Santa Clara County teenagers in mental-health crisis can now access inpatient hospital beds within the county’s borders at a new hospital in San Jose, but the county is still eyeing ways to offer more comprehensive services.

On Tuesday, the Santa Clara County Board of Supervisors unanimously approved an agreement with San Jose Behavioral Health, which opened in early 2016 and added a 17-bed inpatient psychiatric unit for 14- to 17-year-olds in August. The beds are available to patients on Medi-Cal and commercial insurance as well as those who are unsponsored or uninsured.

The agreement followed a failed Request for Proposal (RFP) that the county issued last year to find a provider to open a child and adolescent unit in Santa Clara County. The final vendors, California nonprofit EMQ Families First and Alameda-based Telecare Corporation (the two organizations responded jointly to the RFP), “identified the need for additional funding to develop the facility,” which the county ultimately was not able to provide within the budget constraints of the original Request for Proposal, Director of Behavioral Health Services Toni Tullys wrote in a staff report.

“The vendor was asked to make their last and final offer within the RFP budget, which they were unable to do, given facility costs,” Tullys wrote.

The county closed the RFP on Jan. 10.

Supervisor Joe Simitian, who has been at the forefront of the effort to bring hospital beds for teenagers to Santa Clara County over the last several years, told the Weekly Wednesday that the agreement with San Jose Behavioral Health was one part of but not the full-fledged solution he would like to see. He is continuing conversations with several local health care providers who responded to an earlier Request for Information (RFI), including Palo Alto’s Lucile Packard Children’s Hospital, Mountain View’s El Camino Hospital and Kaiser Permanente, who together submitted a preliminary joint proposal for an 18-bed facility that would serve 12- to 17-year-olds at El Camino’s Mountain View campus.

The “legalistic,” formal Request for Proposal process came with constraints that didn’t “provide a lot of room for the kind of give and take and the kind of collaborative partnership” Simitian sees as the solution to the scarcity of inpatient psychiatric care for teens in Santa Clara County.

“If we see this as a shared responsibility, I think anything is possible,” he said. “I think what it’s going to take is a collaborative model that is a little more creative than the contracting process ordinarily accommodates.”

He said the partnership with San Jose Behavioral Health is “a start, but to me, it’s just a start.”

Rob March, San Jose Behavioral Health’s chief executive officer, told the board that the agreement “will expand access and care to mental health services for adolescents in a significant way.”

At Tuesday’s Board of Supervisors meeting, however, Supervisor Cindy Chavez also expressed concern about the scope of services that San Jose Behavioral Health provides. She requested that staff produce a report by the end of the week that lists all medical services offered at the hospital. (Simitian said there were concerns about adolescents who need both mental and physical health care while hospitalized.)

She also requested that staff return to the Health and Hospital Committee in several months with options for the county’s long-term role in providing inpatient hospitalization services for teenagers with potential partner agencies.

Also “uncomfortable” with the fact that San Jose Behavioral Health was the single bidder for the county, Chavez made a motion, supported by her colleagues, to understand “whether or not the county in partnership with the current proposer or other proposers can come to us with a better, more efficient use of dollars with a more expanded suite of services.”

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5 Comments

  1. Only a churl would disparage the work of so many citizens–especially the likes of Mr. Simitian and Sarah Gentile–who, deeply concerned about adolescent despair, are giving us not only inpatient units but crisis lines, support apps and Facebook groups,community outpatient clinics, and school wellness centers, wellness teams, therapists, and mindfulness sessions.

    But I wish we’d also roll back some of what’s making our kids feel so awful in the first place.

    Wouldn’t it be wise to smooth their road–instead of continually holding out hands to them as they stagger, stumble, fall?

    Advocating for changes to the day-to-day life in our high schools so that it will be as supportive of our kids’ mental health as it is of their aspirations, the community alliance Save the 2,008 is now supported by more than five-hundred parents, teachers, therapists, PAMF physicians, Stanford professors, Palo Alto faith leaders, engineers and realtors and more.

    We’re at savethe2008.com and all are welcome.

  2. While it’s wonderful that teens who are covered by MediCal or who are uninsured can now be treated in-county at SJBH’s beautiful facility, there is still no facility that is reasonably accessible for the families in north Santa Clara County. With “family time” at our two closest options (Mills in San Mateo and SJBH at 101/85) taking place in the early evening, we must drive through the heaviest of commute traffic daily to see our children. It is especially painful to pass by Lucille Packard Children’s Hospital on the way, knowing that our children are not welcome there.
    All children who are younger than 14 are still sent as far away as Sacramento to receive inpatient care for any mental health issue.
    (Thank you, Marc, for the kind words. You are an inspiration.)

  3. It is absolutely abhorrent that LPCH–a children’s hospital– has absolutely NO children’s psychiatric facility!

    A wealthy hospital with many donors, it is criminal that the mental health of children and adolescents is overlooked year after year– so much so that they have to go to facilities in other counties, far away from home and parents.

    Absolutely unforgivable!

    And all anyone actually DOES is give lip service to the subject!

  4. Thank you to the Board of Supervisors, especially Supervisor Simitian and his staff for keeping a particular focus on this need, and all the advocates for this step forward. While need remains, especially in North County, at Family & Children Services of Silicon Valley we appreciate this progress in addressing local mental health needs and are delighted to read about the planned next steps.

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