It’s been a long road for the Providence Saint John’s (PSJ) redevelopment plan, which dates back to the 1994 Northridge earthquake that wreaked significant damage to the 226-bed Mid-City hospital, but during a March 22 Council meeting a milestone was reached — City approval for a massive facilities overhaul that will lead to the creation of ten new structures.
The project, called the Phase Two Master Plan, will transform most of PSJ’s South Campus and a few buildings on its north campus, which will collectively house an array of medical, research, healthcare and childcare services. Phase One focused on the North Campus and was completed in 2013.
Permission for the project was contingent on PSJ agreeing to a weighty community benefit agreement, which they estimate will equate to an approximate $100 million in community health investment for the next 30 years.
This includes giving $10 million in direct near-term funding for City behavioral health initiatives and around $29 million in stages from 2023 through 2052 for nonprofit community organizations focused on homelessness. Other components of the agreement include provision of childcare services, construction of 10 affordable housing units, publicly-accessible open space, community meeting rooms and local hiring and internship programs.
Despite the far-reaching and onerous nature of the community benefit commitments, one thing community members were vocal about wanting to see is absent: inpatient mental health beds.
Currently, there are zero inpatient mental health beds in Santa Monica, despite a demonstrated community need for mental health care for the city’s housed and unhoused population. This means no one experiencing a mental health crisis can be admitted for care in the city for more than 23 hours and 59 minutes.
The nearest facility with inpatient beds is the 74 bed UCLA Resnick Neuropsychiatric Hospital in Westwood. This facility will be shut down in the near future and replaced with a new neuropsychiatric hospital campus in the Mid-Wilshire area. Although this facility plans on having approximately 30 percent more beds, it will be further from most parts of Santa Monica.
When police officers need to transport a subject undergoing a mental health crisis they typically have to travel an even longer distance, all the way to the Harbor-UCLA Medical Center in Torrance, which has the specialized skill set and facilities to handle justice involved individuals.
According to a 2021 RAND Institute study of inpatient mental health services, most of Southern California faces a shortage of beds and a city with a population of 100,000, which is roughly the size of Santa Monica, needs around 50 beds.
PSJ officials have said that they are unwilling to incorporate inpatient psychiatric beds into their redevelopment plan and instead see their contribution to the mental health crisis as providing mental health urgent care and outpatient services. 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.
The $10 million in the community benefits agreement that will be given to the City to fund behavioral health programs is a significant contribution on behalf of Saint John’s.
Regardless, many community members were disappointed to see that inpatient beds did not make it into the final agreement. Representatives from the Wilshire Montana Neighborhood Coalition, Board of Northeast Neighbors, Friends of Sunset Park and the Santa Monica Mid-City Neighbors all provided written comments to the Council meeting asking that inpatient beds be added.
“For the past ten years or more St John’s has come to us when they are petitioning the City for something. And every time they have heard that the community wants mental health services, including beds for 72-hour holds. Every time,” wrote Andrew Hoyer, Santa Monica Mid-City Neighbors Board Secretary & Govt Affairs Officer. “Over a ten-year span, they did not even consider the idea that our city government might request this of them. And they stand before you now asking for permission to disrupt our community with construction for the next twenty five years.”
During the Council meeting Michael Ricks, Chief Executive of Providence Saint John’s, took time to acknowledge the community concern around providing inpatient beds and detailed the alternative ways PSJ could help bring this to the community.
Ricks pointed to the Be Well OC system of mental health services as a potential blueprint for Santa Monica. Be Well OC is a public-private healthcare partnership that provides robust treatment and services for mental health and substance use disorders, including inpatient beds, on one central campus.
Ricks said that if the City is interested in creating such a campus, it could draw from PSJ’s $10 million contribution to behavioral health services. According to Ricks, the largest healthcare provider in Orange County contributed $4 million towards Be Well OC.
Rick described the community benefits agreement as “compelling and unprecedented” and noted that further community benefits will be reaped from the redeveloped facilities at Saint John’s, including the Cancer Institute.
“We want to continue to provide the level of research that truly revolutionizes the treatment of cancer and continue to aid in our pursuit of curing cancer (which) is going to be a massive component of the south campus,” said Ricks.
City Council made minor tweaks to the community benefits agreement, including increasing community access to the conference center, adjusting priorities for childcare spaces and speeding up the timeline for behavioral health payments before passing all sections of it unanimously.
“It’s a win-win for a hospital that we hold dear in our community,” said Councilmember Phil Brock. “It’s also a win-win for our City.”