Monterey County outlines $172.5 million plan for local mental‑health rehabilitation centers; board orders outreach, pauses major design spending

Monterey County officials presented a status update Oct. 28 on Phase 1 of a planned County Health Services campus on Constitution Boulevard in Salinas, outlining a development that would add six 16‑bed mental health rehabilitation centers (MHRCs) and a separate support building intended for 24‑hour, licensed residential care for adults under LPS conservatorship.

“We are pleased to be able to come to you today with the first phase of developing that land to add critical services,” said Elsa Jimenez, Director of Health Services, introducing the proposal and noting the county’s aim to provide more local placements for residents who now are often sent out of county for higher‑acuity care.

The county’s behavioral health bureau chief, Melanie Rhodes, and capital projects staff said the preferred campus plan uses six separate 16‑bed buildings (allowing medical billing for each unit) plus a shared support building that includes an industrial kitchen, administrative offices and back‑of‑house mechanical systems. Luis Ochoa, capital improvement manager, described the site layout and a two‑part construction approach: Phase 1, part 1 would build three MHRC buildings and the support building plus off‑site infrastructure and circulation improvements; phase 1, part 2 would add the remaining three MHRC buildings.

Staff reported a professional estimate of $172,500,000 for the total Phase 1 project, including design, construction, 20% combined contingencies (construction and project), furniture/fixtures and site work. Fabricio Chombo, assistant bureau chief, said the bureau has secured roughly $20,100,000 from the Behavioral Health Continuum Infrastructure Program (BCHIP) Round 5 and has a conditional award for about $31,000,000 from BCHIP bond Round 1; written confirmation from the state for the second award was described as pending. Chief financial officer Nick Cronkite presented a pro forma showing expected annual costs and revenues: total annual costs including estimated debt service were about $16.5 million, and the county projects roughly $8.5 million in MHRC revenue and other savings (including repatriating out‑of‑county patients). Under the bureau—usiness model, an increase in billed direct service hours countywide would generate additional Medi‑Cal revenue to help meet remaining debt obligations.

Staff cited anticipated construction timing that would begin procurement late 2025–mid 2026, with construction starting in early 2027 and an overall completion goal for Phase 1 (parts 1 and 2) by 2029, pending final funding. The plan also calls for design development and environmental review (CEQA/PEIR) before construction.

Board members pressed staff on several risks and assumptions. Supervisor Church said the project—stimate ppeared to have more than doubled from earlier planning estimates and expressed concern about adding long‑term debt in an uncertain economic environment. He asked for further details about contingency use, funding alternatives and how many in‑county versus out‑of‑county patients the facility would serve. Rhodes and Chombo said the project would aim to repatriate many of the roughly 98 Monterey County residents currently placed out of county, but exact counts depend on provider contracts and final design.

Supervisor Alejo pressed staff on community outreach and said residents in neighborhoods adjacent to the site needed clearer notice and opportunities to discuss traffic, public safety and operational details. Jimenez said a mailer to properties within 300 feet had already been sent and that the county would expand bilingual outreach; the board later directed staff to increase in‑person community meetings in advance of final environmental filings.

Supervisor Daniels asked about the stability of Medi‑Cal reimbursement and whether the revenue assumptions to service debt were realistic. Finance staff said the county used conservative Medi‑Cal estimates and that the shift to fee‑for‑service billing (since FY 2023‑24) allows counties to retain excess revenue above cost and reinvest it in local services. The county also plans to seek other capital sources, including a possible foundation stewardship fund and targeted MHSA/Prop 1 allocations for capital costs where legally allowed.

Public commenters at the board hearing urged both support for local mental‑health placements and caution about the project—osts and local impacts. Multiple supervisors and the CAO asked staff for a short list of concrete next steps and risk mitigations.

Board direction and next steps

The board did not approve construction but gave staff specific direction: expand and document bilingual community outreach (in‑person and virtual), have the CAO and financial advisors re‑review the project assumptions (including debt sizing and contingency use), and pause major new design or procurement expenditures until staff returns with a clarified financing plan and a timeline showing on‑ and off‑ramps. The county said it would bring a refined schedule and financing options (including any possible use of Prop 1 capital set‑asides) back to the board before the end of the calendar year.

Why it matters: Monterey County officials say local MHRC capacity would reduce the number of residents placed far from family, lower per‑patient costs for higher‑acuity treatment settings, and improve care coordination. Critics warned that the project—arries large financial risk if Medi‑Cal revenue or construction costs change materially, and nearby residents want more thorough outreach and clearer information about safety, traffic and operations.

Provenance: Presentation and Q&A Oct. 28, 2025 (Elsa Jimenez, Melanie Rhodes, Luis Ochoa, Fabricio Chombo, Nick Cronkite) (topicintro: 17146.42–17166.18; topfinish: 18788.47–18805.45).