In a Jan. 26 meeting, Planning Commissioners supported Providence Saint John’s massive redevelopment plan and its associated community benefits agreement, even though Commissioners raised concerns that the proposal does not include plans for inpatient psychiatric beds.

Providence Saint John’s (PSJ) is a 226-bed hospital and healthcare center located in the Mid-City neighborhood. It is seeking to begin its Phase Two Expansion Plan, which will transform most of its south campus and a few buildings on its north campus by creating ten new structures containing an array of medical, research, healthcare and childcare services.

In order to gain approval for the huge project, PSJ must enter an extensive community benefits agreement with the City.

The twelve part agreement requires significant investment in City priorities around healthcare, child care and mental health care. This includes $10 million in grants to fund City behavioral health initiatives, which would be provided immediately after Council approves the agreement, and $28.5 million in grants to nonprofit community organizations offering homeless services, which would be given in stages from 2023 through 2052.

One community need not included in PSJ’s expansion plan is inpatient psychiatric beds. This means that the hospital only has the ability to deal with mental health crises in urgent care or with outpatient services. If patients need to be admitted for psychiatric care they must hope that beds are available at UCLA Resnick Neuropsychiatric Hospital in Westwood or other facilities outside of Santa Monica. If they are also experiencing substance abuse they must travel all the way to Torrance to access a sober psychiatric facility.

“This is a truly unique opportunity in the history of Santa Monica to provide inpatient services that are desperately needed,” said Commissioner Ellis Raskin. “There’s a tremendous public cost when inpatient care is transported outside our community and dealt with through fire and police resources.”

PSJ Chief Executive Michael Ricks said he recognized that there was an inpatient care crisis in the Southern California region and particularly on the Westside. He said that PSJ plans to address the crisis through other mental health services as opposed to adding beds.

“A standalone inpatient psychiatric unit is not a viable solution for a community in improving the mental health of that community if it doesn’t have wraparound services associated with it,” said Ricks. “It’s easier and quicker to start the mental health projects and initiatives that we’re talking about and get those in place and begin making an immediate impact on our community and that population while we have conversations with multiple stakeholders around the inpatient psychiatric unit.”

According to PSJ estimates, an inpatient facility would cost around $1.4 million per bed to set up and the ongoing operating costs for a 50 bed facility would be around $14 million per year, escalating annually.

When asked by Commissioner Leslie Lambert, Ricks said PSJ would not sign a development agreement if there was a requirement in place to add inpatient psychiatric beds.

“I think we heard quite clearly that PSJ sees its contribution to the inpatient bed shortage as providing the urgent care, wraparound, after care that is going to have to complement somebody else’s inpatient beds,” said Raskin.

Commissioner Shawn Landres suggested adding recommendations to the community benefits agreement that would ensure that PSJ’s behavioral health grants be utilized as effectively as possible. Commissioners voted and approved the recommendations, which were as follows:

1. PSJ shall consult with subject matter experts, community stakeholders, and co-funders in the grantmaking process. Ensure a robust system for funding data-driven innovation that does not unfairly advantage prior grantees over promising new ones.

2. Focus the behavioral health funding on infrastructure and gap funding for mental health outpatient care, with attention to measurable ways that the program can divert from, wrap around, and prevent readmission to inpatient psychiatric care.

3. Limit in-kind funding to clearly measurable capital and operational contributions.

These recommendations, along with commissioners’ various other suggestions on the expansion plan, will be passed along to City Council. Councilmembers will have the final say over approving PSJ’s redevelopment and community benefits agreement.