SLO County "Pathways Home" Behavioral Health Continuum Infrastructure Program (BHCIP) project is a new County of San Luis Obispo Behavioral Health plan to develop a behavioral health facility in Paso Robles, California that provides inpatient mental health and crisis residential services. 
 

• The program is in response to goals outlined in Behavioral Health’s 2024-2029 Strategic Plan (and 2023 Behavioral Health gaps analysis) of expanding access to residential facilities offering inpatient treatment and the development of a behavioral health crisis treatment program for youth in their home County of San Luis Obispo.
• The State’s “Assessing the Continuum of Care for Behavioral Health Services in California” (2022) report also showed that the County of San Luis Obispo is one of the few coastal counties without crisis residential treatment programs. Additionally, the report notes that we do not have enough acute mental health inpatient beds. Many adults receive treatment out of county, and the one existing 16-bed PHF is often at or near capacity.
• The expansion of inpatient beds could also address the increased need to provide services to individuals placed on an involuntary hold based on the new expanded SB-43 criteria for voluntary detention and conservatorship which now include severe substance use disorders.
• The new crisis residential and inpatient beds could also provide additional capacity for new CARE Court participants when crisis care is needed.

The Health Agency plans to renovate an existing facility in Paso Robles (416 Spring Street), on the current SLO County Health Campus.

The new facility in Paso Robles will address a needed increase in access to mental health services for those living in North San Luis Obispo County.

Additionally, the site has added benefits for the health of the community due to it being co-located with the Department of Social Services, SLO Public Health, and existing SLO Behavioral Health outpatient offices. Community members can receive multiple services at the same Health Campus such as outpatient drug and alcohol and mental health services and benefit assistance (e.g. CalWORKs, General Assistance, Medi-Cal) through Social Services. 

The project is going to the Board of Supervisors in January 2026 to request acceptance of the grant and of the grant agreement. From there, the project then moves into the design development phase, with anticipated renovations completing in Fiscal Year 2028-2029. 

Current projections estimate the facility opening in Fiscal Year 2028-2029.

• 16-new adult and youth inpatient mental health beds (12 for adult, 4 for youth).
• 10 new adult and youth crisis residential beds (8 for adult, 2 for youth).

* A“bed” refers to a physical bed in a facility that can accommodate one person per 24-hour period.

Renovations include interior remodeling and renovation to convert the existing 3-story medical facility to include a 16-bed psychiatric health facility (first floor), crisis residential programs (second floor), and additional behavioral health staff offices (third floor) to support the PHF and crisis residential programs in the facility.
More information on designated beds for youth versus adults can be found here.

Local community leaders and stakeholders have been supportive of the project as the grant brings needed and meaningful health services to youth in SLO County.

BHCIP stands for Behavioral Health Continuum Infrastructure Program. It is the grant the department applied for to fund the "Pathways Home" Project.

The project uses $21.6 million in funding from the state’s Behavioral Health Continuum Infrastructure Program (BHCIP) grant to acquire and renovate an existing 23,000 square foot facility to become inpatient and crisis residential beds for youth, and adults.

Medi-Cal is the primary funding source ongoing for operations. The combination of Medi-Cal and other funding sources ensures behavioral health services offered will be sustainable, adaptable, and equipped to meet the evolving needs of the community over the next thirty years. 

The project has several economic benefits including job creation, reduction of caregiver and travel costs that come with out-of-county treatment, and a reduction in public safety costs and hospitalizations, as the local facility will provide quicker transitions from hospitals to treatment and additional crisis stabilization services.

We are collaborating with the Department of Social Services in SLO and Santa Barbara to ensure that services are best utilized regionally to better serve foster youth with complex care needs close to home and their communities.

• Inpatient Psychiatric Hospital Services (youth and adults)- Locked facility with 24/7 admissions.
  • Provides 72 hours of psychiatric evaluation and treatment to individuals who may be involuntarily detained because of a mental disorder, a danger to self, danger to others, or may be gravely mentally disabled, including expansions under new SB43 law for a severe substance use disorder. (5150 adult hold, 5585 youth hold)
  • Services will include psychiatry, clinical psychology, psychiatric nursing, social work, rehabilitation, medication administration, and food services. Coordination and referrals to step down facilities (like crisis residential services), programs, and services will also be provided for patients in preparation for discharge.
• Adult Crisis Residential Services- Unlocked, voluntary facility open 24/7
  • Provides more time for individuals to receive crisis stabilization services and care coordination.
  • Typical stays are 7-30 days, and individuals can stay up to 90 days if clinically appropriate.
  • Focus is on reduction of the crisis, stabilization, referrals, assessments, connections to support systems, connections to vocational programs and income and treatment referrals, transportation, and assistance with self-administration of prescription and non-prescription medications; recreation/activity space. Coordination and referrals to step down facilities, programs, and services will also be provided for patients.
• Youth Crisis Residential Services- Unlocked facility with admissions daily
  • Provides more time for individuals to receive crisis stabilization services and care coordination.
  • Typical stays are 10 days or less, and youth can stay longer if clinically indicated.
  • Services will include structured mental health treatment services such as counseling, crisis intervention, development of community supports system, development of self-advocacy skills, socialization and interpersonal skills, medication support services, targeted case management, psychiatric nursing services, and recreational services. Services will be closely coordinated with County Behavioral Health youth behavioral health programs and the Department of Social Services.

Crisis Residential Treatment:

Crisis Residential Treatment beds will be focused on Medi-Cal insured individuals. Referrals will typically come from County Office of Education, Probation, the County’s Psychiatric Health Facility (PHF), jail, mobile crisis teams, Behavioral Health outpatient clinics, hospitals, Community Action Teams, and law enforcement entities.
The Youth Crisis Residential Treatment beds will prioritize referrals from the SLO County and Santa Barbara County Department of Social Services for foster youth in the child welfare system.

Psychiatric Health Facility (PHF):

The Adult Psychiatric Health Facility will receive referrals for clients from County Behavioral Health programs, law enforcement, mobile crisis, and hospitals for individuals who are on a 5150-hold. The Youth Psychiatric Health Facility will primarily receive referrals from the County’s mobile crisis provider, which has a youth specialty team.
The mobile crisis team receives referrals from schools, community providers, Behavioral Health, hospitals, Social Services, and law enforcement. Law enforcement may also bring youth on 5585-involuntary-holds to the PHF. Additionally, youth consenting to a voluntary admission may be served in the PHF.

The project will meet urgent needs in the care continuum for children, youth, and adults, including unhoused individuals, and veterans. Crisis residential treatment will provide a new level of care in the County, filling a gap between inpatient and outpatient services.

The project addresses gaps by:

1. Adding the first ever children and youth inpatient and crisis residential beds in the San Luis Obispo and Santa Barbara regions,
2. Increasing the number of inpatient adult beds (Psychiatric Health Facility PHF) in the community and,
3. Adding the first ever adult crisis residential beds in SLO County.

Services will significantly reduce the number of out-of-county placements for adults and youth and provide better local care and coordination to SLO County community members in need.

Because there are currently no Behavioral Health inpatient or crisis residential treatment beds for youth in SLO or Santa Barbara Counties, youth are currently placed out of county to receive crisis mental health treatment.
The "Pathways Home" Project will reduce out of county placement and the strain on local youth and their families when receiving psychiatric care. These new youth beds would also reduce hospitalizations and visits to local Emergency Departments. 

The crisis residential beds will provide individuals at-risk or experiencing homelessness a safe place to receive intensive services short-term (for an average of 7 to 30 days) until a longer-term placement can be made, providing more time for stabilization and better health outcomes.

The Crisis Residential Treatment Program and inpatient beds will leverage other housing and homelessness programs to best serve clients. For example, unhoused clients exiting the Psychiatric Health Facility and Crisis Residential Facility will be considered for open Behavioral Health Bridge Housing beds as they become available.