HomeMy WebLinkAboutMINUTES - 06071988 - 2.1 TO._ BOARD OF SUPERVISORS '0
FROM: Mark Finucane C ltra
Health Services Director C )st
DATE'. May 24, 1988 could
SUBJECT: Separation of Mentally Ill Children and Adults in "�
County Facilities
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
Recommendation:
Accept report of Health Services Director regarding the
feasibility and implications of a policy relative to the
separation of mentally ill children and adults in County
facilities.
Background:
In response to your April 25 Board order, we have reviewed our
options regarding the placement of children and adolescents on
the adult psychiatric units at Merrithew Memorial Hospital.
Pursuant to that review, we do not recommend that an adolescent
acute psychiatric inpatient unit be created at the existing
Merrithew Memorial campus. The cost to create an adolescent unit
is prohibitive. The Hospital and Clinics Division has completed
an architectural review on possible sites within the hospital
campus. The only site determined feasible would be the back half
of the Crisis and Screening Unit (E Ward) , currently occupied by
the Nursing Training Unit. The minimum cost would be between
$300-400,000 for renovation of a unit that may well prove too
small. There are also serious concerns about the ongoing
operating losses for such a unit.
A/DA/MH Division personnel have been meeting with Herrick
Hospital and Walnut Creek Hospital to explore contract options
for acute care alternatives in lieu of Merrithew Memorial
Hospital. Both institutions are interested in pursuing a
contract with the County for costs that range between $500 and
$700 per day. We are also beginning discussions with the
recently opened Oak Grove Hospital to determine the possibility
of a contract with them.
To give the Board an idea of the cost if we were required to
place two children per day in an acute care institution, the
annual cost would be $438,000. While it is not likely we will
need to place two children at all times, in the face of the
growth of the County, it is possible that we will find it
necessary to place at this expense level.
CONTINUED ON ATTACHMENT: X YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATUREIS):
ACTION OF BOARD ON lune 7F 1988 APPROVED AS RECOMMENDED X OTHER
VOTE OF SUPERVISORS
1 HEREBY CERTIFY THAT THIS IS A TRUE
X UNANIMOUS (ABSENT �- AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
cc: County Administrator ATTESTED 7 9�0
Health Services Director PHIL BATCHELOR, CLERK OF THE BOARD OF
Mental Health Director SUPERVISORS AND COUNTY ADMINISTRATOR
Mental Health Advisory Board
Hospital Replacement Steering Cte,
M382/7-83 BY ,DEPUTY
Board of Supervisors
May 24, 1988
Page 2
Private psychiatric institutions have also been encouraged to
consider operating less expensive subacute care facilities for
adolescents. Recently we arranged for staff from Herrick
Hospital to present their ideas for a subacute treatment facility
to the Greater Bay Area Mental Health Directors. It is our hope
to create a regional subacute treatment facility that would serve
as many as three to four counties. This alternative is some
distance in the future and is not a practical solution to the
immediate problem.
In addition, the Hospital Replacement Steering Committee of the
Health Services Department is seriously considering the inclusion
of a children and adolescent unit in the plans for a new county
hospital, in recognition of both the current and future needs of
seriously emotionally disturbed children in Contra Costa County.
I would also like to point out that both Stuart McCullough,
Mental Health Director, and Dr. Joseph Hartog, A/DA/MH Division
Medical Director, will be participating on the committee. Thus
they will be able to help ameliorate the problems we all share.
Currently, we are not placing children on our adult psychiatric
inpatient units and have arranged with our Finance Division to
create alternatives in other institutions, as an interim measure,
in lieu of placing children at Merrithew Memorial Hospital.
This issue reflects the severe shortage of options faced by the
A/DA/MH Division. In the Juvenile Hall, Children' s Shelter, on
I, J and E Wards and in our community programs, we are triaging
patient care daily. We very much support the Board of
Supervisors ' mandate that we create acute placement alternatives
for children and adolescents. Unfortunately, these alternatives
will be expensive and really only stopgap measures until the
State provides proper funding for these mandates and until the
County replaces its facility. Managing 1988 problems in a 1948
facility with 1982 money is futile.