Supervisors Give Priority to Housing Mentally Ill

Ventura County supervisors on Tuesday adopted goals for increasing housing options for the mentally ill, calling for the addition of as many as 250 beds over five years.

More beds are needed to stop a “revolving door” that moves many mentally ill patients out of the county’s public hospital and onto the streets only to be readmitted a short time later for more costly treatment, said Dr. David Gudeman, the county’s mental health chief.

“Permanent supported housing will be a benefit to the entire community,” Gudeman said in a short presentation to the Board of Supervisors.

The board’s unanimous adoption of expansion recommendations demonstrates the county’s renewed commitment to the chronic housing shortage problem, said Supervisor John K. Flynn.

“It’s a commitment that should have come years ago,” he said. “As far as I’m concerned, it’s the highest priority we have right now. We need to move on it.”

Recommendations made by the Ventura County Mental Health Board call for the creation of a five-year plan outlining where beds should be added, what support services should come with them and where the estimated $5 million needed to complete the expansion would come from.

Gudeman is expected to present the board with more detailed plans in about two weeks, including options for paying for the new beds.

Funding could be a major sticking point. The county’s treasury has already been squeezed by a $15.3-million payout supervisors approved to settle a federal whistle-blower’s lawsuit involving improper Medicare billing.

That money--which equals the amount the county spends each year to run its harbor, libraries and parks and collect taxes--must be paid over the next five years. The Mental Health Board’s request that supervisors also set aside $1 million a year for five years for the housing plan was rejected, with supervisors instead adopting language that does not specify how much the county will spend.

Flynn suggested that federal housing dollars can be tapped. Reducing the estimated $2 million the county spends each year to send mentally ill patients to out-of-county beds would also offset costs, Flynn said. Each placement outside Ventura County costs $40,000 annually.

But the county should be prepared to lay out its own money if necessary, even if it means borrowing money, Flynn said after the meeting.

“There’s always a way,” he said. “But there won’t be a way unless we demand it.”

In his report to supervisors, Gudeman estimated that there are 1,000 homeless mentally ill people living in Ventura County. The Behavioral Health Department provides some form of assistance to about 2,500 mentally ill adults each year.

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However, there are waiting lists for the 134 permanent beds available countywide, and mental health staff typically hand out vouchers for the mentally ill to stay in cheap motels in Ventura and Oxnard. Advocates for the mentally ill say that is a misguided short-term solution.

With the closure of state psychiatric hospitals, severely ill patients who used to live in wards are being eased back into the community, said Lou Matthews, a longtime mental health advocate. Counties must use some of their mental health funding to make sure such people have somewhere to live, Matthews said.

It is not enough to provide rooms in isolated apartments, the advocates say. Many mentally ill people need the close supervision of doctors, nurses and social workers to survive on their own, and the county needs to build clustered housing that provides those services, Matthews said.

“Almost half of the target population live with their families,” she told the board. “Many others who live in so-called ‘independent’ housing are upheld and supported by families who provide major portions of their ‘case management’ services.”

Besides motel rooms, the types of housing range from the highly supervised Las Posadas rehabilitation center in Camarillo to board-and-care homes with few supportive services.

If completed, the expansion will refine the county’s system of delivering services for 3,000 indigent mentally ill patients each year. For nearly a decade, mentally ill adults have been assigned to teams of psychiatrists, psychologists, social workers and nurses, who meet regularly to discuss treatment options and social needs.

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But the gap in housing has been a significant hole in the county’s so-called Systems of Care, which has been copied by scores of counties across California. Indeed, housing the mentally ill has been a problem statewide since the 1960s, when thousands of mentally ill patients were removed from institutions, said Ann Arneill-Py, director of the California Mental Health Planning Council.

One problem is that county mental health staff have plenty of clinical expertise but little experience dealing with developments.

“Housing grant applications are two inches thick,” she said. “They are not in the business of being housing developers.”

Mentally ill patients typically live on federal disability payments averaging $700 a month. Some counties are pairing up with local nonprofit housing corporations to provide low-cost housing, Arneill-Py said.

“This is a problem that advocates have been concerned about for a long time,” she said.