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San Diego County OKs acceptance of state grant to expand local competency-restoration beds
Summary
The Board of Supervisors authorized county staff to accept a California Department of State Hospitals grant award to convert psychiatric hospital capacity to long‑term beds for felony defendants found incompetent to stand trial and to expand local IST infrastructure; staff said the county received a preliminary award and must spend funds by 2028.
San Diego County supervisors on Tuesday unanimously authorized staff to accept state grant funding to expand local treatment capacity for felony defendants found incompetent to stand trial.
The board approved a request from county staff to accept a preliminary IST (incompetent to stand trial) Diversion and Community‑Based Restoration Infrastructure Project grant award from the California Department of State Hospitals (DSH). County presenters said DSH released a statewide infrastructure grant pool in 2023 and that the program is intended to help counties create local placements so people found incompetent can receive treatment and be restored to competency without long waits for state hospital beds.
Kim Jardina, a county staff member who introduced the request, said the DSH grant is a one‑time, noncompetitive funding round intended to support conversion or rehabilitation of facilities and purchase of minor equipment. Andrew Strong, deputy chief administrative officer for public safety, told the board the county applied for the maximum available amount and was notified of a preliminary award “for the full amount up to $21,375,000,” which the county must spend by 2028.
The county plans to use the funds to convert some psychiatric acute inpatient capacity at the San Diego County Psychiatric Hospital into longer‑term beds focused on competency restoration for justice‑involved patients, staff said. The presenters said DSH expects the statewide program to create roughly 5,000 new IST beds and that San Diego’s local award is intended to fill long‑standing gaps in long‑term behavioral health care for people with complex needs.
Staff also described a statewide “growth cap” program tied to DSH that sets a baseline year (fiscal 2021–22) for each county’s IST referrals. San Diego’s baseline was 207 referrals in 2021–22, presenters said; counties that exceed their growth caps face penalties but may instead reinvest those penalty amounts in local IST diversion and restoration efforts. County staff said they will return to the board later with details of the county’s plan for any growth‑cap penalty funds.
Public commenters spoke during the item’s public‑comment period, including callers who expressed concern about the kinds of clinical treatments that may be used in competency restoration and asked how the county would ensure voluntary consent and safe care. Paul Bold, a caller during public comment, said he wanted “specific plans for what treatments you will use” before supporting the program; another caller urged the county to emphasize nonpharmaceutical or naturopathic approaches.
After brief discussion the board voted to approve the requested authority to accept the funds. The motion passed unanimously.
What the board approved
The board authorized county staff to accept the DSH IST Diversion and Community‑Based Restoration Infrastructure Project grant award in the preliminary amount communicated to the county (staff cited a preliminary award up to $21,375,000) and to use those one‑time funds for facility improvements to support local competency restoration and diversion placements. Staff noted additional programmatic opportunities (community‑based restoration and diversion grants and growth‑cap reinvestment) will return to the board for separate approvals.
Why it matters
County staff said the number of felony defendants found incompetent to stand trial has risen statewide and locally, lengthening waits for state hospital placements. Converting local capacity for longer‑term care and competency restoration could reduce waits, shorten criminal case delays for people with serious mental illness, and keep more treatment in the region rather than relying solely on state hospital placements.
Next steps
Staff said the county will proceed with facility planning and that related program funding requests (community‑based restoration, diversion programs, and growth‑cap reinvestment proposals) will be brought back to the board for authority and acceptance.
Speakers quoted in this article come from the public record of the Jan. 28, 2025 board meeting.
