Board Adopts Mental Health Budget Cuts : Supervisors: Compromise plan calls for eliminating more than half the beds reserved for the acutely mentally ill.

In a move that San Diego County’s top health official called acceptable but “not a solution,” the Board of Supervisors tentatively approved a proposed budget for mental health programs Tuesday that would eliminate dozens of jobs and beds but would still save the San Diego Psychiatric Hospital’s emergency room.

Under the proposal, which the board requested last month in an attempt to spare the 2-year-old mental hospital even more devastating cuts, 79 of the hospital’s 273 staff members would be laid off, while about 40 more would be transferred to other county jobs.

In addition, more than half the 75 beds reserved for acutely mentally ill patients would be eliminated, a loss that health officials could only partially offset by contracting for back-up beds in private hospitals and state institutions.

But the proposed budget, which the board voted 4-to-1 Tuesday to endorse, would preserve the county’s emergency psychiatric unit, which handles an average of 1,000 people a month. Instead of scaling back its services to only serve involuntary patients, as was proposed last month, the emergency unit would be fully maintained under this most recent plan.

The trims and tucks were all part of the county’s effort to offset its $30-million budget shortfall. For months, the supervisors have been wrangling over ways to whittle the county budget, which they are required to approve in final form by Oct. 2. Tuesday’s board meeting was no different as David Janssen, the assistant chief administrative officer, told the board he had no easy answers.

“We would like to be able to tell you that the budget problems have gone away, that the state has allocated additional money, that the economy has improved,” he said before he outlined a long list of proposed cuts. “None of that has happened.”

Under these circumstances, the cuts to mental health programs that Janssen outlined--while not ideal--were less harsh than they could have been, Supervisor Susan Golding said.

“This is an excellent proposal--although excellent is euphemistic. We are not in an excellent situation,” Golding said. “But considering what we were facing at the last meeting, I feel this is preferable.”

County health director J. William Cox agreed.

“This proposal is not a solution to the chronically under-funded mental health system,” he said. “There is much more needed. But recognizing the hole in the county budget, we believe this proposal will ameliorate the adverse impact on hospital emergency rooms and on law enforcement.”

At a previous hearing last month, San Diego Police Chief Bob Burgreen had warned the board that severe cutbacks in mental health programs could increase crime and the number of homeless mentally ill people on downtown streets. Officials at area hospitals had also expressed concern that they would be overburdened if the county’s emergency psychiatric unit were scaled back.

County employees who oppose the cutbacks held a rally Tuesday morning that capped an all-night candlelight vigil and prayer service.

But after the board’s tentative vote, which will come up for final consideration next week, employees at San Diego Psychiatric Hospital were feeling grim.

“The mood at the hospital is not good--we’re going to lose around 80 staff positions,” said Patrick Stalnaker, a spokesman for county mental health services.

Of the hospital’s 75 beds that are reserved for acutely mentally ill patients, 30 would be maintained under the current plan--an improvement over last month’s proposal, which would have saved only 22 beds. The loss of 45 beds will be offset, Cox said, by the addition of 13 back-up beds in local hospitals (up from two beds in the current budget).

Furthermore, Cox said, an attempt will be made to secure 10 extra beds at state institutions. Not counting those, the total loss of beds for acutely ill patients would be 32.

The board also heard from representatives of local labor unions, who have opposed cutbacks at the psychiatric hospital and the Vista Health Center and have fought a proposal to contract out for courthouse custodians.

Eliseo Medina, executive director of the San Diego County Service Council, said that county officials rebuffed attempts to seriously discuss the labor union’s proposals for trimming the budget. Instead, he said, county administrators prefer to ask labor for sacrifices, while maintaining management perks such as $115,000 in free medical exams given to 432 top county administrators.

“I urge you today not to settle for a partial solution,” said Medina, who was one of the leaders of the previous evening’s vigil. “After all, we’re still talking about human life.”

The union represents about 10,000 of the county’s 17,000 employees, Medina said, including 300 at the psychiatric hospital.

Only Supervisor Leon Williams, the lone dissenter in the 4-1 vote, supported postponing Tuesday’s tentative endorsement to allow for additional negotiations between Chief Administrative Officer Norman Hickey’s office and labor.

Golding, meanwhile, predicted that deliberations next week on Sheriff Jim Roache’s budget would not change the status of cuts in mental health services. In fact, Golding held out hope that the supervisors could restore planned budget cuts that threaten to ground the department’s helicopter fleet.