Plan Adds 80 Beds for Mental Care in County

The county, in need of a long-term care facility for mental health patients, has proposed a partnership with a private Santa Ana mental health corporation that calls for the county to pay $58,229 a month for 20 years.

The agreement, scheduled to go before the Board of Supervisors for a vote Tuesday, calls for the purchase of an empty hospital in Mission Viejo by Royale Health Care Center Inc., which would then convert it into an 80-bed facility for mentally ill patients.

In turn, the county would enter a lease-purchase agreement to pay the monthly rent of $58,229--about $1.10 per square foot--and to pay utilities, maintenance, repair, insurance and taxes. At the end of the 20-year term, the county would be able to buy the 53,000-square-foot facility on 4.9 acres for $100.

The county would rely on state funds for 83% of the costs; the remaining 17% would come from tobacco settlement funds.

County health officials acknowledged that after 20 years, the $14-million price tag may seem steep, but they compare it to paying a mortgage on a house. The new facility is needed to help reduce the number of out-of-county mental health rehabilitation beds, now at 274.

“This is key to the county, and [it] has taken several years to get to this stage,” said Howard Sutter, a Health Care Agency spokesman. “It creates 40 new beds, and another 40 beds are moving back from Los Angeles to Orange County as a service to patients and patients’ families.”

In 1996, the state fined Royale $10,000 after attendants subdued a patient by wrapping a towel around his head. The patient, who had lashed out at a nurse, died in the struggle. Royale ultimately paid $6,500.

“The incident, we can’t comment on specifically,” Sutter said. “But following [the death], Royale did implement some staff training, which was reviewed and approved by state.”

The facility has accrued other violations. From 1994 through 1998, Royale allegedly violated state regulations on 10 occasions and was assessed $32,000 in fines, according to state Department of Health Services records.

The county said that Royale has had about 9,000 admissions to its Santa Ana facility in the last five years. “They deal with high-risk patients and those with serious mental health issues who might be a danger to themselves or to others,” Sutter said.

Royale officials did not return repeated telephone calls for comment.

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In recent years, the county has sought its own rehabilitation facility but lacks the funds, Sutter said. Organizations have expressed an interest, he said, but there has been a lack of suitable facilities or the cost of refurbishing them has been prohibitive.

Royale will buy the property for more than $5 million and operate the proposed facility. The company is buying the site of a former Charter hospital on Madero in Mission Viejo.

The Santa Ana facility is licensed and has passed a county agency review, Sutter said.

Dr. Vinayak Shanbhag, a psychiatrist who is on the county’s advisory board for mental health, said he supports the partnership because of convenience to patients, their families and case workers.

“Many people have been asking for a place like this one,” Shanbhag said. “But the biggest problem is finding a site and a service provider. That has been a struggle.”

It’s a case of demand outstripping the county’s supply of beds for Medi-Cal and low-income patients. The county currently contracts with two facilities, including Royale, for 173 beds.

“The new facility by no means meets all the needs in the county,” said Jon Gilwee, a spokesman for the Healthcare Assn. of Southern California, a hospital trade group in Orange County that supports the partnership.

Of the 80 beds, 65 will be in a mental health rehabilitation center and 15 will be in a psychiatric health facility.

The rehabilitation center provides 24-hour care for adults with mental disorders for an average stay of nine to 12 months. The psychiatric section will serve those with acute major mental disorders from seven to 14 days.

Royale’s license application for the new site is under review, said Nora Romero, a state Department of Mental Health spokeswoman.