San Diego supervisors receive plan to expand substance use treatment; county cites Medicaid funding risk

Vice Chair Terra Lawson-Remer called a March 4 San Diego County Board of Supervisors special board conference to review the county's Substance Use Disorder Optimal Care Pathways model and broader behavioral health strategy.

The plan, presented by Deputy Chief Administrative Officer for Health and Human Services Kim Giardina with presentations from Dr. Luke Bergman, director of Behavioral Health Services, and Dr. Nicole Esposito, chief population health officer for Behavioral Health Services, maps service capacity goals across crisis diversion, residential treatment, outpatient care and housing supports and sets multi-year benchmarks for expanding access to care.

Why it matters: San Diego County officials said the model would shift the system from crisis-driven care toward ongoing, community-based treatment that can reduce emergency department visits, hospitalizations and justice system involvement. Vice Chair Lawson-Remer said, "For too long, our system has failed to meet people where they are," and framed the pathway model as part of a five-year vision to grow treatment capacity countywide.

County staff described gains since 2021 and the scale of proposed expansion. Key figures presented include 44 mobile crisis response teams (MCRTs) countywide (grown from a two-team pilot), eight crisis stabilization units (CSUs) with two more planned, and MCRTs having responded to more than 12,500 crises and served over 8,000 unique clients. Staff reported a 28% decrease in monthly…