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Behavioral Health Board warns LPS caseloads and public guardian funding strained after 10 years of static general‑fund support
Summary
The Fresno County Behavioral Health Board delivered its 2024 annual report May 20, highlighting rising LPS conservatorship caseloads, a decade without general‑fund increases for the public guardian and concern that skilled nursing capacity for people with serious mental illness and aging-related needs is insufficient.
The Fresno County Behavioral Health Board presented its 2024 annual report to supervisors on May 20, urging stronger communication among partners and warning of resource pressures tied to growing conservatorship caseloads and aging clients.
Report highlights: Brooke Newell Frost, speaking for the behavioral health board, identified three priorities from 2024: monitoring Behavioral Health Services Act changes, following the evolving care court environment and updating bylaws to comply with state requirements and improve board recruitment. She said the board now has representation from all supervisorial districts but continues to have difficulty filling a youth representative under age 25 and a local education representative.
Conservatorship trends and funding concerns: The board reported that LPS conservatorship referrals have increased sharply — a cited 24% jump from 2023 to 2024 — and that the public guardian’s general‑fund support has not increased for 10 years, while caseloads and document workloads have grown. The board said an LPS referral can require review of hundreds of pages and clinician interviews, and that the county has been using behavioral health realignment funds to help fill gaps.
Aging, skilled‑nursing capacity and service gaps: Board members emphasized a forthcoming challenge as the population ages and people with serious behavioral health needs increasingly require skilled‑nursing care. They asked the board of supervisors to consider general‑fund support for the public guardian and to begin examining public‑private approaches that would enable skilled‑nursing capacity for individuals whose diagnoses complicate placement in typical facilities.
Board action: Supervisors received the behavioral health board’s annual report. Several supervisors thanked the volunteer board members and noted the long-term nature of the problem; no funding appropriation was proposed at the May 20 meeting.
