$10M Secured To House Homeless Individuals With Mental Illness

San Diego County approves $10 million for housing the mentally ill but critics say the county could be doing a lot more. This is KPBS Mid Day Edition . The 10 million will go toward providing permanent supportive housing for homeless people with severe mental illness but critics point to the county's unspent state mental health funds and asked that more be done. Grandiosity residents will get a letter in the mail about a proposal to boost water rates by a total of 40%. And the San Diego Museum of Art hosts the end of the Balboa Park Centennial celebration with an ambitious exhibit called the art of music. I am Maureen Cavanaugh KPBS Mid Day Edition is next. First the news. From NPR news in Washington I am Laxmi saying. Western backed moderate Syrian rebel group is reporting that one of its top officers has been killed in Russian airstrike in serious home province. US defense secretary Ash Carter spoke a short time ago about concerns that Russia's airstrikes meditate Syrian [ Indiscernible ] enemies rather than basis militants. It does appear that they were in areas where there probably were not iso-forces and that was precisely what of the problems with this whole approach. The US accuses a thought of giving rise to the current crisis, government troops and ices militants by ordering of filing crackdown on political dissent several years ago. The Vatican confirms Pope Francis did meet privately with Kim Davis although Brown County clerk of Jeff refusing a quarter to issue marriage licenses to same-sex couples in Kentucky Davis's attorney [ Indiscernible ] founder of liberty cancer told NPR the Pope encouraged Davis and told her to stay strong. Pope [ Indiscernible ] and other people staff and security no one else was in the room. Hope France's Canal he held out his hands he asked Kim Davis to pray for him and she clasped his hands to situate and she asked [ Indiscernible ] to pray for her and he said he would. Word of the meeting angered many gay activists have said the [ Indiscernible ] said little about the subject of gay and lesbian rights many of them had been encouraged by an earlier remark Francis made in which he said quote if someone is getting searches for the Lord and has goodwill who am I to judge? Federal appeals court has reversed and earlier ruling that colleges and universities can pay student athlete up to [ Indiscernible ] in deferred compensation however the court upheld the idea that NCAA rules on amateurism antitrust law. MPR Tomko misplaced because Ninth Circuit Court of Appeals decision its latest chapter in the Ed O'Bannon case. Open it is the former college passed all stores who sue the NCAA for using his name and likeness in video games and TV broadcasts. Leicester federal judge sided with OPM and ruling that NCAA limits on what major college football and men's basketball players can earn violated antitrust rules. The judge said schools can offer players scholarships that cover the full cost of attendance and up to $5000 in deferred compensation. Nappy appeals court has upheld the cost of attendance provision of said no to the payments. The opinions of the [ Indiscernible ] is not minor it's a quantum leap. Tom Goldman MPR news. And last check on Wall Street the Dow was up 100 Senate points more than 1% at 16,231. This is NPR news. The county allocates $10 million on new housing for homeless people with mental illness. And sending a city residents might be spending significantly more than they used to for water. This is KPBS Mid Day Edition. I am Maureen Cavanaugh it is Wednesday, September 30. Here at the San Diego stories we are following in the KPBS newsroom. San Diego County officials will unveil a new online nap this afternoon which will display fire risk around the region. A search tool will allow buses to examine the risk in their neighborhoods. Real service along the north County + will be suspended over the next three weekends. The closures will affect Amtrak and coaster passengers beginning this Saturday and Sunday. The interruption will allow for construction of replacement bridge and track crossover projects. And that's not an emergency it's a true at the ocean beach here lifeguards and Coast Guard personnel responded to a mock airline crash. Listen for the latest news through the date here on KPBS. Our top story amid the addition County supervisors voted this week to allocate more money for housing homeless people with severe mental illness. $10 million will go toward a special needs loan program to provide support of permanent housing. San Diego already has about to enter 40 permanent housing units for the mentally ill. Mental health advocates applaud the move but some also say it's a drop in the bucket considering the number of homeless mentally ill people in the county and because the county has been slow to spend tens of millions of dollars of state money dedicated to mental health services. Earlier today I spoke with Alfredo Akira San Diego County's behavioral health director and here's the interview. Afraid of what does supportive housing mean? Which is the county due to support the people who will move into these units? So there are two pieces to it. One is creating the actual permanent supportive housing units that is affordable for our clients is dedicated for our clients and so the loan program that's part of the what the supervisors approved yesterday provides for an additional $10 million over and above the 33 million we've already dedicated to develop these housing units and that way these last over a long period of time and again, they are affordable and that's one part of it. The other part of it is the actual services and other potential housing support so for example we have developed slots for what is called a surge of community [ Indiscernible ] LP should services for over 1200 people since the assumption of the mental health service act so that is the other part of it you need to create the opportunity for housing and when we talk about permanent supportive housing we're talking about obviously units are going to be consistent over time any talk about the services that support the individuals so they can successfully live in those units and improve their health, achieve their objectives in terms of their recovery and so that is really what it's about. It is providing the appropriate services for those individuals to be successful in the Psalms. You say they are affordable obviously seriously mentally ill people will not be able to afford to buy a house so who is actually going to be purchasing this house? So this is a loan program and like with any other housing project the state [ Indiscernible ] administers this project and they then typically these are mixed housing projects where they pull together monies and tax credits and they are able to develop a housing project that will include for example units that are dedicated for people with serious mental illness but they also may be -- the project may also include perhaps units for older adults units for family units for people with other types of disabilities so it really is a mixed housing approach and then the individuals that are in their pay the rent and it's made affordable because it only really requires a portion for example there is a sigh and the other thing that we do if necessary if there is still a gap through our [ Indiscernible ] program can also provide additional subsidies in order to ensure the person can afford to live in the unit. Of course the other thing transfer that is always a challenge is finding in general is finding affordable housing so through our resources again we have actually place people and helped with first and last months rent in supporting [ Indiscernible ] support just to get people into an apartment but we know and depending on the region in San Diego County this can be quite a challenge in terms of portability. So again with these projects do and we've developed up to 241 units of these types of permanent housing units provides for a stable again affordable place to live peaceably with a person's lifetime. Now the $10 million allocated this week by the county it comes out of our share of prop 63 the mental health services act. Is my understanding of the county is accumulated quite a bit of money from that act about $170 million or so is the right? That is correct. So some mental advocates have wondered why then the need with the need so great in San Diego where I haven't more of those funds in spent? Well it is a fluctuating revenue source depending on how the millionaires do and it's a good economy right now and so what you are seeing is money flowing in but it fluctuates in wildly over time year-to-year and so every year since the inception we have actually enhance our services for example this fiscal year and the annual update that was represented in the board's action yesterday we actually enhance our services by $16.7 million. We have an opportunity with this reserve or this [ Indiscernible ] fund of the amount you mentioned where we can look at some one-time only dedicated dollars for permanent sort of housing so this was an opportunity for us to quickly move on this and dedicate 10 million. Also in addition Maureen we are having October forms to again accentuate the priorities that we already have but based on those forums we are looking at doing some enhancements midyear which is a bit unusual. Typically do these enhancements on an annual basis but because we see the pressing need we understand the advocates and people that are concerned about needs throughout their and if there are resources available and that we can actually enhance programs or establish new programs that we can sustain over time because Maureen whatever we do we have to sustain these programs and so it's not like there's X amount of dollars with Cisco spend it. We want to be the plan for wise and how we spend it and no consisting overtime. We have to do want to get in the position where we invest in that we have two years later have to ratchet effect on. I will say of that figure you mentioned Maureen some of those dollars are actually required by law to be what's called to be placed in a prudent reserve so slightly over $40 million going to a prudent reserve so if it's a real bad not rainy day but a storm were we actually are looking to having to produce programs we can tap that prudent reserve. In addition there are some dedicated dollars in that amount that are one-time only are things like capital facilities and technology and workforce and those programs are actually concluding within a couple of years so there's a bit of apples and oranges again, no doubt right now we have an opportunity to look at some one-time investments like we did the board's authority yesterday and we are going to be looking at further enhancements and address some of the priorities we had like issues around the homeless population with serious mental illness looking at opportunities to expand services because we know even with the good work the county has done there is still needs out there. People are still coming to San Diego and there's the homeless population has loverly decrease. As you know it's either been stable or increased and within that population there's people with serious mental illness and also substance use disorders so we're looking at all of our revenues and doing the best we can to parlay our services with other sources of revenues from housing community development agencies, working in tandem with them to really make a difference for our publisher. I've been speaking with Alfredo in McCue San Diego County's behavioral health director. Think you are much. Thank you. And joining me now is Dr. Michael plop or Hughes chief medical officer of Sharp healthcare and behavioral health services. Dr. plover welcome to show. Basis you tran04. By Utah with emergency services for homeless people for many years. How prevalent is mentally ill and the homeless population here in San Diego to Mac Was really quite prevalent. Not only in the homeless population but in nearly homeless population. There are a lot of people on the edge of becoming homeless and then sort of fall into that in homelessness as a consequence of untreated mental illness all we have substantial publishing a people currently homeless we have again a number of people who are vulnerable to become homeless if their mental illnesses and treated. Was really happened one of the major forces that have occurred in the community that's driving the need for change is the affordable care act. We have 100,000 more people this year than last year on [ Indiscernible ] in this county and one could safely say that 10% of them have a serious and severe mental homeless. Those people are try to access services. And our system of care isn't quite capable of managing that huge influx of people. So they're coming to our emergency rooms and it is creating a significant problem in our [ Indiscernible ] as well as the community all these are affected by this. And what is happiness it more prolonged length of stay in emergency departments which because we can't find good resources are psychiatric hospitals are generally full and so they spent more expense per the time in the ED's and they are not equipped. They're not really build to have people in ED's for long period of times. So we are attempting to manage that. But one of the biggest issues is in one of the major issues in terms of white our hospitals are full is that we are having difficulty getting them out of the hospital ended to save environments. Which is exactly what we're talking about. What types of mental illness? The county specifically made this grant for homeless individuals with severe mental illness. What would constitute severe mental illness? Will typically it is people with psychotic illnesses schizophrenia schizoaffective disorder bipolar disorder sometimes severe recurrent depression and often times in combination with substance dependence. Is a very common phenomena of virtually to have people dually diagnosed with a mental illness as well as with a issue in substance dependence and it complicates treatment considerably. We continue to have sort of despair approaches to chemical dependency as well as mental illness in the community and the funding resources tend to be separated and is is difficult to find adequate treatment situations for people who have both sets of illnesses so that companies it. But typically is people with significant psychotic illnesses which can respond to treatment medication works well generally and people who have psychotic illness so if they are in a situation for example the supported housing arrangement in which they have access to medications that can make appointments follow up appointments they have wraparound social services provides a very effective way to manage people. It is just that the numbers of people we can treat with this approach. I am completely in favor and I think it is hard to imagine anyone who would be in favor of the supported housing approach like this and I'm very happy that the county do this. In fact I was setting with the [ Indiscernible ] last week and we said to ourselves wouldn't be great if some of the [ Indiscernible ] was towards [ Indiscernible ] silicate center patient after discharge.'s we are very much in favor of this approach. Considering the funds though available for the county, I mentioned to Alfredo [ Indiscernible ] there's about 170 million unspent. Is it your opinion the county could be doing more? Well, we have had long dialogues over long period of time over the [ Indiscernible ] funding. At the state created rules in the very beginning after the prop 63 was passed which limited ways in which the counties can spend these funds which I think is truly been unfortunate and that we can't use them to replace any funding for core services but what's happened over the years is that our core service that is County clinics hospital services long-term care services have been impacted significantly and these funds can't be used to augment any of the services. So while we have a lot of money available to provide full-service partnerships to provide innovative and effective ways to take care of a portion of her mentally ill they tend not to be our most severely mentally ill. They tend to be people who will accept services voluntarily tend to be [ Indiscernible ] who in the vacant to specific types of programs many of which are excellent. But we are having trouble getting our most fiercely mentally ill well enough to access these MHS programs. And a lot of it has to do with where they live in the types of services they receive in the community in addition to being in a hospital or other type of facility. In my final question to Dr. Popper is what is the impact of San Diego's healthcare system of having so many homeless people it's estimated that 36% of our homeless publishing it comes out to about 3000 people suffering from mental illness and not being treated or supported adequately? What's the impact on our health care system here? The impact is significant. There's a disproportionate amount of money being spent on this population into great deal of [ Indiscernible ] so 3000 people but the additional group of people who are vulnerable and ready to tip over the edge of become homeless, they are very expensive to take care of. With repeated hospitalizations. Within our [ Indiscernible ] population we are reanimating them at a rate of 25% in 30 days so within 30 days one out of four patients on Medi-Cal are getting treatment on psychiatric committee are readmitted so something is not working and that is the case. And it has to do with I think our long-term treatment options including our water colder IMT's or a person could stay for a few months and receive treatment in a secure environment. Persimmon impacted there have been some recent activity by the county which has been very positive but it's very expensive and it sort of displaces funds which can be used in other more effective ways. Will certainly revisit this topic or, to thank you so much for your time Dr. Michael plop her treatment globs of Sharp healthcare behavioral health services. Pixler. Angst Maureen -- thank you Maureen .