On a recent evening, Templeton resident Murray Powell and 20 or so neighbors met once again to organize their arguments against a plan to build a psychiatric hospital in their community.
“We’re not opposed to a facility that serves our county, but it would need to be much smaller and in a better location,” Powell told The Tribune. “There are absolutely no support services in Templeton and very, very little support services in Paso Robles and Atascadero to support that facility.”
The proposal by property owners and Carmel residents Harvey and Melanie Billig calls for a 91-bed psychiatric hospital and a separate 55- to 60-bed live-in memory care facility on a 5-acre parcel across from Twin Cities Community Hospital.
The opposition has focused on the psychiatric hospital, a voluntary facility designed to treat mental illnesses such as depression, schizophrenia and eating disorders. It would not treat those suffering from substance abuse.
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The hospital would be separated into units for children, adolescents, adults and seniors and be designed for short-term stays.
Currently, no such facility exists in San Luis Obispo County.
The county’s 16-bed Psychiatric Health Facility in San Luis Obispo primarily serves low-
income residents on Medi-Cal and transfers out patients with private insurance — the patient base the Templeton hospital would serve.
Opponents of the Templeton proposal in its current form say they worry that discharged patients won’t leave town and that the area’s public safety, schools and transportation system would be in jeopardy. They’re also skeptical of the statistics that proponents and others use to demonstrate a local need for a facility of its size.
The proposal’s supporters say that stigma against mental illness — not research — is feeding much of these concerns. They say the hospital would fill a huge gap in local psychiatric care, saving local families the heartache and financial burdens of having to travel statewide for care.
“I don’t think it would be the answer to everything, but it would be a good step, and we need it,” San Luis Obispo resident Madeleine Johnson said. “If you had a broken leg, you go to the ER. But with this county, you have to go through all kinds of hoops and distances before anyone helps you for a mental illness.”
Last November, the Templeton Area Advisory Group, which makes recommendations to the San Luis Obispo County Board of Supervisors, voted against the project in a meeting that drew about 250 attendees, the majority of whom also opposed it.
Among them was Templeton resident Gwen Pelfrey.
“I believe each county should be serving their own,” Pelfrey told The Tribune. “It’s not about what a developer wants to build and make money on, but what our county needs for quality of life of our population. I don’t think this facility is it.”
Pelfrey is also a Templeton Community Services District board member but said she was speaking independently of her elected position. She is among those who think that a 91-bed psychiatric hospital would have to draw patients from throughout the state to be profitable.
She’s worried that the county’s finances would be drained by having to treat any patients who come from other counties and then stay in the area once they’re discharged.
Templeton resident Dr. Gregg Ellison, whose office is next to the proposed site of the hospital, agrees.
“I don’t see the advantage of a facility that would add more mentally ill people in our county than we currently have,” he said.
Ellison, an internal medicine doctor in Templeton, said he thinks a 20-bed hospital would be more appropriate.
Melanie Billig said the proposed hospital would fill a local need, although there would be room for patients from other areas.
“It’s not designed to bring people from all over the place — that’s part of their scare tactic,” she said of those who have voiced concerns that it might become a regional hospital.
“It’s primarily for San Luis Obispo County, but what would you do if someone in Santa Maria wanted heart surgery at French Hospital (in San Luis Obispo)? Would you say no because they live outside the county? Comparatively, if someone from Lockwood (45 miles from Templeton) says my kid or parent is in a mental crisis, what would you do?”
Statistics show that hundreds of San Luis Obispo County residents go outside the county each year for psychiatric hospital care.
In 2014, 714 county residents were inpatients at out-of-county psychiatric hospitals, according to the California Office of Statewide Health Planning and Development.
Mark Schneider, chief executive officer of Vizion Health LLC, which would operate the Templeton psychiatric hospital, said he anticipates 900 to 1,000 patients the first year and then about 2,520 patients each year after that.
Supporters believe that the facility would not only attract those who leave the county for care, but also serve those who forgo inpatient treatment entirely because of distance.
Question of safety
Ellison is most concerned about safety.
“There’s (a limited number of sheriff’s deputies) to patrol the whole North County … and we don’t have any support if someone acts out,” he said. “If they get checked out at 9 o’clock at night and if they act out, we don’t have any police presence.
“I worry about people being discharged who’d show up at people’s homes for dinner.”
Schneider of Vizion said the hospital would ensure that patients get home safely.
“If on that rare occasion there’s a patient that has no means of getting home (with family or friends), we will figure out a way to get them there, such as get them a cab or transport them in some way or get them a voucher. But we will not under any means discharge them to the street,” he said.
Moreover, Schneider said, hospital staff will develop plans for when patients “are going home, when they will see their own doctors, and we make appointments for that
follow-up care,” he said.
“Our policy will be that they have to go back to their psychologists or psychiatrists who they regularly see in their home counties,” he said.
But Ellison said the hospital couldn’t force its voluntary patients to leave town.
“How do you tell a person who is at-will to go back to their own home? They might say, ‘Nah. I like it here. I’ll live at the park.’ ”
Hospital proponents say Ellison’s worry is common, but typically unfounded.
“I have friends with mental illnesses that need to be checked in from time to time, and they are upstanding citizens, and they’re not going to be checking out of facilities and sitting on curbs,” said Pam Zweifel, a San Luis Obispo resident. “After they are done, they want to go home. They would be going back to their lives, their own psychiatrists and their own physicians.”
San Luis Obispo resident Joe Johnson facilitates a support group with his wife, Madeleine, through the local chapter of the National Alliance on Mental Illness.
“Nobody wants it in their neighborhood because there’s a lot of stigma about the mentally ill,” he said. “Would the opponents rather have people, their neighbors, suffer from these illnesses and go untreated? I don’t think so.”
A doctor’s assessment would be required before a patient could be discharged, the Billigs said.
If a patient is considered a danger to himself or others, he would be transferred to the county’s psychiatric hospital on a 72-hour involuntary hold.
Powell said that after combing through county documents that indicated interest in designating the facility to accept involuntary patients, his major worry is that the county may persuade the hospital to move in that direction. The Billigs and Schneider said that’s not currently the plan.
Meanwhile, the Sheriff’s Office doesn’t anticipate a safety problem.
“The Sheriff’s Office scope on the behavioral health hospital project is limited to security issues only. And as such, we have no reason to believe at this time that it presents a security concern,” Sheriff Ian Parkinson said in a statement.
In March, the Templeton Unified School District sent a letter on behalf of its board of trustees to the San Luis Obispo County Board of Supervisors warning that the hospital could have a “significant impact” on district finances.
State law requires local school districts to provide regular and special education to children hospitalized within their boundaries.
The law applies to both medical and psychiatric hospitals.
In the letter, the district said, “It is likely that students who need hospitalization in a mental health facility will tend to have substantial special education needs.
“Depending upon the needs of a particular student, these services can range from educational instruction to complex professional services such as nursing, physical therapy, speech and language therapy, or intensive behavioral services.”
Although the school district would receive state funding for hospitalized children to cover general education, no additional funds would be provided to pay for any special educational services, the letter said.
The psychiatric hospital will reimburse the school district for any inpatient education costs the district is tasked to provide per state law, Schneider told The Tribune. He said he would put that commitment in writing through a contract with the school district.
Meanwhile, others are waiting for all the facts to be hashed out when the county Planning Commission considers the proposal before forming an opinion on the project. That public meeting is tentatively set for Dec. 10.
Among them is Atascadero resident Janice Thompson, who has a brother with mental illness.
“Any interest in the mental health problem is good,” she said. “It’s good that these issues will be made so public when the proposal goes before the county’s Planning Commission because it gets people talking.”