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Utah’s new homeless board is warned of major mental health bed shortage

In its first meeting, newly revamped governing body issues nearly $31 million in grants to homeless providers — while signaling it wants to increase oversight to ensure safety in shelters, root out drugs

By Katie McKellar - Utah News Dispatch | May 19, 2024

Courtesy Utah’s Office of Homeless Services

Utah state homeless coordinator Wayne Niederhauser, left, and Salt Lake City Mayor Erin Mendenhall, middle, participate as board members during the newly created Utah Homeless Services Board’s first meeting at the Utah Capitol in Salt Lake City on Thursday, May 16, 2024.

As part of Utah’s ongoing endeavor to improve Utah’s homeless system, the 2024 Utah Legislature passed a bill, HB298, to revamp the powerful governing body that distributes crucial funding to and oversees the state’s local homeless providers.

That new body, now called the Utah Homeless Services Board, met for the first time Thursday — and got to work right away, starting with approving nearly $31 million in grants to homeless providers across the state for fiscal years 2025 to 2027.

It also received a briefing from Rep. Steve Eliason, a lawmaker who has sponsored years of legislation related to homelessness and mental health. He warned that the state is facing a dire mental health bed shortage — an issue he said the state is losing ground on, not gaining.

The new, 11-member Utah Homeless Services Board replaces what was the 29-member Utah Homelessness Council. The smaller board is meant to overhaul what HB298’s sponsor, Rep. Tyler Clancy, said had become “unwieldy and clunky.”

The bill also tasked the new board with updating the state’s homeless plan to specify the state’s goal is to reach a “functional zero” level of homelessness (meaning the number of people exiting homelessness is greater than those entering it). It is also charged with developing metrics to more effectively measure accountability on programs to reduce homelessness, substance abuse and other issues.

The new board also has new membership, meant to convene local elected officials as well as philanthropic leaders who have been a part of a multimillion-dollar effort to bring private dollars to bear to help improve Utah’s homeless system.

Two of the board’s new members — chairman Randy Shumway and Spencer Eccles — are also members of the board of the Utah Impact Partnership, which is a group of powerful philanthropists that lobbied the 2024 Utah Legislature for significant investment this year in Utah’s homelessness efforts. The group helped Gov. Spencer Cox’s administration to secure more than $50 million for emergency homeless services for the 2024 fiscal year (much of which has yet to be spent).

The Utah Impact Partnership agreed to match that more than $50 million with an additional $15 million in philanthropic funds to go toward the state’s homelessness spending.

Here are some highlights from the board’s inaugural meeting:

‘We have a problem’ with mental health beds

Eliason, R-Sandy, warned the Homeless Services Board that big challenges are ahead when it comes to the behavioral and mental health cog of Utah’s homeless system.

While Eliason said the Utah Legislature has “done a lot” to strengthen the state’s civil commitment laws —  including passing HB299 this year to increase the amount of time a patient experiencing mental illness can be involuntarily held for their safety, up from 24 hours to 72 hours — he said the state has a pressing shortage of mental health hospital beds, which is likely to add even more pressure to Utah’s criminal justice and homeless systems.

“We have all the tools that we need for an individual that is psychotic and at great risk of injury to themselves or others,” Eliason said. “The problem we have right now is not the ability to civilly commit people … It’s to have a place to put them.”

Eliason pointed out one of Utah’s largest for-profit behavioral health centers, Highland Ridge Hospital in Midvale, shut down earlier this month after FOX 13 investigated and reported on years of discipline and patient safety concerns.

“It’s closed. There’s no more patients there. And at this juncture, it does not look like it’ll be reopened,” Eliason said of the 83-bed facility. “So with that, we’re probably back to our bed count of last century. Yes, we have a problem.”

For years, Utah’s state-run mental health hospital, the roughly 300-bed Utah State Hospital in Provo, has faced a variety of challenges, from staff shortages to simply not having enough beds or funding to treat all of Utah’s mentally ill patients.

With the closure of Highland Ridge Hospital, Eliason said “we have dramatically fewer options than we did even during” the Utah Legislature’s 2024 session, when lawmakers funded about $11 million in additional funding for behavioral health programs.

A 2023 analysis of the hospital credited the Legislature and county mental health authorities for working to increase funding for mental health resources (including funding outreach teams, receiving centers, homeless services and suicide prevention programs). However, “while these increases have helped markedly, ongoing community assessment still indicates significant gaps in services as well as delays” in discharging patients from the Utah State Hospital, the analysis states.

Additionally, a 2019 report by the University of Utah’s Kem C. Gardner Policy Institute found demand for mental health care in Utah is increasing, the state’s shortage of mental health providers could worsen over time, and funding for Utah’s public mental health system is “bifurcated across different systems, making it difficult to consistently deliver coordinated care.”

When Eliason ended his presentation to the board, Salt Lake City Mayor Erin Mendenhall urged him to leave them with at least some good news for mental health hospital beds, Eliason at first said, “I don’t have any good news for you,” before backtracking and thinking of one thing to highlight.

Eliason noted that the state and Salt Lake County did help fund a new, $47 million Kem and Carolyn Gardner Mental Health Crisis Care Center that is being built in South Salt Lake and is set to open in 2025. The Gardners donated $5 million toward the project and expansion of the Huntsman Mental Health Institute’s mental health crisis services. It will have 30 receiving center beds and 24 acute care unit beds.

When that facility opens, Eliason said it will bring the state’s first new in-patient mental health beds “in I have no idea how many years for psychiatric care.”

“That’s going to be a fabulous facility,” he said. “But you know … I think you can follow me on this math. We just lost 83 beds. Next year we’ll gain 24 beds. We’re still dramatically behind and our population is continuing to grow.”

Eliason noted that in 2020 he passed a bill to fund 30 additional beds at the Utah State Hospital — to open up half of the 60 beds that were shut down during the Great Recession, but so far “we’ve opened only about 10 of those beds now.”

“So there are little pockets of good news, but at this juncture, we are losing ground faster than we are gaining it,” Elisaon said,

Eliason also noted that a newly created Utah Behavioral Health Commission is tasked with looking at the state’s behavioral health master plan, and he intends to tell that body “this is one of your top priorities.”

“There is a contingent of the population that will always need intense, in-patient care until they are safe enough and well enough to live on their own,” he said. “Unfortunately with the influx of methamphetamine — we could talk about that for a long time, how the new meth is causing a type of psychosis that is not treated by meds successfully — the need for beds, I submit, is greater than ever.”

As Utah tries to address issues of people cycling in and out of jails, as well as on and off the streets, Eliason said mental health is a major part of the system that needs to be better addressed.

“If we aren’t striking at the roots of mental health and substance use disorders and years of accumulated trauma, we’re just hacking at the branches,” he said.

Shumway thanked Eliason for his input and told him the board certainly intends to keep mental health issues in mind as it looks to improve Utah’s homeless system.

“Will you please open a bill to get funding for additional hospital beds?” Shumway asked Eliason. “You’ll have our support on that if you do.”

$31 million distributed — but board warns it has its eyes on safety, drug use in shelters

Taking up a task that the previous Utah Homelessness Council was previously charged with, the Utah Homeless Services Board on Thursday approved a lengthy list of grant awards in both state and federal funding to local homeless service agencies across the state

The grants, totaling nearly $31 million, included roughly $25 million appropriated in past legislative sessions, about $2 million from ongoing appropriations the Legislature approved this year, and about $4 million in federal funding (the more than $50 million in new emergency shelter funding has yet to be spent).

The funding is critical for ongoing operations of homeless shelters and other homeless providers across the state. To obtain the funding, grantees are required to submit quarterly and annual performance reports for all of their funded projects.

As providers applied for the grants, the Utah Office of Homeless Services received 113 project applications totaling over $36 million, but had $31.1 million to award annually. The office’s staff recommended the board approve distribution of about $30.99 million, while holding back about $145,192 to save for the upcoming winter homeless response.

The board agreed with the recommendations — but when it came time to cast the vote to approve the list, some board members including Salt Lake City Mayor Erin Mendenhall and some staff members were caught off guard when board member Spencer Eccles made a motion to accept the recommended funding, but with conditions.

It included requirements that:

  • All emergency shelter operators will have and will enforce policies and procedures that provide for client safety, prohibit illicit drugs from entering their facility, and will refer all criminal activity to local law enforcement.
  • Policies and procedures be submitted to the Office of Homeless Services by the first quarter of fiscal year 2025.”
  • All individuals who enter emergency shelter will receive intake and diversion services and be entered into the state’s Homeless Management Information System, or other comparable databases of people receiving homeless services.
  • All individuals will be referred to case management to engage in a case management plan in the state’s Homeless Management Information System within seven days, and providers will be required to monitor their progress.

Mendenhall said she was “put on my heels” with the motion, which wasn’t included in the board’s packet. She asked staff members to weigh in given the Office of Homeless Services’ grant process already has its own rules and requirements attached to the funding requests that providers followed when they applied for the money.

Staff members said most of those requirements are already in place, and homeless shelters are already required to adopt policies to keep shelters safe and drug free.

2021 legislative audit (conducted when board member Jim Behunin was senior audit supervisor within the legislative auditor general’s office) found drug use was still an issue inside Salt Lake County’s new homeless resource centers.

However, the same 2021 audit found that since those centers opened in 2019, safety and security had improved within Utah’s homeless system. A scathing audit in 2018 found serious health and safety concerns, including the pervasive presence of drugs, especially in the Road Home’s downtown shelter, which was shut down and razed after Salt Lake County’s three new resource centers opened to replace it.

After a lengthy discussion over the motion and tweaking it to specify that it didn’t trump existing grant processes or state law requirements, the board eventually approved it and the recommended funding, while directing Office of Homeless Services staff to help the new board ensure homeless service providers are following their own policies.

Though the motion effectively sends a message rather than requiring anything new, it highlighted that board members are signaling they want homeless service providers to know the Utah Homeless Services board intends to watch these issues more closely.

“There’s been more than one time when I’ve encountered a person in the wintertime that’s asking for help, and I said, ‘Do you know where the shelter is?’ and they say, ‘I will not go to that shelter, because I’m a recovering addict, and I don’t feel safe there and there’s too many drugs,'” Eccles said.

“The effort here is dignity for all,” he continued. “Safety and security for the people that are in the shelters. And hold shelter operators accountable to provide that environment.”

Behunin, who recently served as executive director of the Pioneer Park Coalition, a group of downtown business owners that for years has lobbied for improvements to Salt Lake County’s homeless shelters, said the new board is tasked with creating “strategies to reduce illegal drug use within homeless shelters.”

“So really it falls on us,” he said, saying he would support the motion. “But, somewhere down the road we ought to see what the policies are and confirm them, because that’s what (the law) requires.”

Utah News Dispatch is a nonprofit, nonpartisan news source covering government, policy and the issues most impacting the lives of Utahns.


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