The County of San Luis Obispo Department of Behavioral Health contracts with various residential placement providers within a wide range of adult residential services, providing appropriate levels of care to seriously mentally ill individuals in need of residential placement. Board and care facilities offer varying levels of residential care in a non-locked facility, as opposed to State hospitals, acute care hospitals, and Institutions for Mental Disease (IMD) which are locked residential facilities providing the most intensive levels of care. Most clients placed in board and care facilities may be stepping down from a higher level of care (IMD) to a lower level of care (board and care facility), or have not succeeded in outpatient settings, and often times have been placed in residential settings under conservatorship by the courts. The board and care facilities provide an alternative for clients ready to transition to a slightly lower level of care than that provided in an IMD, but not yet ready for more independent living situations. Residential services are designed to enhance basic living skills, improve social functioning, and allow for training opportunities within the community. Mental health support groups are provided at facilities to help clients gain insight into their illness, assist them in symptom management, and encourage peer support activities. As clients demonstrate stability in the board and care setting, the County residential case manager evaluates the potential of transferring clients to more independent living arrangements within San Luis Obispo County, or stepping down services as appropriate, and board and care facilities provide the assistance and structure necessary for each client to be successful in a less restrictive setting and to reintegrate back into the community. Although the desired outcome is to move clients to the least restrictive level in which they can be successful, a certain percentage of the population with severe mental illness will, at any given time, need the level of treatment offered in a board and care setting. The Behavioral Health Department makes great efforts to choose residential provider services that most appropriately meet the current diagnosis and treatment needs of the individual client. Although the Department uses these objectives to track performance, Behavioral Health realizes that fluctuations in a client’s behavioral health condition and/or response to medications do occur, and that movement of clients to higher level placement will be appropriate in some cases and that this does not necessarily reflect any negative performance on the part of the service provider. Due to the lack of available board and care facilities with a specialty in mental health care in San Luis Obispo County, Behavioral Health utilizes the Proposers, often located outside of San Luis Obispo County.
