Citing rising costs, County Supes put a mental health care facility on pause.

Sometimes, the best intentions of government collide with the very real day-to-day fiscal obligations of government. In the case of one noble idea – to build a 96-bed mental health rehabilitation center – the collision came on Tuesday, Oct. 28, when members of the Monterey County Board of Supervisors had a series of pointed questions.

In the broadest terms, the project is sorely needed. About 100 Monterey County residents at any given time are in a mental health rehabilitation center – a locked facility for patients suffering from a serious mental health crisis – but they are all out of county. That’s because our county currently has zero beds, so patients instead are placed elsewhere for care.

Due to the non-existence of beds in Monterey County, and a shortage statewide, many end up staying in hospital settings for longer – not ideal for a variety of reasons, straining hospital staffs, and a decidedly non-therapeutic place for a person in crisis. For patients placed outside of the county, Behavioral Health Services Bureau Chief Melanie Rhodes told the supervisors, it can be prohibitive for family members to visit.

That’s the problem. The solution, as pitched by Rhodes and Health Department Director Elsa Jimenez, is to construct a psychiatric care center locally. They envision a 96-bed campus with six 16-bed buildings (that sizing is driven by state requirements) and an admin building. The hope is that patients are treated and someday become independent, with family and friends as a support system.

But that solution introduces a whole new series of challenges. The Health Department started with plans to use part of the old jail – not as counterintuitive as it may sound, because these are secure, locked facilities. When they learned the Sheriff’s Office still needed that space, they shifted gears from renovating an existing building to new construction on a parcel in Salinas just north of the Natividad campus on Constitution Boulevard, across from the soccer complex. The projected cost grew from $46 million to $75 million. Then came serious sticker shock amid rising construction costs: a new budget of $172 million.

“I appreciate the ambitious proposal,” Supervisor Glenn Church said. “I’m not completely comfortable with these moving numbers… I have real concerns on the financial viability.”

All of the supervisors cited the global uncertainty right now emanating from Washington. Medi-Cal coverage for physical health care is already set to shrink significantly; what’s to say a federal policy slashing mental health coverage isn’t coming down the road? Tariffs and interest rates and construction costs remain unpredictable.

Jimenez and Finance Manager Nick Cronkhite emphasized that the facility would be self-sustaining. They’ve already secured $50 million in state grants. The health department would pay down the remaining debt, not tapping the County’s general fund. That would happen partly by fundraising, “really leaning in on philanthropy and private donors who may be interested in making sure our residents have the services they need,” Jimenez said.

It would also happen by service providers increasing their billable hours by 10.5 percent – for a staff member who spends four hours per day directly delivering client services, they would go up to spending four hours and 25 minutes of their day doing direct patient services, increasing hours billable to insurance. This is where the supervisors had the most questions: How do you simply find more minutes in the day for each staff member?

There are also neighbor concerns. “I would move, immediately, the day that you broke ground,” one Creekbridge woman, who shares a backyard fenceline with the site, told the board. “I would put my house up for sale.”

Supervisor Luis Alejo demanded more serious engagement with residents. “Neighbors are taken aback when a project is so far along,” he said. “[This timing] is saying, the community is an afterthought.”

So far, $2.7 million has been spent on the project. With another $3 million expected to be spent by year end, the supervisors decided to hit pause.

My hope is that they get the answers to questions they rightly asked, and that the project can get back on track. If not, it could be shelved indefinitely.

SARA RUBIN is the Weekly’s editor. Reach her at sara@montereycountynow.com