Psychiatric Center Spared Budget Ax : Health: The county reverses itself and decides to fully fund the hospital, which treats some of San Diego’s sickest and poorest mentally ill. A major study of spending policies is planned for next year.

The County Board of Supervisors rescued San Diego’s public psychiatric hospital from severe budget cuts Wednesday, agreeing in a last-minute change of heart to fully fund the mental health facility of last resort for at least the next three months.

The supervisors, in approving a $1.9 billion budget for fiscal 1991-92, resolved to undertake a wide-ranging study of mental health spending policies early next year that still could result in major service reductions at the mental hospital--or even its closure.

But until then, the board infused the hospital with a one-time dose of cash to stave off elimination of 45 acute care beds and the elimination of 77 jobs. The exact amount of funding necessary to keep the hospital fully staffed into January was undetermined Wednesday. Most of the money will come from state health programs.

“I just can’t support the reduction in the capacity of the hospital,” Supervisor Leon Williams said. “We need it for the safety of everybody, to have a place for people who are high-risk.”

Workers at the San Diego County Psychiatric Hospital, who received their first good news since county officials proposed a $4.7-million cut in services there three months ago, were encouraged to hear that their protests had swayed the supervisors. Just two weeks ago, the board had tentatively approved a $3.7-million cut in the facility’s budget.

“We’re very pleased that the plea of the medical staff has been heard and hope that this will allow an orderly approach to any kind of changes,” said Dr. David Schein, supervising psychiatrist of the hospital’s emergency room.

“It’s a victory for all residents of the county, and it’s a victory for mental health,” said Kraig Peck, field director for the Service Employees International Union, which represents many of the hospital’s workers. “We hope that our elected leaders, having spent millions of taxpayer dollars to build the facility, will make every effort to keep it open.”

The supervisors’ vote, coming on the last day allowed by state law, gives the county a spending plan for the fiscal year that began July 1. Despite facing a $30-million deficit when they began deliberations in earnest, the supervisors managed to avoid layoffs by imposing a hiring freeze, transferring custodians whose jobs were eliminated and agreeing to spend onetime funds on programs, said Assistant Chief Administrative Officer David Janssen.

Although the budget is technically balanced, the board deferred action on an expected shortfall that could reach $15 million because carry-over funds from the 1990-91 fiscal year fell far short of predictions.

The board is expected to address that deficit within a few weeks, after county auditors close the books on the previous fiscal year.

Cuts at the 2-year-old psychiatric hospital on Rosecrans Street had become one of the most contentious issues in deliberations over how to fill the budget gap, attracting criticism from mental health professionals concerned about forcing severely ill people onto the streets and labor groups attempting to protect their jobs.

The county psychiatric hospital treats some of San Diego’s sickest and poorest mentally ill, many of them uninsured and homeless people brought in by the police.

As recently as two weeks ago, the board was prepared to close 45 of the 75 beds for acute care patients and pay for 20 beds in private hospitals. The expenditure of onetime funds made that unnecessary, but Janssen warned the supervisors that they will face a more severe funding crunch in fiscal 1992-93 when the money runs out.

“You may be facing the complete closure of the hospital next year if we can’t make up the one-time money,” he said.

In the review now scheduled for January, supervisors will compare the cost of funding the psychiatric hospital with the cost of contracting for private care, saying that, if privatization is a better deal, they might be persuaded to close the county facility completely.

Administrators have touted contracting for private beds as a method of saving money, but Schein and others believe there are hidden costs in that policy that make it more expensive than fully staffing the county psychiatric hospital.

In addition, Schein said, some mental hospitals will not accept the severely ill people who show up at the county facility.

The supervisors also want to understand how the recent transfer of mental health programs from state to county authority will affect the amount of state money flowing into the county.