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County moves forward with new mental health, coroner's facilities

POSTED November 13, 2012 9:57 p.m.

A dearth of beds for mental health patients in Stanislaus County, coupled with surging demand, has driven Stanislaus County mental health costs millions of dollars well above projections in recent months.

On Tuesday, the Stanislaus County Board of Supervisors took the first steps to respond to that shortage of beds, approving a recommendation to develop a county-owned Psychiatric Health Facility at the Stanislaus Recovery Center in Ceres.

“We are increasing the level of care in this county while avoiding cost,” said Bill O’Brien, chair of the Stanislaus County Board of Supervisors. “It's a win-win situation for this county.”

The PHF will repurpose a vacant building, previously used for residential perinatal services. The new facility would be home to a 16 bed inpatient facility, offering psychiatric, psychological, social work, and drug treatment programs.

The remodel is projected to cost $2.2 million, including the replacement of a HVAC system and roof repair. But the cost would be recovered in just a year and a half, according to county projections.

The savings comes as the cost of providing services would be lower at the PHF than the county’s existing 67 bed Doctors Behavioral Health Center inpatient psychiatric hospital. According to the county, hospitalization at the existing site costs $1,031 per day, while the PHF would cost only $629 per day. Out of area hospitals, used when demand exceeds local capacity, average a cost of $907 per day.

Additionally, the new PHF could reduce the county’s costs in repaying local hospitals for emergency room psychiatric services, while increasing the number of emergency beds available to those with life-threatening medical issues.

“It does make sense that the savings will pay for this thing,” said County Supervisor Terry Withrow, an accountant in his day job.

The county is required to provide 24 hour a day, 7 day a week help for those in need, under state law.

But many affected county residents don’t need the extremely high level of care offered at the county’s inpatient psychiatric hospital. By offering slightly reduced services to those who don’t need the extra assistance, the county could save millions while broadening the region’s spectrum of care.

The new facility is just one part of a new Mental Health Services Strategic Plan, developed by the county, consultants, and with help of the region’s hospitals to address a growing need for mental health services.

In the last year alone, inpatient admissions drastically increased, from 19 per day to more than 40 per day. That increased demand has driven markedly higher county costs, $1.9 million above the $3.4 million budgeted for inpatient mental health services in the 2011-2012 fiscal year.

County staff project the PHF remodeling will be complete in early 2014. The county must still locate a design-build contractor for the project and supervisors must approve the contract before construction will begin.

The outdated, overcrowded Stanislaus County Coroner’s Facility will move to a vacant county-owned building in downtown Modesto, following Stanislaus County Board of Supervisors approval on Tuesday.

That move, to the Medical Arts Building at the corner of 17th and G Streets, will come instead of constructing a new, $11 million facility from scratch, once-thought unavoidable. Instead, the County will spend $5 million to renovate the MAB, saving the cash-strapped county $6 million.

The project is just another example of the County’s commitment to save money while still performing essential duties, according to county staff and supervisors.

“This capital projects team has got to be one of the best in the state,” said Supervisor Jim DeMartini.

Responsible for investigating deaths with unknown causes, no known medical provider, or due to criminal acts, the Stanislaus County Coroner’s facility has become increasingly overtaxed.

Since 1978, the Sheriff-Coroner facility has been located at County Center III on Oakdale Road, in Modesto. The available space, equipment, and storage has not kept pace either with current demand, or projected increases given the volume of death investigations conducted.

The process to replace the building began nearly 10 years ago, DeMartini said, when he and other local leaders went on a trip to visit the Napa County coroner’s facility. Even then, it was apparent that Stanislaus County’s facility was outdated and too small to handle a local emergency.

In 2007, aware of the facility’s antiquated state, supervisors adopted a Public Safety Services Master Plan, which called for the construction of a brand new Coroner’s facility at a cost of $11 million. But as the economy crashed, the odds of finding that $11 million decreased substantially.

The Board of Supervisors hired a consultant in 2008 to begin investigating repurposing the vacant MAB in downtown Modesto as the future home of the Coroner’s office. And in 2011, supervisors first approved the plan to re-use the building for that purpose, hiring an architect in April.

“There were days where it didn't look that good, and today we are confident in our ability to move forward,” said Patty Hill-Thomas, county assistant CEO, before Tuesday’s vote.

Tuesday’s action approved the base architectural drawings, and allows the county to begin seeking a design-build contractor for the facility.

The plans call for the MAB to undergo a significant renovation, removing most of the existing interior, reconstructing new spaces, and replacing the building’s HVAC system. What was once the atrium will become the main autopsy suite, with neighboring rooms expanded and transformed into laboratories, storage, and offices.

The final product is projected to meet the County’s coroner needs through at least 2030.

The renovated building will also include the1,498 square-foot Sheriff’s Detention Public Video Visitation Center. The center will allow friends and family of inmates housed within County Jails to visit loved ones via videoconferencing, reducing public access to the secured jails. The visitation center will be accessed through a separate entrance from the Coroner facility.

The basement will be repurposed too, serving as a 4,271 square foot medical records storage facility for the County’s Health Services Agency. Eventually, the coroner’s office may expand into the basement, should demand warrant additional space.

The myriad uses found for the vacant building – all at a reasonable cost – earned unanimous approval from county supervisors.

“I think you've done a great job reusing this building,” said O’Brien.

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