a valuable county asset. Situated on a narrow strip of land at the edge of the cliff that forms the southern boundary of Mission Valley, the property offers sweeping views west over Mission Bay with the ocean in the distance.

Fletcher said he was not advocating going back to the previous plan of leasing the land to private developers, but rather favored building a different set of resources to serve those with mental health care needs, with a “board and care” accommodation for those coming out of mental health treatment. top of the list of options. Any other such pivot for Third Avenue would require additional support from the full board.

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