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New Mandate Could Further Stress San Diego’s Clogged Behavioral Health System

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New Mandate Could Further Stress San Diego’s Clogged Behavioral Health System




A scarcity of long-term care choices for behavioral well being sufferers that has for years fueled a clogged care system turned a fair greater downside in the course of the pandemic.  

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The COVID-19 disaster that restricted healthcare entry additional uncovered San Diego County’s deficit of psychiatric step-down care and housing that had already led to lengthy waits in hospital beds and delays for others looking for hospital care.  

County knowledge obtained by Voice of San Diego reveals the variety of days that grownup behavioral well being sufferers with Medi-Cal insurance coverage spent ready in hospital beds for post-hospital care surged 48 % from fiscal 12 months 2020 to 2021.  

A security evaluation type in a medical examination room at Sharp Mesa Vista Hospital on Sept. 20, 2022. / Picture by Ariana Drehsler

Sufferers additionally collectively spent greater than 19,000 days ready in hospital beds regionwide after docs determined they have been able to be discharged to a decrease degree of care in the course of the fiscal 12 months that ended this June. That complete is 40 % greater than the waits reported two years in the past. 

These waits have wreaked havoc on the remainder of the system and an upcoming state mandate to supply and compel therapy by the state’s new CARE Courtroom initiative by October 2023 will put extra stress on the area’s restricted choices. If the county can’t ship civil court-ordered take care of CARE Courtroom individuals, it may face fines of as much as $1,000 a day.  

Steve Koh, chief of normal psychiatry at UC San Diego Well being, mentioned he fears extra sufferers shall be caught ready in emergency rooms absent new long-term choices. 

“The place am I imagined to ship them?” he mentioned. 

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County officers who’ve lately centered most of their investments in disaster companies reasonably than back-end assets anticipated to be essential touchdown locations for CARE Courtroom individuals are pledging motion. They plan to quickly unveil an evaluation of the area’s want for longer-term care choices, and an growth technique.  

County supervisors additionally lately created a coaching fund to handle the area’s scarcity of behavioral well being staff. County Board of Supervisors Chair Nathan Fletcher argues the scarcity is hampering efforts to increase companies. 

Fletcher and Mayor Todd Gloria, each advocates of CARE Courtroom reforms, notice that Gov. Gavin Newsom has devoted vital funding to assist counties increase their behavioral well being methods, together with $1.5 billion for so-called bridge housing. 

Clearing present clogs within the behavioral well being system – and serving CARE Courtroom individuals – will probably relaxation on the county’s means to ship new beds. 

… 

Traditionally, there have been three phases of medical take care of sufferers in psychiatric misery: the emergency room, an inpatient hospital mattress the place sufferers may stabilize and post-hospital care for specialised therapy. 

A shortfall within the latter class has triggered a systemwide backup.  

Exhibit A: On a single day in late August, 10 of the 36 inpatient behavioral well being beds at Scripps Mercy Hospital in Hillcrest have been crammed with sufferers ready to maneuver to a different degree of care, that means greater than 1 / 4 of Scripps beds weren’t obtainable to sufferers in disaster.  

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The county has funded so-called disaster stabilization items the previous few years so fewer psychiatric sufferers enter native ERs after which inpatient beds, however sufferers nonetheless want someplace to go after they depart native hospitals. 

These hospital sufferers awaiting beds at long-term care amenities waited a median of 48 days between July 2021 and April, in accordance with county knowledge obtained by Voice. 

Christiana Paul, a vp at Sharp Mesa Vista Hospital, mentioned waits problem each sufferers and hospital workers. 

“It simply actually sticks this individual with us for these lengthy durations of instances the place this individual has cycles of nice enchancment, after which due to the size of the time within the hospital, (they) might even regress, which could be very demoralizing for the affected person and the workers,” Paul mentioned. 

Psychiatric social employee Carrie Dillon speaks to a different group member on Sept. 20, 2022 a few affected person being discharged from Sharp Mesa Vista Hospital. Dillon and her colleagues are tasked with discovering step-down placements for sufferers who want further care after they depart the hospital. / Picture by Ariana Drehsler

The San Diego County Psychiatric Hospital has been hit with lengthy waits too. The county studies common wait instances to maneuver sufferers from the county hospital to a state hospital surged to a median of about three years from July 2020 by June 2021. That’s up from about 5 months within the 2019 fiscal 12 months. 

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“Generally now we have to go for a unique degree of care, or they wait within the hospital till we are able to place them,” mentioned Annie Vizcarra, social companies supervisor at Alvarado Parkway Institute.  

Aaron Mellon, a skilled peer counselor with bipolar dysfunction who grappled with homelessness on and off for greater than a decade, estimated he has watched a number of dozen associates stabilize in hospitals solely to be pressured again onto the road.  

“For lots of people, it’s a endless loop,” Mellon mentioned. 

Clairemont resident Anastasia’s 26-year-old son has bipolar dysfunction with psychotic options and has been hospitalized a number of instances since 2020. She mentioned he struggled at unbiased residing amenities even whereas enrolled in an intensive therapy program.  

Garments sit on cabinets and are given to sufferers as quickly as attainable however can fluctuate from affected person to affected person at Sharp Mesa Vista Hospital on Sept. 20, 2022.

Anastasia mentioned she was repeatedly informed there have been no openings in board-and-care properties, which usually present residents with help with treatment and higher oversight. The properties lengthy thought-about essential housing choices for folks with critical psychological sicknesses are a shrinking useful resource statewide. 

After one five-day hospital keep for an an infection and one other 5 days at nursing facility this spring, Anastasia and her son’s case managers agreed he shouldn’t return to his unbiased residing dwelling, however there was no house in a board-and-care dwelling.  

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He moved into her Clairemont dwelling, forcing Anastasia to get permission to work at home. 

Carol, a retired trainer who lives in Tierrasanta, mentioned her 41-year-daughter recognized with schizophrenia has been kicked out of greater than 15 unbiased residing properties within the final 13 years. A number of facility managers have mentioned she belongs in a board-and-care facility.  

“She wants the next degree of care,” Carol mentioned.  

They haven’t discovered it. 

Certainly, 2-1-1 San Diego reported the area misplaced practically 400 board-and-care beds over the past decade. 

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Expert nursing amenities match for behavioral well being sufferers with medical points are additionally scarce. 

Psychiatrists say the sicker the affected person, the harder it’s to discover a place for them. 

Earlier this 12 months, the state awarded the county $12.4 million for a 12-bed psychiatric unit in its Edgemoor Expert Nursing Facility to permit residents to get psychiatric care with out transferring. 

Transferring into psychological well being rehabilitation amenities means lengthy waits, too. 

Native hospital methods mentioned waits rose considerably in the course of the pandemic however are leveling off at a one-to-three month wait. 

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The scenario may have been worse. Earlier than the pandemic, the county funded dozens extra psychological well being rehabilitation beds. 

Psychiatric social staff Carrie Dillon (left) and Jacqueline Rivera (proper) work at Sharp Mesa Vista Hospital on Sept. 20, 2022. They’re tasked with discovering step-down placements for sufferers who want further care after they depart the hospital. / Picture by Ariana Drehsler

The area has additionally added practically 2,300 everlasting supportive housing slots for previously homeless people who find themselves thought-about notably susceptible – together with folks with critical psychological sicknesses – since early 2019. However these additions haven’t dramatically diminished waits in hospitals and lots of behavioral well being sufferers require extra help than these amenities supply.  

“The actual fact of the matter is we simply want extra post-acute care,” mentioned Dimitrios Alexiou, CEO of the Hospital Affiliation of San Diego and Imperial Counties. 

Nadia Privara Brahms of the county’s behavioral well being companies division lately informed an advisory board the county plans to spice up step-down care and can share its wants at a Sept. 27 assembly. 

“As an alternative of being caught in additional acute care or not with the ability to get care in any respect as a result of these ranges of care or sorts of beds that they want don’t exist, the objective is to proceed to construct out capability a lot of which is within the decrease, much less restrictive areas of care to verify shoppers get linked after which they can get care long-term,” Privara Brahms mentioned. 



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San Diego, CA

Student Accused Of Raping Girl At Mount Miguel High School

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Student Accused Of Raping Girl At Mount Miguel High School


SAN DIEGO, CA — A Mount Miguel High School student suspected of raping a 15-year-old girl at the Spring Valley campus turned himself in to authorities Thursday and was jailed on a slate of criminal charges.

Reyvon Tafare English, 18, surrendered at the San Diego County Sheriff’s Department’s Rancho San Diego station and was booked on suspicion of kidnapping, false imprisonment and various sex assault offenses, the regional law enforcement agency reported.

The victim was at the campus on Blossom Valley Lane for an after- school program when English allegedly attacked her in a restroom about 4 p.m. last Thursday.

Find out what’s happening in San Diegowith free, real-time updates from Patch.

“She notified school staff, who contacted the Sheriff’s Department immediately,” sheriff’s Lt. Lon Nguyen said.

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The lieutenant did not disclose how investigators identified English as the alleged rapist.

Find out what’s happening in San Diegowith free, real-time updates from Patch.

English was being held at San Diego Central Jail without bail pending arraignment, scheduled for Monday afternoon.

— City News Service

We’ve removed the ability to reply as we work to make improvements. Learn more here

To request removal of your name from an arrest report, submit these required items to arrestreports@patch.com.



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California spending millions to address encampments, San Diego gets none

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California spending millions to address encampments, San Diego gets none


SAN DIEGO — On Thursday, Governor Gavin Newsom announced that the state is dedicating $192 million to helping people move out of tents on the streets and into homes.

“It’s not what you see; it’s what you don’t see. It’s cleaning up these encampments,” Newsom said when asked what difference people will see in their communities when this funding is implemented.

The Governor’s office revealed a list of cities that will receive a portion of the funding. San Diego was not on the list.

A spokesperson for the City of San Diego says the City did not apply for this round of funding, saying: “We have three significant awards under this grant program and are focusing our resources on delivering results with the money we’ve been awarded.”

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Those awards include:

  • Downtown – E Street: $2.45 million
  • County Collaboration – San Diego Riverbed: $3.7 million
  • I-15 Corridor: $3.2 million

Newsom also issued a fact sheet addressing increasing oversight when it comes to how local agencies are spending the funding.
The announcement comes just over a week after a state audit reported that San Diego needs to improve how it spends and keeps track of money used to tackle homelessness.

In response to the Governor’s announcement, Mayor Todd Gloria issued a statement reading in part:

In San Diego County, Oceanside is the only city receiving money from this round of funding.

A full list of jurisdictions awarded money is below:

  • The city of Anaheim will receive $3.1 million
  • The city of Chico will receive $2.7 million
  • The city of Fresno will receive $10.9 million
  • The City of Los Banos will receive $11.8 million
  • The City of Oakland will receive $7.2 million
  • The City of Oceanside will receive $11.4 million
  • The City of Ojai will receive $12.7 million
  • The City of San Bernardino will receive $4.6 million
  • The City of Santa Cruz will receive $4 million
  • The Humboldt County Continuum of Care will receive $3.4 million
  • Los Angeles County will receive $51.5 million
  • Marin County will receive an award of $18.2 million
  • Monterey County will receive an award of $11.1 million
  • Nevada County will receive $2.5 million
  • Santa Barbara County will receive $7.9 million
  • San Mateo County will receive $14.1 million
  • The Tehama County Continuum of Care will receive $14.1 million





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First Look: Tanner’s Prime Burgers Opens in Oceanside | San Diego Magazine

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First Look: Tanner’s Prime Burgers Opens in Oceanside | San Diego Magazine


Sometime in 2018 or 2019—he’s not sure exactly which—Brandon Rodgers called Eric Brandt. At the time, Rodgers was chef de cuisine at Benu, a three-Michelin-starred restaurant in San Francisco. He’d also done stints at The French Laundry and In Situ at SFMOMA and represented the US at the Olympics of culinary competitions, the Bocuse d’Or, where he initially met Brandt in 2007.

“He said, ‘Have you ever thought about doing a fast casual burger joint?’” recalls Brandt. “I’m like, ‘Brandon, you just got three Michelin stars. What are you thinking about a burger joint?’ And he’s like, ‘It would be the best burger joint in the world.’” 

The pair percolated over the idea and decided to try it, first as a concession concept at Acrisure Arena in Palm Desert in 2021 and then at the Del Mar Thoroughbred Club in 2023. But winning the Avocado Cup Culinary Competition at the inaugural Del Mar Wine + Food Festival last year convinced them to turn it into a full-fledged restaurant, with Brandt as owner/CEO and Rodgers as co-founder and chef.

Courtesy of Tanner’s Prime Burgers

“When we won that, it was kind of like, ‘All right, we probably better do a brick and mortar,” laughed Brandt

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Tanner’s Prime Burgers, a brick-and-mortar restaurant, officially opens this Friday, April 19 at the Freeman Collective in Oceanside. The 2,000-square-foot space will feature inside and outside seating and will use 100% USDA prime-grade beef supplied from Brandt Beef, Brandt’s family ranch, which has operated in the Imperial Valley since 1945. 

“This whole concept is about the beef,” explains Rodgers, adding that they will make every item on the menu with Brandt’s beef, from the bacon to the ice cream. But with burger in the name, it’s still definitely the star of the show. “We have one burger. You can get a single, or you can get that double,” he says. “We want to keep it simple and do it right.” 

But it will be the details that set them apart. The cheese is more than just cheese—it’s a unique aged cheddar that melts like American cheese, created especially for Tanner’s by Eric Greenspan from cheese company New School. Nearby, Artifex Brewing will brew the Tanner’s Lager and Tanner’s IPA. Honey for their sweet tea comes from Avery Girl Honey, another family-owned company near Brandt’s ranch. Even their Tanner’s Prime Hot Sauce is homemade, made with a 14-day fermented chile mash and blended with vinegar. 

Other menu items include options for kids, like a slider or all-beef hot dog, fries that come plain, cheesy, or “dirty” with beef tallow, a juicy, rich beef flavor rendered from beef fat. Yes, it’s decadent. But it’s outrageously delicious, and what Brandt says makes their ice cream extra creamy. 

Tanner's Prime Burgers' Fatty Patty which consists of two chocolate chip cookies between vanilla beef tallow ice cream available at their new Oceanside, San Diego location
Courtesy of Tanner’s Prime Burgers

“That creaminess from the beef tallow just holds—it can be a hot sunny afternoon, and it doesn’t melt all over you,” he laughs, pointing to their Fatty Patty, which is a scoop of the beef tallow ice cream sandwiched between two homemade chocolate chip cookies. “You can’t leave without trying a Fatty Patty.”

Rodgers and Brandt’s commitment to using as much of the animal as possible goes beyond the food. They also incorporated it into the design by Michael Francis, principal at SAINT (Studio for Architecture and Interiors), who used Brandt leather to create red leather barstools in the dining area. Rodgers says they took inspiration from fast-casual places like Chipotle and Shake Shack for a “functional, but simple” interior where people can get unpretentious food that will still knock their socks off. 

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Rodgers says the potential to captivate even more people by elevating a classic dish was a huge reason he left a three-star kitchen. “As a Michelin-starred chef, you’re preparing the best 40 meals a night, max,” he says. “What an opportunity to be able to try to prepare a burger that someone’s had 1,000 times, and try to serve that to 1,000 people a day. If you could touch 1,000 people versus 40 people a night, for me, that’s a great feeling.”

After April 19, Tanner’s will be open seven days a week from 10:30 a.m. to 10 p.m. The duo says they’ll see how it goes, but future locations are not off the table. “I’m focused on one, [but] Eric is focused on 21,” Rodgers jokes. Brandt agrees but says getting this off the ground has been an incredible journey already.

“I get chills thinking about the fact that we’re actually opening our first brick-and-mortar,” he says, recalling that prescient phone call from years ago. “This is a toast and a cheers to that call.”

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