County Scuttles UCSD Plan for Mental Hospital

A plan to have UC San Diego take control of the county’s Hillcrest mental health program was dropped Tuesday when county supervisors decided they did not want to delay construction of their own mental health hospital.

The supervisors voted, 5-0, to go forward immediately with their plans for a $9.3-million hospital on Rosecrans Street rather than wait six months, and perhaps longer, to see if the UCSD proposal could work.

County staff members told the supervisors that the delay could mean more than $500,000 in increased costs for construction, consultants and the lease on the state-owned building that houses the county’s acute-care mental health program at Hillcrest.

The new county hospital is expected to be built and operating within two years.

Supervisor Susan Golding, who earlier endorsed the UCSD proposal in concept, said she voted to go forward with the county hospital because she sensed that top university officials did not wholeheartedly support the plan, which was the brainchild of Dr. Lewis Judd, chairman of the UCSD Department of Psychiatry.

Golding said she feared the consequences of abandoning the county’s plans for its own hospital in favor of a nebulous proposal that might never materialize. Her colleagues agreed.

Judd, who had hoped his proposal would become a model for the nation, said he was disappointed by the board’s action.

Judd’s proposal called for the creation of an academic mental health center to provide state-financed research and training for the university’s faculty and students while at the same time serving the county’s poorest and most troubled mentally ill patients. Those patients are now cared for by the county at its Hillcrest hospital, which earlier this year lost its eligibility for federal Medicare payments after being found to have provided substandard care.

A key part of Judd’s proposal was the construction of a hospital for the mentally ill at the Hillcrest site, which is owned by the university and is adjacent to the school’s teaching hospital. Judd said the facility could be built with a combination of state money and $13 million the county has been holding in reserve for its own hospital.

But Tuesday, the supervisors decided not to give Judd the time he said was needed to develop his plan and win approval--and funding--from top university officials, the Board of Regents and the Legislature.

“It’s over,” an exasperated Judd said after the supervisors’ decision. “It’s finished.”

Judd said his plan could not survive politically without the possibility of the county matching state funds for the construction of the “first-class, high quality” health center he envisioned.

Judd said he thought Tuesday’s decision reflected the county’s unwillingness to consider creative approaches to solving its problems in mental health care.

“Our experience with them has consistently been a refusal to consider what we feel are the most imaginative options,” Judd said.

Assemblyman Larry Stirling (R-San Diego), who had called for the creation of such a center and had vowed to win support for the idea in the Legislature, termed the board’s action “a step backward” for the county and the state.

“I think it’s a long-term loss to the quality of life in California that we’re not aiding and abetting the research needed to conquer this problem,” he said.

But Kathy Wachter-Poynor, the county’s director of mental health services, said she believes the county and the university can still cooperate in treating and researching mental illness.

“I would like to see them more involved,” Wachter-Poynor said of UCSD. “I think they have a lot to offer.”

Dr. Jay Shaffer, chairman of the county’s Mental Health Advisory Board, also said he favors closer ties between the university and the county. But he said the county must retain the upper hand in deciding how money is spent to care for poor patients.

Earlier, Shaffer predicted in comments to the board that any agreement allowing UCSD to run the Hillcrest hospital would end in disaster, because the university would demand more funding and the county would be unable to determine how much of its money was going toward UCSD’s research and training.