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LA County clears way for dozens of ‘most needed’ mental health beds in Boyle Heights

Los Angeles County leaders are moving forward with a project that will supply nearly 100 treatment beds for people living with serious mental illness, a much-needed step toward providing options for some of the region’s most vulnerable residents.
The new beds — 96 of them — will help finish the county’s Restorative Care Village in Boyle Heights, a facility set up to serve the health needs of Los Angeles County’s unhoused population.
County Supervisor Hilda Solis said in a news release that these types of treatment beds have been identified as the “most needed to help address our County’s behavioral health crisis.”
“Once completed, the Restorative Care Village will restore dignity to our communities and give our most vulnerable hope for a new beginning,” Solis said.
Who is the project for?
County authorities say the new beds will mostly be for people living with serious mental illness — like schizophrenia or bipolar disorder — who no longer need to be hospitalized but are not ready to live independently.
They will be housed within a locked facility where patients can get round-the-clock psychiatric care.
What will it cost?
The cost is estimated at $143 million, with some of that funding coming from the federal American Rescue Plan Act, county authorities said.
The project is expected to be completed in 2026.
How severe is the need?
These so-called subacute beds are the “most urgent resource need” for the county to address the ongoing behavioral health crisis, according to a February report from a consulting agency hired by the county.
Estimates vary, but many experts say L.A. County needs hundreds more beds at this treatment level to meet the needs of residents living with serious mental illness.
Why is it so hard to provide psychiatric beds?
Experts link the bed shortage, in part, to a rule that was baked into the foundation of the federal Medicaid program in 1965.
The Institutions for Mental Disease exclusion bars any facility focused on treating adults with mental illness from receiving Medicaid dollars if it has more than 16 beds.
The lawmakers’ intent for the exclusion was to move away from the large asylums of the time, some of which had become notorious for inhumane treatment. The plan was that smaller, more community-based facilities would spring up around the country, offering an alternative to the large institutions that locked people away from society and often mistreated them.
But the number of smaller facilities needed to make up for the closure of larger ones never materialized.
The Boyle Heights project would likely comply with that federal rule because it consists of six separately-operated programs within a 92,000-square-foot facility, according to the county.
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