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County behavioral health reports heavy caseloads, staffing shortfalls and aims to expand peer support
Summary
The countys interim behavioral health director told the Board of Supervisors on July 15 that specialty mental-health services serve the countys most acute Medi-Cal beneficiaries, that staff numbers fall well short of targets, and that the department plans to increase peer-support services and improve hospital and ER notification processes.
Sharon Souza, interim director of Plymouth County Behavioral Health, told the Board of Supervisors on July 15 that the department provided more than 10,000 services in 2024, handled hundreds of crisis evaluations and faces a staffing shortfall that limits care options.
Souza said the department is the countys specialty mental-health provider for Medi-Cal beneficiaries and provides 24/7 access, crisis intervention, targeted case management and medication services. She said the department recorded 517 requests for services in 2024; 200 screened into specialty care and the county provided about 10,000 total services for the year. The department recorded 68 evaluations under the states Section 5150 standard for evaluation of grave disability or danger and placed 127 people in acute psychiatric hospitals for inpatient care.
Souza described a substantial workforce gap. The departments stated need is 10 behavioral health therapists but staffing stood at roughly 3.25 full-time equivalents at the time of the presentation. She said the county must improve recruitment and retention and suggested that salary and recruitment efforts tied to the countys salary study could affect hiring, noting that salary constraints in a high-wage environment make rural recruitment difficult.
Souza and staff identified program goals: raise staff productivity to 50 percent (a state benchmark), increase timely ASAM assessments for substance-use clients, resolve delayed ER notifications from hospitals, and expand certified peer-support specialists. Souza said peer specialists, who have lived experience, will be able to provide supports and eventually bill Medi-Cal for services once training and certification are in place.
Supervisors questioned whether increased therapist staffing would improve public safety and post-discharge follow-up and asked staff to pursue creative hiring and partnership solutions. The board did not allocate new funds during the meeting; supervisors and staff discussed bringing behavioral health needs to the countys strategic planning and regional behavioral-health convenings.
Why it matters: The department serves the countys highest-need Medi-Cal population; staffing shortfalls and information gaps with local hospitals can delay follow-up care and affect continuity of services.
