Beware of unintended consequences 

The landowner-developer (a Carmel, Calif., resident) and promoters of the proposed massive 91-bed Templeton Acute Care Mental Hospital have conducted a misleading publicity campaign to win the support of SLO County residents. They claim that the facility is designed to treat “your friends, neighbors, and family members living in our community.” They are supported by the SLO County Health Agency, the SLO Tribune, and a large majority of members of the SLO County mental services industry.

We agree that acute mental care services should be established in SLO County. We support all levels of mental care services and are very concerned about the quality and availability of mental services in our county and in the state. However, a reasonably-sized acute care facility designed to treat primarily SLO County residents is what should be established in the SLO South County area where 65 percent of the county resides and where 90 percent of private and public SLO County agency mental health patients and other support services operate. 

We question the size of the proposed facility. It is designed to draw at least 3,000 of its patients (85 to 90 percent) from areas outside of SLO County. This influx of non-residents will place extreme demands on many SLO County services. 

SLO residents are generally misinformed regarding the nature of services the facility will provide to our county’s mentally ill. 

Here is the real story. SLO patients are forced to travel to institutions in other areas for acute care hospitalization. Existing data indicates that an estimated 700 to 830 SLO County residents will need these services each year. These numbers are supported by the National Institute of Health that says that three-tenths of 1 percent of the population requires acute care hospitalization each year. The SLO Tribune reported on the front page of its four-day article on this issue that 714 SLO residents were transferred in 2014 to other county facilities according to a state Health Agency. 

So what’s the problem with the Templeton 91-bed facility. There are many. Here’s a few.

• The developer claims that this facility will be an “at will” voluntary facility. We believe this will exclude all “involuntary” acute care patients that are treated by the SLO County Health Agency which claims to refer approximately 275 to 350 acute care patients a year to other county facilities. This leaves about 350 to 425 voluntary SLO residents that may be admitted to the proposed facility. 

• The facility is designed to serve thousands of patients a year. Not 400 or 500. Simple math shows that at least 3,600 patients a year will be admitted to fully utilize the facility, assuming an average nine-day treatment period. That’s a turnover rate of 40 times a year. Accordingly, 3,100 to 3,200 patients a year will flow into our county from areas throughout California and beyond.

• The developer claims that only “voluntary” patients will be admitted with an average treatment period of five to eight days and a typical maximum stay of 10 days. These limited treatment periods are often determined by available insurance coverage offered by private carriers and Obamacare. That’s not much time to cure acute mental illness problems. 

• It gets worse. Adult patients (21 to 64 years old) that are on Medi-Cal health plans will not be accepted for treatment in this facility. Various estimates indicate that 20 percent to 30 percent of adults in the county are on Medi-Cal plans. Youth and elderly (over 64 years) Medi-Cal patients can be admitted. Adults make up 65 percent of the population.

• The developer, representatives, and supporters have made various misleading statements in SLO Tribune opinion pieces, in written documents to the county Planning Department, and to the public in a mailer sent to Templeton residents and in two Templeton Community meetings attended by several hundred residents.

• They claim that discharged patients “must be returned to their residence of origin,” and, “They will not be released onto the street of Templeton.” We believe this is a false statement; voluntary “at will” patients are free to go or to stay in the area or anywhere in the county. 

• They claim that the facility is secure. We believe voluntary “at will” patients are free to leave the facility at any time day or night.

• They claim that the facility “is not in a residential area.” A misleading statement. The facility’s rear property line is shared with a 41-home development currently under construction and is surrounded by hundreds of homes within short walking distance from the facility.

• They claim that the need for this facility is “well documented” by the county’s own departments and commissions. Anne Robbin, the SLO County Behavior Health Department administrator, spoke at a meeting that I attended, acknowledging that the county has no reliable data to support the size and nature of services that it needs to treat acute mental illness. The SLO Health Agency in responses to several Public Records Act requests for patient service numbers stated that “the information is not available” or “the information may be available ... but not in an existing document or report.”

• They quote a California Hospital Association claim that we need “50 inpatient beds per 100,000 population” or 138 beds; The SLO Tribune reported that it was unable to verify the accuracy of this claim with any other reliable mental health sources; 138 beds with a nine-day patient turn ratio would provide treatment to 5,600 patients a year.  

• The developer implies that this facility will relieve SLO County’s Health Agency mental health service load. In reality, this operation will significantly increase demands on the county’s health agency services by referring patients that are no longer able to pay for facility services that require additional inpatient care. Acute mental illness is not cured in 10 days. The county operated Psychiatric Health Facility (PHF Unit) is frequently overwhelmed with patients that exceed the unit’s 16-bed legal limit.

What we support:

• A 15-bed facility that will treat approximately 600 SLO County residents a year.

• Locate the 15-bed facility in the South SLO County area where 90 percent of mental health care support services exist and where 65 percent of SLO County resides. Templeton has no mental health support services.

• Establish a second 16-bed SLO County Health Agency operated and funded Psychiatric Health Facility (PHF Unit) to treat involuntary committed children, adolescents, elderly, and adult Medi-Cal patients not qualified for treatment at the proposed Templeton facility. 

Please attend the Dec. 10 Planning Commission hearing regarding this project.

Murray Powell is an active member of the Facebook community, Proposed Templeton Mental Hospital—The Real Story. Email his group opposed to development of the facility at [email protected]. Send comments or responses to the editor at [email protected].