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UT: County approves Third Avenue mental health hub agreement, but Scripps bows out


Read the full article by Paul Sisson in the San Diego Union-Tribune here.

Supervisors approved a memorandum of understanding with UC San Diego that will serve as a rough framework for building a new building with space for a range of mental health services and including 60 inpatient beds, on the Third Avenue property. Supervisors made it clear that their vote, and their investment, was about more than a building that will take five years to construct and open.

“In the end, it’s not just the facility, but what’s going to be going on in there that’s really important,” said supervisor Dianne Jacob.

Jacob commended her colleague, Supervisor Nathan Fletcher, for pushing to have the Third Avenue property used for mental health rather than residential redevelopment and for sinking a large amount of political capital into pushing for changes that go deeper than merely building a few additional buildings with enough beds to replace those that will be lost in coming years.

Fletcher, who said UC San Diego Health Chief Executive Officer Patty Maysent was instrumental in making the agreement happen, said the real secret sauce will be a new legal entity, a joint venture, capable of directing the efforts of care coordinators and others whose jobs will be to make sure that patients are not lost in the shuffle when they move between the wide range of programs that each serve a different piece of the mental health care pie.

“We are creating a joint venture, an entity that can move now on care coordination, an entity that can move now on data sharing and an entity that can move now on better outcomes and value-based health care,” Fletcher said.

The phrase care coordination has long been a buzzword of growing currency in the health care world as providers and policy wonks try to find ways to prevent health care problems while they’re still small, rather than following the traditional model, which has traditionally been less proactive than reactive.

At first, said Dr. Luke Bergmann, director of behavioral health services for the county, UCSD and the county plan to focus on those at greatest risk of hospitalization, either at the county’s psychiatric hospital on Rosecrans Street or in the behavioral health unit of UC San Diego Medical Center in Hillcrest.

“We can pay for a day of care coordination vastly more cheaply than we can pay for a day of hospitalization,” Bergmann said.

He credited Fletcher for making the plan, which many have been discussing for a long time, arrive at the point where real results are not on the horizon. The first batch of care coordinators, he said, should be trained and on the job by the end of the year.

“Supervisor Fletcher’s embrace of this issue, his championing of it, has been critical to our efforts to stand this up,” Bergmann said.