Opinion: San Diego County's delay of conservatorship bill to address mental health is 'abhorrent'

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Editorial by Terra Lawson-Remer  |  Read full article in the San Diego Union-Tribune

In a time when access to quality health care has never been more crucial, the California Medicaid program, also known as Medi-Cal, offers a vital lifeline for some of our county’s most vulnerable community members. The program’s promise that no one should be left behind in the pursuit of health care has never been more significant. However, the stark reality is that there are challenges that need our immediate attention to make the paper promise of health care coverage a reality for Medi-Cal recipients in San Diego County. We must deliver on its pledge and ensure that access to health care is not a privilege limited by circumstances, but a fundamental right upheld for all.

The most recent example of our failure to fulfill this promise was when the Board of Supervisors voted this month to delay implementation of California State Senate Bill 43, to expand the conservatorship criteria — a bill unanimously approved by the state Assembly and the state Senate. Tackling the converging crises of mental illness, addiction and homelessness has never been more important. We must act with the urgency this problem demands. By delaying Senate Bill 43, we prevented our residents who rely on Medi-Cal the vital care they need to become stable and live with dignity.

I recognize that it would have been ideal to have even more lead time on Senate Bill 43 ramp-up for the county, hospital partners, services providers and cities, but we all should be moving as fast as possible to help the people we serve. There are challenges to overcome regarding the availability of access to appropriate treatment options upon a person’s discharge from the hospital, but that shouldn’t stop us from moving with urgency.

When faced with a public health emergency or a natural disaster, I have seen us quickly evacuate entire neighborhoods within minutes to keep families safe, and stand up emergency shelters at our convention center in a matter of weeks to provide care for our unhoused neighbors and protect them from a deadly virus. We should meet the challenges of implementing Senate Bill 43 with the same focus and expedience.

Some other counties in California decided to delay implementation, but San Francisco is moving forward.

I joined the Board of Supervisors to move our region past decades of stagnant, status-quo policymaking, and for the better part of three years we have successfully done it with investments in more behavioral health services than any other Board of Supervisors. We have gone from zero shelter beds to nearly 900 in the last three years. We have hired five times more county outreach staff. We’ve launched the Mobile Crisis Response Team program regionwide, which allows residents to contact mental health professionals to help with a non-emergency behavioral health crisis, rather than tying up law enforcement.

Implementing Senate Bill 43 was not the time to pull back — we should have continued to press ahead by using this tool to help as many people as possible. We must continue to make wise investments that increase our region’s capacity to deliver mental health and addiction treatment. That’s why in January, I will bring a policy to my colleagues to make a significant investment to support the development of new recuperative care shelter capacity to provide critically needed step down beds to support Senate Bill 43 implementation and address hospital overcrowding for medically vulnerable homeless individuals.

We cannot sit idly by while people struggle. It’s morally abhorrent to not implement Senate Bill 43 and let people die on our streets without the care they need and deserve. We must always do everything we can in our power to act with the utmost urgency to address the No. 1 issues our constituents are concerned about.

Our region, and most importantly the people in dire need of treatment, would have been better served if we worked with the same sense of urgency we have proven to be capable of to implement this new law.