San Diego County seeks shift away from locked psychiatric units. 'The change that we need in behavioral health is dramatic'

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Analysis before Board of Supervisors Tuesday calls for massive investments in community-based care

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, an advocacy and activism group operating in Southern California, said she appreciated the big picture take but has concerns about the details. Bergmann said he believes that the effort was comprehensive enough to accurately show what needs changing and left him with a core belief that a more preventive strategy can work.

Respite centers would offer a longer path, perhaps operating in residential homes or other low-key “warm and welcoming settings” staffed by a mix of peer workers and clinicians trained to provide higher-level treatment. In California, this work has always had an informal connotation, but that began to change in 2020 with the passage of a bill that allows peer support workers to take a state proficiency test and become certified. While the full testing system is not yet up and running, it is expected to offer a path to better pay and Medi-Cal reimbursement soon.

A particularly massive increase is recommended for skilled nursing facilities that specialize in neurobehavioral treatment. The region is said to currently provide about 4,000 bed days of such care annually but the modeling predicts that this resource should be increased 13-fold to nearly 55,000 bed days of capacity per year.

 

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