Here's Why California Housing For Mentally Ill Adults Is Disappearing

In one of his first moves as chair of a new state commission on supportive housing, Sacramento Mayor Darrell Steinberg met last week with leaders in mental health and homelessness to discuss California’s lack of board and care facilities for adults with severe mental illness.

Attendees weighed in on what they’re calling a shrinking safety net for the mentally ill. According to data from the California Department of Social Services, 1,426 of these facilities have closed over the past five years.

Board and care homes, also known as adult residential facilities, are designed to provide 24-hour support to adults who can’t live independently but don’t require medical care. Many live with mental illnesses such as schizophrenia, mood disorders or PTSD.

The homes — which can range from rooms with a few beds to large apartment buildings— are run by staff who provide meals and help residents with medications, independent living skills and permanent housing solutions.

Advocates cite low reimbursement rates from the state, resistance from new housing developers and complicated licensing regulations as primary factors in the decline in these homes.

At last week’s forum, Steinberg led county health providers, homelessness advocates and board and care staff in a discussion about possible solutions. Gov. Gavin Newsom put Steinberg in charge of the new California Commission on Homelessness and Supportive Housing during his State of the State address in February. Steinberg has a long history of efforts to house the mentally ill, including his “No Place Like Home” initiative which established housing bonds for this purpose.

Karen Larsen, director of Health and Human services for Yolo County, says they’ve put as many resources as they can into keeping the doors of their adult residential facilities open, but they need more support from the state.

“For us, losing even one bed is horrible,” she said at the forum. “We don’t have a lot of general funds at the county to support things like housing, which aren’t traditionally supported by health departments long term, especially once people are stable.”

The Steinberg Institute, a nonprofit mental health policy group founded by the mayor, says alleviating the shortage requires raising the reimbursement rates for these facilities, which were reduced at the start of this year.

Other solutions include removing regulatory barriers and addressing land use requirements. Advocates are also encouraging counties to use funding from the Mental Health Services Act to support the safety net for people experiencing homelessness.

A bill currently moving through the legislature would fast-track supportive housing development projects by exempting them from the California Environmental Quality Act if they meet the same requirements as other multi-family projects in the area.